Having a decreased sense of security leads to unnecessary suffering and distress for patients. Establishing trust is critical for nurses to promote a patient's sense of security, consistent with trauma‐informed care. Research regarding nursing action, trust, and sense of security is wide‐ranging but fragmented. We used theory synthesis to organize the disparate existing knowledge into a testable middle‐range theory encompassing these concepts in hospitals. The resulting model illustrates how individuals are admitted to the hospital with some predisposition to trust or (...) mistrust the healthcare system and/or personnel. Patients encounter circumstances increasing their emotional and/or physical vulnerability to harm, leading to experiences of fear and anxiety. Without intervention, fear and anxiety lead to a decreased sense of security, increased distress, and suffering. Nurse action can ameliorate these effects by increasing a hospitalized person's sense of security or by promoting the development of interpersonal trust, also leading to an increased sense of security. Increased sense of security results in diminished anxiety and fear, and increased hopefulness, confidence, calm, sense of value, and sense of control. The consequences of a decreased sense of security are harmful to patients and nurses should know that they can intervene in ways that both increase interpersonal trust and sense of security. (shrink)

In Emotions and Reasons, Patricia Greenspan offers an evaluative theory of emotion that assigns emotion a role of its own in the justification of action. She analyzes emotions as states of object-directed affect with evaluative propositional content possibly falling short of belief and held in mind by generalized comfort or discomfort.

Psychopaths are agents who lack the normal capacity to feel moral emotions (e.g. guilt based on empathy with the victims of their actions). Evidence for attributing psychopathy at least in some cases to genetic or early childhood causes suggests that psychopaths lack free will. However, the paper defends a sense in which psychopaths still may be construed as responsible for their actions, even if their degree of responsibility is less than that of normal agents. Responsibility is understood in Strawsonian terms, (...) as a question of our appropriate reactive attitudes toward an agent for what she does, and as distinct from the question of the agent's own motivating attitudes, which lead him to do what he does. The latter is the question more directly relevant to free will, though moral motivation normally depends on the capacity in early childhood to pick up motivating attitudes from others' reactive attitudes. Reactive attitudes based on hatred rather than anger (e.g. disgust or contempt) count as alternative forms of blame that may be appropriately directed toward agents manifesting bad qualities of will, even as a matter of motivational impairment. So psychopaths may still be said to deserve blame, even if they are incapable of modifying their behavior in response to blame. (shrink)

In its treatment of the role of emotion in ethics the argument of the book outlines a new way of packing motivational force into moral meaning that allows for a ...

What is morality? Where does it come from? And why do most of us heed its call most of the time? In Braintrust, neurophilosophy pioneer Patricia Churchland argues that morality originates in the biology of the brain. She describes the "neurobiological platform of bonding" that, modified by evolutionary pressures and cultural values, has led to human styles of moral behavior. The result is a provocative genealogy of morals that asks us to reevaluate the priority given to religion, absolute rules, (...) and pure reason in accounting for the basis of morality. Moral values, Churchland argues, are rooted in a behavior common to all mammals--the caring for offspring. The evolved structure, processes, and chemistry of the brain incline humans to strive not only for self-preservation but for the well-being of allied selves--first offspring, then mates, kin, and so on, in wider and wider "caring" circles. Separation and exclusion cause pain, and the company of loved ones causes pleasure; responding to feelings of social pain and pleasure, brains adjust their circuitry to local customs. In this way, caring is apportioned, conscience molded, and moral intuitions instilled. A key part of the story is oxytocin, an ancient body-and-brain molecule that, by decreasing the stress response, allows humans to develop the trust in one another necessary for the development of close-knit ties, social institutions, and morality. A major new account of what really makes us moral, Braintrust challenges us to reconsider the origins of some of our most cherished values. (shrink)

The aim of this paper is discussion of a new middle‐range theory of patient safety goal priming via safety culture communication. Bedside nurses are key to safe care, but there is little theory about how organizations can influence nursing behavior through safety culture to improve patient safety outcomes. We theorize patient safety goal priming via safety culture communication may support organizations in this endeavor. According to this theory, hospital safety culture communication activates a previously held patient safety goal and increases (...) the perceived value of actions nurses can take to achieve that goal. Nurses subsequently prioritize and are motivated to perform tasks and risk assessment related to achieving patient safety. These efforts continue until nurses mitigate or ameliorate identified risks and hazards during the patient care encounter. Critically, this process requires nurses to have a previously held safety goal associated with a repertoire of appropriate actions. This theory suggests undergraduate educators should foster an outcomes focus emphasizing the connections between nursing interventions and safety outcomes, hospitals should strategically structure patient safety primes into communicative activities, and organizations should support professional development including new skills and the latest evidence supporting nursing practice for patient safety. (shrink)

The everyday expressions of nursing practices are driven by their entanglement in complex flows of social, cultural, political and economic interests. Early expressions of trained nursing practice in the United States and Europe reflect claims of moral, spiritual and clinical exceptionalism. They were both imposed upon—and internalized by—nursing pioneers. These claims were associated with an endogenous narrative of discipline and its physical manifestation in early nursing schools and hospitals, which functioned as “total institutions.” By contrast, the external forces—diffuse yet pervasive—impacting (...) upon contemporary nursing more closely align with the power dynamics explored in Gilles Deleuze's concept of the Society of Control. The example of sensor technology and telemetric monitoring of nurses’ locations in the clinical setting exemplifies the intense presence of surveillance, performance metrics and the “rationalization” of nursing practice. It falls upon nurses to recognize, accept or challenge these dynamics in order to shape the future of nursing practice into a discipline which embodies our values and priorities. (shrink)

Anydomainofscientificresearchhasitssustainingorthodoxy. Thatis, research on a problem, whether in astronomy, physics, or biology, is con- ducted against a backdrop of broadly shared assumptions. It is these as- sumptionsthatguideinquiryandprovidethecanonofwhatisreasonable-- of what "makes sense." And it is these shared assumptions that constitute a framework for the interpretation of research results. Research on the problem of how we see is likewise sustained by broadly shared assump- tions, where the current orthodoxy embraces the very general idea that the business of the visual system is to (...) create a detailed replica of the visual world, and that it accomplishes its business via hierarchical organization and by operatingessentiallyindependently of other sensorymodalitiesas well as independently of previous learning, goals, motor planning, and motor execution. (shrink)

There seems to be evidence of a genetic component in criminal behavior. It is widely agreed not to be "deterministic"--by which discussions outside philosophy seem to mean that by itself it is not sufficient to determine behavior. Environmental factors make a decisive difference--for that matter, there are nongenetic biological factors--in whether and how genetic.

Ours is a time of dramatic and confusing transformations in everyday life, many of them originating in the social enfranchisement of women that has occurred over the past twenty-five years. Sociologist Arlie Hochschild demonstrates a widespread phenomenon of work-family imbalance in our society, experienced by people in terms of a time bind, and a devaluation of familial relationships. As large numbers of women have moved into the workplace, familial relations of all sorts have been colonized by what Virginia Held critically (...) refers to as the contractual paradigm. Even the mother/child relationship, representing for Held an alternative feminist paradigm of selfhood and agency, has been in large part "outsourced." I believe that an Arendtian conception of speech and action might enable us to assert anew the grounds for familial relations. If we require a new site upon which to address our human plurality and natality, the postpatriarchal family may provide that new site upon which individuals can freely act to recreate the fabric of human relationships. It would seem to be our moral and political responsibility as social philosophers today to speculatively contribute to the difficult yet imperative task of reconfiguring the family. In this paper, I attempt to articulate the basic assumptions from which such a reconfiguration must begin. (shrink)

States of the brain represent states of the world. A puzzle arises when one learns that at least some of the mind/brain’s internal representations, such as a sensation of heat or a sensation of red, do not genuinely resemble the external realities they allegedly represent: the mean kinetic energy of the molecules of the substance felt (temperature) and the mean electromagnetic reflectance profile of the seen object (color). The historical response has been to declare a distinction between objectively real properties, (...) such as shape motion and mass, and merely subjective properties, such as heat, color and smell. This hypothesis leads to trouble. A challenge for cognitive neurobiology is to characterize, in suitably general terms, the nature of the relationship between brain models and the world modeled. We favor the hypothesis that brains develop high-dimensional maps whose internal relations correspond in varying degrees of fidelity to the enduring causal structure of the world. From this perspective, the basic epistemological relation is not “single-percept to single- external-feature” but rather “background-brain-maps to causal-domain-portrayed. (shrink)

In this dissertation, I present Marx's conception of ideology as a counterpart of his critical analysis of society. I take exception to current Marxist notions of ideology, and I attempt to show that they correspond to Marxism's failure to develop an historical, material analysis of contemporary society, and its consequent reliance upon an idealist theory of social change. I am ultimately interested in utilizing Marx's theory of ideological critique as the basis for a return to a materially grounded social criticism. (...) ;The thesis begins with an analysis of Marx's early philosophical investigations, showing his concept of ideology emerge with his recognition of a pattern of philosophical abstractions from social movement. Marx's demonstration that nineteenth century economists reduced political economy to a static theory of social distribution and reproduction is contrasted with his theory of the dynamics of social production. ;Marx's anti-ideological methodology decrees, however, a continuing need to reassess the social organism, digging beneath prominent theoretical abstractions to reveal the processes of historical development immanent in present society. Modern Marxism shirks this responsibility, countering the abstractions of liberal theory with its own tired categories of class struggle and false consciousness, offering a moral critique rather than an alternative conception of capitalism. ;I present Althusser's theory of ideological practices as the basis for a renewed interest in the historically specific structures of present society. It grounds my critique of the ideological assumption, shared by Marxism and liberalism, that economic relations have priority in theories of social transformation. Applying Marx's materialist, historical methodology to the analysis of contemporary social relations, I conclude that a post-Marxist theory, emphasizing noneconomic contradictions as sources of instability and immanent social change, is now warranted. The traditional economic oppositions of class and consciousness have, I maintain, been superseded rather than merely conditioned by noneconomic social antagonisms. (shrink)