The objective of this survey was to assess the extent to which nurses encounter and identify dilemma-generating situations in the light of the publication and circulation of the Israeli code of ethics for nurses in 1994. The results are being used as a basis for a programme aimed at promoting nurses' decision-making skills in coping with ethical dilemmas. In this era of major advances in medicine, the nurse's role as the protector of patient rights may bring about conflicts with physicians' (...) orders, with institutional policies, or with patients' families. Nurses will then become confronted with ethical and moral dilemmas. A nationwide survey was carried out to identify and describe the ethical conflicts with which nurses in Israel are confronted in the course of their work. A third of the enumerated dilemmas were encountered by more than 50% of the nurses. The major determinant influencing encounters with dilemmas, as perceived by the participating nurses, was their work setting, namely, the hospital versus the community. It was shown that nurses seek support mainly among their peers, they are barely familiar with the Israeli Code, and they consider their own families as the predominant factor in shaping their ethical attitudes. (shrink)

This article addresses the question of what history an obstacle that stands in the way of our performing a certain action must have in order to render us socially unfree to x. The most promising view on this question is the moral responsibility view, according to which such an obstacle renders us socially unfree to x, if and only if another person is morally responsible for its existence. The main challenge of this view is to identify a serviceable test for (...) establishing when someone is morally responsible for the existence of an obstacle. Numerous attempts to do so have been made over the years, but none of them proved to be successful. In my discussion of the moral responsibility view I will expose the failure of the most recent and powerful attempt to identify such a test. Then I will suggest a more plausible test and defend it from a few possible objections. Before discussing the moral responsibility view I will discuss its main rivals and show why it is superior to them in the first place. (shrink)

Linguistic forms with dedicated evidential meanings have been described for a number of Australian languages (eg. Donaldson 1980, Laughren 1982, Wilkins 1989) but there has been little written on how these are used in social interaction. This paper examines evidential strategies in ordinary Garrwa conversations, by taking into account what we know more generally about the status of knowledge and epistemic authority in Aboriginal societies, and applying this understanding to account for the ways knowledge is managed in `ordinary' interactions.

In lieu of an abstract, here is a brief excerpt of the content:The Truth about Narrative, Or:How Does Narrative Matter?Ruth Ronen and Efrat BibermanIn the summer of 1898, a sixteen-year-old girl, intelligent and good looking, entered Freud's clinic in Vienna. The girl, whom Freud would call Dora, suffered recurrent attacks of aphonia (inability to speak) and of coughing, attacks that came on and passed off spontaneously. Freud soon discovers that Dora's illness is connected to the love affair her father (...) is having with a Frau K., a family acquaintance, while the lover's husband is courting Dora herself. In analyzing the history of Dora, Freud unfolds the course of events that brought Dora to the clinic and produces her case by means of a fragmentary discourse consisting of Dora's speech, her dreams and thoughts as revealed to Freud while the analysis was going on. The psychoanalytic discourse yet also consists of Freud's own reports and interpretations of Dora's dreams, actions and speech and of his overall understanding of her case, an understanding that undergoes a few radical changes during the analysis. When Dora decides to leave the treatment three months later, which is much too soon in Freud's view, Freud interprets her act as an act of vengeance against himself, repeating her neurotic reactions to the romantic complexity she recounted through the person of Freud. However, when Freud learns later that Dora got married and has overcome her hysterical sicknesses, he re-reads her second dream as announcing that Dora was about to tear herself free from her father (from Mr. K. she tore herself free through an act of vengeance) and "had been reclaimed once more by the realities of life."1How has the narration of the case of Dora by herself and by Freud, changed her situation from a hysterical subject who suffers from severe symptoms, to a subject "able to be reclaimed by the realities of life"? [End Page 118] How has Dora's spoken words to Freud, and his way of responding and directing her speech, changed her situation so radically? What is the power of narrative in changing or affecting the object of narration? What constitutes the "true story" of a subject and how is it affected by the narrative modes by which the story is presented? Can narrative change the facts of the matter narrated? In this paper, as part of the attempt to define the constitutive power of narrative, a power that cannot yet reduce the constituted subject to an effect of discourse (Dora after psychoanalysis surely cannot be viewed as a construct of discourse, yet is so different from what she was prior to analysis), we will examine these questions as addressed in two, apparently diverse, contexts: that of analytic aesthetics and that of psychoanalytic thought. We will show that these two perspectives tackle similar problems regarding narrativity yet choose to solve them in ways that raise important questions regarding the effects of narrative.IIt is a widely spread opinion about narrative that it creates its own world in the act of telling, that "the structures of narrative impose some kind of barrier between language and fact; rather than being directly 'mirrored', the facts, as represented in narrative, are filtered through layers of linguistic artifice."2 The diagnosis that narrative somehow distorts or constructs the events it recounts, that narration changes the modality of what is narrated, is one important implication of the booming interest in narrative in the 1980s and 90s. To understand how such an implication was drawn, requires that the nature of the interest in narrative is more closely qualified as part of the growing attention paid to the pervasiveness of narrative in discourses traditionally considered to lie outside the domain of narrative rendering, and to the naturalness of narrative presentation in extra-literary contexts. These pervasiveness and naturalness of narrative were often interpreted as reflecting the literariness or fictionality of discourses that officially claim to be committed to reality and truth.Yet, how did it come about that the discovery of narrative elements in a wide variety of contexts was interpreted as entailing the fictionalizing of these discursive contexts? As narrative entails the imposition of structure on... (shrink)

What do we mean when we diagnose a patient with a disease? What does it mean to say that two people have the same disease? In this paper, I argue that diseases are natural kinds, using a conception of kinds derived from John Stuart Mill and Ruth Millikan. I demonstrate that each disease is a natural kind and that the shared properties occur as a result of the pathogenesis of the disease. I illustrate this with diverse examples from internal medicine (...) and compare my account to alternative ontologies. (shrink)

In Brazil, the epicenter of the Zika crisis, brown, black, and indigenous poor women living in municipalities with scarce resources were disproportionally affected. The gendered consequences of the epidemic exposed how intersectional lenses are central to understand the impact of public health emergencies in the lives of women and girls. The demand for Zika-affected children and women to be research participants is relevant for an ethical analysis of participant protection procedures during a crisis. We investigated how women experienced research participation (...) by analyzing their narratives. Two-year-long longitudinal qualitative study in Brazilian sites located in the epidemic's epicenter was performed using mixed methods: ethnography with women from two distinct states and individual semi-structured interviews with five women in different Zika-affected states, four of which were community leaders. All women in the study were mothers or grandmothers of Zika-affected children. Thematic analysis was used for data evaluation. Women perceived being pressured to participate in research and a lack of benefit sharing. Structural determinants of gender inequality, such as its effect on power distribution, were found to impact research participant protection. Formal procedures for research protocols approvals were insufficient in protecting participants because these instruments were unable to account for structural aspects. Communitarian mobilization, through WhatsApp groups, was found to be an important mechanism to create conditions to challenge oppressive structures. Strengthening public health, effective community-based participation in research planning and implantation of ethical strategies that promotes gender equality can have transformative effect on unequal power structures and promote participant protection. (shrink)

Smajdor addresses the problem of inferior clinical outcomes among adults with impairments of capacity to give informed consent (AWIC). She notes that AWIC are generally excluded from clinical trials to protect them against harms and avoid exploitation and claims there is a causal link between involvement in clinical trials and favourable outcomes. She argues, given this link, that we should increase AWIC representation in clinical trials and can justifiably do so by recognising the capacity of AWIC to assent. AWIC form (...) a diverse group, with multiple aetiologies, including, for example, Down syndrome, traumatic brain injury and dementia. In some cases, the inability to consent may fluctuate so that the same person could be AWIC only at certain times. Yet despite these differences, the group has a shared unmet need. We agree with Smajdor that AWIC outcomes should be improved, but question whether simply increasing representation in clinical trials is sufficient to achieve this. We identify the following points: 1. AWIC are under-represented in clinical trials. There is evidence of widespread exclusion of AWIC in clinical trials within the UK and abroad and it is often a specific exclusion criterion.1 2. AWIC have worse clinical outcomes and a lower life expectancy. The life expectancy …. (shrink)

Adam and Eve have the same record yet receive different punishments. Adam receives the punishment that they both deserve, whereas Eve receives a more lenient punishment. In this article, we explore whether a deserved-but-unequal punishment, such as what Adam receives, can be just. We do this by explicating the conceptions of retributive justice that underlie both sides of the debate. We argue that inequality in punishment is disturbing mainly because of the disrespect it often expresses towards the offender receiving the (...) harsher treatment, and also because it casts doubt on whether Adam got what he deserved. We suggest that when no disrespect is involved and when it is clear that the criminal got what he deserved, inequality is not worrisome. (shrink)

This paper questions the fairness of our current tort-law regime and the philosophical underpinnings advanced in its defense, a theory known as corrective justice. Fairness requires that the moral equality and responsibility of persons be respected in social interactions and institutions. The concept of luck has been used by many egalitarians as a way of giving content to fairness by differentiating between those benefits and burdens that result from informed choice and those that result from fate or fortune. We argue (...) that the theory of corrective justice, along with its institutional embodiment of tort law, is at odds with an egalitarian commitment to fairness because it allows luck an unjustifiable role in determining dissimilar liability for similar wrongs and dissimilar compensation for similar losses to bodily integrity. Many egalitarian political theorists have also recognized, if not defended, the notion of distinct forms of justice, namely corrective, retributive, and distributive. Although theorists of these different forms of justice have been concerned with negating unfair luck inside the operations of each form of justice, there has been little attention to the way in which luck operates to sort cases into each form of justice. We claim that there is a significant way in which luck operates to subject different people to principles of corrective, retributive, and distributive justicewhich flies in the face of the egalitarian value of fairness. After surveying the arguments put forward by theorists defending a categorical distinction between corrective justice and retributive and distributive principles, we argue that although analytical distinctions can be made between different forms of justice (although, we also suggest that the distinctions are not as sharp as some commentators suggest), there is no good reason to defend an acoustic separation between these forms of justice when doing so creates unfair outcomes. (shrink)

:We propose to strengthen Popper’s notion of falsifiability by adding the requirement that when an observation is inconsistent with a theory, there must be a ‘short proof’ of this inconsistency. We model the concept of a short proof using tools from computational complexity, and provide some examples of economic theories that are falsifiable in the usual sense but not with this additional requirement. We consider several variants of the definition of ‘short proof’ and several assumptions about the difficulty of computation, (...) and study their different implications on the falsifiability of theories. (shrink)

Preferences for options that do not secure optimal outcomes, like the ones catalogued by Sunstein, derive from two sources: cognitive heuristics and deontological rules. Although rules may stem from automatic affective reactions, they are deliberately maintained. Because strongly held convictions have important behavioral implications, it may be useful to regard cognitive heuristics and deontological rules as separate sources of nonconsequential judgment in the moral domain.

By closely reading Lacan’s references to the way philosophers (primarily Kant and Aristotle) use the notion of the “soul,” this paper suggests that the soul represents whatever in the body is unattainable to thought. The paper aims to reveal the philosophical moment in which a soul distinguishes itself from both mind and body and to show that this moment, in which a soul is summoned by philosophers, is needed in order to overcome the fundamental alienation of the body with regard (...) to thought. Lacan’s way of addressing the soul along these lines suggests why having a soul carries ethical implications. (shrink)

Doctors Pratt and de Vries propose a well-structured and courageous approach to analyse and repair an insufficiently recognised discussion about epistemologies and knowledge production in bioethics.1 The authors invite researchers, scholars, public health experts and bioethicists from the global North to reflect about their lack of imagination regarding different sources of narratives produced by the global South. There is a critical analysis of injustices and an urgent call for global bioethicists to reorient their field and focus on the analysis and (...) development of ethical interventions to achieve a comprehensive epistemic justice for global health ethics. Feminist bioethicists from the global South already argued about the importance of the voices and biographies of the people and groups in the communities to reframe the bioethical reasoning regarding the meaning of individual’s needs during public health and humanitarian emergencies.2 Over a decade ago, Diniz and Guilhem described the role and goal of feminist bioethics in Latin America, shaped in an oppressive context promoted and created by …. (shrink)

Au cours des années 1910 et 1920, les effets conjugués des idées savantes sur la spécificité des anticorps, de la croyance profane à l’existence d’un sang syphilitique et de l’importance attribuée à la détection de la syphilis par les autorités sanitaires ont permis de transformer un test diagnostique peu efficace, la réaction de Wassermann, en «fait scientifique» incontestable. Ce fait scientifique établit l’équivalence« individu Wassermann positif= personne infectée par l’agent étiologique de la syphilis, la bactérie Treponema pallidum ». Il a (...) ainsi modifié les contours de l’entité nosologique «syphilis», les pratiques professionnelles, les représentations profanes de la syphilis et les politiques de santé. Tenu pour solide pendant une trentaine d’années, ce «fait scientifique» fut toutefois déstabilisé dans les années 1950 en raison du hiatus croissant entre les résultats accumulés grâce à la diffusion massive du test de Wassermann et les données épidémiologiques sur la prévalence de la syphilis, et de la comparaison entre les résultats de la réaction de Wassermann et ceux des nouveaux tests diagnostiques spécifiques du tréponème. Un pourcentage élevé de personnes «Wassermann positives» fut alors redéfini comme des « faux positifs biologiques », soit des individus souffrant de pathologies autres que la syphilis, mais cependant capables d’induire une réaction Wassermann positive. L’équivalence « personne Wassermann positive = individu infecté par Treponema pallidum » fut remplacée par l’équation« personne Wassermann positive = individu infecté par le tréponème ou faux positif biologique ». La nouvelle vision de la réaction de Wassermann modifia à son tour les pratiques des professionnels et les représentations que le grand public se fait de la maladie. L’histoire de la détection de la syphilis illustre les interactions complexes entre « faits scientifiques » et « faits sociaux» et l’interdépendance de leur évolution. (shrink)

Hillel Steiner’s left-libertarian theory of justice is the most serious recent attempt to reconcile the ideals of (luck-egalitarian) equality and freedom. This attempt consists in an argument that a universal right to equal freedom, which in Steiner’s view means also a universal right to maximal freedom, implies a universal right to self-ownership and to an egalitarian share of the world’s natural resources. In this article, I argue that this argument fails on Steiner’s own terms. I argue that, on Steiner’s conceptions (...) of freedom, self-ownership, and an egalitarian share of the world’s natural resources, insofar as the right to equal freedom implies the right to self-ownership and to an egalitarian share of the world’s natural resources, it is incompatible with (luck-egalitarian) equality. (shrink)

As mídias facilitam as aprendizagens e oportunizam a expressão das Habilidades Sociais dos estudantes. Este estudo objetiva caracterizar o uso das Tecnologias da Informação e Comunicação e as Habilidades Sociais de 456 estudantes de escolas privadas do Sul do Brasil. Trata-se de um estudo quantitativo, descritivo e transversal. Utilizou-se um questionário de dados sociodemográficos, Questionário de Utilização das Tecnologias de Informação e Comunicação e Inventário de Habilidades Sociais para Adolescentes Del-Prette. O celular/ smartphone e as redes sociais foram as principais (...) tecnologias utilizadas. Destaca-se maior frequência nas Habilidades Sociais de Civilidade e Desenvoltura social e menores frequências em Empatia, Autocontrole, Assertividade e Abordagem Afetiva. Além de alta dificuldade na emissão de Empatia, Autocontrole e Assertividade. Sugere-se estudos clínicos para desenvolvimento de maior repertório de habilidades sociais nesta população para fins de prevenção de comportamentos problemáticos relacionados a baixos níveis de habilidades sociais e alto uso de mídias. (shrink)

This paper discusses Franz Rosenzweig’s use of the term “the unconscious” (das Unbewußte) and possible influences on his understanding of it. I claim that for Rosenzweig, it is through the unconscious that the individual becomes aware of himself and becomes capable of fulfilling his longing to achieve self-fulfillment and eventually to take part in a collective redemption. The unconscious is often perceived as the mental sphere related to trauma and repression in which defense mechanisms and fantasies are evolved. Fantasies are (...) psychological tools that allow the individual to cope with trauma, but they are also “layers of enclosedness,” illusions that should be dissolved. Hence, in the unconscious, we find a possibility of liberation. (shrink)

Following Levinas’ articulation that “truth is accessible only to the mind capable of experiencing an exile away from its preconceptions and prejudices,” Exile and Otherness posits that Shinran, the founder True Pure Land Buddhism, and Maimonides, a Jewish philosopher and Torah scholar, exhibit sensitivity to the neglected and suffering others.

Nearly forty percent of the world’s financial assets are located in loosely defined British Empire city-state jurisdictions. This article seeks to provide an explanation for this odd development. My explanation of the rise of such a British Empire-centered economy links the development of the Euromarket, or the offshore financial market, to three sets of theories. The first is the hinterland theory that explains why small city-state types of jurisdictions are in an advantageous position when it comes to trading in Euromarket (...) financial assets in comparison to other states. Second is the dependent jurisdictions theory, which suggests that dependent jurisdictions are perceived as safer locations for investment than independent islands, in addition to which they are able to offer better treatment of nonresident capital because they are subsidized by the motherland. As the British Empire was the largest Empire the world has ever seen, it is perhaps not surprising that the British state has inherited the greatest number of such dependent jurisdictions, and that they, in turn, have taken advantage of their "Britishness" to develop their financial centers. Third, I advance a related argument that suggests that the hegemonic position of the British Empire in the world economy prior to the rise of the United States was an important factor as well. Here, I draw on the idea that city-states and, more generally, trading centers tend to be dominated by commercially outward-oriented elites. (shrink)

In 1939 Sigmund Freud published his latest book, Moses and Monotheism, which is his most unusual and problematic work. In Moses Freud offers four groundbreaking claims in regard to the biblical story: [a] Moses was an Egyptian [b] The origin of monotheism is not Judaism [c] Moses was murdered by the Jews [d] The murder sparked a constant sense of unconscious guilt, which eventually contributed to the rational and ethical development of Jewish monotheism. As is well known, Freud’s Moses received (...) extremely negative reviews from Jewish thinkers. The social psychoanalyst, Erich Fromm, who wrote extensively on Freud as well as on Judaism and the biblical narrative, did not explicitly express his position on Freud’s latest work. This paper offers explanations for Fromm’s roaring silence on Freud’s Moses. (shrink)