Let the chain antichain principle (CAC) be the statement that each partial order on $\mathbb{N}$ possesses an infinite chain or an infinite antichain. Chong, Slaman, and Yang recently proved using forcing over nonstandard models of arithmetic that CAC is $\Pi^1_1$-conservative over $\text{RCA}_0+\Pi^0_1\text{-CP}$ and so in particular that CAC does not imply $\Sigma^0_2$-induction. We provide here a different purely syntactical and constructive proof of the statement that CAC (even together with WKL) does not imply $\Sigma^0_2$-induction. In detail we show using a (...) refinement of Howard's ordinal analysis of bar recursion that $\text{WKL}_0^\omega+\text{CAC}$ is $\Pi^0_2$-conservative over PRA and that one can extract primitive recursive realizers for such statements. Moreover, our proof is finitary in the sense of Hilbert's program. CAC implies that every sequence of $\mathbb{R}$ has a monotone subsequence. This Bolzano-Weierstraß}-like principle is commonly used in proofs. Our result makes it possible to extract primitive recursive terms from such proofs. We also discuss the Erdős-Moser principle, which—taken together with CAC—is equivalent to $\text{RT}^2_2$. (shrink)

Background: The global COVID-19 pandemic has imposed challenges on healthcare systems and professionals worldwide and introduced a ´maelstrom´ of ethical dilemmas. How ethically demanding situations are handled affects employees’ moral stress and job satisfaction. Aim: Describe priority-setting dilemmas, moral distress and support experienced by nurses and physicians across medical specialties in the early phase of the COVID-19 pandemic in Western Norway. Research design: A cross-sectional hospital-based survey was conducted from 23 April to 11 May 2020. Ethical considerations: Ethical approval granted (...) by the Regional Research Ethics Committee in Western Norway (131421). Findings: Among the 1606 respondents, 67% had experienced priority-setting dilemmas the previous two weeks. Healthcare workers who were directly involved in COVID-19 care, were redeployed or worked in psychiatry/addiction medicine experienced it more often. Although 59% of the respondents had seen adverse consequences due to resource scarcity, severe consequences were rare. Moral distress levels were generally low (2.9 on a 0–10 scale), but higher in selected groups (redeployed, managers and working in psychiatry/addiction medicine). Backing from existing collegial and managerial structures and routines, such as discussions with colleagues and receiving updates and information from managers that listened and acted upon feedback, were found more helpful than external support mechanisms. Priority-setting guidelines were also helpful. Discussion: By including all medical specialties, nurses and physicians, and various institutions, the study provides information on how the COVID-19 mitigation also influenced those not directly involved in the COVID-19 treatment of patients. In the next stages of the pandemic response, support for healthcare professionals directly involved in outbreak-affected patients, those redeployed or those most impacted by mitigation strategies must be a priority. Conclusion: Empirical research of healthcare workers experiences under a pandemic are important to identify groups at risks and useful support mechanisms. (shrink)

Der Beitrag untersucht die Langeweile auf klinischem Terrain und als literarisches/philosophisches Sujet in Abgrenzung zu benachbarten Phänomenen wie Muße, Müßiggang und Faulheit. Da sich das Phänomen Langeweile im Bedeutungsspektrum zwischen »horror vacui« (Kant) und »Windstille der Seele« (Nietzsche) einer definitorischen Klarheit entzieht, schlägt die Autorin anhand klinischer Vignetten vor, drei Qualitäten und regulierende Funktionen der Langweile zu differenzieren: eine vernichtende, mit »Desobjektalisierung« (Green) einhergehende Langeweile, eine als Abwehr eines traumabedingten Ich-Verlusts fungierende Langeweile sowie eine Langeweile als kreativer Übergangsraum. Freuds Gedanken (...) über die Existenz von »lustvolle(n) Spannungen und unlustige(n) Entspannungen« enthalten eine triebökonomische Perspektive, die einen Blick auf sehr unterschiedliche Lust- und Unlustqualitäten der Langeweile erlaubt. (shrink)

Prologue: the hooded friar -- A most solemn act of justice -- The Nolan philosopher -- "Napoli e tutto il mondo" -- "The world is fine as it is" -- "I have, in effect, harbored doubts" -- "I came into this world to light a fire" -- Footprints in the forest -- A thousand worlds -- Art and astronomy -- Trouble again -- Holy asininity -- The signs of the times -- A lonely sparrow -- Thirty -- The gifts of (...) the Magi -- The song of Circe -- "Go up to Oxford" -- Down risky streets -- The art of magic -- Canticles -- Squaring the circle -- Consolation and valediction -- Infinities -- Return to Italy -- The witness -- The adversary -- Gethsemane -- Hell's purgatory -- The sentence -- The field of flowers -- Epilogue: the four rivers. (shrink)

Having Too Much is the first academic volume devoted to limitarianism: the idea that the use of economic or ecosystem resources should not exceed certain limits. This concept has deep roots in economic and political thought. One can find similar statements of such limits in thinkers such as Plato, Aquinas, and Spinoza. But Having Too Much is the first time in contemporary political philosophy that limitarianism is explored at length and in detail. Bringing together in one place the best writing (...) from key theorists of limitarianism, this book is an essential contribution to political philosophy in general, and theories of distributive justice in particular. Including some of the key published articles as well as new chapters, Having Too Much is necessary reading for scholars and students of political theory and philosophy, as well as anyone interested in questions of distributive justice. (shrink)

Human embryos produced in labs since the 1970s have generated layers of uncertainty for law and policy: ontological, moral, and administrative. Ontologically, these lab-made entities fall into a gray zone between life and not-yet-life. Should in vitro embryos be treated as inanimate matter, like abandoned postsurgical tissue, or as private property? Morally, should they exist largely outside of state control in the zone of free reproductive choice or should they be regarded as autonomous human lives and thus entitled to constitutional (...) protection like full-fledged citizens? Administratively, if they deserve protection, what institutional and policy mechanisms are best suited to carrying out the necessary oversight? Using a method termed comparative problematization, this article traces divergent answers to these questions produced in three countries—the United States, United Kingdom, and Germany—across the last twenty-five years. Comparison reveals distinct bioconstitutional foundations that give rise to systematically different understandings of each state’s responsibilities toward human life and hence its particular treatment of claims on behalf of embryonic lives. (shrink)

People with dementia have previously not been active participants in research, with ethical difficulties often being cited as the reason for this. A wider inclusion of people with dementia in research raises several ethical and methodological challenges. This article adds to the emerging debate by reflecting on the ethical and methodological issues raised during an interview study involving people with dementia and their spouses. The study sought to explore the impact of living with dementia. We argue that there is support (...) for the inclusion of people with dementia in research and that the benefits of participation usually far outweigh the risks, particularly when a `safe context' has been created. The role of gatekeepers as potentially responsible for excluding people with dementia needs further consideration, with particular reference to the appropriateness of viewing consent as a primarily cognitive, universalistic and exclusionary event as opposed to a more particularistic, inclusive and context relevant process. (shrink)

In this article, Ingrid Andersson discusses the decolonial philosophy of Sylvia Wynter, with a special focus on addressing her concepts of the hybrid human and origin stories. Andersson shows how Wynter's philosophizing about the being of being human is premised on an entanglement of nature and culture that is on par with the posthuman understanding of the ontological inseparability of matter and discourse. She goes on to interrogate some productive tensions between Wynter's decolonial philosophy and posthumanism by pointing out (...) how Wynter's hybrid human formulates an understanding of human nature that is different in itself and not solely in relation to other nonhuman entities. In the final part of the article, she proposes how we, with Wynter, can devise a pedagogical approach that seeks to counteract harmful taxonomizing practices. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:You Can't Say "No" to That!(A "Difficult Patient" Story)Ingrid BergAs a sequela of COVID-19, my rural Wisconsin hospital has been jam-packed for months with patients for whom we routinely provide care and many for whom we do not. An exodus of health care workers and other constraints have made the transfer of critically ill patients very difficult. In this disquieting "new-normal" of our work life, we routinely must (...) call bigger cities throughout our state to find beds for complex patients.So, it was not surprising when a young patient, an IV drug user in sepsis from a heart infection, was admitted to me in the middle of the night. In less disheartening times, before the pandemic, this patient would have been transferred promptly to the big-city hospital. Now, though, the possibility of finding an open bed is next to impossible. Resigned, I placed admission orders, continued antibiotics and fluids, and crossed my fingers. Then the unexpected happened: a bed opened up, and we could send her at once!The patient had a harsh heart murmur. It was likely that a "vegetation" was clinging to the valve, between the right upper and lower chambers of her heart. A vegetation is a clump of debris, such as platelets, clotting proteins, and bacteria that is a menace to the body. Her chest imaging looked like her infection had already spread to her lungs.A definitive diagnosis for endocarditis requires a special ultrasound with a probe that goes down through the esophagus, a procedure performed by cardiologists. It's a serious infection, one that requires weeks of IV antibiotics and is best monitored by infectious disease specialists. Sometimes, cardiothoracic surgeons are called upon to strip away the infection at the site, depending on how badly the valve has been slayed or the size of the vegetation. My only recommendation for a young, otherwise healthy patient in this scenario, is transfer.All of these reasons for transfer were lolling around in my tired head when the night-time [End Page 14] nursing supervisor approached me and said, "We have a problem." When the patient was updated about the transfer, she balked: "She says she is tired and refusing to go," the supervisor began. "She doesn't feel like getting into an ambulance in the middle of the night and she doesn't care if her condition is life-threatening. She knows we can't force her to go and she will only talk about it again in the morning."The cartoon version of myself at that moment had bugged-out eyes, a dropped jaw, fists tight and clenched at my sides, and steam coming out of my head. I can look past a patient's self-neglect, poor medication adherence, abysmal communication, alcohol and drug addiction, and other crimes. But saying no to a bed at a tertiary care facility? Unacceptable!I marched down the quiet hallway and into her room. She was lying on her side, facing the door, one IV in a thin arm. I was confident I could reason with her once I explained the scarcity of beds and the medical necessity of transfer. But she was having none of it. I was calm until I could no longer maintain my cool: "You can't give up this bed!""Maybe in the morning," she insisted, yawning. "But not now. I am tired and want to rest!""But there might not be a bed in the morning," I countered. "And your infection can be life-threatening." (This is true, but we both knew she wasn't dying at this very moment.)"I am not going anywhere!" She raised her voice and then closed her eyes.And she was right. I had no choice but to keep her. I could not kick her out of the hospital because she was making a poor choice, and I was frustrated for having to manage the fallout of that decision. Giving her antibiotics and fluid boluses to bolster her blood pressure was certainly within my scope of practice. And fretting. Fretting is always within my scope of practice; not that my scope of practice matters when all the big... (shrink)

Choosing a compassionate lifestyle that makes you feel good and positively impacts on the environment and on animals has never been easier. In this practical and accessible handbook, loaded with resources for all products that are mentioned, Ingrid Newkirk presents fabulous options that will not only enhance your life, but those of your neighbors, your community, animals, and the earth itself. From comfortable home furnishings, to delicious foods, to fashionable clothing there are a myriad of choices to be made (...) that can have a lasting positive effect on the well-being of animals and the environment, including: - recognizing hidden animal ingredients in cosmetics and household products - raising ecologically aware and animal-friendly kids - creating healthy, environmentally-friendly meals for everyday and special occasions - dressing with style without using leather or other animal products - dealing kindly with mice, insects, and other 'pests' in home or garden - adopting the right animal companion for you - volunteering and investing in eco- and animal-friendly companies - traveling with Eco-consciousness. (shrink)

In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and (...) nurses’ ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses’ everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care. (shrink)

1) Daß das Ich »nothwendig Identität des Subjects und Objects« sei, und zwar »schlechthin«: Diese These hat Fichte in der 2. Aufl. der WL 1794 bekräftigt. Das klingt denn doch nach einer cartesianischen Absolutsetzung des Ich. Die Aporien oder Begründungsschwierigkeit der Frage wissender Selbstbeziehung, die daraus entstehen, wenn das Ich als Instanz den Akten des Erkennens vorausgesetzt wird, die die Identität des Ich gerade erst plausibel machen sollen, brauche ich hier nicht auszuführen. Es reicht nicht hin, die »Identität des Subjekts« (...) durch das bloß »dem Gedanken angehängte Ich« zu bezeichnen. Was diesen höchsten Punkt aller Transzendental-Philosophie angeht, hat Hölderlin einen Lösungsansatz formuliert, der darin besteht - und darauf sollen die folgenden Skizzen hinweisen –, daß dasjenige, was als Identität eines Subjekts gedacht wird, als Relation zu begreifen ist. Sinn und Vermögen der Erinnerung erlangen in diesem Zusammenhang grundlegende Bedeutung. (shrink)

Ethical dilemmas are part of medicine, but the type of challenges, the frequency of their occurrence and the nuances in the difficulties have not been systematically studied in low-income settings. The objective of this paper was to map out the ethical dilemmas from the perspective of Ethiopian physicians working in public hospitals. A national survey of physicians from 49 public hospitals using stratified, multi-stage sampling was conducted in six of the 11 regions in Ethiopia. Descriptive statistics were used and the (...) responses to the open-ended question “If you have experienced any ethical dilemma, can you please describe a dilemma you have encountered in your own words?” were analyzed using a template analysis process. A total of 587 physicians responded, and 565 met the inclusion criteria. Twelve of 24 specified ethically challenging situations were reported to be experienced often or sometimes by more than 50% of the physicians. The most frequently reported challenge concerned resource distribution: 93% agreed that they often or sometimes had to make difficult choices due to resource limitation, and 83% often or sometimes encountered difficulties because patients were unable to pay for the preferred course of treatment. Other frequently reported difficulties were doubts about doing good or harming the patient, relating to conflicting views, concern for family welfare, disclosure issues and caring for patients not able to consent. Few reported dilemmas related to end-of-life issues. The 200 responses to the open-ended question mirrored the quantitative results. Ethiopian physicians report ethical challenges related more to bedside rationing and fairness concerns than futility discussions and conflicts about autonomy as described in studies from high-income countries. In addition to the high report of experienced challenges, gravity of the dilemmas that are present in their narratives are striking. Recognition of the everyday experiences of physicians in low-income settings should prompt the development of ethics teaching and support mechanisms, discussion of ethical guidelines as well as increase our focus on how to improve the grave resource scarcity they describe. (shrink)

This paper addresses the strength of Ramsey's theorem for pairs ($RT^2_2$) over a weak base theory from the perspective of 'proof mining'. Let $RT^{2-}_2$ denote Ramsey's theorem for pairs where the coloring is given by an explicit term involving only numeric variables. We add this principle to a weak base theory that includes weak König's Lemma and a substantial amount of $\Sigma^0_1$-induction (enough to prove the totality of all primitive recursive functions but not of all primitive recursive functionals). In the (...) resulting theory we show the extractability of primitive recursive programs and uniform bounds from proofs of $\forall\exists$-theorems. There are two components of this work. The first component is a general proof-theoretic result, due to the second author, that establishes conservation results for restricted principles of choice and comprehension over primitive recursive arithmetic PRA as well as a method for the extraction of primitive recursive bounds from proofs based on such principles. The second component is the main novelty of the paper: it is shown that a proof of Ramsey's theorem due to Erdős and Rado can be formalized using these restricted principles. So from the perspective of proof unwinding the computational content of concrete proofs based on $RT^2_2$ the computational complexity will, in most practical cases, not go beyond primitive recursive complexity. This even is the case when the theorem to be proved has function parameters f and the proof uses instances of $RT^2_2$ that are primitive recursive in f. (shrink)

En varias oportunidades, el filósofo francés Maurice Merleau-Ponty plantea que hay una "carne del lenguaje" que se puede entender como la comprensión paradójica de sí y del otro en el seno mismo del lenguaje; esta "carne" está en relación con el desarrollo de la vida humana y da testimonio del cambio en los individuos que, observándose a sí mismos, quieren ser individuos nuevos a cada momento. Siguiendo a Merleau-Ponty, el presente ensayo se propone reconocer la condición del ser reinventado continuamente (...) por la expresión del lenguaje. On several occasions, the French philosopher Maurice Merleau-Ponty says there is a "flesh of language" that can be understood as a paradoxical understanding of self and the other within the same language. This "flesh" is related to the development of human life and bears witness to the change in individuals, observing themselves, who want to be new individuals each time. Following Merleau-Ponty, this essay proposes to recognize the condi-tion of being continually reinvented by the expression of language. (shrink)

This article analyses the general ethical milieu in a nursing home for elderly residents and provides a decision-making model for analysing the ethical situations that arise. It considers what it means for the residents to live together and for the staff to be in ethically problematic situations when caring for residents. An interpretative phenomenological approach and Sandman’s ethical model proved useful for this purpose. Systematic observations were carried out and interpretation of the general ethical milieu was summarized as ‘being in (...) the same world without meeting’. Two themes and four subthemes emerged from the analysis. Three different ethical problems were analysed. The outcome of using the decision-making model highlighted the discrepancy between the solutions used and well-founded solutions to these problems. An important conclusion that emerged from this study was the need for a structured tool for reflection. (shrink)

Journal of Political Philosophy, Volume 30, Issue 2, Page 249-270, June 2022.

Journal of Economic Methodology, Volume 19, Issue 2, Page 159-163, June 2012.

The aim of this literature study was to suggest a value ground for nursing anchored in two ethical principles: the principle of human value and the right to experience a meaningful life. Previous nursing research between the years 2000 and 2009 was analysed. Presented values suggested in this value ground are thus in line with the nursing context and science of today. Statements within ethical literature have been used in order to formulate arguments aimed at supporting the values that were (...) found in the study. In the literature study six values were found: trust, nearness, sympathy, support, knowledge and responsibility. These values hold equal status and are not presented in hierarchical order. They vary due to the persons involved, nursing situations and cultural surroundings, but have the common requirement of being non-excluding. In order to implement the values within the value ground, two prerequisites are discussed and claimed as essential: ethical dialogue and a caring encounter between care provider and patients. (shrink)

Background: According to ethical guidelines, healthcare professionals should be able to provide care that allows for the patients’ values, customs and beliefs, and the existential issues that are communicated through them. One widely discussed issue is existential loneliness. However, much of the debate dealing with existential loneliness concludes that both the phenomenon and the concept are quite vague. Aim: To clarify what constitutes existential loneliness, and to describe its lived experiences. A further aim was to provide a definition of existential (...) loneliness that can function as a tool for identifying the phenomenon and for differentiating it from other kinds of loneliness. Method: A literature review including theoretical and empirical studies. Different search strategies were used to gather the articles included in the study. The analysis of the empirical studies had an interpretative approach. The articles were also analysed with the aim of providing a definition of existential loneliness. This was done by means of criteria such as language, uniqueness, theory and usefulness. This study is not empirical and does therefore not require an ethics review. Results: The analysis resulted in two main characteristics. The first one was perceiving oneself as inherently separated (disconnected) from others and from the universe. The second one brings out emotional aspects of EL, such as isolation, alienation, emptiness and a feeling of being abandoned. The empirical findings were divided into two categories: experiences of EL and circumstances in which EL arises. A definition of EL is also suggested, based on the two main characteristics identified. Conclusion: In order to meet patients’ needs, it is an ethical duty for healthcare staff to be able to recognise experiences of EL, that is, to communicate with the patients about these experiences in an appropriate manner. This in turn demands knowledge about existential issues and skills to deal with them. (shrink)

Social-emotional competences are critical for positive development and significantly predict educational and occupational attainment, health, and well-being. There is however a lack of consensus about the number of core competences, and how these are defined and operationalized. This divergence in approach challenges future research as well as the scientific usefulness of the construct. In an effort to create an integrative framework, this focused review evaluates different approaches of conceptualizing and assessing social-emotional competences. Building on shared conceptions, an integrative taxonomy “DOMASEC” (...) is introduced, specifying core domains and manifestations of social-emotional competences that bridge across frameworks focusing on social and emotional learning, personality traits and self-determination theory. Core domains include intrapersonal, interpersonal and task-oriented competencies, differentiating between affective, cognitive, and behavioral manifestations of competences across these domains. It is argued that the integrative taxonomy facilitates the conceptual specification of key constructs, that it helps to better organize the multitude of terms and definitions used, and to guide the conceptualization and operationalization of social-emotional competences and their various facets. (shrink)

During the past decade, screening tests using computed tomography have disseminated into practice and been marketed to patients despite neither conclusive evidence nor professional agreement about their efficacy and cost-effectiveness at the population level. This phenomenon raises questions about physicians' professional roles and responsibilities within the setting of medical innovation, as well as the appropriate scope of patient autonomy and access to unproven screening technology. This article explores how physicians ought to respond when new screening examinations that lack conclusive evidence (...) of overall population benefit emerge in the marketplace and are requested by individual patients. To this end, the article considers the nature of evidence and how it influences decision-making for screening at both the public policy and individual patient levels. We distinguish medical and ethical differences between screening recommended for a population and screening considered on an individual patient basis. Finally, we discuss specific cases to explore how evidence, patient risk factors and preferences, and physician judgment ought to balance when making individual patient screening decisions. (shrink)

This article is based on an empirical study regarding ethical challenges in intercultural nursing. The focus is on autonomy and disclosure. Autonomy is a human capacity that has become an important ethical principle in nursing. Although the relationship between autonomy and patients’ possibly harmful choices is discussed, the focus is on ‘forced’ autonomy. Nurses seem to equate respect with autonomy; it seems to be hard to cope with the fact that there are patients who voluntarily undergo treatment but who actively (...) participate neither in the treatment offered nor in making choices regarding that treatment. Nurses’ demand for patients to be autonomous may in some cases jeopardize the respect, integrity and human worth that the ethical principle of autonomy is meant to ensure. Even though respect for a person’s autonomy is also respect for the person, one’s respect for the person in question should not depend on his or her capacity or aptitude to act autonomously. Is autonomy necessarily a universal ethical principle? This article negates this question and, through the issues of culture, individualism versus collectivism, first- and second- order autonomy, communication and the use of family interpreters, and respect, an attempt is made to explain why. (shrink)

We show how one can obtain solutions to the Arzelà‐Ascoli theorem using suitable applications of the Bolzano‐Weierstraß principle. With this, we can apply the results from and obtain a classification of the strength of instances of the Arzelà‐Ascoli theorem and a variant of it. Let be the statement that each equicontinuous sequence of functions contains a subsequence that converges uniformly with the rate and let be the statement that each such sequence contains a subsequence which converges uniformly but possibly without (...) any rate. We show that is instance‐wise equivalent, over, to the Bolzano‐Weierstraß principle and that is instance‐wise equivalent, over, to, and thus to the strong cohesive principle (). Moreover, we show that over the principles, and are equivalent. (shrink)