Background: Nurses are expected to provide comprehensive, holistic and ethically accepted care according to their code of ethics and practice. However, in Malawi, this is not always the case. This article analyses moral competence concept using the Walker and Avant's strategy of concept analysis. Objective: The aim of this article is to analyse moral competence concept in relation to nursing practice and determine defining attributes, antecedents and consequences of moral competence in nursing practice. Method: Analysis of moral competence concept was (...) done using Walker and Avant's strategy of concept analysis. Results: Deductive analysis was used to find the defining attributes of moral competence, which were kindness, compassion, caring, critical thinking, ethical decision making ability, problem solving, responsibility, discipline, accountability, communication, solidarity, honesty, and respect for human values, dignity and rights. The identified antecedents were personal, cultural and religious values; nursing ethics training, environment and guidance. The consequences of moral competence are team work spirit, effective communication, improved performance and positive attitudes in providing nursing care. Conclusion: Moral competence can therefore be used as a tool to improve care in nursing practice to meet patients' problems and needs and consequently increase public's satisfaction in Malawi. (shrink)

We are living at the dawn of the first truly scientific picture of the universe-as-a-whole, yet people are still dragging along prescientific ideas about God that cannot be true and are even meaningless in the universe we now know we live in. This makes it impossible to have a coherent big picture of the modern world that includes God. But we don't have to accept an impossible God or else no God. We can have a real God if we redefine (...) God in light of knowledge no one ever had before. The key question is, “Could anything actually exist in the scientific universe that is worthy of the name, God?” My answer is yes: God is an “emergent phenomenon,” as real as the global economy or the government or the worldwide web, which are all emergent phenomena. But God arose from something deeper: the complex interactions of all humanity's aspirations. An emerging God has enormous implications. (shrink)

Nurses make an important contribution to the organisation and coordination of patient care but receive little formal educational preparation for this work. This paper builds on Allen's care trajectory management framework to specify evidence‐based and theoretically informed competencies for this component of the nursing role and proposes how these might be incorporated into nursing curricula. This is necessary so that at the point of registration nurses have the expertise to realise their potential as both providersandorganisers of patient care and are (...) better able to articulate and develop this aspect of nursing practice. (shrink)

ANGUS J, HODNETT E and O’BRIEN-PALLAS L. Nursing Inquiry 2003; 10: 218–228Implementing evidence-based nursing practice: a tale of two intrapartum nursing unitsDespite concerns that the rise of evidence-based practice threatens to transform nursing practice into a performative exercise disciplined by scientific knowledge, others have found that scientific knowledge is by no means the preeminent source of knowledge within the dynamic settings of health-care. We argue that the contexts within which evidence-based innovations are implemented are as influential in the outcomes as (...) the individual practitioners who attempt these changes. A focused ethnography was done in follow-up to an earlier trial that evaluated the effectiveness of a marketing strategy to encourage the adoption of evidence-based intrapartum nursing practice. Bourdieu's (1990, 1991) concepts of habitus, capital and social field were used in our refinement of the analysis of the ethnographic findings. Nursing leadership, interprofessional struggle with physicians, the characteristics of the community and the physical environment were prominent issues at all of the sites. Detailed descriptions of the sociohistorical context and of the experiences at two sites are presented to illustrate the complexities encountered when implementing innovations. (shrink)

Introduction -- Introducing phenomenology: Husserl and Heidegger -- Imagining the possible: hermeneutical phenomenology -- Experiencing transcendence: the "theological turn" of French phenomenology -- Letting be: the gelassenheit of the Annunciation -- Conclusion: Being-in-life: reading the Annunciation as theopoesis.

Ellen Meiksins Wood is a leading contemporary political theorist who has elaborated an innovative approach to the history of political thought, the social history of political theory .

Global health law has now emerged as an area of specialisation for students interested in global problems concerning health due largely, if not principally, to the inspiring lifelong scholarly work of Professor Lawrence Gostin. A growing number of universities in the world have established programs on global health law in which they address questions of equity and solidarity in addressing public health issues and emergencies, global and national preparedness for pandemics and other health related emergencies, international health regulations, and the (...) intersection between health and human rights, to mention a few. We can expect that as global health threats and inequalities in access to health continue to rise, interest in global health law as a field of legal research and education will continue to grow. (shrink)

The author analyses the design of her collaborative animation about inattention blindness, the phenomenon of not being able to see things that are actually there, and compares it to related scientific research.1 The term was coined by Arien Mack and Irvin Rock in 1992. Stealing Attention, co-created by the author and neuroscientist Michael E. Goldberg, Director of the Mahoney Center for Brain and Behavior at Columbia University, explored inattention blindness. Animated images of hands playing the con game Three-Card Monte were (...) superimposed over images of antiquities stolen from Iraq. The flashing cards, yellow circles and stated instructions distracted the viewer from seeing the images of stolen antiquities, which disappeared from depicted shelves one by one over the time span of approximately three minutes. The author considers five questions: What is perceived without attention What does attention select Under what circumstances can attention be shifted Is an observer trained in art less likely to be distracted Can attention be trained. (shrink)

Ellen Goodman uses extensive extracts from original writings to highlight the main themes of the Western legal tradition.The strength of the book is its clear ...

Background: For the experience of end-of-life care to be ‘good’ many ethical challenges in various relationships have to be resolved. In this article, we focus on challenges in the nurse–next of kin relationship. Little is known about difficulties in this relationship, when the next of kin are seen as separate from the patient. Research problem: From the perspective of nurses: What are the ethical challenges in relation to next of kin in end-of-life care? Research design: A critical qualitative approach was (...) used, based on four focus group interviews. Participants: A total of 22 registered nurses enrolled on an Oncology nursing specialisation programme with experience from end-of-life care from various practice areas participated. Ethical considerations: The study was approved by the Norwegian Social Science Data Service, Bergen, Norway, project number 41109, and signed informed consent obtained from the participants before the focus groups began. Findings and discussion: Two descriptive themes emerged from the inductive analysis: ‘A feeling of mistrust, control and rejection’ and ‘Being between hope and denial of next of kin and the desire of the patient to die when the time is up’. Deductive reinterpretation of data (in the light of moral distress from a Feminist ethics perspective) has made visible the constraints that certain relations with next of kin in end-of-life care lay upon the nurses’ moral identity, the relationship and their responsibility. We discuss how these constraints have political and societal dimensions, as well as personal and relational ones. Conclusion: There is complex moral distress related to the nurse–next of kin relationship which calls for ethical reflections regarding these relationships within end-of-life care. (shrink)

The development of T cells and B cells from pluripotent hematopoietic precursors occurs through a stepwise narrowing of developmental potential that ends in lineage commitment. During this process, lineage-specific genes are activated asynchronously, and lineage-inappropriate genes, although initially expressed, are asynchronously turned off. These complex gene expression events are the outcome of the changes in expression of multiple transcription factors with partially overlapping roles in early lymphocyte and myeloid cell development. Key transcription factors promoting B-cell development and candidates for this (...) role in T-cell development are discussed in terms of their possible modes of action in fate determination. We discuss how a robust, stable, cell-type–specific gene expression pattern may be established in part by the interplay between endogenous transcription factors and signals transduced by cytokine receptors, and in part by the network of effects of particular transcription factors on each other. BioEssays 21:726–742, 1999. © 1999 John Wiley & Sons, Inc. (shrink)

A 1999–2000 national study of U.S. hospitals raised concerns about ethics consultation (EC) practices and catalyzed improvement efforts. To assess how practices have changed since 2000, we administered a 105-item survey to “best informants” in a stratified random sample of 600 U.S. general hospitals. This primary article details the methods for the entire study, then focuses on the 16 items from the prior study. Compared with 2000, the estimated number of case consultations performed annually rose by 94% to 68,000. The (...) median number of consults per hospital was unchanged at 3, but more than doubled for hospitals with 400+ beds. The level of education of EC practitioners was unchanged, while the percentage of hospitals formally evaluating their ECS decreased from 28.0% to 19.1%. The gap between large, teaching hospitals and small, nonteaching hospitals widened since the prior study. We suggest targeting future improvement efforts to hospitals where needs are not being met by current approaches to EC. (shrink)

To address the current lack of knowledge about clinical ethics fellowship programs (CEFPs), we surveyed all 36 programs in the U.S. and Canada. The number of CEFPs has grown exponentially over the last 40 years and far exceeds previous estimates. Commonalities among CEFPs include: 88.8% require an advanced degree or rarely accept applicants without one; 91.7% of programs do not restrict applicants to a specific background such as medicine or philosophy; and 88.9% of programs compensate fellows. CEFPs vary widely on (...) numbers of fellows trained in the last 3 years (1–111), numbers of consultations performed by each fellow (0–450), and salaries paid ($0-$95,000). Less than half of programs meet CEFP standards established by ABPD. Nonpaying programs and larger programs tend to have lower admission standards and lower expectations for fellows. We hope these data will help inform CEFP standards that promote quality and consistency without stifling desirable diversity and innovation. (shrink)

In Enthymemes and Topoi in Dialogue, Ellen Breitholtz presents a novel and precise account of reasoning from an interactional perspective. The account draws on the concepts of enthymemes and topoi, originating in Aristotelian rhetoric and dialectic, and integrates these in a formal dialogue semantic account using TTR, a type theory with records. Argumentation analysis and formal approaches to reasoning often focus the logical validity of arguments on inferences made in discourse from a god's-eye perspective. In contrast, Breitholtz's account emphasises (...) the individual perspectives of interlocutors and the function and acceptability of their reasoning in context. This provides an analysis of interactions where interlocutors have access to different topoi and therefore make different inferences. (shrink)

There is strong theoretical support for a relationship between various characteristics of religiousness and attitudes towards business ethics. This paper examines three frequently- studied dimensions of religiousness (fundamentalism, conservatism, and intrinsic religiousness) and their ability to predict students' willingness to behave unethically. Because prior research indicated a possible relationship between the religious affiliation of an institution and its members' ethical orientation, we studied students at universities with three different types of religious affiliation: evangelical, Catholic, and none.Results of the study lend (...) support to a negative relationship between the above-mentioned dimensions of religiousness and willingness to behave unethically. In addition, students at the Evangelical university were far less willing to engage in unethical behavior than were students at either the Catholic or the unaffiliated institutions. (shrink)

It is a mistake to oppose law and grace, for God's grace makes way for a radically transformed social and moral order. The law of Christ enables a new way of life that is obedient to God.

Klein (philosophy, U. of Northern Florida-Jacksonville) offers an analysis of modern-day feminism and a personal memoir of coming of age and coming to terms with feminism as it relates to university politics and teaching. She presents a critique of contemporary feminism, discussing feminist and nonfeminist philosophy, feminist nonphilosophy, and feminist epistemology and pedagogy. She exposes the dogmas and fallacies of feminism, and argues that feminism is oppressive to women. Annotation copyright by Book News, Inc., Portland, OR.

There has been much discussion concerning the consequences of 'going natural', i.e., of replacing a priori epistemology with empirical psychology. Traditionalists claim that a naturalized epistemology is not viable—to eliminate the normative from an account of knowledge is to cease to do epistemology at all. Naturalists claim that a naturalized account is the only viable one—assuming, in step with the urgings of Quine, that there are no standards independent of (and external to) science, science itself must act as the sole (...) epistemic norm. In the wake of the above debate some epistemologists have attempted to argue in favor of, and develop, a middle-ground position— normative naturalism . Such a position is intended to be consistent with the naturalist's intuition that the traditional search for a 'first philosophy'is misguided and consistent with the traditionalist's intuition that a complete elimination of the normative would leave epistemology impotent. In this paper I will examine one argument in favor of a normative naturalism . / will show that such a proposal is inherently problematic and argue that naturalism and normativity are mutually exclusive concepts. Therefore, I suggest that, even in the 'age of cognitive science', epistemologists continue to do traditional epistemology by attempting to develop, a priori , the general criteria for determining the justificatory status of our (scientific) beliefs. (shrink)

Context: Although ethics consultation is commonplace in United States (U.S.) hospitals, descriptive data about this health service are lacking. Objective: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. Design: A 56-item phone or questionnaire survey of the "best informant" within each hospital. Participants: Random sample of 600 U.S. general hospitals, stratified by bed size. Results: The response rate was 87.4%. Ethics consultation services (ECSs) were found in 81% of all general hospitals in the U.S., and (...) in 100% of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians (34%), nurses (31%), social workers (11%), or chaplains (10%). Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices. (shrink)

ABSTRACTHow does practice change our behaviors such that they go from being awkward, unskilled actions to elegant, skilled performances? This is the question that I wish to explore in this paper. In the first section of the paper, I will defend the tight connection between practice and skill and then go on to make precise how we ought to construe the concept of practice. In the second section, I will suggest that practice contributes to skill by structuring and automatizing the (...) motor routines constitutive of skilled actions. I will cite how this fact about skilled action has misled many philosophers to conclude that skills are mindless or bodily. In the third section of the paper, I will challenge this common misconception about automaticity by appealing to empirical evidence of motor chunking. This evidence reveals that there are two opposing processes involved in the automaticity of skilled action: one process that is largely associative, which I will call “concatenation,” and a second which is a contro... (shrink)

When reflecting on the nature of skilled action, it is easy to fall into familiar dichotomies such that one construes the flexibility and intelligence of skill at the level of intentional states while characterizing the automatic motor processes that constitute motor skill execution as learned but fixed, invariant, bottom-up, brute-causal responses. In this essay, I will argue that this picture of skilled, automatic, motor processes is overly simplistic. Specifically, I will argue that an adequate account of the learned motor routines (...) that constitute embodied skills cannot be given in a purely bottom-up, brute-causal fashion. Rather, motor control is intelligent all the way down. To establish this, I will first review two recent accounts of skill, Stanley and Krakauer and Papineau, which characterize the automatic motor control responsible for the fine-grained movements constitutive of motor skill as brute, low-level phenomena. I will then isolate five key features that should apply to skilled motor control, if these accounts are correct. Together, the accounts posit that motor control is: ballistic, invariant, independent of general action trajectories, Insensitive to semantic content, and independent of personal-level intentions. In the final section of this paper, I will appeal to optimal control theory for empirical evidence to challenge the commitment to skilled action as qualified by the above features. (shrink)

It is not rare in philosophy and psychology to see theorists fall into dichotomous thinking about mental phenomena. On one side of the dichotomy there are processes that I will label “unintelligent.” These processes are thought to be unconscious, implicit, automatic, unintentional, involuntary, procedural, and non-cognitive. On the other side, there are “intelligent” processes that are conscious, explicit, controlled, intentional, voluntary, declarative, and cognitive. Often, if a process or behavior is characterized by one of the features from either of the (...) above lists, the process or behavior is classified as falling under the category to which the feature belongs. For example, if a process is implicit this is usually considered sufficient for classifying it as “unintelligent” and for assuming that the remaining features that fall under the “unintelligent” grouping will apply to it as well. Accordingly, if a process or behavior is automatic, philosophers often consider it to be unintelligent. It is my goal in this paper to challenge the conceptual slip from “automatic” to “unintelligent”. I will argue that there are a whole range of properties highlighted by the existing psychological literature that make automaticity a much more complex phenomenon than is usually appreciated. I will then go on to discuss two further important relationships between automatic processes and controlled processes that arise when we think about automatic processes in the context of skilled behavior. These interactions should add to our resistance to classifying automaticity as unintelligent or mindless. In Sect. 1, I present a few representative cases of philosophers classifying automatic processes and behaviors as mindless or unintelligent. In Sect. 2, I review trends in the psychology of automaticity in order highlight a complex set of features that are characteristic, though not definitive, of automatic processes and behaviors. In Sect. 3, I argue that at least some automatic processes are likely cognitively penetrable. In Sect. 4, I argue that the structure of skilled automatic processes is shaped diachronically by practice, training and learning. Taken together, these considerations should dislodge the temptation to equate “automatic” with “unintelligent”. (shrink)

To design effective strategies to improve ethics consultation (EC) practices, it is important to understand the views of ethics practitioners. Previous U.S. studies of ethics practitioners have overrepresented the views of academic bioethicists. To help inform EC improvement efforts, we surveyed a random stratified sample of U.S. hospitals, examining ethics practitioners’ opinions on EC in general, on their own EC service, on strategies to improve EC, and on ASBH practice standards. Respondents across all categories of hospitals had very positive perceptions (...) of their own ethics consultation service (ECS) and few concerns about quality. Our findings suggest that the ethics-related needs of small, rural, non-teaching hospitals may be very different from those of academic medical centers, and therefore, different approaches to addressing ethical issues might be warranted. (shrink)

The last several decades have witnessed an explosion of research in Platonic philosophy. A central focus of his philosophical effort, Plato's psychology is of interest both in its own right and as fundamental to his metaphysical and moral theories. This anthology offers, for the first time, a collection of the best classic and recent essays on cenral topics of Plato's psychological theory, including essays on the nature of the soul, studies of the tripartite soul for which Plato argues in the (...) Republic, and analyses of his varied arguments for immortality. With a comprehensive introduction to the major issues of Plato's psychology and an up-to-date bibliography of work on the relevant issues, this much-needed text makes the study of Plato's psychology accessible to scholars in ancient Greek philosophy, classics, and history of psychology. (shrink)

Abstract:Elena Ferrante’s Neapolitan Quartet – an almost continuous rave of interconnected love and desire, anger and violence – is also a story of the protagonist’s struggle to make sense of her life by writing it. She turns a traditional genre of a young person’s coming of age into a neurologically realistic portrait of the growth of an artist by multiplying narrative voices and by ignoring conventional bounds of narrative probability. Her story of the growth of a creative mind adumbrates well (...) the picture of brains and their processes currently being described and developed as a “predictive processing” model. Work in neurobiology and neurophysiology has been producing empirical demonstrations of the centrality of failure to successful human cognition. (shrink)

The Dutch government has a double moral message for Dutch parents. On the one hand, they expect mothers to work more hours outside the home; on the other hand, they expect parents to perform better in their parental tasks. New research shows again that in spite of all stimulation measures, Dutch women with children prefer their part-time jobs, and parents prefer not to leave their children to the responsibility of day care all week. To what extent is the government allowed (...) to oblige mothers to work more hours a week if the consequence is that the responsibility for upbringing shifts from parents to day care centres? (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Border CrossingEllen T. ArmourAs a philosophical theologian deeply formed by a long apprenticeship in continental philosophy, I find more points of entry into Kalpana Seshadri's HumAnimal: Race, Law, Language than I can possibly pass through in the space available to me here. Inevitably, whichever point of entry I take will violate what I take to be a core responsibility of a respondent: to hew closely to the text in (...) question, to trace in one's own words its outline in order to open it up to those who have not had the privilege to devote time and attention (those most valuable of assets for academics, it seems) to the project in question. Such a model of a responsible response itself bespeaks the central problematic of the project: the relationship between speech and silence, language and law, ethics and politics.And so I begin with a de-cision that is, simultaneously, an in-cision; I enter this text through this opening, not that, and in doing so, I relegate to a spectral silence of not-saying what other (in/de)cisions would bring to speech and/or to the invisibility of not-writing what other (in/de)cisions would render legible. In the spirit of a Derridean supplément, I hope to productively open and extend for you, if not precisely retrace, Seshadri's project.HumAnimal: Race, Law, Language (Seshadri 2012) is a brave book in many respects, but particularly in its attempt not just to delineate but to map out certain contested yet liminal spaces. In addition to those I've already mentioned, [End Page 175] let me add those between literature and philosophy, theology and philosophy, work and play, Agamben and Derrida, deconstruction and biopolitics, human and animal. (Any one of these alone would have been plenty for one book.) I take my mark from the site where these last two (or perhaps three) liminal spaces meet. First, allow me to indulge in a bit of intellectual autobiography: I began my career as a Derridean (and may yet end it that way … that remains to be seen), but have in the last few years, taken a decidedly more Foucauldian turn. Reading HumAnimal made me keenly aware of how profound a reorientation I have undergone in the process. And yet I entered into that process of reorientation (perhaps quite naively) sensing that, for all that separated Derrida from Foucault, deconstruction from biopolitics, they were not unconnected (please note the double negative). Thus, I found myself in deep sympathy with Seshadri's project in many ways. Whatever separates projects that foreground the machinations of power (as constitutive of knowledge, and vice versa) as object of analysis and those that foreground language (as constitutive of knowledge, and vice versa) as object of analysis,1 Seshadri's detailed readings suggest they share important points of overlap (which is not to say sameness). To a degree, then, HumAnimal undoes the very delineation between these kinds of projects that I just articulated. To be sure, Seshadri is aided a great deal in this by the fact that Agamben's own work invokes (though not uncritically) both Derridean and Foucauldian antecedents framed largely though not exclusively in and through the relationship between sovereignty and (bare) life.The book's title, HumAnimal: Race, Law, Language, names both the stakes of and framework for Seshadri's incision into this shared but contested space. Her neologism humAnimal marks a boundary integral to sovereignty's exercise, that between human and animal. The subtitle marks the forces at play in sovereignty's construction and its deployment. Race has often figured as the border demarcating those served by the law and those served up by it; those granted access to language and those denied it. Consignment to the nether side of law and language entails as well consignment to the nether side of the human/animal divide. The American practice of chattel slavery serves as one constitutive exemplar of a biopolitical and legal/linguistic regime in HumAnimal, as it will in my comments. But Seshadri seeks out the possibilities for resistance from this nether side; of possibilities opened up by and in silence, the suspension of law, and even... (shrink)

Photographs of the body of a drowned three-year-old Kurdish boy from Syria washed up on a Turkish beach encapsulated the plight of refugees fleeing the civil war in Syria with particular pathos and power. Through what these photographs index, this essay considers what they open up and open on to: the philosophical problematics embedded in the political issues the refugee crisis raises. These issues and problematics are rendered legible in Jacques Derrida’s recently published seminar on the death penalty and in (...) his reflections on cosmopolitanism. Together, they prompt further reflections on what I call spectatorial responsibility as a potential cosmopolitical site. (shrink)

Probing Proverbs with imagination and depth might be the best way for the preacher to counter our society's deadly propensity to reduce religion to “spirituality,” abstracted from concrete social and economic practices and our relationship with the material world. The contemporary crisis of wisdom—the proliferation of powerful knowledge divorced from godly wisdom—sets us fundamentally at odds with the structure of the universe: “yhwh by wisdom established the earth” (Prov 3:19).

Professor Solmsen's interpretation is orthodox; his comprehensive account builds on recent more specialized studies, including his own, and those of Jaeger, Ross, and Cherniss. If in some ways the book contains no large surprises, it nevertheless makes a major contribution by its treatment of Plato. The author has skillfully disengaged Plato's observations about nature from the customary ethical, epistemic, or, as the case may be, metaphysical contexts. He demonstrates that Plato was toward the end of his career a more serious (...) investigator of physical phenomena than is commonly supposed. Moreover, at almost every turn he finds Platonic precedents for Aristotle's thinking in this field. He does not detract from Aristotle's originality, but illumines it, and Plato's as well. (shrink)

This article retrieves Sara Ruddick’s Maternal Thinking as a resource for analyzing contemporary activism by mothers advocating for gun control and police reform. Concerns about ethnocentrism and gender essentialism have discouraged engagement with maternal thinking. However, self-identified “moms” continue an historical pattern of protecting their children through public advocacy on social issues. Given the role that maternal identity plays in political activism, feminist ethics must continue to develop robust theoretical resources for analysis and critique. Sara Ruddick’s Maternal Thinking should remain (...) part of that repertoire. (shrink)