Kliniske etikkomiteer har vært etablert i norske helseforetak siden 1996, først som et prøveprosjekt, senere som et permanent tiltak med et nasjonalt mandat. I forbindelse med det nasjonale etikkprosjektet «Samarbeid om etisk kompetanseheving» har det også i noen kommuner blitt etablert KEK. Senter for medisinsk etikk ved Universitetet i Oslo er tildelt ansvaret for oppfølging av KEK i helseforetakene og er i tillegg gitt et langsiktig ansvar for etikkarbeid og forskning i den kommunale helse- og omsorgstjenesten. Hensikten med denne studien (...) har vært å fremskaffe kunnskap om hvordan det står til med KEK som er etablert i kommunene. Hva jobber de med, hvilken betydning erfarer de at KEK har og hvilke ressurser har de? Studien har et kvalitativt design. Materialet er basert på telefonintervjuer med ledere for KEK og gjennomgang av komiteenes årsrapporter. Det er gjennomført en kvalitativ innholdsanalyse av datamaterialet. Komiteene arbeider både med enkeltsaker, saker av mer prinsipiell karakter og etikkskolering. Arbeidet vurderes som betydningsfullt og gjennomføres til tross for få ressurser og svak forankring. Kanskje vil en styrket forankring og ressurssituasjon og et nasjonalt mandat bidra positivt til komiteenes arbeid. Nøkkelord: Kliniske etikkomiteer, kommunal helse- og omsorgstjeneste, evaluering English Summary: Are clinical ethics committees in the municipal health and care services sustainable? Clinical ethics committees have been established in Norwegian hospital trusts since 1996, first as a pilot project, later on a permanent basis with a national mandate. As part of the national ethics project "Cooperation on ethical competence" some municipalities have also established a CEC. Centre for Medical Ethics at the University of Oslo is given the responsibility to support CECs in hospital trusts, and is also given a long-term responsibility for ethics support and research in municipal health care services. The purpose of this study was to obtain knowledge about the situation of CECs established in municipalities. What are they working on, what impact do they find that CEC has, and what resources do they have? The study has a qualitative design. The material is based on telephone interviews with CEC chairs, and reviews of the committees' annual reports. We have carried out a qualitative content analysis of the data. The committees work with individual cases, issues of a more principle character, and ethics training. The work is considered to be significant, and is carried out despite limited resources and weak anchoring. Perhaps a stronger anchoring, resource situation and a national mandate could strengthen the committees’ situation. Keywords: Clinical ethics committees, municipal health and care services, evaluation. (shrink)

This study ascertained reports of assent (affirmative agreement) and permission (agreement by an adult fully capable of being informed) in 114 children's research articles in 1990 in Child Development (CD), Journal of Consulting and Clinical Psychology (JCCP), Journal of Pediatric Psychology, and Journal of Clinical Child Psychology. Of the research projects, 43% failed to specify permission, and 68.5% failed to specify assent. JCCP reported assent significantly more than CD. Assent was reported significantly more in research with older children than with (...) younger children. This lack of sensitivity to assent and permission suggests that many authors, reviewers, and editors consider reporting assent and permission unessential. We recommend specifying assent and permission in all manuscripts, highlighting children's research issues in graduate training, and using specific safeguards when conducting research with children. (shrink)

In this paper, I enquire into the nature of the influence culture has on the experience of trauma. I begin with a brief elaboration of the dominant conceptualisation of post-traumatic experiences: the diagnostic category of PTSD as it can be found in the DSM. Then, I scrutinise the nature and extent to which cultural factors may influence the phenomenology of the experience of certain events as traumatic and subsequent symptoms of post-traumatic stress. It seems that cultural circumstances alter the way (...) in which trauma is experienced; it is not clear whether there is in fact a core pathology of PTSD, as the DSM assumes, or whether the structure of the experience of trauma is too multifaceted to be summarised in one diagnostic category. Finally, I show that phenomenological enquiry promises to identify the structural similarities that would justify the delineation of a distinct diagnostic category. (shrink)

Ethics support in primary health care has been sparser than in hospitals, the need for ethics support is probably no less. We have, however, limited knowledge about how to develop ethics support that responds to primary health-care workers’ needs. In this article, we present a survey with a mixture of closed- and open-ended questions concerning: How frequent and how distressed various types of ethical challenges make the primary health-care workers feel, how important they think it is to deal with these (...) challenges better and what kind of ethics support they want. Five primary health-care institutions participated. Ethical challenges seem to be prominent and common. Most frequently, the participants experienced ethical challenges related to scarce resources and lack of knowledge and skills. Furthermore, ethical challenges related to communication and decision making were common. The participants welcomed ethics support responding to their challenges and being integrated in their daily practices. (shrink)

The relationship between traumatic experiences and subsequent distress is not well understood, and little research focuses on the lived experience of psychological trauma. I draw on Louis Sass’s phenomenological taxonomy to address this lacuna. I present his differentiation between relations of phenomenological causality and implication and demonstrate that his taxonomy can be applied to experiences of trauma. Relations of phenomenological causality and implication can be identified in the genesis and constitution of post-traumatic distress. My adaptation of Sass’s taxonomy will furthermore (...) offer an extension and development of his account, applying it to the study of post-traumatic experiences and elaborating it in the process. I shall demonstrate that whether experiences occur synchronically or diachronically is not essential to their categorization in terms of phenomenological implication and causality, respectively. I will show that an alteration in perception or behavior post trauma might temporally succeed the traumatizing event while, at the same time, being implied in the experience of the event. Thereby, I demonstrate how phenomenology may contribute to a detailed understanding of experiences of trauma. Scrutiny of traumatic experiences furthermore promises to contribute to the philosophical discourse on causality, implication, and temporal experience. (shrink)

Their nursing experience and/or training may lead students preparing for the nursing profession to have less moral distress and more favorable attitudes towards a hastened death compared with those preparing for other fields of study. To ascertain if this was true, 66 undergraduates (54 women, 9 men, 3 not stated) in southeastern USA completed measures of moral distress and attitudes towards hastening death. Unexpectedly, the results from nursing and non-nursing majors were not significantly different. All the present students reported moderate (...) moral distress and strong resistance to any efforts to hasten death but these factors were not significantly correlated. However, in the small sample of nurses in training, the results suggest that hastened death situations may not be a prime reason for moral distress. (shrink)

In recent years, there has been a wide-ranging debate about the neo-republican principle of non-domination. Neo-republicans argue that domination is a capacity for one to intentionally use arbitrary power to interfere in someone’s life. Critics of neo-republicanism argue that this definition of freedom as non-domination precludes a structural analysis of domination, which would explain and critique the ways in which societies produce structural domination unintentionally. The article focuses on capitalism’s labor process and its labor markets. It argues that critics are (...) correct to think that the neo-republican principle of non-domination has an insufficient scope, but that an alternative account of structural domination should still support the neo-republican idea that agency must be involved. Otherwise, we might simply fail to explain the social processes that reproduce structural domination. What is needed is to explain how the labor process creates incentives for agents to intentionally produce structures that have unintended, yet dominating effects, and in turn, how the intentions of agents are conditioned by their social positions. Domination is thus agential and structural. (shrink)

The Norwegian Parliament has decided to give priority to ethics in municipal health services. This priority is supposed to raise competence in ethics within municipal health services. As part of the national project, the participating municipalities were encouraged to develop and carry out local projects. In this article, we present a local ethics project in one of the participating municipalities in central eastern Norway. The local project for raising competence in ethics was carried out in cooperation with researchers at the (...) Centre for Medical Ethics (CME) at the University of Oslo. Most people agree that ethics are important in health services. However, there are many ways to increase competence in ethics and to stimulate ethical reflection. In this article we present a broad overview of this local ethics project, but special focus will be put on presenting the actions that have been used for increasing the level of ethical competence and stimulating ethical reflection among the participants. We describe our evaluation of the project and the research we carried out. Explanations will be given for the thought process behind the decisions that were made. (shrink)

Systematic ethics support in community health services in Norway is in the initial phase. There are few evaluation studies about the significance of ethics reflection on care. The aim of this study was to evaluate systematic ethics reflection in groups in community health , - from the perspectives of employees participating in the groups, the group facilitators and the service managers. The reflection groups were implemented as part of a research and development project.

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

In the search for the roots of computer art, the notes of Leonardo provide guiding principles which continue to surface in much of 20th century art. The essay is written in Leonardo's voice to combine excerpts from his early writings with the author's extrapolations from his teachings. This text purports that the heritage of computer art is linked to Renaissance precepts, and descended from the Mechanical age, Visual arts, and Animation. This exploration positions a new movement, herein called ?Pixellence,?? in (...) an historical framework with respect to past art genres. (shrink)

This article explores an under-examined theme, which is who or what is the working class and what is wrong with the situation that members of this class share. It argues that class divisions impose a unique harm for a diverse and interdependent group within capitalist societies both in spite and because of differences among group members. Class matters not just because it creates economic groups in which some are rich and others are poor, but because competition creates conditions that militate (...) against solidarity, toward cleavage and conflict. Class is a constraint on collective self-determination and, therefore, a source of domination. (shrink)

With my research, I wish to contribute to the discussion of post-traumatic psychopathologies from a phenomenological perspective. The main question I pursue is to what extent PTSD can be understood as an intersubjective psychopathology and which implications this view might have. In this paper, I argue that the mode of perception allowing for intersubjective experience is vulnerable to disruptions through traumatic events. I begin with a short elaboration on what intersubjectivity entails before proceeding to illustrate how it can be impaired. (...) Then, I focus on the concept of empathy as a mode of perception: I propose that due to a disruption of the ability to empathize an individual suffering from PTSD may cease to experience the other as another subject that offers possibilities for interaction. The traumatized individual is thus unable to establish meaningful connections with others. I offer some implications this view might entail for thinking about trauma treatment. (shrink)

In this article, I will outline an assessment model that allows instructors to continuing assigning term papers and argumentative papers without compromising the authenticity of student assessment. This path forward relies upon a pseudo flipped classroom model in which students will complete a scaffolded term paper through a series of in-class assessments that build upon previously completed components. The final steps of completing this assignment will require producing a draft and final version of a traditional term paper outside of the (...) classroom but only after the instructor ensures they have critically thought through the preceding components independently. The intention is to maintain the nuance, critical thinking, engagement with primary and secondary sources, and depth of content comprehension that a thoughtful paper requires, while also ensuring that students are completing the work themselves and not merely outsourcing bits and pieces of it to LLMs. (shrink)

Africa has a colonial past that renders it a linguistic melting pot, where language is not only important for communication but is inextricably related to cultural identity. In Africa, there are over 2000 languages that are still being used and spoken. Language diversity coupled with cultural diversity may affect the process of obtaining informed consent in data-intensive research. We explore some of the challenges and opportunities of multilingualism in handling informed consent in the context of data-intensive research. In multilingual contexts, (...) as in most African countries, language is exceptionally central, and translation has potential cultural, social, historical, functional and scientific importance. However, it is recognised that terminological and translation activities may not always be cost-effective or feasible. We consider alternative mechanisms of harmonisation of data-related terminology and concepts in multilingual contexts, such as iconography, graphic elicitation and other multimedia formats of information sharing. The inclusion of visual or multimedia explanations in informed consent forms can improve comprehension, enhance information transfer and learning, reduce potential vulnerabilities associated with low literacy levels or the inability to interpret technical language associated with data-intensive research, build trust with participants and their communities, and promote autonomy of potential participants. We recognise that the inclusion of visual or multimedia content to facilitate information transfer is only one component of the informed consent process for data-intensive research. Research ethics committees (RECs) should be mindful of other key considerations and challenges of informed consent for data-intensive research in sub-Saharan Africa (SSA), and to explore whether these alternative forms of consent are ethical and effective in multilingual contexts. (shrink)

I thank Jane Sedlakova and Manuel Trachsel for their work on situating conversational artificial intelligence’s (CAI) potential role in psychotherapy. In their article, Sedlakova and Trachsel argue...

Inclusive, non-elitist art spaces are mounted by remarkably talented, creative individuals. Alfred Stieglitz and Donald Judd were two such individuals. Stieglitz's space was an intimate urban art gallery in Manhattan while Judd's space in Marfa, Texas was expansive, isolated, and rural. Aside from sharing the usual characteristics of the very creative, both were charismatic, physically attractive, intelligent men who held forceful visions about art. Unlike most of their peers, they had the capacity to write well and speak convincingly. Their resolute (...) confidence and aesthetic competencies enabled them to attract and hold astute colleagues. Last they had the necessary expertise and connections to obtain resources required to maintain their vision. (shrink)

The treatment of employees during downsizing and corporate restructuring raises many ethical issues. To provide a common framework for understanding ethical decisions facing organizations delivering the news of dismissal to affected employees, Integrative Social Contracts Theory and the research on social exchange was used to integrate existing research on employee dismissal. Of particular importance was determining the criteria necessary to manage the dismissal process within ethical boundaries. Three basic criteria, which together represent a variety of contractual and transactional obligations, are (...) proposed as necessary for an ethical approach to dismissal; 1) advance warning of the job loss, 2) open communication, and 3) institutionalized support services. The frequency with which organizations meet these criteria is examined using a geographically dispersed, cross-organizational sample of 770 involuntarily displaced professional employees. In addition, the effect of such an ethical approach to dismissal on individual psychological and financial outcomes is examined. Findings are discussed as they relate to the implicit contract between employee and employer and organizations' responsibility to employees during corporate restructuring. (shrink)

Gender equality is something that the human race has been struggling with since time immemorial. No country has achieved gender equality despite the legislative, social, and economic gains for women. Therefore, modern society likes to blame certain groups, such as religion for the gender inequalities which are faced, more than others. The main focus of this study is to evaluate the role of religious leaders in promoting gender equality through the legislation and religious texts in Zimbabwe. The study further explores (...) how certain religious norms and practices can be modified through religious texts to accommodate women in achieving gender equality. The paper acknowledges that religious leaders have a greater responsibility to standup, speak and act with and on behalf of those with less power, such as the marginalized and discriminated against, including exploited planet Earth. The paper seeks to foreground how certain traditional religious practices and norms have exacerbated gender inequality in Zimbabwe, despite the laws that have been enacted by the government of Zimbabwe to promote gender equality. The data for the paper was gathered through observations and semi-structured interviews conducted with both religious leaders and women to establish how religious norms and practices directly or indirectly affect women and how they can be modified to achieve gender equality in Zimbabwe. The data gathered was analysed through descriptive data analysis. The paper concludes by recommending that religious leaders should be thoroughly trained on how to promote gender equality through religious texts and legislation. Contribution: The article evaluated the role of religious leaders in promoting gender equality through legislation and religious texts in Zimbabwe. It argued that religious leaders have a higher need to support, advocate and act on behalf of individuals who are marginalised and subjected to discrimination on planet Earth. Hence, its contribution was in promoting gender equality through religious texts and legislation in Zimbabwe for sustainable development. (shrink)

In the end, even the creative achievements of Shakespeare and Bach must be eradicated by death and nothingness, when the earth is burnt up in the sun. But the temporality of human existence and meaning does not invalidate the quest for meaning-for even that future universe, as dead as it must be will have some meaning, in that it contains the artifacts, even in ashes, of the sometime existence of human life and consciousness. We HAVE BEEN. It was towards this (...) vision that Mahler strove. (shrink)

The puzzle has played a significant role in Chinese culture since its formation. The Lo-shu and the Ba-gua, the most prominent number puzzle in ancient China, with its instinctual quest for universal order, has constructed a philosophical system that has incorporated human being as an integral part of nature. The system has exerted great influence on Chinese culture to this day. Because of its mysterious origin and magical evolution, the Ba-gua has been used to predict the fortune of both the (...) nation and the individual. The Chinese character-deconstructing puzzle has also functioned as a foreshadow of one’s fate. By analyzing the components of a character, written by the subject in a specific context, divination was made. In contrast to the solemn mission of the number puzzle, and the character-deconstructing puzzle, the wedding puzzle and the riddle are lighthearted, and intended to provoke humor, and to function pedagogically. A latecomer, once the mysteriousness of number and character has faded, the riddle is used to promote the intellectual development of children. The wedding puzzle has been popular among those who are illiterate and make analogy by using common occurrence to allude to taboo in the oral dialect. Since their illiteracy has excluded them from reading and writing, they are free to make puzzles in their own dialect without being limited by a reverence for the written character. (shrink)

Our aim was to describe Chinese nurses' experiences of workplace distress and ethical dilemmas on a neurological ward. Qualitative interviews were performed with 20 nurses. On using latent content analysis, themes emerged in four content areas: ethical dilemmas, workplace distress, quality of nursing and managing distress. The ethical dilemmas were: (1) conflicting views on optimal treatment and nursing; (2) treatment choice meeting with financial constraints; and (3) misalignment of nursing responsibilities, competence and available resources. The patients' relatives lacked respect for (...) the nurses' skills. Other dilemmas could be traced to the transition from a planned to a market economy, resulting in an excessive workload and treatment withdrawal for financial reasons. Lack of resources was perceived as an obstacle to proper patient care in addition to hospital organization, decreasing the quality of nursing, and increasing moral and workplace distress. The nurses managed mainly by striving for competence, which gave them hope for the future. (shrink)