Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of ‘bricolage’ which means our approach was inductive. Most participants report (...) positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices. (shrink)

The idea behind this article is to discuss the importance and to develop the concept of reciprocity in asymmetric professional relationships. As an empirical starting point for an examination of the possible forms of reciprocity between patients and nurses in psychiatry, we chose two qualitative in-depth interviews with two different patients. The manners in which these two patients relate to medical personnel—one is dependent, the other is independent—show that this presents challenges to nurses. The theoretical context is provided by the (...) notion of mature care as it has been developed by feminist-oriented ethics of care, in contrast to the notion of altruistic care. In relation to the concept of mature care, we discuss how nursing can be perceived in demanding relationships with patients in psychiatry. Reciprocity implies that, in principle, the interests of the nurses also matter in a nurse-patient relationship. We show that reciprocity—in practice—is complicated and challenging in a number of different ways. Mature care—with its systematic inclusion of relationships and reciprocity—provides an alternative understanding of what takes place between patients and nurses compared with an altruistic notion of care. As such, mature care can be regarded as an useful paradigm for nurse-patient relationships in psychiatry. (shrink)

Background: To better understand the kinds of ethical challenges that emerge when using coercion in mental healthcare, and the importance of these ethical challenges, this article presents a systematic review of scientific literature. Methods: A systematic search in the databases MEDLINE, PsychInfo, Cinahl, Sociological Abstracts and Web of Knowledge was carried out. The search terms derived from the population, intervention, comparison/setting and outcome. A total of 22 studies were included. Ethical considerations: The review is conducted according to the Vancouver Protocol. (...) Results: There are few studies that study ethical challenges when using coercion in an explicit way. However, promoting the patient’s best interest is the most important justification for coercion. Patient autonomy is a fundamental challenge facing any use of coercion, and some kind of autonomy infringement is a key aspect of the concept of coercion. The concepts of coercion and autonomy and the relations between them are very complex. When coercion is used, a primary ethical challenge is to assess the balance between promoting good (beneficence) and inflicting harm (maleficence). In the included studies, findings explicitly related to justice are few. Some studies focus on moral distress experienced by the healthcare professionals using coercion. Conclusion: There is a lack of literature explicitly addressing ethical challenges related to the use of coercion in mental healthcare. It is essential for healthcare personnel to develop a strong awareness of which ethical challenges they face in connection with the use of coercion, as well as challenges related to justice. How to address ethical challenges in ways that prevent illegitimate paternalism and strengthen beneficent treatment and care and trust in connection with the use of coercion is a ‘clinical must’. By developing a more refined and rich language describing ethical challenges, clinicians may be better equipped to prevent coercion and the accompanying moral distress. (shrink)

Origin of the movement: J. H. Stirling. --T. H. Green. --Edward Caird. --John Caird. --William Wallace. --D. G. Ritchie. --F. H. Bradley. --Bernard Bosanquet. --John Watson. --Henry Jones. --J. H. Muirhead. --J. S. Mackenzie. --Lord Haldane. --J. E. McTaggart as an interpreter of Hegel. --Appendix: Hegelianism and human personality.

This essay examines the iconography and role of animals in medieval and early modern bestiaries. In being without original sin “God’s creatures” were deemed proximate to divine perfection and to salvation. Animals, whether symbolic or actual, both instructed man’s moral behaviour and ushered man towards salvation. Bestiaries, it will be argued, are keys to understanding how modern law would eventually co-ordinate itself in relation to the concept of a future salvic moment.

For some time we have seen a shift away from direct marketing, a core feature and dominant exchange form in the alternative food world, towards a greater role for intermediation. Yet, we still need to better understand to what extent and in what ways new mediated Alternative Food Networks represent an evolution of or departure from core tenets of alternative food systems. This paper focuses on AFNs with new intermediaries that connect small-scale producers with urban end-consumers. Based on original research (...) in Frankfurt, Berlin, and Calgary, we analyze three different types of mediated AFNs: one driven by consumers, one by an external intermediary, and one by producers. Our cases include non-capitalist, capitalist, and alternative capitalist economic practices as identified by Gibson-Graham. Conceptually, we base our analysis on the three-pillar-model of alternative agri-food systems, which we further refine. Besides comparing our cases with each other, for heuristic purposes we also compare them with an ideal-type model that adheres to core tenets of alterity in all three pillars. Our empirical analysis shows that intermediary organizations can bring important benefits and that mediated AFNs are in principle able to hold true to the core tenets of alternative agri-food systems. However, it is very important to develop models of democratic control and ownership as well as economic arrangements in which created value is fairly shared. Only then can the potentials of new mediated models be realized while the pitfalls of the conventional systems they seek to replace be avoided. (shrink)

A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five studies were included. The ethics support activities described were moral case deliberations and ethics rounds. Different qualitative and quantitative research methods were utilized. The results show that (a) participants felt that they gained an increased insight into (...) moral issues through systematic reflection; (b) there was improved cooperation among multidisciplinary team members; (c) it was uncertain whether clinical ethics support services led to better patient care; (d) the issue of patient and client participation is complex; and (e) the implementation process is challenging. Clinical ethics support services have mainly been studied through the experiences of the participating facilitators and healthcare professionals. Hence, there is limited knowledge of whether and how various types of clinical ethics support services influence the quality of care and how patients and relatives may evaluate clinical ethics support services. Based on the six excluded ‘grey zone articles’, in which there was an implicit focus on ethics reflection, other ways of working with ethical reflection in practice are discussed. Implementing and evaluating clinical ethics support services as approaches to clinical ethics support that are more integrated into the development of good practice are in focus. In order to meet some of the shortcomings of the field of clinical ethics support services, a research project that aims to strengthen ethics support in the mental health services, including patients’ and caregivers’ views on ethical challenges, is presented. (shrink)

Focusing on the ‘problem’ of pleasure _Law, Orientalism and Postcolonialism_ uncovers the organizing principles by which the legal subject was colonized. That occidental law was complicit in colonial expansion is obvious. What remains to be addressed, however, is the manner in which law and legal discourse sought to colonize individual subjects as subjects of law. It was through the permission of pleasure that modern Western subjects were refined and domesticated. Legally sanctioned outlets for private and social enjoyment instilled and continue (...) to instil within the individual tight self-control over behaviour. There are, however, states of behaviour considered to be repugnant to, and in excess of, modern codes of civility. Drawing on a broad range of literature,, yet concentrating on the experience of British India, the argument here is that such excesses were deemed to be an Oriental phenomenon. Through the encounter with the Orient and with the fantasy of its excess, Piyel Haldar concludes, the relationship between the subject and the law was transformed, and must therefore be re-assessed. (shrink)

_In this lively and groundbreaking book, arts educator Marit Dewhurst examines why art is an effective way to engage students in thinking about the role they might play in addressing social injustice._ Based on interviews and observations of sixteen high schoolers participating in an activist arts class at a New York City museum, Dewhurst identifies three learning processes common to the act of creating art that have an impact on social justice: connecting, questioning, and translating. Noting that “one of (...) the challenges of social justice art education has been the difficulty of naming effective strategies that can be used across multiple contexts,” Dewhurst outlines core strategies for an “activist arts pedagogy” and offers concrete suggestions for educators seeking to incorporate activist art projects inside or outside formal school settings. _Social Justice Art _seeks to give common language to educators and others who are looking to expand and refine their practices in an emerging field, whether they work in art education, social justice programming, or youth development. (shrink)

__Teachers Bridging Difference_ describes how educators can move out of their comfort zones and practice connecting with others across differences to become culturally responsive teachers. _Based on a course developed for preservice teachers, the book illustrates how educators can draw on the visual arts as a resource to explore their own identities and those of their students, and how to increase their understanding of the ways our lives intersect across sociocultural differences. Drawing on scholarship from multiple disciplines and from her (...) own experience, Marit Dewhurst identifies four stances designed to help educators connect with students in today’s multicultural classrooms. To practice these stances, the book introduces eight arts-based activities that can be used by educators in multiple contexts. Ranging from community maps and conversation portraits to scenario comics and reflection zines, the activities are designed to be accessible to even those with little arts experience and can be executed with a wide variety of materials and media. Unique and timely, _Teachers Bridging Difference _is an arts-based tool kit for teachers interested in exploring issues of identity and difference as a foundation for creating a more just and equal society. (shrink)

Few qualitative studies explore the phenomenon of positive ethical climate and what actions are perceived as promoting it. Therefore, the aim of this study was to explore and describe actions that acute care ward nurses perceive as promoting a positive ethical climate. The critical incident technique was used. Interviews were conducted with 20 nurses at wards where the ethical climate was considered positive, according to a previous study. Meeting the needs of patients and next of kin in a considerate way, (...) as well as receiving and giving support and information within the work group, promoted a positive ethical climate. Likewise, working as a team with a standard for behaviour within the work group promoted a positive ethical climate. Future research should investigate other conditions that might also promote a positive ethical climate. (shrink)

Besides Giving An Account Of The Origin And Development Of Buddhism As Well As The Works Of Vasubandhu And Reviewing The Abhidarwa Literature Of Buddhism, Written In Sanskrit And Pali This Book Thoroughly Analyses The Doctrine Of Sarvastivada And The Buddhist Conceptions Of Feeling, Perception, Consciousness And Impression.

When you enrol as a student you are assigned a ‘place’ in education. This assignment will gradually imply an assessment of you as a human being. We argue that these are processes taking place in educational practice. In our orientation in educational research an orientation towards a theory of action has been inspired by the French philosopher Paul Ricoeur. In our search for an educational practice that could describe what it is that makes the student a capable human being we (...) continue in the spirit of Ricoeur. The text is divided in two parts. In the first part, Basic Capabilities in Education, we are asking: Who is the student if education is the process where the student learns to be a capable human being? We try to answer this with the help of Ricoeur’s phenomenology of the capable human being which is structured around the capacity to speak, to act, to tell and finally to impute. In the second part, Institutional Mediations of Capabilities in Education, we try to show how the transmission of the human capacities to an actualization through education at an institutional level, represented by the teacher, is necessary. If the student shall become a capable human being s/he has to have conditions for actualizations of her capacities. A paradigm for this is found in the process of assigning and assessing in education. (shrink)

Background: Ethics rounds are one way to support healthcare personnel in handling ethically difficult situations. A previous study in the present project showed that ethics rounds did not result in significant changes in perceptions of how ethical issues were handled, that is, in the ethical climate. However, there was anecdotal evidence that the ethics rounds were viewed as a positive experience and that they stimulated ethical reflection. Aim: The aim of this study was to gain a deeper understanding of how (...) the ethics rounds were experienced and why the intervention in the form of ethics rounds did not succeed in improving the ethical climate for the staff. Research design: An exploratory and descriptive design with a qualitative approach was adopted, using individual interviews. Participants and research context: A total of 11 healthcare personnel, working in two different psychiatry outpatient clinics and with experience of participating in ethics rounds, were interviewed. Ethical considerations: The study was based on informed consent and was approved by one of the Swedish Regional Ethical Review Boards. Findings: The participants were generally positive about the ethics rounds. They had experienced changes by participating in the ethics rounds in the form of being able to see things from different perspectives as well as by gaining insight into ethical issues. However, these changes had not affected daily work. Discussion: A crucial question is whether or not increased reflection ability among the participants is a good enough outcome of ethics rounds and whether this result could have been measured in patient-related outcomes. Ethics rounds might foster cooperation among the staff and this, in turn, could influence patient care. Conclusion: By listening to others during ethics rounds, a person can learn to see things from a new angle. Participation in ethics rounds can also lead to better insight concerning ethical issues. (shrink)

In the debate around ecological democracy, a pivotal point of contention has long been the question why democracy should actually be expected, as some claim, to deliver (more) ecological outcomes. This point is empirical as well as conceptual: it is difficult to conceive why voters would support any policies that – as is often (perceived to be) the case with environmental legislation – would leave them worse off; whilst democracy conceptually must remain open to all outcomes rather than being tied (...) to any particular agenda ex ante. Yet both empirically and conceptually, the nature and extent of this key puzzle has always hinged on the particular definitions used. This paper reconsiders the link between democracy and ecological sustainability from a cultural angle: I argue that conceiving of both sustainability and democratisation as essentially cultural transformations resolves the puzzle and thus makes a renewed case for ecological democracy. Only as cultural processes – the creation of new meanings of sustainable prosperity in people's everyday lives, and a culturally rather than institutionally based form of democratisation – can these transformations be deep-seated rather than superficial, and thus self-perpetuating rather than merely enforced. (shrink)

. A space for ‘who’ – a culture of ‘two’: speculations related to an ‘in-between knowledge’. Ethics and Education: Vol. 7, Creating spaces, pp. 251-260. doi: 10.1080/17449642.2013.767084.

The aim of this study was to describe nurses' conceptions of decision making with regard to life-sustaining treatment for dialysis patients. Semistructured interviews were conducted with 13 nurses caring for such patients at three hospitals. The interview material was subjected to qualitative content analysis. The nurses saw decision making as being characterized by uncertainty and by lack of communication and collaboration among all concerned. They described different ways of handling decision making, as well as insufficiency of physician—nurse collaboration, lack of (...) confidence in physicians, hindrances to patient participation, and ambivalence about the role of patients' next of kin. Future research should test models for facilitating communication and decision making so that decisions will emerge from collaboration of all concerned. Nurses' role in decision making also needs to be discussed. (shrink)

Introduction: We discuss Carol Gilligan's original concept of mature care in the light of the altruistic approach to caring and good clinical judgment. Discussion: In particular, we highlight how the concept of mature care can capture important challenges in today's nursing. Further, we illuminate how mature care might differ normatively from an altruistic approach to caring and the traditional prudential virtues in nursing. We also discuss similarities between mature care and virtue ethics. Conclusion: For nursing and nurses' identity, in today's (...) health care system that is increasingly pressured to ‘produce' health, we believe it is important to both developing further theories on mature care and having normative discussions about care. (shrink)

In recent years, the attention on the use of coercion in mental health care has increased. The use of coercion is common and controversial, and involves many complex ethical challenges. The research question in this study was: What kind of ethical challenges related to the use of coercion do health care practitioners face in their daily clinical work?

Inhaltsübersicht: Vorwort, Göttin, Tod und Geburt, Mensch, Subjekt, Leib, Sprache, Vernunft, Differenz, Ethik, Freiheit, Gerechtigkeit, Glück, Liebe, Arbeit, Kunst, Zeit, Anhang: Literaturverzeichnis, Kommentiertes Personenverzeichnis, Bildnachweise, Sach- und Personenregister.

Henrich Steffens (1773-1845) war einer der frühen politischen Professoren Deutschlands. Er war Verfechter der souveränen Wissenschaft, Fürsprecher der individuellen Pädagogik, Gegner des ideologischen Turnens Friedrich Ludwig Jahns und Verteidiger einer natürlichen Nationsbildung.

The ideal of trust pervades nursing. This article uses empirical material from acute psychiatry that reveals that it is distrust rather than trust that is prevalent in this field. Our data analyses show how distrust is expressed in the therapeutic environment and in the relationship between nurse and patient. We point out how trust can nonetheless be created in an environment that is characterized by distrust. Both trust and distrust are exposed as `fragile' phenomena that can easily `tip over' towards (...) their opposites. Trust is not something that nurses possess or are given; it is rather something that they earn and have to work hard to achieve. Regarding themselves as potential causes of distrust and active wielders of power can contribute to nurses developing a more realistic view of their practice. Assuming a realistic middle-way perspective can help to manoeuvre between the extremities of excellence and resignation, which in turn can lead to processes that create trust between psychotic patients and nurses. (shrink)

Im Gegensatz zum drei Jahre jüngeren Schelling, dem er sein Leben lang verbunden blieb, wird Steffens nach seinem Tod nahezu vergessen; in der landläufigen Überlieferung hat er als der Überbringer der Romantik nach Dänemark überlebt. Erst mit Beginn des 21. Jahrhunderts wird er als Naturforscher, als Philosoph und Universitätsreformer wiederentdeckt, nicht zuletzt auch im Diskurs-Zusammenhang um das Anthropozän. Steffens-Forscherinnen und Forscher aus Norwegen, Dänemark und Deutschland setzen sich mit dem romantischen Denken der Zeit, mit den Aspekten der nationalen Wiedergeburt in (...) Kultur, Politik und Wissenschaft auseinander, mit Naturgeschichte und Kunst: Marit Bergner, Marie-Theres Federhofer, Bernd Henningsen, Lore Hühn, Daniel Fulda, Norman Kasper, Jesper Lundsfryd Rasmussen, Jessika Piechocki, Anna Lena Sandberg und Elisabeth Décultot. (shrink)

Grammatical categories represent implicit knowledge, and it is not known if such abstract linguistic knowledge can be continuously grounded in real-life experiences, nor is it known what types of mental states can be simulated. A former study showed that attention bias in peripersonal space affects reaction times in grammatical congruency judgments of nominal classifiers, suggesting that simulated semantics may include reenactment of attention. In this study, we contrasted a Chinese nominal classifier used with nouns denoting pinch grip objects with a (...) classifier for nouns with big object referents in a pupil dilation experiment. Twenty Chinese native speakers read grammatical and ungrammatical classifier-noun combinations and made grammaticality judgment while their pupillary responses were measured. It was found that their pupils dilated significantly more to the pinch grip classifier than to the big object classifier, indicating attention simulation in PPS. Pupil dilations were also significantly larger with congruent trials on the whole than in incongruent trials, but crucially, congruency and classifier semantics were independent of each other. No such effects were found in controls. (shrink)

This article grapples with the causes of India’s microfinance crisis. By contrasting Bangladesh’s highly successful Grameen model with the allegedly “universalizable” version of India’s SKS Microfinance, trust or social capital is isolated—not just narrowly interpreted within standard economic theory, but more broadly construed—as the essential element accounting for the early success of microfinance. It is argued that the microfinance experience has been widely misinterpreted, in both analytical and policy terms. This article suggests inherent limits in extending the model to for-profit (...) institutions and, in particular, to the pace of scaling up. (shrink)

Amsterdam University Press is a leading publisher of academic books, journals and textbooks in the Humanities and Social Sciences. Our aim is to make current research available to scholars, students, innovators, and the general public. AUP stands for scholarly excellence, global presence, and engagement with the international academic community.

Informed consent represents a cornerstone of the endeavours to make health care research ethically acceptable. Based on experience of qualitative research on power dynamics in nursing care in acute psychiatry, we show that the requirement for informed consent may be practised in formalistic ways that legitimize the researcher's activities without taking the patient's changing perception of the situation sufficiently into account. The presentation of three patient case studies illustrates a diversity of issues that the researcher must consider in each situation. (...) We argue for the necessity of researchers to base their judgement on a complex set of competencies. Consciousness of research ethics must be combined with knowledge of the challenges involved in research methodology in qualitative research and familiarity with the therapeutic arena in which the research is being conducted. The article shows that the alternative solution is not simple but must emphasize the researcher's ability to doubt and be based on an awareness of the researcher's fallibility. (shrink)

Embodied cognitive theories predict that linguistic conceptual representations are grounded and continually represented in real world, sensorimotor experiences. However, there is an on-going debate on whether this also holds for abstract concepts. Grammar is the archetype of abstract knowledge, and therefore constitutes a test case against embodied theories of language representation. Former studies have largely focussed on lexical-level embodied representations. In the present study we take the grounding-by-modality idea a step further by using reaction time (RT) data from the linguistic (...) processing of nominal classifiers in Chinese. We take advantage of an independent body of research, which shows that attention in hand space is biased. Specifically, objects near the hand consistently yield shorter RTs as a function of readiness for action on graspable objects within reaching space, and the same biased attention inhibits attentional disengagement. We predicted that this attention bias would equally apply to the graspable object classifier but not to the big object classifier. Chinese speakers (N = 22) judged grammatical congruency of classifier-noun combinations in two conditions: graspable object classifier and big object classifier. We found that RTs for the graspable object classifier were significantly faster in congruent combinations, and significantly slower in incongruent combinations, than the big object classifier. There was no main effect on grammatical violations, but rather an interaction effect of classifier type. Thus, we demonstrate here grammatical category- specific effects pertaining to the semantic content and by extension the visual and tactile modality of acquisition underlying the acquisition of these categories. We conclude that abstract grammatical categories are subjected to the same mechanisms as general cognitive and neurophysiological processes and may therefore be grounded. (shrink)

With the rising of the reported cases of COVID-19 and home quarantine being implemented, the Internet became a channel for effective human interaction. Doing most of the work online brought an increasing number of online fraudsters to exploit the public fear of the pandemic to attack people through cybercrime. This paper introduces what cybersecurity is all about. It also lists some of the cybersecurity issues that are being faced at this time. Further, it discusses forms of attacks being encountered and (...) lists recommendations on how to be safe online. (shrink)

The question whether memory aberrations in posttraumatic stress disorder also manifest as an increased production of false memories is important for both theoretical and practical reasons, but is yet unsolved. Therefore, for the present study we investigated veridical and false recognition in PTSD with a new scenic variant of the Deese–Roediger–McDermott paradigm, which was administered to traumatized individuals with PTSD , traumatized individuals without PTSD , and non-traumatized controls . The PTSD group neither produced higher rates of false memories nor (...) expressed more confidence in errors, but did show inferior memory sensitivity. Whereas depressive symptoms did not correlate with veridical nor false recognition, state dissociation was positively associated with false memories. (shrink)