I survey four categories of factors that might give a digital mind, such as an upload or an artificial general intelligence, an advantage over humans. Hardware advantages include greater serial speeds and greater parallel speeds. Self-improvement advantages include improvement of algorithms, design of new mental modules, and modification of motivational system. Co-operative advantages include copyability, perfect co-operation, improved communication, and transfer of skills. Human handicaps include computational limitations and faulty heuristics, human-centric biases, and socially motivated cognition. The shape of hardware (...) growth curves, as well as the ease of modifying minds, are found to have a major impact on how quickly a digital mind may take advantage of these factors. (shrink)

We present a hypothetical process of mind coalescence, where arti cial connections are created between two or more brains. This might simply allow for an improved form of communication. At the other extreme, it might merge the minds into one in a process that can be thought of as a reverse split-brain operation. We propose that one way mind coalescence might happen is via an exocortex, a prosthetic extension of the biological brain which integrates with the brain as seamlessly as (...) parts of the biological brain integrate with each other. An exocortex may also prove to be the easiest route for mind uploading, as a person's personality gradually moves away from the aging biological brain and onto the exocortex. Memories might also be copied and shared even without minds being permanently merged. Over time, the borders of personal identity may become loose or even unnecessary. (shrink)

Background: The ethics and value bases in healthcare are widely acknowledged. There is a need to improve and raise awareness of ethics in complex systems and in line with competing needs, different stakeholders and patients’ rights. Evidence-based strategies and interventions for the development of procedures and practice have been used to improve care and services. However, it is not known whether and to what extent ethics can be developed using interventions. Objectives: To examine ethics interventions conducted on healthcare professionals and (...) healthcare students to achieve ethics-related outcomes. Research design: A systematic review. Methods: Five electronic databases were searched: CINAHL, the Cochrane Library, Philosopher’s Index, PubMed and PsycINFO. We searched for published articles written in English without a time limit using the keywords: ethic* OR moral* AND intervention OR program OR pre-post OR quasi-experimental OR rct OR experimental AND nurse OR nursing OR health care. In the four-phased retrieval process, 23 full texts out of 4675 citations were included in the review. Data were analysed using conventional content analysis. Ethical consideration: This systematic review was conducted following good scientific practice in every phase. Findings: It is possible to affect the ethics of healthcare practices through professionals and students. All the interventions were educational in type. Many of the interventions were related to the ethical or moral sensitivity of the professionals, such as moral courage and empowerment. A few of the interventions focused on identifying ethical problems or research ethics. Conclusion: Patient-related outcomes followed by organisational outcomes can be improved by ethics interventions targeting professionals. Such outcomes are promising in developing ethical safety for healthcare patients and professionals. (shrink)

This article addresses the ‘Indirection Problem’ in Sartrean ethics of authenticity and compares it to the problem of the same name in virtue ethics. Both ethical frameworks encounter a disharmony between core concepts and proper motivation. The article reviews the indirection problem in virtue ethics, highlighting Swanton's solution of defining virtues as promoting specific values. It then explores how Sartrean ethics faces a more profound indirection problem due to the elusive nature of its core concept—authenticity. The motivation for authenticity cannot (...) be its rationale (salvation). Freedom seems to be a more direct value, but the desire for freedom itself risks falling into being yet another pursuit of being. The article advocates a radically negative motivation for authenticity—a resignation from futile, inauthentic projects. (shrink)

This essay is a critical analysis of some themes in Wittgenstein’s later philosophy. It is not primarily Wittgenstein-exegesis. Much more modestly, my purpose is to express my own thoughts about some questions which Wittgenstein has treated in his writings. It is the first in a series of two articles. The second article, “Remarks on Wittgenstein’s Philosophy: Philosophical Method and Contradictions”, will occur in next year’s issue of the present YEARBOOK. Section 1, “The Private Language Argument”. An independent argument is given (...) for Wittgenstein’s thesis that there is no private language. I show that psychological terms in ordinary language, in contrast to an implication of Wittgenstein’s own private language argument, in their meanings do contain references to inner states, processes, or events. Section 2, “Meaning”. Wittgenstein’s definition of meaning as use in the language is criticised. Meaning is instead identified with something in the content of a conscious mind. Applications are given to some suggestions in philosophy of language by Chomsky, Grice, Harman and Fodor, and Kripke. For orientation, I also include here the abstract for the second article, “Remarks on Wittgenstein’s Philosophy: Philosophical Method and Contradictions”. Section 1, “Philosophical Method”. Wittgenstein’s conception of philosophy as language therapy is criticised. Instead philosophy is construed as foundational research. Wittgenstein’s statement that mathematical logic cannot contribute to progress in philosophy is repudiated. Several examples of ideas and results in mathematical logic which have led to the solution of philosophical problems are given. Section 2, “Contradictions: The Wittgenstein-Turing Debate”. In lectures on the foundations of mathematics given in 1939, Wittgenstein claimed that contradictions in mathematical theories are harmless. A debate ensued on this question between him and Alan Turing. In support of Turing’s standpoint, I use the theorem on Taylor series, Church’s Theorem, and Gentzen’s Cut-Elimination Theorem to show that Wittgenstein’s standpoint is untenable. (shrink)

Eight derivations of Bell’s inequality are given. First a simple and concrete derivation is given drawing on the full strength of the two hypotheses of locality and hidden variables. Two attempts at deriving Bell’s inequality without locality are made. They fail, but give valuable insight into the form which nonlocality must take in quantum physics. Arguments are given against this form of nonlocality. Ontological ideas which allow separation, realism, and locality in quantum mechanics are indicated. In the following five derivations, (...) a number of variants of the assumption of hidden variables are tried. Among the insights which these derivations give rise to are: Particles cannot be assumed to have spin or polarisation values for as much as one fixed direction. The classical picture of electromagnetic radiation is incompatible with QM. Heisenberg’s idea of potentiality in elementary particles is incompatible with QM. There is a weakest form of hidden variables, called realisability, which is sufficient to yield Bell’s inequality. Quantum states cannot be identified with physical states. The mathematical problem of the integration of quantum states into physical states is nontrivial. (shrink)

Pregnancy has been traditionally defined as the period during which developing embryos are incubated in the body after egg–sperm union. Despite strong similarities between viviparity in mammals and other vertebrate groups, researchers have historically been reluctant to use the term pregnancy for non‐mammals in recognition of the highly developed form of viviparity in eutherians. Syngnathid fishes (seahorses and pipefishes) have a unique reproductive system, where the male incubates developing embryos in a specialized brooding structure in which they are aerated, osmoregulated, (...) protected and likely provisioned during their development. Recent insights into physiological, morphological and genetic changes associated with syngnathid reproduction provide compelling evidence that male incubation in these species is a highly specialized form of reproduction akin to other forms of viviparity. Here, we review these recent advances, highlighting similarities and differences between seahorse and mammalian pregnancy. Understanding the changes associated with the parallel evolution of male pregnancy in the two major syngnathid lineages will help to identify key innovations that facilitated the development of this unique form of reproduction and, through comparison with other forms of live bearing, may allow the identification of a common set of characteristics shared by all viviparous organisms. BioEssays 29:884–896, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Due to the potential ethical and psychological implications of screening, and especially inregard of screening on children without available and acceptable therapeutic measures, there is a common view that such procedures are not advisable. As part of an independent research- and bioethical case study, our aim was therefore to explore and describe bioethical issues among a representative sample of participant families (n = 17,055 children) in the ABIS (All Babies In South-east Sweden) research screening for Type 1 diabetes (IDDM).The primary (...) aim is the identification of risk factors important for the development of diabetes and other multifactorial immune-mediated diseases. Four hundred, randomly chosen, participant mothers were asked to complete a questionnaire exploring issues of information, informed consent, bio-material, confidentiality and autonomy, and of prevention/intervention. 293 completed the questionnaire, resulting in a response rate of 73.3%. The majority of questions had the form of 6-point Likert-type response scales (1–6).We found that the majority of respondents felt calm in regard of samples and written material, and also concerning the possibility of their child in the future being identified as having high risk of developing Type 1 diabetes. An important finding concerning access and control of mainly biological data was indicated, with the respondents expressing concern for potential future use. We believe our findings indicate that this kind of empirical studies can substantially contribute to our understanding of bioethical issues of medical research involving genetics. Issues, such as safeguards ensuring theethical criteria of autonomy and respect, were emphasised by our respondents. We believe theissues brought up may promote further discussion, and do suggest issues for consideration by, among others, researchers, bioethicists and Institutional Review Boards. (shrink)

Background: Exploring the concept of ethical competence in the context of healthcare is essential as it pertains to better quality of care. The concept still lacks a comprehensive definition covering the aspects of ethical expertise, ethical knowledge and action of a health professional. Objective: This article aims to report an analysis of the concept of ethical competence. Method: A modified strategy suggested by Walker and Avant was used to analyse the concept. Results: As a result, the concept of ethical competence (...) can be defined in terms of character strength, ethical awareness, moral judgement skills and willingness to do good. Virtuous professional, experience of a professional, human communication, ethical knowledge and supporting surroundings in the organisation can be seen as prerequisites for ethical competence. Ethical competence results in the best possible solutions for the patient, reduced moral distress at work and development and democratisation of society. Conclusion: The results of the analysis establish a basis for an instrument to evaluate health professionals’ ethical competence. It will guide educators, as well as managers in healthcare, to support the development of ethical conduct in healthcare. (shrink)

A class of probability functions is studied. This class contains the probability functions of half-spin particles and spinning classical objects. A notion of realisability for these functions is defined. In terms of this notion two versions of Bell's theorem and their inverses are stated and proved.

I formulate the Zermelo-Russell paradox for naive set theory. A sketch is given of Zermelo’s solution to the paradox: the cumulative type structure. A careful analysis of the set formation process shows a missing component in this solution: the necessity of an assumed imaginary jump out of an infinite universe. Thus a set is formed by a suitable combination of concrete and imaginary operations all of which can be made or assumed by a Turing machine. Some consequences are drawn from (...) this improved analysis of the concept of set, for the theory of sets and for the philosophy and foundations of mathematics. (shrink)

This essay is a critical analysis of some themes in Wittgenstein’s later philosophy. It is not primarily Wittgenstein-exegesis. Much more modestly, my purpose is to express my own thoughts about some questions which Wittgenstein has treated in his writings. It is the second in a series of two articles. The first article, “Remarks on Wittgenstein’s Philosophy: Private Language and Meaning", was published in Volume 42, 2007, of the present YEARBOOK. Section 1, “Philosophical Method”. Wittgenstein’s conception of philosophy as language therapy (...) is criticised. Instead philosophy is construed as foundational research. Wittgenstein’s statement that mathematical logic cannot contribute to progress in philosophy is repudiated. Several examples of ideas and results in mathematical logic which have led to the solution of philosophical problems are given. Section 2, “Contradictions: The Wittgenstein- Turing Debate”. In lectures on the foundations of mathematics given in 1939, Wittgenstein claimed that contradictions in mathematical theories are harmless. A debate ensued on this question between him and Alan Turing. In support of Turing's standpoint, I use the theorem on Taylor series, Church's Theorem, and Gentzen’s Cut-Elimination Theorem to show that Wittgenstein’s standpoint is untenable. For orientation, I also include here the abstract for the first article in the series, “Remarks on Wittgenstein’s Philosophy: Private Language and Meaning”. Section 1, “The Private Language Argument”. An independent argument is given for Wittgenstein’s thesis that there is no private language. I show that psychological terms in ordinary language, in contrast to an implication of Wittgenstein’s own private language argument, in their meanings do contain references to inner states, processes, and events. Section 2, “Meaning”. Wittgenstein’s definition of meaning as use in the language is criticised. Meaning is instead identified with something in the content of a conscious mind. Applications are given to some suggestions in the philosophy of language by Chomsky, Harman and Fodor, Grice, and Kripke. (shrink)

Linking arbitrary shapes to personal labels or reward values results in immediate processing benefits for those stimuli that happen to be associated with the self or high rewards in perceptual matching tasks. Here we further explored how social and reward associations interact with multisensory stimuli by pairing labels and objects with tones. We also investigated whether self and reward biases persist for multisensory stimuli with the label removed after an association had been made. Both high reward stimuli and those associated (...) with the self, resulted in faster responses and improved discriminability, which persisted for multisensory stimuli even when the labels were removed. However, these self- and reward-biases partly depended on the specific alignment between the physical tones and the conceptual order. Performance for reward associations improved when the endpoints of low or high rewards were paired with low or high tones; meanwhile, for personal associations, there was a benefit when the self was paired with either low or high tones, but there was no effect when the stranger was associated with either endpoint. These results indicate that, unlike reward, social personal associations are not represented along a continuum with two marked endpoints but rather with a single reference point. (shrink)

The aim of the study was to report the results of a systematically conducted literature review of empirical studies about healthcare organizations’ ethics and management or leadership issues. Electronic databases MEDLINE and CINAHL yielded 909 citations. After a two stage application of the inclusion and exclusion criteria 56 full-text articles were included in the review. No large research programs were identified. Most of the studies were in acute hospital settings from the 1990s onwards. The studies focused on ethical challenges, dilemmas (...) in practice, employee moral distress and ethical climates or environments. Study samples typically consisted of healthcare practitioners, operational, executive and strategic managers. Data collection was mainly by questionnaires or interviews and most of the studies were descriptive, correlational and cross-sectional. There is need to develop conceptual clarity and a theoretical framework around the subject of organizational ethics and the breadth of the contexts and scope of the research needs to be increased. (shrink)

Moral injury emerged in the healthcare discussion quite recently because of the difficulties and challenges healthcare workers and healthcare systems face in the context of the COVID-19 pandemic. Moral injury involves a deep emotional wound and is unique to those who bear witness to intense human suffering and cruelty. This article aims to synthesise the very limited evidence from empirical studies on moral injury and to discuss a better understanding of the concept of moral injury, its importance in the healthcare (...) context and its relation to the well-known concept of moral distress. A scoping literature review design was used to support the discussion. Systematic literature searches conducted in April 2020 in two electronic databases, PubMed/Medline and PsychInfo, produced 2044 hits but only a handful of empirical papers, from which seven well-focused articles were identified. The concept of moral injury was considered under other concepts as well such as stress of conscience, regrets for ethical situation, moral distress and ethical suffering, guilt without fault, and existential suffering with inflicting pain. Nurses had witnessed these difficult ethical situations when faced with unnecessary patient suffering and a feeling of not doing enough. Some cases of moral distress may turn into moral residue and end in moral injury with time, and in certain circumstances and contexts. The association between these concepts needs further investigation and confirmation through empirical studies; in particular, where to draw the line as to when moral distress turns into moral injury, leading to severe consequences. Given the very limited research on moral injury, discussion of moral injury in the context of the duty to care, for example, in this pandemic settings and similar situations warrants some consideration. (shrink)

The aim of this review was to analyse the empirical studies that focus on ethics in nursing care for older people, scoping the need and areas for further study. A search of the MEDLINE and CINAHL databases (earliest to August 2009) was conducted using the the keywords: ethic* and nursing or care or caring and elderly or aged or older. After a four-stage process, 71 empirical articles were included in the review, with informants ranging from elderly people to relatives, caregivers, (...) managers and students in care settings. The review focusses on the concepts, contexts, methods and validity of these studies. Based on the analysis, the reviewed research seems to be fragmented and multifaceted, focussing on selected issues such as autonomy, self-determination and informed consent. No large research programs or research traditions were found so it was not possible to draw any conclusions about suitable methods, study designs or instruments of measurement for use in this research area. (shrink)

Ethics is a foundational competency in healthcare inherent in everyday nursing practice. Therefore, the promotion of qualified nurses’ and nursing students’ moral competence is essential to ensure ethically high-quality and sustainable healthcare. The aim of this integrative literature review is to identify the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence. The review has been registered in PROSPERO (CRD42023386947) and reported according to the PRISMA guideline. Focusing on qualified nurses’ and nursing students’ moral competence, a (...) literature search was undertaken in January 2023 in six scientific databases: CINAHL, Cochrane Library, PsycINFO, PubMed Medline, Scopus and Web of Science. Empirical studies written in English without time limitation were eligible for inclusion. A total of 29 full texts were retrieved and included out of 5233 citations. Quality appraisal was employed using Joanna Briggs Institute checklists and the Mixed Method Appraisal Tool. Data were analysed using inductive content analysis. Research about the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence is limited and mainly explored using descriptive research designs. The contributing factors were identified as comprising two main categories: (1) human factors, consisting of four categories: individual, social, managerial and professional factors, and ten sub-categories; and (2) structural factors, consisting of four categories: educational, environmental, organisational and societal factors, and eight sub-categories. This review provides knowledge about the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence for the use of researchers, nurse educators, managers, organisations and policymakers. More research about the contributing factors is needed using complex intervention, implementation and multiple methods designs to ensure ethically sustainable healthcare. (shrink)

Background: The exploration of the ethical climate in the care settings for older people is highlighted in the literature, and it has been associated with various aspects of clinical practice and nurses’ jobs. However, ethical climate is seldom studied in the older people care context. Valid, reliable, feasible measures are needed for the measurement of ethical climate. Objectives: This study aimed to test the reliability, validity, and sensitivity of the Hospital Ethical Climate Survey in healthcare settings for older people. Design: (...) A non-experimental cross-sectional study design was employed, and a survey using questionnaires, including the Hospital Ethical Climate Survey was used for data collection. Data were analyzed using descriptive statistics, inferential statistics, and multivariable methods. Participants and research context: Survey data were collected from a sample of nurses working in the care settings for older people in Finland (N = 1513, n = 874, response rate = 58%) in 2011. Ethical considerations: This study was conducted according to good scientific inquiry guidelines, and ethical approval was obtained from the university ethics committee. Results: The mean score for the Hospital Ethical Climate Survey total was 3.85 (standard deviation = 0.56). Cronbach’s alpha was 0.92. Principal component analysis provided evidence for factorial validity. LISREL provided evidence for construct validity based on goodness-of-fit statistics. Pearson’s correlations of 0.68–0.90 were found between the sub-scales and the Hospital Ethical Climate Survey. Discussion: The Hospital Ethical Climate Survey was found able to reveal discrimination across care settings and proved to be a valid and reliable tool for measuring ethical climate in care settings for older people and sensitive enough to reveal variations across various clinical settings. Conclusion: The Finnish version of the Hospital Ethical Climate Survey, used mainly in the hospital settings previously, proved to be a valid instrument to be used in the care settings for older people. Further studies are due to analyze the factor structure and some items of the Hospital Ethical Climate Survey. (shrink)

Background: Identifying and safeguarding ethics in eHealth services from the service users’ perspective in social care and healthcare is important. The use of eHealth services should not prejudice the quality of services or the social interaction required in care. There is a lack of studies about the ethics of eHealth services from the service users’ perspective. Aim: The aim of this study is to identify and analyse ethical issues related to eHealth in social care and healthcare from the service users’ (...) perspective. Research design: An integrative literature review. Ethical considerations: The review followed good scientific conduct. Research context and data sources: A systematic literature search was performed using CINAHL, Scopus, PubMed/MEDLINE, Web of Science, Cochrane Library and Academic Search Premier to find relevant empirical studies published in English from their earliest up to 30 November 2018. In addition, reference lists from the identified research papers were searched. A quality appraisal of each paper included in the review was conducted before thematic analysis. Results: In total, 26 studies were included in the review, and from these four ethical themes were identified: (1) privacy in eHealth, (2) beneficence and nonmaleficence in eHealth, (3) justice in eHealth and (4) trust in eHealth. The ethical issues within these themes were related to information sharing; ownership; access to information and data protection; informed consent; defence of rights; and equity, equality and proportionality of response. Conclusion: eHealth inequality occurs in social care and healthcare. eHealth service designers and social care and healthcare professionals need to act to maintain and improve user access and data accuracy and provide different levels of security in eHealth services, relative to the information stored. There is a need for further research about ethical issues of eHealth from the user’s perspective, including the customer-oriented availability and usability of eHealth services which avoid discrimination. (shrink)

Background: Demographic trends indicate growth of population aged 65 and older in Western countries. One of the greatest challenges is to provide high-quality care for all. Technological solutions designed for older people, gerontechnology, can somewhat balance the gap between resources and the increasing demand of healthcare services. However, there are also ethical issues in the use of gerontechnology that need to be pointed out. Purpose: To describe what ethical issues are related to the use of gerontechnology in the care of (...) community-dwelling older people. Methods: A scoping review was performed to identify and analyse studies concerning ethical issues when using gerontechnology in the home care of older people. The literature search was limited to studies published after 1990 and addressed to the electronic databases CINAHL, PubMed, Cochrane, Medic, IEEE Explore and Web of Science. The search was performed in July−August 2018. Data from empirical studies were analysed using thematic analysis. Ethical considerations: This scoping review was conducted in accordance with good scientific practice. The work of other researchers was respected and cited appropriately. Results: A total of 17 studies were identified. Two main themes were found. ‘Balancing between the benefits of using gerontechnology and the basic rights of older people’, consisted of the subthemes safety, privacy and autonomy. The other main theme, ‘Gerontechnology as a risk of insecurity for older people’, included the subthemes fear of losing human contact and concern and fear. Surveillance and monitoring technologies were mainly studied. Conclusion: These results suggest that there may be ethical issues related to the use of gerontechnology and they must therefore be taken into consideration when implementing technology in the care of community-dwelling older people. (shrink)

The aim was to synthesize the findings of empirical research about the unmet nursing care needs of older people, mainly from their point of view, from all settings, focusing on (1) methodological approaches, (2) relevant concepts and terminology and (3) type, nature and ethical issues raised in the investigations. A scoping review after Arksey and O’Malley. Two electronic databases, MEDLINE/PubMed and CINAHL (from earliest to December 2019) were used. Systematic search protocol was developed using several terms for unmet care needs (...) and missed care. Using a three-step retrieval process, peer-reviewed, empirical studies concerning the unmet care needs of older people in care settings, published in English were included. An inductive content analysis was used to analyse the results of the included studies (n = 53). The most frequently used investigation method was the questionnaire survey seeking the opinions of older people, informal caregivers or healthcare professionals. The unmet care needs identified using the World Health Organization classification were categorized as physical, psychosocial and spiritual, and mostly described individuals’ experiences, though some discussed unmet care needs at an organizational level. The ethical issues raised related to the clinical prioritization of tasks associated with failing to carry out nursing care activities needed. The unmet care needs highlighted in this review are related to poor patient outcomes. The needs of institutionalized older patients remain under-diagnosed and thus, untreated. Negative care outcomes generate a range of serious practical issues for older people in care institutions, which, in turn, raises ethical issues that need to be addressed. Unmet care needs may lead to marginalization, discrimination and inequality in care and service delivery. Further studies are required about patients’ expectations when they are admitted to hospital settings, or training of nurses in terms of understanding the complex needs of older persons. (shrink)

Conducting nursing research in long-term care facilities and with samples of older people requires careful attention to research ethics and the ethical conduct of the study. This review analysed the research ethics of the empirical studies that focus on older people in long-term care settings as research participants. Articles (n = 66) focussing on older people in long-term care settings as research informants were retrieved from an electronic search of MEDLINE (1990 to February 2012) using the MESH terms ‘Nursing’ AND (...) ‘Long-term care’ (578 citations) and ‘Institutionalization’ and ‘Nursing’ (89 citations). Ethical approval procedure was reported in more than half of the studies (58%) and informed consent in two-thirds of the studies (70%). Ethical issues in data collection were described in most of the articles, but only a few reported ethics in problem statement, reporting or presenting implications. There is a need to focus on reporting research ethics and procedures in empirical research on vulnerable people. (shrink)

Conducting nursing research in long-term care facilities and with samples of older people requires careful attention to research ethics and the ethical conduct of the study. This review analysed the research ethics of the empirical studies that focus on older people in long-term care settings as research participants. Articles (n = 66) focussing on older people in long-term care settings as research informants were retrieved from an electronic search of MEDLINE (1990 to February 2012) using the MESH terms ‘Nursing’ AND (...) ‘Long-term care’ (578 citations) and ‘Institutionalization’ and ‘Nursing’ (89 citations). Ethical approval procedure was reported in more than half of the studies (58%) and informed consent in two-thirds of the studies (70%). Ethical issues in data collection were described in most of the articles, but only a few reported ethics in problem statement, reporting or presenting implications. There is a need to focus on reporting research ethics and procedures in empirical research on vulnerable people. (shrink)

Purpose This paper aims to formalize long-term trajectories of human civilization as a scientific and ethical field of study. The long-term trajectory of human civilization can be defined as the path that human civilization takes during the entire future time period in which human civilization could continue to exist. -/- Design/methodology/approach This paper focuses on four types of trajectories: status quo trajectories, in which human civilization persists in a state broadly similar to its current state into the distant future; catastrophe (...) trajectories, in which one or more events cause significant harm to human civilization; technological transformation trajectories, in which radical technological breakthroughs put human civilization on a fundamentally different course; and astronomical trajectories, in which human civilization expands beyond its home planet and into the accessible portions of the cosmos. -/- Findings Status quo trajectories appear unlikely to persist into the distant future, especially in light of long-term astronomical processes. Several catastrophe, technological transformation and astronomical trajectories appear possible. -/- Originality/value Some current actions may be able to affect the long-term trajectory. Whether these actions should be pursued depends on a mix of empirical and ethical factors. For some ethical frameworks, these actions may be especially important to pursue. (shrink)

Occupational Health Nursing (OHN) has followed a complex path to build and strengthen its theoretical basis. Starting with Public Health core principles, theories were shaped by the dualism of person worker and working environment, where sometimes the centre of the thought was given to the latter and other times to the former. The problem was not much on such conflict but on the definition of the correct OHN focus and whether genuine nursing knowledge was being applied. We are worried that (...) other disciplines radically influenced the theoretical path taken by OHN theorists. To approach this problem, a unitary‐transformative perspective can help us describe and analyse this phenomenon and engage scholars to reflect upon the accurate epistemological focus of OHN. We aimed to deepen this reflection and uncover a new OHN theoretical focus. (shrink)