The informed consent process provides protection by ensuring that potential research subjects understand the goals of the research project they are being asked to voluntarily partake in as well as the risks associated with the study. We examined subjects' comprehension and ability to identify issues explicitly raised during the consent process that was conducted as part of their participation in a genetic family study (GFS). We employed cross-sectional design by providing a short, self-administrative questionnaire to 246 participants recruited from families (...) enrolled in the Extended Family Investigation of Nephropathy and Diabetes (EFIND) study conducted at the University of Texas Health Science Center. Participants responded to the questionnaire directly after their enrollment in the EFIND study. The questionnaire consisted of multiple-choice questions and focused on the understanding of the purposes, procedures, and risks associated with their participation in the EFIND study. These questions were formulated to reflect basic information presented to subjects through the consent process. Responses to questions were expressed as percentages, placing equal weight on each response. Participants were Mexican-American, 62.3% female and averaged 35.2 ± 12.7 years old (range: 18-76). Our findings showed that the average comprehension score was 58. About 30% of the participants did not know the name of the study, and 70% did not identify all elements related to the study procedures. The most striking finding was the lack of understanding concerning the social risks associated with participation in EFIND. While 35.1% of participants identified all potential physical risks, only 1.3% could identify all of the social risks. Our findings showed that participants comprehension score was significantly associated with their level of education and income. We conclude that using the informed consent process to communicate research social risks to subjects participating in GFS has some limitations. Future research directed at improving risk communications to subjects of low socioeconomic levels participating in genetic research is justified. (shrink)

Hanna Pitkin has made key contributions to the field of political philosophy, pushing forward and clarifying the ways that political theorists think about action as the exercise of political freedom. In so doing, she has offered insightful studies of the problems of modern politics that theorists are called to address, and has addressed them herself in a range of theoretical genres. She is an innovator in bringing conceptual work inspired by ordinary language philosophy to the field of political philosophy, (...) as well as a penetrating and exacting interpreter of texts who draws on the insights of psychoanalysis, gender, and historical study. This collection of her works approaches each of these dimensions of Pitkin's contributions in turn, recognizing that she typically blends these modes of engagement in much of her political theorizing. The Modern Condition and the Impetus to Theorize. At several moments in her career, Pitkin has offered sustained reflection on what aspects of modern political life prompt the impulse to theorize politics. She has also drawn out with great nuance the pitfalls that modern life and philosophy also present for that enterprise, for example, in attempts to naturalize human community or in turning to theoretical abstraction. Her study of Wittgenstein in particular structured her most penetrating study of these questions. Pitkin suggests an agenda for political theorizing to engage the dilemmas of modernity in ways that grasp the importance of paradox as a portal of insight into the modern condition, and eschews attempts at easy resolution. In keeping with this, Pitkin has herself explored a variety of conceptual paradoxes that arise in the work of other theorists (e.g., regarding freedom, interest, and obligation), each as symptomatic of modern dilemmas. In each encounter, Pitkin offers a clearer picture of the problems of political modernity and the outlines of political responses to them. Moral Philosophy, Judgment, Justice: Pitkin has turned at several points in her career to the concept of justice as one that particularly brings together questions of agency and responsibility, the insights of moral philosophy, and judgment. Characteristic of her work, her engagements with justice have drawn upon a variety of methodological resources and theoretical inspirations. Her work engages ordinary language philosophy, pedagogical practice, and textual study, to yield a complex and subtle set of observations, all of which open moral philosophy and matters of judgment to questions of action and responsibility in the exercise of political freedom. Action: Political agency and its obstacles are a key theme in Pitkin's work and a main area of her theoretical innovation. She has approached the question of political agency from several directions. In some works, she has examined the appeal of autonomy as a picture of political agency, probing in particular the gendered dimension of the fantasy of autonomy. In other works - perhaps most famously, in her work on representation - Pitkin has explored the ways that the institutional arrangements of modern liberal societies attempt to link of individual and political agency--and the pitfalls of these approaches. Finally, Pitkin has offered a picture of political freedom as maintaining the tension, between individual "parts" and collective "wholes," that these modern institutional arrangements attempt to resolve. Finally, through her groundbreaking and definitive work on Hannah Arendt, Pitkin has meditated on the political and social conditions that most impede our ability to grasp agency as a practice of political freedom, and gestured to paths that may lead forward. (shrink)

Objectives: To examine the willingness of patients to participate in a resuscitation study that requires exception from informed consent and to determine if willingness to participate is associated with demographic and other characteristics.Methods: Adult patients in an emergency department and in a geriatric outpatient clinic were surveyed. Patients were asked to imagine that they presented to an emergency department with cardiac arrest and asked about their willingness to receive a new drug outside of a study, receive a new drug as (...) part of a study and participate in a randomised controlled trial for a new drug. Patients were also asked about participation in studies of invasive procedures.Results: 213 patients from a geriatric clinic and 207 from an emergency department were surveyed. Two thirds of patients from the geriatric clinic and 83% from the emergency department were willing to receive an experimental drug outside of a study. Patients were less willing to participate in a study of the new drug and even less likely to participate in an RCT for the new drug . Patients were less likely to participate in a study of thoracotomy than in a study that required placement of a femoral catheter . Willingness to participate was not associated with trust in the doctors.Conclusions: Study design and invasiveness of the intervention were associated with the willingness of patients to participate in resuscitation studies that require exception from informed consent. (shrink)

Drug use and drug addiction are severely stigmatised around the world. Marc Lewis does not frame his learning model of addiction as a choice model out of concern that to do so further encourages stigma and blame. Yet the evidence in support of a choice model is increasingly strong as well as consonant with core elements of his learning model. I offer a responsibility without blame framework that derives from reflection on forms of clinical practice that support change and recovery (...) in patients who cause harm to themselves and others. This framework can be used to interrogate our own attitudes and responses, so that we can better see how to acknowledge the truth about choice and agency in addiction, while avoiding stigma and blame, and instead maintaining care and compassion alongside a commitment to working for social justice and good. (shrink)

Hanna Pitkin argues that Wittgenstein's later philosophy offers a revolutionary new conception of language, and hence a new and deeper understanding of ourselves and the world of human institutions and action.

The financial sector has seen a transformation towards ‘sustainable’ finance particularly in Europe, driven also by unprecedented regulatory reforms. At the same time, many are sceptical about the real impact of these reforms, fearing that they are triggering a paradoxical financialisation of sustainability. Building on recent research on institutional logics and institutional fields formation, we examine changes in the EU regulatory dynamics as characterised by shifts in framing the relationship between sustainability and finance. Deploying a longitudinal approach, consisting of archival (...) data and semi-structured interviews, we explore the development of EU sustainable finance regulation as an extended, interactive and contested process. Specifically, we suggest that regulatory dynamics depend on the hybrid configuration of the social constituencies supporting sustainable finance reforms and on shifts in the overall prevalence of the financial logic in society. Our paper sheds light on the inherent contradictions and limitations of sustainable finance as a means for transformative sustainability reforms. (shrink)

This article is based on a qualitative longitudinal study that followed the subjective experiences of both people living with dementia and their family members during the early stages of the illness. The purpose of this article is to describe and reflect on the ethical and methodological issues that occurred during data collection. The article focuses on the situation of the person with dementia and the family member and the role of the researcher when conducting the research interviews. Based on the (...) results of this study, conducting research interviews with people with dementia and their family members poses several ethical and methodological challenges that must be addressed. In doing so, ethically sound dementia-specific research methods will be actively developed enhancing our understanding of living with dementia and providing new insights into the care of people with dementia and their family members. (shrink)

This study examined cognitive predictors of susceptibility to orientation illusions: Poggendorff, Ponzo, and Zöllner. It was assumed that lower efficiency of information processing in WM and higher field dependence are conducive to orientation illusions. 61 architects aged M = 29, +/- 1.6, and 49 university students aged M = 23.53, +/- 4.24, were tested with Witkin’s EFT to assess their field dependence; the SWATT method was used as a measure of WM efficiency, and susceptibility to visual illusions was verified with (...) a series of computer tasks. We obtained a small range of the explained variance in the regression models including FDI and WM indicators. On the basis of WM efficiency indicators, we managed to confirm the existence of memory predictors of susceptibility to illusions. Among the architects, lower efficiency of WM processing and higher field dependence are responsible for greater susceptibility to orientation illusions. (shrink)

I clarify some ambiguities in blame-talk and argue that blame's potential for irrationality and propensity to sting vitiates accounts of blame that identify it with consciously accessible, personal-level judgements or beliefs. Drawing on the cognitive psychology of emotion and appraisal theory, I develop an account of blame that accommodates these features. I suggest that blame consists in a range of hostile, negative first-order emotions, towards which the blamer has a specific, accompanying second-order attitude, namely, a feeling of entitlement—a feeling that (...) these hostile, negative first-order emotions are what the blamed object deserves. (shrink)

Objectives: This study investigated Finnish physicians’ experiences of decisions concerning living wills and do not resuscitate orders and also their views on the role of patients and family members in these decisions.Design: A questionnaire was sent to 800 physicians representing the following specialties: general practice ; internal medicine ; neurology , and oncology .Results: The response rate was 56%. Most of the respondents had a positive attitude toward , and respect for living wills, and 72% reported situations in which such (...) a will would have been helpful, although experience with their use was limited. The physicians reported both benefits and problems with living wills. Thirteen per cent had completed a living will of their own. Half did not consider living wills to be reliable if they were several years old. Do not resuscitate orders were interpreted in two ways: resuscitation forbidden or only palliative care required . The respondents also documented DNR orders differently. Seventy two per cent discussed DNR decisions always or often with patients able to communicate, and even 76% discussed DNR orders with the family members of patients unable to communicate. Most respondents were able to approach a dying patient without difficulty. They also felt that education in general was needed.Conclusions: In general Finnish physicians accept living wills, but find they are accompanied by several problems. Many problems could be avoided if physicians and patients conducted progressive discussions about living wills. The differing interpretations of DNR orders are a matter of concern in that they may affect patient treatment. The promotion of patient autonomy with respect to treatment seems rather good, but the limitations of the study need to be kept in mind. (shrink)

Robert Hanna argues for the importance of Kant's theories of the epistemological, metaphysical, and practical foundations of the "exact sciences"--relegated to the dustbin of the history of philosophy for most of the 20th century. In doing so he makes a valuable contribution to one of the most active and fruitful areas in contemporary scholarship on Kant.

Berichte zur Wissenschaftsgeschichte, Volume 45, Issue 3, Page 344-354, September 2022.

Despite being considered the proverbial backbone of our healthcare systems, nursing still seems to struggle to scientifically demonstrate its contribution to care experiences and patient outcomes. This leads to erosive tendencies that threaten the development of the profession and its progress as an academic discipline. With this paper, we want to contribute to the theoretical discourse concerning the nature of nursing and the research into its effectiveness. We begin by outlining a set of prevailing paradoxes and their consequences relating to (...) nursing and nursing research: the issue of demonstrating its unique contribution despite a clear societal mandate; a discrepancy between subjectively experienced effectiveness and objectively ascertainable effectiveness; and a mismatch between theoretical premises of nursing and task‐oriented cultures in practice environments. Using an example of a seemingly simple nursing intervention, we intend to demonstrate the qualities and complexities of nursing. We further illustrate this by drawing on several of our research projects using theory‐based evaluation methodologies. From these illustrative examples, we distil two insights relating to nursing interventions that we consider fundamental: the nurse, as a person, is central to its unique effectiveness; and there is always an interplay between context, intervention and its intended effect. We summarise our considerations and argue the case for conceiving research designs in alignment with theoretical premises of nursing. (shrink)

Background: Healthcare professionals encounter ethical dilemmas and concerns in their practice. More research is needed to understand these ethical problems and to know how to educate professionals to respond to them. Research objective: To describe ethical dilemmas and concerns at work from the perspectives of Finnish and Dutch healthcare professionals studying at the master’s level. Research design: Exploratory, qualitative study that used the text of student online discussions of ethical dilemmas at work as data. Method: Participants’ online discussions were analyzed (...) using inductive content analysis. Participants: The sample consisted of 49 students at master’s level enrolled in professional ethics courses at universities in Finland and the Netherlands. Ethical considerations: Permission for conducting the study was granted from both universities of applied sciences. All students provided their informed consent for the use of their assignments as research data. Findings: Participants described 51 problematic work situations. Among these, 16 were found to be ethical dilemmas, and the remaining were work issues with an ethical concern and did not meet criteria of a dilemma. The most common problems resulted from concerns about quality care, safety of healthcare professionals, patients’ rights, and working with too few staff and inadequate resources. Discussion: The results indicated that participants were concerned about providing quality of care and raised numerous questions about how to provide it in challenging situations. The results show that it was difficult for students to differentiate ethical dilemmas from other ethical work concerns. Conclusion: Online discussions among healthcare providers give them an opportunity to relate ethical principles to real ethical dilemmas and problems in their work as well as to critically analyze ethical issues. We found that discussions with descriptions of ethical dilemmas and concerns by health professionals provide important information and recommendations not only for education and practice but also for health policy. (shrink)

The present study aimed at investigating the relationship between environmental and individual factors and Stress of Conscience among nursing staff in psychiatric in-patient care. A questionnaire involving six different instruments measuring Stress of Conscience, the ward atmosphere, the psychosocial work environment, Perceived Stress, Moral Sensitivity, and Mastery was answered by 93 nursing staff at 12 psychiatric in-patient wards in Sweden. The findings showed that Sense of Moral Burden, Mastery, Control at Work and Angry and Aggressive Behavior were related to Stress (...) of Conscience. We conclude that Mastery and Control at Work seemed to work as protective factors, while Sense of Moral Burden and perceptions of Angry and Aggressive Behavior made the nursing staff more vulnerable to Stress of Conscience. Future research should investigate whether measures to increase the level of perceived control and being part of decision making will decrease the level of Stress of Conscience among the staff. (shrink)

Publication date: 26 January 2017 Source: Author: Hanna David Many gifted children are “double labeled”, namely in addition of being gifted they are also learning disabled and/or suffer from emotional, social or behavioral problems. This article will present the difficulties gifted children with a double label have to deal with, especially the difficulties in the educational system. Because of the double label the educational team faces a double challenge, in most cases without being equipped with the required knowledge or (...) the support they need. This article will describe three case studies; techniques for intervention with such children and their families will be suggested. (shrink)

Popular and neurobiological accounts of addiction tend to treat it as a form of compulsion. This contrasts with personality disorder, where most problematic behaviours are treated as voluntary. But high levels of co-morbidity, overlapping diagnostic traits, and the effectiveness of a range of comparable clinical interventions for addiction and personality disorder suggest that this difference in treatment is unjustified. Drawing on this range of clinical interventions, we argue that addiction is not a form of compulsion. Rather, the misuse of drugs (...) and alcohol is like many of the problematic behaviours associated with personality disorder: it is typically a way of coping with psychological distress. We suggest that a satisfying explanation of why many addicts struggle to control their use can be given without departing from concepts employed in our basic folk psychological understanding of agency. In particular, we appeal to five rough-and-ready folk psychological factors to explain addiction: (i) strength of desire and habit; (ii) willpower; (iii) motivation; (iv) functional role; and (v) decision and resolve. (shrink)

Driven by privacy-related fears, users of Online Social Networks may start to reduce their network activities. This trend can have a negative impact on network sustainability and its business value. Nevertheless, very little is understood about the privacy-related concerns of users and the impact of those concerns on identity performance. To close this gap, we take a systematic view of user privacy concerns on such platforms. Based on insights from focus groups and an empirical study with 210 subjects, we find (...) that (i) Organizational Threats and (ii) Social Threats stemming from the user environment constitute two underlying dimensions of the construct Privacy Concerns in Online Social Networks . Using a Structural Equation Model, we examine the impact of the identified dimensions of concern on the Amount, Honesty, and Conscious Control of individual self-disclosure on these sites. We find that users tend to reduce the Amount of information disclosed as a response to their concerns regarding Organizational Threats. Additionally, users become more conscious about the information they reveal as a result of Social Threats. Network providers may want to develop specific mechanisms to alleviate identified user concerns and thereby ensure network sustainability. (shrink)

This paper investigates the value of trust and the proper attitude lay people ought to have towards scientific experts. Trust in expertise is usually considered to be valuable, while distrust is often analyzed in cases where it is harmful. I will draw on accounts from political philosophy and argue that it is not only public trust that is valuable when it comes to scientific expertise – but also public vigilance. Expertise may be distorted in different ways, which cannot be remedied (...) by internal control mechanisms alone. This reveals the importance of some forms of democratic oversight. The proper attitude is vigilant trust in expertise. However, vigilant trust seems to be a contradictory notion: How can one be trusting and watchful at the same time? I will show that it is not, and that trust and vigilance can be compatible to a certain extent. I will do so by distinguishing between different levels of both trust and vigilance. Interestingly, this argument requires acknowledging the value of some forms of distrust in scientific expertise, even if that distrust targets trustworthy experts. (shrink)

Robert Hanna presents a fresh view of the Kantian and analytic traditions that have dominated continental European and Anglo-American philosophy over the last two centuries, and of the connections between them. But this is not just a study in the history of philosophy, for out of this emerges Hanna's original approach to two much-contested theories that remain at the heart of contemporary philosophy. Hanna puts forward a new 'cognitive-semantic' interpretation of transcendental idealism, and a vigorous defense of (...) Kant's theory of analytic and synthetic necessary truth, making this compelling reading for all who are interested in these fundamental philosophical issues. (shrink)

"Fortune is a woman, and if you want to keep her under, you've got to knock her around some."--Niccolò Machiavelli Hanna Pitkin's provocative and enduring study of Machiavelli was the first to systematically place gender at the center of its exploration of his political thought. In this edition, Pitkin adds a new afterword, in which she discusses the book's critical reception and situates the book's arguments in the context of recent interpretations of Machiavelli's thought. "A close and often brilliant (...) exegesis of Machiavelli's writings."-- The American Political Science Review. (shrink)

This chapter offers a novel defence of Szasz’s claim that mental illness is a myth by bringing to bear a standard type of thought experiment used in philosophical discussions of the meaning of natural kind concepts. This makes it possible to accept Szasz’s conclusion that mental illness involves problems of living, some of which may be moral in nature, while bypassing the debate about the meaning of the concept of illness. The chapter then considers the nature of schizophrenia and the (...) personality disorders (PDs) within this framework. It argues that neither is likely to constitute a scientifically valid category, but that nonetheless their symptoms can be scientifically explained. It concludes with a discussion of the way in which Cluster B or ‘bad’ PDs involve failures of virtue or character, and argues that this does not preclude them from being appropriately treated within contemporary, multidisciplinary, mental health services. (shrink)

The problem of addiction is one of the major challenges and controversies confronting medicine and society. It also poses important and complex philosophical and scientific problems. What is addiction? Why does it occur? And how should we respond to it, as individuals and as a society? The Routledge Handbook of Philosophy and Science of Addiction is an outstanding reference source to the key topics, problems and debates in this exciting subject. It spans several disciplines and is the first collection of (...) its kind. Organised into three clear parts, forty-five chapters by a team of international contributors examine key areas, including: the meaning of addiction to individuals conceptions of addiction varieties and taxonomies of addiction methods and models of addiction evolution and addiction history, sociology and anthropology population distribution and epidemiology developmental processes vulnerabilities and resilience psychological and neural mechanisms prevention, treatment and spontaneous recovery public health and the ethics of care social justice, law and policy. Essential reading for students and researchers in addiction research and in philosophy, particularly philosophy of mind and psychology and ethics, The Routledge Handbook of Philosophy and Science of Addiction will also be of great interest to those in related fields, such as medicine, mental health, social work, and social policy. (shrink)

The sources of Singer's moral philosophy -- The origins of ethics -- Reason and ethics -- Key aspects of Singer's ethical system -- Singer's critique of human dignity -- Infanticide a new frontier.

In Rationality and Logic, Robert Hanna argues that logic is intrinsically psychological and that human psychology is intrinsically logical. He claims that logic is cognitively constructed by rational animals and that rational animals are essentially logical animals. In order to do so, he defends the broadly Kantian thesis that all rational animals possess an innate cognitive "logic faculty." Hanna 's claims challenge the conventional philosophical wisdom that sees logic as a fully formal or "topic-neutral" science irreconcilably separate from (...) the species- or individual-specific focus of empirical psychology.Logic and psychology went their separate ways after attacks by Frege and Husserl on logical psychologism--the explanatory reduction of logic to empirical psychology. Hanna argues, however, that--despite the fact that logical psychologism is false--there is an essential link between logic and psychology. Rational human animals constitute the basic class of cognizers or thinkers studied by cognitive psychology; given the connection between rationality and logic that Hanna claims, it follows that the nature of logic is significantly revealed to us by cognitive psychology. Hanna 's proposed "logical cognitivism" has two important consequences: the recognition by logically oriented philosophers that psychologists are their colleagues in the metadiscipline of cognitive science; and radical changes in cognitive science itself. Cognitive science, Hanna argues, is not at bottom a natural science; it is both an objective or truth-oriented science and a normative human science, as is logic itself. (shrink)

Background: Today’s healthcare environment is often characterized by an ethically demanding work situation, and nursing students need to prepare to meet ethical challenges in their future role. Moral sensitivity is an important aspect of the ethical decision-making process, but little is known regarding nursing students’ moral sensitivity and its possible development during nursing education. Objectives: The aims of this study were to investigate moral sensitivity among nursing students, differences in moral sensitivity according to sample sub-group, and the relation between demographic (...) characteristics of nursing students and moral sensitivity. Research design: A convenience sample of 299 nursing students from one university completed a questionnaire comprising questions about demographic information and the revised Moral Sensitivity Questionnaire. With the use of SPSS, non-parametric statistics, including logistic regression models, were used to investigate the relationship between demographic characteristics and moral sensitivity. Ethical considerations: The study followed the regulations according to the Swedish Ethical Review Act and was reviewed by the Ethics Committee of South-East Sweden. Findings: The findings showed that mean scores of nursing students’ moral sensitivity were found in the middle to upper segment of the rating scale. Multivariate analysis showed that gender (odds ratio = 3.32), age (odds ratio = 2.09; 1.73), and parental status (odds ratio = 0.31) were of relevance to nursing students’ moral sensitivity. Academic year was found to be unrelated to moral sensitivity. Discussion and conclusion: These demographic aspects should be considered when designing ethics education for nursing students. Future studies should continue to investigate moral sensitivity in nursing students, such as if and how various pedagogical strategies in ethics may contribute to moral sensitivity in nursing students. (shrink)

An observation of Hume’s has received a lot of attention over the last decade and a half: Although we can standardly imagine the most implausible scenarios, we encounter resistance when imagining propositions at odds with established moral (or perhaps more generally evaluative) convictions. The literature is ripe with ‘solutions’ to this so-called ‘Puzzle of Imaginative Resistance’. Few, however, question the plausibility of the empirical assumption at the heart of the puzzle. In this paper, we explore empirically whether the difficulty we (...) witness in imagining certain propositions is indeed due to claim type (evaluative v. non-evaluative) or whether it is much rather driven by mundane features of content. Our findings suggest that claim type plays but a marginal role, and that there might hence not be much of a ‘puzzle’ to be solved. (shrink)

Extant philosophical accounts of schizophrenic alien thought neglect three clinically signifi cant features of the phenomenon. First, not only thoughts, but also impulses and feelings, are experienced as alien. Second, only a select array of thoughts, impulses, and feelings are experienced as alien. Th ird, empathy with experiences of alienation is possible. I provide an account of disownership that does justice to these features by drawing on recent work on delusions and selfknowledge. Th e key idea is that disownership occurs (...) when there is a failure of rational control over one’s mind. Th is produces a clash between the deliverances of introspection and practical enquiry as ways of knowing one’s mind. Th is explanation places disownership on a continuum with more common aspects of our psychological life, such as addiction, akrasia, obsessional thinking, and immoral, selfi sh or shameful thoughts. I conclude by addressing objections, and exploring the relevance of my account to questions in the philosophy of psychiatry concerning the validity of our current taxonomy of symptoms, and the nature of psychiatric classifi cation.. (shrink)