Background:Ideas of patient involvement are related to notions of self-determination and autonomy, which are not always in alignment with complex interactions and communication in clinical practice.Aim:To illuminate and discuss patient involvement in routine clinical care situations in nursing practice from an ethical perspective.Method:A case study based on an anthropological field study among patients with advanced cancer in Denmark.Ethical considerations:Followed the principles of the Helsinki Declaration.Findings:Two cases illustrated situations where nurses refused patient involvement in their own case.Discussion:Focus on two ethical issues, (...) namely ‘including patients’ experiences in palliative nursing care’ and ‘relational distribution of power and knowledge’, inspired primarily by Hannah Arendt’s concept of thoughtlessness and a Foucauldian perspective on the medical clinic and power. The article discusses how patients’ palliative care needs and preferences, knowledge and statements become part of the less significant background of nursing practice, when nurses have a predefined agenda for acting with and involvement of patients. Both structurally conditioned ‘thoughtlessness’ of the nurses and distribution of power and knowledge between patients and nurses condition nurses to set the agenda and assess when and at what level it is relevant to take up patients’ invitations to involve them in their own case.Conclusion:The medical and institutional logic of the healthcare service sets the framework for the exchange between professional and patient, which has an embedded risk that ‘thoughtlessness’ appears among nurses. The consequences of neglecting the spontaneous nature of human action and refusing the invitations of the patients to be involved in their life situation call for ethical and practical reflection among nurses. The conditions for interaction with humans as unpredictable and variable challenge nurses’ ways of being ethically attentive to ensure that patients receive good palliative care, despite the structurally conditioned logic of healthcare. (shrink)

Psychopathology in children cannot be understood without considering developmental processes and transactional relationships, particularly the relationship with caregivers. Time-limited intersubjective child psychotherapy is a developmental and transactional approach aimed at helping children and caregivers get back on healthier developmental trajectories. Core developmental processes, such as self-other-regulation and affect integration, are considered particularly important for healthy function and transactions with caregivers and contexts. Therefore, TIC seeks to strengthen core developmental processes in the child and the caregivers’ ability to scaffold the child’s (...) development. This is achieved through parallel child therapy and parent sessions. The current study is a qualitative study of parents’ experiences of change after TIC. The study explores parents’ perception of change in their child, themselves, and their transactions, and what they experienced as helpful in therapy.Materials and MethodsNine semi-structured qualitative interviews were conducted with parents of nine children aged 9–12 years with internalizing difficulties after completing TIC. The data were analyzed with thematic analysis.ResultsThe parents described positive changes in the children’s ability to understand, regulate and express themselves. The parents also described positive changes in their parenting, and for all nine children the parents reported positive changes in the transactions between themselves and the child. Most parents saw the parallel child and parental sessions as particularly important, while several parents mentioned play and the therapeutic focus.DiscussionParents’ description of changes after TIC indicate that the parents perceived their children as strengthened in core developmental processes important for intersubjective exchanges such as self-regulation and affect integration. In addition, parents saw their children and their own contributions more clearly, and their transactions were described as more supportive and positive.ConclusionThe results from this study give support to TIC as a developmentally supportive approach to therapy, with potential effects on children’s core developmental processes, their parents’ ability to both see and scaffold the child’s development and positive effects on the transactions between children and parents. The positive effects likely result from the integration of the different parts of TIC and the synergies taking place between them, rather than any one component by itself. (shrink)

The tradition of Western philosophy—in particular, the ideals of reason and objectivity—has come down to us from white males, nearly all of whom are demonstrably sexist, even misogynist. What are the implications of this fact for contemporary feminists working within this tradition? Is this tradition so imbued with patriarchy that it is impossible for feminists to work on the same problems or to use the same tools? Or can feminists remain feminists while helping themselves to the philosophical tradition?In this splendidly (...) provocative volume, thirteen feminist theorists of many different persuasions address these questions. The chapters touch on many historical figures as well as many contemporary modes of thought, but a common theme running through them all is the question of whether there is a place for the traditional ideals of objectivity and rationality in a committed feminist view of philosophy and of the world.A Mind of One's Own stands as testimony to the variety, vigor, and vitality of current feminist philosophy. It will be essential reading and an essential reference for philosophers as well as for all scholars and students concerned about the nature of knowledge and our pursuit of it. (shrink)

In Sweden, palliative care has, over the past decades, been object to policies and guidelines with focus on how to achieve “good palliative care”. The aim of this study has been to analyse how experts make sense of the development and the current state of palliative care. Departing from this aim, focus has been on identifying how personal experiences of ‘the self’ are intertwined with culturally available meta-level concepts and how experts contribute to construct new scripts on palliative care. Twelve (...) qualitative interviews were conducted. Four scripts were identified after analysing the empirical material: 1. script of paths towards working within palliative care; 2. script of desirable and deterrent reference points; 3. script of tensions between improvement and bureaucracy; and 4. script of low status and uncertain definitions. The findings of this study illustrate how experts in complex ways intertwine experiences of ‘the self’ with meta-levels concepts in order to make sense of the field of palliative care. The participants did not endorse one “right way” of “good” deaths. Instead, palliative care was considered to be located in a complex state where the historical development, consisting of both desirable ideals, death denials and lack of guidelines, and more recent developments of strives towards universal concepts, “improvement” and increased bureaucracy altogether played a significant role for how palliative care has developed and is organised and conducted today. (shrink)

Transient receptor potential vanilloid 4 (TRPV4), a member of the TRP superfamily, is a broadly expressed, cell surface‐localized cation channel that is activated by a variety of environmental stimuli. Importantly, TRPV4 has been increasingly implicated in the regulation of cellular morphology. Here we propose that TRPV4 and the cytoskeletal remodeling small GTPase RhoA together constitute an environmentally sensitive signaling complex that contributes to pathological cell cytoskeletal alterations during neurological injury and disease. Supporting this hypothesis is our recent work demonstrating direct (...) physical and bidirectional functional interactions of TRPV4 with RhoA, which can lead to activation of RhoA and reorganization of the actin cytoskeleton. Furthermore, a confluence of evidence implicates TRPV4 and/or RhoA in pathological responses triggered by a range of acute neurological insults ranging from stroke to traumatic injury. While initiated by a variety of insults, TRPV4–RhoA signaling may represent a common pathway that disrupts axonal regeneration and blood–brain barrier integrity. These insights also suggest that TRPV4 inhibition may represent a safe, feasible, and precise therapeutic strategy for limiting pathological TRPV4–RhoA activation in a range of neurological diseases. (shrink)

Feminist work in the history of philosophy has come of age as an innovative field in the history of philosophy. This volume marks that accomplishment with original essays by leading feminist scholars who ask basic questions: What is distinctive of feminist work in the history of philosophy? Is there a method that is distinctive of feminist historical work? How can women philosophers be meaningfully included in the history of the discipline? Who counts as a philosopher? This collection is a unique (...) collaboration among philosophers from North America and the Nordic Countries, including papers written from both analytic and continental philosophical perspectives and discussing both ancient and modern philosophers. Feminist Reflections on the History of Philosophy will be of interest to historians of philosophy, feminist theorists, women's studies faculty and students, and humanists interested in canon formation and transformation. (shrink)

The paper discusses intention as a rhetorical key term and argues that a consideration of rhetor’s intent should be maintained as relevant to both the production and critique of rhetorical discourse. It is argued that the fact that the critic usually has little or no access to the rhetor’s mind does not render intention an irrelevant factor. Rather than allowing methodological difficulties to constrain critical inquiry, I suggest some ways in which the critic can incorporate the rhetor’s intention in evaluating (...) argumentation. To this end, a standard of fairness is presented. (shrink)

These days many gyms and fitness centers are closed to reduce transmission of the SARS-CoV-2 virus in society. The gym is an environment rich in microorganisms, and careful hygiene is a necessity to keep infections at bay. Exercise centers strive for better hygiene compliance among their members. This effort has become essential in light of the current pandemic. Several experimental studies show that others’ physical presence, or the “illusion” of being watched, may alter behavior. This article reports on a natural (...) field experiment testing one specific social nudge intended to increase gym members’ hygienic behavior. The study was conducted before the SARS-COV-2 pandemic. A picture of “observing eyes” was attached to paper dispensers and cleanser spray bottles at two different gyms in Norway. A reversal design, also called an ABA design, with and without the nudge’s presence, was used to investigate the impact on gym members’ hygienic behavior. A follow-up study was conducted in one of the centers to investigate whether the nudge stimuli would function over time. The study included 254 individual choice situations during nine observation sessions conducted over 9 weeks. The results from both centers provide evidence of a strong effect of the nudge. However, the effect decreased during the follow-up study. These findings support previous research indicating that human behavior is influenced by the presence of implicit observation cues – in this case – observing eyes. However, insights into the long-term effect of implicit observation cues are still needed since the salience of the stimuli faded over time. (shrink)

(2006). First thoughts: An unpublished letter from Gilbert Ryle to H. J. Paton∗. British Journal for the History of Philosophy: Vol. 14, No. 4, pp. 747-756.

In 2015, observers argued that the fourth agricultural revolution had been initiated. This article focuses on one part of this high-tech revolution: the origin, development, applications, and user value of unmanned aerial systems (UAS). Institutional changes connected to the UAS innovation are analyzed, based on a Swedish case study. The methods included autoethnography. The theoretical frame was composed by four perspectives: innovation, institutions, sustainability, and ethics. UAS can help farmers cut costs and produce higher quantity with better quality, and also (...) has environmental benefits. However, this promising innovation was exposed to institutional forces and suddenly became subordinated the Act of Camera Surveillance. This study illuminates how legislative institutions can inhibit responsible innovation. The study shows that different ethical perspectives can collide with each other. (shrink)

Background Implementing person-centred care (PCC) in nursing homes is challenging due to a gap between theory and practice. Bridging this gap requires suitable education, which focuses on learning how to attune care to the values and preferences of residents and take moral, relational, and situational aspects into account. Staff’s stories about the care they provide (i.e. caring stories) may deliver valuable insights for learning about these aspects. However, there is limited research on using staff's narratives for moral learning. Objective This (...) study aims to provide insight into the perspectives of nursing staff on using their caring stories to learn about PCC. Research design In this qualitative research, we conducted two rounds of interviews with 17 participants working in nursing homes. We wanted to obtain nursing staff’s perceptions of working with their caring stories and the impact on PCC. Ethical considerations Participation was voluntary, and participants provided written consent. The study protocol is approved by The Institutional Review Board of the Medical Ethical Committee Leiden-Den Haag-Delft. Findings Working with caring stories enables nursing staff to provide PCC and improves job satisfaction. It increases awareness of what matters to residents, fosters information rich in context and meaning, and enhances voice and vocabulary. Through in-depth team reflections, nursing staff discussed the significant moments for residents, which centralizes the discussions on the moral quality of care. Discussion Working with caring stories fosters dialogue on PCC and enhances reflection on ethical situations in daily encounters, contributing to the moral development of nursing staff. Putting nursing staff’s narratives at the centre of learning suits their daily practice and intrinsic motivation. Therefore, the outcomes of this study are an addition to the existing literature about using narratives in long-term care. Conclusion Using nursing staff's narratives contributes to PCC and positively impacts nursing staff. We recommend using staff's caring stories as a vehicle for moral learning in the transition to PCC. (shrink)

Several philosophical problems concerning the object of criticism in dance are identified and analyzed as preliminary to an eventual theory of evaluation of dance. Basic to philosophical adequacy is understanding the artform as it is actually practiced and appreciated, recognizing its complexity as a performing artform using unique human bodies as instruments. ;Definitions of "dance" proposed by philosophers, dance historians, and others are inadequate to specify necessary and sufficient conditions of dance, to distinguish dance from other human non-art phenomena, and (...) to distinguish dance from other artforms. Definitions can be adequate for a specific purpose, using descriptive characteristics and standards for evaluation and appreciation by an audience. ;The ontological status of dance is best understood as consisting of the primary media of movement by human bodies and music and secondary media of the visual dimensions of costumes, scenery, and lighting. Improved understanding of the artform is possible with this more comprehenive recognition of its complex multi-media status, as shown in an analysis of "appropriateness" of the various media, a typical criterion for evaluation. ;The identity of a work of art in dance can be established using a notational system in conjunction with a standard for acceptable compliance with that notation. "Substantial similarity," as determined by lay observers, the test for copyright infringement, provides a useful standard for dance. Other theories have required too much of an identity standard; its purpose is to identify a particular performance as one of a certain work, not to teach dancers to perform the work, nor to enable directors to produce it, nor to provide standards for a good performance of the work. ;A necessary condition of the proper object of criticism is perceivability. The considerable interest in the dance world in production and other factors not perceivable on stage during performance is best understood as a interest in the on-going skills of artists, as opposed to the evaluation of an aesthetic object. (shrink)

Using a nationwide survey, this study compared the ethical values and decision processes ofFortune executives and MBA students. Statistically significant differences in ethical values were found by class of respondent, gender, and professed decision approach. MBAs were also found to process ethical decisions differently than business professionals.

Charlotte Wolff was born in Riesenburg, West Prussia into a middle-class Jewish family. She studied philosophy and then medicine at several German universities, completing her doctorate in Berlin in 1926. Working in various institutions over the next few years, she was also interested in psychotherapy and had a small private medical and psychotherapeutic practice. In 1933 she was forced to leave Germany because of the Nazi regime, and settled for a few years in Paris. As a German refugee she (...) was unable to practice medicine, so she began her research into the correlation between hand traits and personality. In 1936 she went to London to continue her research work and lived there until her death. An active lesbian from an early age, her later research turned to sexology and her writing on lesbianism and bisexuality were influential early works in the field. This is a great opportunity to rediscover her early work, including her first autobiography. (shrink)

Although it is clear in Schelling's Freiheitsschrift that he takes an agent's atemporal choice between good and evil to be central to understanding human freedom, there is no consensus in the literature and no adequate account of how to understand this choice. Further, the literature fails to render intelligible how existential freedom is possible in the light of this atemporal choice. I demonstrate that, despite their differences, the dominant accounts in the literature are all guilty of these failings and argue (...) that this is due to their misunderstanding of Schelling's conception of the relationship between essence and form. After outlining what I take Schelling's account of this relationship to be, I return to the Freiheitsschrift to demonstrate that with this account in mind we can make intelligible Schelling's claims about the agent's atemporal act, and the possibility of existential freedom on his account. (shrink)

Patients in around 20 countries worldwide are now offered online access to at least some of their medical records. Access includes test results, medication lists, referral information, and/or the very words written by clinicians (so-called ‘open notes’). In this paper, I discuss the possibility of one unintended negative consequence of patient access to their clinical notes—the potential to increase ‘nocebo effects’. A growing body of research shows that nocebo effects arise by engaging perceptual and cognitive processes that influence negative expectancies, (...) and as a consequence, adverse health effects. Studies show that increased awareness about the side effects of medications, the framing of information and the socioemotional context of care can increase the risk of nocebo effects. Connecting research into the nocebo effect with open notes provides preliminary support for the hypothesis that patient access to clinical notes might be a forum for facilitating unwanted nocebo effects. Furthermore, current findings indicate that we might expect to see systematic differences in how nocebo effects are experienced among different patient populations. The ethical implications of the tension between transparency and the potential for harm are discussed, with an emphasis on what open notes might mean for justice and equity in clinical care for a range of already marginalised patient populations. I argue that to resolve these challenges does not thereby justify ‘closed notes’, and conclude with suggestions for how health systems and clinicians might adapt to this innovation to reduce the risk of potential nocebo effects arising via this novel route. (shrink)

This paper discusses some of the ethical aspects in research in Adapted Physical Activity (APA). It indicates some of the ethical challenges related to the choice of research problem to be investigated, and the treatment of participants, not least when working with people who are in some ways in a more vulnerable life situation. Drawing also on experiences as a researcher with a disability, the challenges and potential benefits of involving people with disabilities in APA research is critically discussed.

"An astutely argued and elegantly written (and translated) book on the philosophical genealogy and logical implications of the work of Jacques Lacan."Choice.

Why do 'maladies of the soul' such as hysteria, anxiety disorders, or depression wax and wane over time? Through a study of the history of psychiatry, Mikkel Borch-Jacobsen provocatively argues that most mental illnesses are not, in fact, diseases but the product of varying expectations shared and negotiated by therapists and patients. With a series of fascinating historical vignettes, stretching from Freud's creation of false memories of sexual abuse in his early hysterical patients to today's promotion and marketing of (...) depression by drug companies, Making Minds and Madness offers a powerful critique of all the theories, such as psychoanalysis and biomedical psychiatry, that claim to discover facts about the human psyche while, in reality, producing them. Borch-Jacobsen proposes such objectivizing approaches should be abandoned in favor of a constructionist and relativist psychology that recognizes the artifactual and interactive character of psychic productions instead of attempting to deny or control it. (shrink)

Charlotte Sabourin,Marguerite Deslauriers.

This paper addresses the actual practice of justifying definitions in mathematics. First, I introduce the main account of this issue, namely Lakatos's proof-generated definitions. Based on a case study of definitions of randomness in ergodic theory, I identify three other common ways of justifying definitions: natural-world justification, condition justification, and redundancy justification. Also, I clarify the interrelationships between the different kinds of justification. Finally, I point out how Lakatos's ideas are limited: they fail to show how various kinds of justification (...) can be found and can be reasonable, and they fail to acknowledge the interplay among the different kinds of justification. (shrink)

The Metaphysics of Gender is a book about gender essentialism: what it is and why it might be true.

Aristotle's defense of Dunamis -- Power and potentiality -- Rational and nonrational powers -- The priority of actuality -- Ontological hierarchy, normativity, and gender.

The central question of this paper is: are deterministic and indeterministic descriptions observationally equivalent in the sense that they give the same predictions? I tackle this question for measure-theoretic deterministic systems and stochastic processes, both of which are ubiquitous in science. I first show that for many measure-theoretic deterministic systems there is a stochastic process which is observationally equivalent to the deterministic system. Conversely, I show that for all stochastic processes there is a measure-theoretic deterministic system which is observationally equivalent (...) to the stochastic process. Still, one might guess that the measure-theoretic deterministic systems which are observationally equivalent to stochastic processes used in science do not include any deterministic systems used in science. I argue that this is not so because deterministic systems used in science even give rise to Bernoulli processes. Despite this, one might guess that measure-theoretic deterministic systems used in science cannot give the same predictions at every observation level as stochastic processes used in science. By proving results in ergodic theory, I show that also this guess is misguided: there are several deterministic systems used in science which give the same predictions at every observation level as Markov processes. All these results show that measure-theoretic deterministic systems and stochastic processes are observationally equivalent more often than one might perhaps expect. Furthermore, I criticise the claims of the previous philosophy papers Suppes (1993, 1999), Suppes and de Barros (1996) and Winnie (1998) on observational equivalence. (shrink)

The governments of China, India, and the United Kingdom are unanimous in their belief that bioinformatics should supply the link between basic life sciences research and its translation into health benefits for the population and the economy. Yet at the same time, as ambitious states vying for position in the future global bioeconomy they differ considerably in the strategies adopted in pursuit of this goal. At the heart of these differences lies the interaction between epistemic change within the scientific community (...) itself and the apparatus of the state. Drawing on desk-based research and thirty-two interviews with scientists and policy makers in the three countries, this article analyzes the politics that shape this interaction. From this analysis emerges an understanding of the variable capacities of different kinds of states and political systems to work with science in harnessing the potential of new epistemic territories in global life sciences innovation. (shrink)

____Remembering Anna O.__ offers a devastating examination of the very foundations of psychoanalytic theory and practice, which was born with the publication of Breuer and Freud's ____Studies on Hysteria__ in 1895. Breuer described the case of Anna O., a young woman afflicted with a severe hysteria whom he had cured of her symptoms by having her recount under hypnosis the traumatic events that precipitated her illness. Drawing on the most recent Freud scholarship and on long-secret documents, Borch-Jacobsen demonstrates, however, (...) that Anna O. was never cured by Breuer's "talking cure" and that both Breuer and Freud knowingly falsified the historical record. Borch-Jacobsen points out the numerous inconsistencies in Breuer's account that suggests that Anna O.'s symptoms were simulated to meet Breuer's theoretical expectations and that her famed "reminiscences" were in fact fictitious memories induced by Breuer in the course of a hypnotic treatment. (shrink)

Wofür auch immer wir uns sonst halten mögen - wir halten uns für Personen. Doch was heisst dies genau? Bin ich dieselbe Person, die vor zehn Jahren an diesem Schreibtisch sass? Existiert eine Person noch, wenn sie im irreversiblen Koma liegt? Ist eine Person identisch mit ihrem Körper? Müssen wir an die Existenz geistiger Entitäten glauben, wenn sie es nicht ist? Die Autorin untersucht anhand des Ansatzes von P. F. Strawson, was den Begriff, den wir von uns selbst haben, auszeichnet (...) - und ob dieser Begriff adäquat ist. Es werden Gründe betrachtet, die für eine Revision des Begriffs sprechen könnten, und Alternativen erwogen. Dabei zeigt sich, ob und inwiefern wir davon ausgehen können, dass wir sind, wofür wir uns halten. Die Studie rückt eine Perspektive auf Fragen rund um den Personenbegriff ins Licht, die in vielen Debatten ausgeblendet wird. (shrink)

On the observational equivalence of continuous-time deterministic and indeterministic descriptions Content Type Journal Article Pages 193-225 DOI 10.1007/s13194-010-0011-5 Authors Charlotte Werndl, Department of Philosophy, Logic and Scientific Method, London School of Economics, Houghton Street, London, WC2A 2AE UK Journal European Journal for Philosophy of Science Online ISSN 1879-4920 Print ISSN 1879-4912 Journal Volume Volume 1 Journal Issue Volume 1, Number 2.

The use of ‘placebos’ in clinical practice is a source of continued controversy for physicians and medical ethicists. There is rarely any extensive discussion on what ‘placebos’ are and how they work. In this paper, drawing on Louhiala and Puustinen's work, the author proposes that the term ‘placebo effect’ be replaced in clinical contexts with the term ‘positive care effect’. Medical treatment always takes place in a ‘context of care’ that encompasses all the phenomena associated with medical intervention: it includes (...) the particular method of treatment, the interpersonal relationships between medical staff and the patient and other factors, including physicians' and patients' beliefs in the power of the treatment. Together, these phenomena can result in a full spectrum of therapeutic effects to the patient—from no effects, to small effects, to large effects. In cases where there are significant therapeutic benefits to the patient, ‘positive care effects’ may be spoken of. Since the ethical codes of the General Medical Council and the American Medical Association demand transparency with respect to patient treatment and insist on complete openness in ‘placebo’ usage, the author argues that, as a matter of conceptual rigour and consistency, if the term ‘placebo effect’ is replaced by ‘positive care effect’, these ethical codes appear to insist on transparency about all such beneficial components of treatment. Given that this appears to be a counterintuitive obligation, the author concludes the paper with some comments on the clinical consequences of this conceptual revision, including a brief discussion of how this important debate might develop. (shrink)