An ideal in mental health care is user participation. This implies inclusion and facilitation by clinicians to enable users to participate in decisions about themselves and in the design of suitable treatment. However, much of the work of clinicians consists of handovers and other meetings where patients are not present. It is therefore interesting to study how the patient perspective is handled in such meetings and whether it forms a basis for user participation. We conducted fieldwork in three different inpatient (...) wards in Norwegian District Psychiatric Centres. We used an interactional perspective in our analysis, where speech acts, framing and footing were key concepts. The findings show that the talk in the handovers and meetings contained five main themes and that there was a clear correlation between what was said and how it was said, and whether clinicians related to the content in a decisive, person‐centred or indecisive manner. We discuss potential participation statuses for patients and their limited opportunity to influence the talk and possible decisions about themselves. Our conclusion is that handover meetings primarily function as an aid in organising clinicians' work and could ultimately be seen as counteracting user participation. (shrink)

Durch Analyse einiger zentraler Begriffe der Lebenswelt, wie z. B. Perspektivität, Intentionalität und Reflexion, wird versucht zu zeigen, daß und wie philosophisch fundierende Motive in der Lebenswelt verankert sind. Hierdurch wird wenigstens ein Teil der Grundlage enthüllt, auf der die Bedingung des Transzendierens der Lebenswelt bei der philosophischen Suche nach Einsicht und Wahrheit beruht. - Der Aufsatz versucht ebenfalls zu zeigen, daß Phänomenologie und transzendentale Pragmatik nicht unvereinbare Positionen sind. Dies hat allerdings zur Folge, daß die transzendentale Pragmatik eine Rechtfertigung (...) durch eine Analyse ihrer lebenswichtigen Vorbedingungen zu benötigen scheint. (shrink)

Once relegated to the margins of the responsibility debate, moral influence theories have recently been rehabilitated. This paper offers a moral influence theory with two parts: a theory of responsibility as influenceability and an act-consequentialist justification of blame. I defend this account against six concerns commonly raised both by opponents and by advocates of similar views. Some concerns target act consequentialism, claiming that it 1) permits blaming innocents; 2) permits coercion, manipulation, and other objectionable forms of influence; and 3) fails (...) to capture intuitions about desert. Other concerns target responsibility as influenceability, claiming that influenceability accounts are 4) unsophisticated, 5) make ascriptions of responsibility dependent on assessments of permissible blame, and 6) have various counterintuitive implications. (shrink)

An important way to become self-deceived, omitted by Mele, is by intentionally ignoring and avoiding the contemplation of evidence one has for an upsetting conclusion, knowing full well that one is giving priority to one's present peace of mind over the search for truth. Such intentional self-deception may be especially hard to observe scientifically.

The purpose of the present thesis is to apply philosophical methods to the ongoing debate of the precautionary principle, in order to illuminate this debate. The thesis consists of an Introduction and five papers. Paper I con-cerns an objection to the method of conceptual analysis, the Charge from Psychology. After a brief characterisation of conceptual analysis, I argue that the Charge from Psychology is misdirected. In Paper II, the method of conceptual analysis is applied to the concept of precaution which (...) is ana-lysed in terms of precautionary actions. The purpose is explicatory. A definition involving three necessary and jointly sufficient conditions is proposed, and the implications of this analysis for the debate on the pre-cautionary principle are discussed. Paper III attempts to provide an ana-lytical apparatus which may be used for finding improved formulations of the precautionary principle. The approach is lexicographical. Several exist-ing and possible formulations of the precautionary principle are examined, and four common elements and a common structure of the precautionary principle are identified. It is suggested that the analytical apparatus pre-sented can be used in negotiations of the precautionary principle. Paper IV questions the soundness of some arguments against the precautionary prin-ciple. Five common arguments are discussed and rejected. In Paper V, two of these arguments are further discussed. I argue that an attempt at rejec-tion of the precautionary principle delivered by John Harris and Søren Holm is unwarranted, because their arguments against it are based on in-terpretations of the precautionary principle that ignore context. Paper VI deals with the idea of de minimis risk. After a discussion of the distinction between disregarding a risk and accepting it, I examine one way of deter-mining how small a risk ought to be in order to be disregarded, namely the use of natural risk levels as benchmarks. I argue that this approach fails, even if the distinction between what is natural and what is not natural can be upheld. (shrink)

The first part of this paper seeks to clarify how interpersonal relationships are generally rooted in considerations about trust, vulnerability and interpersonal dependence. However, for nurse–patient relationships, and from the point of view of justice and fair rationing, it is essential to investigate their distinct moral nature. Hence, the second part of the paper argues that nurse–patient relationships, as a special kind of interpersonal relationship, raise particular normative issues. I will discuss dilemmas facing nurses and professional care‐givers in general who (...) are torn between their obligations to existing patients and more general and impartial considerations regarding the distribution of nursing care. This discussion concerning the normative claims of immediacy and mercy vs. fairness in health care is a pressing issue for nursing care. The claims that arise from particular relationships in nursing care are typically associated with closeness to a person's vulnerabilities. The pressing issue is how considerations of mercy and protection of individual patients can be safeguarded within today's nursing and health‐care practices in which distributivist considerations are crucial. (shrink)

This article considers the foundation of nursing as a moral practice. Its basic claim is that all nursing knowledge and action reside on a moral foundation. The clinical gaze meets vulnerability in the patient’s human condition. To see a patient’s wound is to see his or her hurt and discomfort; it is a concerned observation. To see the factual and pathophysiological is at the same time to see the ethical: the moral realities of suffering, pain and discomfort. A nurse’s emotional (...) sensitivities are central to understanding a patient’s experiences of illness. Emotions reveal value and ascribe moral importance to certain situations; they are addressed centrally by vulnerability and the moral realities of illness. Hence, the essence of nursing knowledge and nursing performance cannot be understood merely as ontology (i.e. as being-with-the-other). Nursing is basically being-for-the-other; it is responsibility; it is ethics. (shrink)

The concept of ‘empowerment’ is used frequently in a number of professional areas, from psychotherapy to social work. But even if the same term is used, it is not always clear if the concept denotes the same goals or the same practice in these various fields. The purpose of this paper is to clarify the discussion and to find a plausible and useful definition of the concept that is suitable for work in various professions. Several suggestions are discussed in the (...) paper, for example control over life or health, autonomy, ability, self-efficacy, self-esteem, and freedom, and it is concluded that there are two plausible complementary uses, one as a goal and one as a process or approach. Empowerment as a goal is to have control over the determinants of one’s quality of life, and empowerment as a process is to create a professional relation where the client or community takes control over the change process, determining both the goals of this process and the means to use. (shrink)

Abolitionism is the view that if no one is responsible, we ought to abandon the reactive attitudes. This paper defends abolitionism against the claim, made by P.F. Strawson and others, that abandoning these attitudes precludes the formation and maintenance of valuable personal relationships. These anti-abolitionists claim that one who abandons the reactive attitudes is unable to take personally others’ attitudes and actions regarding her, and that taking personally is necessary for certain valuable relationships. I dispute both claims and argue that (...) this objection exaggerates the role of the reactive attitudes and underestimates the importance of non-reactive moral emotions. (shrink)