Background: Ethics stimulation in nursing education focuses on human, non-technical factors in a clinical reality. Simulation as a teaching method began in the 1930s with flight simulators. In the beginning of the 1990s, simulations developed further in tandem with other technological and digital inventions, including touchscreen and three-dimensional anatomical models. Medical science first used simulation as a pedagogical teaching tool. In nursing education, simulation has been used for approximately a hundred years. Teaching has mainly focused on medical-technical, patient-specific interventions and (...) their management. Objective: The objective of this study was, from a caring science didactic perspective, to deepen the understanding of ethics simulation in nursing education. Design: Qualitative design and explorative, descriptive and hermeneutic approach of an inductive character. Methods: Semi-structured face-to-face interviews in 2016–2017 with six Norwegian nursing students who were encouraged to narrate about their experiences of ethics simulation in nursing education. Ethical considerations: Informed consent was obtained from the participants. Anonymity and confidentiality regarding data material were guaranteed. Results: Interpretation of the nursing students’ narratives resulted in the following meaning units: ethical being and ethos, nursing students’ formation process, bridge-building between theory and clinical practice, and teacher and ethics simulation. Conclusion: Through ethics simulation, nursing students can obtain an increased knowledge and a sense of being able to handle difficult ethical situations. Nursing students’ values, moral actions and ethical value base offer a positive point of departure, for both theoretical and practical ethics teaching, and an awareness of the unique human being, the patient, in clinical reality. The implementation of ethics simulation needs more attention in nursing education. (shrink)

Biobanks and biospecimen collections are becoming a primary means of delivering personalized diagnostics and tailoring individualized therapeutics. This shift towards precision medicine requires interactions among a variety of stakeholders, including the public, patients, healthcare providers, government, and donors. Very few studies have investigated the role of healthcare students in biobanking and biospecimen donations. The main aims of this study were to evaluate the knowledge of senior healthcare students about biobanks and to assess the students’ willingness to donate biospecimens and the (...) factors influencing their attitudes. A cross-sectional study was conducted among senior healthcare students at King Abdulaziz University, Saudi Arabia. The data were obtained using a self-administered questionnaire in English. In addition to the respondents’ biographical data section, the questionnaire assessed the respondents’ general knowledge about biobanking, the factors influencing their willingness to donate biospecimens to biobanks and their general attitudes towards biomedical research. A total of 597 senior healthcare students were included in the study. The general knowledge score was 3.2 out of 7. Only approximately 44% and 27% of students were aware of the terms “Human Genome Project” and “biobank,” respectively. The majority of the students were willing to donate biospecimens to biobanks. Multiple factors were significantly associated with their willingness to donate, including their perceived general health, past experience with both tissue testing and tissue donation, biobanking knowledge score and biomedical research attitude score. The main reasons for students’ willingness to donate were advancement of medical research and societal benefits, whereas misuse of biospecimens and confidentiality breaches were the main reasons for a reluctance to donate. Despite their strong willingness to donate biospecimens, students exhibited a notable lack of knowledge about biobanking and the HGP. To expedite the transition towards PM, it is highly recommended to enhance healthcare curricula by including more educational and awareness programmes to familiarize students with OMICs technologies in addition to the scope of research and clinical applications. (shrink)

Background: Older people in institutional care should be allowed to live a meaningful life in a home-like environment consistent with their own free will. Research on actualisation of older people’s own free will in nursing home context is scarce. Objectives: The purpose of this study was to describe older people’s experiences of free will, its actualisation, promoters and barriers in nursing homes to improve the ethical quality of care. Research design: Fifteen cognitively intact older people over 65 years in four (...) nursing homes in Southern Finland were interviewed. Giorgi’s phenomenological method expanded by Perttula was used to analyse the data. Ethical considerations: Chief administrators of each nursing home gave permission to conduct the study. Informants’ written informed consent was gained. Findings: Older people described free will as action consistent with their own mind, opportunity to determine own personal matters and holding on to their rights. Own free will was actualised in having control of bedtime, dressing, privacy and social life with relatives. Own free will was not actualised in receiving help when needed, having an impact on meals, hygiene, free movement, meaningful action and social life. Promoters included older people’s attitudes, behaviour, health, physical functioning as well as nurses’ ethical conduct. Barriers were nurses’ unethical attitudes, institution rules, distracting behaviour of other residents, older people’s attitudes, physical frailty and dependency. Discussion: Promoting factors of the actualisation of own free will need to be encouraged. Barriers can be influenced by educating nursing staff in client-orientated approach and influencing attitudes of both nurses and older people. Conclusion: Results may benefit ethical education and promote the ethical quality of older people’s care practice and management. (shrink)

Despite the seemingly widespread agreement that racial and ethnic immigration criteria are always wrong, some cases seem potentially permissible and, in particular, do not seem to wrong either disfavored members or nonmembers. I demonstrate that an “antidiscrimination” approach to understanding when and why discrimination is wrong provides a compelling general explanation for this. The explanation’s key ingredient is the concept of global social status: many groups sharing a race or ethnicity have a social status beyond, and that can differ from, (...) their status in a particular state. (shrink)

Concerns about the unsustainability of the conventional food system have promoted interest in alternative food networks, which are typically conceptualized through their differences from conventional food networks. Real-life AFNs, however, tend to show some similarities to the conventional food system. This hybridity has caused some criticism, but also, increasingly, calls for a more open examination of AFNs. Indeed, AFNs can be seen as relational to and shaped by the prevailing food system, for example the expectations the conventional system has promoted (...) among consumers. In this paper, through a multiple case study of nine alternative food retailers, we examine the negotiation of acceptable practice in AFNs and the challenges encountered in trying to do things alternatively. We employ convention theory, which encourages a view of action as socially negotiated and situational, and acknowledges plural legitimate notions of worth in guiding and justifying actions. Our findings show a plurality of ideals in the domain of AFNs and a complex navigation between the retailers’ own expressed ideals and considerations and perceived consumer expectations. The retailers’ justification of actions highlights several areas of tension in AFN practice, helping also to understand the challenges in adopting sustainable practices. While responding to consumer expectations sometimes involved adopting more conventional practices, the retailers also challenged consumers on certain issues. Our findings also show how even market-oriented AFNs may take radically alternative courses of action. The study supports the broader argument for examining all food networks in an open way, focusing on actual sustainability outcomes. (shrink)

We present a unified approach for investigating rational reasoning about basic argument forms involving indicative conditionals, counterfactuals, and basic quantified statements within coherence-based probability logic. After introducing the rationality framework, we present an interactive view on the relation between normative and empirical work. Then, we report a new experiment which shows that people interpret indicative conditionals and counterfactuals by coherent conditional probability assertions and negate conditionals by negating their consequents. The data support the conditional probability interpretation of conditionals and the (...) narrow-scope reading of the negation of conditionals. Finally, we argue that coherent conditional probabilities are important for probabilistic analyses of conditionals, nonmonotonic reasoning, quantified statements, and paradoxes. (shrink)

The contributors to the book discuss the depth-psychological concepts of amae and wa, the Ajase complex, and the filial piety complex, underscoring the ...

We applaud Notini and colleagues for highlighting the clinical and ethical complexities of a case in which a non-binary individual desires indefinite treatment with puberty blockers.1 While we agree discontinuing treatment may cause psychological distress, we believe there are potential physical and neurocognitive harms caused by prolonged treatment that have been underestimated given the limited research conducted to date. Specifically, the impact of permanent pubertal suppression on the brain and decision-making capacity should be considered. In this context, we outline the (...) potential risks of ongoing pubertal suppression on bone and cardiovascular health, sexual and reproductive function, and brain development—all noted in the article but perhaps in an overly simplistic manner.1 First, the authors’ note OPS will almost certainly result in reduced bone density.1 Although we agree the absolute fracture risk is low in studies among older adults, there is less clarity about implications during adolescence and young adulthood when peak bone accrual occurs.2 Further, the authors propose ongoing monitoring with bone density scans, but no clear guidelines for clinicians if bone density becomes critically low—so we ask, at what point would a potential fracture risk outweigh the proposed benefits …. (shrink)

As we speak about time in the context of everyday life, we have no problem with what we mean by time. We take time as given. Different kinds of theories of development rely on the ordinary concept of time. Time is a sequence of instants, and we are moving along from the past to the future, from birth to death. Moving in time also means development. It does not take into account how a human being is in the time. It (...) flattens our view of human life and cannot describe our manifold being. According to theories of development, if a child does not behave in a certain instant as the theories expect, there must be a problem with that child or she has not developed as well as others. Heidegger uses terms like time-space, temporality and ecstases of time. The question of time is of the same kind as the question of Being. We are in the world and in time in the same way. We all have experience of time, how it sometimes goes quickly and sometimes very slowly. Time is not experienced as moments one after another. It is time-space. Time-space means that time has three dimensions and it consists of the ecstatical opening up of the future, the past and the present. In this article, I will open up the question how the traditional understanding of time and the ecstatic understanding of time understand children differently. What does it mean that little children live exclusively in the present? (shrink)

Does a liberal state, dedicated to the principles of freedom and equality, have a moral right to exclude? In her book, Liberal Self-Determination in a World of Migration, Luara Ferracioli makes a c...

Progress in psychological science can be limited by a number of factors, not least of which are the starting assumptions of scientists themselves. We believe that some influential accounts of autism rest on a questionable assumption that many of its behavioral characteristics indicate a lack of social interest – an assumption that is flatly contradicted by the testimony of many autistic people themselves. In this article, we challenge this assumption by describing alternative explanations for four such behaviors: low levels of (...) eye contact, infrequent pointing, motor stereotypies, and echolalia. The assumption that autistic people's unusual behaviors indicate diminished social motivation has had profound and often negative effects on the ways they are studied and treated. We argue that understanding and supporting autistic individuals will require interrogating this assumption, taking autistic testimony seriously, considering alternative explanations for unusual behaviors, and investigating unconventional – even idiosyncratic – ways in which autistic individuals may express their social interest. These steps are crucial, we believe, for creating a more accurate, humane, and useful science of autism. (shrink)

The rule against bias is a central tenet of English law and it also impacts on collegiate courts which typically exercise appellate/review jurisdictions over their professional or student members. This is true of the Bar Standards Board which has established the adjudicatory bodies to enforce its regulatory framework and has vested the procedure of fair trials upon the Council of the Inns of Court which is responsible for appointing the Disciplinary Tribunal panels that conduct hearings for professional misconduct. The COIC (...) has been exposed for ‘irregularities’ in the findings of guilt against barristers who have been adjudged by non-qualified judges. In R v Visitors to the Inns of Court and Ors [2014] EWCA Civ 1630, the Court of Appeal ruled that a disciplinary tribunal or a panel of visitors appointed from barristers or lay representatives outside its pool of enrolled judges would still ensure independence and guarantee freedom from outside pressure. The impugned tribunal members who were not entitled to sit nevertheless had authority to act as de facto judges. This part of the ruling reinforces the regulatory bodies inherent power to appoint its own tribunal to adjudicate and it needs a more rigorous application of natural justice principle on the part of the BSB. (shrink)

The essays in this collection, which were written by European and North American specialists, position intermediality as a praxis of interpretative analysis in order to show how intermediality challenges our notion of art. The writers examine the various intermedial relations between the arts, which may take the form of reference to another form of art, a combination of two or more forms of art or a generic transformation from one form of art to another. In such cases, an intermedial approach (...) helps us to grasp the changing relationship between the arts, which affects our reception of experience. Intermediality has profoundly changed our understanding of interdisciplinary relations, formerly examined in the field of interart studies. By introducing a medial aspect, intermediality has succeeded in making a "leap" from past practices of artistic interrelatedness to our contemporary medial age, in which literature along with other arts may be understood as a medium. This ambitious undertaking has contributed to the liberation of literature and other arts from an isolated position in the established scholarly landscape with its clear-cut borderlines between disciplines. The essays in this collection are a valuable contribution to this on-going discussion about the relationships between the arts. The variety of essays published in this collection makes it an excellent introduction to academics and university students in such disciplines as literature, music, theatre, art history and media studies. Due to its clarity - which does not sacrifice philosophical depth concerning the role of intermedial studies for several forms of art - this book will also be of interest to academics and students who are currently working at advanced level art schools. (shrink)

Jean-Paul Sartre claims in his 1945 lecture ‘Existentialism is a Humanism’ that there are two kinds of existentialism: that of Christians like Karl Jaspers, and atheistic like Martin Heidegger. Sartre's ‘spiritual master’ Heidegger had no problem with Sartre defining him as an atheist, but he had serious problems with Sartre's concept of humanism and existentialism. Heidegger claims that the essence of humanism lies in the essence of the human being. After the Enlightenment, the Western concept of man has been presented (...) in education in the form of Kantian humanistic essentialism. At least in the Finnish educational system, Kantian humanism is almost an official ideological background of all national curriculums. Is such a kind of essentialism and metaphysics plausible in our modern or postmodern times? We examine the Sartre-Heidegger controversy on humanism and the concept of man in education using Freire's humanism and Gelassenheit education as exemplars. (shrink)

Background Nursing students spend approximately half of their time in clinical practice. It is important that clinical supervisors understand nursing students’ path of learning and can support their growth and development during the different and multifaceted learning situations offered in the clinical-practice period. Objective Based on nursing students’ perspective and rooted in the didactics of caring science, to examine how a learning and constructive caring relationship between nursing students and supervisors in clinical practice can be formed. Design Qualitative and quantitative (...) concurrent triangulation design of mixed methods. Methods Focus group interviews with Finnish nursing students (n = 21) in the qualitative part of the study. In the quantitative part, a closed questionnaire with closed answers was analysed using descriptive statistics. The analysis process was conducted using inductive content analysis. Ethical considerations Ethical issues were considered throughout the research process according to ethical principles and scientific guidelines. Informed consent was obtained from the informants, confidentiality regarding the data material was guaranteed and quotations were anonymized. Results A caring relationship between nursing students and supervisors is based on mutual respect, the ethos of responsibility, motivation, willingness and professionalism. Dignity and a caring ethical approach, where nursing students feel they belong, are recognized, seen and heard enables learning and professional development. It is also significant that the supervisor’s actions and reflections are ethically defensible, equal and protect nursing students from suffering and various power relationships in clinical practice. Conclusion A good cooperative relationship and shared responsibility between the nurse education institution, which offers theory and prepares nursing students for the encounter with clinical practice and the healthcare organizations is crucial for enabling a caring relationship in clinical supervision. (shrink)

The nucleolus may represent a key stress response organelle in the nucleus following proteotoxic stress by serving as a platform for protein aggregates. Aggregation of proteins often results from insufficient protein degradation by the ubiquitin‐proteasome system (UPS), occurring in inclusion diseases, upon treatment by proteasome inhibitors (PIs) or due to various forms of stress. As the nucleolar inclusions resemble cytoplasmic aggresomes in gathering ubiquitin and numerous UPS components and targets, including cancer‐related transcription factors and cell cycle regulators (e.g. p53 and (...) cyclin D) and proteins involved in neurodegenerative diseases (e.g. ataxin‐1, Malin), these organelles are termed herein as nucleolar aggresomes. These nucleolar aggresomes contain polyadenylated RNA, and seem to be linked to defects in nuclear export. Nucleolar aggresomes have been identified in non‐neuronal cells, but prominent similarities with nuclear ubiquitin and/or ribonuclear foci detected in triplet and other repeat disease pathologies are revealed here, creating a common interest between research in cancer and neurodegeneration. (shrink)

Background The principle of respect for autonomy (PRA) is a central tenet of bioethics. In the quest for a global bioethics, it is pertinent to ask whether this principle can be applied as it is to cultures and societies that are devoid of the Western sociopolitical historical pressures that led to its emergence. Relational autonomists have argued for a more inclusive approach to patient autonomy which takes into account factors such as interdependency and social relations. However, at the outset of (...) any relational approach, it is necessary to identify underlying factors that influence patient autonomy in non-Western cultures. Objective To conduct a review of the literature to uncover the mechanisms through which social, cultural, and religious factors influence and impact the application of the PRA in healthcare decision-making in non-Western cultures and societies. Methods We conducted a systematic review through a comprehensive search of three major electronic databases of biomedical sciences. Returned citations were imported to Covidence, full texts were assessed for eligibility, included articles were thoroughly reviewed and data was synthesized. PRISMA guidelines were followed. Results Our search retrieved 590 non-duplicate results, 50 of which were included after screening and full-text eligibility checks. The included studies were predominantly qualitative in nature, with few quantitative, mixed-methods, and review studies included. Our synthesis of data identified nine key factors that influenced patients’ autonomous decision-making through cultural, social, religious, or intersectional pathways. Conclusion Two main conclusions emerge from this review. Firstly, there is a notable dearth of bioethical research examining the influence of diverse factors on patients’ inclination towards different conceptions of autonomy. Secondly, the analysis of prevalent collectivist cultures and deference of autonomy adds value to the solution-oriented relational autonomy debate. This raises questions regarding how decision-making can be truly autonomous in the presence of such large-scale factors, warranting further attention. (shrink)

This comprehensive survey of contemporary Islam provides a philosophical and theological approach to the issues faced by Muslims and the question of global secularisation. Engaging with critics of modern Islam, Shabbir Akhtar sets out an agenda of what his religion is and could be as a political entity. Exploring the views and arguments of philosophical, religious and political thinkers, the author covers a raft of issues faced by Muslims in an increasingly secular society. Chapters are devoted to the Qurâean (...) and Islamic literature; the history of Islam; Sharia law; political Islam; Islamic ethics; and political Islamâes evolving relationship with the West. Recommending changes which enable Muslims to move from their imperial past to a modest role in the power structures of todayâes society, Akhtar offers a detailed assessment of the limitations and possibilities of Islam in the modern world. Providing a vision for an empowered yet rational Islam that distances itself from both Islamist factions and Western secularism, this book is an essential read for students and scholars of Islamic studies, religion, philosophy and politics. (shrink)

What was the relationship between government and religion in Middle Eastern history? In a world of caliphs, sultans, and judges, who exercised political and religious authority? In this book, Ali Humayun Akhtar investigates debates about leadership that involved ruling circles and scholars of jurisprudence and theology. At the heart of this story is a medieval rivalry between three caliphates: the Umayyads of Cordoba, the Fatimids of Cairo, and the Abbasids of Baghdad. In a fascinating revival of Late Antique Hellenism, (...) Aristotelian and Platonic notions of wisdom became a key component of how these caliphs debated their authority as political leaders. By tracing how these political debates impacted the theological scholars and their own conception of communal guidance, Akhtar offers a new picture of premodern political authority and the connections between Western and Islamic civilizations. It will be of use to students and specialists of the premodern and modern Middle East. (shrink)

If states have the moral authority to decide their memberships by denying citizenship, I argue that they may also strip citizenship, from law-abiding members, for the same reasons. The only real difference is that when states revoke citizenship they may need to compensate people for their prior contributions, but that is not unlike what frequently occurs in divorce. Once just termination rules are established, stripping citizenship could become, like divorce, an everyday event. Partly because of this implication, we should reject (...) the membership authority of states. (shrink)

Communitarian writers argue that social identity is deeply important to individual autonomy and thus liberal societies have an obligation to recognize identity. Any liberal view that attempts to account for this charge must specify a procedure to recognize identity that also ensures that the liberal sense of autonomy is not weakened. In this article, I develop such an account. I argue that liberals must distinguish an identity that belongs to particular persons (particularized identity) from the collective form of that identity. (...) For instance, Naisha will have her own particularized way of being Indian in addition to the collective form of the culture that she shares with others. To determine which acts would be about recognizing the particularized form, I provide a counterfactual test. One major implication of the test is that special collective rights would not be endorsed. At the same time, the test is not equivalent to the liberal positions of insisting either that rights belong to individuals or that individuals are not harmed. Because identity is almost always viewed in terms of groups, valuing identity seems to be at odds with the principles of liberalism and democratic theory in which individual persons are the ultimate source of value. I show that there is a significant way to recognize identity that is harmonious with these principles. (shrink)

To understand ethical consumer choice, it should be studied from a holistic, configurational perspective. We use fuzzy-set qualitative comparative analysis (fsQCA) ( N = 715) with a randomized experiment in the context of animal welfare to examine (a) the interdependencies of factors aiding or impeding ethical choice, and (b) whether ethical choices occur differently in a loss frame than in a gain frame. We identify several alternative pathways to ethical choice and non-choice, and within these pathways, we reveal substitution effects, (...) complementarities, and contingencies, reflecting the complexities of consumer choice. Furthermore, we demonstrate how ethical choice results more easily in a loss frame, and non-choice more easily in a gain frame, but how framing can also be irrelevant in certain situations. We contribute theoretically to ethical consumer choice in general and to food choice in particular by showing how it is the interplay of several factors in complex configurations that determines whether the situation favors ethical choice or non-choice. We outline important management and policy implications of our findings. (shrink)

Most challenges to immigration restrictions have not shown that states lack a claim-right to exclude, or a moral right against outside interference to make membership decisions. And an important, unexamined aspect of the claim-right is that states have the right against interference to wrongfully exclude, or the right to do wrong when making admission decisions. A major implication of this right is that even political or economic measures to affect states’ immigration policies are off the table – significantly compromising the (...) prospect of meaningfully addressing the world’s growing refugee crisis. In the form of a reductio argument, I provide reason to reject this position. Specifically, I try to demonstrate that, in the relevant cases, a plausible moral defense for the right to wrongfully exclude can only be given for states with objectionable character – protecting the very states whose immigration policies we should be most concerned with, which is surely morally counterintuitive. (shrink)

Section 75 of the Criminal Justice Act (CJA) of 2003 overturned the principle in English law that a person cannot be retried for an offense of which he has been acquitted, recognizing advances in forensic science that uses modern analysis of DNA in adducing in evidence. The special plea of autrefois acquit can be overturned based on finding of compelling evidence after a previous acquittal of a suspect who can now be tried again for the same offense. The double jeopardy (...) arises only after a lawful acquittal or autrefois convict of the accused for the first offense and these principles have allowed exceptions to the rule against double jeopardy developed by the courts. There is an analogous rule in common law courts based on the unreasonable splitting of the case when there is a severing of indictments which overrides the bar on the accused being retried for the same offense. This paper examines the difficulty of trying a defendant fairly in the English courts when the defense has pleaded an abuse of process and there is no clear overall argument for trial. This question needs an appraisal of legal ethics in criminal courts because a retrial of the accused on the same charge breaches the autrefois acquit doctrine, and severing of an indictment can cause the fair trial process to be undermined. (shrink)

Concerns about the unsustainability of the conventional food system have brought attention to so called alternative food networks, which are widely thought to be more sustainable. However, claims made about AFNs’ sustainability have been subject to a range of criticisms. Some of them present counterevidence, while others have pointed to problematic underlying features in the academic literature and popular discourse that may hamper our understanding of AFNs’ sustainability. Considering these criticisms, together with the fact that the literature often addresses a (...) specific type of AFN or a specific sustainability-related issue, it is hard to form a clear overall picture of the sustainability promise of AFNs. In this article, we seek to contribute to a clearer understanding of this promise through a structured review, focusing on links between AFN characteristics and sustainability. Through an analysis of AFN conceptualizations reflected in the literature, we identify and consolidate their key characteristics. We then synthesize claims of how these characteristics may translate into sustainability, finding a wide range of potential direct and indirect impacts. Examining these from different angles, we find that the sustainability promise of AFNs found in these claims is qualified by the presence of potentially unaddressed issues, by criticisms regarding for example the evidence base of the assumed impacts and their power in addressing sustainability, and by considerations of how these impacts might play out in actual, real-life food networks. Indirect impacts of learning and participation may be highly significant for sustainability. We conclude with recommendations for research and practice. (shrink)

Given the civic needs of open Western societies which respect pluralism, democracy and human rights, how should Christians read the Qur’an? I examine four major methods or ways on how Christians do read the Qur’an, and demonstrate that all are inappropriate to the needs of our modern secular democracies. These are often allied to approaches that use the mask of revisionist scholarship to conceal malice and irrational hatred of Islamic values. First, major Christian methods that approach Islam, the Qur’an, and (...) the Prophet Muhammad could be entitled as follows, successively in this chapter: the non/reception method, the externalization method, the rejection method, and the paternalist method. Examples of such methods will be referred to. Second, a further examination of revisionist scholarship and literature shows other methods of approaching Islam and its sacred text and prophet; here, five other methods are outlined, which intertwine with the first four methods; these five are as follows: the Qur’an’s alleged misunderstanding of Christian dogmas method, the radical skepticism of the origins of Islam method, the Qur’an’s half-way to truth method, the Qur’an’s unoriginality method, and Muhammad as a messenger for the Arabs only method. Critical comments follow each of these methods, as a way of overcoming biases and prejudices that nurture Islamophobia and right-wing parties and populist movements. (shrink)