This article explores the 2020 Turkish Netflix series Bir Başkadır (Ethos) written and directed by Berkun Oya about contemporary Turkey through its objects. With objects surge memories, which are both personal and collective. From the charged objects that convey private attachments, traumas, and histories to ordinary household trinkets and finally archival audiovisual material, this series assumes the status of museum in its drive to carefully exhibit the material world on screen. As the Turkish title of the series indicates, these objects (...) are “bir başkadır”: one of a kind. Through themes and practices of lost innocence, counter-archives, and archiveology, I sift through the quotidian objects, miniatures, old photos, souvenirs, and analogue film footage re-presented and re-collected in this series with an eye to their new scope and allure. The past and present rest adjacent to one another in the mise-en-scène of this series. In engagement with the philosophical writings of Walter Benjamin on the collector, the archive, and memory, Andreas Huyssen's concept of the “museal gaze,” Jennifer Culbert's “counter-archival sensibility,” and finally Catherine Russell's practice of “archiveology,” this article examines how the objects that fashion the on-screen world acquire depth and meaning and the film as museum comes to form. (shrink)

Structural realism has rapidly gained in popularity in recent years, but it has splintered into many distinct denominations, often underpinned by diverse motivations. There is, no monolithic position known as ‘structural realism,’ but there is a general convergence on the idea that a central role is to be played by relational aspects over object-based aspects of ontology. What becomes of causality in a world without fundamental objects? In this book, the foremost authorities on structural realism attempt to answer this and (...) related questions: ‘what is structure?’ and ‘what is an object?’ Also featured are the most recent advances in structural realism, including the intersection of mathematical structuralism and structural realism, and the latest treatments of laws and modality in the context of structural realism. The book will be of interest to philosophers of science, philosophers of physics, metaphysicians, and those interested in foundational aspects of science. (shrink)

This paper considers the nature and role of axioms from the point of view of the current debates about the status of category theory and, in particular, in relation to the "algebraic" approach to mathematical structuralism. My aim is to show that category theory has as much to say about an algebraic consideration of meta-mathematical analyses of logical structure as it does about mathematical analyses of mathematical structure, without either requiring an assertory mathematical or meta-mathematical background theory as a "foundation", (...) or turning meta-mathematical analyses of logical concepts into "philosophical" ones. Thus, we can use category theory to frame an interpretation of mathematics according to which we can be structuralists all the way down. (shrink)

Against the background of a deeply uneven package of work–family reconciliation measures and an increasing focus on engaging men in unpaid care work, in this article I discuss the extension of the Irish discrimination law framework to provide protection against family status discrimination to workers who are engaged in certain care relationships. While this development of the law to recognize a relational understanding of inequality is welcome, its confined definition of family status fails to capture the range of workers’ caring (...) relationships and networks. Adopting a contextualized assessment of 12 years of litigation generated under the ‘family status’ ground, with reference to complainants’ gender and work status, the study considers the types of experiences being litigated as ‘family status’ discrimination. The study show how much of the nature and forms of inequality presented before the tribunals are beyond the conceptual boundaries of the principle of equal treatment that depends upon a sameness of treatment model with the ‘care-less’ comparator. Despite its potential to question the neutrality of workplace structures predicated upon the division between paid work and unpaid care, the principle of indirect family status discrimination has been under utilised as a litigation strategy. The most successful dimension of family status discrimination protection has been in respect of its ability to capture the negative stereotyping of worker–carers who continue to perform as ideal workers. I suggest that this extension of a limited negative rights framework, when considered alongside the state’s extremely poor support for workcare reconciliation more broadly, places negligible obligations on employers, and that the gender neutrality implicit in its provisions have yet to impact on gender equality as regards work–care reconciliation. (shrink)

Professional codes of ethics are regarded as elements of nurses' ethical knowledge base and consequently part of their ethics education. However, research focusing on these codes from an educational viewpoint is scarce. This study explored the need and applicability of nursing codes of ethics in modern health care, their importance in the nursing ethics curriculum, and the need for development of their teaching. A total of 183 Finnish nurse educators and 212 nursing students answered three structured questions, with an opportunity (...) to justify their responses, and one open-ended question. Descriptive statistics and content analysis were used to analyse the data. The results suggest that the existence of the codes was seen as important and their applicability mainly as appropriate, despite new challenges posed by modern health care. The codes were regarded as an important part of nurses' ethics education, but current integrated teaching methods require development. (shrink)

Recent semantic approaches to scientific structuralism, aiming to make precise the concept of shared structure between models, formally frame a model as a type of set-structure. This framework is then used to provide a semantic account of (a) the structure of a scientific theory, (b) the applicability of a mathematical theory to a physical theory, and (c) the structural realist’s appeal to the structural continuity between successive physical theories. In this paper, I challenge the idea that, to be so used, (...) the concept of a model and so the concept of shared structure between models must be formally framed within a single unified framework, set-theoretic or other. I first investigate the Bourbaki-inspired assumption that structures are types of set-structured systems and next consider the extent to which this problematic assumption underpins both Suppes’ and recent semantic views of the structure of a scientific theory. I then use this investigation to show that, when it comes to using the concept of shared structure, there is no need to agree with French that “without a formal framework for explicating this concept of ‘structure-similarity’ it remains vague, just as Giere’s concept of similarity between models does ...” (French, 2000, Synthese, 125, pp. 103–120, p. 114). Neither concept is vague; either can be made precise by appealing to the concept of a morphism, but it is the context (and not any set-theoretic type) that determines the appropriate kind of morphism. I make use of French’s (1999, From physics to philosophy (pp. 187–207). Cambridge: Cambridge University Press) own example from the development of quantum theory to show that, for both Weyl and Wigner’s programmes, it was the context of considering the ‘relevant symmetries’ that determined that the appropriate kind of morphism was the one that preserved the shared Lie-group structure of both the theoretical and phenomenological models. (shrink)

Our collective enthusiasm for empathy reflects a sense that it is deeply valuable. I show that empathy bears a complex and surprisingly problematic relation to another social epistemic phenomenon that we have reason to value, namely testimonial trust. My discussion focuses on empathy with and trust in people who are members of one or more oppressed groups. Empathy for oppressed people can be a powerful tool for engendering a certain form of testimonial trust, because there is a tight connection between (...) empathy and a approval of another's outlook. I then argue that the qualities of empathy that make it such a powerful tool for bridging differences and building trust also have a problematic upshot: they make it the case that reliance on empathy will sometimes have a distorting effect upon the ways we extend testimonial trust. (shrink)

I argue that recollection, in Plato's Meno , should not be taken as a method, and, if it is taken as a myth, it should not be taken as a mere myth. Neither should it be taken as a truth, a priori or metaphorical. In contrast to such views, I argue that recollection ought to be taken as an hypothesis for learning. Thus, the only methods demonstrated in the Meno are the elenchus and the hypothetical, or mathematical, method. What Plato's (...) Meno demonstrates, then, is that we cannot be philosophers if we fail to make use of the mathematician's hypothetical method. (shrink)

The aim of this paper is to put into context the historical, foundational and philosophical significance of category theory. We use our historical investigation to inform the various category-theoretic foundational debates and to point to some common elements found among those who advocate adopting a foundational stance. We then use these elements to argue for the philosophical position that category theory provides a framework for an algebraic in re interpretation of mathematical structuralism. In each context, what we aim to show (...) is that, whatever the significance of category theory, it need not rely upon any set-theoretic underpinning. (shrink)

This chapter addresses the question of what makes expressions meaningful according to the conception of meaning offered by Donald Davidson. It addresses this question by reflecting on Kathrin Glüer’s recent response to it. It argues that Glüer misconstrues both the evidence for meaning that the radical interpreter must rely on and the way in which the principle of charity must be deployed. The articulation of the correct construal of the evidence and the principle reveals the thoroughly non-reductionist aspect of Davidson’s (...) conception of meaning. This aspect becomes even clearer in his later work, through the articulation of the triangulation argument. I try to show how this argument, which is reconstructed in accordance with Claudine Verheggen’s interpretation of it, helps answer the initial question. The question whether the conception has the resources to account for the objectivity of meaning is briefly discussed. (shrink)

In the context of the changes and challenges of the 21st century, the main focus of education, especially religious education, is to prepare students to live purposeful and meaningful lives with well-developed analytic, emotional and spiritual abilities to assist them in achieving a life perspective that allows them to face the larger world with greater self-confidence and self-awareness. Therefore, the main objectives of the study are: to bring forward the concepts of religious education, emotional intelligence and spiritual intelligence; to discuss (...) the importance of emotional and spiritual literacy in children’s education; and to discuss the main strategies to enhance the educational process through emotional and spiritual intelligence. This article is a conceptual framework based on a theoretical review. The author reviews literature from books, scientific journals and research reports to develop relevant concepts. Contribution: This study provides information about two important intelligence in Christian Orthodox religious education. Recognising emotional and spiritual intelligence has allowed teachers to engage with students and help them perform at their best. Emotional intelligence and spiritual intelligence promote self-efficacy, self-awareness, self-regulation, motivation, empathy and social skills, which help students perform management tasks in their future occupations but also help them to improve relationships with parents, colleagues and God. (shrink)

Background: Spasticity following a stroke occurs in about 30% of patients. The mechanisms underlying this disorder, however, are not well understood. Method: This review aims to define spasticity, describe hypotheses explaining its development after a stroke, give an overview of related neuroimaging studies as well as a description of the most common scales used to quantify the degree of spasticity and finally explore which treatments are currently being used to treat this disorder.

Introduction: Teaching and misleading -- Ethical fables and antifeminist exempla -- From sermon story to novella -- Lives of saints; lives of sinners -- Classical and vernacular exempla -- Magister amoris -- Afterword in time of plague.

I argue that if we distinguish between ontological realism and semantic realism, then we no longer have to choose between platonism and formalism. If we take category theory as the language of mathematics, then a linguistic analysis of the content and structure of what we say in and about mathematical theories allows us to justify the inclusion of mathematical concepts and theories as legitimate objects of philosophical study. Insofar as this analysis relies on a distinction between ontological and semantic realism, (...) it relies also on an implicit distinction between mathematics as a descriptive science and mathematics as a descriptive discourse. It is this latter distinction which gives rise to the tension between the mathematician qua philosopher. In conclusion, I argue that the tensions between formalism and platonism, indeed between mathematician and philosopher, arise because of an assumption that there is an analogy between mathematical talk and talk in the physical sciences. (shrink)

My name, Liv, is the number fifty four in Roman numerals. Is fifty five, then, the sum of me plus my disease? It is a larger number, but the “i” has been taken out. To become something more than myself, and at the same time, something less: that is the essence of receiving a..

In the present research, we validated a new scale developed from self-determination theory (SDT) to assess the functional meaning of cash rewards offered in the workplace. According to SDT, rewards can take on different meanings based on the way they are perceived by individuals. In a series of three studies in different socioeconomic contexts, we replicated the two-factorial structure of the scale measuring respectively workplace cash rewards’ informative and controlling meanings. In Study 1, we validated the English version of the (...) scale by exploring and then confirming its two-factor structure with two English-speaking employee samples. We further replicated its two-factor structure in a French-speaking employee sample of employees in Study 2 and in a Greek-speaking employee sample in Study 3, allowing us to validate its French and Greek version. Results from our three studies show how distinct meanings attributed to cash rewards, i.e., informative or controlling, relate differently to autonomous and controlled forms of motivation based on SDT. These findings suggest that workplace cash rewards differently influence employees’ motivation depending on whether they are perceived as informative or controlling, thus providing empirical evidence for the theoretical and practical implications of SDT’s concept of functional meaning of cash rewards. Our research contributes to the assessment and understanding of employees’ experience of workplace cash rewards and provides empirical evidence that the concept of the functional meaning of cash rewards is a distinct concept from other money-related concepts such as subjective pay satisfaction, performance-contingent rewards, and financially contingent self-worth. (shrink)

In this paper I argue that category theory ought to be seen as providing the language for mathematical discourse. Against foundational approaches, I argue that there is no need to reduce either the content or structure of mathematical concepts and theories to the constituents of either the universe of sets or the category of categories. I assign category theory the role of organizing what we say about the content and structure of both mathematical concepts and theories. Insofar, then, as the (...) structuralist sees mathematics as talking about structures and their morphology, I contend that category theory furnishes a framework for mathematical structuralism. (shrink)

Controlled Human Infection Model (CHIM) research involves the infection of otherwise healthy participants with disease often for the sake of vaccine development. The COVID-19 pandemic has emphasised the urgency of enhancing CHIM research capability and the importance of having clear ethical guidance for their conduct. The payment of CHIM participants is a controversial issue involving stakeholders across ethics, medicine and policymaking with allegations circulating suggesting exploitation, coercion and other violations of ethical principles. There are multiple approaches to payment: reimbursement, wage (...) payment and unlimited payment. We introduce a new Payment for Risk Model, which involves paying for time, pain and inconvenience and for risk associated with participation. We give philosophical arguments based on utility, fairness and avoidance of exploitation to support this. We also examine a cross-section of the UK public and CHIM experts. We found that CHIM participants are currently paid variable amounts. A representative sample of the UK public believes CHIM participants should be paid approximately triple the UK minimum wage and should be paid for the risk they endure throughout participation. CHIM experts believe CHIM participants should be paid more than double the UK minimum wage but are divided on the payment for risk. The Payment for Risk Model allows risk and pain to be accounted for in payment and could be used to determine ethically justifiable payment for CHIM participants.Although many research guidelines warn against paying large amounts or paying for risk, our empirical findings provide empirical support to the growing number of ethical arguments challenging this status quo. We close by suggesting two ways (value of statistical life or consistency with risk in other employment) by which payment for risk could be calculated. (shrink)

Human adaptive behavior in sensorimotor control is aimed to increase the confidence in feedforward mechanisms when sensory afferents are uncertain. It is thought that these feedforward mechanisms rely on predictions from internal models. We investigate whether the brain uses an internal model of physical laws to help estimate body equilibrium when tactile inputs from the foot sole are depressed by carrying extra weight. As direct experimental evidence for such a model is limited, we used Judoka athletes thought to have built (...) up internal models of external loads as compared with Non-Athlete participants and Dancers. Using electroencephalography, we first tested the hypothesis that the influence of tactile inputs was amplified by descending cortical efferent signals. We compared the amplitude of P1N1 somatosensory cortical potential evoked by electrical stimulation of the foot sole in participants standing still with their eyes closed. We showed smaller P1N1 amplitudes in the Load compared to No Load conditions in both Non-Athletes and Dancers. This decrease neural response to tactile stimulation was associated with greater postural oscillations. By contrast in the Judoka’s group, the neural early response to tactile stimulation was unregulated in the Load condition. This suggests that the brain can selectively increase the functional gain of sensory inputs, during challenging equilibrium tasks when tactile inputs were mechanically depressed by wearing a weighted vest. In Judokas, the activation of regions such as the right posterior inferior parietal cortex as early as the P1N1 is likely the source of the neural responses being maintained similar in both Load and No Load conditions. An overweight internal model stored in the right PPC known to be involved in maintaining a coherent representation of one’s body in space can optimize predictive mechanisms in situations with high balance constraints. This hypothesis has been confirmed by showing that postural reaction evoked by a translation of the support surface on which participants were standing wearing extra-weight was improved in Judokas. (shrink)

Empathy is a form of emotionally charged imaginative perspective‐taking. It is also the unique source of a particular form of understanding, which I will call humane understanding. Humane understanding consists in the direct apprehension of the intelligibility of others’ emotions. This apprehension is an epistemic good whose ethical significance is multifarious. In this paper, I focus on elaborating the sense in which humane understanding of others is non‐instrumentally valuable to its recipients. People have a complex but profound need to be (...) humanely understood. Because we respond to others’ very real need when we pursue this sort of understanding of their emotions, empathy is best understood as itself a way of caring, rather than just a means to promote other caring behavior. (shrink)

Background: Nursing practice takes place in a social framework, in which environmental elements and interpersonal relations interact. Ethical climate of the work unit is an important element affecting nurses’ professional and ethical practice. Nevertheless, whatever the environmental circumstances, nurses are expected to be professionally competent providing high-quality care ethically and clinically. Aim: This study examined newly graduated nurses’ perception of the ethical climate of their work environment and its association with their self-assessed professional competence, turnover intentions and job satisfaction. Method: (...) Descriptive, cross-sectional, correlational research design was applied. Participants consisted of 318 newly graduated nurses. Data were collected electronically and analysed statistically. Ethical considerations: Ethical approval and permissions to use instruments and conduct the study were obtained according to required procedures. Data were rendered anonymous to protect participant confidentiality. Completing the questionnaire was interpreted as consent to participate. Findings: Nurses’ overall perception of the ethical climate was positive. More positive perceptions related to peers, patients and physicians, and less positive to hospitals and managers. Strong associations were found between perceived ethical climate and self-assessed competence, turnover intentions in terms of changing job, and job satisfaction in terms of quality of care. Nurses at a higher competence level with positive views of job satisfaction and low turnover intentions perceived the climate significantly more positively. Conclusion: Nursing management responsible for and having the power to implement changes should understand their contribution in ethical leadership, as well as the multidimensional nature of nurses’ work environment and the interaction between work-related factors in planning developmental measures. Future research should focus on issues in nurse managers’ ethical leadership in creating ethical work environments. There is also a need for knowledge of newly graduated nurses’ views of factors which act as enhancers or barriers to positive ethical climates to develop. Interventions, continuing education courses, and discussions designed to promote positive ethical climates should be developed for managers, nurses, and multi-professional teams. (shrink)

This paper examines Hannah Ginsborg's attempt to address the challenge raised by Saul Kripke's meaning sceptic. I start by identifying the two constraints that the sceptic claims must be met by a satisfactory answer. Then I try to show that Ginsborg's proposal faces a dilemma. In the first instance, I argue that it is able to meet the second constraint, but not the first. I then amend the proposal in order to make room for the first constraint. I go on (...) to argue that, under this new interpretation, it cannot meet the second constraint. (shrink)

In this essay Olivia Newman critically examines two opposing rights claims: the liberal claim that children have a right to become liberal choosers and the fundamentalist claim that children have a right to not become liberal choosers. These positions reflect differing views regarding the value of critically choosing, rather than simply accepting, a way of life. Given their assumptions regarding preference formation, both of these rights appear untenable in light of recent scholarship in psychology: we can neither select a (...) way of life independent of our social milieu, as liberals often imply, nor can we predict how different experiences will affect our preferences, as fundamentalists assume. Nevertheless, each position points to important concerns. Children have a substantive right of exit from constraining social milieus, as liberals purport, as well as a right to respect in public institutions, as fundamentalists insist. When liberals and fundamentalists assert these more modest rights claims, educators can and should strive to satisfy both. (shrink)

Background: Nursing as an ethical practice requires courage to be moral, taking tough stands for what is right, and living by one’s moral values. Nurses need moral courage in all areas and at all levels of nursing. Along with new interest in virtue ethics in healthcare, interest in moral courage as a virtue and a valued element of human morality has increased. Nevertheless, what the concept of moral courage means in nursing contexts remains ambiguous. Objective: This article is an analysis (...) of the concept of moral courage in nursing. Design: Rodgers’ evolutionary method of concept analysis provided the framework to conduct the analysis. Data sources: The literature search was carried out in September 2015 in six databases: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and The Philosopher’s Index. The following key words were used: “moral” OR “ethical” AND “courage” OR “strength” AND “nurs*” with no time limit. After applying inclusion and exclusion criteria, 31 studies were included in the final analysis. Ethical considerations: This study was conducted according to good scientific guidelines. Results: Seven core attributes of moral courage were identified: true presence, moral integrity, responsibility, honesty, advocacy, commitment and perseverance, and personal risk. Antecedents were ethical sensitivity, conscience, and experience. Consequences included personal and professional development and empowerment. Discussion and conclusion: This preliminary clarification warrants further exploring through theoretical and philosophical literature, expert opinions, and empirical research to gain validity and reliability for its application in nursing practice. (shrink)

Law moves, whether we notice or not. Set amongst a spatial turn in the humanities, and jurisprudence more specifically, this book calls for a greater attention to legal movement, in both its technical and material forms. Despite various ways the spatial turn has been taken up in legal thought, questions of law, movement and its materialities are too often overlooked. This book addresses this oversight, and it does so through an attention to the materialities of legal movement. Paying attention to (...) how law moves across different colonial and contemporary spaces, this book reveals there is a problem with common law's place. Primarily set in the postcolonial context of Australia - although ranging beyond this nationalised topography, both spatially and temporally - this book argues movement is fundamental to the very terms of common law's existence. How, then, might we move well? Explored through examples of walking and burial, this book responds to the challenge of how to live with a contemporary form of colonial legal inheritance by arguing we must take seriously the challenge of living with law, and think more carefully about its spatial productions, and place-making activities. Unsettling place, this book returns the question of movement to jurisprudence. (shrink)

Interest in sport cyberpsychology has become more popular over the last decade, primarily due to the increased use of technology and the online world, including social media, within sport settings. In 2020, this became even more apparent for many athletes, their support teams and their sport organisations, when their professional and social worlds became cyber-dominated due to the COVID-19 pandemic. Many challenges were encountered by: the athletes, in their efforts to remain active and well during this time when all competitions (...) were cancelled and the healthcare professionals, working with these athletes, in their efforts to continue to support the athletes, when severe travel restrictions and social distancing were in place for considerable periods of time. The purpose of this paper, using a narrative review process, is to present and scrutinise an array of Internet interventions, remote psychological supports and applications that the athletes and their support personnel used to help them meet their physical, social, and emotional needs during the pandemic. The beneficial and restrictive features of these online options will be presented. Two main themes will be considered in order to focus this discussion, namely, the potential physical and mental opportunities and challenges using the online world extensively during this time presented for the individuals working in sport and suggestions for how such online interventions used by the athletes, their coaches and sport science personnel during the pandemic may be maintained in some positive ways into the future, to help the athletes prepare for their upcoming competitions, their training and their future careers when they retire from elite sport. (shrink)

Streaming in secondary schools is not beneficial for improving student outcomes of education with vast amounts of educational research indicating that it does not improve academic results and increases inequity. Yet teachers often prefer working in streamed classes, and research shows that teachers mediate the effects of streaming on students. This study sought to add to the understanding of teachers’ role in student learning by investigating how teachers conceptualise the students in streamed classes. A qualitative case study approach was used, (...) where 18 teachers were interviewed in-depth to create narrative examples, three of which are presented here. These narratives summarise the research findings that teachers saw students in high and low streams as having homogenous characteristics according to five dichotomous categories: approach to learning, attitude to learning, learning style, autonomy and background. Students in mixed-ability classes were viewed along these same continua, but as more heterogeneous groups. Furthermore, these views of students had direct implications for how teachers planned for learning and the expectations that they held of their students. The discussion links streaming research with teacher expectation research, suggesting that teachers of streamed classes in this secondary school hold specific whole-class ideas that affect student learning. The article concludes with recommendations for further inquiry that links these two important fields of educational research. (shrink)

This book is a meticulous argument for the contemporary value of Marx's democratic theory as an interpretive key for the postmodernism debates.

Background: Moral courage as a part of nurses’ moral competence has gained increasing interest as a means to strengthen nurses acting on their moral decisions and offering alleviation to their moral distress. To measure and assess nurses’ moral courage, the development of culturally and internationally validated instruments is needed. Objective: The objective of this study was to validate the Dutch-language version of the four-component Nurses’ Moral Courage Scale originally developed and validated in Finnish data. Research design: This methodological study used (...) non-experimental, cross-sectional exploratory design. Participants and research context: A total of 559 nurses from two hospitals in Flanders, Belgium, completed the Dutch-language version of the Nurses’ Moral Courage Scale. Ethical considerations: Good scientific inquiry guidelines were followed throughout the study. Permission to translate the Nurses’ Moral Courage Scale was obtained from the copyright holder, and the ethical approval and permissions to conduct the study were obtained from the participating university and hospitals, respectively. Findings: The four-component 21-item, Dutch-language version of the Nurses’ Moral Courage Scale proved to be valid and reliable as the original Finnish Nurses’ Moral Courage Scale. The scale’s internal consistency reliability was high (0.91) corresponding with the original Nurses’ Moral Courage Scale validation study (0.93). The principal component analysis confirmed the four-component structure of the original Nurses’ Moral Courage Scale to be valid also in the Belgian data explaining 58.1% of the variance. Confirmatory factor analysis based on goodness-of-fit indices provided evidence of the scale’s construct validity. The use of a comparable sample of Belgian nurses working in speciality care settings as in the Finnish study supported the stability of the structure. Discussion and conclusion: The Dutch-language version of the Nurses’ Moral Courage Scale is a reliable and valid instrument to measure nurses’ self-assessed moral courage in speciality care nursing environments. Further validation studies in other countries, languages and nurse samples representing different healthcare environments would provide additional evidence of the scale’s validity and initiatives for its further development. (shrink)

Background: Moral courage is required at all levels of nursing. However, there is a need for development of instruments to measure nurses’ moral courage. Objectives: The objective of this study is to develop a scale to measure nurses’ self-assessed moral courage, to evaluate the scale’s psychometric properties, and to briefly describe the current level of nurses’ self-assessed moral courage and associated socio-demographic factors. Research design: In this methodological study, non-experimental, cross-sectional exploratory design was applied. The data were collected using Nurses’ (...) Moral Courage Scale and analysed statistically. Participants and research context: The data were collected from a convenience sample of 482 nurses from four different clinical fields in a major university hospital in Finland for the final testing of the scale. The pilot comprised a convenience sample of 129 nurses. Ethical considerations: The study followed good scientific inquiry guidelines. Ethical approval was obtained from the university ethics committee and permission to conduct the study from the participating hospital. Findings: Psychometric evaluation showed that the 4-sub-scale, 21-item Nurses’ Moral Courage Scale demonstrates good reliability and validity at its current state of development showing a good level of internal consistency for a new scale, the internal consistency values ranging from 0.73 to 0.82 for sub-scales and 0.93 for the total scale, thus well exceeding the recommended Cronbach’s alpha value of >0.7. Principal component analysis and confirmatory factor analysis supported the theoretical construct of Nurses’ Moral Courage Scale. Face validity and expert panel assessments markedly contributed to the relevance of items in establishing content validity. Discussion and conclusion: Nurses’ Moral Courage Scale provides a new generic instrument intended for measuring nurses’ self-assessed moral courage. Recognizing the importance of moral courage as a part of nurses’ moral competence and its assessment offers possibilities to develop interventions and educational programs for enhancement of moral courage. Research should focus on further validation measures of Nurses’ Moral Courage Scale in international contexts. (shrink)

Cultural competence, a clinical skill to recognise patients' cultural and religious beliefs, is an integral element in patient‐centred medical practice. In the area of death and dying, physicians' understanding of patients' and families' values is essential for the delivery of culturally appropriate care. Dementia is a neurodegenerative condition marked by the decline of cognitive functions. When the condition progresses and deteriorates, patients with advanced dementia often have eating and swallowing problems and are at high risk of developing malnutrition. Enteral tube (...) feeding is a conventional means of providing artificial nutrition and hydration to meet nutritional needs, but its benefits to the frail population are limitedly shown in the clinical evidence. Forgoing tube feeding is ethically challenging when patients are mentally incompetent and in the absence of an advance directive. Unlike some developed countries, like the United States of America, death and dying is a sensitive issue or even a taboo in some cultures in developing countries that forgoing enteral tube feeding is clinically and ethically challenging, such as China and Malaysia. This article in three parts 1) discusses the clinical and ethical issues related to forgoing tube feeding among patients with advanced dementia, 2) describes how Hong Kong Chinese, North American, and Malaysian Islamic cultures respond differently in the decision‐making patterns of forgoing tube feeding for patients with advanced dementia, and 3) reiterates the clinical implications of cultural competence in end‐of‐life care. (shrink)

Critics contend that Aristotelianism demands too much of the virtuous person in the way of knowledge to be credible. This general charge is usually directed against either of two of Aristotelianism’s apparent claims about the necessary conditions for the possession of a single virtue, namely that 1) one must know what all the other virtues require, and 2) one must also be the master of a preternatural range of technical/empirical knowledge. I argue that Aristotelianism does indeed have a very high (...) standard when it comes to the knowledge necessary for the full possession of a virtue, in both of these respects. However, focus on the necessary conditions for full virtue tends to obscure an important fact: some kinds of knowledge are much more important to various virtues than others are. A proper appreciation of the significance of this fact will go a long way toward answering critics’ worries about Aristotelianism’s knowledge requirements. (shrink)