Background Preserving persons’ dignity is integral to nursing. More research is needed to explore how a diversity of patients, particularly those that experience illness from a young age, experience dignity. Aim Describe the characteristics of dignity for persons living with serious illness. Research design Using a secondary data set of twenty audio-recorded interviews, a thematic content analysis was conducted to identify characteristics of dignity. The research team employed van Gennip et al.’s, 2013 “Model of Dignity in Illness” (1) to create (...) a codebook, which the authors utilized to independently code twenty narrative interview transcripts. Participants and research context Twenty persons living with serious illness of heart failure and/or dialysis-dependent renal failure who were admitted in an acute care hospital. Ethical considerations This study was approved on August 26, 2019, by the Colorado Multiple Institutional Review Board (COMIRB) IRB Protocol #19-1874. Findings Early-onset participants expressed markedly different dignity concerns than late-onset participants. In the individual domain, early-onset participants felt that their illness was “normal”; they did not experience the “healthy person to patient” transition described by older onset participants. In the relational domain, early-onset participants expressed that their relationships had already integrated their illness while late-onset participants felt that their illness harmed many of their relationships. In the societal domain, early-onset participants described dignity concerns related to how society impacted their ability to financially support themselves during their illness. Discussion Differences in the dignity experience of early-onset and late-onset participants are informed by Erikson’s “Model of Development” and by Aranda and Jones feminist critique of dignity in healthcare. Conclusions Persons with early-onset illness experience dignity differently. Awareness of the importance of work and financial independence to the experience of dignity for seriously ill patients may enhance persons’ dignity experience. (shrink)

It is usually held that representative government is not strictly democratic, since it does not allow the people themselves to directly make decisions. But here, taking as her guide Thomas Paine’s subversive view that “Athens, by representation, would have surpassed her own democracy,” Nadia Urbinati challenges this accepted wisdom, arguing that political representation deserves to be regarded as a fully legitimate mode of democratic decision making—and not just a pragmatic second choice when direct democracy is not possible. As Urbinati (...) shows, the idea that representation is incompatible with democracy stems from our modern concept of sovereignty, which identifies politics with a decision maker’s direct physical presence and the immediate act of the will. She goes on to contend that a democratic theory of representation can and should go beyond these identifications. Political representation, she demonstrates, is ultimately grounded in a continuum of influence and power created by political judgment, as well as the way presence through ideas and speech links society with representative institutions. Deftly integrating the ideas of such thinkers as Rousseau, Kant, Emmanuel Joseph Sieyès, Paine, and the Marquis de Condorcet with her own, Urbinati constructs a thought-provoking alternative vision of democracy. (shrink)

This article traces the development of the theory and practice of what is known as ‘community of inquiry’ as an ideal of classroom praxis. The concept has ancient and uncertain origins, but was seized upon as a form of pedagogy by the originators of the Philosophy for Children program in the 1970s. Its location at the intersection of the discourses of argumentation theory, communications theory, semiotics, systems theory, dialogue theory, learning theory and group psychodynamics makes of it a rich site (...) for the dialogue between theory and practice in education. This article is an exploration of those intersections, and a prospectus of its possible role in the formation and reformulation of school curriculum. It will be argued here that, when formulated as community of philosophical inquiry in particular, it offers the possibility of ‘philosophising’ the school curriculum in general, by extending the concept-work that doing philosophy entails to all of the disciplines. The article begins with an attempt at an operational definition of the term as, move to an analysis of its dynamics, offers an example of its use in a mathematics classroom, and finishes with a schematic view of its whole-curriculum and whole-school possibilities. (shrink)

Increasingly organizations have dedicated systems and personnel (recipients) to receive and handle internal whistleblower reports. Yet, the complexity of handling whistleblower reports is often underestimated, and there is a dearth of literature that attempts to describe or analyse the challenges internal recipients face. This paper uses an agency theory inspired lens to provide insight into the complexity of internal whistleblowing, with the aim to identify focal points for improving internal whistleblowing processes. We conceive of internal recipients as agents of two (...) principals in the event of whistleblowing: owner/top management as well as whistleblowers. We identify sources of agency problems and agency costs within these double-agent relationships. We provide avenues for solving these problems and reducing the agency costs. We close by offering paths for future research. (shrink)

This article conceptualizes corporate accountability under international law and introduces an analytical framework translating corporate accountability into seven core elements. Using this analytical framework, it then systematically assesses four models that could be used in a future business and human rights treaty: the United Nations Guiding Principles on Business and Human Rights model, the Universal Declaration of Human Rights model, the progressive model, and the transformative model. It aims to contribute to the BHR treaty negotiation process by clarifying different options (...) and possible trade-offs between them, while taking into account political realities. Ultimately, the article argues in favour of the BHR treaty embracing a progressive model of corporate accountability, which combines ambitious development of international law with realistic prospects of state support. (shrink)

Redirecting attention to Mill as a political thinker, Nadia Urbinati argues that this claim misrepresents Mill's thinking.

This essay reclaims a political proceduralist vision of democracy as the best normative defense of democracy in contemporary politics. We distinguish this vision from three main approaches that are representative in the current academic debate: the epistemic conception of democracy as a process of truth seeking; the populist defense of democracy as a mobilizing politics that defies procedures; and the classical minimalist or Schumpeterian definition of democracy as a competitive method for selecting leaders.

When individual patients' medical decisions contribute to population-level trends, physicians may struggle with how to promote justice while maintaining respect for patient autonomy. This article argues that this tension might be resolved by using the informed consent conversation as an opportunity to position patients as societal stewards.

Consumer-targeted sleep tracking applications (STA) that run on mobile devices (e.g., smartphones) promise to be useful tools for the individual user. Assisted by built-in and/or external sensors, these apps can analyze sleep data and generate assessment reports for the user on their sleep duration and quality. However, STA also raise ethical questions, for example, on the autonomy of the sleeping person, or potential effects on third parties. Nevertheless, a specific ethical analysis of the use of these technologies is still missing (...) so far. The aim of the current analysis is to identify the characteristics of sleep tracking apps and to explore the specific ethical aspects associated with this form of self-tracking. Firstly, the field of mobile health applications was screened for STA to explore their typical functions and target user groups. Secondly, an ethical analysis was conducted focusing on the three ethical dimensions: (1) medicalization, (2) vulnerability, and (3) relationality. The analysis indicates that these three normative dimensions are decisive for assessing STA and that the ethical profile of this technology varies greatly depending on the respective user group. As the three dimensions medicalization, vulnerability, and relationality play a distinguishing role in the use of STA, they should be especially addressed in responsible development and implementation of STA. In addition, the analysis helps to evaluate the use of STA, in terms of different risks for specific user groups, the sensitive contexts of usage, and potential interference with the intimacy of third parties. (shrink)

Since the COVID‐19 pandemic, ongoing reports have highlighted the urgency of addressing anti‐Black racism within Canada's healthcare system. The paucity of research within a Canadian context has created growing concerns among Millennials and Generation Zs for healthcare to address growing health disparities and health inequities that are attributed to institutional and structural racism. Recognizing the paradigm shift that has occurred because of the pandemic and the sleuth of racial killings, the nursing classroom has witnessed a change and a need for (...) nursing education to be relevant for the cohort of nursing students who are seeking answers. The scarcity of nursing literature addressing diverse forms of learning demonstrates the need for nursing education to explore new ways of being diverse, inclusive and innovative when teaching intergenerationally. In this paper, the author challenges nurse educators to revisit the student–educator relationship by introducing critical digital pedagogy to dismantle anti‐Black racism and promote student–educator engagement for transformative learning to occur. As an educator, the author implements the use of digital illustration as a tool of resistance for students and educators to assess, engage, act and reflect on creating change within nursing education. Using Black feminist thought and culturally responsive learning, the author introduces an arts‐based approach through the innovative design of an illustration, titled, ‘Ain't I a Nurse. Combining historical stories with contemporary socio‐political experiences, the author demonstrates how students and educators can enter a cognitive learning experience where they can connect mentally and emotionally, and in so doing re‐envision and recreate a new world that centralizes equity, diversity and inclusivity through critical discourses. Through the illustration anti‐Black racism is challenged and anti‐Black racism resistance is discovered as an antidote in dismantling anti‐Black racism within nursing education. (shrink)

Background The wide proliferation of Covid-19 has impacted billions of people all over the world. This catastrophic pandemic outbreak and ostracism at work have posed challenges for all healthcare professionals, especially for nurses, and have led to a significant increase in the workload, several physical and mental problems, and a change in behavior that is more negative and counterproductive. Therefore, leadership behaviors that are moral in nature serve as a trigger and lessen the adverse workplace effects on nurses’ conduct. Aim (...) this research is directed to explore the impact of post-COVID-19 workplace ostracism on nurses’ counterproductive behavior and examine the role of moral leadership as a mediating factor in post-COVID-19 workplace ostracism and nurses’ counterproductive behavior. Ethical consideration Ethical review and approval Was received from Ethical Committee at the Faculty of Nursing, Alexandria University, Egypt. Methods A cross-sectional and correlation study was implemented in all units of medical, surgical, critical and intensive care units by using three tools; moral leadership questionnaire, Workplace Ostracism Instrument (WOS), and Counterproductive Work Behaviors Questionnaire (CWBs). A convenient sample of 340 from 699 bedside nurses was granted. Results This study revealed that nurses’ perceived moderate mean percent (55.49 ± 3.46) of overall workplace ostracism and counterproductive behavior (74.69 ± 6.15). However, they perceived a low mean percentage of moral leadership. There was a significant positive correlation between workplace ostracism and counterproductive behavior. Otherwise, a significant negative correlation was found between moral leadership, workplace ostracism and counterproductive behavior. Also, this study proved the mediating effect of moral leadership in decreasing workplace ostracism by 79.3% and counterproductive behavior by 36.7%. Conclusion Hospital administrators need to be aware of the significance of moral leadership and apply integrity in the clinical setting to reduce the drawback of isolation on nurses' conduct and increase value for the organization as a whole and nurses in particular. (shrink)

This article tracks the development of the Globethics.net Foundation’s work on ethics in higher education, mainly as a focus on the University administration and good practices. Ethics in university management and organisation is a center of focus since the new strategic focus of the Foundation in 2016, paying tribute to the leadership of Globethics.net Executive Director Obiora F. Ike. Prof. Dr Ike pioneered the work and laid firm foundations for its continuation and global implementation. In addition to the Globethics.net resources (...) of library, publications and online education through its academy, Globethics.net launched processes and tools to inspire and equip higher education institutions to reach true ethics excellence in their organisation as institutions. (shrink)

Сучасна філософія тяжіє до осмислення людської дійсності у дедалі ширших міждисциплінарних контекстах. Спочатку традиційні, а віднедавна й інтернет-медіа та інформаційні технології опинилися у полі зору філософів та стали джерелом для переосмислення чималої кількості так званих вічних філософських запитань. Серед них зокрема і найширші, як-от усвідомлення меж реального та розуміння, які саме явища й речі з тих, що конституюють людське, можна вважати реальними. Цю статтю присвячено дослідженню одного з понять, що є ключовим для осмислення реальності, – поняттю віртуальності. Авторка висвітлює його (...) витоки, особливості і специфіку вжитку в сучасному філософському дискурсі. Зокрема, показано конотації віртуального з усіма трьома часовими вимірами: минулим, теперішнім та майбутнім. Наголошено, що поняття віртуального спочатку було «перевідкрите» Жилем Дельозом, а потім пережило ще низку сутнісних змін у філософії ХХ–ХХІ століть. Тож віртуальне розглянуто як контрагент реального. Зокрема, у статті приділено увагу різноманітним конотаціям між поняттями віртуальності, реальності та фактичності. Крім того, розкрито моральні аспекти віртуальності – як у трансцендентному, так і в іманентному сенсі. Висвітлено підґрунтя для нерозрізнюваності «реального» та «віртуального». Зроблено висновок про те, що в ситуації так званої підміни реальності різноманіття конотацій поняття віртуальності може бути використане для перевідкриття вже самого поняття реальності. (shrink)

Die vorliegende Untersuchung bemüht sich um eine Klärung des Verhältnisses von Lebenswelt und Wissenschaft. Zum einen treten die Wissenschaften bereits ihrem Begriffe nach mit dem Anspruch auf eine besondere Qualität des von ihnen zur Verfügung gestellten Wissens auf. Soll es sich hierbei nicht um ein leeres Versprechen handeln, muss sich zeigen lassen, inwiefern sich die Wissenschaften von anderen Wissensformen wie eben dem Alltagswissen abheben. Die Klärung dieses Verhältnisses stellt also implizit eine Bestimmung der besonderen Qualität der Wissenschaften dar - eine (...) der Hauptaufgaben der Wissenschaftsphilosophie. Zum anderen muss auch der Verlässlichkeit unseres Alltagswissens Genüge getan werden. Das lebensweltliche Wissen ermöglicht uns eine mehr als hinreichende Orientierung im Alltag, so dass eine Degradierung desselben zu einer Ansammlung von bloßen Scheingebilden nur eine unzureichende Analyse darstellt. Da sich prinzipiell drei unterschiedliche Gewichtungen des genannten Verhältnisses denken lassen - die erste optiert zu Gunsten der Wissenschaften, die zweite favorisiert die lebensweltlichen Erfahrungsformen, die dritte will beiden Erkenntnisformen zu ihrem jeweiligen Recht verhelfen -, werden diese nacheinander diskutiert und gegeneinander abgewogen. (shrink)

In a number of very influential publications, Epstein and Hoover (among other authors) have recently argued that a thoroughly micro-foundationalist approach towards economics is unconvincing for metaphysical reasons. However, as we show in this article, this metaphysical/social ontological approach to the debate fails to resolve the status of micro-foundations in the practice of economic modelling. To overcome this, we argue that endogenizing a model—that is, providing micro-foundations for it—correlates with making that model more complex. Specifically, we show that models with (...) more micro-foundations tend to have more parameters or variables. This matters, as there are well-established methodological reasons for preferring models with fewer parameters or variables—ceteris paribus. We therefore conclude that, from a practice-based point of view, micro-foundations are only defensible to the extent that they significantly improve the ability of the relevant model to fit the data of interest. In this way, we arrive at a practice-based, methodological reconceptualization of the debate surrounding the need for micro-foundations in economics. (shrink)

Ce texte est tiré de la thèse de doctorat de Nadia Taïbi, présentée à l'Université Jean Moulin Lyon 3, le 29 octobre 2007, sous la direction de Jean-Jacques Wunenburger : L'expérience ouvrière de Simone Weil. La philosophie au travail, pp. 28-33. N'ayant pas pu joindre Nadia Taïbi pour lui demander son autorisation, nous espérons qu'elle ne nous en tiendra pas rigueur. 1.1.2. La pensée comme résistance L'expérience de la vie d'usine telle que Simone Weil la traduit nous paraît (...) révéler ce qu'il faut - Philosophie – Nouvel article. (shrink)

In view of recent studies that identified certain interest groups as potential whistleblowers, we propose an integrative conceptual framework to examine whistleblower behavior by whistleblower type. The framework, dubbed the whistleblowing triangle, is modeled on the fraud triangle and is comprised of three factors that condition the act of whistleblowing: pressure, opportunity, and rationalization. For a rich examination, we use a qualitative research framework to analyze 11 whistleblowing cases of corporate financial statement fraud in Canada that were publicly denounced between (...) 1995 and 2012. Our analysis indicates that whistleblowers are not only insiders but also outsiders [financial analysts, auditing firms, journalists, politicians, customers, and investors]. It also suggests that a dynamic relation may exist between whistleblowers. In addition, our findings show that most whistleblowers opt for external channels when they fail to receive an adequate response from management, seek media exposure, are interested in financial benefits resulting from the act of whistleblowing, or are interested in protecting their investment. Lastly, we propose categorizing whistleblowers into four conceptual types: protective, skeptical, role-prescribed, and self-interested. (shrink)

The practice of Islamic veiling has over the last ten years emerged into a popular site of investigation. Different researchers have focused on the various significations of this bodily practice, both in its gendered dimensions, its identity components, its empowering potentials, as a satorial practice or as part of a broader economy of bodily practices which shape pious dispositions in accordance with the Islamic tradition. Lesser, however, has this been the case for the practice of not veiling or unveiling. If (...) and when attention is accorded to the latter, it is often grasped as a product of integration or an effect secular governmentality, but only rarely as a bodily practice. Drawing on narratives of second generation secular and religious Maghrebi Muslims in Belgium, this paper pursues this second perspective by examining to which extent not-veiling can be understood as a technique of the self (Foucault) that is functional to shaping a liberal (Musilm) subject. While a first part of this article will unpack the ethical substance of such discursive interrogations and point to the ways in which they are intertwined with the enactment of a liberal self, the second part will examine the embodied contours of this problematization, which appeared through the labour upon one's affect and bodily dispositions that this refusal of the hijab, or the act of unveiling, implies. (shrink)

Earlier this year, the U.S. Department of Health and Human Services announced its intent to strengthen enforcement of legal protections for health care providers' conscience rights. It proposed regulations that would give the DHHS Office of Civil Rights greater authority to ensure that recipients of federal funding comply with federal conscience laws. This recent development creates an opportunity for scholars and policy‐makers to revisit the perennial debate about whether and how law should protect health care providers' rights of conscience. Arguments (...) about who should be protected, what actions should be protected, and whether there should be any limitations on the exercise of conscience rights have brought us no closer to a resolution. However, there is one remaining avenue for analysis that has, surprisingly, received very little attention—the question of how providers are protected, and from what consequences. Existing U.S. conscience laws immunize health care providers from a wide range of adverse consequences—including civil liability, criminal prosecution, administrative penalties, adverse action by employers, and discrimination by private actors, among others. However, academic and public policy debates rarely acknowledge the breadth of these protections. It is essential to disentangle this network of possible protections. (shrink)

The COVID-19 emergency has hit the whole world, finding all countries unprepared to face it. The first studies focused on the medical aspects, neglecting the psychological dimension of the populations that were forced to face changes in everyday life and in some cases to stay forcedly at home in order to reduce contagion. The present research was carried out in Italy, one of the countries hardest hit by the pandemic. The aim was to analyze the perception of happiness, mental health, (...) and the sense of loneliness experienced by adults during the lockdown due to the COVID pandemic. Specifically, the variables will be examined in relation to gender difference, living alone, with partner, or with partner and children. The research followed a quantitative approach using an online questionnaire. The project involved 1100 subjects from whom 721 participants were extrapolated. Of them, 17.3% claimed to live alone, 39.5% with their partner, and 43.1% with their partner and children. The results show that people in general experienced a lower level of happiness and mental health and higher levels of loneliness compared to normative sample. The lockdown and pandemic condition due to COVID-19 seems to have canceled the gender differences in the perception of happiness and mental health, while it seems to have increased the perception of loneliness experienced by males compared to the pre-pandemic condition. In addition, those who lived alone perceived a greater level of loneliness than those who lived with their partner or partner and children. Unexpectedly, no significant differences emerged regarding the level of happiness and mental health between those who had direct contact with the virus and those who did not. These data should make political decision-makers reflect on the need to pay more attention to the implications that such drastic measures as a lockdown can have on people’s psychological well-being. (shrink)

How did vanilla, once a rare luxury, become a global sensation? Rather than taking the vanilla flavor of vanilla beans as a pre-existing natural fact, this essay argues that the sensory experience that came to be recognized as vanilla was a hybrid artifact produced by an expanding global trade in a diverse set of pleasurable substances, including cured beans from artificially pollinated vanilla orchids, synthetic vanillin, sugar, and a far-flung miscellany of other botanical and chemical materials. Global trade and large-scale (...) production resulted not in the production of a homogenous, stable commodity, but in a range of local vanillas, heterogeneous mixtures with a range of qualities and virtues. As local commercial and regulatory interests competed to define the origins, and thus the market value, of authentic vanilla flavor, scientific experts were called upon to adjudicate these rival claims. In the United States, these debates played out in the context of the 1906 Pure Food and Drug Act, where efforts to define and chemically enforce a ‘standard’ vanilla extract, in contradistinction from adulterated, ‘imitation’ extracts, clashed with the interests of makers and users of both synthetic and ‘genuine’ vanilla flavorings. As regulatory chemists grappled with the growing variety of vanillas, they were required to determine the appropriate chemical components of genuine vanilla, and consequently to delimit the subjective sensory effects proper to the flavor. Nonetheless, the materials, experiences, and meanings popularly associated with vanilla flavor continued to exceed the limits prescribed by officials. (shrink)

This article argues that the Supreme Court’s decision in Dobbs is likely to impact medical decision-making by pregnant patients in a variety of contexts. Of particular concern are situations where a patient declines treatment recommended for its potential benefit to the fetus and situations where treatment is withheld due to potential risk to the fetus. The Court’s elevation of fetal interests, combined with a history of courts using abortion jurisprudence to guide their reasoning in compelled treatment cases, means that Dobbs (...) has the potential to limit patient autonomy in a wide array of clinical settings. The article calls on professional medical associations to issue ethical guidance affirming the duty to respect the medical self-determination of pregnant patients. (shrink)

ABSTRACTThe aim of this study was to examine the extent to which cognitive emotion regulation strategies were “common or transdiagnostic correlates” of symptoms of depression and anxiety and/or “specific correlates” distinguishing one problem category from the other. The sample comprised 582 13- to 16-year-old secondary school students. Symptoms of depression and anxiety were measured by the SCL-90, and cognitive emotion regulation strategies were measured by the CERQ, in a cross-sectional design. Multivariate regression analyses were performed. Before controlling for comorbidity, the (...) same cognitive emotion regulation strategies that were related to symptoms of depression were also related to symptoms of anxiety. However, after controlling for comorbid anxiety symptoms, rumination, self-blame, positive reappraisal, and positive refocusing were uniquely associated with depression symptoms; and after controlling for comorbid depression symptoms, ca... (shrink)

In this paper, I discuss the social philosopher Pierre Bourdieu’s concept of habitus, and use it to locate and examine dispositions in a larger constellation of related concepts, exploring their dynamic relationship within the social context, and their construction, manifestation, and function in relation to classroom mathematics practices. I describe the main characteristics of habitus that account for its invisible effects: its embodiment, its deep and pre-reflective internalization as schemata, orientation, and taste that are learned and yet unthought, and are (...) subsumed by our practices, which we understand as something that “goes without saying.” I also propose that, similarly to Bourdieu’s concept of linguistic habitus, a math habitus is made up of a complex intertwining of collective and individual histories that turn into “nature,” which structure all individual and collective action and inform mathematical classroom practice. I suggest that individual math dispositions may be liable to reconstruction through the reconstruction of the collective math habitus, which follows from opening spaces for dialogue, problematization and reconstruction of the unthought categories of the doxa. This requires that students acquire new concrete and symbolic means with which to challenge their current sense of mathematics as a discipline, and mathematical practice tout court. Finally, I argue that community of inquiry, employed as a pedagogical model, provides an avenue for both: for opening those spaces for reflective dialogical inquiry into concepts and questions whose meanings and references have so far been taken for granted, and for acquiring critical thinking and dialogical skills and dispositions that are a necessary means for participating in such reflective inquiry that offers significant promise for reconstructing individual and collective habitus in school settings. (shrink)

Résumé La situation interculturelle des jeunes issus de familles d’origine nord-africaine installées en France pose les problèmes de l’identité et des liens qui unissent les membres de la fratrie. À travers l’expérience d’une psychothérapie familiale et quelques résultats d’une étude menée sur les stratégies identitaires utilisées par les jeunes nés de parents nord-africains, l’article témoigne des différences qui existent dans la gestion des apports culturels entre les garçons et les filles dans les familles maghrébines, de l’importance de la fratrie comme (...) espace de médiation potentiel et des liens fraternels à mobiliser dans les dispositifs thérapeutiques familiaux. La création d’un dispositif de soin prenant en compte des approches diachroniques et synchroniques a ainsi permis d’appréhender et de dénouer les conflits dans la fratrie confrontée à la complexité des situations interculturelles. (shrink)

Background In nursing homes, residents’ relatives represent important sources of support for nurses. However, in the heightened stress of emergency situations, interaction between nurses and relatives can raise ethical challenges. Research objectives The present analysis aimed at elaborating a typology of nurses’ experience of ethical support and challenges in their interaction with relatives in emergency situations. Research design Thirty-three semi-structured interviews and six focus groups were conducted with nurses from different nursing homes in Germany. Data were analysed according to Mayring’s (...) method of qualitative content analysis. Participants and research context Participants were licensed nurses working in nursing homes. Ethical considerations Ethical approval was granted by Ostfalia University of Applied Sciences (02.07.2020) and the Ethics Committee of Hannover Medical School (Nr. 8866_BO_K_2020; 27.01.2020). Interviewees were anonymised and focus group were pseudonymised during transcription. All participants provided written consent. Findings/results In emergency situations, relatives can represent important sources of support for nurses. However, they may also give rise to different challenges, relating to four ethical conflicts: (1) the challenge of meeting the information needs of relatives while providing appropriate care to all residents; (2) the challenge of managing relatives’ demands for hospitalisation when hospitalisation is not deemed necessary by nurses; (3) the challenge of managing relatives’ demands for lifesaving treatment when such treatment contradicts the will of the resident; and (4) the challenge of attempting to initiate hospitalisation when relatives oppose this course of action. Several external factors make these conflicts especially challenging for nurses: fear of legal consequences, a low staffing ratio, and a lack of qualified nursing staff. Conclusions Conflict between nurses and relatives typically revolves around hospitalisation and the initiation of lifesaving treatment. Whether nurses perceive interaction with relatives as supportive or conflictual essentially depends on the quality of the relationship, which may be negatively influenced by a number of external factors. (shrink)

The values of individuals who have never had the capacity to express their preferences are often overlooked or even ignored in the decision-making process. The case of “Michael,” a non-verbal young adult with a genetic condition and intellectual disability, is presented to challenge the traditional approach of relying solely on clinical indicators and the “best interest” standard narrowly construed in healthcare decision-making. Michael's interaction with his environment, gleaned through his family's input, illustrates that values and quality of life can be (...) discerned through observed behaviors and preferences, even in the absence of communicative ability. We argue for a broader definition of “values” that encompasses any aspect of life that brings meaning or enjoyment to the individual. This model not only personalizes care for never-capacitated individuals but may also be applied to other incapacitated populations, such as those with dementia, suggesting that past directives may not always align with their evolving values and interests. Underlying this expanded understanding of values in healthcare is a patient-centered approach that accounts for personal elements that contribute to an individual's sense of purpose and satisfaction. (shrink)

This paper analyzes critically the appeal the unpolitical is enjoying among contemporary political philosophers who are democracy's friends. Unlike a radical critique of democracy, what I propose to call "criticism from within," takes the form of dissatisfaction with the erosion of an independent mind and impartial judgment per effect of the partisan character of democratic politics. This paper proposes three main criticisms of the actual trend toward unpolitical views of democracy: the first points to the strategic use of deliberation as (...) an antidote against democratic procedures themselves ; the second to the negative conception of democracy that the unpolitical aspiration makes visible; and the third to the dissolution of political judgment within a model of judgment that is tailored around justice. (shrink)