During the last two decades there has been an enormous development in treatment possibilities in the field of neonatology, particularly for (extremely) premature infants. Although there are cross-cultural differences in treatment strategy, an overview of the literature suggests that every country is confronted with moral dilemmas in this area. These concern decisions to initiate or withhold treatment directly at birth and, later on, decisions to withdraw treatment with the possible consequence that the child will die. Given that the neonate cannot (...) express his or her own will, who will decide? And on the basis of what information, values and norms? We explored some of these issues in daily practice by interviewing a small sample of health care practitioners in a Dutch university Neonatal Intensive Care Unit (NICU). It turned out that experiencing moral dilemmas is part of their daily functioning. Nurses underline the suffering of the newborn, whereas physicians stress uncertainty in treatment outcome. To make the best of it, nurses focus on their caring task, whereas physicians hope that future follow-up research will lead to more predictable outcomes. As for their own offspring, part of these professionals would hesitate to bring their own extremely premature newborn to a NICU. For the most oppressing dilemma reported – terminating an already initiated treatment – we propose the concept of ‘evidence shift’ to clarify the ambiguous position of uncertainty in decision making. (shrink)

During the last two decades there has been an enormous development in treatment possibilities in the field of neonatology, particularly for (extremely) premature infants. Although there are cross-cultural differences in treatment strategy, an overview of the literature suggests that every country is confronted with moral dilemmas in this area. These concern decisions to initiate or withhold treatment directly at birth and, later on, decisions to withdraw treatment with the possible consequence that the child will die. Given that the neonate cannot (...) express his or her own will, who will decide? And on the basis of what information, values and norms? We explored some of these issues in daily practice by interviewing a small sample of health care practitioners in a Dutch university Neonatal Intensive Care Unit (NICU). It turned out that experiencing moral dilemmas is part of their daily functioning. Nurses underline the suffering of the newborn, whereas physicians stress uncertainty in treatment outcome. To make the best of it, nurses focus on their caring task, whereas physicians hope that future follow-up research will lead to more predictable outcomes. As for their own offspring, part of these professionals would hesitate to bring their own extremely premature newborn to a NICU. For the most oppressing dilemma reported – terminating an already initiated treatment – we propose the concept of ‘evidence shift’ to clarify the ambiguous position of uncertainty in decision making. (shrink)

Max van Manen offers an extensive exploration of phenomenological traditions and methods for the human sciences. It is his first comprehensive statement of phenomenological thought and research in over a decade. Phenomenology of practice refers to the meaning and practice of phenomenology in professional contexts such as psychology, education, and health care, as well as to the practice of phenomenological methods in contexts of everyday living. Van Manen presents a detailed description of key phenomenological ideas as they have (...) evolved over the past century; he then thoughtfully works through the methodological issues of phenomenological reflection, empirical methods, and writing that a phenomenology of practice offers to the researcher. Van Manen’s comprehensive work will be of great interest to all concerned with the interrelationship between being and acting in human sciences research and in everyday life. (shrink)

One hundred and ninety participants (95 undergraduates and 95 employees) responded to a factorial survey in which a number of case-based organizational allocation tasks were described. Participants were asked to imagine themselves as employees in fictitious organizations and chose among three allocations of employee development schemes invested by the manager in different work groups. The allocations regarded how such investments should be allocated between two parties. Participants chose twice, once picking the fairest and once the best allocation. One between-subjects factor (...) varied whether the parties represented social (i.e., choosing among allocations between two different work groups) or temporal comparisons (i.e., choosing among allocations between the present and the following year). Another between-subjects factor varied whether participants’ in-group was represented by the parties or not. One allocation maximized the outcome to one party, another maximized the joint outcome received by both parties, and a third provided both parties with equal but lower outcomes. It was predicted that equality, although always deficient to both parties, would be the preferred allocation when parties represented social comparisons and when choices were based on fairness. When parties represented temporal comparisons, and when choices were based on preference, maximizing the joint outcome was hypothesized to be the preferred allocation. Results supported these hypotheses. Against what was predicted, whether the in-group was represented by the parties or not did not moderate the results, indicating that participants’ allocation preferences were not affected by self-interest. The main message is that people make sensible distinctions between what they prefer and what they regard as fair. The results were the same for participating students who imagined themselves as being employees and participants who were true employees, suggesting that no serious threats to external validity are committed when university students are used as participants. (shrink)

Spasticity and muscle weakness is common in children with cerebral palsy (CP). Spasticity can be treated with Botulinum Neurotoxin-A (BoNT-A), but this drug has also been reported to induce muscle weakness. Our purpose was to describe the effect on muscle strength in the lower extremities after BoNT-A injections in children with cerebral palsy. A secondary aim was to relate the effect of BoNT-A to gait pattern and range of motion. Twenty children with spastic cerebral palsy were included in the study, (...) eight girls and 12 boys (mean age 7.7 years). All were able to walk without support, but with increased muscle tone interfering with motor function and gait pattern. Sixteen children had unilateral spastic CP and four bilateral spastic CP. Twenty-four legs received injections with BoNT-A in the plantar flexor muscles. The children were tested before treatment, around six weeks after at the peak effect of BoNT-A, and at six months after treatment, with measurement of muscle strength, gait analysis and range of motion. There were no differences in muscle strength in plantar flexors of treated legs at peak effect compared to baseline. Six months after treatment, there was still no change in untreated plantar flexor muscles, but an increasing trend in plantar flexor strength in legs treated with BoNT-A. Parents reported positive effects in all children, graded as: small in three children, moderate in eight, and large in nine children. The gait analysis showed a small improvement in knee extension at initial contact, and there was a small increase in passive range of motion for ankle dorsiflexion. Two children had a period with transient weakness and pain. We found that voluntary force production in plantar flexor muscles did not decrease after BoNT-A, instead there was a trend to increased muscle strength at follow-up. The increase may be explained as an effect of the blocking of involuntary nerve impulses, leading to an opportunity to using and training the muscles with voluntary control. Adequate muscle strength is important for maintaining the ability to walk and knowledge of how a treatment affects muscle strength is useful when selecting interventions. (shrink)

This text gives examples of how a different kind of human experience may be explored, and how the methods used for investigating phenomena may contribute to the process of human understanding.

In this paper we explore the phenomenon of writing online. We ask, ‘Is writing by means of online technologies affected in a manner that differs significantly from the older technologies of pen on paper, typewriter, or even the word processor in an off‐line environment?’ In writing online, the author is engaged in a spatial complexity of physical, temporal, imaginal, and virtual experience: the writing space, the space of the text, cyber space, etc. At times, these may provide a conduit to (...) a writerly understanding of human phenomena. We propose that an examination of the phenomenological features of online writing may contribute to a more pedagogically sensitive understanding of the experiences of online seminars, teaching and learning. (shrink)

Vergelijkend onderzoek naar de theologie van Rosenzweig (1886-1929) en Miskotte (1894-1976).

This chapter discusses different perspectives and trends in social decision making, especially the actual processes used by humans when they make decisions in their everyday lives or in business situations. The chapter uses cognitive psychological techniques to break down these processes and set them in their social context. Most of our decisions are made in a social context and are therefore influenced by other people. If you are at an auction and bidding on a popular item, you will try to (...) guess how long the others will keep in the bidding race. Likewise, when you and another person have to coordinate your decision to win a card game you will also try to think about what the other person know and what s/he will do, so you can adjust your choice. In other words, you are trying to come up with a model of the person and his decision-making process. This involves the capability to think about the thoughts and intentions of others, to put yourself in another person's shoes (perspective taking), and to think recursively about your and another person's over several steps (like in a game of chess). Especially, recursive social reasoning is one of the hallmarks of social decision-making. Whereas observational, competitive and cooperative decision-making can all be seen as trying to maximize the own reward or profit, altruistic decision-making blatantly violates this axiomatic principle of behavioral economics. Yet, altruistic behavior is quite common throughout human society. -/- . (shrink)

Within the mother’s womb, life finds its first stirrings. The womb shelters the fetus, the growing child within. We recognize the existential traces of a wombed existence when a newborn calms in response to being held; when a newborn stills in response to his or her mother’s heartbeat; and, when a newborn startles in the presence of bright light. Yet, how does experiential human life begin within another human being? What are the conditions and paths of becoming for the fetus (...) within the womb? And for the child born early, what “womb” welcomes the premature child in neonatal intensive care? (shrink)

An important problem for decision-makers in society deals with the efficient and equitable allocation of scarce resources to individuals and groups. The significance of this problem is rapidly growing since there is a rising demand for scarce resources all over the world. Such resource dilemmas belong to a conceptually broader class of situations known as social dilemmas. In this type of dilemma, individual choices that appear ‘‘rational’’ often result in suboptimal group outcomes. In this article we study how people make (...) monetary allocation decisions between the community where they live and a neighbouring community, with the aim of finding out to what extent these decisions are subject to biased over-weighting. The manuscript reports four experiments that deal with the way individuals make such allocation decisions when the potential beneficiaries are such communities. The specific goal of these experiments is to gauge the amount of bias in the weights that people assign to the various beneficiaries. Taken together, the results from all the four experiments suggest that making the gain of the neighbouring community prominent to a higher extent de-biases the outcomes (the prominence effect) compared to when own community gain is made prominent. Place identity is discussed as a potentially important factor in this connection. Hence, it may be argued that there seems to be some kind of a pro-self component that is able to explain a large part of the variance observed for the prominence effect. Connections between such a factor and in-group favouritism are discussed. A strength of the study was that these major results appeared to be quite robust when considered as task effects, as the salience of the manipulated context factors in the studies (in terms of reliable main or interaction effects) did not distort them. (shrink)

Examining the ways and extent to which systemic factors affect health outcomes with regard to quality, affordability and access to curative healthcare, this explorative book compares the relative merits of tax-funded Beveridge systems and insurance-based Bismarck systems. The Law and Policy of Healthcare Financing charts and compares healthcare system outcomes throughout 11 countries, from the UK to Colombia. Thematic chapters investigate the economic and legal explanations for the relevant similarities, variations and trends across the globe. Concluding that systemic factors may (...) be less significant than previously believed, this comprehensive book notes that no one system consistently outperforms the others, yet incentives and funding improvements may lift performances across all curative healthcare systems. Analytical and comparative, this book will be of interest to academics working in the fields of health law and health economics. Public authorities including health ministries, policymakers and international health organisations will also find this to be an invaluable resource. (shrink)

Phenomenology of practice is a useful, rigorous way of deeply understanding human phenomena. Therefore, it allows research to be conducted into nursing's most sensitive and decisive aspects. While it is a widely used research approach and methodology in nursing, it is seldom addressed and made use of in its practical and applied value. This article aimed to approach the global outlook of van Manen's hermeneutic‐phenomenological method to better understand its theoretical background and to address and support the contribution this (...) method can make to nursing, if rigorously applied. For a professional discipline like nursing, van Manen's approach is especially interesting because, in addition to contributing to the body of knowledge of nursing, it provides a special kind of knowledge that allows nurses to act in a more reflective manner, and with tact and skill, in certain situations and relationships that arise in their daily practice. A more in‐depth understanding of this research methodology may help nurse‐researchers make good use of it and also harness knowledge derived from this type of research. This comes as a result of assuming that phenomenological texts, the final product of the research, have tremendous educational potential for people who read them carefully. (shrink)

Since its inception, phenomenological philosophy has exerted an influence on empirical science. But what is the best way to practice, use and apply phenomenology in a non‐philosophical context? How deeply rooted in phenomenological philosophy must qualitative research be in order to qualify as phenomenological? How many of the core commitments of phenomenology must it accept? In the following contribution, I will take a closer look at Max van Manen's work. I will argue that van Manen's understanding of and (...) presentation of phenomenology is quite problematic and that his book Phenomenology of Practice rather than amounting to a clear and accessible presentation of the phenomenological method that would make it do‐able to researchers who are not themselves professional philosophers is in fact both abstruse and excessively complicated. I will then turn to nursing, and by taking that as my example, outline a better way to apply and practice phenomenology. (shrink)

본 연구는 20세기 전반기 철학으로서 현상학이 20세기 후반이후 지금까지 질적 연구방법론으로서 현상학으로 변용되는 과정에서 주도적인 역할을 담당했던 판 마넨(M. van Manen) 의 질적 연구방법론인 현상학의 원리와 발전과정을 탐구하고자 한다. 먼저 판 마넨의 질적 연구방법론으로서 현상학의 특성과 변화를 살펴본다. 또한 2017년과 2018년에 판 마넨과 경험과학자 페일리(J. Paley), 스미스(J. A. Smith)가 현상학적 방법론을 두고 벌인 논쟁 그리고 철학자 자하비(D. Zahavi)가 판 마넨의 현상학적 방법론에 대해 가한 비판을 철학적으로 의미있는 논점을 중심으로 검토하면서 전체적으로 세 가지 주요 쟁점 - 현상학적 탐구의 대상, 현상학적 (...) 탐구방법으로서 판단중지와 환원의 여부와 방식, 철학으로서 현상학과 연구방법으로서 현상학의 관계 -을 찾고 그에 대한 논평과 향후 연구방법론과 관련된 과업을 밝혔다. (shrink)

Phenomenology as Qualitative Research: A Critical Analysis of Meaning Attribution has attracted the attention of Max van Manen, who has published a highly critical review article. Anyone reading this article, but unfamiliar with the book, will get a distorted view of what it is about, whom it is addressed to, what it tries to achieve, and how it goes about presenting its arguments. Not mildly distorted, in need of the odd correction here and there, but systematically misrepresented. One problem (...) is that van Manen appears to have an idée fixe which prevents him from recognizing that the book is not about a certain philosophical tradition (known as “phenomenology”), but about a particular type of qualitative research (also known, unfortunately and confusingly, as “phenomenology”). A second idée fixe disposes him to misread an earlier article of mine and (much more seriously) three works by Heidegger. My aim in this article is to describe these two idées fixes, and exhibit their consequences. In doing so, I will examine what van Manen has to say on four crucial topics: meaning, lived experience, empathy, and Heidegger's analysis of boredom in The Fundamental Concepts of Metaphysics. (shrink)

A partir del cuestionamiento de Dan Zahavi respecto de la idoneidad del enfoque fenomenológico empleado por Max van Manen, el artículo pretende mostrar que la obra de este reconocido investigador de origen holandés ofrece un acercamiento al sentido original de la fenomenología. En particular, se plantea que la crítica de Zahavi a la ausencia de alineación del proyecto de Van Manen con las fuentes de la tradición fenomenológica debe ser matizada. Así, en lo que respecta a las obras (...) del investigador holandés que son sometidas a examen crítico por Zahavi, se puede establecer una cercanía con el enfoque fenomenológico-existencial de Martin Heidegger. Para ello, se destacan, en primer lugar, los elementos centrales del carácter fenomenológico que se plasma en estas obras. En segundo lugar, se ofrece un breve acercamiento a las lecciones impartidas por Heidegger en el semestre de 1919-1920. En estas, se expresa un sentido de la investigación fenomenológica que se corresponde con el carácter existencial que puede identificarse en algunas de las obras del investigador holandés, y que mantiene una significativa vigencia en la práctica de la fenomenología como enfoque de la investigación cualitativa. Finalmente, se plantea que la crítica de Zahavi a Van Manen puede comprenderse no solo como el resultado de una preocupación por la idoneidad del enfoque fenomenológico en el contexto de la investigación cualitativa, sino, de modo más básico, que es la expresión de una tensión entre diferentes maneras de apropiarse del ejercicio fenomenológico. (shrink)

On trouve dans l'oeuvre de saint Augustin plusieurs allusions à Sagesse 7:27b: in seipsa manens innouat omnia. Il est évident que la source principale de l'expression manens in se, fréquemment employée par l'évêque africain, est le Livre de la Sagesse. Dans les «Confessions» VII, IX, 14, Augustin affirme que l'origine de cette doctrine se trouve dans le «Libri platonicorum». L'A. montre qu'il a facilement pu extraire cette phrase des «Ennéades» de Plotin, ainsi que l'idée de l'action divine dans le monde (...) malgré le caractère immuable de Dieu. (shrink)

Frontmatter -- Vorrede -- Den manen wakefield's -- TEXT -- Erstes buch -- Zweites buch -- Drittes buch -- Viertes buch -- Fünftes buch -- Sechstes buch -- KOMMENTAR -- Erstes buch -- Zweites buch -- Drittes buch -- Viertes buch -- Fünftes buch -- Sechstes buch.

Background The phenomenon of ‘moral distress’ has continued to be a popular topic for nursing research. However, much of the scholarship has lacked conceptual clarity, and there is debate about what it means to experience moral distress. Moral distress remains an obscure concept to many clinical nurses, especially those outside of North America, and there is a lack of empirical research regarding its impact on nurses in the United Kingdom and its relevance to clinical practice. Research aim To explore the (...) concept of moral distress in nursing both empirically and conceptually. Methodology Feminist interpretive phenomenology was used to explore and analyse the experiences of critical care nurses at two acute care trauma hospitals in the United Kingdom. Empirical data were analysed using Van Manen’s six steps for data analysis. Ethical considerations The study was approved locally by the university ethics review committee and nationally by the Health Research Authority in the United Kingdom. Findings The empirical findings suggest that psychological distress can occur in response to a variety of moral events. The moral events identified as causing psychological distress in the participants’ narratives were moral tension, moral uncertainty, moral constraint, moral conflict and moral dilemmas. Discussion We suggest a new definition of moral distress which captures this broader range of moral events as legitimate causes of distress. We also suggest that moral distress can be sub-categroised according to the source of distress, for example, ‘moral-uncertainty distress’. We argue that this could aid in the development of interventions which attempt to address and mitigate moral distress. Conclusion The empirical findings support the notion that narrow conceptions of moral distress fail to capture the real-life experiences of this group of critical care nurses. If these experiences resonate with other nurses and healthcare professionals, then it is likely that the definition needs to be broadened to recognise these experiences as ‘moral distress’. (shrink)

Starting from the practice of hermeneutic phenomenological writing as it has been advanced by van Manen, this paper addresses the understanding of an ‘experiential givenness’ of the world as basis for our ‘lived writing’; an understanding that is essential to the new phenomenological writer if s/he is to be part of the phenomenological writing process. As the ultimate givenness of the world is the basis of knowledge, we constantly strive to “reach out on life beyond itself” (Gadamer, 1960/1985, p. (...) 62), and thus need the right language to let the phenomenological text speak. The phenomenological writer’s understandings of the chiasm of world and self, the depth of phenomenological awareness, and the interlacement of ethic-aesthetical poetic writing, are qualities discussed as essential for the phenomenological writer to understand in a felt–sensed way in order to write a phenomenological text. A deconstructive approach to (pre)reflective phenomenological writing is put forth by provocatively asking what it means to be involved in, and profoundly enclosed with the “wordliness of the world” (Saevi, 2011a, p. 3). The radical hermeneutic phenomenological openness to what it means to be human and how to encounter the human givenness of phenomenological seeing and writing renders it possible for the writer’s personal voice to evolve. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:THE QUEST FOR AN ADEQUATE PROPORTIONALIST THEORY OF VALUE RoNALD H. McKINNEY, S.J. U'IWversity of Scranton Scranton, Pennsylvania EDWARD VACEK shrewdly observes that proportionalism attempts to synthesize the crucial insights of both the teleologist and the deontologist.1 Indeed, Vacek provides a fine summary of this achievement. However, he reflects that the most underdeveloped feature of proportionalism is its value theory by which we are enabled to know how to (...) resolve conflict situations.2 Richard McCormick, among others, has attempted to meet this deficiency by ·adopting John Finnis' notion of associated basic goods. In this essay, I will show how such an ·approach fails to remain true to the basic aims of proportionalism. Nor should this come as a surprise, since Finnis is himself indebted to one of McCormick's archopponents, Germain Grisez. Moreover, I will attempt to outline the elements involved in a non-hierarchfoal theory of value which I will argue to be the only adequate alternative to McCormick 's attempted solution. Deontologists argue that certain acts are right or wrong regardless of the ·consequences. Proportionalists, however, are opposed to such notions as an " intrinsically evil " act or an "absolute" duty, since they recognize the existence of moral dilemmas. A moral dilemma arises whenever there is a situation in which pre-moral values •are in conflcit, i.e., whatever choice one makes will result in the omission or harm of one or other of the values at stake. According to the proportionl Edward Vacek, "Proportionalism: One View of the Debate," Theological Studies 46/2 (June, 1985), 289. 2 Va.eek, 302. 56 PROPORTIONALIST THEORY OF VALUE 57 alist reformulation of the principle of double effect, the permission or oausrution of ontic evil is not necessarily a moral evil as long as there is a proportionate reason justifying,such an action, e.g., when a father shoots an!intruder threatening to harm his family. McCormick's initial description of the requirements of proportionate reason [s ias follows: "a) a v1alue at least equal to that sacrificed is at 1 stake; b) there is no less harmful way of protecting ithe value here and now; c) the manner of its protection here and now will not undermine it in the long run." 8 McCormick argues that it simply will not do to claim that the ontic evil permitted or caused in a conflict situation is always only indirectly intended.4 For, in many instances, this simply is not true. Moreover, he would argue that to intend an end is not necess1arily to desire it as deontologists suppose. What justifies the ontic evil resulting from such actions, then, is solely the proportionate reason for which it is allowed or caused. There are some obvious criticisms that have been hurled at this proportionalist proposal for resolving conflict situations: I) that it leaves itself open to the practical, if not theoretical, difficulty of weighing different values;!2) that it results in the possibility of many resolutions that could go counter to our normal moral intuitions; 8) that there exists an inherent fallibility in the calcul,ation of long-range consequences; and 4) that this uncertainty might easliy promote an undesirable attitude of skeptical relativism. It is perhaps the onslaught of these and other criticisms which prompted McCormick to adopt Finnis' theory of associated basic goods. Lisa Cahill,argues that this new theory constitutes an "abandonment" of McCormick's prior proposal.5 To understand how this new theory leads to inevitable s Richard McCormick, ".Ambiguity in Moral Choice," Doing Evil To Achieve Good: Moral Choice in Oonfiict Situations, eds. R. McCormick and P. Ramsey (Chicago: Loyola U. Press, 1978), 45. 4 McCormick, 35-38. 5 Lisa Cahill, "Theology, Utilitarianism, and Christian Ethics," Theologica,I Studies 42/4 (Dec., 1981), 618-24. 58 RONALD H. MCKINNEY, S.J. inconsistency for McCormick, we must first examine Finnis' position itself. Finnis' Theory of Basic Goods By "value," Finnis refers to any " general form of good that oan be participated iin or realized in indefinitely many ways on indefinitely many occasions." 6 Basic values, moreover, refer to ·intrinsic goods that are desired for their own sake (NL, 62, 65). They are good not because they are... (shrink)

Albert the Great’s theological and exegetical-biblical works often reshape naturalphilosophical doctrines derived from his earlier Aristotelian paraphrases. Accordingly, Albert’s caveats, distinguishing the treatment of topics in physicis and in theologicis, are not abstract disciplinary borderlines but point out to his Dominican students that he will return to crucial matters of the peripatetic paraphrases, recontextualizing them in later works. This article illustrates such interdisciplinary dynamics by analyzing Albert’s commentary on Gen., 1, 20-23, the fifth day of creation, as discussed in STh., (...) II, xi, 60. Albert questions the seeming asymmetry arising from a single element, water, giving rise to two different outcomes: birds for the sublunar sky and reptiles for the earth. The arguments put forth by opponents and Albert’s solution draw upon earlier natural-philosophical works of his, namely De animalibus, De vegetabilibus, and De sensu et sensatu. Notably, Albert reuses his doctrine of humiditates in living bodies and generative processes (such as humidum seminale, humidum vaporativum, humidum spirans, humidum manens). Additionally, Albert analyzes the processes of subtiliatio and digestio, which transform siccum terreum into the matter required for the formation of animate bodies. (shrink)

Shortly after the publication of The Reflective Practitioner (1983) and the sequel Educating the Reflective Practitioner (1987) ‘reflection-in-action’ became a major concept in teacher education. The concept has, however, been criticised on ontological/epistemological as well as practice oriented accounts (Van Manen, 1995; Newman, 1999; Erlandson, 1995). In this paper I argue that reflection-in-action is a theoretical construction that snatches the interacting, working, and producing bodies from their practices, and consequently, matters of politics, of discipline, of institutional interaction and of (...) the workings of social categories are reduced to matters of thinking. Turning to Foucault (1991) I claim that the doctrine of reflection is interwoven in the logic of discipline. (shrink)

The purpose of this phenomenological study is to describe the experience of enduring marriage in mid-life. The literature reveals a lack of research about contemporary mid-life marriage, reflecting only theoretical pieces and research studies on marital happiness, factors that make a marriage successful, and variables contributing to divorce. Noticeably absent are studies conducted from a phenomenological philosophical perspective. Questioning what enduring marriage involves for individuals in mid-life served to orient the researchers to the meaning of the experience. Seventeen volunteers participated (...) in twenty-six initial and follow-up interviews. Using van Manen's methodological structure of human science research, a composite description that reflects enduring marriage in mid-life emerged. Two essential themes that characterize the experience, The Threads that Bind Us and A Season of Change and seven sub-themes explicating these essential themes portray the partnership of enduring mid-life marriage. The themes that comprise the structure of the experience reflect its form as a relational, time-space, and corporeal phenomenon. The findings are described in detail using narrative description in order to offer a rich account of each theme, and the implications provide a direction for future research. (shrink)

El punto de partida de esta investigación se concentra en el estudio de la crisis de lashumanidades en una economía de mercado hegemónica, movida por el lucro y la explotación. Enel proyecto del que se deriva este artículo y que tiene la fenomenología hermenéutica como enfoquemetodológico, conforme lo presentó Max van Manen (2016), se muestra el alcance y el aporte de una ética contemporánea frente a estos dos movimientos; asimismo, desde una lectura crítica de conjunto, las variantes de la (...) formación ética frente a la crisis actual de las humanidades en la que se reduce la persona a sujeto de rendimiento. El artículo se estructura en cuatro partes: primero, se contextualiza la investigación y la publicación misma; segundo, se detalla el proceso metodológico;tercero, se muestra brevemente el estado de la cuestión; y cuarto, se precisa el sedimento teóricocon variantes que integran la respuesta a la pregunta problema del proyecto, esto es: fundamentarla importancia de atender a la temporalidad como un problema ético sustantivo; la necesidad dedeconstruir la libertad como estrategia neoliberal de control; el sentido de desinstrumentalizar las emociones; y, la necesidad de cultivar la capacidad de indignarse y de promover una vidacontemplativa como prácticas experienciales del mundo de la vida. (shrink)

In recent years there has been a notable increase in the use of phenomenology as a research method, particularly in educational research. With the rise of phenomenology as a research method, confusion has also arisen concerning what counts as phenomenology, and how best to practice phenomenological research in non-philosophical contexts. Consequently, this article will be concerned with three issues: firstly, to contextualise the debate, I provide a brief overview of three popular and influential approaches to phenomenology as a research method: (...) (1) Giorgi’s descriptive phenomenological method; (2) van Manen’s hermeneutic phenomenology; and, (3) Smith’s interpretative phenomenological analysis; secondly, for the sake of conceptual clarity, I then turn my attention to a critical discussion of these approaches and argue that these approaches tend to converge phenomenology into either a descriptive or interpretative focus that essentially transforms phenomenology into a kind of solipsist subjectivism; and, lastly, to progress the debate forward, I argue that it makes sense to look beyond the qualitative or educational research literature to successful applications of phenomenology in non-philosophical contexts because there are plenty of relevant resources that can offer significant theoretical and methodological support to researchers. (shrink)

Ethical decision making is a complex issue because it strongly depends on the religion, beliefs, traditional laws and moral views of each society. The purpose of this study was to explore the experience of Iranian family caregivers of end stage cancer patients about ethical decision making. This qualitative study is based on van Manen’s method of hermeneutic phenomenology. In-depth interviews were carried out to collect data. Participants were 12 caregiver. Audiotapes were transcribed and analyzed for common themes that represented (...) the participants’ experiences. Trustworthiness of the findings was established using the Lincoln and Guba’s criteria. Three themes reflected the essence of caregivers’ lived experience including; fluctuating between hope and despair, wandering dilemma, and ethical decision making. Each of these themes consisted of several subthemes. The present study revealed that, the caregivers of terminally ill cancer patients need different information about prognosis and end of life decision making process. Our perception of how families negotiate ethical issues in their decision-making is still developing. Opportunities should be created to empowering caregivers to talk about their uncertainties and concerns. (shrink)

In this text, I explore the phenomenon of moral disquiet as an existential phenomenon with its invariant qualities. This intention makes the paper both methodological and educational. The reason I consider it worthwhile to explore moral disquiet and distinguish this phenomenon from other phenomena is twofold. First, I want to establish a reliable phenomenological research basis and an argument for moral disquiet as an educationally relevant quality. Second, as an educationally relevant quality, moral disquiet must imply phenomenological clarity to avoid (...) confusion with other phenomena that are similar but not the same. I start by exploring the two words ‘moral’ and ‘disquiet’ that constitute the phenomenon 'moral disquiet’. I explore the word disquiet in relation to three related phenomena: fear, distress, and critique. Then I investigate the connection between moral disquiet and tact as presented by van Manen. Finally, I bring in methodological and epistemological arguments to try to substantiate what I have been doing and why the phenomenon of ‘moral disquiet’ is a highly significant educational issue. (shrink)

Reflection has been proclaimed as a means to help physicians deal with medicine’s inherent complexity and remedy many of the shortcomings of medical education. Yet, there is little agreement on the nature of reflection nor on how it should be taught and practiced. Emerging neuroscientific concepts suggest that human thought processes are largely nonconscious, in part inaccessible to introspection. Our knowledge of the world is fraught with uncertainty, ignorance and indeterminacy, and influenced by emotion, biases and illusions, including the illusion (...) of not having illusions. Neuroscience also documents that lifelong learning processes may hone nonconscious cognition to high levels of sophistication, allowing rapid and precise perceptions, judgments and actions in complex situations. We argue that knowledge of mechanisms underlying human thought may be useful in designing educational programs to foster desired attributes such as curiosity, critical self-awareness and intuitive acumen in medical professionals. The juxtaposition of neuroscientific insights with ideas from Kant on reflective judgement, van Manen on tact, and Aristotle on phronésis, supports a concept of reflection that manifests as wise practice. We suggest that reflection in medical education should be an imperative for educators seeking to guide learners to manage the complexity and “messiness” of medical practice, and a role-modelling mode of medical practice characterized by self-correcting behaviors that culminate in good and right professional actions. An example illustrates reflective practice in the teaching and learning of physicianship. (shrink)

During preparation for early abortion in Norway, an ultrasound examination is usually performed to determine gestation and viability. This article aims to provide a deeper understanding of women’s and health care personnel’s (HCP) experiences with ultrasound viewing during abortion preparation in the first trimester. Qualitative in-depth interviews with women who had been prepared for early abortion and focus group interviews with HCP from gynaecological units were carried out. A hermeneutic-phenomenological analysis, inspired by van Manen, was chosen. Thirteen women who (...) were pregnant and considering abortion in their first trimester and 20 HCP, namely, 19 registered nurses and one medical doctor, were recruited from gynaecological units at six hospitals. The study was approved by the ethics committee (2014/1276). The essential meaning structure of ‘autonomy under pressure’ consisted of two themes that expressed the different experiences of both the women and the HCP, namely, expectations versus precautions and choice versus protection. The women and HCP expressed different attitudes before the consultation that affected their experiences of the ultrasound examination. While the women had expectations of a clarification based on their choice to either see or not see the ultrasound image, HCP seemed to be more concerned with predetermined rules that they believed would protect the women. Consequently, the basis for dialogue was not optimal, and women’s autonomy was under pressure. Health care personnel are ethically challenged during preabortion ultrasound examinations. Meeting the individual woman’s needs and respecting her autonomy during preparation for abortion requires sensitivity, involvement, and dialogue skills by health personnel. According to the woman’s desire to be informed about the possibility of viewing the image during the abortion preparations, a dialogue that is focused in this direction should arise before the examination. (shrink)