Background: Palliative carers constantly face ethical problems. There is lack of organised support for the carers to handle these ethical problems in a consistent way. Within organisational ethics, we find models for moral deliberation and for developing organisational culture; however, they are not combined in a structured way to support carers’ everyday work. Research objective: The aim of this study was to describe ethical problems faced by palliative carers and develop an adapted organisational set of values to support the handling (...) of these problems. Research design: Ethical problems were mapped out using focus groups and content analysis. The organisational culture were developed using normative analysis and focus group methodology within a participatory action research approach. Main participants and research context: A total of 15 registered nurses and 10 assistant nurses at a palliative unit (with 19 patient beds) at a major University Hospital in Sweden. Ethical considerations: The study followed standard ethics guidelines concerning informed consent and confidentiality. Findings: We found six categories of ethical problems (with the main focus on problems relating to the patient’s loved ones) and five categories of organisational obstacles. Based on these findings, we developed a set of values in three levels: a general level, an explanatory level and a level of action strategies. Discussion: The ethical problems found corresponded to problems in other studies with a notable exception, the large focus on patient loved ones. The three-level set of values is a way to handle risks of formulating abstract values not providing guidance in concrete care voiced in other studies. Conclusion: Developing a three-level set of values adapted to the specific ethical problems in a concrete care setting is a first step towards a better handling of ethical problems. (shrink)

The prevention, treatment and management of disease are closely linked to how the causes of a particular disease are explained. For multi-factorial conditions, the causal explanations are inevitably complex and competing models may exist to explain the same condition. Selecting one particular causal explanation over another will carry practical and ethical consequences that are acutely relevant for health policy. In this paper our focus is two-fold; the different models of causal explanation that are put forward within current scientific literature for (...) the high and rising prevalence of the common complex conditions of coronary artery disease and type 2 diabetes mellitus ; and how these explanations are taken up within national health policy guidelines. We examine the causal explanations for these two conditions through a systematic database search of current scientific literature. By identifying different causal explanations we propose a three-tier taxonomy of the most prominent models of explanations: evolutionary, lifecourse, and lifestyle and environment. We elaborate this taxonomy with a micro-level thematic analysis to illustrate how some explanations are semantically and rhetorically foregrounded over others. We then investigate the uptake of the scientific causal explanations in health policy documents with regard to the prevention and management recommendations of current National Service Frameworks for CAD and T2D. Our findings indicate a lack of congruence between the complexity and frequent overlap of causal explanations evident in the scientific literature and the predominant focus on lifestyle recommendations found in the mainstream health policy documents. (shrink)

Antimicrobial Resistance is a threat to individual and to population health and to future generations, requiring “collective sacrifices” in order to preserve antibiotic efficacy. ‘Who should make the sacrifices?’ and ‘Who will most likely make them?’ are ethical concerns posited as potentially manageable through Antimicrobial Stewardship. Antimicrobial stewardship almost inevitably involves a form of clinical cost-benefit analysis that assesses the possible effects of antibiotics to treat a diagnosed infection in a particular patient. However, this process rarely accounts properly for patients (...) – above and beyond assessments of potential (non)compliance or adherence to care regimes. Drawing on a vignette of a pregnant woman of colour and migrant diagnosed with Mycoplasma genitalium, a sexually transmissible bacterium, this article draws out some of the ethical, speculative, and practical tensions and complexities involved in Antimicrobial Stewardship. We argue that patients also engage in a form of cost-benefit analysis influenced by experiences of reproductive and social (in)justice and comprising speculative variables - to anticipate future possibilities. These processes have the potential to have effects above and beyond the specific infection antimicrobial stewardship was activated to address. We contend that efforts to practice and research antimicrobial stewardship should accommodate and incorporate these variables and acknowledge the structures they emerge with(in), even if their components remain unknown. This would involve recognising that antimicrobial stewardship is intricately connected to other social justice issues such as immigration policy, economic justice, access to appropriate medical care, racism, etc. (shrink)

The "public sphere" -- an idea with deep roots in the European enlightenment -- has always been a contested concept in American culture and society. American intellectuals, artists, politicians, and activists have stressed the non-unitary, diversified, and oppositional dynamics of all things public. From the early days of the American republic, competing interest groups and commercial mass media (first newspapers, novels, and the theater, then radio, television, and the internet) have worked to pluralize public speech and public action -- and (...) ultimately the notion of "publicness" itself. This essay collection explores the public sphere in North America as a multi-agential, commercially embattled, highly mediated, and ultimately trans-nationalized aggregate of publics and counterpublics. The contributors present innovative theoretical and historical assessments of American counter/publics across an array of fields including social activism, political communication, literary discourse, and contemporary mass media. (shrink)

Abstract: This article argues that Christine Korsgaard's stimulating claim that practical identity is at the foundation of agency is weakened by her reliance on a Kantian conception of freedom. The commitments that make up our practical identity are, the article suggests, better described through a system like Hegel's that attends to the nature of and connection among different kinds of commitments. Beginning with such an analysis allows us better to describe human agency; it also enables us to reflect the place (...) commitments have in our lives more accurately. Hegel offers a description of ethical life in which commitments are central but still subject to norms that themselves better allow humans to achieve concrete freedom. (shrink)

Epistemic democrats are rightly concerned with the quality of outcomes and judge democratic procedures in terms of their ability to ‘track the truth’. However, their impetus to assess ‘rule by experts’ and ‘rule by the people’ as mutually exclusive has led to a meagre treatment of the role of expert knowledge in democracy. Expertise is often presented as a threat to democracy but is also crucial for enlightened political processes. Contemporary political philosophy has so far paid little attention to our (...) reliance on experts and has not sufficiently addressed the question of how expertise can be used to improve the epistemic quality of democratic decision making. We believe this lack of interest is spurred by a too hasty acceptance of arguments dismissive of the political role of experts. The article examines a series of often-cited epistemic objections and concludes that several of them are overstated or misconceived, yet they all reflect real difficulties that need to be addressed. On this background, we tentatively outline a set of mechanisms that can contribute to alleviating the irreducible problem of epistemic asymmetries and ensuring that experts really are experts and use their expertise in the right way. (shrink)

This dissertation argues that an agent's particular commitments are an integral and necessary part of his autonomy. I refer to Hegel's Philosophy of Right to argue that the autonomous self is in fact a committed self. According to Hegel, freedom is only possible when the agent inhabits roles within a family, civil society, and the greater community of the state. These roles make up the agent's practical identity, or the set of commitments and characteristics around which he orients his actions. (...) His practical identity provides him with norms: he has specific obligations as, for instance, a parent, police officer, or judge. ;Chapter One critiques Christine Korsgaard's Kantian account of practical identity, arguing that it is inadequate because of its insistence on an ontologically divided self. Chapter Two argues that practical identity according to Hegel must include consideration of an agent's contingent circumstances. Chapter Three claims that Hegel's agent knows himself and other humans to possess universal rights and to be sources of moral certainty. Chapter Four discusses social institutions and the norms they generate. When the agent freely embraces roles in these institutions, he embraces the obligations that accompany those roles. He gives himself these obligations and is autonomous through them. ;Chapter Five argues that Hegel's definition of conscience crucially depends on his theory of practical identity. Hegel's conscience is not a source of arbitrary, unimpeachable conclusions but refers to the norms of rational institutions. It does not neglect an agent's particular commitments within those institutions such as commitments to particular causes, family members, or political organizations. It rather explains the freedom of his actions through those commitments. So defined, conscience allows for both inner certainty and external sanction. Chapter Six argues that a wide range of professions describe their ethical experience in terms of conscience, and that Hegel's definition of conscience makes sense of this experience. By referring to roles, Hegel's conscience also requires the agent to be involved in the evaluation and reformation of institutions. As such, his theory is of great relevance to contemporary ethical life. (shrink)

Immanuel Kant's description of humans' first encounter with each other depicts a peaceful recognition of mutual worth. G.W.F. Hegel's by contrast depicts a struggle to the death. I argue in this paper that Hegel's description of conflict results in an ethical theory that better preserves the distinctness of the other. I consider Christine Korsgaard's description of first encounters as a third alternative but conclude that Hegel's approach better accounts for the specific commitments we make--as family members, works, and citizens --in (...) ethical life. (shrink)

In his early and unpublished essay on Schiller’s trilogy Wallenstein, Hegel criticizes the plays’ denouement as “horrific” and “appalling” and for depicting the triumph of death over life. Why was the young Hegel’s response to Wallenstein so negative? To answer this question, I first offer an analysis of Wallenstein in terms of Hegel’s mature theory of modern tragedy. I argue that Schiller’s portrayal of Wallenstein’s character and death indeed render the play a particularly dark and unredemptive example of modern tragedy (...) as Hegel understands it. I suggest, however, that Hegel’s early objections are primarily motivated by his philosophy of history rather than by his theory of tragedy. Hegel accurately sensed the loss of faith in historical progress that Schiller experienced in the wake of the French Revolution; in essays written shortly before Wallenstein appeared, Schiller associates the tragic sublime with humans’ ability to act in the face of the meaninglessness of history. In his essay “The German Constitution,” composed during the same period as his Wallenstein review, Hegel instead formulates his familiar exhortation that we see history as meaningful. Hegel’s objection to Wallenstein’s darkness, then, is primarily an objection to the vision of history it portrays. Against the background of Peter Stein’s 2007 Berlin production of Wallenstein, I suggest that Wallenstein’s lasting appeal lies in its ability to allow audiences to experience the sublime as Schiller intended: as an assertion of our agency despite the cycles of history we so little control. (shrink)

Gustav Theodor Fechners (1801-1887) philosophische, ethische und ästhetische Überlegungen, die anders als seine naturwissenschaftlichen Arbeiten der Öffentlichkeit weniger bewußt sind, werden in diesem Band, Ergebnis eines zu seinem 200. Geburtstag an der Universität Leipzig veranstalteten interdisziplinären Kolloquiums, in ihren Wirkungen auf die Geisteswissenschaften des 20. Jahrhunderts aus philosophischer, theologischer, linguistischer, kultur- und literaturwissenschaftlicher sowie wissenschaftshistorischer Sicht erörtert - mit Blick auf seine interdisziplinäre Leistung und unter Einbeziehung biographischer Aspekte.

This book is a philosophical analysis of knowledge in practices, focused on knowing how, tacit knowledge and expert knowledge. Knowing in action is argued to be more basic than propositional or theoretical knowledge. The analytical framework is pragmatist, with references to William James and Ludwig Wittgenstein.

Philip Roth’s novel 'The Human Stain' recounts an instance of racial passing: its protagonist, Coleman Silk, is African-American but light-skinned enough to pass as white. Coleman’s decision to pass and his subsequent violent death, I argue, confront us with complex ethical questions regarding unjust social roles, loyalty, and moral luck. I also argue, building on Hegel’s definition of tragedy, that 'The Human Stain' is a particularly modern tragedy. The novel highlights conflicting role obligations, inadequate conceptions of freedom, and the tensions (...) of cultural paradigm shifts—all characteristics typical of modern tragedy. I claim that parsing 'The Human Stain' as a tragedy deepens our understanding of the novel as well as drawing our attention to its philosophical significance. (shrink)

Christine Korsgaard attempts to reinterpret Kantian ethics in a way that might alleviate Bernard Williams’ famous worry that a man cannot save his drowning wife without determining impartially that he may do so. She does this by dividing a reflective self that chooses the commitments that make up an agent’s practical identity from a self defined as a jumble of desires. An agent, she then argues, must act on the commitments chosen by the reflective self on pain of disintegration. Using (...) Harry Frankfurt’s emphasis on love as a final end, I argue that disintegration as motivation is not a more acceptable motivation than impartiality and so does not adequately address Williams’ criticism. I also argue that the idea of a divided self either leads to an infinite regress or to an implausible description of how our commitments evolve and change. To make this last claim, I discuss a case from John Updike’s novel 'In the Beauty of the Lilies.'. (shrink)

Christine Korsgaard attempts to reinterpret Kantian ethics in a way that might alleviate Bernard Williams’ famous worry that a man cannot save his drowning wife without determining impartially that he may do so. She does this by dividing a reflective self that chooses the commitments that make up an agent’s practical identity from a self defined as a jumble of desires. An agent, she then argues, must act on the commitments chosen by the reflective self on pain of disintegration. Using (...) Harry Frankfurt’s emphasis on love as a final end, I argue that disintegration as motivation is not a more acceptable motivation than impartiality and so does not adequately address Williams’ criticism. I also argue that the idea of a divided self either leads to an infinite regress or to an implausible description of how our commitments evolve and change. To make this last claim, I discuss a case from John Updike’s novel 'In the Beauty of the Lilies.'. (shrink)

This paper discusses the conditions for legitimate expert arrangements within a democratic order and from a deliberative systems approach. It is argued that standard objections against the political role of experts are flawed or ill-conceived. The problem that confronts us instead is primarily one of truth-sensitive institutional design: Which mechanisms can contribute to ensuring that experts are really experts and that they use their competencies in the right way? The paper outlines a set of such mechanisms. However, the challenge exceeds (...) that of producing epistemically optimal expert deliberations because a deliberative political system must also fulfil the ethical and democratic requirements of respect and inclusion. Yet, epistemic concerns justify expertise arrangements in the first place, and measures taken to make the use of expertise compatible with these requirements have to balance the potential rewards from expertise against potential deliberative costs. In the final part of the paper, the regulatory framework of a best practice expert advice system is tentatively analysed to illustrate the applicability and critical potential of our approach. (shrink)

Respect for autonomy and self-determination is a central principle in nursing ethics. Autonomy and quality of life are strongly connected, and, at the same time, autonomy is an important quality indicator on how older persons' housing functions. In this study, autonomy was conceived as self-determination. The aim of the study was to describe how older people living in sheltered housing experience self-determination and how they are valued as human beings. Eleven persons living in five different housing facilities for older people (...) in southern Sweden were interviewed. The data were analysed by manifest and latent qualitative content analysis. The overall theme expressing the latent content in the interviews emerged as disempowerment, which implied an environment that does not strengthen individual self-determination. The results showed a negative experience of how these older people thought they were valued in the sheltered housing where they lived. In sheltered housing, more attention should be paid to residents' self-determination and sense of value. (shrink)

The first extensive examination of Stein's notebooks, manuscripts and letters, prepared over a period of twenty years, _Gertrude Stein: The Language That Rises_ asks new questions and explores new ways of reading Stein. This definitive study give us a finely detailed, deeply felt understanding of Stein, the great modernist, throughout one of her most productive periods. From "An Elucidation" in 1923 to _Lectures In America_ in 1934, Ulla E. Dydo examines the process of the making and remaking of Stein's (...) texts as they move from notepad to notebook to manuscript, from an idea to the ultimate refinement of the author's intentions. The result is an unprecedented view of the development of Stein's work, word by word, text by text, and over time. (shrink)

A woman risks her life to save someone else's child from a house that is on fire. While in his prime, a man donates one of his kidneys to a dialysis patient whom he does not know. In Auschwitz, Maximilian Kolbe sacrifices his life for the life of another prisoner.

Merchants in late medieval Antwerp worked with a number of different representatives: They appointed proxies to trade on their behalf, to collect debts in their name or to represent them in court. If a merchant wanted to authorize another person to act on his behalf, he went to a notary who issued a letter of procuration. The article discusses the role of Roman law in these procurations. It contrasts the procurations issued by the notaries with other models for procurations found (...) in a form book for notaries in Antwerp. The analysis comes to the conclusion that the basic idea of installing a proxy did not rely on Roman law. However, knowledge of Roman law was crucial if someone wanted to be represented in a Roman law court. Furthermore, concepts derived from Roman law were applied when complicated problems or phenomena had to be shortened to a few words. In sum, the practice of including phrases and concepts of Roman law wherever they proved useful can be regarded as a part of the lex mercatoria, the customary law of merchants. (shrink)

Even though teacher education has been successful in preparing students for their future profession, the classroom reality can differ greatly from the inservice training. Many novice teachers therefore find the transition from student teacher to inservice teacher overwhelming To support beginning teachers, mentoring programs—where more experienced teachers support novice teachers—have become commonplace in many schools worldwide. In Sweden, mentoring for beginning teachers has been a frequent feature of support since 2001. This study, conducted in Sweden, examines seven novice teachers and (...) the impact the mentoring process had upon them during their first‐year teaching. Based on interviews, it was found that these experienced both professional and personal support from their mentors. The study also showed the significance of observant leaders within the mentorship program following up on the development of the mentor–mentee relationship. (shrink)

Handlungen, mit denen wir mehr Gutes tun, als unsere Pflicht ist, heißen in der Ethik supererogatorisch. Die Autorin steckt einen Rahmen für Theorien der Supererogation ab. In jenem Rahmen dokumentiert sie die Geschichte dieses Begriffes und würdigt aktuelle Theorien - um deren Beschränkungen zu überwinden. Auch wenn wir über das Gebotene hinausgehen, so ihre These, können wir fehlen; wir können uns neue Pflichten einhandeln.

This anthology focuses on “practical” forms and expressions of knowledge, like thinking through artistic media or by crafting things out of materials. The ten chapters follow and review various tracks in conceptions of contemporary knowledge, exploring human knowledge and experience from the perspective of human activities or practices, professional, artistic, domestic, or whatever. A guiding idea is that human knowledge seldom, perhaps never, fits into the traditional dualism between thinking and doing. -/- The chapters are written by philosophers and musicians (...) – some with a double experience as artists and theoreticians. The themes are philosophical, but above all, they touch on questions that are essential for how we understand ourselves as thinking and playing bodies, indeed as parts of nature. The book does not propose one single “theory of knowledge” but steps towards a more diverse and open attitude to the meaning of knowledge. -/- We hope that the texts will be of interest and useful in both disciplinebased and professional education: in philosophy, art schools, tea cher education, and in other programmes where tacit and practical knowledge are essential for the (future) practitioners. It is possible to independently read, and profit from, most of the chapters. (shrink)

The paper explores the promise of ethical codes as a means to control unethical behavior in business. After a review of arguments for ethical codes from outside the business system, the paper outlines the arguments for codes from inside the business system at the level of the industry, firm and individual executive.The paper then discusses the problems of code design — the dilemma between specific practices and general precepts — and offers a model for a thoroughgoing code. This is followed (...) by a discussion of the problems of promulgation and code enforcement. (shrink)

The discretionary powers of welfare state professionals are in tension with the requirements of the democratic Rechtsstaat. Extensive use of discretion can threaten the principles of the rule of law and relinquish democratic control over the implementation of laws and policies. These two tensions are in principle ineradicable. But does this also mean that they are impossible to come to grips with? Are there measures that may ease these tensions? We introduce an understanding of discretion that adds an epistemic dimension (...) (discretion as a mode of reasoning) to the common structural understanding of discretion (an area of judgment and decision). Accordingly we distinguish between structural and epistemic measures of accountability. The aim of the former is to constrain discretionary spaces or the behaviour within them while the aim of the latter is to improve the quality of discretionary reasoning. The focus in this article is on epistemic measures that are internally related to the main characteristic of accountability, namely justified use of discretionary power. (shrink)

Today, coolness is a term most often used in advertising trendy commodities, or, more generally, in promoting urban lifestyles. The Cultural Career of Coolness explores the history of the term as a metaphor for affect control and aesthetic detachment, charts various cultural p...