Introduction With an ageing population, end-of-life care is increasing in importance. The present work investigated characteristics and time trends of older peoples' attitudes towards euthanasia and an end-of-life pill. Methods Three samples aged 64 years or older from the Longitudinal Ageing Study Amsterdam (N=1284 (2001), N=1303 (2005) and N=1245 (2008)) were studied. Respondents were asked whether they could imagine requesting their physician to end their life (euthanasia), or imagine asking for a pill to end their life if they became tired (...) of living in the absence of a severe disease (end-of-life pill). Using logistic multivariable techniques, changes of attitudes over time and their association with demographic and health characteristics were assessed. Results The proportion of respondents with a positive attitude somewhat increased over time, but significantly only among the 64–74 age group. For euthanasia, these percentages were 58% (2001), 64% (2005) and 70% (2008) (OR of most recent versus earliest period (95% CI): 1.30 (1.17 to 1.44)). For an end-of-life pill, these percentages were 31% (2001), 33% (2005) and 45% (2008) (OR (95% CI): 1.37 (1.23 to 1.52)). For the end-of-life pill, interaction between the most recent time period and age group was significant. Conclusions An increasing proportion of older people reported that they could imagine desiring euthanasia or an end-of-life pill. This may imply an increased interest in deciding about your own life and stresses the importance to take older peoples' wishes seriously. (shrink)

This book explores the social practice of holding each other in our identities, beginning with pregnancy and on through the life span. Lindemann argues that our identities give us our sense of how to act and how to treat others, and that the ways in which we we hold each other in them is of crucial moral importance.

The essays in this volume critically analyze and revitalize agrarian philosophy by tracing its evolution in the classical American philosophy of key figures such as Franklin, Jefferson, Emerson, Thoreau, Dewey, and Royce.

The opportunity cost model (OCM) aims to explain various phenomena, among which the finding that performance degrades if executive functions are used repeatedly (). We argue that an OCM account of resource depletion requires two unlikely assumptions, and we discuss an alternative that does not require these assumptions. This alternative model describes the interplay between executive function and motivation.

Background In long-term care, registered nurses and other care providers often experience tensions between ideals and realities in the delivery of services, which can result in stress of conscience. Burnout, low quality of care and a tendency to leave the profession are perceived as consequences. Objectives This study aimed to identify the socio-demographic and work-related factors associated with a high level of stress of conscience, particularly between nursing occupations. Research design A cross-sectional survey was conducted among care providers who worked (...) in Norwegian nursing homes and home care services in the spring of 2021. The sample consisted of 950 registered nurses and 1143 other care providers. Data were collected online using the Stress of Conscience Questionnaire (SCQ). Ethical considerations Participation was voluntary and based on consent. The study was approved by the Norwegian Center for Research Data. Results Registered nurses were nearly twice as likely to report high levels of stress of conscience compared to other care providers in long-term care. In addition, being a female, living alone, caring for their own children, working in an institution (versus home based), working >75% time, working shifts, not having scheduled meetings for ethical reflection and working in municipalities with a higher population density were factors associated with a high level of SCQ score. Discussion Knowledge of factors that increase the risk of high SCQ scores in registered nurses provides opportunities for prevention. Managers in long-term care should pay more attention to how work is distributed between the occupational groups and should facilitate real opportunities for ethical reflection. Conclusions The results of this study show that registered nurses have particular exposure to high levels of stress of conscience compared to other care providers in long-term care. Particular attention should be paid to registered nurses working in nursing homes. (shrink)

Hilde Lindemann Nelson focuses on the stories of groups of people--including Gypsies, mothers, nurses, and transsexuals--whose identities have been defined by those with the power to speak for them and to constrain the scope of their actions. By placing their stories side by side with narratives about the groups in question, Nelson arrives at some important insights regarding the nature of identity. She regards personal identity as consisting not only of how people view themselves but also of how others view (...) them. These perceptions combine to shape the person's field of action. If a dominant group constructs the identities of certain people through socially shared narratives that mark them as morally subnormal, those who bear the damaged identity cannot exercise their moral agency freely.Nelson identifies two kinds of damage inflicted on identities by abusive group relations: one kind deprives individuals of important social goods, and the other deprives them of self-respect. To intervene in the production of either kind of damage, Nelson develops the counterstory, a strategy of resistance that allows the identity to be narratively repaired and so restores the person to full membership in the social and moral community. By attending to the power dynamics that constrict agency, Damaged Identities, Narrative Repair augments the narrative approaches of ethicists such as Alasdair MacIntyre, Martha Nussbaum, Richard Rorty, and Charles Taylor. (shrink)

I introduce the notion of the counterstory: a story that contributes to the moral self-definition of its teller by undermining a dominant story, undoing it and retelling it in such a way as to invite new interpretations and conclusions. Counterstories can be told anywhere, but particularly when told within chosen communities, they permit their tellers to reenter, as full citizens, the communities of place whose goods have been only imperfectly available to its marginalized members.

If personhood involves the construction of a narrative identity, then what are we to say of someone who is seriously ill or disabled? How can her life have any narrative when she is unable to write one?

This essay takes a close look at a species of care that is particularly needed by people with progressive dementias but that has not been much discussed in the bioethics literature: the activity of holding the person in her or his identity. It presses the claim that close family members have a special responsibility to hold on to the demented person's identity for her or him, and offers some criteria for doing this morally well or badly. Finally, it considers how (...) even those with dementia can hold others in their identities, and suggests that this kind of holding too can have great moral worth. (shrink)

Although the existence of implicit motor learning is now widely accepted, the findings concerning perceptual implicit learning are ambiguous. Some researchers have observed perceptual learning whereas other authors have not. The review of the literature provides different reasons to explain this ambiguous picture, such as differences in the underlying learning processes, selective attention, or differences in the difficulty to express this knowledge. In three experiments, we investigated implicit visual learning within the original serial reaction time task. We used different response (...) devices in order to manipulate selective attention towards response dimensions. Results showed that visual and motor sequence learning differed in terms of RT-benefits, but not in terms of the amount of knowledge assessed after training. Furthermore, visual sequence learning was modulated by selective attention. However, the findings of all three experiments suggest that selective attention did not alter implicit but rather explicit learning processes. (shrink)

An Invitation to Feminist Ethics is a hospitable approach to the study of feminist moral theory and practice. Designed to be small enough to be used as a supplement to other books, it also provides the theoretical depth necessary for stand-alone use in courses in feminist ethics, feminist philosophy, and women's studies. The "overviews" section introduces important concepts in feminist ethical theory and contrasts that theory with the standard moral theories. The "close-ups" section looks at three topics--bioethics, violence, and the (...) globalized economy--to help students put the theories presented in the Overviews section to practical use. (shrink)

Enthusiasm over technology is found among men. Or, at least, that is the impression we get from the main body of earlier research, which leaves us with an understanding of men as computer enthusiasts, while women are more reluctant and ‘rational’ in their relation to the computer. In this paper I will argue that women do in fact enjoy working with computers. The empirical material is from a study of a group of students taking a computer course. We will meet (...) women who enjoy working with computers, and explore how they express their pleasure in relation to the computer. Contrary to earlier claims that ‘computing is incompatible with being a girl’, we will find that many of the 21 women in this study are not afraid to articulate their pleasure in computing. (shrink)

I defend the view that a person's identity is injured when a powerful social group views the members of her own, less powerful group as unworthy of full moral respect, and in consequence unjustly prevents her from occupying valuable social roles or entering into desirable relationships that are themselves identity constituting. We may call this harm deprivation of opportunity. Further, a person's identity is injured when she endorses, as a portion of her self-concept, a dominant group's dismissive or exploitative understanding (...) of her group, and in consequence loses or fails to acquire a sense of herself as worthy of full moral respect. We may call this harm infiltrated consciousness. Either injury to the identity constricts the person's ability to exercise her moral agency. ;I argue that because identities are narratively constituted and narratively injured, they can be narratively repaired. The morally pernicious stories that construct the identity according to the requirements of an abusive power system can be at least partially dislodged and replaced by identity-constituting counterstories that portray group members as fully developed moral agents. I develop the concept of the counterstory: it is a purposive act of moral definition, developed on one's own behalf or on behalf of others. It sets out to resist, to one degree or another, the stories that identify certain groups of people as targets for ill treatment. Its aim is to reidentify such people as competent members of the moral community and so to free their moral agency. (shrink)

Our research concerns political knowledge among eighteen-year-old pupils in Belgium and the variables that may cause a differential level of political knowledge.The results point out that the average level of political knowledge is really low, though some elementary items score up to 98 %. The studyreveals as the most significant independent variables : the sex, political participation of the parents, mass media, and school. Mass media are most frequently mentioned as the most important sources of political information. Moreover, respondents with (...) a high level of newsmedia exposure do indeed score best. Political education at school shows to have low impact, on the contrary, respondents that mention school as their most important source of political information tend to score worst. (shrink)

Background: Visual technologies are central to youth culture and are often the preferred communication means of adolescents. Although these tools can be beneficial in fostering relations, adolescents’ use of visual technologies and social media also raises ethical concerns. Aims: We explored how school public health nurses identify and resolve the ethical challenges involved in the use of visual technologies in health dialogues with adolescents. Research design: This is a qualitative study utilizing data from focus group discussions. Participants and research context: (...) We conducted focus group discussions using two semi-structured discussion guides with seven groups of public health nurses (n = 40) working in Norwegian school health services. The data were collected during January and October 2016. Discussions were audio recorded, transcribed, and coded into themes and subthemes using systematic text condensation. Ethical considerations: The leader of the public health nursing service who agreed to provide access for the study and the Norwegian Center for Research Data that reviewed and approved the study. All participants gave informed consent. Findings: In adolescents’ use of visual materials with public health nurses, ethical concerns were raised regarding suicide ideations, socially unacceptable content, violation of privacy, and presentations of possible child neglect. The nurses utilized their professional knowledge and experience when identifying and navigating these ethical dilemmas; they resolved ethical uncertainties through peer discussion and collaboration with fellow nurses and other professionals. Discussion: We discussed the findings in light of Annemarie Mol’s interpretation of the ethics of care. Mol expands the notion of ethical care to include the action of technologies. Conclusion: Although the increasing use of visual technologies offered benefits, school nurses faced ethical challenges in health dialogues with adolescents. To address and navigate these ethical issues, they relied on their experience and caring practices based on their professional ethics. Uncertainties were resolved through peer dialogue and guidance. (shrink)

All conceptions of equal opportunity draw on some distinction between morally justified and unjustified inequalities. We discuss how this distinction varies across a range of philosophical positions. We find that these positions often advance equality of opportunity in tandem with distributive principles based on merit, desert, consequentialist criteria or individuals' responsibility for outcomes. The result of this amalgam of principles is a festering controversy that unnecessarily diminishes the widespread acceptability of opportunity concerns. We therefore propose to restore the conceptual separation (...) of opportunity principles concerning unjustified inequalities from distributive principles concerning justifiable inequalities. On this view, equal opportunity implies that that morally irrelevant factors should engender no differences in individuals' attainment, while remaining silent on inequalities due to morally relevant factors. We examine this idea by introducing the principle of ‘opportunity dominance' and explore in a simple application to what extent this principle may help us arbitrate between opposing distributive principles. We also compare this principle to the selection rules developed by John Roemer and Dirk Van de Gaer. (shrink)

The authority of surrogates—often close family members—to make treatment decisions for previously capacitated patients is said to come from their knowledge of the patient, which they are to draw on as they exercise substituted judgment on the patient’s behalf. However, proxy accuracy studies call this authority into question, hence the Patient Preference Predictor (PPP). We identify two problems with contemporary understandings of the surrogate’s role. The first is with the assumption that knowledge of the patient entails knowledge of what the (...) patient’s choice of treatment would be. The second is with the assumption that a good decision reproduces the content of that choice. If we are right, then the PPP, helpful though it might be in guiding surrogates’ decisions, nevertheless would hold them to the wrong standards and in that way could add to, rather than relieve, the stress they experience as they try to do their job. (shrink)

: The feminist ethic of care has often been criticized for its inability to address four problems--the problem of exploitation as it threatens care givers, the problem of sustaining care-giver integrity, the dangers of conceiving the mother-child dyad normatively as a paradigm for human relationships, and the problem of securing social justice on a broad scale among relative strangers. We argue that there are resources within the ethic of care for addressing each of these problems, and we sketch strategies for (...) developing the ethic more fully. (shrink)

A long lasting debate in the field of implicit learning is whether participants can learn without acquiring conscious knowledge. One crucial problem is that no clear criterion exists allowing to identify participants who possess explicit knowledge. Here, we propose a method to diagnose during a serial reaction time task those participants who acquire conscious knowledge. We first validated this method by using Stroop-like material during training. Then we assessed participants’ knowledge with the Inclusion/Exclusion task and the wagering task . Both (...) experiments confirmed that for participants diagnosed as having acquired conscious knowledge about the underlying sequence the Stroop congruency effect disappeared, whereas for participants not diagnosed as possessing conscious knowledge it only slightly decreased. In addition, both experiments revealed that only participants diagnosed as conscious were able to strategically use their acquired knowledge. Thus, our method allows to reliably distinguish between participants with and without conscious knowledge. (shrink)

Este texto se centra en la génesis de las ciencias sociales a través de una reflexión analítico- descriptiva sobre la sistematización de la ciencia. La ciencia es una creación del ser humano y constituye la mejor herramienta para adquirir conocimientos acerca de su entorno, de sí mismo, del universo... Debe ser interdisciplinaria y para dar soporte a este empeño, hemos tenido que elegir, y hemos optado por comparar la sociología con la filosofía buscando aportaciones (implícitas o explícitas) de prestigiosos pensadores.

Introducing the main theories of distributional justice the book covers utilitarianism and welfare economics, moving on to Rawls's social contract and the Sen/Nussbaum capability approach with a refreshingly readable style. There is a chapter covering the position of mothers and children in theories of justice. The book then studies empirical methods used in analysing the distribution of economic goods, covering Lorenz curves and inequality measures. The concepts of income, wealth and economic goods are comprehensively discussed, with a particular view to (...) their role in theories of justice. This book is an important read for economists and other social scientists, as well as philosophers who want to quantify social and economic justice. (shrink)

Machine generated contents note: -- Acknowledgements -- Disrupting the Impression of Stability in the Gender-Technology Relation -- Changing Images of Computers and its Users since 1980 -- Discursive Developments Within Computer Education -- Variations in Gender-ICT Relations Among Male and Female Computer Students -- Stories About Individual Change and Transformation -- Layered Meanings and Differences Within -- Is there an Elsewhere? -- References -- Endnotes -- Index.

Nowadays, special attention is given to the hazards associated with genetic engineering and new inventions in biotechnology, and in fear of severe consequences, researchers, institutions and governments are required to act responsibly. The term “responsibility” may be defined in numerous ways. The definition considered in this paper, is one we believe is in common use: “Generally speaking, a person has a special responsibility for a particular outcome if they knowingly brought it about and it would not exist if not for (...) what they did”. This concept of moral responsibility rests on what we term the three ‘I's’: individual, intentional and informed. Responsibility is individual in the sense that it must be directed towards someone. A second requirement of moral responsibility presupposes the ability to do otherwise, i.e. it presupposes each human being as an intentional actor, capable of acting according to his/her own free will. In order for someone to be responsible for their actions, the choice between alternatives must be informed. The article focus' on these three aspects of responsibility in order to reveal how difficult it is to apply and make sense of this definition with regard to new inventions in science. (shrink)

Surrogate motherhood-at least if carefully structured to protect the interests of the women involved-seems defensible along standard liberal lines which place great stress on free agreements as moral bedrocks. But feminist theories have tended to be suspicious about the importance assigned to this notion by mainstream ethics, and in this paper, we develop implications of those suspicions for surrogacy. We argue that the practice is inconsistent with duties parents owe to children and that it compromises the freedom of surrogates to (...) perform their share of those duties. Standard liberal perspectives tend to be insensitive to such considerations; we propose a view which takes more seriously the moral importance of the causal relationship between parents and children, and which therefore illuminates rather than obscures the stake that women and children have in surrogacy. (shrink)

The Patient in the Family diagnoses the ways in which the worlds of home and hospital misunderstand each other. The authors explore how medicine, through its new reproductive technologies, is altering the stucture of families, how families can participate more fully in medical decision-making, and how to understand the impact on families of medical advances to extend life but not vitality.

Several criticisms of the Groningen Protocol rest on misunderstandings about how it works or which babies it concerns. Some other objections—about quality‐of‐life judgments and parents' role in making decisions about their children—cannot be easily cleared away, but at least in the context of Dutch culture and medicine, the protocol is acceptable.

I re-examine Coherence Arguments (Dutch Book Arguments, No Arbitrage Arguments) for diachronic constraints on Bayesian reasoning. I suggest to replace the usual game–theoretic coherence condition with a new decision–theoretic condition ('Diachronic Sure Thing Principle'). The new condition meets a large part of the standard objections against the Coherence Argument and frees it, in particular, from a commitment to additive utilities. It also facilitates the proof of the Converse Dutch Book Theorem. I first apply the improved Coherence Argument to van Fraassen's (...) (1984) Reflection principle. I then point out the failure of a Coherence Argument that is intended to support Conditionalization as a naive, universal, update rule. I also point out that Reflection is incompatible with the universal use of Conditionalization thus interpreted. The Coherence Argument therefore defeats the naive view on Bayesian learning that it was originally designed to justify. (shrink)

Naturalized bioethics represents a revolutionary change in how health care ethics is practised. It calls for bioethicists to give up their dependence on utilitarianism and other ideal moral theories and instead to move toward a self-reflexive, socially inquisitive, politically critical, and inclusive ethics. Wary of idealisations that bypass social realities, the naturalism in ethics that is developed in this volume is empirically nourished and acutely aware that ethical theory is the practice of particular people in particular times, places, cultures, and (...) professional environments. These essays situate the bioethicist within the clinical or research context, take seriously the web of relationships in which all human beings are nested, and explore a number of the different kinds of power relations that inform health care encounters. Naturalized Bioethics aims to help bioethicists, doctors, nurses, allied health professionals, disability studies scholars, medical researchers, and other health professionals address the ethical issues surrounding health care. (shrink)

ABSTRACTDo physicians have a duty to sustain the pregnancies of women who die during the first or second trimester? Physicians cannot simply assume that the woman would have wished the pregnancy to continue, nor is it clear that the state has any interest in fetal life before viability. The conditions for beneficence‐based duties of fetal rescue will often be unmet, both because sustaining the pregnancy is not always a clear gain to the born child and because it may impose a (...) substantial burden on the benefactor. And duties of special relationship cannot readily be applied in these cases, as it is difficult to see how the relationship between someone who no longer exists and someone who does not yet exist can breed special duties. Further, to draw on Marx's distinction between the architect, who builds purposefully, and the bee, who cannot help what she is doing, I argue that human pregnancy is in a number of respects purposeful, creative, and deliberate, and that postmortem pregnancy, which follows the model of the bee, is a destructive icon that undercuts women's agency. (shrink)

We should not always expect parents to put their children first.