The importance of patient involvement is increasing in healthcare, and initiatives are constantly implemented to reach the ideal of involved and educated patients. This secondary analysis was initially embedded in a randomized controlled study where the aim was to gain insight into perceptions and experiences within a group of women undergoing fertility treatment through two focus group interviews. In this secondary analysis, we investigated how patient involvement was strived for in both clinical practice and research. During the analysis, it became (...) apparent that the women exercised and maintained a clear perspective on their hope for a child, Project Child, while the interviewer pursued a treatment perspective, Project Treatment. Despite different perspectives, the conversation during the interviews seemed effortless, and it became apparent how the interviewer and the participants were actually focusing partly on the same, but primarily on different issues but without addressing or acknowledging this. Knowledge and awareness of the difference in perspectives is important when healthcare professionals seek to involve patients both in clinical practice and in research. Patient involvement in both research and clinical practice has shown to be a challenge and entails that pathways are organized and decisions shared by healthcare professionals. (shrink)

ABSTRACT In this survey we have investigated the experiences and attitudes of Danish physicians regarding end‐of life decisions. Most respondents have made decisions that involve hastening the death of a patient, and almost all find it acceptable to do so. Such decisions are made more often, and considered ethically more acceptable, with the informed consent of the patient than without. But both non‐resuscitation decisions, and decisions to provide pain relief in doses that will shorten the patient's life, have been made (...) and found acceptable by at least 50% of the respondents, even when there is no informed consent. Furthermore, 12% have doubled morphine dosages with fixed intervals, thus providing doses substantially higher than that necessary to control pain, without the informed consent of the patient. Two per cent have helped in assisted suicide, and 5% have administered a lethal injection at the patient's request. Respectively 37% and 34% find these last two practices ethically acceptable. Amongst those that do not find them acceptable, the most important reasons to be opposed are, the doctrine of double effect, the doctrine of doing and allowing, and the view that human life is sacred. Amongst supporters, the most important reasons mentioned are, that the patient's right to self‐determination should be respected, the view that a patient should not be forced to suffer, and the view that the patient has a right to be helped to a dignified death. (shrink)

In this survey we have investigated the experiences and attitudes of Danish physicians regarding end-of-life decisions. Most respondents have made decisions that involve hastening the death of a patient, and almost all find it acceptable to do so. Such decisions are made more often, and considered ethically more acceptable, with the informed consent of the patient than without. But both non-resuscitation decisions, and decisions to provide pain relief in doses that will shorten the patient's life, have been made and found (...) acceptable by at least 50% of the respondents, even when there is no informed consent. Furthermore, 12% have doubled morphine dosages with fixed intervals, thus providing doses substantially higher than that necessary to control pain, without the informed consent of the patient. Two per cent have helped in assisted suicide, and 5% have administered a lethal injection at the patient's request. Respectively 37% and 34% find these last two practices ethically acceptable. Amongst those that do not find them acceptable, the most important reasons to be opposed are, the doctrine of double effect, the doctrine of doing and allowing, and the view that human life is sacred. Amongst supporters, the most important reasons mentioned are, that the patient's right to self-determination should be respected, the view that a patient should not be forced to suffer, and the view that the patient has a right to be helped to a dignified death. (shrink)

Neoliberal ideology and exclusionary policies based on racialized identities characterize the current contexts in North America and Western Europe. Nursing knowledge cannot be abstracted from social, political and historical contexts; the task of examining the influence of race and racial ideologies on disciplinary knowledge and inquiry therefore remains an important task. Contemporary analyses of the role and responsibility of the discipline in addressing race‐based health and social inequities as a focus of nursing inquiry remain underdeveloped. In this article, we examine (...) nursing's engagement with ideas about race and racism and explore the ways in which nursing knowledge and inquiry have been influenced by race‐based ideological discourses. Drawing on Henry and Tator's framework ofdemocratic racism, we consider how strategic discursive responses—the discourses of individualism, multiculturalism, colour‐blindness, political correctness and denial—have been deployed within nursing knowledge and inquiry to reinforce the belief in an essentially fair and just society while avoiding the need to acknowledge the persistence of racist discourses and ideologies. Greater theoretical, conceptual and methodological clarity regarding race, racialization and related concepts in nursing inquiry is needed to address health and social inequities. (shrink)

Many policies hinge on determining whether someone’s situation is due to luck or choice. In political philosophy, this prevalence is mirrored by luck egalitarian theories. But overemphasizing the distinction between luck and choice will lead to tensions with the value of moral agency, on which the distinction is grounded. Here, we argue that the two most common contemporary critiques of luck egalitarianism, holding it to be harsh and disrespectful are best understood as illustrating exactly this tension. Elaborating on this conflict, (...) we argue that it should lead us to modify how luck and choice are used in theories of justice. (shrink)

What does it take for an individual to be personally responsible for behaviors that lead to increased risk of disease? We examine three approaches to responsibility that cover the most important aspects of the discussion of responsibility and spell out what it takes, according to each of them, to be responsible for behaviors leading to increased risk of disease. We show that only what we call the causal approach can adequately accommodate widely shared intuitions to the effect that certain causal (...) influences—such as genetic make-up or certain social circumstances—diminish, or undermine personal responsibility. However, accepting the causal approach most likely makes personal responsibility impossible. We therefore need either to reject these widely shared intuitions about what counts as responsibility-softening or undermining or to accept that personal responsibility for behaviors leading to increased risk of disease rests on premises so shaky that personal responsibility is probably impossible. (shrink)

In this paper, I ask what is wrong with sufficiency. I formulate a generic sufficiency principle in relation to which I discuss possible problems for sufficientarianism. I argue against the arbitrariness–concern, that sufficiency theory need only to identify a possible space for determining a plausible threshold, and I argue against the high–low threshold dilemma concern, that multiple-threshold views can solve this dilemma. I then distinguish between currency-pluralist and currency-monist multiple-threshold views and test them against two different versions of the widely (...) shared ‘ignorance of inequality objection’ to sufficientarianism—a benefit-driven and a burden-driven version. I argue that currency-pluralist sufficiency views are better capable of responding to the former than currency-monist views. However, I show that no existing sufficiency view can provide a plausible response to the burden-driven version. Hence, I conclude that the problem of unequal distribution of burdens above the thresholds represents an overlooked threat to the sufficiency view, in any version. (shrink)

Walter Fisher's narrative paradigm has sparked intense debate about the role of narratives in rhetorical scholarship. The theory has subsequently been followed up by numerous criticisms and revisions. This article argues that especially the latter can benefit from a complementary phenomenological perspective that Fisher himself placed within the original paradigm. Through the Heideggerian concepts of building and dwelling, rhetoric within the narrative paradigm may be seen as a primary means for engaging with both individual and communal goals and exigencies, providing (...) a more nuanced account for how people care for and act on the narratives in their lives. (shrink)

In recent literature, there has been much debate about whether and how luck egalitarianism, given its focus on personal responsibility, can justify universal health care. In this paper we argue that, whether or not this is so, and in fact whether or not egalitarianism should be sensitive to responsibility at all, the question of personal responsibilization for health is not settled. This is the case because whether or not individuals are responsible for their own health condition is not all that (...) is relevant when considering whether we should somehow hold them responsible for their own health condition, e.g. cost-wise. There may also be efficiency-based reasons to hold them responsible, and there may even be egalitarian reasons. Defining universal health care as an insurance system where everyone’s deductible and premium is 0, we will argue that efficiency-based reasons for cost-responsibilization are not convincing, but that there are egalitarian reasons for cost-responsibilization. Luck egalitarianism, therefore, cannot, at least not on its own term, justify universal health care. (shrink)

On the basis of the Weber, Jaspers, and Arendt style ‘ideal types’ of the manager as Eichmann, Richard III, and Faust it is explained how under strong organizational pressures to obey orders and further organizational ends, different types of managers cooperate with organization behavior that harms people. On the basis of Arendt's and Tillich's action philosophies, the manager as Institution Citizen with the courage to be both as oneself and as a part is presented as alternative, contrast, and resistance model (...) to the other ‘ideal types’, particularly to the Eichmann ‘ideal type’. (shrink)

There are three remarks of Norman Malcolm’s with which I should like to begin. The first is his remark that.

After 150 years of scientific developments, the periodic system of chemical elements is still an icon of modern science. Its resilience is striking. The icon used today by scientists and teachers is in fact the outcome of many rearrangements and reinterpretations by the scientific community during that period. This success is often explained as a result of the underlying atomic structure, discovered in the first decades of the 20th century, an explanation that completely neglects the fine structure of the process (...) of ongoing renegotiation and successive stabilizations. How did indeed contemporary scientists navigate in times of reinterpretation? The physicist Lise Meitner and the chemist Ida Noddack were, in different ways, involved in discoveries and interpretations of the periodic system. In 1934, as part of the celebration of the centenary of Dmitri Mendeleev's birth, they each published an article on the system: Meitner in Die Naturwissenschaften, and Noddack in Angewandte Chemie. These two articles, written from the perspectives of a nuclear physicist and a chemist experienced in searching for undiscovered elements, respectively, constitute excellent sources for understanding what new discoveries and insights meant for the meaning and value of the periodic system at the very beginning of the nuclear age in science. Through an analysis of the two contributions, we will argue that resilience is the foremost value of the periodic system. We will also discuss what this value means for the future of the periodic system and its representations. (shrink)

An identification is made of the core metaphilosophical, philosophical, and intellectual history theses in Richard Rorty's pragmatism. Their rationale is displayed and it is argued that his metaphilosophical theses are very much dependent on certain of his non‐metaphilosophical philosophical theses, most centrally his anti‐representationalism. Questions emerge about the status and justification of these theses. Rorty, in his programmatic pronouncements, resists providing a vindication of them. Seeking to avoid what has been called performative contradictions, he regards it as sufficient to provide (...) the best narrative going of what is to be said here. It is argued that a more straightforward defence can be provided that does not depart from his holism or his historicism with its setting aside of claims of necessity. (shrink)

Ageism is the view that it is of greater moral value to allocate health care resources to younger people than to older people. In medical ethics, it is well-known that standard interpretations of distributive principles such as utilitarianism and egalitarianism imply some form of ageism. At times, ethicists argue as if practical complications are the only or main reason for not abiding to ageism. In this article, we argue that inferences to ageism from such distributive principles tend to commit what (...) we call the anticipation-blindness fallacy: A much too narrow focus on life quality benefits of health care treatments inclines us to overlook the importance of life quality benefits of health care safety, that is the mere trust in and expectation of being treated and cared for as one grows old. This is a key omission because health safety has value for a much larger population and for much longer time. Taking health safety into account therefore has important implications as for how ageist we ought to be. (shrink)

Multi-method research is any research that uses more than one research technique or strategy to study one or several closely related phenomena. This method is described by triangulation. This article examines the multi-method tradition in empirical legal research, defines basic concepts, discusses when and why multi-method research is useful, and how the different actions of research can provide unique approaches to the same questions. It explores examples of projects to demonstrate how research that employs multiple tactics for observing and understanding (...) is more reliable than a single study if the studies are of comparable quality. At the same time, multi-method research comes with great costs and risks that must be considered at the outset of such a project as well as during the project itself. However, it is speculated that multi-method research is perhaps the most effective way to understand the relationship between law and society. (shrink)

Discussing the intercultural reception of Pier Paolo Pasolini, this article looks into the intercultural and medial crossovers of his person and his work. It shows the historical particularities of Pasolini's work, and it traces layers of intermedial references in his movie production, describing the many-layered intercultural interplay. Lastly, it focuses on the discussions of media relations, and the remedialisation inherent in much of Pasolini's work.

Through an international case study, this paper illustrates how a conversation method was used effectively to address a cross-cultural ethics problem. The method included as moments in one continuous process three different dimensions of postmodernism-Gadamer reconstruction, Derrida deconstruction, and Rorty neopragmatism. In addition to including different dimensions of postmodernism, the method combines effective mutual learning and effective action. Strengths and limitations of the approach are discussed. The article demonstrates how it can be beneficial to build bridges between and within the (...) postmodernism and organization ethics literatures. Also, the article demonstrates how postmodernism can be positively ethical and not necessarily aethical or nihilistic. (shrink)

Name der Zeitschrift: Jahrgang: 13 Heft: 2 Seiten: 190-206.

These conference proceedings consider visual and literary images of ancient Rome created by artists and scholars from Late Antiquity until the present day. The occasion for the conference was the colossal panorama Rome 312 by Yadegar Asisi that was displayed in Leipzig. The papers explore the ways and means by which the idea of Rome was developed by the individual artists and authors and transferred to the cultural context of the epoch and of the personalities involved.

The use of prisoners as research participants is controversial. Efforts to protect them in response to past exploitation and abuse have led to strict regulations and reluctance to involve them as participants. Hence, prisoners are routinely denied the opportunity to participate in research. In the absence of comprehensive information regarding prisoners’ current involvement in research, we examined UK prisoners’ involvement through review of research applications to the UK National Research Ethics Service. We found that prisoners have extremely limited access to (...) research participation. This analysis was augmented by a survey of those involved in research and research governance (UK researchers and Research Ethics Committee members). Our results suggest that pragmatic concerns regarding the perceived burden of including prisoners are far more prominent in motivating their exclusion than ethical concerns or knowledge of regulations. While prisoners may remain a vulnerable research population due to constraints upon their liberty and autonomy and the coercive nature of the prison environment, routine exclusion from participation may be disadvantageous. Rigorous ethical oversight and the shift in the prevailing attitude towards the risks and benefits of participation suggest that it may be time for research to be more accessible to prisoners in line with the principle of equivalence in prison healthcare. We suggest the necessary first step in this process is a re-examination of current guidance in the UK and other countries with exclusions. (shrink)

Much of the literature on the question “Is a human essentially distinct from every possible machine?” proceeds on the assumption that we know what a man essentially is, namely a living body with such attributes as consciousness, freedom, feeling and linguistic competence. Is a man essentially that? The paper contrasts that picture of man with Kierkegaard’s account of man as essentially self. Hard limits of machine subjectivity begin to appear in the failure of certain everyday concepts involving ‘self’ to engage (...) at all with the concept ‘machine’. (shrink)

L'articolo presenta l'edizione di un gruppo di questioni sul numero, l'istante e il tempo discusse da Thomas Wylton in contesti teologici. Le questioni sono le seguenti: Q. 1 An numerus sit ens formaliter praeter animam ; Q. 2 An nunc secundum substantiam sit mensura propria rei generabilis et corruptibilis secundum esse permanens eius ; Q. 3: Utrum tempus habeat esse reale distinctum a motu secundum suum esse formale ; Q. 4: Utrum numerus qui oritur ex divisione continui addat aliquam rem (...) super continuum . L'edizione, riportata in appendice, è proceduta da una trattazione analitica di ciascuna questione, accompagnata da uno studio delle fonti. (shrink)

Band 13 der psycho-logik widmet sich aus fächerübergreifendem Blickwinkel dem Thema Identität, das in den Sozial- und Geisteswissenschaften zu einem Schlagwort des 20. und 21. Jahrhunderts geworden ist. Gerade die moderne und liberale Gesellschaftsordnung, die uns ungeahnt viel Freiheit ermöglicht hat, charakterisiert ein Patchwork aus Identifikationsangeboten, das zugleich die kollektive und personale Identitätsfindung problematisch macht. Aktuell hat die narrative Theorie die erinnerte und erzählte Lebensgeschichte zum Gründungsort des Selbst erhoben. Sie spielt auch in den Beiträgen dieses Bandes eine prominente Rolle. (...) Es zeigt sich, dass die Identitätskonstruktion ein Prozess ist, in dem sich Identität als etwas Fragiles und Plurales offenbart. Identität ist ein tragisches Spiel zwischen Einheit und Mannigfaltigkeit: Identität(en). Forscher*innen aus Deutschland, Irland und den USA mit ihren Beiträgen aus Literaturwissenschaft, Theologie, Philosophie und Psychologie diskutieren u. a. das Band zwischen Identität und Erinnerung bei Marcel Proust, transsexuelle Identitätskonstruktionen in US-amerikanischen Biopics, den Film als Identitätsbildungsmedium des Publikums, Identitätspolitik(en) am Beispiel des Zugangs zu US-amerikanischen Hochschulen, die Identitätsfindung in Lebensgeschichten und den psychotherapeutischen Umgang mit gebrochenen Identitäten. Fotoarbeiten des Künstlers Hermann Recknagel runden den Band ab. Mit Beiträgen von Michaela I. Abdelhamid, Carsten Albers, Paul Clogher, Katherine Duval, Winfried Eckel, Fiona Ennis, Annette Hilt, Christopher A. Nixon, Paul Nnodim, Hermann Recknagel, Patricia Rehm-Grätzel, Martin Reker, Annika Schlitte und Hartwig Wiedebach. (shrink)

Many of the same fundamental principles and regulations that govern civilian biomedical research also apply to research conducted by the US Military. Despite these similarities, the conduct of research by the US Military has additional requirements designed to preserve service members’ informed consent rights, ethical standards and information that may be deemed classified. Furthermore, there are also additional rules and regulations associated with potential research to be done in a combat setting. Before conducting battlefield research, many unique circumstances must be (...) considered to include: (1) the current legal and regulatory requirements for advanced informed consent (2) the tactical situations, and the ability to adequately document in the “austere” environment (3) the need to provide improved drugs and devices for combat casualty care and (4) the special nature of the superior-subordinate relationship. This paper discusses historical background, regulatory oversight, ethical implications and release of information as it pertains to research conducted by the US Military. (shrink)

The semantic relations between and within utterances are marked by the use of connectors and adverbials. One type of semantic relations is causal relations expressed by causal markers such as because, therefore, so, for, etc. Some of these markers cover different types of causal relations such as causality, explanation and justification. In certain types of discourse, causal relations also imply an intentional element. This paper describes the way in which the semantic and pragmatic functions of causal markers can be accounted (...) for in terms of linguistic and rhetorical theories of argumentation. (shrink)

Through the second year, children’s copying behaviour shifts from a focus on emulating to a focus on imitating. This shift can be explained by a change in focus from copying others to satisfy cognitive motivations to copying in order to satisfy social motivations. As elegant and detailed as the shared circuits model (SCM) is, it misses this crucial, motivation-based feature of imitation.

Is the work of Michael Hardt and Antonio Negri compatible with critical realism? In this article I argue that their book Empire is not, whereas Multitude is. Critical realists should be interested in this question because the passage from Empire to Multitude can be reconstructed as a case of critical realist underlabouring and, as such, exemplifies an openness to critique and changing political circumstances that critical realists prescribe for themselves but unfortunately tend in practice to ignore. Highlighting the concepts and (...) practice of underlabouring, of judgemental rationality and epistemological relativism, I argue that Hardt and Negri can also underlabour for critical realists, in that their work demonstrates the need for underlabouring to proceed in a non-philosophical as well as philosophical vein. Thus, striving for a new science and human emancipation in critical realism can assume a theoretically as well as an empirically informed content, and a historically situated commitment. (shrink)