Bernadette M Tobin; An Aristotelian Theory of Moral Development, Journal of Philosophy of Education, Volume 23, Issue 2, 30 May 2006, Pages 195–211, https://doi.

Moral distress is a phenomenon of increasing concern in nursing practice, education and research. Previous research has suggested that moral distress is associated with perceptions of ethical climate, which has implications for nursing practice and patient outcomes. In this study, a randomly selected sample of registered nurses was surveyed using Corley’s Moral Distress Scale and Olson’s Hospital Ethical Climate Survey (HECS). The registered nurses reported moderate levels of moral distress intensity. Moral distress intensity and frequency were found to be inversely (...) correlated with perceptions of ethical climate. Each of the HECS factors (peers, patients, managers, hospitals and physicians) was found to be significantly correlated with moral distress. Based on these findings, we highlight insights for practice and future research that are needed to enhance the development of strategies aimed at improving the ethical climate of nurses’ workplaces for the benefit of both nurses and patients. (shrink)

One of the core goals of Digital Health Technologies (DHT) is to transform healthcare services and delivery by shifting primary care from hospitals into the community. However, achieving this goal will rely on the collection, use and storage of large datasets. Some of these datasets will be linked to multiple sources, and may include highly sensitive health information that needs to be transferred across institutional and jurisdictional boundaries. The growth of DHT has outpaced the establishment of clear legal pathways to (...) facilitate the collection, use and transfer of potentially sensitive health data. Our study aimed to address this gap with an ethical code to guide researchers developing DHT with international collaborative partners in Singapore. We generated this code using a modified Policy Delphi process designed to engage stakeholders in the deliberation of health data ethics and governance. This paper reports the outcomes of this process along with the key components of the code and identifies areas for future research. (shrink)

À partir de l’œuvre de Marie-Dominique Chenu sur la théologie du travail et de sa contribution à la revue Lumière et vie, cet article s’interroge sur les conditions de possibilité d’une telle démarche aujourd’hui et invite à en dessiner les contours. Plus que tout autre projet théologique, la théologie du travail doit à la fois s’enraciner dans une lecture des signes des temps, lecture difficile qui interroge les conditions d’exercice de l’activité humaine, les modes de sociabilité qui l’accompagne et son (...) impact sur la nature. Les enjeux climatiques et environnementaux invitent à privilégier une réflexion sur le travail comme soin, soin de chacun, de la société, de la nature, et à continuer d’engager une démarche ecclésiale de discernement social en commun. À cet égard, la revue Lumière et vie apparaît comme un laboratoire, qui a trouvé un écho dans les démarches des mouvements d’Action catholique. Avec des ressources moindres, mais des facilités plus grandes pour engager une conversation globale, il paraît utile de continuer dans cette direction, à même de soutenir une espérance pour notre monde commun. (shrink)

In Older Adults (OAs), Electroencephalogram (EEG) slowing in frontal lobes and a diminished muscle atonia during Rapid Eye Movement sleep (REM) have each been effective tracers of Mild Cognitive Impairment (MCI), but this relationship remains to be explored by non-linear analysis. Likewise, data provided by EEG, EMG (Electromyogram) and EOG (Electrooculogram)—the three required sleep indicators—during the transition from REM to Non-REM (NREM) sleep have not been related jointly to MCI. Therefore, the main aim of the study was to explore, with (...) results for Detrended Fluctuation Analysis (DFA) and multichannel DFA (mDFA), the Color of Noise (CN) at the NREM to REM transition in OAs with MCI vs. subjects with good performances. The comparisons for the transition from NREM to REM were made for each group at each cerebral area, taking bilateral derivations to evaluate interhemispheric coupling and anteroposterior and posterior networks. In addition, stationarity analysis was carried out to explore if the three markers distinguished between the groups. Neuropsi and the Mini-Mental State Examination (MMSE) were administered, as well as other geriatric tests. One night polysomnography was applied to 6 OAs with MCI (68.1 ± 3) and to 7 subjects without it (CTRL) (64.5 ± 9), and pre-REM and REM epochs were analyzed for each subject. Lower scores for attention, memory and executive funcions and a greater index of arousals during sleep were found for the MCI group. Results confirmed that EOGs constituted significant markers of MCI, increasing the CN for the MCI group in REM sleep. The CN of the EEG from the pre-REM to REM was higher for the MCI group vs. the opposite for the CTRL group at frontotemporal areas. Frontopolar interhemispheric scaling values also followed this trend as well as right anteroposterior networks. EMG Hurst values for both groups were lower than those for EEG and EOG. Stationarity analyses showed differences between stages in frontal areas and right and left EOGs for both groups. These results may demonstrate the breakdown of fractality of areas especially involved in executive functioning and the way weak stationarity analyses may help to distinguish between sleep stages in OAs. (shrink)

Bernadette M Tobin; Richard Peters's Theory of Moral Development, Journal of Philosophy of Education, Volume 23, Issue 1, 30 May 2006, Pages 15–27, https://doi.

" Façonner le monde atome par atome " : tel est l'objectif incroyablement ambitieux affiché par les promoteurs américains de la " National Nanoinitiative ", lancée en 1999. Un projet global de " convergence des sciences ", visant à " initier une nouvelle Renaissance, incorporant une conception holiste de la technologie fondée sur [..] une analyse causale du monde physique, unifiée depuis l'échelle nano jusqu'à l'échelle planétaire. " Ce projet démiurgique est aujourd'hui au coeur de ce qu'on appelle la " (...) technoscience ", étendard pour certains, repoussoir pour d'autres. En précisant dans ce livre la signification de ce concept, pour sortir enfin du sempiternel conflit entre technophiles et technophobes, son auteur propose d'abord une sorte d'archéologie du terme " technoscience ". Loin d'être un simple renversement de hiérarchie entre science et technique, il s'agit d'un changement de régime de la connaissance scientifique, ayant désormais intégré la logique entrepreneuriale du monde des affaires et mobilisant des moyens considérables. Surtout, Bernadette Bensaude-Vincent montre que le brouillage de la frontière entre science et technique n'est que la manifestation d'un tremblement plus général, marqué par l'effacement progressif des distinctions traditionnelles : nature/artifice, inerte/vivant, matière/esprit, homme/machine, etc. Alors que nos sociétés sont silencieusement reconfigurées par les nanotechnologies, Internet, le génie génétique ou les OGM, ce livre montre l'importance de faire enfin pleinement entrer les questions de choix technologiques et scientifiques dans la sphère du politique et dans l'arène publique. Car la technoscience est un processus historique qui engage la nature en la refaçonnant et qui implique la société dans son ensemble. (shrink)

Bernadette M Tobin; Development in Virtues, Journal of Philosophy of Education, Volume 20, Issue 2, 30 May 2006, Pages 201–214, https://doi.org/10.1111/j.1467-9.

Summary With regard to the dynamics of human experience and behavior, Gestalt theoretical psychotherapy (GTP) relies mainly on Kurt Lewin’s dynamic field theory of personality. GTP is carried out by including a re-interpretation of Lewin’s theory in some aspects of psychotherapeutic practice in relation to critical realism. Human experience and behavior are understood to be functions of the person and the environment (including the other individuals therein) in a psychic field (life space), which encompasses both of these mutually dependent factors. (...) The anthropological model of this approach is, therefore, not mono-personal but, a priori, structural and relational in nature. It does not one-sidedly focus on the “inner components” of a person, but on the interrelation of the individual and a given environment, which affects experience and behavior. After a brief introduction of these basic concepts, this lecture will focus especially on Lewin’s concept of tension-systems, which may be considered as the Gestalt theoretical counterpart of Freud’s drive theory. Further, we define the basic assumptions which underlie GTP and explain how the person moves through her/his life experience in terms of Gestalt psychology. (shrink)

The current empirical research and normative arguments on physician-assisted dying in the Netherlands seem insufficient to provide ethical guidance to general practitioners in the practice of PAD, due to a gap between the evidence and arguments on the one hand and the uncertainties and complexities as found in everyday practice on the other. This paper addresses the problems of current ethical arguments and empirical research and how both seem to be profoundly influenced by the Dutch legislative framework on PAD and (...) a certain view on ethics. Furthermore, the paper elaborates on how other approaches to empirical research in bioethics, such as found in the broad field of narrative research, could supplement the empirical and ethical evaluation of PAD in the Netherlands. This paper also addresses the challenging question of how empirical data—in this case narratives—relate to normativity. The paper is written in the form of a personal narrative of the author, a young Dutch general practitioner and researcher in bioethics. This style is intentionally chosen, to illustrate how work context and professional background influence the observations one makes and the questions one may ask about the topic of PAD. In addition, by using this style, this paper not only gives a different perspective on a much-contested bioethical issue, but also on the challenges faced when a physician–bioethicist has to navigate different disciplinary fields and epistemological paradigms, especially since the ‘empirical turn’ in bioethics. (shrink)

Approaches to business ethics can be roughly divided into two streams: ‹codes of behavior’ and ‹forms of subjectification’, with code-oriented approaches clearly dominating the field. Through an elaboration of poststructuralist approaches to moral philosophy, this paper questions the emphasis on codes of behaviour and, thus, the conceptions of the moral and responsible subject that are inherent in rule-based approaches. As a consequence of this critique, the concept of a practice-based ‹ethics of responsiveness’ in which ethics is never final but rather (...) always ‹to come’, is investigated. In such an approach the ethical self is understood as being continuously constituted within power/knowledge relations. Following this line, we ask how one can become a responsible subject while also acknowledging certain limits of full responsibility. We thereby explore responsibility as a considered but unconditional openness in response to the other. (shrink)

Au cours de cette recherche, nous réfléchissons à la question de la couverture médiatique du domaine sportif. Nous nous concentrons sur l’impact de la présence des médias sur la construction de l’information sportive elle-même. Nous discutons de la position de l’analyste du discours vis-à-vis de ce contexte de production de discours ; production fortement influencée par l’outil technologique. Par exemple, nous montrons que le placement de microphones sur les acteurs de la rencontre sportive pousse l’analyste à considérer ces participants comme (...) des objets et des producteurs de la couverture médiatique. Par l’analyse de ce type de corpus, nous proposons donc d’étudier ces questions de positionnement de l’analyste au sein de ce double contexte de production. (shrink)

The feminist sex wars have been characterized by debates between radical feminists and sex radical feminists about women's experiences of empowerment versus oppression in the sex industry. Based on a qualitative study of the experiences of exotic dancers, this article introduces a new theoretical paradigm to the feminist sex wars that values the contributions of both sex radicals and radical feminists. It articulates a twofold temporal dimension of sex workers' experiences: how women's feelings of pleasure and empowerment gradually decline over (...) time and how good and bad experiences rapidly transform into their opposites over the course of a single evening, making the strip bar a volatile and unsettling space for performers. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Evaluation, Standards, Normalization: Historico-philosophical Formations and the Conditions of Possibility for Checklist Thought Bernadette Baker University of Wisconsin-Madison In education today a new vocabulary has emerged that is far more than just words. In the context of educational policy the setting of goals or objectives is now being subsumed under terms such as statewidestandards, child development is now being adjectivized by descriptors such as learning disability or emotionally (...) disturbed, and the evaluation ofclassroom-based performance is now being collated in aportfolio. These are more than just buzz words-at one level they are new ways of governing children and teachers, of organizing action, and of perceiving the world. What, for instance, does it tell us about ourselves when first-grade students Mikey, Enrique, Waldo, orDonal are introduced to visitors to the school by labels such as LD, ED, ADD, ADHD, and so forth, rather thanby their name? What does it tell us about ourselves when we say a curriculum or program of study is in line with the standards established somewhere else? And what story do we think is being narratedin the documentation of a child's performance in portfolio form across a semester or year? In consideringwhyterms suchasstandards, child development, or even evaluation have such contemporary currency I am necessarily drawn into a study of the timespaces in which they did not have such currency at all. This paper maps four moves into a moment that I think of as a rather long present-day-a present that is not simply this morning, yesterday, or the daybefore, but one that links the subjectivities ofthose now living in educational workto those made available about one hundred years ago. The four moves that I analyze here can be thought of as conditions of possibility for the operation of contemporary educational mies of reasoning, especially those that have formed around the resurgent popularity of"checklist thought" in reform efforts. The four moves collectively historicize how notions of standards, child development, and evaluation can pop up as commonsensical tropes through which to gather and degather action in the educational field. The first ofthese moves is that which flows from the operation ofan ideal to the operation of a norm. The second move is that which flows between the advent of statistics and the advent of eugenics. The third move is that which flows between the appearance ofnovels and fiction and the novel ficticityoffacts. And the fourth move is that which flows from the fictions of child development narratives to the stories that standards tell us. Collectively, these historico-philosophical moves will enable reconsideration of what we think evaluation, standards, and norms for child development actually narrate, lending food for thought to the specificityoftheir uptake in music education. From Ideal to Norm One way inwhichto examinethe shift from a seventeenth-century concept of the ideal to the nineteenth-century concept of the norm is by telling a story that was told in the early twentieth century. At this time when the educational field was formalizing, there was great care taken to record discussions held at conferences. When conferenceproceedings werepublished, theywere usually structured so that the presenter's paper©Philosophy ofMusic Education ReviewlO, no. 1 (Fall, 2002): 92-101. Bernadette Baker 93 was followed by a transcript of the conversation held after it. Like today, in the discussion time, audience members asked questions or made comments. Unlike today, the names of such participating audience members were typed into the proceedings and their specific questions or comments were written up as part ofreporting on the paper presented. In a discussion held at a conference in 1 905 on the topic of methods for training children labeledas feebleminded, apresenterhadspokenof the positive uses of a vegetable garden in the disciplining of feebleminded girls. The audience members relayed their own versions of experimenting with gardening and gathering, some complaining oftoo little space and others indicating the effects of having too many fields from which to gather. Dr. Dunlap was one such participant, indicatingimplicitlytheeffectsofhavingtoo many choices. In the spirit ofthe hunter/gatherer dichotomy, thegirlslabeledas feeblemindedatthe institutionwhereDr. Dunlap worked weresentout to pick com. The following story emerged. Dr. Dunlap: Our girls go out under an attendant and gather vegetables... (shrink)

It is in its Consequentialist mood that Australian philosophizing most clearly displays the 'no-nonsense' quality that we are tempted to think of as a national virtue: I hope this volume goes some way to showing the dangers of our being tempted by such flattering but ultimately shallow (and indeed morally coarse) national myths.

This paper offers a rhizomatic reading of Foucault scholarship in anglophone educational research. It delineates unique parameters of an educational field, the conditions of receptivity for Foucault's work, and identifies three temporary plateau-formations that have erupted in educational research. Indebted to (non-formulaic) principles of connectivity and heterogeneity, multiplicity, and asignifying ruptures the analysis brings to notice the recombinatorial attributes of the discipline of education through attention to what is encamped and what seeps in debates over his work.

Croire ne peut s’appréhender sans son corollaire, douter. Le doute revêt des formes diverses que l’on retrouve en particulier chez les couples en thérapie. Dans ce cadre, pour tenter d’en approcher l’origine et la nature, l’auteur s’appuie sur les concepts d’identification projective, intrusive, adhésive, et de contenance développés par Meltzer. Dans cette perspective, un lien peut être fait entre la relation de couple et celle du bébé à son premier objet. La thérapie de couple est envisagée comme une tentative pour (...) chacun de passer du doute destructeur au doute positif, constructeur, permettant un véritable croire en l’autre et au couple. (shrink)

Open peer commentary on the article “Exploring the Depth of Dream Experience: The Enactive Framework and Methods for Neurophenomenological Research” by Elizaveta Solomonova & Xin Wei Sha. Upshot: Neurophenomenology requires a first-person report at the sub-personal level. Thus, the neurophenomenology of dreaming and sleep can be figuratively located in a model of perspectives and levels of analysis. Even when Solomonova and Sha do admit creativity to explain bizarreness and emphasize dreams’ enaction and, especially, dreams’ perception-dependence, an innate and developmental framework (...) of neurophenomenology becomes a requirement to understand fully its sub-personal counterpart, i.e., sleep, especially the evidence derived from innate processing observed during the sleep of neonates - even without the dreaming counterpart. Finally, precisions about the depth of dreaming in Hobson’s work are presented. (shrink)

Most people do their utmost to avoid any and every type of suffering; yet, as this experience-based article shows, Newman, early in life, came to realize from his own illnesses that physical suffering can bring the sufferer to an awareness of the presence of God and so be an important part of personal spiritual development.

All articles in May 2019’s special issue of Bioethics offer profound insights into the issue of “being a burden to others” in relation to wishes to die, which are highly relevant for ethical debates about end‐of‐life care and physician‐assisted dying. In this reply, we wish to stress the importance of acknowledging and analyzing the sociopolitical context of the phenomenon “being a burden” in relation to wishes to die and we will show how this analysis could benefit from a care ethical (...) approach. As discussions in care ethics have made clear, caring practices are both social and political practices. An empirical and ethical analysis of “being a burden” therefore needs to take institutional and societal norms and structures into account, in addition to first‐person experiences and concepts such as caring needs, relational autonomy, and interdependency. Besides the relevance of the sociopolitical context for the phenomenon “being a burden” as such, the sociopolitical context also seems relevant for the investigation of the phenomenon, which we will illustrate by reflecting on “being a burden” in relation to the practice of physician‐assisted dying in the Netherlands. (shrink)

Family members do not have an official position in the practice of euthanasia and physician assisted suicide in the Netherlands according to statutory regulations and related guidelines. However, recent empirical findings on the influence of family members on EAS decision-making raise practical and ethical questions. Therefore, the aim of this review is to explore how family members are involved in the Dutch practice of EAS according to empirical research, and to map out themes that could serve as a starting point (...) for further empirical and ethical inquiry. A systematic mixed studies review was performed. The databases Pubmed, Embase, PsycInfo, and Emcare were searched to identify empirical studies describing any aspect of the involvement of family members before, during and after EAS in the Netherlands from 1980 till 2018. Thematic analysis was chosen as method to synthesize the quantitative and qualitative studies. Sixty-six studies were identified. Only 14 studies had family members themselves as study participants. Four themes emerged from the thematic analysis. 1) Family-related reasons to request EAS. 2) Roles and responsibilities of family members during EAS decision-making and performance. 3) Families’ experiences and grief after EAS. 4) Family and ‘the good euthanasia death’ according to Dutch physicians. Family members seem to be active participants in EAS decision-making, which goes hand in hand with ambivalent feelings and experiences. Considerations about family members and the social context appear to be very important for patients and physicians when they request or grant a request for EAS. Although further empirical research is needed to assess the depth and generalizability of the results, this review provides a new perspective on EAS decision-making and challenges the Dutch ethical-legal framework of EAS. Euthanasia decision-making is typically framed in the patient-physician dyad, while a patient-physician-family triad seems more appropriate to describe what happens in clinical practice. This perspective raises questions about the interpretation of autonomy, the origins of suffering underlying requests for EAS, and the responsibilities of physicians during EAS decision-making. (shrink)

The promises of nanotechnology have been framed by a variety of metaphors, that not only channel the attention of the public, orient the questions asked by researchers, and convey epistemic choices closely linked to ethical preferences. In particular, the image of the ‘therapeutic missile’ commonly used to present targeted drug delivery devices emphasizes precision, control, surveillance and efficiency. Such values are highly praised in the current context of crisis of pharmaceutical innovation where military metaphors foster a general mobilization of resources (...) from multiple fields of cutting-edge research. The missile metaphor, reminiscent of Paul Ehrlich’s ‘magic bullet’, has framed the problem in simple terms: how to deliver the right dose in the right place at the right moment? Chemists, physicists and engineers who design multi-functional devices operating in vitro can think in such terms, as long as the devices are not actually operating through the messy environment of the body. A close look at what has been done and what remains to be done suggests that the metaphor of the “therapeutic missile” is neither sufficient, nor even necessary. Recent developments in nanomedicine suggest that therapeutic efficacy cannot be obtained without negotiating with the biological milieu and taking advantage of what it affords. An ‘oikological’ approach seems more appropriate, more heuristic and more promising than the popular missile. It is based on the view of organism as an oikos that has to be carefully managed. The dispositions of nanocapsules have to be coupled with the affordances of the environment. As it requires dealing with nanoparticles as relational entities (defined by their potential for interactions) rather than as stable substances (defined by intrinsic properties) this metaphor eventually might well change research priorities in nanotechnology in general. (shrink)