Inequalities in expectations to receive care permeate social structures, reinforcing racialized and gendered hierarchies. Harming the people who are overburdened and disadvantaged as caregivers, these inequalities also shape the subjectivities and corporeal habits of the class of people who expect to receive care from others. With three examples, I illustrate a series of justificatory asymmetries across gender and racial lines that illustrate (a) asymmetries in deference and attendance to the needs of others as well as (b) assertions of the rightful (...) occupation of space. These justificatory asymmetries are cogent reasons to evaluate the justice of caregiving arrangements in a way that tracks data about who cares for whom, which can be understood by the concept of the arrow of care map. I suggest, therefore, that the arrow of care map is a necessary component of any critical care theory. In addition, employing a method called living counterfactually, I show that when women of color assert full claimant status, we are reversing arrows of care, which then elicits resistance and violence from varied actors in the real world. These considerations together contribute to further defense of the theory of liberal dependency care’s constructivism, which combines hypothetical acceptability with autonomy skills in the real world. Each level, in turn, relies on the transparency of care practices in the real world as enabled by the arrow of care map. (shrink)

RésuméDans cet article, je réponds à Clark Wolf, Elizabeth Edenberg et Helga Varden. Partageant des sympathies pour le libéralisme opposé à l'oppression et pour la théorie du contrat social, ils me recommandent avec insistance de développer ma théorie dans des directions nouvelles — respectivement comme une forme de justice pour tous les sujets, avec une justification politique libérale, et suivant la conception kantienne de « droit privé ». Je réponds en expliquant que l'inclusivité est incorporée dans l'idée même du schéma (...) des relations de soin (« arrow of care map ») que je mets de l'avant, comme elle est inscrite dans la variété des théories contractuelles que je soutiens. De plus, j'insiste sur le fait que le libéralisme qui rejette l'oppression ne doit pas formuler ses arguments seulement dans les termes de la politique libérale. (shrink)

This paper advances a framework to conceptualize societal care-giving arrangements abstractly. It is abstract in that it brackets the meaning of our particular relationships. This framework, which I call “the arrow of care map”, is a descriptive tracking model that is a necessary component of a theory of justice, but it is not a normative prescription in itself. The basic idea of the map is then multiply specifiable to track various ascriptive identity categories as well as different categories of care (...) labor. In this way, the idea of the arrow of care map serves as a conceptual frame within which to begin to understand every human society’s care-giving arrangement. I characterize it as a component of “ideal theory” insofar as it seeks to clarify our values, without the immediate aim of formulating principles to govern a just society. The resultant partial theory of justice is one that responds to non-ideal theory’s critiques of the ideological nature of liberal contractarianism’s idealizations and abstractions while moving towards new visions of a just society. (shrink)

This book presents the first systematic account of dependency care in a liberal theory of justice. Despite the fact that receiving dependency care is necessary for human survival, the practices with which we meet society’s care needs are seldom recognized for their functional role. Instead, norms about gender and race obscure and shape expectations about whose needs for care are legitimate as well as about whose caregiving labor more advantaged members of society will receive. These opaque arrangements must be made (...) visible if we are to remedy skewed intuitions and judgements about care. Freedom to Care develops a modified form of social contract theory with which to evaluate society’s caregiving arrangements. Building on work by feminist liberals and care ethicists, it reframes debates about care to move beyond gender with an inequality-tracking framework that can be employed in any culture. Because care provision has been enmeshed in the subordination of women and people of color, eliminating the invisibility of these forms of labor yields a critical liberal theory of justice with feminist and anti-racist aims. (shrink)

The negative health effects of stress are well documented in medical and psychological research, but these effects are underexplored in political philosophy. This essay evaluates these effects in relation to the explanatory and normative value of the concept that I call “being at home.” The phenomenological description of the state of being at home is the sense of feeling safe and at ease in your context, and therefore able to relax. Although it characterizes a particular state of being for an (...) individual person, its conditions are relational. I show how the normative value of being at home can guide nonideal action-guiding recommendations to respond to racism in light of the claim that one of the negative effects of racism is a steady stream of disruptions to a person’s sense of ease in the world. Racism and microaggressions create stress, which then causes further negative health effects to the minority body. Consequently, the physical harms perpetrated by racist and sexist societies on the members of oppressed identities can be as great as the effects of actions standardly understood as violence. Demonstrating that a nonideal theoretical approach to bioethics is well suited to evaluating the philosophical ramifications of the bodily damage incurred by microaggressions, I recommend selective and episodic separatism from the perpetrators of microaggressions as a health-protective response to the realities of living in an unjust world. (shrink)

This essay assess the compatibility of Eva Kittay's dependency critique with Rawlsian political liberalism. I argue for the inclusion of a modified version of Kittay's revisions within Rawlsian theory in order to yield a theory that suppports a substantial subset of dependency work. Beyond these selected changes, however, I argue that Kittay's other proposed changes should not be included because they are incompatible with Rawls, and furthermore, their incorporation does not yield a theory that includes utter dependents.

Dependency care is an asymmetric good; everyone needs to receive it, but it is not the case that we all have to provide it. Despite ethicists’ of care’s theorizing about the importance of dependency care, it has yet to be theorized within a form of liberalism. This paper theorizes two components of a liberal theory of dependency care. First, it advances a liberal justification to include the receipt of dependency care among the benefits of social cooperation. Then, it advances an (...) autonomy-based principle to guide how care should be provided (“strong proceduralism”). Strong proceduralism is based on an account of autonomy that incorporates the significance of a person’s skills when he parses options. Strong proceduralism consequently requires educational efforts to teach care-giving skills to groups who have not previously possessed them. I hypothesize that strong proceduralism will secure adequate care provision as the outcome of autonomous choice, but if an inadequate number of people choose to provide care, then a secondary stage of deliberations will be necessary. If the outcome of those secondary deliberations is that people want to have their care needs met, then a fair process for distributing infringements on autonomy must be devised. (shrink)

The value of autonomy is a hallmark of liberal doctrine. It would seem to follow that liberals must reject the practice of “arranged marriage” on the grounds that the “arranging” component of the practice eschews autonomy and individuality. However, in policy debates in Great Britain, the difference between “arranged marriage” and “forced marriage” has been defined as the presence of autonomy or free choice for an arranged marriage and their absence in cases of forced marriage. A paradox seems to result: (...) arranged marriage is defined as a marriage practice that both rejects autonomy and requires autonomy. In this article, I will show that the resultant paradox arises from the inadequacy of the autonomy analysis rather than from any intrinsically puzzling feature of arranged marriage. I then offer an alternative normative framework to assess arranged marriage’s potential contribution to a just society. My tri-metric analysis for arranged marriage includes the autonomy of the participants (Metric 1), as well as two societal metrics: the fairness of the distribution of care-giving labor (Metric 2) and the degree to which the society meets its members’ legitimate needs for care (Metric 3). (shrink)

This essay responds to Jan Narveson’s libertarian commentary on my earlier work “Liberal Dependency Care.” There, I argued that the underlying logic of the circumstances of justice warrants adding care to a liberal theory of justice. In this essay, I rebut Narveson’s skeptical claims about the liberal credentials of my justificatory argument by identifying the extent to which my view shares the same reasonable constraints on liberty as those defended by John Stuart Mill. I also suggest that a libertarian refusal (...) to add care to the core functions of the state is plausible only if women’s labor remains invisible. Finally, I refute Narveson’s contention that my strong procedural principle of care provision is incipiently totalitarian. The case for public support to teach basic levels of attentiveness and responsiveness is analogous to the case for teaching the foundational skills of arithmetic, which are legitimately taught in primary and secondary schools. (shrink)

This author’s reply addresses critiques by Daniel Engster, Kelly Gawel, and Andrea Westlund about my 2020 book, Freedom to Care: Liberalism, Dependency Care, and Culture. I begin with a statement of my commitment to liberalism. In section two, I defend the value of a distinction between conceptions of persons in the real world and in contract theory to track inequalities in care when indexed to legitimate needs. I argue, as well, that my variety of contract theory supplies the normative content (...) needed to reject the subordination of women of color. Acknowledging the enduring danger of expressive subordination, I emphasize my theory’s compatibility with the full social inclusion of people with disabilities. Section three then defends liberal dependency care’s compatibility with radical critique and transformative change by emphasizing the abstract nature of its core theoretical module. Finally, in section four, I reaffirm conceptual distinctions between autonomy skills, care skills, and a sense of justice by explicating their theoretical roles. In that section, I also embrace Westlund’s insight that theorists of justice need to have skills enabling responsiveness to other perspectives. To this new requirement for actual theorists of justice, I further add that we must attain capacities to engage critically with our society’s norms. Thus, the final section of this article supplements the justificatory module of liberal dependency care, building from the necessary conditions specified as two-level contract theory toward an account of necessary and sufficient conditions for this liberalism’s justificatory module. (shrink)

This paper advances a Millian concept of care by re-evaluating his defense of the “common arrangement,” or a gendered division of labor in marriage, in connection with his views about traditionally feminine capacities, time use, and societal expectations. Informed by contemporary care ethics and liberal feminism, I explicate the best argument Mill could have provided in defense of the common arrangement, and I show that it is grounded in a valuable concept of care for care-givers. This dual-sided concept of care (...) theorizes care-giving both as a domain of human excellence and as labor with accompanying burdens. Liberal feminists should adopt this Millian concept of care, which can then inform principled thinking about distributive arrangements. (shrink)

This summary of Freedom to Care begins with the core claims and conceptualizations upon which the theory of liberal dependency care rests. It then summarizes the book’s chapters. The first five chapters (Part I) delineate its theoretical foundations, which include the two-level contract theory approach to distributive justice for caregiving arrangements. In Part II of the book, chapters six through nine, I formulate liberal proposals for justice-enhancing social change before identifying cross-cultural metrics of justice for the internal evaluation of caregiving (...) arrangements. (shrink)

Caring for Liberalism brings together chapters that explore how liberal political theory, in its many guises, might be modified or transformed to take the fact of dependency on board. In addressing the place of care in liberalism, this collection advances the idea that care ethics can help respond to legitimate criticisms from feminists who argue that liberalism ignores issues of race, class, and ethnicity. The chapters do not simply add care to existing liberal political frameworks; rather, they explore how integrating (...) dependency might leave core components of the traditional liberal philosophical apparatus intact, while transforming other aspects of it. Additionally, the contributors address the design of social and political institutions through which care is given and received, with special attention paid to non-Western care practices. This book will appeal to scholars working on liberalism in philosophy, political science, law, and public policy, and it is a must-read for feminist political philosophers. (shrink)

Book review of Serene Khader's "Adaptive Preferences and Women's Empowerment".

Though accountable care organizations are increasingly important to American healthcare, ethical inquiry into ACOs remains in its nascent stages. Several articles have raised the concern that ACOs have an incentive to avoid enrolling high-cost patients and, thereby, have an incentive to deny care to those who need it the most. This concern is borne out by the reports of consultants working with newly formed ACOs. This paper argues that, contra initial appearances, there is no financial incentive for ACOs to avoid (...) enrolling high-cost patients. (shrink)

Accountable Care Organizations are a key mechanism of the Patient Protection and Affordable Care Act. ACOs will influence incentives for providers, who must understand these changes to make well-considered treatment decisions. Our paper defines an ethical framework for physician decisions and action within ACOs. Emerging ethical pressures providers will face as members of an ACO were classified under major headings representing three of the four principles of bioethics: autonomy, beneficence, and justice. Conflicts include a bias against transient populations, a motive (...) to undertreat conditions lacking performance measures, and the mandate to improve population health incentivizing life intrusions. After introducing and explaining each conflict, recommendations are offered for how providers ought to precede in the face of novel ethical choices. Our description of novel ethical choices will help providers know what to expect and our recommendations can guide providers in choosing well. (shrink)

RésuméDans cette introduction, je propose un survol de Freedom to Care: Liberalism, Dependency Care, and Culture d'Asha Bhandary, afin que les lecteurs puissent mieux situer les suggestions des contributeurs au symposium, Clark Wolf, Elizabeth Edenberg et Helga Varden. Bhandary développe et défend la théorie libérale de la prise en charge de la dépendance en réponse à l’échec des théories libérales passées à reconnaître que cette prise en charge de la dépendance, qui est essentielle à notre survie, relève (...) de la justice. En terminant, je tisse des liens avec la philosophie de Jean Hampton, afin de stimuler la discussion autour des travaux inédits de Bhandary, qui élargissent l'influence de la théorisation libérale féministe contemporaine. (shrink)

RésuméCette analyse situe la théorie du soin d'Asha Bhandary, telle que définie dans Freedom to Care, dans l'histoire de la philosophie, note certaines caractéristiques distinctives de la théorie qui font clairement évoluer la tradition de la théorie du soin, et soulève des énigmes et des questions concernant des éléments spécifiques de la théorie. Mes remarques portent principalement sur la première partie du livre et sur les quatre sujets suivants : (1) les racines rawlsiennes de la théorie de (...) class='Hi'>Bhandary ; (2) les échanges de Bhandary avec Eva Feder Kittay ; (3) le choix de Bhandary de prendre J.S. Mill et John Rawls comme principaux interlocuteurs historiques ; et enfin (4) le choix méthodologique de Bhandary de cibler les « hommes/pères », les « femmes/mères » et les « enfants/filles/garçons » dans une grande partie de son analyse. (shrink)

This contribution discusses Asha Bhandary’s book Freedom to Care: Liberalism, Dependency Care and Justice and engages with some key concepts used by three commentators Daniel Engster, Kelly Gawel, and Andrea Westlund in this book symposium. The symposium makes it clear that care can be a central notion not only in the ethics of care, but also in debates about liberalism, justice and autonomy.

This article claims that Asha Bhandary’s theory of justice in Freedom to Care: Liberalism, Dependency Care, and Culture is right to stress the interdependency of justice and care in addressing structural oppressions, but wrong in upholding liberalism’s capacity for doing so. Against her procedural mechanism of education for caregiving skills in particular, I point to the critical and generative methods of social reproduction feminism and Transformative Justice as models of radical praxis in the collective work of politically centering (...) and radically transforming cultures of care. (shrink)

In this paper I examine and elaborate on Asha Bhandary’s conception of autonomy, and take up the question of what education for autonomy, thus understood, might require. I argue that educating for autonomy requires educators to impart, to students, an interlocking set of dialogical or relational skills that center responsiveness to the perspectives of others, and that these skills significantly overlap with the skills required for basic education in care.

According to Asha Bhandary, there is a liberal (Rawlsian) justification for including “the receipt of dependency care among the benefits of social cooperation” (“Liberal Dependency Care,” 43). The novelty is to claim that such care is among the Rawlsian circumstances of justice. I argue that liberalism does not support this extremely strong claim. Dependency care is indeed among the goods generated by social cooperation, broadly speaking—but so are virtually all goods, such as pizza provision, scarcely any of which (...) are among the circumstances of justice. Most of us have ample inclination toward caring for dependents—but neither is this extended to everyone else’s dependents, nor is it mostly a legal duty, as indeed having children at all is not. Nor should it be on liberal principles. Neither of the two Rawlsian Principles support general dependency care. And, Bhandary’s “strong proceduralism,” calling for the training of all persons in care-giving skills, would edge up toward totalitarianism—hardly a welcome outcome of liberalism. (shrink)

This is an anthology that is coming out in Farsi. -/- Table of Contents (in English): -/- 1. (2021). “On a Supposed Right to Lie from Philanthropy.” The Cambridge Kant Lexicon, ed. Julian Wuerth, Cambridge: Cambridge University Press, pp. 691-695. 2. (2010). “Kant and Lying to the Murderer at the Door . . . One More Time: Kant’s Legal Philosophy and Lies to Murderers and Nazis.” The Journal of Social Philosophy, Vol. 41(4), pp. 403-421. 3. (2006). “Kant and Dependency Relations: (...) Kant on the State’s Right to Redistribute Resources to Protect the Rights of Dependents.” Dialogue – Canadian Philosophical Review, Vol. 45, pp. 257-284. 4. (2011). “A Kantian Conception of Global Justice.” Review of International Studies, Vol. 37(5), pp. 2043-2057. 5. (2010). “Kant’s Non-Absolutist Conception of Political Legitimacy: How Public Right ‘Concludes’ Private Right in ‘The Doctrine of Right.’”Kant-Studien, Vol. 3, pp. 331-351. 6. (2008). “Kant’s Non-Voluntarist Conception of Political Obligations: Why Justice Is Impossible in the State of Nature.” Kantian Review, Vol. 13(2), pp. 1-45. 7. (2021). “Kant and Arendt on Barbaric and Totalitarian Evil.” Proceedings of the Aristotelian Society, Vol. 121 (2), pp. 221-248. 8. (2020). “Kantian Care.” Caring for Liberalism: Dependency and Political Theory, ed. Asha L. Bhandary and Amy Baehr, New York: Routledge, pp. 50-74. 9. (2020). “Kant and Moral Responsibility for Animals.” Kant & Animals, ed. Lucy Allais and John Callanan, Oxford: Oxford University Press, pp. 157-175. -/- Thanks to all the original publishers of these articles for permitting them to be reprinted in translation here. Photo cover: pluspointsphere(.com). (shrink)

Asha Bhandary’s Freedom to Care represents an important challenge to the idea that care ethics and liberalism necessarily stand in tension, arguing instead that most of the commitments of care ethics can be integrated within a recognizably mainstream liberal contract theory. Although I am sympathetic to Bhandary’s project, I identify three ways in which it falls short: Bhandary’s thin moral premises fail to support decent care for all; her survival baseline principle of care does not support (...) some important forms of care; and her proceduralist approach offers little alternative other than coercion for assuring sufficient care for all. I argue a thicker set of moral assumptions based on the importance of decent care for all are necessary for reconciling liberalism and care ethics on more equal terms. (shrink)

RésuméJohn Rawls et Asha Bhandary utilisent les conditions de justice définies par David Hume pour encadrer le choix de la position originale à partir de laquelle les principes de justice sont sélectionnés. Utiliser les conditions de Hume de cette manière exclut de la représentation ceux qui ne sont pas des coopérateurs à part entière, y compris les personnes qui ont besoin de soins de dépendance pendant toute la vie. Cela implique que la demande de soins de ces personnes (...) n'est pas une revendication fondamentale de justice, mais qu'elle doit avoir une priorité nettement inférieure. Cet article soutient qu'une théorie libérale appropriée de la prise en charge de la dépendance abandonnera ce cadrage humien et traitera la demande de prise en charge de la dépendance comme une exigence fondamentale de justice. (shrink)

RésuméLes soins sont cruciaux pour toute société ; cependant, les théories de la justice les ignorent souvent dans leur analyse. La théorie d'Asha Bhandary sur la prise en charge libérale de la dépendance cherche autant à rectifier l'invisibilité des soins qu’à défendre les principes de justice concernant les modalités de soins en revendiquant plusieurs modifications importantes à la théorie de la justice de John Rawls. Dans cet article, j'analyse les modifications de Bhandary à la théorie de Rawls (...) pour examiner comment la prise en charge libérale de la dépendance s'intègre dans un cadre politique libéral plus large, tout en protégeant contre l'oppression. J’évalue également la licéité et les limites de l'enseignement de l'autonomie et des habiletés de soins aux enfants dans une société politiquement libérale. (shrink)

We present a unified approach for investigating rational reasoning about basic argument forms involving indicative conditionals, counterfactuals, and basic quantified statements within coherence-based probability logic. After introducing the rationality framework, we present an interactive view on the relation between normative and empirical work. Then, we report a new experiment which shows that people interpret indicative conditionals and counterfactuals by coherent conditional probability assertions and negate conditionals by negating their consequents. The data support the conditional probability interpretation of conditionals and the (...) narrow-scope reading of the negation of conditionals. Finally, we argue that coherent conditional probabilities are important for probabilistic analyses of conditionals, nonmonotonic reasoning, quantified statements, and paradoxes. (shrink)

Background: Ethics stimulation in nursing education focuses on human, non-technical factors in a clinical reality. Simulation as a teaching method began in the 1930s with flight simulators. In the beginning of the 1990s, simulations developed further in tandem with other technological and digital inventions, including touchscreen and three-dimensional anatomical models. Medical science first used simulation as a pedagogical teaching tool. In nursing education, simulation has been used for approximately a hundred years. Teaching has mainly focused on medical-technical, patient-specific interventions and (...) their management. Objective: The objective of this study was, from a caring science didactic perspective, to deepen the understanding of ethics simulation in nursing education. Design: Qualitative design and explorative, descriptive and hermeneutic approach of an inductive character. Methods: Semi-structured face-to-face interviews in 2016–2017 with six Norwegian nursing students who were encouraged to narrate about their experiences of ethics simulation in nursing education. Ethical considerations: Informed consent was obtained from the participants. Anonymity and confidentiality regarding data material were guaranteed. Results: Interpretation of the nursing students’ narratives resulted in the following meaning units: ethical being and ethos, nursing students’ formation process, bridge-building between theory and clinical practice, and teacher and ethics simulation. Conclusion: Through ethics simulation, nursing students can obtain an increased knowledge and a sense of being able to handle difficult ethical situations. Nursing students’ values, moral actions and ethical value base offer a positive point of departure, for both theoretical and practical ethics teaching, and an awareness of the unique human being, the patient, in clinical reality. The implementation of ethics simulation needs more attention in nursing education. (shrink)

This article assesses which policies for addressing antibiotic resistance as part of a multi-pronged approach would benefit from legalization through an international legal agreement. Ten candidate policies were identified based on a review of existing literature, especially The Lancet Series on Antimicrobial Resistance, The Lancet Infectious Diseases Commission on AMR, and the World Health Organization Global Action Plan for AMR. These policies were then grouped under the headings of access, conservation, and innovation.Each of the ten policies were assessed using four (...) criteria developed by Hoffman, Røttingen, and Frenk to help consider why their legalization may be helpful, necessary and/or justified. These criteria are: the problem has a significant transnational dimension; the goal justifies the coercive nature of law; the outcome is likely to be beneficial; and legalization represents the best commitment mechanism among competing alternatives. (shrink)

A person’s financial well-being is the complete contentment gained from one’s present financial condition. This has a powerful impact on the entire achievement of an employee’s “well-being.” Researchers, financial analysts, financial planners, educationists, and economists have explored the “enablers” to improve employees’ living standards by investigating the possible “FWB” resources for decades. There is no literature available to show the connection between social capital theory, social exchange theory, social cognitive theory, financial literacy and FWB, and employees’ financial knowledge sharing a (...) moderator to expand the complete FWB. (shrink)

Biobanks and biospecimen collections are becoming a primary means of delivering personalized diagnostics and tailoring individualized therapeutics. This shift towards precision medicine requires interactions among a variety of stakeholders, including the public, patients, healthcare providers, government, and donors. Very few studies have investigated the role of healthcare students in biobanking and biospecimen donations. The main aims of this study were to evaluate the knowledge of senior healthcare students about biobanks and to assess the students’ willingness to donate biospecimens and the (...) factors influencing their attitudes. A cross-sectional study was conducted among senior healthcare students at King Abdulaziz University, Saudi Arabia. The data were obtained using a self-administered questionnaire in English. In addition to the respondents’ biographical data section, the questionnaire assessed the respondents’ general knowledge about biobanking, the factors influencing their willingness to donate biospecimens to biobanks and their general attitudes towards biomedical research. A total of 597 senior healthcare students were included in the study. The general knowledge score was 3.2 out of 7. Only approximately 44% and 27% of students were aware of the terms “Human Genome Project” and “biobank,” respectively. The majority of the students were willing to donate biospecimens to biobanks. Multiple factors were significantly associated with their willingness to donate, including their perceived general health, past experience with both tissue testing and tissue donation, biobanking knowledge score and biomedical research attitude score. The main reasons for students’ willingness to donate were advancement of medical research and societal benefits, whereas misuse of biospecimens and confidentiality breaches were the main reasons for a reluctance to donate. Despite their strong willingness to donate biospecimens, students exhibited a notable lack of knowledge about biobanking and the HGP. To expedite the transition towards PM, it is highly recommended to enhance healthcare curricula by including more educational and awareness programmes to familiarize students with OMICs technologies in addition to the scope of research and clinical applications. (shrink)

We applaud Notini and colleagues for highlighting the clinical and ethical complexities of a case in which a non-binary individual desires indefinite treatment with puberty blockers.1 While we agree discontinuing treatment may cause psychological distress, we believe there are potential physical and neurocognitive harms caused by prolonged treatment that have been underestimated given the limited research conducted to date. Specifically, the impact of permanent pubertal suppression on the brain and decision-making capacity should be considered. In this context, we outline the (...) potential risks of ongoing pubertal suppression on bone and cardiovascular health, sexual and reproductive function, and brain development—all noted in the article but perhaps in an overly simplistic manner.1 First, the authors’ note OPS will almost certainly result in reduced bone density.1 Although we agree the absolute fracture risk is low in studies among older adults, there is less clarity about implications during adolescence and young adulthood when peak bone accrual occurs.2 Further, the authors propose ongoing monitoring with bone density scans, but no clear guidelines for clinicians if bone density becomes critically low—so we ask, at what point would a potential fracture risk outweigh the proposed benefits …. (shrink)

Once we shift the intension of the concept of wage-labour from juridical attributes of negative ownership and contractual freedom to the actual performance of capital-positing labour, the extension of the concept – the cases that fall under it – changes as well. Once the concept of wage-labour is intensively re-defined as capital-positing labour, it becomes evident that the history and the geographical scope of wage-labour have not been well understood. This shift in the intension of the concept of wage-labour also (...) disjoins the association between capitalism and freedom. (shrink)

In plants, robust defense depends on the efficient and resilient trafficking supply chains to the site of pathogen attack. Though the importance of intracellular trafficking in plant immunity has been well established, a lack of clarity remains regarding the contribution of the various trafficking pathways in transporting immune‐related proteins. We have recently identified a trans‐Golgi network protein, TGN‐ASSOCIATED PROTEIN 1 (TGNap1), which functionally links post‐Golgi vesicles with the cytoskeleton to transport immunity‐related proteins in the model plant species Arabidopsis thaliana. We (...) propose new hypotheses on the various functional implications of TGNap1 and then elaborate on the surprising heterogeneity of TGN vesicles during immunity revealed by the discovery of TGNap1 and other TGN‐associated proteins in recent years. (shrink)

Background Nursing students spend approximately half of their time in clinical practice. It is important that clinical supervisors understand nursing students’ path of learning and can support their growth and development during the different and multifaceted learning situations offered in the clinical-practice period. Objective Based on nursing students’ perspective and rooted in the didactics of caring science, to examine how a learning and constructive caring relationship between nursing students and supervisors in clinical practice can be formed. Design Qualitative and quantitative (...) concurrent triangulation design of mixed methods. Methods Focus group interviews with Finnish nursing students (n = 21) in the qualitative part of the study. In the quantitative part, a closed questionnaire with closed answers was analysed using descriptive statistics. The analysis process was conducted using inductive content analysis. Ethical considerations Ethical issues were considered throughout the research process according to ethical principles and scientific guidelines. Informed consent was obtained from the informants, confidentiality regarding the data material was guaranteed and quotations were anonymized. Results A caring relationship between nursing students and supervisors is based on mutual respect, the ethos of responsibility, motivation, willingness and professionalism. Dignity and a caring ethical approach, where nursing students feel they belong, are recognized, seen and heard enables learning and professional development. It is also significant that the supervisor’s actions and reflections are ethically defensible, equal and protect nursing students from suffering and various power relationships in clinical practice. Conclusion A good cooperative relationship and shared responsibility between the nurse education institution, which offers theory and prepares nursing students for the encounter with clinical practice and the healthcare organizations is crucial for enabling a caring relationship in clinical supervision. (shrink)

Background: Older people in institutional care should be allowed to live a meaningful life in a home-like environment consistent with their own free will. Research on actualisation of older people’s own free will in nursing home context is scarce. Objectives: The purpose of this study was to describe older people’s experiences of free will, its actualisation, promoters and barriers in nursing homes to improve the ethical quality of care. Research design: Fifteen cognitively intact older people over 65 years in four (...) nursing homes in Southern Finland were interviewed. Giorgi’s phenomenological method expanded by Perttula was used to analyse the data. Ethical considerations: Chief administrators of each nursing home gave permission to conduct the study. Informants’ written informed consent was gained. Findings: Older people described free will as action consistent with their own mind, opportunity to determine own personal matters and holding on to their rights. Own free will was actualised in having control of bedtime, dressing, privacy and social life with relatives. Own free will was not actualised in receiving help when needed, having an impact on meals, hygiene, free movement, meaningful action and social life. Promoters included older people’s attitudes, behaviour, health, physical functioning as well as nurses’ ethical conduct. Barriers were nurses’ unethical attitudes, institution rules, distracting behaviour of other residents, older people’s attitudes, physical frailty and dependency. Discussion: Promoting factors of the actualisation of own free will need to be encouraged. Barriers can be influenced by educating nursing staff in client-orientated approach and influencing attitudes of both nurses and older people. Conclusion: Results may benefit ethical education and promote the ethical quality of older people’s care practice and management. (shrink)

Jean-Paul Sartre claims in his 1945 lecture ‘Existentialism is a Humanism’ that there are two kinds of existentialism: that of Christians like Karl Jaspers, and atheistic like Martin Heidegger. Sartre's ‘spiritual master’ Heidegger had no problem with Sartre defining him as an atheist, but he had serious problems with Sartre's concept of humanism and existentialism. Heidegger claims that the essence of humanism lies in the essence of the human being. After the Enlightenment, the Western concept of man has been presented (...) in education in the form of Kantian humanistic essentialism. At least in the Finnish educational system, Kantian humanism is almost an official ideological background of all national curriculums. Is such a kind of essentialism and metaphysics plausible in our modern or postmodern times? We examine the Sartre-Heidegger controversy on humanism and the concept of man in education using Freire's humanism and Gelassenheit education as exemplars. (shrink)

In the world today, human beings are confronted with a number of problems due ultimately to the apparent conflicts among the different religions (religious faiths). Religious attitudes, ideas, and practices differ and even seem to be incompatible with one another. I argue, however, that these faiths do not contradict. To see this, we need to engage in the comparative study of religion. This will show that the ultimate aim of all the world's religions is to establish unity among people, and (...) will thereby provide a basis for tolerance and understanding on the part of the followers of every religion towards other religions. (shrink)

The shift to companionate marriage in South Asia and elsewhere is widely read as a move from ‘tradition’ to ‘modernity’ resulting in an expansion of individual agency, especially for women. This paper critically examines the narratives of urban middle-class women in Sri Lanka spanning three generations to illustrate that rather than indicating a radical shift in the way they negotiated between individual desires and social norms, the emphasis on ‘choice’ signals a shift in the narrative devices used in the presentation (...) of the ‘self’. The paper illustrates how young women's narratives about marriage appear to suggest ‘modernity’ as inevitable—that its processes are reconstituting the person who, less constrained by ‘tradition’ and collective expectations, is now experiencing greater freedom in the domain of marriage. However, it also shows how urban middle-class families in Sri Lanka have collectively invested in the narrative of choice through which ‘a choosing person’ is consciously created as a mark of the family's modernity and progress. Rather than signalling freedom, these narratives about choice reveal how women are often burdened with the risks and responsibility of agency. The paper illustrates that the ‘choosing person’ is produced through narratives that emphasise agency as a responsibility that must be exercised with caution because women are expected by and obligated to their families to make the ‘right’ choices. Hence, a closer look at the individualised ‘choosing person’ reveals a less unitary, relational self with permeable boundaries embedded within and accountable to family and kinship. (shrink)

Background: Midwifery students are confronted with several ethical dilemmas and challenging situations during clinical midwifery care practice. Since ethical competence of midwifery students is under development, it is important to support the students’ learning progress of ethical issues from diverse viewpoints. Objective: From the perspective of didactics of caring science and the context of midwifery students, to explore how midwifery students’ experience supports for ethical competence in midwifery education and investigate how ethically challenging situations have been carried out during clinical (...) midwifery care practice. Design: Qualitative, explorative and descriptive design with inductive nature. Methods: Focus group interviews with nine Swedish midwifery students. Hans-Georg Gadamer’s philosophical hermeneutics was applied to guide the interpretation. Ethical considerations: Ethical principles and scientific guidelines were followed. Informed consent was obtained from the participants. Confidentiality was respected and quotations anonymised. Results: Receiving support when ethically challenging situations occur in clinical midwifery practice is important and necessary. One main theme, such as support is a human and caring factor in the midwifery students’ Bildung process on ethical competence, and four subthemes, such as supporting through trust and responsibility; supporting through dignity and respect; supporting through truthfulness and justice; and supporting through dialogue and reflection, were created from the hermeneutical interpretation. Discussion: Teaching ethics should be carefully planned, consistent and continue throughout the midwifery education. There is dispersion in the pedagogy of ethical situations, the methods and perceptions associated with it, and in obtaining possible support for students. Developing well-experienced methods could benefit the support of midwifery students’ ethical competence when they experience ethically challenging situations in midwifery care practice. (shrink)

To understand ethical consumer choice, it should be studied from a holistic, configurational perspective. We use fuzzy-set qualitative comparative analysis (fsQCA) ( N = 715) with a randomized experiment in the context of animal welfare to examine (a) the interdependencies of factors aiding or impeding ethical choice, and (b) whether ethical choices occur differently in a loss frame than in a gain frame. We identify several alternative pathways to ethical choice and non-choice, and within these pathways, we reveal substitution effects, (...) complementarities, and contingencies, reflecting the complexities of consumer choice. Furthermore, we demonstrate how ethical choice results more easily in a loss frame, and non-choice more easily in a gain frame, but how framing can also be irrelevant in certain situations. We contribute theoretically to ethical consumer choice in general and to food choice in particular by showing how it is the interplay of several factors in complex configurations that determines whether the situation favors ethical choice or non-choice. We outline important management and policy implications of our findings. (shrink)