Ongoing changes in many Western countries have resulted in more healthcare services being transferred to municipalities and taking place in patients’ homes. This greatly impacts nurses’ work in home care, making their work increasingly diverse and demanding. In this study, we explore home‐care nursing through a critical discourse analysis of focus group interviews with home‐care nurses. Drawing on insights from positioning theory, we discuss the content and delineation of their work and the interweaving of contextual changes. Nurses hold a crucial (...) position in home healthcare, particularly in ensuring care for sicker patients with complex needs. Assessing health needs, performing advanced care, and at the same time, providing customized solutions in various homes were identified as distinctive for home‐care nurses’ work. Changes have made nurses’ work become driven by comprehensive tasks and acute medical needs that require much of their competence and time. Urgent care seems to take precedence in nurses’ work, leaving less time and attention for other tasks such as conversations and support for coping with everyday life. This underlines the need to investigate and discuss the content and scope of nurses’ work to help shape the further development of home‐care nursing. (shrink)

BackgroundSexual boundary violations in healthcare are harmful and exploitative sexual transgressions in the professional–client relationship. Persons with mental health issues or intellectual disabilities, especially those living in residential settings, are especially vulnerable to SBV because they often receive long-term intimate care. Promoting good sexual health and preventing SBV in these care contexts is a moral and practical challenge for healthcare organizations.MethodsWe carried out a qualitative interview study with 16 Dutch policy advisors, regulators, healthcare professionals and other relevant experts to explore (...) their perspectives on preventing SBV in mental health and disability care organizations. We used inductive thematic analysis to interpret our data.ResultsWe found three main themes on how healthcare organizations can prevent SBV in mental health and disability care: setting rules and regulations, engaging in dialogue about sexuality, and addressing systemic and organizational dimensions.ConclusionOur findings suggest that preventing SBV in mental health and disability care organizations necessitates setting suitable rules and regulations and facilitating dialogue about positive aspects of sexuality and intimacy, as well as about boundaries, and inappropriate behaviors or feelings. Combining both further requires organizational policies and practices that promote transparency and reflection, and focus on creating a safe environment. Our findings will help prevent SBV and promote sexual health in mental health and disability care organizations. (shrink)

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)

The progress of electronic health technologies and biobanks holds enormous promise for efficient research. Evidence shows that studies based on sharing and secondary use of data/samples have the potential to significantly advance medical knowledge. However, sharing of such resources for international collaboration is hampered by the lack of clarity about ethical and legal requirements for transfer of data and samples across international borders. Here, the International Clinical Trial Center Network reports the legal and ethical requirements governing data and sample exchange (...) across four continents. The most recurring requirement is ethical approval, whereas only in specific conditions approval of national health authorities is required. Informed consent is not required in all sharing situations. However, waiver of informed consent is only allowed in certain countries/regions and under certain circumstances. The current legal and ethical landscape appears to be very complex and under constant evolution. Regulations differ between countries/regions and are often incomplete, leading to uncertainty. With this work, ICN illuminates the unmet need for a single international collaborative framework to facilitate DSE. Harmonising requirements for global DSE will reduce inefficiency and waste in research. There are many challenges to realising this ambitious vision, including inconsistent terminology and definitions, and heterogeneous and dynamic legal constraints. Here, we identify areas of agreement and significant difference as a necessary first step towards facilitating international collaboration. We propose the establishment of a working group to continue the comparison across jurisdictions, create a standardised glossary and define a set of basic principles and fundamental requirements for DSE. (shrink)

Background: Caring for a partner with primary malignant brain tumour can be a dramatic life-changing event. Primary malignant brain tumour is known to give poor life expectancy and severe neurological and cognitive symptoms, such as changed behaviour and personality, which demand greater caring responsibilities from spouses. Aim: The aim of the study is to explore ethical dilemmas spouses experience in the everyday care of a partner in treatment for primary malignant brain tumour. Research design, participants and research context: A phenomenological (...) and hermeneutic qualitative descriptive design was adopted as a method for collecting and analysing data. Ten spouses were interviewed twice using an in-depth, semi-structured interview guide. The interviews took place at the spouses’ homes or at the hospital. Ethical consideration: Ethical matters were considered throughout the research process. Permission from The National Committee on Health Research Ethics and the Danish Data Protection Agency was obtained. Findings: The analysis showed that the spouses perceived daily ethical dilemmas in caring for a partner with primary malignant brain tumour. Their life as well as their partner’s life had changed considerably. The main theme that emerged therefore was ‘oscillating in a changing relationship’. This theme was further elaborated in three subthemes that in more detail demonstrated the dilemmas: ‘doing the right thing in unpredictable daily situations’; ‘torn between patience and guilt’; and ‘living in a time of uncertainty, hope and despair’. Conclusion: Caring for a partner with changed behaviour and personality due to primary malignant brain tumour may involve exhausting ethical caring dilemmas. Spouses’ married life may change to a semi-professional asymmetrical relationship, which is challenged by the oscillation between acting responsibly for their partners’ well-being and caring dilemmas with no answer for what the right thing to do is. Mixed feelings of right and wrong, patience and guilt, hope and despair seem to be spousal companions through their partners’ progressing illness. (shrink)

In paradigm exercises of agency, individuals guide their activities toward some goal. A central challenge for action theory is to explain how individuals guide. This challenge is an instance of the more general problem of how to accommodate individuals and their actions in the natural world, as explained by natural science. Two dominant traditions–primitivism and the causal theory–fail to address the challenge in a satisfying way. Causal theorists appeal to causation by an intention, through a feedback mechanism, in explaining guidance. (...) Primitivists postulate primitive agential capacities in their explanations. The latter neglect to explain how primitive capacities integrate with findings from natural science. The former do not explain why some feedback mechanism’s activity amounts to the agent’s guidance. In this paper I argue that both traditions should acknowledge a capacity to guide, as actually constituted by the executive system. I argue that appeals to this empirically discovered psychological system explain how individuals guide in a way that integrates with explanations from cognitive science. Individuals’ capacity to guide is embedded in the natural world through the activity of its constituent (mechanistic) components. (shrink)

This book studies the major characteristics of the social pedagogical approach to early childhood education and care. It does so by investigating the distinctive elements of the Nordic approach and tradition. The cultural, educational, and ideological structures and values within the Nordic tradition indicate a strong "social pedagogical" rather than "early education" emphasis. The Nordic tradition applies a social learning approach that emphasizes play, relationships and outdoor life, and presumes that learning takes place through children's participation in social interaction and (...) processes. Set against this background, the book examines the characteristics of the pedagogue and the important features that develop through the Nordic approach. It compares children educated in the Nordic tradition with those educated in the French-English and Anglo-American tradition. It explores quality in relation to how children can enjoy childhood, and at the same time become able to actively participate in society and develop the social and cognitive skills and competences that individuals require to do well in society. (shrink)

Every year medical researchers make contact with a large number of cancer survivors with the aim of evaluating cancer treatment. For this reason we decided to investigate how Swedish cancer survivors perceived their participation in research studies focusing on the long-term consequences of being a survivor of gynaecological or urinary bladder cancer. Data were collected by means of two study-specific postal questionnaires, both consisting of questions covering physical symptoms, well-being and the experience of being a cancer survivor. Both questionnaires also (...) included questions evaluating the participants’ experience of being research subjects. The questionnaires were developed in close co-operation with cancer survivors. The study population consisted of 1068 cancer survivors. Of these, 95% (n=1003) reported that they thought the study was valuable and 54% (n=559) that they had been positively affected by participating. Four per cent (n=39) expressed that they had been negatively affected by their participation in the study. The vast majority of the cancer survivors thought that participating in their particular study was valuable. (shrink)

This paper, co-authored by undergraduate students and their instructor part of an educational psychology seminar, describes a participatory curriculum design approach for preservice teacher education that focuses on the use of the principles of second-order cybernetics to teach about teaching and learning. Using elements of an Open Source Educational Processes framework, our Spring ESEPSY2309 section created project-based collective hive minds of preservice teachers, relying on a cybernetic approach at the crossroads of Gregory Bateson and Gordon Pask's theories. The classroom community (...) used four innovative tool-mediated pillars to guide collaborative activity: 1) Live-chatting using the Reddit social media platform, 2) observation of the lives, strategies, and practices used by teachers and students in their own social networks through Soundcloud podcasting to expand their own perceptions of pedagogies and best practices that they could employ in their careers, 3) open-ended paper writing, exploring sources beyond the object language provided by the textbook through extensive dyadic conversations with the instructor, and 4) training in the use of the Alice 3 game creation tool for block programming enabling the accumulation of competence in designing classroom systems that may treat students these undergraduates would soon teach as active historical agents in learning environments, combining skills from varied subjects into transdisciplinary educational experiences. We showcase outcomes of our class projects using a narrative inquiry to describe podcast episodes, a topic network analysis to illustrate the expansive nature of Open Source writing activity, and a visual depiction of our class Alice 3 games. (shrink)

COVID-19 caused levels of household food insecurity to spike, but the precarity of so many people in wealthy countries is an outgrowth of decades of eroding public provisions and labour protections that once protected people from hunger, setting the stage for the virus’ unevenly-distributed harms. The prominence of corporate-sponsored foodbanking as a containment response to pandemic-aggravated food insecurity follows decades of replacing rights with charity. We review structural drivers of charity’s growth to prominence as a hunger solution in North America, (...) and of its spread to countries including the UK. By highlighting pre-pandemic pressures shaping foodbanking, including charities’ efforts to retool themselves as health providers, we ask whether anti-hunger efforts during the pandemic serve to contain ongoing socioeconomic crises and the unjust living conditions they cause, or contest them through transformative pathways to a just food system. We suggest that pandemic-driven philanthropic and state funding flows have bolstered foodbanking and the food system logics that support it. By contextualising the complex and variegated politics of foodbanking in broader movements, from community food security to food sovereignty, we reframe simplistic narratives of charity and highlight the need for justice-oriented structural changes in wealth redistribution and food system organisation if we are to prevent the kinds of emergency-within-emergency that we witnessed as COVID-19 revealed the proximity of many to hunger. (shrink)

This article examines the human placenta not only as a scientific, medical and biological entity but as a consumer bio-product. In the emergent placenta economy, the human placenta is exchanged and gains potentiality as food, medicine and cosmetics. Drawing on empirical research from the United States, the United Kingdom, Denmark and Japan, the authors use feminist cultural analysis and consumer theories to discuss how the placenta is exchanged and gains commodity status as a medical supplement, smoothie, pill and anti-ageing lotion. (...) Placenta preparers and new mothers cite medical properties and spirituality as reasons for eating or encapsulating the placenta, reinstating ideas of the liberated good mother. Meanwhile, the cosmetics industry situates the placenta as an extract and hence a commodity, re-naturalizing it as an anti-ageing, rejuvenating and whitening bio-product. The authors conclude that, in the emergent bio-economy, the dichotomy between the inner and the outer body is deconstructed, while the placenta gains clinical and industrial as well as affective value. (shrink)

How do individuals guide their activities towards some goal? Harry Frankfurt once identified the task of explaining guidance as the central problem in action theory. An explanation has proved to be elusive, however. In this paper, I show how we can marshal empirical research to make explanatory progress. I contend that human agents have a primitive capacity to guide visual attention, and that this capacity is actually constituted by a sub-individual psychological control-system: the executive system. I thus illustrate how we (...) can explain exercises of individual-level guidance by appeal to its sub-individual constitution. This opens up a new avenue for explicating agency. (shrink)

Skilled action typically requires that individuals guide their activities toward some goal. In skilled action, individuals do so excellently. We do not understand well what this capacity to guide consists in. In this paper I provide a case study of how individuals shift visual attention. Their capacity to guide visual attention toward some goal (partly) consists in an empirically discovered sub-system – the executive system. I argue that we can explain how individuals guide by appealing to the operation of this (...) sub-system. Understanding skill and skilled action thus requires appreciating the role of the executive system. (shrink)

What is attention? On one influential position, attention constitutively is the selection of some stimulus for coupling with a response. Wayne Wu has proposed a master argument for this position that relies on the claim that cognitive science commits to an empirical sufficient condition (ESC), according to which, if a subject S perceptually selects (or response-couples) X to guide performance of some experimental task T, she therein attends to X. In this paper I show that this claim about cognitive science (...) is false. Cognitive science allows for inattentive selection-for-task, or inattentive response-coupling. This means that Wu’s account is without independent support. (shrink)

There has recently been much interest in the role of attention in controlling action. The role has been mischaracterized as an element in necessary and sufficient conditions on agential control. In this paper I attempt a new characterization of the role. I argue that we need to understand attentional control in order to fully understand agential control. To fully understand agential control we must understand paradigm exercises of agential control. Three important accounts of agential control—intentional, reflective, and goal-represented control—do not (...) fully explain such exercises. I argue that understanding them requires understanding how deployments of visual attention implement flexible occurrent control, or a capacity to flexibly adjust the degree of control that individuals exercise over their actions. While such deployments of attention are neither necessary nor sufficient for exercising agential control, they constitute an attentional skill for controlling action, understanding which is central to fully understanding agential control. We can appreciate its centrality if we appreciate that this attentional skill for controlling action is plausibly crucial to acting non-negligently. (shrink)

How can we argue, from neural facts, that representational states exhibit some specific representational structure? This paper approaches the question through a case study on the priority map-mechanism that underlies our capacity to orient visual attention. Computational models from cognitive neuroscience describe this mechanism as operating over neural topographic structures. These neural structures exhibit the functional profile of topographic representational structure. I argue that this fact warrants attributing topographic structure to the priority map mechanism’s representational states.

The past twenty five years have seen an explosion of feminist writing on the philosophical canon, a development that has clear parallels in other disciplines like literature and art history. Since most of the writing is, in one way or another, critical of the tradition, a natural question to ask is: Why does the history of philosophy have importance for feminist philosophers? This question assumes that the history of philosophy is of importance for feminists, an assumption that is warranted by (...) the sheer volume of recent feminist writing on the canon. This entry explores the different ways that feminist philosophers are interacting with the Western philosophical tradition. (shrink)

Executive functioning has been said to bear on a range of traditional philosophical topics, such as consciousness, thought, and action. Surprisingly, philosophers have not much engaged with the scientific literature on executive functioning. This lack of engagement may be due to several influential criticisms of that literature by Daniel Dennett, Alan Allport, and others. In this paper I argue that more recent research on executive functioning shows that these criticisms are no longer valid. The paper clears the way to a (...) more fruitful philosophical engagement with findings on the central executive system. (shrink)

One of the most influential recent accounts of attention is Wayne Wu’s. According to Wu, attention is selection-for-action. I argue that this proposal faces a dilemma: either it denies clear cases of attention capture, or it acknowledges these cases but classifies many inattentive episodes as attentive.

This paper suggests a method to calculate a degree of validity for the proof of a statement which is derived from empirical statements by means of logic conclusions. The empirical statements are assumed not to be completely valid or their validity to be doubtful. The suggested rules are consistent with two-valued logic, yield decreasing validities with increasing number of applications of modus ponens and obey the law of the excluded middle. The actual calculation of validity values, the relation of the (...) suggested method to some truth tables of multi-valued logic and to fuzzy logic are discussed. (shrink)

This article is concerned with the concept of “informed consent” as applied both in biomedical research involving human subjects and in clinical medicine in general. The current crisis over the elaboration and interpretation of the concept will be examined, along with the broader question of whether “informed consent” is any longer meaningful or viable as a criterion for complex bioethical policy-making. Finally, I will attempt to sketch a prognosis for the concept in doctor-patient relations, even if it is only wishful (...) thinking. (shrink)

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 aim of the article is to illustrate concrete problems in the asymmetrical nurse–patient power relationship. It is an ethical demand that the nurse is faced with the challenges that the power in the relation is administered so that the patient's room for action is expanded and trust maintained. It is an essential message in care philosophy, but in clinical practice, success is not always achievable. A hidden and more or less unconscious restriction of the patient's room for action may (...) result in the excesses of care. Three selected aspects: dependence, trust, and power described by the Danish philosopher K.E. Løgstrup and the Norwegian nursing philosopher Kari Martinsen's care philosophy has inspired this empirically based examination of some current barriers in the asymmetrical nurse–patient relationship. On the basis of qualitative interviews with six patients and six nurses, the research thus provides an identifying and problem‐exploratory examination of some current obstacles in which the handling of trust and power reflects the excesses of care. The findings develop three themes. ‘Being a burden’ acknowledges that the balance of power will always tip to the nurse's advantage. The second theme, ‘Doing only what's absolutely necessary’, shows how a fixation with ‘technicalism’ creates a distance between people that may constrain the patient's room for action. The last theme is concerning the nurse's ability to navigate between closeness and distance is essential in avoiding ‘the excesses of care’, paternalism, and overprotectiveness. A situation in which distance takes the upper hand and care turns into paternalism. A different situation would arise if the nurse's emotions became sentimental or intimate with the result that closeness gets the upper hand. To avoid a harmful exercise of power and the excesses of care, the findings have demonstrated that a relationship‐based caring is a demand for situation‐specific sensitive attention skills. (shrink)

In March 2020, the Government produced a document entitled “Responding to COVID-19: The Ethical Framework for Adult Social Care”(‘The Ethical Framework’). In this article, we summarise the key features of the proposed ethical framework and subject it to critical analysis. We highlight three primary issues. First, the emphasis placed on autonomy as the primary ethical principle. We argue if ever there was a context in which autonomy should dominate the ethical analysis, this is not it. Second, we examine the interface (...) between ethics and law which is largely overlooked in the document. Finally, we explore the surprising lack of attention paid to the concept of responsibility and communal obligations within the framework. (shrink)

This highly original book examines, for the first time, how the patient movement, which works to improve the quality of healthcare, can actually be considered an emancipation movement when led by its radical elements.

The doctor-patient relationship is built on an implicit covenant of trust, yet it was not until the post-World War Two era that respect for patient autonomy emerged as an article of mainstream medical ethics. Unlike their medical forebears, physicians today are expected to furnish patients with adequate information about diagnoses, prognoses and treatments. Against these dicta there has been ongoing debate over whether placebos pose a threat to patient autonomy. A key premise underlying medical ethics discussion is the notion that (...) the placebo effect necessitates patient deception. Indeed, the American Medical Association guidelines imply that placebo treatment necessary entails a form of deception. As a consequence of this assumption, the fulcrum of debate on the use of placebo treatment has hinged on whether that deception is ever justified. Recently performed experiments with open-label transparently prescribed placebos have begun to challenge the notion that deception is necessary in eliciting the placebo effect and such effects necessarily involve a binary distinction between autonomy and beneficence. In this article we focus on the content of disclosures in distinctive open-label, transparently disclosed placebo studies and inquire whether they might be said to invoke deception in clinical contexts, and if so, whether the deception is unethical. We find that open placebos may be said to involve equivocation over how placebos work. However, drawing on surveys of patient attitudes we suggest that this equivocation appears to be acceptable to patients. We conclude that open placebos fulfil current American Medical Association guidelines for placebo use, and propose future research directions for harnessing the placebo effect ethically. (shrink)

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

In cases of complicity in one’s own unfreedom and in structural injustice, it initially appears that agents are only vicariously responsible for their complicity because of the roles circumstantial and constitutive luck play in bringing about their complicity. By drawing on work from the phenomenological tradition, this paper rejects this conclusion and argues for a new responsive sense of agency and responsibility in cases of complicity. Highlighting the explanatory role of stubbornness in cases of complicity, it is argued that although (...) agents may only be vicariously responsible for becoming complicit, they can be held more directly responsible for entrenching their complicity. The complicit agent is responsible for their complicity to the extent that they fail to take responsibility for it. (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.

Your Digital Rebel XSi/450D, with its 12.2 megapixel resolution, 3-inch view screen, and the option for "Live View" shooting, is designed for simplicity without sacrificing creative freedom. This guide is ideal for helping you use that creative control and get great shots anywhere, anytime. If you’re new to dSLRs, it makes the transition easy. If you’re already comfortable with the various modes and settings, the book helps you make the most of every one. Set up your camera and learn when (...) to choose automatic, semi-automatic, and manual modes Understand the camera's controls, menus, and when to use different metering and autofocus modes Explore Canon Picture Styles and custom functions Learn to manipulate ISO, exposure, depth of field, and shutter speed Create intriguing night and low-light images, capture sports action, portraits, and get tips for better macro photography. (shrink)

This article focuses on three recent discussions on determinism in the philosophy of science. First, determinism and predictability will be discussed. Then, second, the paper turns to the topic of determinism, indeterminism, observational equivalence and randomness. Finally, third, there will be a discussion about deterministic probabilities. The paper will end with a conclusion.

Hume is committed, By one of his criticisms of reason as the route to moral knowledge, To an internalist position. In the argument from motivation, Hume starts by observing that morality is practical--That morals excite passions and produce or prevent actions. But, Hume argues, Rationalist moral theories cannot explain how moral considerations motivate. This is because reason alone is incapable of motivating us. The premise that morality is practical, However, May be interpreted in two ways--Either in an externalist or internalist (...) manner. Charity requires us to adopt the internalist reading because only then is the argument valid. An internalist reading of the argument, However, Commits hume, In his constructive phase, To construing the moral sentiments of approval and disapproval as possessing motivational influence by themselves. But an examination of what hume has to say about the motives that prompt us to do what is right shows that he fails to provide such an account himself. This points to an inconsistency in hume's moral theory. (shrink)

Charlotte Sabourin | : Cet article vise à souligner l’importance du rôle joué par la conception kantienne des Lumières dans la Critique de la raison pure. On verra en effet que la connaissance de soi au coeur du projet critique gagne à être comprise en relation avec l’idée de penser par soi-même. Cette connaissance de soi dévoile cependant certaines erreurs tenaces commises par la raison, qui doivent précisément être rectifiées sous peine de compromettre la liberté de penser. La conception (...) kantienne des Lumières nous permettra ainsi de faire sens de la nature réflexive de l’entreprise critique. | : The aim of this paper is to show that the Kantian conception of enlightenment plays an important role in the Critique of Pure Reason. I will show that the self-knowledge central to Kant’s critical philosophy can be better understood by considering it in relation with the idea of thinking for oneself. Moreover, this self-knowledge reveals some deep-rooted errors made by pure reason that must be rectified in order not to compromise freedom of thought. I will thus use Kant’s conception of enlightenment to make sense of the reflexive nature of the critical project. (shrink)