(1996). A European influence in British local government discourse? The European Legacy: Vol. 1, Fourth International Conference of the International Society for the study of European Ideas, pp. 580-585.

In lieu of an abstract, here is a brief excerpt of the content:In Their Father’s Library: Books Furnish Not Only a Room, But Also a Tradition ELIZABETH POWERS Although they shared close life dates and became famous in the same years for their epistolary novels, Johann Wolfgang von Goethe (1749–1832) and Fanny Burney (1752–1840) would seem to have been worlds apart literarily. (Goethe had in his Weimar library a copy of Evelina, while Burney was probably not ignorant of the Europe-wide (...) sensation The Sorrows ofYoung Werther.) What might be called their literary apprenticeship, however, was remarkably similar, consisting not of schooling in a traditional institution in which students (and, importantly, most eighteenth-century writers) were drilled in the classical curriculum, but, instead, from wide reading within the confines of their fathers’ libraries. It is true that Goethe and his younger sister Cornelia were supplied at home with a number of tutors and that their progress was monitored by their father, but their acquaintance with literature was fostered within the confines of the family home. Burney had no formal education at all. Indeed, on the appearance of Evelina, her father (according to her diary) remarked : “[S]he has had very little Education but what she has given herself,—less than any of the others!” Burney, however, had the advantage of growing up in a milieu in which books mattered. While the Goethes were eminently respectable, on the mother’s side part of what was the patriciate of the city of Frankfurt, the Burney household in London was bursting with wits and with what can only be called celebrities. The Burneys knew God and the world: David Garrick, Dr. Johnarion 28.1 spring/summer 2020 116 in their father’s library son, Hester Thrale. As Virginia Woolf noted of the famous father, Dr. Charles Burney, he was a musician “who could talk of intellectual things and ask clever people to his house.” Goethe has given plenty of evidence of roaming freely among his father’s books, a collection of 1,700 calfskin-bound volumes. When Burney went to serve at the court of King George III, Queen Charlotte was disappointed at how few books the author of Evelina possessed. (Similarities accumulate: Goethe also served at court, as minister in the duchy of Weimar.) But why cart around a load of books? As Burney wrote in her diary: “[M]y Father’s most delightful Library, as I then told her [the Queen], with my free access to it, had made [owning my own books] a thing unnecessary... ” Libraries in the eighteenth and early nineteenth century, whether private or public affairs, were not like contemporary public libraries, catering to a wide array of tastes, but were repositories of what Matthew Arnold termed “the best that is known and thought in the world.” Let’s call it the Western intellectual and cultural heritage. Most respectable homes would possess at a minimum a Bible, while the holdings in private homes, as evident in the library of Goethe’s father, could reach astounding proportions. According to Burney biographer Claire Harman, Fanny’s brother left at his death one of the finest private libraries of the age. Moreover, the antiquity of the works in the venerable libraries scattered across Europe from Dublin to Saint Petersburg, and especially their survival despite centuries of vicissitudes, was testimony to the authoritative nature of the transmission. Anyone who took the Bible in hand, who took lessons from it, adhering, for instance, to the injunctions of the Ten Commandments, was conscious of subscribing to values shared by preceding generations. Literary practitioners, also showing obeisance to authoritative predecessors, followed earlier models, in the process contributing to an evolving literary heritage. There was no purity in this transmission. It was truly promiscuous, but its quasi-biological character, like a mother’s left-handedness in a child, can be seen in the family Elizabeth Powers 117 resemblances among writers of different eras. Just as individuals perpetuate traits of their parents, so literature and the other arts recycled features of artistic predecessors. Writers as diverse in background and language and religion as Ariosto and Milton transmitted the dna, so to speak, of such epical forebears as Homer and Virgil. This sort of family legitimacy was... (shrink)

To commemorate 40 years since the founding of the Journal of Business Ethics, the editors in chief of the journal have invited the editors to provide commentaries on the future of business ethics. This essay comprises a selection of commentaries aimed at creating dialogue around the theme Ethics at the centre of global and local challenges. For much of the history of the Journal of Business Ethics, ethics was seen within the academy as a peripheral aspect of business. However, in (...) recent years, the stakes have risen dramatically, with global and local worlds destabilized by financial crisis, climate change, internet technologies and artificial intelligence, and global health crises. The authors of these commentaries address these grand challenges by placing business ethics at their centre. What if all grand challenges were framed as grand ethical challenges? Tanusree Jain, Arno Kourula and Suhaib Riaz posit that an ethical lens allows for a humble response, in which those with greater capacity take greater responsibility but remain inclusive and cognizant of different voices and experiences. Focussing on business ethics in connection to the grand challenge of environmental emergencies, Steffen Böhm introduces the deceptively simple yet radical position that business is nature, and nature is business. His quick but profound side-step from arguments against human–nature dualism to an ontological undoing of the business–nature dichotomy should have all business ethics scholars rethinking their “business and society” assumptions. Also, singularly concerned with the climate emergency, Boudewijn de Bruin posits a scenario where, 40 years from now, our field will be evaluated by its ability to have helped humanity emerge from this emergency. He contends that Milieudefensie v. Royal Dutch Shell illustrates how human rights take centre stage in climate change litigation, and how business ethics enters the courtroom. From a consumer ethics perspective, Deirdre Shaw, Michal Carrington and Louise Hassan argue that ecologically sustainable and socially just marketplace systems demand cultural change, a reconsideration of future interpretations of “consumer society”, a challenge to the dominant “growth logic” and stimulation of alternative ways to address our consumption needs. Still concerned with global issues, but turning attention to social inequalities, Nelarine Cornelius links the capability approach to global and corporate governance, arguing that CA will continue to lie at the foundation of human development policy, and, increasingly, CSR and corporate governance. Continuing debate on the grand challenges associated with justice and equality, Laurence Romani identifies a significant shift in the centrality of business ethics in debates on managing differences, positing that dialogue between diversity management and international management can ground future debate in business ethics. Finally, the essay concludes with a commentary by Charlotte Karam and Michelle Greenwood on the possibilities of feminist-inspired theories, methods, and positionality for many spheres of business ethics, not least stakeholder theory, to broaden and deepen its capacity for nuance, responsiveness, and transformation. In the words of our commentators, grand challenges must be addressed urgently, and the Journal of Business Ethics should be at the forefront of tackling them. (shrink)

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)

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)

A fact of life for farmers, hunter-gatherers, and fishermen in the rural parts of the world are that crops fail, wild resources become scarce, and winds discourage fishing. In this article we approach subsistence risk from the perspective of "coexistence thinking," the simultaneous application of natural and supernatural causal models to explain subsistence success and failure. In southwestern Madagascar, the ecological world is characterized by extreme variability and unpredictability, and the cosmological world is characterized by anxiety about supernatural dangers. Ecological (...) and cosmological causes seem to point to different risk minimizing strategies: to avoid losses from drought, flood, or heavy winds, one should diversify activities and be flexible; but to avoid losses caused by disrespected spirits one should narrow one's range of behaviors to follow the code of taboos and offerings. We address this paradox by investigating whether southwestern Malagasy understand natural and supernatural causes as occupying separate, contradictory explanatory systems (target dependence), whether they make no categorical distinction between natural and supernatural forces and combine them within a single explanatory system (synthetic thinking), or whether they have separate natural and supernatural categories of causes that are integrated into one explanatory system so that supernatural forces drive natural forces (integrative thinking). Results from three field studies suggest that (a) informants explain why crops, prey, and market activities succeed or fail with reference to natural causal forces like rainfall and pests, (b) they explain why individual persons experience success or failure primarily with supernatural factors like God and ancestors, and (c) they understand supernatural forces as driving natural forces, so that ecology and cosmology represent distinct sets of causes within a single explanatory framework. We expect that future cross-cultural analyses may find that this form of "integrative thinking" is common in unpredictable environments and is a cognitive strategy that accompanies economic diversification. (shrink)

Whether any non-human animal can attribute mental states to others remains the subject of extensive debate. This despite the fact that several species have behaved as if they have a ‘theory of mind’ in various behavioral tasks. In this paper, we review the reasons of skeptics for their doubts: That existing experimental setups cannot distinguish between ‘mind readers’ and ‘behavior readers’, that results that seem to indicate ‘theory of mind’ may come from studies that are insufficiently controlled, and that our (...) own intuitive biases may lead us to interpret behavior more ‘cognitively’ than is necessary. The merits of each claim and suggested solution are weighed. The conclusion is that while it is true that existing setups cannot conclusively demonstrate ‘theory of mind’ in non-human animals, focusing on this fact is unlikely to be productive. Instead, the more interesting question is how sophisticated their social reasoning can be, whether it is about ‘unobservable inner experiences’ or not. Therefore, it is important to address concerns about the setup and interpretation of specific experiments. To alleviate the impact of intuitive biases, various strategies have been proposed in the literature. These include a deeper understanding of associative learning, a better knowledge of the limited ‘theory of mind’ humans actually use, and thinking of animal cognition in an embodied, embedded way; that is, being aware that constraints outside of the brain, and outside of the body, may naturally predispose individuals to produce behavior that looks smart without requiring complex cognition. To enable this kind of thinking, a powerful methodological tool is advocated: Computational modeling, namely agent-based modeling and, particularly, cognitive modeling. By explicitly simulating the rules and representations that underlie animal performance on specific tasks, it becomes much easier to look past one’s own biases and to see what cognitive processes might actually be occurring. (shrink)

The association between online Flow and Internet Gaming Disorder (IGD) has attracted significant attention. Despite the consensus that online Flow plays a pivotal role in the development of IGD and other Internet addictive behaviours, there has been a lack of consistency in measurement scales used to assess online Flow. Even widely used measures of online Flow have not been psychometrically assessed across culturally diverse populations of gamers. Such an assessment would enhance the accuracy of cross-cultural comparisons regarding the association between (...) online Flow and IGD. Attending to this need, the present study assessed the psychometric properties of the binary coded (i.e. Yes, No) Online Flow Questionnaire (OFQ), while concurrently taking into consideration country, age, language, and mode of data collection (online or face-to-face) differences. Two sequences of successive multiple group confirmatory factor analyses were used to assess the psychometric properties of the OFQ, between: a) emergent adults from the United States of America (N = 482, Mage = 25.23, SD = 2.746) and Australia (N = 168, Mage = 23.55, SD = 3.37) and b) adolescents from Greece (N = 1579, Mage = 16.12, SD =.849) and Cyprus (N = 1372, Mage = 15.54, SD =.656). Configural and partial metric invariance were confirmed between the USA and Australian samples. For the Greek and Cypriot samples, results indicated full configural and metric invariance. These results provide initial information to researchers and clinicians of the extent to which the OFQ maintains its consistency when used across cultures and invite for further cross-cultural studies in the field. Implications, as well as limitations, are discussed. (shrink)

In “The Bioethics of Environmental Injustice,” Ray and Cooper (2024) lay out compelling arguments to increase attention to environmental health within bioethics. Advocacy is crucial, they argue, co...

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)

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 received wisdom in statistical mechanics is that isolated systems, when left to themselves, approach equilibrium. But under what circumstances does an equilibrium state exist and an approach to equilibrium take place? In this paper we address these questions from the vantage point of the long-run fraction of time definition of Boltzmannian equilibrium that we developed in two recent papers. After a short summary of Boltzmannian statistical mechanics and our definition of equilibrium, we state an existence theorem which provides general (...) criteria for the existence of an equilibrium state. We first illustrate how the theorem works with a toy example, which allows us to illustrate the various elements of the theorem in a simple setting. After a look at the ergodic programme, we discuss equilibria in a number of different gas systems: the ideal gas, the dilute gas, the Kac gas, the stadium gas, the mushroom gas and the multi-mushroom gas. In the conclusion we briefly summarise the main points and highlight open questions. (shrink)

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)

In his recent work, Providence and Prayer, Terrance Tiessen considers a variety of views on divine providence ranging from those in which God’s sovereignty is a risky business to so-called no-risk views. Tiessen tentatively settles on a no-risk view he dubs ‘A Middle Knowledge Calvinist Model of Providence.’ I argue that, given a compatibilist account of free will, an essential feature of Calvinism, there is no room for the threefold distinction between God’s natural, middle, and free knowledge. The knowledge a (...) Calvinist God possesses must be entirely free knowledge or entirely natural knowledge. (shrink)

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)

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

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)

The article examines the construction of “Big Data” in media discourse. Rather than asking what Big Data really is or is not, it deals with the discursive work that goes into making Big Data a socially relevant phenomenon and problem in the first place. It starts from the idea that in modern societies the public understanding of technology is largely driven by a media-based discourse, which is a key arena for circulating collectively shared meanings. This largely ignored dimension invites us (...) to appreciate what matters to journalists and the wider public when discussing the collection and use of data. To this end, our study looks at how Big Data is framed in terms of the governmental use of large datasets as a contentious area of data application. It reconstructs the perspectives surrounding the so-called “Handygate” affair in Germany based on broadcast news and social media conversations. In this incident, state authorities collected and analyzed mobile phone data through a radio cell query during events to commemorate the Dresden bombing in February 2011. We employ a qualitative discourse analysis that allows us to reconstruct the conceptualizations of Big Data as a proper instrument for criminal prosecution or an unjustified infringement of constitutional rights. (shrink)

* INTRODUCTION This book seeks to add dimension to our understanding of Greek Skepticism by concentrating attention on a particular area that is of ...

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.

In the development of governmental policy for artificial intelligence that is informed by ethics, one avenue currently pursued is that of drawing on “AI Ethics Principles”. However, these AI Ethics Principles often fail to be actioned in governmental policy. This paper proposes a novel framework for the development of ‘Actionable Principles for AI’. The approach acknowledges the relevance of AI Ethics Principles and homes in on methodological elements to increase their practical implementability in policy processes. As a case study, elements (...) are extracted from the development process of the Ethics Guidelines for Trustworthy AI of the European Commission’s “High Level Expert Group on AI”. Subsequently, these elements are expanded on and evaluated in light of their ability to contribute to a prototype framework for the development of 'Actionable Principles for AI'. The paper proposes the following three propositions for the formation of such a prototype framework: preliminary landscape assessments; multi-stakeholder participation and cross-sectoral feedback; and, mechanisms to support implementation and operationalizability. (shrink)

A common observation in placebo studies is that definitional disagreement is rife. Philosopher and historian of science Robin Nunn recently argued that "Nobody who came and saw the placebo has conquered its definition". Nunn insists that "the placebo construct conceals more than it clarifies," and that we need to prepare for "a post-placebo paradigm". Pronouncements that disagreement is endemic are often the prologue for new definitions of placebo and "placebo effect": for example, in the opening of a recent philosophical paper (...) on the issue, Jeremy Howick observed that debates about placebos "rage," and that "there is currently no widely accepted definition of the 'placebo'".... (shrink)

From the beginning of chaos research until today, the unpredictability of chaos has been a central theme. It is widely believed and claimed by philosophers, mathematicians and physicists alike that chaos has a new implication for unpredictability, meaning that chaotic systems are unpredictable in a way that other deterministic systems are not. Hence, one might expect that the question ‘What are the new implications of chaos for unpredictability?’ has already been answered in a satisfactory way. However, this is not the (...) case. I will critically evaluate the existing answers and argue that they do not fit the bill. Then I will approach this question by showing that chaos can be defined via mixing, which has never before been explicitly argued for. Based on this insight, I will propose that the sought-after new implication of chaos for unpredictability is the following: for predicting any event, all sufficiently past events are approximately probabilistically irrelevant. (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)

Leadership plays an essential part in creating competitive advantage and well-being among employees. One way in which formal leaders can deal with the variety of responsibilities that comes with their role is to share their responsibilities with team members (i.e., shared leadership). Although there is abundant literature on how high-quality peer leadership benefits team effectiveness (TE) and well-being, there is only limited evidence about the underpinning mechanisms of these relationships and how the formal leader can support this process. To address (...) this lacuna, we conducted an online survey study with 146 employees from various organizations. The results suggest that an empowering leadership style of the formal leader is associated with higher perceived peer leadership quality (PLQ) on four different leadership roles (i.e., task, motivational, social, and external leader). In addition, formal leaders who empower their team members are also perceived as better leaders themselves. Moreover, the improved PLQ was in turn positively related to TE and work satisfaction, while being negatively related to burnout. In line with the social identity approach, we found that team identification mediated these relationships. Thus, high-quality peer leaders succeeded in creating a shared sense of “us” in the team, and this team identification in turn generated all the positive outcomes. To conclude, by sharing their lead and empowering the peer leaders in their team, formal leaders are key drivers of the team’s effectiveness, while also enhancing team members’ health and well-being. (shrink)

In pluralist societies, stakeholders in healthcare may have different experiences of and moral perspectives on health, well-being, and good care. Increasing cultural, religious, sexual, and gender diversity among both patients and healthcare professionals requires healthcare organizations to address these differences. Addressing diversity, however, comes with inherent moral challenges; for example, regarding how to deal with healthcare disparities between minoritized and majoritized patients or how to accommodate different healthcare needs and values. Diversity statements are an important strategy for healthcare organizations to (...) define their normative ideas with respect to diversity and to establish a point of departure for concrete diversity approaches. We argue that healthcare organizations ought to develop diversity statements in a participatory and inclusive way in order to promote social justice. Furthermore, we maintain that clinical ethicists can support healthcare organizations in developing diversity statements in a more participatory way by fostering reflective dialogues through clinical ethics support. We will use a case example from our own practice to explore what such a developmental process may look like. We will critically reflect on the procedural strengths and challenges as well as on the role of the clinical ethicist in this example. (shrink)

Patients have to be respected with dignity as the masters of their own lives. The problem, however, is that autonomy may become so dominant and the fundamental value of caring in professional nursing that the patient’s dignity is affected. The aim of this article is to point out some of the issues with the interplay between autonomy, also called self-management and dignity. Given voice to the patient perspective the background is provided by cases from research conducted through qualitative interviews with (...) patients and expanded by summarizing empirical research concerning the interplay between autonomy and dignity. The search strategy and the research question gave five empirical research papers and three theoretical studies and concept analyses. A concise overview of the relevant research contains information about all the major elements of the studies. The background research and an interpretative summary address new issues to be taken into account in dignity conserving care. (shrink)

InThe Second Sex, Simone de Beauvoir argues that women are often complicit in reinforcing their own unfreedom. But why women become complicit remains an open question. The aim of this article is to offer a systematic analysis of complicity by focusing on the Heideggerian strands of Beauvoir's account. I begin by evaluating Susan James's interpretation of complicity qua republican freedom, which emphasizes the dependent situation of women as the primary cause of their complicity. I argue that James's analysis is compelling (...) as far as it goes, but that it implies complicity is the inevitable outcome of women's current existence and fails to adequately account for Beauvoir's claim that women actively embrace their own unfreedom. I then draw out the Heideggerian strands of Beauvoir's analysis, demonstrating how this enables us to systematize Beauvoir's account of women's oppressive situation with her claims regarding the active role women can play in reinforcing their own unfreedom. I argue that this approach preserves the strengths of the republican interpretation, but provides a better account of cases where complicity may not be inevitable and yet some women still act to reinforce rather than resist their own unfreedom. (shrink)