Background: Nursing documentation is an essential aspect of ethical nursing care. Lack of awareness of ethical dilemmas in nursing documentation may increase the risk of patient harm. Considering this, ethical dilemmas within nursing documentation need to be explored. Aim: To explore ethical dilemmas in nurses’ conversations about nursing documentation. Research design, participants and context: The study used a qualitative design. Participants were registered nurses from a Patient Hotel at a Danish University Hospital. Data were collected in three focus groups with (...) a total of 12 participants. Data analysis consisted of qualitative content analysis inspired by Graneheim and Lundman. Ethical consideration: This study was conducted in accordance with the ethical principles of research and regulations in terms of confidentiality, anonymity and provision of informed consent. Findings: Ethical dilemmas were strongly present in nurses’ conversations about nursing documentation. These dilemmas were demonstrated in two themes: (1) a dilemma between respecting patients’ autonomy and not causing harm, which was visible in nurses’ navigation between written documentation and oral tradition, and (2) a dilemma concerning justice and fair distribution of goods, which was visible in nurses’ balancing between documenting deviations and proof of nursing practice. Discussion: Ethical dilemmas in nursing documentation regarding respecting patients’ autonomy and not causing harm accentuated discussions on professional responsibility and patient participation in clinical decisions. Dilemmas in justice and fair distribution of goods emphasised discussions on trust in relationships versus trust in electronic health records. Conclusion: Actual tendencies in the healthcare system may increase ethical dilemmas in nursing documentation. Sharing otherwise invisible and individual experiences of ethical dilemmas in nursing documentation among nurses, nurse leaders and decision-makers will enable addressing these in reflections and discussions as well as in considering adjustments of conditions for nursing documentation. (shrink)

Cognitive Phenomenology Phenomenal states are mental states in which there is something that it is like for their subjects to be in; they are states with a phenomenology. What it is like to be in a mental state is that state´s phenomenal character. There is general agreement among philosophers of mind that the category of mental states includes at least some sensory states. For example, there is something that it is like to taste chocolate, to smell coffee, to feel the (...) wind in one´s hair, to see the blue sky and to feel a pain in one´s toe. Is there also something that it is like to consciously think, to consciously judge and to consciously believe something? Are such cognitive states, when conscious, phenomenal states? Is there a clear distinction between sensory states and cognitive states? Or, can our knowledge, thoughts and beliefs influence our sensory experiences? Is there a cognitive phenomenology? It is challenging to give a clear characterization of the cognitive phenomenology debate, since different contributors conceive of the debate in different ways. Central for the debate is the question of whether conscious thoughts possess a non-sensory phenomenology. Intuitively, there is something that it is like to consciously think, consciously judge and consciously believe something. However, the debate about cognitive phenomenology is not, strictly speaking, about whether there is something that it is like to consciously think. Rather, the debate concerns the nature of cognitive phenomenology. Is the phenomenology of cognitive states reducible to purely sensory phenomenology? Or, is there an irreducible cognitive phenomenology? A sceptic about cognitive phenomenology claims that conscious cognitive states are non-phenomenal. But, conscious cognitive states may seem to be phenomenal because they are accompanied by sensory states. For instance, when one thinks that ´Paris is a beautiful city`, one´s thought may be expressed in inner-speech and an image of Paris may accompany it. These accompanying sensory states are phenomenal states, and not the thought itself. Contrary to this, the proponent of cognitive phenomenology claims that a conscious cognitive state can have a phenomenology that is irreducible to purely sensory phenomenology. Other debates have also been placed under the ´cognitive phenomenology’ label. There is an ongoing debate within the philosophy of perception about how cognition influences our sensory experiences. Philosophers tend to agree that, for example, an expert ornithologist´s perceptual experience of a type of bird can differ from that of a novice, even if the viewing conditions for both expert and novice are the same. The expert´s knowledge of birds can influence her experience. However, what philosophers disagree about is how the expert´s knowledge influences her experience, and how her knowledge contributes to what her experience is like. (shrink)

Reasoning may be defined as a deliberate effort to coordinate inferences so as to reach justifiable conclusions. Thus defined, reasoning includes collaborative as well as individual forms of cognitive action. The purpose of the present study was to demonstrate a circumstance in which collaborative reasoning is qualitatively superior to individual reasoning. The selection task, a well known logical hypothesis-testing problem, was presented to 143 college undergraduates-32 individuals and 20 groups of 5 or 6 interacting peers. The correct (falsification) response pattern (...) was selected by only 9% of the individuals but by 75% of the groups. The superior performance of the groups was due to collaborative reasoning rather than to imitation or peer pressure. Groups typically co-constructed a structure of arguments qualitatively more sophisticated than that generated by most individuals. The results support Piagetian and Habermasian views of peer interaction as a locus of rational social processes. (shrink)

Bioethical research has tended to focus on theoretical discussion of the principles on which the analysis of ethical issues in biomedicine should be based. But this discussion often seems remote from biomedical practice where researchers and physicians confront ethical problems. On the other hand, published empirical research on the ethical reasoning of health care professionals offer only descriptions of how physicians and nurses actually reason ethically. The question remains whether these descriptions have any normative implications for nurses and physicians? In (...) this article, we illustrate an approach that integrates empirical research into the formulation of normative ethical principles using the moral-philosophical method of Wide Reflective Equilibrium (WRE). The research method discussed in this article was developed in connection with the project ‘Bioethics in Theory and Practice’. The purpose of this project is to investigate ethical reasoning in biomedical practice in Denmark empirically. In this article, we take the research method as our point of departure, but we exclusively discuss the theoretical framework of the method, not its empirical results. We argue that the descriptive phenomenological hermeneutical method developed by Lindseth and Norberg (2004) and Pedersen (1999) can be combined with the theory of WRE to arrive at a decision procedure and thus a foundation for the formulation of normative ethical principles. This could provide health care professionals and biomedical researchers with normative principles about how to analyse, reason and act in ethically difficult situations in their practice. We also show how to use existing bioethical principles as inspiration for interpreting the empirical findings of qualitative studies. This may help researchers design their own empirical studies in the field of ethics. (shrink)

The experience with genetically modified foods has been prominent in motivating science, industry and regulatory bodies to address the social and ethical dimensions of nanotechnology. The overall objective is to gain the general public’s acceptance of nanotechnology in order not to provoke a consumer boycott as it happened with genetically modified foods. It is stated implicitly in reports on nanotechnology research and development that this acceptance depends on the public’s confidence in the technology and that the confidence is created on (...) the basis of information, education, openness and debate about scientific and technological developments. Hence, it is assumed that informing and educating the public will create trust, which will consequently lead to an acceptance of nanotechnology. Thus, the humanities and social sciences are seen as tools to achieve public acceptance. In this paper, the author argues that this is a narrow apprehension of the role of the humanities and social sciences. The humanities and social sciences have a critical function asking fundamental questions and informing the public about these reflections. This may lead to scepticism, however, the motivation for addressing the social and ethical dimensions of nanotechnology should not be public acceptance but informed judgement. The author illustrates this critical function by discussing the role, motivation and contribution of ethics as an example. Lastly, the author shows that a possible strategy for incorporating the humanities and the social sciences into nanotechnology research and development is Real-Time Technology Assessment, where the purpose is to integrate natural science and engineering investigations with ethical, legal and social science from the outset. (shrink)

This collection of new essays addresses emotion in relation to the arts. The essays consider such topics as the paradox of fiction, emotion in the pure and abstract arts, and the rationality and ethics of emotional responses to art.

While it is generally agreed that companies need to manage their relationships with their stakeholders, the way in which they choose to do so varies considerably. In this paper, it is argued that when companies want to communicate with stakeholders about their CSR initiatives, they need to involve those stakeholders in a two-way communication process, defined as an ongoing iterative sense-giving and sense-making process. The paper also argues that companies need to communicate through carefully crafted and increasingly sophisticated processes. Three (...) CSR communication strategies are developed. Based on empirical illustrations and prior research, the authors argue that managers need to move from ‘informing’ and ‘responding’ to ‘involving’ stakeholders in CSR communication itself. They conclude that managers need to expand the role of stakeholders in corporate CSR communication processes if they want to improve their efforts to build legitimacy, a positive reputation and lasting stakeholder relationships. (shrink)

In this article, we develop a conceptual framework to understand how a company’s CSR identity becomes defined as a political activity destabilizing the strong identity–image relations. We draw on theories of political CSR and organizational identity–image relations to study how CSR emerges as a corporate political activity in a context where the corporate CSR work is first appreciated and later critiqued by the public in the wake of socio-political events. We analyse the micro-organizational processes in the context of macro-political level (...) changes, and we refer to this as the ‘identity–image dynamics of political CSR’. Concretely, we describe in two vignettes how IKEA’s declared ‘apolitical and neutral’ CSR identity becomes entangled with national and international socio-political events that critically challenge the corporate engagement prior national understandings of citizenship rights. In this process, IKEA’s CSR identity becomes defined as a political and non-neutral activity. Our article contributes by bringing attention to the organizational level dynamics of political CSR by offering a conceptualization of how global and local socio-political events may disturb the alignment between CSR identity and image and challenge the corporate CSR work beyond managerial control. (shrink)

In 2004, twelve capuchin monkeys were moved from the labs of the Danish psychiatric hospital of Sankt Hans to a small private-owned zoo in another part of Denmark in order to be rehabilitated. These monkeys were the last nonhuman primates to be used as research animals in Danish biomedical laboratories. The normal procedure would be to kill research animals after the termination of an experiment; in this case, however, a decision was reached to close down the lab. The moral landscape (...) had changed, and it was no longer considered acceptable to use nonhuman primates in Danish biomedicine. From being considered a biological resource serving as a model of man, the monkeys had become moral subjects with a claim to a life suiting their natural needs. Simultaneously, the monkeys became instrumental in creating moral legitimacy for the actors involved in their rescue. What we see is an instance of pathfinding in a changing moral landscape where actors negotiate nonhuman primate nature as they create new moral positions for themselves. (shrink)

This article takes up film and imagination via the problem of empathy. Proposing a different entry into contemporary polemics over empathy, the ‘empathic imagination’ is reconceptualized as a problematic of form rather than psychological experience. That is, instead of adopting a pre-given notion of empathy to illuminate the relation between film and the spectator's moral imagination, this article considers how that imagination is constituted in and through the image to begin with. After tracing the genealogy of empathy in German aesthetics, (...) the concept is put into play through readings of ‘#Look Beyond Borders’, an online video produced by Amnesty International, and two documentaries by Johan van der Keuken – Face Value and Herman Slobbe. In these works, the facial image is read as the imaginary terrain in which to explore very different notions of what might count as empathy and the empathic imagination in film and media. (shrink)

A growing body of evidence suggests that the informed consent process, in which patients are warned about potential side effects of a treatment, can trigger a nocebo effect where expectations about side effects increase side effect occurrence. This has sparked an ethical debate about how much information patients ought to receive before a treatment while trying to balance the moral principles of patient autonomy and nonmaleficence. In keeping with the principle of patient autonomy, the opinion of patients themselves in relation (...) to how much information they want about side effects is of utmost relevance in this debate. The literature was searched to identify surveys assessing patient attitudes towards side effect information. Across a broad variety of patient populations, treatment types, and countries, the majority of patients wished to be fully informed of potential side effects, particularly in relation to frequent and severe side effects, while only a small minority wanted minimal or no information at all. Results from this review suggest that nocebo research should focus on methods of avoiding nocebo effects of informed consent while ensuring that patients are well-informed about potential side effects. (shrink)

BackgroundThis study presents an empirical investigation of the ethical reasoning and ethical issues at stake in the daily work of physicians and molecular biologists in Denmark. The aim of this study was to test empirically whether there is a difference in ethical considerations and principles between Danish physicians and Danish molecular biologists, and whether the bioethical principles of the American bioethicists Tom L. Beauchamp and James F. Childress are applicable to these groups.MethodThis study is based on 12 semi-structured interviews with (...) three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company.ResultsIn this sample, the authors found that oncology physicians and molecular biologists employed in a private biopharmaceutical company have the specific principle of beneficence in mind in their daily work. Both groups are motivated to help sick patients. According to the study, molecular biologists explicitly consider nonmaleficence in relation to the environment, the researchers' own health, and animal models; and only implicitly in relation to patients or human subjects. In contrast, considerations of nonmaleficence by oncology physicians relate to patients or human subjects. Physicians and molecular biologists both consider the principle of respect for autonomy as a negative obligation in the sense that informed consent of patients should be respected. However, in contrast to molecular biologists, physicians experience the principle of respect for autonomy as a positive obligation as the physician, in dialogue with the patient, offers a medical prognosis based upon the patients wishes and ideas, mutual understanding, and respect. Finally, this study discloses utilitarian characteristics in the overall conception of justice as conceived by oncology physicians and molecular biologists from the private biopharmaceutical company. Molecular biologists employed at a public university are, in this study, concerned with allocation, however, they do not propose a specific theory of justice.ConclusionThis study demonstrates that each of the four bioethical principles of the American bioethicists Tom L. Beauchamp & James F. Childress – respect for autonomy, beneficence, nonmaleficence and justice – are reflected in the daily work of physicians and molecular biologists in Denmark. Consequently, these principles are applicable in the Danish biomedical setting. (shrink)

Only a few studies explore the lifeworld of the spouses of persons affected by early-onset Alzheimer disease. The aim of this study is to explore the lifeworld of spouses when their partners are diagnosed with AD, focusing on spouses’ lived experience. The study employs an interpretative phenomenological framework. Ten in-depth interviews are performed. The results show that spouses’ lifeworld changes with the diagnosis. They experience an imprisoned existence in which added obligations, fear, and worry keep them trapped at home, both (...) physically and mentally. In their longing for freedom, new strategies and attitudes helps the spouses to create an extended “lived space” with their partner. The findings stress the importance of paying attention to the lifeworld of spouses and making clinical recommendations on this basis. Most importantly, the lifeworld perspective has implications for how we understand what care is. We hope to challenge all different healthcare professionals and invite them to discuss the deep meaning of care and the definition of being professional in encounters with vulnerable others from a lifeworld perspective. (shrink)

Beliefs about the importance of ethical behavior to competent practice have prompted major shifts in psychology ethics over time. Yet few studies examine ethical beliefs and behavior after training, and most comprehensive research is now 30 years old. As such, it is unclear whether shifts in the field have resulted in general improvements in ethical practice: Are we psychologists “ships in the rising sea,” lifted by changes in ethical codes and training over time? Participants completed a survey of ethical beliefs (...) and behaviors. Analyses examined group differences, consistency of frequency and ethicality ratings, and comparisons with past data. More than half of behaviors were rated as less ethical and occurring less frequently than in 1987, with early career psychologists generally reporting less ethically questionable behavior. Recommendations for enhancing ethics education are discussed. (shrink)

Denmark is a constitutional monarchy resting on the founding Constitution of 1849 and later amendments. The 179 members of parliament are democratically elected, and the government is formed on the basis of parliamentary principles. The queen functions as head of state without any power to intervene in legislative or executive matters. Greenland and the Faroe Islands are part of the kingdom, but self-governing. In total, the population is around 5.6 million. The country is divided into five regions and 98 municipalities. (...) Members of both regional and municipal councils are democratically elected. (shrink)

One of the key features of the contemporary data economy is the widespread circulation of data and its interoperability. Critical data scholars have analysed data repurposing practices and other factors facilitating the travelling of data. While this approach focused on flows provides great potential, in this article we argue that it tends to overlook questions of attachment and belonging. Drawing upon ethnographic fieldwork within a Danish data-linkage infrastructure, and building upon insights from archival science, we discuss the work of data (...) practitioners enabling the repurposing of pathology samples extracted from patients for the conduct of ‘personal medicine’ – our term to discuss the so-called old-fashioned treatment of patients – towards personalised medicine. This first involves ‘getting to know’ the tissues and unpacking their previous uses and meanings, then detaching them from their original source to extract data from such tissues and making them flow towards a new container where they can be worked on and connected with other data. As data practitioners make these tissues travel, transforming them into research data, they organise the attachments of data to new agendas, persons and places. Crucially, in our case, we observe the prominence of national attachments, whereby managing tissues and data in and out of containers involves tying them to the nation to serve its interests. We thus expose how the building of data linkage infrastructures entails more than the accumulation and curation of data, but also involves crafting meanings, futures and belonging to specific communities and territories. (shrink)

After her baptism at the age of 32, Stein engaged with Aquinas on several levels. Initially she compared his thought with that of Husserl, then proceeded to translate several of his works, and attempted to explore some of his fundamental concepts (potency and act) phenomenologically. She arrived finally in Finite and Eternal Being at a philosophical position inspired by his synthesis of Christian faith and philosophical tradition without abandoning her phenomenological starting point and method. Whether one would want to call (...) this position Thomist depends on what one understands Thomism to be. (shrink)

Introduction O DY ss E us , one of the earliest and best-known strategists in the history of literature, chances upon the cave of the dim-witted giant ...

“In an age where companies are scrutinised and transparency is the only way to gain trust,” says Novo Nordisk CEO Lars Rebien Sørensen, “social responsibility is vital to maintain a business advantage.” This case examines how transparency underlines the application of Novo Nordisk’s sustainability policy—how it is integrated, administered, monitored and measured throughout the organisation. It looks closely at one of Novo Nordisk’s business units, Diabetes Finished Products, to see the process in action. Novo Nordisk is a pharmaceutical company specialising (...) in diabetes care and hormone therapy. Since 2003, commitment to sustainability has been a keynote of company policy, supported by the Novo Nordisk Way of Management, a tool developed to help managers provide the leadership in sustainability within the organisation. But how far is it really possible to influence sustainability at the operational level through management control systems? And how effective are systems like the Novo Nordisk Way of Management in supporting sustainability organisation-wide? (shrink)

Many interested reader will have put aside a work by Edith Stein due to its seeming inaccessibility, with the awareness that there was something important there for a future occasion. This collection of essays attempts to provide an idea of what this important something might be and give a key to the reading of Stein’s various works. It is divided into two parts reflecting Stein’s development. The first part, «Phenomenology», deals with those features of Stein’s work that set it apart (...) from that of other phenomenologists, notably Husserl. The second part is entitled «Metaphysics», although Stein the phenomenologist would, like Husserl, initially have shied away from this designation. However, as Stein gradually understood the importance of the Christian faith for completing the phenomenological project of founding the sciences, and accepted it as indispensable for a philosophical view of the whole, her «attempt at an ascent to the meaning of being» can legitimately be called metaphysics, even as it also constitutes a fundamental criticism of Aristotle and Aquinas. (shrink)

Given the prevalence of emotional and psychological problems among professional psychologists, a primary concern to the field is impairment, or problems of professional competence. Graduate students, in particular, are an especially vulnerable subpopulation of mental health care professionals. Despite graduate students' heightened risk of impairment, relatively little attention has been paid in the literature to the handling of impairment in graduate students in academic training programs. Recommendations for a proactive approach to addressing impairment in trainees are discussed with respect to (...) students, supervisors, and training programs. As graduate school is the first major milestone in a therapist's development, psychologists as gatekeepers of the field of psychology must accept an ethical responsibility to appropriately monitor, acknowledge, and manage impairment among trainees. (shrink)

In 2005, The International Federation of Organic Agricultural Movements (IFOAM) developed four new ethical principles of organic agriculture to guide its future development: the principles of health, ecology, care, and fairness. The key distinctive concept of animal welfare in organic agriculture combines naturalness and human care, and can be linked meaningfully with these principles. In practice, a number of challenges are connected with making organic livestock systems work. These challenges are particularly dominant in immature agro-ecological systems, for example those that (...) are characterized by industrialization and monoculture. Some of the current challenges are partly created by shortages of land and manure, which encourage zero-grazing and other confined systems. Other challenges are created in part by the conditions for farming and the way in which global food distribution systems are organized, e.g., how live animals are transported, how feed is traded and transported all over the globe, and the development of infrastructure and large herds. We find that the overall organic principles should be included when formulating guidelines for practical organic animal farming. This article explores how the special organic conceptions of animal welfare are related to the overall principles of organic agriculture. The aim is to identify potential routes for future development of organic livestock systems in different contexts and with reference to the specific understanding of animal welfare in organic agriculture. We include two contrasting cases represented by organic livestock systems in northwestern Europe and farming systems in tropical low-income countries; we use these cases to explore the widely different challenges of organic livestock systems in different parts of the world. (shrink)

Sometimes retracted or refuted scientific information is used and propagated long after it is understood to be misleading. Likewise, retracted news items may spread and persist, despite being publi...

The core function of argumentation in a democratic setting must be to constitute a modality for citizens to engage differences of opinion constructively – for the present but also in future exchanges. To enable this function requires acceptance of the basic conditions of public debate: that consensus is often an illusory goal which should be replaced by better mastery of living with dissent and compromise. Furthermore, it calls for an understanding of the complexity of real-life public debate which is an (...) intermixture of claims of fact, definition, value, and policy, each of which calls for an awareness of the greater ‘debate environment’ of which particular deliberative exchanges are part. We introduce a rhetorical meta-norm as an evaluation criterion for public debate. In continuation of previous scholarship concerned with how to create room for differences of opinion and how to foster a sustainable debate culture, we work from a civically oriented conception of rhetoric. This conception is less instrumental and more concerned with the role of communication in public life and the maintenance of the democratic state. A rhetorical meta-norm of public argumentation is useful when evaluating public argumentation – not as the only norm, but integrated with specific norms from rhetoric, pragma-dialectics, and formal logic. We contextualise our claims through an example of authentic contemporary public argumentation: a debate over a biogas generator in rural Denmark. (shrink)

Both traditional and recent accounts of the beneficial and therapeutic effects of psychedelic experiences tie these effects to specifically epistemic changes, for example the enabling of spiritual or psychological insight, or disruption of problematic beliefs or thought patterns. While these alleged benefits have sometimes been thought to be facilitated by false or even delusional beliefs (e.g. Pollan 2015), recent philosophical discussion strikes a more optimistic tone, arguing that the epistemic risks involved with psychedelic drug use tend to be relatively benign (...) and outweighed by epistemic benefits (Letheby 2021). In this paper, we seek to nuance this picture by drawing attention to the crucial role played by social factors in determining the epistemic effects of psychedelic experiences. We argue that the very openness of mind and heightened sense of clarity and certainty that is often thought to facilitate the epistemic benefits of psychedelic drug use, also make the user more vulnerable to adverse epistemic influence from the social environment, to a degree not acknowledged in the current literature. Examining the epistemic influences of the social environment is thus important for understanding the necessary precautions of informed consent and overall safe drug use. (shrink)

Les théories post-colonialistes nous ont montré à quel point l'absence d'une reconnaissance de la valeur de certaines formes culturelles produit des effets nuisibles. Ces théories ignorent pourtant la nature asymétrique des relations régissant l'interaction entre des cultures mineures et des cultures majeures, c'est-à-dire entre les grandes et les petites nations. Par conséquent, la nécessité d'une politique de la reconnaissance spécifique aux petites nations privilégiées n'est pas reconnue. Afin d'établir ce point, j'examine quelques aspects de la production cinématographique danoise. J'essaie aussi (...) de montrer que les cinéastes appartenant à des petites nations privilégiées doivent adopter une stratégie précise de la reconnaissance.Influential postcolonial theories have successfully shown that the failure to recognize the value of certain cultural forms inflicts a form of harm. What these theories fail to note is that small, prosperous nations also require a politics of recognition as a result of the asymmetrical nature of relations governing major and minor cultures. To prove this point I consider aspects of contemporary Danish cinematic production. I attempt to identify the strategy for recognition that is best suited to filmmakers belonging to small, but prosperous nations. (shrink)

Since the early 1980s, service management representatives have made an effort to distinguish service from manufacturing industries and highlight specific traits that characterize service industries. However, others have claimed that there is no need for such a distinction, and service would benefit from a clear technocratic thinking and standardization in order to improve quality, productivity and profitability. Service businesses are though personnel-intense and many encounters occur between managers, employees and customers. Using standards is not enough for this endeavour and managers (...) are important as role models. Instead, it is argued that managers need ‘proper’ education to be able to meet that which does not follow patterns of rational reasoning and action. Humanism is introduced as an important aspect of future management education. Humanism can prepare managers to meet with those unique conditions and demands characterizing the personnel- and encounter-intense service sector. (shrink)

This paper concerns one of the central problems of modern philosophy, namely the problem of giving a naturalistic explanation of phenomenal consciousness. In the first part of the paper I argue that traditional physicalist theories have problems dealing with anti-physicalist arguments deducible from the armchair. Hench, such theories are unable to give a proper explanation of phenomenal consciousness as a natural phenomenon. In the second part of the paper I present an alternative view – Type-F monism- and I argue that (...) this view provides the best naturalistic explanation available of phenomenal consciousness. (shrink)