Diverse leadership in information and communication technology can be defined as an approach to empower digital innovation. Digital innovation is a key driver of digital and business transformation. This process demands human transformation to complement business transformation in order to achieve long term sustainability. Changing the culture, fostering an inclusive mindset and guaranteeing diversity are challenging yet foundational elements in building a legacy and require inclusive digital ethics leadership. Our society needs to undergo disruptive and transformative changes in order to (...) adapt to exponential technological advances in the educational, professional, cultural and governance fields. The digital era holds great potential for increased inclusion, reduction or even closure of the „Gender Leadership Gap “in all industries, especially in the Construction and IT industry, Research and Development sectors, as well as in Academia where women are still underrepresented. This article analyzes how diverse leadership in ICT is a moral imperative for our society, emphasizes the need to recalibrate and reshape our approach and highlights the benefits of leveraging women’s potential in the social, digital and business transformation arenas. This article aims to fill an ‘ethical vacuum’ brought to light by the emerging technologies` revolution, focuses on both ethical and data governance aspects in digital innovation and offers approaches to answer how diverse leadership can contribute towards avoiding gender bias, optimizing inclusion and further improve crucial digital ethics aspects in data-driven technologies - such as algorithmic bias, fairness, transparency in AI. (shrink)

Background: Studies from Western countries show that doctors working in neonatal intensive care units find withdrawal of treatment to be their most difficult ethical dilemma. There is less knowledge of how this is experienced in other economic, cultural, religious and educational contexts.Objectives: To explore and describe how Indian doctors experience ethical dilemmas concerning the withdrawal of treatment among critically sick and/or premature neonates.Method: Qualitative data from interviews was analysed according to Giorgi's phenomenological approach. The subjects were 14 doctors with various (...) levels of neonatal experience, recruited from two state‐owned NICUs in India. Main outcome measures: description reflecting the nature of ethical dilemmas and how they are experienced.Results: All doctors reported situations where the question of withdrawal of treatment was experienced as the worst part of their job. They felt that they lacked training in how to handle such dilemmas, and some had never talked about ethics before. They were especially concerned about non‐medical considerations that do not feature in current treatment guidelines. In describing their personal experiences, the informants mentioned their sense of responsibility in situations where they were aware that their decisions would influence a family's economy and reputation, availability of food and education for siblings, other children's access to equipment in the unit, and the use of resources in an underprivileged population. Sometimes lack of resources, usually ventilators, forced them to make decisions about which babies should get the chance to live. Other reported dilemmas included difficulties co‐operating with uneducated and poor parents.Conclusion: While Western doctors seem to focus on the rights and problems of the individual child, Indian doctors tend to refer to consequences for other children, for parents and society. There is a need for further research in this field, and for the development of guidelines on how to cope with differences in resources, and how to handle different patient groups’ cultural and religious concerns. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Expose of a BreakdownIngrid HindellIregard my pension as a social wage, and even though I wish it took my disability and the extra costs that brings into consideration, eighteen years ago, I felt privileged to be able to work in the community, not in a sheltered workshop.At this time, a number of us worked voluntarily for numerous little organizations when the government cut their funding and in effect, took (...) away our jobs.It was around this time that I started a “stress cough.” Foolishly, I didn’t take much notice. I was enjoying “life”—studying, working, taking part in a documentary called “Untold Desires” and being a member of the “Friendship Group”—in which a group of us tackled the subject and nature of friendship for people with and without disabilities....The processes and the cohesion of the group brought up a lot of “stuff” for me that I wasn’t able to articulate. It made me question the wisdom of my lifestyle up to then—of marrying a person without a physical disability, for example.My mother used to tell me to tell him to tidy the flat, not in the least realizing that: i) it was distressing that I couldn’t do this; ii) that given all our interests it was difficult to tidy up. (This situation was also not helped, I now realize, by us trying to live and run home businesses from my small three–roomed accommodation behind my parent’s home, without enough support worker hours....)The flat was always cluttered, not conducive to encouraging a feeling of ease in us bringing clients onto the premises. As Robert’s massage workload grew, so did our underlying tension, I see now. And when I was starting to counsel other people with disabilities the situation was made worse....Added to this, my mother had, just prior to this period in our lives, stopped giving us our main meal because we were becoming more and more interested in eating organic and vegetarian food.At the same time, listening to other group members’ stories made me realize how “undervalued” people with disabilities are in society as I had been brought up in a loving extended family and had not long been “out.”It made me realize how much people with disabilities were constrained by lack of governmental funding for recreational—especially relationship options—with each other and with able–bodied people. The government was trying to close down little advocacy organizations that could keep this issue in the forefront of policy makers’ minds. No wonder I was getting close to breaking point! [End Page E1]When I got really bad, my husband almost went mad himself trying to cope with me. I had been the outgoing partner in the relationship for the past 12 years. Now I was getting panic attacks and clinging like poison ivy....And the therapists I went to at that stage didn’t help. The Naturopath was so expensive she made me much worse. She had told a “friend” of Rob’s that she would treat me for $30.00 a time. She did not say that she would present me with an ever– increasing bill every time I had an appointment—to pay her back when I could! And that her admin assistant would keep commenting, in my hearing, that people wouldn’t pay their bills on time.... At last, when the amount got to $450.00, I paid her all my savings, and managed to quit.I now also believe she treated me with a totally inappropriate therapy—colonic irrigation—for far too long, any natural therapist would say nowadays—five weeks!I believe it made my mental state worse. People say that an unquiet mind can stress the body into illness but I believe losing too much weight too fast as I certainly did, stressed my mind, instead of other way around.By this time I wasn’t only having panic attacks. I had slipped into, what I recently discovered, was a clinical depression. This brought in its wake, a terror so real, so all encompassing that I wonder I lived through a day of it—much less four... (shrink)

If, as argued in some simulationist accounts, empathy aims at grasping the phenomenal richness of the other’s experience and resonating with it, it is difficult to explain our empathy with emotions that we have never experienced ourselves. According to a long philosophical tradition, imagination is constrained by experience. We have to be acquainted with the qualitative feel of the other’s experience in order to imagine it. A critical view of simulationist accounts would claim that if we cannot imagine how the (...) other feels because we are not acquainted with it, empathy cannot take place. Contrary to such criticism, this paper takes a moderately optimistic view of the simulationist claim. It develops a model to explain how we imagine the other’s emotions by drawing on phenomenal concepts, affective memories, and imaginative scaffoldings. I argue that this model can explain how we empathize with the other’s emotions regardless of whether these are familiar or novel to us. However, in the latter case, the imagined phenomenal quality is not identical but probably only similar to the other’s emotion. This similarity suffices for us to speak about empathy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Right HeartIngrid GouldI remarked to a friend, “We haven’t spoken since my arrest!” Alarm and confusion clouded his face, given my half-century of squeaky-clean living. “Cardiac arrest,” I clarified. “The fire department rebooted me.”An electrophysiologist diagnosed Arrhythmogenic Right Ventricular Dysplasia, prescribed medication, and implanted a defibrillator. For the next three-and-a-half years, he helped me live with a disease I didn’t know existed until he told me I had (...) it.The disease progressed—an ironic, disease-centric term since its advancement was to my detriment— prompting my cardiologist to recommend seeing someone who specialized in heart failure. I resisted the very idea of heart failure, a terrible term for a struggling organ, but took her advice and scheduled an appointment.The new cardiologist urged transplant testing, a lengthy process. I agreed, figuring that by the time I needed a new heart in 15–20 years, they’d be rolling off 3D printers.To record occasional transplant musings and inchoate fears and perhaps, over time, untangle them, I began journaling. I chronicled my passage through the echocardiogram, heart catheterization, 31 tubes of bloodwork, interviews with different clinical specialties, a pulmonary function test in a machine reminiscent of Star Trek’s Transporter, and more. Testing had barely begun when my medication stopped working—a Halloween shock.I began a harsher medication, underwent an ablation, and spent six weeks in a wearable defibrillator, a vest with abundant wires, and a purse-sized battery pack that made me resemble a character in [End Page 123] the Jetsons. This attire did not bring holiday comfort or joy to the TSA1 when I flew to visit my sister. As my R-waves faded to a whisper, I swapped the vest for a second implanted defibrillator, substantially more sensitive than the first.In early 2018, we learned I had qualified for transplant listing, though I wished to get as much mileage as possible from the original engine. My cardiologist warned, “There is no Plan B—no machine, device, or medication for the long-term. You will need a transplant.” He explained that since most cardiac patients have left-heart problems, companies develop products for the left side of the heart. My problem was on the right—a tiny market. He also cautioned that a patient needs to be sick enough to warrant transplant and well enough to remain a candidate, survive the surgery, and recover.Although clinically I was ready, I was not personally ready. I felt too good to trade an excellent quality of life for the promised miserable post-transplant year. The cardiologist wisely asked if I wanted to speak with another patient. When I requested someone beyond the dreaded first year, he put me in touch with two women who had received new hearts a few years earlier and befriended each other. They soon became my invaluable mentors and cherished friends. I will never forget seeing them stride into our first meeting and thinking, “They are beautiful! They look totally normal!”By May, climbing four flights of stairs took as much effort as five used to take. Tests confirmed further deterioration and suggested I had 7–13 months of declining health before my heart would give out completely. We chose a date for hospital admission, and I started telling people outside my immediate family. Most were flabbergasted, believing heart transplants were the last hope of the desperately ill. I did not look moribund, though, apparently, I was.The eight months after my first transplant appointment let me prepare psychologically to bid farewell to my heart—the metaphor for kindness, love, and bravery in our culture—and to welcome a new organ from a generous person less medically fortunate than I.In the hospital, I met others awaiting their hearts. A sudden intimacy arises when mortal choices catapult people into a medical realm suggestive of science fiction. Add the emotional intensity that accompanies knowing your extended life comes courtesy of a person who breathes no more on this earth and you wonder how an organ recipient integrates sorrow and gratitude.Two weeks after I was hospitalized, my cardiologist informed me the wait was over... (shrink)

This chapter explores the early phenomenological accounts of Ressentiment provided by Else Voigtländer, Max Scheler, and Adolf Reinach. In particular, it examines the self-deceptive processes that lead to the “inversion of values” inherent to Ressentiment, i.e., how an object previously felt as valuable is denuded of its worth when the subject realizes that she cannot achieve it. For the comparative analysis of the three accounts, attention is paid to three crucial issues: 1) the origins of Ressentiment (etiology); 2) its place (...) in the taxonomy of the affective mind (ontology); and 3) the psychological mechanisms responsible for the inversion of value (psychology). The early phenomenological accounts are then analyzed in the light of recent accounts of Ressentiment elaborated by authors close to the phenomenological tradition. It is argued that the early phenomenological accounts provide central insights on the interrelation between affectivity and value. (shrink)

Often in our everyday lives, for instance, in decision-taking, empathizing with others, and engaging with fictions, we are able to imagine what a particular emotion feels like. This chapter analyzes the structure of these imaginings as a kind of experiential imagining. After introducing the topic (section 1), I argue that these imaginings cannot be explained exclusively by their content and that a focus on the mode of imagining is required. We not only imagine having emotions, but we also imagine them (...) experientially, and this means that we imagine feeling them (section 2). I proceed to analyze the content of such imaginings in terms of the phenomenal properties of emotions undergone from a particular subjective perspective within the imagined scenario (section 3). Next, I argue that the mode in which such emotions are experientially imagined requires other-oriented perspective-shifting and the recreation of an emotion-like state (section 4). I examine how we recreate emotion-like states in two cases: when the emotion has been previously felt (section 5) and when it has not been previously experienced (section 6). The main findings are summarized in the conclusion (section 7). (shrink)

A very basic form of experience consists in feeling energetic, vital, alive, tired, dispirited, vigorous and so on. These feelings – which I call feelings of vitality or vital feelings – constitute the main concern of this paper. My aim is to argue that these feelings exhibit a distinctive form of affectivity which cannot be explained in terms of emotions, moods, background feelings or existential feelings and to explore different paths for their conceptualization. The paper proceeds as follows. After introducing (...) the topic (sect. 1), I show that these feelings cannot be subsumed under any of the current categories of the affective mind (sect. 2). Against this backdrop, I present and critically assess Scheler’s notion of vital feelings as an alternative model for capturing their distinctive nature (sect. 3). Next, I explore varieties of vital feelings by focusing on different levels of the bodily-felt experience (sect. 4) and analyze their specific form of self-involvement (sect. 5). Finally, I conclude by showing how the study of vital feelings might contribute to phenomenological bioethics (sect. 6). (shrink)

Background: In the neonatal intensive care unit, immigrant parents may experience even greater anxiety than other parents, particularly if they and the nurses do not share a common language. Aim: To explore the complex issues of trust and the nurse–mother relationship in neonatal intensive care units when they do not share a common language. Design and methods: This study has a qualitative design. Individual semi-structured in-depth interviews and two focus group interviews were conducted with eight immigrant mothers and eight neonatal (...) intensive care unit nurses, respectively. Data analysis was based on Braun and Clarke’s thematic analytic method. Ethical considerations: Approval was obtained from the hospital’s Scientific Committee and the Data Protection Officer. Interviewees were informed in their native language about confidentiality and they signed an informed consent form. Results: Trust was a focus for mothers and nurses alike. The mothers held that they were satisfied that their infants received the very best care. They seemed to find the nurses’ care and compassion unexpected and said they felt empowered by learning how to care for their infant. The nurses discussed the mother’s vulnerability, dependency on their actions, attitudes and behaviour. Discussion: Lack of a common language created a challenge. Both parties depended on non-verbal communication and eye contact. The nurses found that being compassionate, competent and knowledgeable were important trust-building factors. The mothers were relieved to find that they were welcome, could feel safe and their infants were well cared for. Conclusion: The parents of an infant admitted to the neonatal intensive care unit have no choice but to trust the treatment and care their infant receives. Maternal vulnerability challenges the nurse’s awareness of the asymmetric distribution of power and ability to establish a trusting relationship with the mother. This is particularly important when mother and nurse do not share a verbal language. The nurses worked purposefully to gain trust. (shrink)

Next SectionBackground International and national agencies play a major role in setting HIV care-and-treatment priorities in low-income-countries. Little is known about priority setting at lower health-system levels. The objective of this article is to explore experiences of HIV priority decisions, at what levels these decisions are made and how they might influence the distribution of health benefits in a high-endemic region in Tanzania. Methods This is a qualitative study using observations, key documents and semistructured focus-group and individual interviews (43) with (...) health workers, patients and administrators at one regional and one district hospital. The analysis was based on an editing analysis style. Results Health workers did not perceive themselves as bedside rationing agents and they reported following national recommendations and felt they have little impact on important priority decisions. Health benefit distributions were largely determined by priority decisions made at a national level. External factors, such as eligibility criteria, inadequate funding and barriers to access seemed to play a major role in the actual distribution of health services and benefits in the region. Patient groups who were actually given high priority were the sickest patients, those living near a facility and those who could afford long journeys and frequent visits. Low-priority groups were those experiencing other co-morbidities or treatment failure, children, asymptomatic patients and the poorest. Conclusions/significance The interaction of priority setting across health-system levels and their impact on distribution of health outcomes in the population has been underestimated. The distributional pattern of health outcomes calls for further normative assessment. (shrink)

Drawing on insights found in both philosophy and psychology, this paper offers an analysis of hate and distinguishes between its main types. I argue that hate is a sentiment, i.e., a form to regard the other as evil which on certain occasions can be acutely felt. On the basis of this definition, I develop a typology which, unlike the main typologies in philosophy and psychology, does not explain hate in terms of patterns of other affective states. By examining the developmental (...) history and intentional structure of hate, I obtain two variables: the replaceability/irreplaceability of the target and the determinacy/indeterminacy of the focus of concern. The combination of these variables generates the four-types model of hate, according to which hate comes in the following kinds: normative, ideological, retributive, and malicious. (shrink)

Often in our everyday lives, for instance, in decision-taking, empathizing with others, and engaging with fictions, we are able to imagine what a particular emotion feels like. This chapter analyzes the structure of these imaginings as a kind of experiential imagining. After introducing the topic (section 1), I argue that these imaginings cannot be explained exclusively by their content and that a focus on the mode of imagining is required. We not only imagine having emotions, but we also imagine them (...) experientially, and this means that we imagine feeling them (section 2). I proceed to analyze the content of such imaginings in terms of the phenomenal properties of emotions undergone from a particular subjective perspective within the imagined scenario (section 3). Next, I argue that the mode in which such emotions are experientially imagined requires other-oriented perspective-shifting and the recreation of an emotion-like state (section 4). I examine how we recreate emotion-like states in two cases: when the emotion has been previously felt (section 5) and when it has not been previously experienced (section 6). The main findings are summarized in the conclusion (section 7). (shrink)

Do usual commercials elicit the full spectrum of emotions? For this perspective paper, we posit that they do not. Concepts and measures related to the adaptive functions and well-being areas of emotion research cannot simply be transferred for use in advertising research. When a commercial elicits emotions, the emotions staged in the commercial must not be directly associated with the emotions felt by consumers when exposed to those commercials. This is why “aesthetic” emotions seem more appropriate than “utilitarian” emotions in (...) advertising research, with the former generally felt more significantly than they are acted upon. Aesthetic emotions elicit limited physiological change, and they rely on the intrinsic pleasantness appraisal of commercials. Accordingly, pleasure and displeasure—as observed through expressive and subjective components of aesthetic emotion—often form the first and only step of commercial appraisal, and they are directed toward attitude formation rather than overt behaviors. Our preliminary psychophysiological study shows this by investigating the contributions of psychophysiological and self-reported measures of aesthetic emotions induced by commercials to explain attitudes toward advertisements. The results show that only two components of aesthetic emotion positively influenced attitudes toward the advertisements: expressive (measured by facial electromyography) and subjective (measured by the self-assessment manikin scale). Also, the subjective component of aesthetic emotion partially mediates the effects of the expressive components on attitudes toward the ads. Our exploratory study illustrates the relevance of focusing on aesthetic emotions in advertising research. It also shed new light on the contributions of the physiological, expressive, and subjective feelings components of aesthetic emotions in advertising effectiveness. (shrink)

Background Physicians play a fundamental role in the care of patients at the end of life that includes knowing how to accompany patients, alleviate their suffering and inform them about their situation. However, in reality, doctors are part of this society that is reticent to face death and lack the proper education to manage it in their clinical practice. The objective of this study was to explore the residents’ concepts of death and related aspects, their reactions and actions in situations (...) pertaining to death in their practice, and their perceptions about existing and necessary training conditions. Methods A qualitative approach was used to examine these points in depth based on interviews conducted with seven oncology residents. Results Participants do not have a clear concept of death and, although it is seen as a common phenomenon, they consider it an enemy to beat. The situations to which respondents react more frequently with frustration and sadness after the death of patients were when they felt emotionally involved, if they identify with the patient, in cases of pediatric patients and with patients who refuse treatment. To deal with death, participants raise barriers and attempt to become insensitive. Although residents in this study recognize the importance of training to learn how to better deal with death, it seems they are not fully invested in reaching more of it. Conclusions Participants face death in a daily basis without the necessary training, which appears to impact them more than they are willing to accept. They do not achieve their goals managing situations regarding death as well as they assume they do. Despite recognizing the need of more training and support for better coping with death, they prefer to continue to learn from their experience. Trial registration Not applicable. (shrink)

How are we able to experience values? Two sides are competing in contemporary literature: ‘Meinongians’ (represented notably by Christine Tappolet) claim that axiological properties are apprehended in emotions, while ‘Hildebrandians’ (represented in particular by Ingrid Vendrell Ferran) assert that such experiences of value (or valueceptions) are accomplished in special ‘value feelings’, and that emotions are only responses to these felt values. In this paper, I study the Husserlian viewpoint on this issue. I reveal that, contrary to what almost all (...) scholars have assumed so far, Husserl’s position is not reducible to Meinong’s and must on the contrary be regarded as an innovative and stimulating approach that helps unifying the two standard frameworks. It indeed recognizes (with Hildebrandians) the existence of non-emotional value feelings, while maintaining (with Meinongians) that originary axiological experiences are necessarily emotional. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:An Invitation to Play:A Response to Patrick Schmidt's "What We Hear is Meaning Too:Deconstruction, Dialogue, and Music"Patrice Madura Ward-SteinmanThe aims of dialogue-as-deconstruction, as described by Patrick Schmidt, are concepts I have pondered as a result of a five-week sabbatical visit to Melbourne, Australia. My research focus there was improvisation, and early in my visit I attended two concerts at the premier jazz club, Bennett's Lane. There I heard twelve (...) improvisers in a variety of ensembles, all in celebration of the seventieth birthday of their mentor, Tony Gould, who also performed. Gould is cited by John Whiteoak and Aline Scott-Maxwell as an "outstanding player who has never ceased to develop as an improviser" and who "as a pianist, records prolifically across a wide musical spectrum."1While the music was jazz, it was freer and fresher than usual. There was striking interaction among the musicians, including facial expressions that reflected genuine ecstasy, and body movement that was naturally "in sync" with the music. I began to ask many questions, including: Is Australia's jazz different from that [End Page 82] in the U.S.? Is Tony Gould's influence as a teacher the reason for the difference? What accounts for the sensation of "freshness" in this music? And why is this musical experience so gripping, both aurally and visually? Serendipitously, I discovered answers through the opportunity to respond to Schmidt's aims of dialogue-of-deconstruction. I shall illustrate how those aims, namely decentralized power and conflict, multiplicity and meaning, and mis-listening may be met in the improvising music ensemble.Decentralized Power and ConflictThe lifeblood of "free jazz" and "free improvisation" ensembles is de-centralized musical interaction, which may be considered a metaphor for dialogue-as-deconstruction. Case in point: the Tony Gould Quartet was an improvising unit with each musician contributing to the musical whole. The air was electric with each musician poised in both the anticipation of what the other might play and in the moment of creation.A recent trend in studies of organizational behavior is on "self-directed" or "self-managed" groups, as identified by Keith R. Sawyer.2 David Borgo3 explains that the characteristics of these "self-organizing systems" or "SOSs" are threefold: they operate without centralized control, they "exhibit both complex and adaptive dynamics," and they are comprised of autonomous individuals who demonstrate a high degree of connectivity. Both authors assert that an ideal SOS is the free improvising ensemble, where musical ideas are allowed to emerge and adapt, and even musical "mistakes" may be manipulated into the context, thus creating new directions in dialogue.However, SOSs have some inherent problems. For example, they are "slow to emerge.... The more complex they are, the longer it may take them to warm up: hierarchical layers have to settle down... and individual(s) have to acquaint themselves with one another."4 Borgo explained that even advanced improvisers often need to pursue a musical idea for a long while for it to achieve coherence. Philip Alperson adds: "As the number of designing intelligences increases, the greater is the difficulty in coordinating all the parts; the twin dangers of cacophony and opacity lurk around the corner."5It seems that "interactional synchrony"6 can develop among musicians who have "good chemistry" after a warm-up period, but those with conflicting personalities, aesthetic dispositions, or musical styles may have a more difficult time of it. When members of the Tony Gould Quartet were asked how they are able to achieve musical unity, they explained that they have played together for many years, they "hang out and drink together" when not on the bandstand, and they trust each other. Even when one of the members feels "out of sorts," their improvisations are respected as authentic expressions. Others' differences are honored, [End Page 83] rather than felt in opposition to one's self.7 Ingrid Monson8 quotes several musicians who use the metaphor of marriage to describe the musical relationship during a peak performance; on the other hand, jealousy, competition, and even hostility on the bandstand are not uncommon and can destroy an ensemble. So, it appears... (shrink)

Continuing medico-technical progress has led toan increasing medicalisation of pregnancy andchildbirth. One of the most common technologiesin this context is ultrasound. Based on someidentified `pro-technology feminist theories',notably the postmodernist feminist discourse,the technology of ultrasound is analysedfocusing mainly on social and political ratherthan clinical issues. As empirical researchsuggests, ultrasound is welcomed by themajority of women. The analysis, however, showsthat attitudes and decisions of women areinfluenced by broader social aspects. Furthermore, it demonstrates how the visualtechnology of ultrasound, in addition to otherreproductive technology (...) in maternity care, islinked to the `personification' of the foetusand has therefore contributed to a new image ofthe foetus. The exploration of these issueschallenges some arguments of feministdiscourse. It draws attention to possibleadverse implications of the technology forwomen's reproductive freedom and indicates theimportance of the topic for politicaldiscussions. (shrink)

Paradoxically, the practical necessity of love seems to combine the personal character of psychological necessity with the inescapable and authoritative quality of moral necessity. Traditionally, philosophers have avoided this paradox by treating love as an amalgam of impersonal evaluative judgments and affective responses. On my account, love participates in a different form of practical necessity, one characterized by a non-moral yet normative type of expectation. This expectation is best understood as a kind of second-personal address that does not support derivative (...) third-personal demands. It is revealed when we react with hurt feelings instead of resentment upon its disappointment. (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)

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

This monograph on the capability approach does two things. First, it provides an advanced introduction to the capability approach, as an account used in philosophy, as well as other disciplines. Second, it provides an account of the capability approach which is able to encompass all existing views and theories on the capability approach, including the writings on the capability approach by Martha Nussbaum and Amartya Sen.

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)

My dissertation, “Love, Self-Constitution, and Practical Necessity,” offers an interpretation of love between people. Love is puzzling because it appears to involve essentially both rational and non-rational phenomena. We are accountable to those we love, so love seems to participate in forms of necessity, commitment, and expectation, which are associated with morality. But non-rational attitudes—forms of desire, attraction, and feeling—are also central to love. Consequently, love is not obviously based in rationality or inclination. In contrast to views that attempt to (...) fit love into existing models of practical reasoning, I argue that love participates in a unique form of practical necessity, different from both moral and psychological necessity, yet bearing resemblances to each. Distinctive to this type of practical necessity is a direct appeal to another particular person that cannot be delivered in third-personal terms—that is, a non-moral yet normative type of expectation on another person. This type of expectation is predominant in loving relationships, but can also make better sense of the experiences of humor and beauty, as well as attitudes like forgiveness, gratitude, and agent-regret. I treat Immanuel Kant’s discussion of the experience of beauty in the Critique of Judgment and Christine Korsgaard’s work on self-constitution as fruitful starting points for this account of love. I conclude that our loving relationships enable us to have distinctive personal selves, and provide support for this account of love by offering a complementary theory of grief. In Part One of the dissertation, I focus on two prominent approaches to love characteristic of the sentimentalist and rationalist traditions. I begin with the work of David Hume, which treats desire (understood as something like a simple impulse or craving) as the paradigmatic mental state, and emphasizes our personal and affective dimensions. Hume has the valuable insight that loving someone affects our sense of ourselves. But Hume’s view becomes unsatisfying when he claims that love is essentially enfeebling, implying that to love is to be passive toward and readily overcome by another person. While this indicates Hume’s awareness that love involves being open and receptive to another person, the problem is that love is also a demanding attitude. Hume lacks the conceptual resources to offer a nuanced view of the self, in which we can—with one attitude—be both demanding of and vulnerable to another person. Hume’s model of a desire-based deliberative process has recently been revived in Harry Frankfurt’s discussions on love and rationality. Frankfurt, however, goes beyond Hume’s picture of the self by introducing a notion of “identification,” which he offers to make sense of our apparent ability to commit ourselves decisively to certain projects or people. I argue that active powers like identification and commitment cannot be accommodated within any basically Humean moral psychology. Such abilities, and with them the possibility of love, depend on something closer to a Kantian conception of rational agency. I next focus on the work of Kant, who provides the substantial counterpart to Humean-inspired moral theories, but is not known for his insight into our emotional lives. In the Metaphysics of Morals, Kant divides love into “practical love”—what we experience when we are morally motivated to help someone—and “pathological love”—what we experience when we feel fond of something. But in reality, we experience love neither as a mere preference for another person, nor as something that generates the kind of demands that would be binding on any rational creature. David Velleman attempts to remedy the deficiency of Kant’s dichotomy. Velleman offers a Kantian theory in which he describes love and respect as two ends of a continuum of attitudes that it is morally appropriate to have toward people. Velleman’s view has the peculiar implication that everyone deserves the love of everyone else, and I argue that this is a fatal flaw. Like Kant and Velleman, Korsgaard characterizes personal love as involving the treatment of other people as Kantian ends-in-themselves to a heightened degree. Korsgaard, though, also contends that our individual identities depend upon our personal relationships, and I take this position seriously for the remainder of the dissertation. Ultimately, however, characterizations of loving relations as subsets of moral relations can account for the authority of the demands of love, but not its particularity. The major conclusion of Part One is that any attempt to understand love primarily on a model of practical reasoning with which we are already familiar is doomed to fail. Our experience of love calls for a theory of a unique type of practical necessity. In Part Two I take seriously the possibility that love is simultaneously inescapable (in something like the way morality is supposed to be), and yet ineluctably personal. In love, we experience an engagement with a person as essentially particular, rather than as an instance of a rational agent in general. To make sense of this direct attachment to an individual, I argue that love involves distinctive forms of expectation and disappointment. When those we love let us down, they hurt our feelings, which is not a response to a failed prediction, but nor is it a reaction to a moral insult or offense. According to Peter Strawson and Stephen Darwall, second-personal moral reactive attitudes (such as resentment) always have third-personal analogues (such as indignation). In contrast, I argue that the type of hurt feelings associated with love is a second-personal reactive attitude that does not have a third-personal corollary. I take this as evidence that the expectations involved in love are not objective in the way that the moral is objective. Nor, however, is love a matter of mere preference. On my interpretation, Kant introduces this different type of expectation in the Critique of Judgment. Whereas he characterizes moral judgments as universally communicable, judgments of beauty implicitly involve only second-personal address: I appeal to your direct experience with a particular object. This provides the conceptual space for an account of love according to which it involves a uniquely second-personal form of practical necessity. I contend that the second-personal addresses we make in love are appeals to strengthen the intimacy implicit in the loving relationship, and I identify three interrelated dimensions of that intimacy. First, those we love have the standing to interpret us in a constitutive manner. We fine-tune and make determinate the character of our concerns and interests in part by accepting the interpretations provided by those we love. In that way, the people we love have the normative power to constitute who we are. Second, we share a perspective with those we love in a way that is not reducible to or derivative of our independent perspectives. Loving someone centrally involves the activity of forming concerns together, and we do this in a mode best understood on the model of playing a spontaneous game or improvising music. Finally, being loved enables us to see ourselves as distinctive and special, because the concern those who love us have for us does not track the objective merit of our characteristics. These dimensions of the intimacy that characterizes a loving relationship reveal what it is that we appeal for in love, and how we are hurt when our appeals are rebuffed. In broad terms, this dissertation advocates the recognition of a non-moral yet normative type of expectation, which is predominant in loving relationships. Humor and beauty, too, make more sense when understood in terms of this non-moral yet normative type of expectation, as they involve appeals to others that are more than mere predictions of, but less than rational demands for, a certain kind of response. Introducing this alternative notion of expectation into the discourse of moral philosophy can shed light on other common attitudes that are clearly normative, but defy translation into objective, third-personal terms. Such attitudes include certain experiences of pride and shame, apology and forgiveness, the bestowing of mercy, gratitude, agent-regret, and perhaps a basic sense of trust we have in others. Ultimately, I situate love in respect to grief, which demonstrates my theory’s ability to make sense of related dimensions of our emotional lives. The people we love and grieve over give us a sense of who we are as distinctive, particular individuals, as the three interrelated dimensions of intimacy in loving relationships reveal. Consequently, grief is best understood as a type of practical disorientation—namely, a disorientation that involves the loss of the personal self. I present my account of grief against the type of account that would draw philosophical conclusions about the nature of love and grief from empirical psychological data alone. In particular, these data indicate that we recover quickly from the deaths of loved ones, and Dan Moller draws the philosophical conclusion that those we love fulfill certain roles in our lives and are replaceable. In contrast, I contend that while we should acknowledge the truth of the objective judgment, made in the third-person, that we will likely recover after the deaths of those we love, it does not follow that we must affirm such a claim from the internal perspective of one person who loves another. As a result, the case of love and grief supports a general claim concerning the proper work of moral philosophy, which is that the understanding of ourselves gained through empirical data is not a substitute for the normative conclusions that are revealed through first-personal reflections on our relationships. (shrink)

Il est question de l'analogie et de la comparaison selon la démarche dialectique platonicienne, ainsi que des topoi empruntés aux textes anciens: la chasse, le labyrinthe, le vase, la statue intérieure que l'on doit polir, le Soleil pour désigner de manière visible le Bien, ou la caverne pour rappeler la parabole de laconnaissance, mais aussi pour évoquer le lieu de transit de l'âme. Les principaux textes utilisés sont extraits des Discours théologiques de Grégoire de Nazianze. Un passage du Traité sur (...) le Saint Esprit (149 B-C) de Basile de Césarée, cité à la fin, illustre dans un contexte un peu différent le même procédé que celui utilisé par Grégoire. Dans tous ces passages il est question de travailler le langage sous le double aspect ontologique et sémantique, afin de trouver les modalités discursives les plus appropriées à la définition de la substance divine, à la nature de l'unité divine et à la détermination du caractère spécifique des hypostases. La théologie chrétienne se sert donc des moyens de la philosophie et emprunte des figures à la rhétorique, mais se défend de toute confusion avec ces disciplines. Invente-t-elle alors un genre nouveau, le «discours théologique», sur le modèle fourni par les Cappadociens? Encore faut-il savoir si le discours pouvait être perçu au IVᵉ siècle comme un genre approprié à la théologie, ou seulement comme un contrepoint à l'exégèse et au traité: un contrepoint par lequel les Pères ne rechignent pas à faire concurrence aux Sophistes pour les besoins politiques, et subsidiairement polémiques, de l'institution nouvellement créée. (shrink)

People who make graveside promises consider themselves bound by them, which raises the question of whether a promise can morally obligate a promisor directly to a promisee who cannot acknowledge the promise. I show that it can by using the theoretical framework provided by “transaction accounts” of promising. Paradigmatically, these accounts maintain that the creation of a promissory obligation requires that the promisee consent to the promise. I extend these accounts to capture promises made by proxy and self-promises, and conclude (...) that we can make promises to absent promisees when we bear responsibility for their moral and personal development. (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)

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)

Twenty-four children (aged 5 months to 18 years) who were admitted to a university hospital were observed for a total of 135 hours with the aim of describing their degree of participation in decisions concerning their own care. Grading of their participation was made by using a 5-point scale. An assessment was also made of what was considered as optimal participation in each situation. The results indicate that children are not always allowed to participate in decision making to the extent (...) that is considered optimal. In no case was it judged that a child participated in or was forced to make a decision that was too difficult for the child. The interactions between children, parents and staff were also described in connection with discussions and decision-making processes. This showed that parents do not always support their children in difficult situations and that health care staff often inform children about what is going to happen without presenting alternatives or asking for their views. Staff may, however, find themselves facing an ethical conflict in deciding between supporting a child’s view or following hospital routine. It is of great importance that children are looked upon as potentially autonomous individuals and that staff members realize that one of their core duties is to facilitate children’s participation in decision making concerning their health care. (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)

Emprunte au domaine de la lumiere et assimile au domaine de la pensee, le diaphane designe pour Aristote, son inventeur, une nature commune a tout milieu dans lequel la vue et la visibilite des choses s'achevent en regard recepteur et en image recue du monde diurne. Car, il ne suffit pas qu'il y ait de la lumiere et du solide pour que le monde puisse etre vu dans ses couleurs et connu sous ses formes et ses especes; il faut aussi (...) qu'il y ait du diaphane, c'est-a-dire un tertium quid qui relie les choses entre elles et ouvre a travers lui la porte de la reception sensible et de l'entendement. Des lors, la notion de diaphane en vient a impregner tacitement toute la representation du monde sous son double aspect sensible et intelligible; il s'opere la une veritable mutation du physique au metaphysique. (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)

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)

The category of “former friend” is familiar, yet the nature of this relationship type remains underexplored. Aristotle, for example, poses but does not answer the question of what constitute appropriate relations between former friends. To elucidate post-friendship expectations, I promote an account of friendship according to which some of our most significant friendships participate in a type of intimacy characterized by having normative standing to interpret each other in a constitutive manner, which I call the “co-interpretation view” of friendship. Unchecked (...) powers of co-interpretation, however, invite and allow for violations of each friend’s personhood, so I draw on Kantian resources to guide the co-interpretation view and render it more plausible. These Kantian resources help to establish relevant expectations for co-interpretation between friends. This positions me to provide an account of appropriate expectations between former friends, which I analyze in three types of post-friendship circumstance: when the friendship has faded but the parties still share a general outlook; when the friendship has become damaging for the friends but not due to viciousness; and, when the friendship ruptures due to vicious behaviors. (shrink)

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)

Social enterprises are seen as innovative towards solving societal problems, but little research exists on possible negative aspects, the so‐called dark sides. In this study, the emphasis is on dark sides of social entrepreneurship, how they are managed, and how systems thinking can contribute towards managing these effects. Dark sides of social entrepreneurship can take many forms, like unethical or insincere motives and unintended outcomes like the negative impact on the well‐being of founders and employees, but they are also a (...) call for a critical reflection on the role of the government in society and the economic system social enterprises have to operate in. This paper aims to contribute to the dark side theory of social entrepreneurship by linking system archetypes to themes of dark side thereby stressing how management strategies act as balancing feedback loops to mitigate or prevent dark sides. A qualitative research was conducted by interviewing 21 respondents who play an important role in the world of social entrepreneurship in Belgium. The results show that dark sides of social enterprises manifest itself mostly in the form of trade‐offs and financial, business, and management related issues. Taking over the habits of profit‐oriented companies emerged as a new dark side element. Management strategies include anchoring goals, transparency, obtaining external views, changing the system, and above all reflection. The latter is an important first step to become aware of these issues to be able to change the negative dynamism of these dark sides. (shrink)

The aim of this study is to understand how governance mechanisms in cross-sector collaborations (CSCs) for sustainability affect value creation and capture and subsequently the survival of this organizational form. Drawing on a longitudinal, participatory, single-case study of collaborative action in the textile industry, we identify three governance mechanisms—safeguarding, bundling and connecting—that coevolve with the rising and waning of collaborative tensions and the shifting levels of action in the CSC we studied. These mechanisms aided value creation and helped facilitate private (...) value capture. We integrate these insights into a process model that visualizes the interplay between governance mechanisms of tensions and systems of value creation and capture in CSCs for sustainability. Our study contributes to the cross-sector collaboration literature by providing a dynamic and nuanced understanding of how governance mechanisms influence outcomes in CSCs for sustainability. We also add to the business model for sustainability literature by theorizing the value creation and capture system of collaborative rather than individual organizations. Our findings have important implications for policymakers who fund collaborative organizations and practitioners who manage or participate in them. (shrink)

Many older gay men experience diminished psychological well‐being (PWB) due to unique circumstances including discrimination, living with HIV, and aging through the HIV/AIDS crisis. However, there remains ambiguity as to how older gay men define and understand PWB. Our team interviewed and analyzed the accounts of 26 older (50+) self‐identifying English‐speaking men living in southwestern British Columbia, Canada. We drew on tenets of constructivist grounded theory and intersectionality to account for unique contextual considerations and power relations. Semi‐structured Zoom interviews were (...) conducted from August‐October 2022. Interview transcripts were compared to generate high‐order conceptual findings underpinned by processes understood as central to PWB. Three PWB temporal processes highlighted interlocking social and contextual circumstances intersecting with power and maturation: (1) being emotionally balanced, (2) living gratitude (3) and fully embracing self‐acceptance. Being emotionally balanced supported the affective and sustainable state of contentment, living gratitude drew from the wisdom of accrued experiences to cultivate a positive affective state inclusive to recognising social location privileges, whilst fully embracing self‐acceptance redressed the harms of anti‐gay discourses that men endured throughout their lives. The knowledge is relevant to service and resource development to deliver tailored PWB supports to older gay men. (shrink)