To investigate the current status of hospital clinical ethics committees (CEC) and how they have evolved in Canada over the past 20 years, this paper presents an overview of the findings from a 2008 survey and compares these findings with two previous Canadian surveys conducted in 1989 and 1984. All Canadian hospitals over 100 beds, of which at least some were acute care, were surveyed to determine the structure of CEC, how they function, the perceived achievements of these committees and (...) opinions about areas with which CEC should be involved. The percentage of hospitals with CEC in our sample was found to be 85% compared with 58% and 18% in 1989 and 1984, respectively. The wide variation in the size of committees and the composition of their membership has continued. Meetings of CEC have become more regularised and formalised over time. CEC continue to be predominately advisory in their nature, and by 2008 there was a shift in the priority of the activities of CEC to meeting ethics education needs and providing counselling and support with less emphasis on advising about policy and procedures. More research is needed on how best to define what the scope of activities of CEC should be in order to meet the needs of hospitals in Canada and elsewhere. More research also is needed on the actual outcomes to patients, families, health professionals and organisations from the work of these committees in order to support the considerable time committee members devote to this endeavour. (shrink)

This study examined the association of nurses’ ethical conflict with hospitals with organizational commitment, stress, turnover intention, absence and turnover. Participants were 410 nurses working at four different Canadian hospitals. A longitudinal design was used where nurses completed a questionnaire to capture ethical conflict, stress and organizational commitment, and one year later, measures of turnover intention, absence and actual turnover were obtained for the same sample. We found three aspects of nurses’ ethical conflict with hospitals: patient care values, value of (...) nurses, and staffing policy values. Our findings showed that all three aspects of nurses’ ethical conflict are associated with stress and patient care values is associated with actual turnover. We also found that staffing policy values is predictive of turnover intention, and that patient care values is predictive of absenteeism. Thus, our findings show the multidimensionality of nurses’ ethical conflict with hospitals. Further implications of our findings for practice and theory are discussed. (shrink)

Nurses and physicians may experience ethical conflict when there is a difference between their own values, their professional values or the values of their organization. The distribution of limited health care resources can be a major source of ethical conflict. Relatively few studies have examined nurses' and physicians' ethical conflict with organizations. This study examined the research question ‘What are the organizational ethical conflicts that hospital nurses and physicians experience in their practice?’ We interviewed 34 registered nurses, 10 nurse managers, (...) and 31 physicians as part of a larger study, and asked them to describe their ethical conflicts with organizations. Through content analysis, we identified themes of nurses' and physicians' ethical conflict with organizations and compared the themes for nurses with those for physicians. (shrink)

While the influence of emotion on individuals'' ethical decisions has been identified by numerous researchers, little is known about how emotions influence individuals'' ethical decision process. Thus, it is not clear whether different emotions promote and/or discourage ethical decision-making in the workplace. To address this gap, this paper develops a model that illustrates how emotion affects the components of individuals'' ethical decision-making process. The model is developed by integrating research findings that consider the two dimensions of emotion, arousal and feeling (...) state, into an applied cognitive-developmental perspective on the process of ethical decision-making. The model demonstrates that certain emotional states influence the individual''s propensity to identify ethical dilemmas, facilitate the formation of the individual''s prescriptive judgments at sophisticated levels of moral development, lead to ethical decision choices that are consistent with the individual''s prescriptive judgements, and promote the individual''s compliance with his or her ethical decision choices. In particular, the model suggests that individuals experiencing arousal and positive affect resolve ethical dilemmas in a manner consistent with more sophisticated cognitive moral structures. Implications for theory and practice are discussed. (shrink)

Hospitals in many countries have had clinical ethics committees for over 20 years. Despite this, there has been little research to evaluate these committees and growing evidence that they are underutilized. To address this gap, we investigated the question ‘What are the barriers and facilitators nurses and physicians perceive in consulting their hospital ethics committee?’ Thirty-four nurses, 10 nurse managers and 31 physicians working at four Canadian hospitals were interviewed using a semi-structured interview guide as part of a larger investigation. (...) We used content analysis of the interview data related to barriers and facilitators to use of hospital ethics committees to identify nine categories of barriers and nine categories of facilitators. These categories as well as their subcategories are discussed and those specific to nurses or physicians are identified. The need to increase health professionals' use of clinical ethics committees through reducing barriers and maximizing facilitators is discussed. (shrink)

Much of the literature on clinical ethical conflict has been specific to a specialty area or a particular patient group, as well as to a single profession. This study identifies themes of hospital nurses’ and physicians’ clinical ethical conflicts that cut across the spectrum of clinical specialty areas, and compares the themes identified by nurses with those identified by physicians. We interviewed 34 clinical nurses, 10 nurse managers and 31 physicians working at four different Canadian hospitals as part of a (...) larger study on clinical ethics committees and nurses’ and physicians’ use of these committees. We describe nine themes of clinical ethical conflict that were common to both hospital nurses and physicians, and three themes that were specific to physicians. Following this, we suggest reasons for differences in nurses’ and physicians’ ethical conflicts and discuss implications for practice and research. (shrink)

If the professionalization of the social professions is increasingly based on the model of professionalization engineering, what are the imaginaries underlying this movement? How can we understand that the profession of engineer, the one who, at least in the imagination, invents and designs machines with a magically predictable functioning, can be the model for designing training systems for the helping professions? This contribution proposes to explore these questions through two mythological figures often summoned when it comes to engineering and technology (...) : Prometheus and Hephaestus. These two figures will help us to move from the model of professionalization engineering to ingenium. (shrink)

A multiple-case study of four hospital ethics committees in Canada was conducted and data collected included interviews with key informants, observation of committee meetings and ethics-related hospital documents, such as policies and committee minutes. We compared the hospital committees in terms of their structure, functioning and perceptions of key informants and found variation in the dimensions of empowerment, organizational culture of ethics, breadth of ethics mandate, achievements, dynamism, and expertise.

Peut-on interpréter le Cratyle sans recourir aux développements du Théétète et du Sophiste sur la proposition verbale ? L'exigence analytique, présentée pour la première fois par G. Ryle, autorise à examiner la prétention soit des noms, soit de leurs éléments phonétiques à jouer le rôle de « signifiants » authentiques. Could we give an interpretation of Cratylus without looking at the later dialogues (Theaetetus and Sophist) which carry Plato on to the concept of verbal proposition ? The requirements of analytical (...) philosophers (first, G. Ryle) lead us to examine the claim of the word or of its phonetic elements as genuine « significantes ». (shrink)

Background Despite news reports of morally distressing situations resulting from complex and demanding community-care delivery in Canada, there has been little research on the topic of ethical conflicts experienced by community-based health care professionals. Research aim To identify ethical conflicts experienced by community nurses. Research design Data were collected using semi-structured interviews and then relevant text was extracted and condensed using qualitative content analysis. This research was part of a larger grounded theory project examining how community nurses manage ethical conflict. (...) Research context and participants Community nurses, including 13 public health nurses and 11 home care nurses from two Canadian provinces, were interviewed. Ethical considerations Study approval was granted by the Health Research Ethics Authority of Newfoundland and Labrador and by provincial health authorities. Findings Seven ethical conflicts were identified and assigned to one of two groups. In the grouping categorized as challenges with obligations or risks, the ethical conflicts were: (1) screening for child developmental issues knowing there is a lack of timely early intervention services; (2) encountering inequities in the health care system; (3) not fulfilling principles, goals, and initiatives of primary and secondary prevention; and (4) feeling powerless to advocate for clients. The remaining ethical conflicts were categorized as challenges with process, risks, and consequences, and were: (5) jeopardizing therapeutic relationships while reporting signs of a child at risk; (6) managing confidentiality when neighbors are clients; and (7) supporting client autonomy and decision-making but uncertain of the consequences. Conclusions Research investigation will continue to be important to raise awareness and mobilize ethics supports as health care services are steadily shifted from institutional to community settings. Moreover, with heightened potential for communicable disease outbreaks across international borders from global warming, community nurses around the world will continue to be required to address ethically-difficult care situations with competence and compassion. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Maurice Blanchot and the Literature of TransgressionColette GaudinMaurice Blanchot and the Literature of Transgression, by John Gregg; 241 pp. Princeton: Princeton University Press, 1994, $29.95.In the preface to The Gaze of Orpheus (1981), the first book in English to present a collection of Maurice Blanchot’s critical essays, Geoffrey Hartman recalls his excitement on discovering this philosopher-novelist in the fifties. As for Hélène Cixous, she speaks of “Blanchot’s terrifying (...) but admirable art.” Blanchot indeed holds a paradoxical place in French literature and criticism. His books constitute a fundamental work of our time, yet his reflection developed in total independence of the noisiest intellectual debates of his times. A contemporary of Sartre, a friend of Georges Bataille and of Emmanuel Levinas, Blanchot began his career as a literary chronicler before World War II, even collaborating for a few years in rightist publications. But he generally remained at a forbidding distance from the media and the public, revealing [End Page 160] himself only through his writings: three novels, a number of terse short stories or récits, and an abundant critical corpus evolving toward fragmentary meditations on the conditions of literature’s possibility and on the experience of writing. He was the first, in the midst of the existentialist wave following the war, to pay close attention to the poetics of Mallarmé and Rilke, the art of Flaubert or Kafka, and the ethical provocations of Nietzsche, all of which were to become trademarks of postmodernist thinkers. Yet our present familiarity with these motifs does not make Blanchot less difficult and even less esoteric.With Maurice Blanchot and the Literature of Transgression, John Gregg now gives us the first English book-length study devoted exclusively to Blanchot, organized around solid analyses of several difficult texts—more extensively of the novel Le Très-Haut and the fragmentary narrative L’Attente l’oubli. There is unfortunately very little excitement or terror in the way Gregg presents his work, which bears traces of the doctoral thesis it evidently once was. Whereas the choice of transgression, as the focus of the study is quite appropriate, the title suggests, somewhat misleadingly, that transgression will be treated as a theme common to a group of authors including Blanchot. The “Introduction,” barely more than an extended table of contents, fails to prepare the reader for the provocative notion of transgression illustrated and theorized in Blanchot’s writing, a notion inherited from psychoanalysis and ethnology via Bataille, and which has to do with the law, Eros, and negativity. In his opening pages, moreover, we are confronted with concepts that Gregg takes for granted. A neologism such as “worklessness” (p. 8), for instance, does not make sense without a minimal gloss relating it to Blanchot’s pair of opposites, œuvre/désœuvrement. Similarly, the opposition between “regional economy” and “general economy,” which is Gregg’s constant point of reference, needs to be anchored historically and philosophically in order to accomplish its function.To nuance the preceding criticism, it should be stressed that Blanchot’s thought defies summary, linear exposition, and dialectical closure, just as his fiction illustrates the impossibility of narration. His work draws on multiple influences and at the same time is fiercely original. His reflection proceeds through two apparently contradictory processes, dispersion and repetition, the function of the latter being more to situate what is said in its difference from itself than to convince others. Gregg’s first chapter (poorly titled “Literature and transgression”) rightly indicates the ambivalent Hegelian heritage found in Blanchot as well as in Bataille. For if Hegel is a great inspiration to them, he is also a constant foil, in that he ignores the surplus of negativity that no dialectic can absorb through the historical or artistic process. Gregg’s method, that of tracing a pattern of nondialectical play of opposites in Blanchot’s writing, takes on its full effectiveness in the following chapters, in which he shows the circular relation (or exigence circulaire) that Blanchot establishes repeatedly between death and writing in his definition of the “suicidal artist.” The study of Orpheus as a mythical portrayal of writing and reading equates [End Page... (shrink)

Cette édition numérique a été réalisée à partir d'un support physique, parfois ancien, conservé au sein du dépôt légal de la Bibliothèque nationale de France, conformément à la loi n° 2012-287 du 1er mars 2012 relative à l'exploitation des Livres indisponibles du XXe siècle. La philosophie de Platon se trouve ici interrogée sur la conception de l'alphabet, c'est-à-dire sur les éléments qui rendent possibles la lecture, l'écriture et l'énonciation de quelque pensée que ce soit. « Copyright Electre » Pages de (...) début Introduction Note bibliographique I - De l'écriture II - Une chimère d'écriture III - Le savoir des lettres IV - On n'entend pas la voix de Platon V - L'ame comme un livre VI - L'épaisseur du sémantique VII - L'orthotès, orthophonie, orthographe VIII - Redécouverte du phonétique IX - Stoicheïologie et définition X - La combinaison des genres et le concept d'élément XI - De la lecture XII - Le réceptacle Les archétypes et leur inscription ConclusionIndex nominum Index rerum Pages de fin. (shrink)

Il était sans doute audacieux de choisir une notion aussi peu stabilisée d’un point de vue théorique (en même temps qu’assise sur un véritable usage pédagogique) que celle de registre pour donner son unité à un volume de Mélanges. Les contributeurs ont, cependant, volontiers relevé le défi, et l’ouvrage représente de ce fait l’espace d’une vraie confrontation théorique, dont le lieu commun serait constitué par l’article d’Alain Viala (« Des registres », Pratiques, n°109-110, 2001). Ainsi soup..

Il était sans doute audacieux de choisir une notion aussi peu stabilisée d’un point de vue théorique (en même temps qu’assise sur un véritable usage pédagogique) que celle de registre pour donner son unité à un volume de Mélanges. Les contributeurs ont, cependant, volontiers relevé le défi, et l’ouvrage représente de ce fait l’espace d’une vraie confrontation théorique, dont le lieu commun serait constitué par l’article d’Alain Viala (« Des registres », Pratiques, n°109-110, 2001). Ainsi soup...

Alexandre-Edouard Baudrimont est surtout connu des historiens des sciences pour avoir fait partie de cette lignées de chimistes français qui, de Haüy à Pasteur en passant par Ampère, Gaudin, Laurent, Delafosse, ont étroitement associé dans leurs spéculations les données cristallographiques et le comportement chimique.Dans son ouvrage de 1844 : Traité de chimie générale et expérimentale dont la structure est tout à fait originale pour l’époque, il consacre une première partie à l’étude statique des corps et une seconde partie à (...) l’étude cinématique des corps. Nous montrons que Baudrimont, à une époque où les chimistes sont presque uniquement occupés par la chimie organique qui connaît un développement explosif, pose des jalons dans des domaines qui annoncent la Chimie physique. (shrink)

Academic research studies examining the ethical attitudes and behaviors of salespeople have produced several frameworks that explore the ethical decision-making processes to which salespeople adhere when faced with ethical dilemmas. Past literature enriches our understanding; however, a critical review of the relevant literature suggests that an emotional route to salesperson ethical decision-making has yet to be explored. Given the fact that individuals’ emotional capacities play an important role in decision-making when faced with an ethical dilemma, there is a need for (...) empirical research in this area. We address this issue by outlining and testing an emotion-based model to study the ethical attitudes and behaviors of salespeople in a relational selling context. Building on the cognitive-affective model proposed by Gaudine and Thorne (J Bus Ethics 31:175–187, 2001 ), we outline a framework that incorporates higher order prosocial emotions: capacity for concern and capacity for guilt. We include salesperson’s role clarity within the organization as a moderator to examine person–situation interaction. (shrink)

The objective of this article is to clarify the conceptual domains of organizational identity, image, and reputation. To initiate this theory development process, we present a “social actor” conception of organizational identity. Identity-congruent definitions of image and reputation are then specified and an integrated model proposed. With the aid of this model, a structural flawin the organizational reputation literature is identified and suitable remedies proposed. In addition, the authors explore the implications of invoking identity and identification in explanations and justifications (...) of organizational reputation. (shrink)

The ongoing controversy about sweatshop labor has mainly focused on economic, on the one, and ethical aspects, on the other side. While proponents of sweatshop labor have argued that low wages would attract foreign investments, would create new workplace opportunities and thus improve economic welfare in less-developed countries, opponents of sweatshop labor argue that such treatment of laborers would violate their dignity, and they prompt western buyers to stop this kind of exploitation. However, the arguments in this debate are not (...) new. As we will show, they can be traced back to the early “sweatshop” debate between social reformers and classical liberals in the 19th century. Interestingly, the 19th century debate identified sweatshop labor not as an industrial system but as a social phenomenon which becomes more likely when several social preconditions are fulfilled. It will be shown that the social preconditions identified in this debate determine working conditions till today and can be used to identify industries were sweatshop labor is more likely than in others—even in western countries. (shrink)

Open peer commentary on the article “Amusement, Delight, and Whimsy: Humor Has Its Reasons that Reason Cannot Ignore” by Edith K. Ackermann. Upshot: Ackermann tackles “humor” as an agentive participant in the process of knowledge construction. Performing her thesis in her writing, she give a reflective account of how oblique ways of knowing have always been present in debates concerning epistemology, albeit not given equal status as rational ones. As such, her endeavors in this text are geared towards lifting up (...) the position of “humor” to a much deserved higher level in educational and learning practices. Consequently, our endeavors in this commentary are targeted towards a little more in this direction by focusing on how “humor” becomes a way of accessing the process of knowledge construction and of unraveling its significance. (shrink)

Background: The magnitude of bullying and harassment among psychiatrists is reportedly high, yet no peer-review published studies addressing this issue could be found. Therefore, it was decided to conduct a pilot study to assess the degree of the problem, the types of bullying/harassment and to provide some insights into the situation.Methods and Principal Findings: Following multiple focus group meetings, a yes/no response type questionnaire was developed to assess the degree and type of bullying and harassment experienced by psychiatrists. Over a (...) 3-month period the questionnaire was administered to a random sample of 60 psychiatrists. 57 out of the 60 psychiatrists reported harassment and bullying. Frequencies of the following response variables are presented in descending order: rumours 40% ; defamation 20% ; passing remarks 20% ; false accusations 15% ; threats 13.3% ; verbal abuse 13.3% ; unjustified complaints 13.3% ; promotion blocked 13.3% ; humiliation 13% ; bad reference given 10% ; credentials questioned 8.3% ; physical attacks 5% ; termination 5% ; derogatory remarks 1.7% and 1.7% were subjected to personal work. As a result of being subjected to harassment, 66.7% of the psychiatrists did not take any action, whereas 33.3% confronted the person they believed responsible. Asked whether the bullying and harassment caused distress, 18.3% of the psychiatrists did not report any effect, 30% reported mild distress, 40% moderate distress and severe distress was reported by 11.7%.Conclusions: It was concluded that the magnitude of bullying and harassment among psychiatrists may be quite high, as evidenced by this pilot study. There is a need for extensive systematic studies on this subject and to establish strategies to prevent and address this issue at a national and regulatory level. (shrink)

Not being satisfied with the interpretation offered by Sankara and his followers, or some other teachers the author has attempted in the following pages to present to the readers his own interpretation of the work as he has understood it. But in no way does he claim that his interpretation is the interpretation, i.e., the interpretation intended by Gaudapada himself. In the present volume the author has given a new edition of the text of the Agamasastra based on a number (...) of MSS and different editions, followed by an English translation. After this comes his annotation. At the end there are Appendixes including the text and English translation of the Mandukya Upanisad, VAriants of the MSS used for the edition of the text of the Agamasastra, and different indexes. (shrink)

The nature of tragedy has always been felt to be a problem, not only by the philosopher, but also, and perhaps even more, by the ordinary man. The question so often asked is: why, if there is so much suffering already in the world, do we want to go to a theatre or read a story describing more suffering? Why indeed should the spectacle of suffering ever be pleasing to us? Yet it is obvious that olarge numbers of ordinary people (...) do like reading or seeing tragedies; and that there are some tragedies which are generally judged to be the most valuable works of literary art ever produced. What then is the nature of the value which we extract from these works? That is the question to which I would like to address myself. (shrink)

There are in iambic trimeters a number of examples of hiatus where is followed by forms of , mainly in Comedy but also in Tragedy. These are notable because they fall outside the usual range of hiatus in drama, which covers passages with interrogative and , invocatory exclamations such as , and interjections. The use seems to deserve closer attention.

Following a previous article published in Biological Theory, in this study we present a mathematical theory for a science of qualities as directly perceived by living organisms, and based on morphological patterns. We address a range of qualitative phenomena as observables of a psychological system seen as an impredicative system. The starting point of our study is the notion that perceptual phenomena are projections of underlying invariants, objects that remain unchanged when transformations of a certain class under consideration are applied. (...) The study develops with the observables, the entailed total order and metric, whence the algebra and the geometry of such a science, presenting a formal phenomenological model for phenomena that are not rigidly Euclidean. We show how non-Euclidean perception can have many useful Euclidean formalizations, as well as locally-homeomorphic-to-Euclidean-space models. The mathematical models we provide are tested on the basis of results from experimental psychology, in particular from the field of color, time, and space perception. (shrink)

Background: Only data of published study results are available to the scientific community for further use such as informing future research and synthesis of available evidence. If study results are reported selectively, reporting bias and distortion of summarised estimates of effect or harm of treatments can occur. The publication and citation of results of clinical research conducted in Germany was studied.Methods: The protocols of clinical research projects submitted to the research ethics committee of the University of Freiburg in 2000 were (...) analysed. Published full articles in several databases were searched and investigators contacted. Data on study and publication characteristics were extracted from protocols and corresponding publications.Results: 299 study protocols were included. The most frequent study design was randomised controlled trial , followed by uncontrolled studies , laboratory studies and non-randomised studies . 182 were multicentre studies including 97 international collaborations. 152 of 299 had commercial funding and 46 non-commercial funding. 109 of the 225 completed protocols corresponded to at least one full publication ; the publication rate was 48%. 168 of 210 identified publications were cited in articles indexed in the ISI Web of Science. The median was 11 citations per publication .Conclusions: Results of German clinical research projects conducted are largely underreported. Barriers to successful publication need to be identified and appropriate measures taken. Close monitoring of projects until publication and adequate support provided to investigators may help remedy the prevailing underreporting of research. (shrink)

The logical flow graphs of sequent calculus proofs might contain oriented cycles. For the predicate calculus the elimination of cycles might be non-elementary and this was shown in [Car96]. For the propositional calculus, we prove that if a proof of k lines contains n cycles then there exists an acyclic proof with O(k n+l ) lines. In particular, there is a polynomial time algorithm which eliminates cycles from a proof. These results are motivated by the search for general methods on (...) proving lower bounds on proof size and by the design of more efficient heuristic algorithms for proof search. (shrink)

On the theory of Teilhard de Chardin, P.