This study describes the theoretical assumptions and the application for health‐promoting conversations, as a communication tool for nurses when talking to patients and their families. The conversations can be used on a promotional, preventive and healing level when working with family‐focused nursing. They are based on a multiverse, salutogenetic, relational and reflecting approach, and acknowledge each person's experience as equally valid, and focus on families’ resources, and the relationship between the family and its environment. By posing reflective questions, reflection is (...) made possible for both the family and the nurses. Family members are invited to tell their story, and they can listen to and learn from each other. Nurses are challenged to build a co‐creating partnership with families in order to acknowledge them as experts on how to lead their lives and to use their own expert knowledge in order to facilitate new meanings to surface. In this way, family health can be enhanced. (shrink)

The Perceptions of Conscience Questionnaire (PCQ) and the Stress of Conscience Questionnaire (SCQ) have previously been developed and validated within the ‘Stress of Conscience Study’. The aim was to revalidate these two questionnaires, including two additional, theoretically and empirically significant items, on a sample of healthcare personnel working in direct contact with patients. The sample consisted of 503 healthcare personnel. To test variation and distribution among the answers, descriptive statistics, item analysis and principal component analysis (PCA) were used to examine (...) the underlying factor structure of the questionnaires. Support for adding the new item to the PCQ was found. No support was found for adding the new item to the SCQ. Both questionnaires can be regarded as valid for Swedish settings but can be improved by rephrasing some of the PCQ items and by adding items about private life to the SCQ. (shrink)

The aim of this observational longitudinal cohort study was to describe relationships over time between degrees of stress of conscience, perceptions of conscience, burnout scores and assessments of person-centred climate and social support among healthcare personnel working in municipal care of older people. This study was performed among registered nurses and nurse assistants (n = 488). Data were collected on two occasions. Results show that perceiving one’s conscience as a burden, having feelings of emotional exhaustion and depersonalization and noticing disturbing (...) conflicts between co-workers were positively associated with stress of conscience. No significant changes were observed during the year under study, but degrees of stress of conscience and burnout scores were higher than in previous studies, suggesting that downsizing and increased workloads can negatively affect healthcare personnel. Following and expressing one’s conscience in one’s work, and perceiving social support from superiors are of importance in buffering the effects of stress of conscience. (shrink)

Background: Nurses and physicians in nephrology settings provide care for patients with end-stage kidney disease receiving hemodialysis treatment along a complex illness trajectory. Aim: The aim was to explore physicians’ and nurses’ perspectives on the trajectories toward the end of life involving decisions regarding hemodialysis withdrawal for patients with end-stage kidney disease. Research design and participants: A qualitative research approach was used. Four mixed focus group interviews were conducted with renal physicians (5) and nurses (17) in Sweden. Qualitative content analysis (...) was used to analyse data. Ethical considerations: Ethical approval was obtained (Dnr 2014/304-31). Findings and discussion: Findings illuminated multi-faceted, intertwined processes encompassing healthcare professionals, patients, and family members. The analysis resulted in four themes: Complexities of initiating end-of-life conversations, Genuine attentiveness to the patient’s decision-making process, The challenge awaiting the family members’ processes, and Negotiating different professional responsibilities. Findings showed complexities and challenges when striving to provide good, ethical care which are related to beneficence, nonmaleficence, and self-determination, and which can give rise to moral distress. Conclusion: There are ethical challenges and strains in the dialysis context that healthcare professionals may not always be prepared for. Supporting healthcare professionals in not allowing complexities to hinder the patient’s possibilities for shared decision-making seems important. An open and continual communication, including family meetings, from dialysis initiation could serve to make conversations involving decisions about hemodialysis withdrawal a more natural routine, as well as build up a relationship of trust necessary for the advance care planning about the end of life. Healthcare professionals should also receive support in ethical reasoning to meet these challenges and handle potential moral distress in the dialysis context. (shrink)

The patient’s home is a common setting for palliative care. This means that we need to understand current palliative care philosophy and how its goals can be realized in home‐care nursing encounters (HCNEs) between the nurse, patient and patient’s relatives. The existing research on this topic describes both a negative and a positive perspective. There has, however, been a reliance on interview and descriptive methods in this context. The aim of this study was to explore planned HCNEs in palliative care. (...) The design was a multiple case study based on observations. The analysis includes a descriptive and an explanation building phase. The results show that planned palliative HCNEs can be described as a process of co‐creating possibilities for the patient to reach vital goals through shared knowledge in a warm and caring atmosphere, based on good caring relations. However, in some HCNEs, co‐creation did not occur: Wishes and needs were discouraged or made impossible and vital goals were not reached for the patients or their relatives. Further research is needed to understand why. The co‐creative process presented in this article can be seen as a concretization of the palliative care ideal of working with a person‐centered approach. (shrink)

Troubled conscience may jeopardize the health of healthcare personnel and, hence, the quality of care provided. Learning more about how personnel deal with their troubled conscience therefore seems important. The aim of this study was to describe personnel’s experiences of how they deal with troubled conscience generated in their daily work in municipal care of older people. Interviews were conducted with 20 care providers and analysed with a thematic content analysis. The findings show that in order to deal with troubled (...) conscience, personnel dialogued with themselves and with others. They took measures in a direction they perceived to be correct, and they expressed a need for distancing and re-energizing. It is of importance to share situations that generate troubled conscience in order to find ways to deal with them. Reconsidering one’s ways of dealing with troubled conscience may give care providers an opportunity to reach consensus within themselves. (shrink)

With regard to current debates on the ethical implementation of AI, especially two demands are linked: the call for explainability and for ultimate human responsibility. In the medical field, both are condensed into the role of one person: It is the physician to whom AI output should be explainable and who should thus bear ultimate responsibility for diagnostic or treatment decisions that are based on such AI output. In this article, we argue that a black box AI indeed creates a (...) rationally irresolvable epistemic situation for the physician involved. Specifically, strange errors that are occasionally made by AI sometimes detach its output from human reasoning. Within this article it is further argued that such an epistemic situation is problematic in the context of ultimate human responsibility. Since said strange errors limit the promises of explainability and the concept of explainability frequently appears irrelevant or insignificant when applied to a diverse set of medical applications, we deem it worthwhile to reconsider the call for ultimate human responsibility. (shrink)

If one of the most important aims of education on military ethics is to strengthen moral competence, we argue that it is important to base ethics education on virtue ethics, the Socratic attitude and the process of ?living learning?. This article illustrates this position by means of the example of a ?train the trainer? course on military ethics for Non-Commissioned Officers (NCOs), which is developed at the Netherlands Defence Academy, and uses a number of examples both from its structure and (...) from experiences from its actual use. (shrink)

The aim of the present paper is to examine the contribution of evaluative conditioning (EC) to attitude formation theory in social psychology. This aim is pursued on two fronts. First, evaluative conditioning is analysed for its relevance to social psychological research. We show that conditioned attitudes can be acquired through simple co‐occurrences of a neutral and a valenced stimulus. Moreover, we argue that conditioned attitudes are not confined to direct contact with a valenced stimulus, but can be formed and dynamically (...) reformed indirectly, through association chains. Second, social research is examined in an effort to identify evaluative learning mechanisms. We suggest that several important phenomena in social psychology (e.g., ingroup favouritism, prejudice, name letter effect) are at least partly due to simple mechanisms of evaluative learning. The implications for attitude formation theory and for applied settings are discussed. (shrink)

Die Entscheidung für oder gegen lebensverlängernde Behandlungsmaßnahmen geht inzwischen der Hälfte aller Todesfälle in Europa voraus. Sie wird im klinischen Alltag häufig als ethische Herausforderung wahrgenommen, zudem sind unter Klinikern juristische Unsicherheiten und Fragen der korrekten Vorgehensweise verbreitet. Die hier vorgestellte Münchner Leitlinie zu Entscheidungen am Lebensende soll rechtliche Unsicherheit reduzieren, Klinikumsmitarbeiter für die ethische Dimension von Therapieentscheidungen am Lebensende sensibilisieren und ethisch begründete Entscheidungen fördern. Aus organisationsethischer Perspektive soll mit der Leitlinie eine Reflexion und Meinungsbildung zu einem ethisch relevanten (...) Themenbereich erfolgen und ein Beitrag zur Qualitätssicherung der Patientenversorgung und damit auch zur Patientenzufriedenheit geleistet werden. Die Prozesse der Leitlinienentwicklung, -aktualisierung und -implementierung werden vorgestellt. Die wesentlichen inhaltlichen Elemente der Leitlinie mit Darstellung der Rechtslage, der Definition zentraler Begriffe und Klärung medizinischer Entscheidungskriterien werden an Hand eines Entscheidungsalgorithmus dargestellt. Inhalt und Prozess der Leitlinienentwicklung werden auf die folgenden organisationsethischen Qualitätskriterien hin überprüft: deliberativer Prozess, inhaltliche Transparenz, repräsentative Zusammensetzung der Arbeitsgruppe, Implementierung und Evaluation der Leitlinie. Institutionen, die diese Leitlinie übernehmen wollen, sollten diese von einem autorisierten Gremium überprüfen lassen und auf die spezifischen Bedürfnisse ihrer Institution adaptieren. Hierfür ist eine vorgeschaltete Bedarfserhebung hilfreich. In dem Gremium sollten all diejenigen vertreten sein, die in der Folge mit der Leitlinie arbeiten werden. (shrink)

Nietzsche's notion of the Übermensch is one of his most famous. While he himself never defined or explained what he meant by it, many philosophical interpretations have been offered in secondary literature. None of these, however, has examined the significance of the notion for Nietzsche the man, and this essay therefore attempts to address this gap.The idea of the Übermensch occurred to Nietzsche rather suddenly in the winter of 1882-1883, when his life was in turmoil after yet another deep personal (...) setback. The early loss of his father had deprived Nietzsche of a meaningful “mirroring” and a chance to experience realistic, age appropriate disappointment. This left him with a lifelong tendency towards idealisation. It became his proverbial Achilles’ heel and the source of repeated disillusionments and sorrow. The Übermensch may thus have been a culmination of his impulse to create altars and worlds before which he could kneel. Trying to cope with his own vulnerability, Nietzsche evoked an ideal of the Übermensch, a mask of hardness that was designed, if unconsciously, to ward off any future assaults on his fragile self.The double aspect of Nietzsche's personality is explored in this essay. While a highly provocative, belligerent and uncompromising Nietzsche often emerges from his published works, a vulnerable, lonely and sometimes self-pitying Nietzsche lurks in his letters and the accounts of his friends and acquaintances. But could an “ideal of strength”, such as the Übermensch, serve as a protective mask for someone with a sensitive, passionate interior? Nietzsche's descent into madness would suggest that no ideal can be a substitute for human, all too human, compassion. (shrink)

In his article, Bester (2018) criticizes the so-called “harm consensus” movement among a growing number of bioethicists and practitioners. He argues that the harm principle is unable to replace the...

Although consolation is one of the classic religious subjects it plays no role in the current debate about religious emotions. One reason for this neglect could be that this debate is mostly based on classical emotions such as joy and fear, love and hope, and that consolation is not understood as an emotion. This paper tries to show that consolation in fact can and should be seen as an emotion. After naming and refuting some reasons that speak against taking consolation (...) to be an emotion, I will explain how consolation can be positively conceptualized as an emotion within a recent theory of emotions. It will be decisive to see that the experience of consolation can be understood not only hedonistically-qualitatively, but also intentionally. This structural conception allows for a differentiated description of various types of consolation as an emotion, also, in the tradition of William James, of a secular as well as a religious form of consolation. (shrink)

Based on a unique data set on US direct microloans, we study the funding determinants of interest-free peer-to-peer crowdlending aimed at borrowers in the US. By performing logistic regressions on funding success and Tobit regressions on the reversed funding time, the existence of a social underwriting by a third-party trustee and information in the description texts fostering the investors’ trust are shown to be the main predictors of successful funding. Regarding social impact, the possibility to empower women and groups of (...) borrowers appeals to the investors, whereas empowerment of the family or community beyond the borrowers themselves appears to remain unappreciated. When examining the vulnerability of the borrowers as a predictor, the results manifest differences amongst the attitudes of the investors towards social impact. In the subsample of non-endorsed loans, the investors appear to prefer to support borrowers with an immigration background. In contrast, this is not the case with endorsed loans. (shrink)

As a metaphysical theory, radical ontic structural realism is characterised mainly in terms of the ontological primacy it places on relations and structures, as opposed to the individual relata and objects that inhabit these relations/structures. The most popular criticism of ROSR is that its central thesis is incoherent. Bain attempts to address this criticism by arguing that the mathematical language of category theory allows for a coherent articulation of ROSR’s key thesis. Subsequently, Wüthrich and Lam and Lal and Teh have (...) criticised Bain’s arguments and claimed that category theory fares no better than set theory in coherently articulating the main ideas of ROSR. In this paper, we defend Bain’s main arguments against these critiques, and attempt to elaborate on the sense in which category theory can be seen as providing a coherent articulation of ROSR. We also consider the relationship between ROSR and Categorical Quantum Mechanics. (shrink)

The author investigates the notion of linguistic meaning in gender research. She approaches this basic problem by drawing upon two very different conceptions of language and meaning: that of the logician Gottlob Frege and that of the linguist Ferdinand de Saussure. Motivated by the controversial response the Anglo-American sex/gender debate received within the German context, the author focuses on the connection between this epistemological controversy among feminists and two discursive traditions of linguistic meaning , to show how philosophy of language (...) can contribute to current feminist debates. (shrink)

Cet article dresse, à partir de correspondances et de documents inédits déposés à Jérusalem aux Archives centrales sionistes, un portrait d'Émile Meyerson ( 1859-1933), essentiellement du point de vue de l'homme. C'est ainsi qu'apparaissent son environnement familial (à Lublin), sa formation universitaire (en Allemagne) et son parcours professionnel (installé en France, il travaille dans l'industrie chimique, avant d'occuper un poste dans la presse, puis de diriger un secteur important à la Jewish Colonization Association). Sont également évoquées ses relations avec le (...) milieu intellectuel français et international, où il côtoie tant les savants que les hommes de lettres. (shrink)

The way in which philosophers have thought about the scientific method and the nature of good scientific reasoning over the last few centuries has been consistently and heavily influenced by the examples set by physics. The astounding achievements of 19th and 20th century physics demonstrated that physicists had successfully identified methodologies and reasoning patterns that were uniquely well suited to discovering fundamental truths about the natural world. Inspired by this success, generations of philosophers set themselves the goal of taxonomising, codifying, (...) formalising and evaluating these reasoning patterns. Many will concede that this has been a tremendously fruitful exercise that has served both to illuminate characteristic methodological and epistemological features of the physical sciences, and to inform the way that philosophers think about the epistemic ideals served by science more generally. However, as has been widely noted, the great challenges confronted by contemporary physics have led to a number of fundamental shifts in the way that physicists formulate, assess and apply their theories of the physical world. The most prominent examples of this trend occur in the realm of theoretical high energy physics, where many of the most influential theories advocated by physicists lie beyond the reach of extant experimental methods, and are therefore extremely difficult to test empirically. The fact that whole communities of physicists have devoted so much time and effort to evaluating theories that are largely disconnected from experiments and empirical testing suggests that existing philosophical accounts of the epistemology of physics, based as they are on a broadly empiricist conception of physics, are no longer completely apt, or are at least somewhat out of date. This in turn suggests that it is time for philosophers to redirect their attention towards the characteristic reasoning strategies at play in contemporary physics. As well as clarifying the epistemic structure of 21st century physics and providing new stimulation for general debates surrounding the epistemology of science, this will also allow more philosophers to confront and engage with the existential methodological debates currently raging within physics. There is currently intense and wide spread disagreement surrounding what kinds of reasoning strategies can legitimately be employed in the assessment of competing physical theories and research programs. This special issue aims to facilitate the further engagement of philosophers in this crucial debate by collecting eight contributions that both highlight the deep philosophical issues at stake in debates surrounding the proper methodology for theory assessment in physics, and present novel philosophical perspectives on specific reasoning strategies in the physical sciences. (shrink)

Исследуются подходы в философском осмыслении исторической науки представителей ведущих направлений общественной мысли в России. Для всех, кто интересуется историей русской философии и методологией истории.

Цель данного издания - познакомить широкий круг читателей с основными вехами жизни ученого, организатора, ее научными трудами, литературой о ней.

The “immersion conception” concerned with the virtual reality was discussed and criticised mainly in the 1990's. However, there were anticipations of the impendent creation of the tools for reality simulation and of the following preference of such reality at the expense of “basic” reality. An individual was meant to be shaped by the artificial experience of virtual world. The “immersion conception” has been overcome due to new relationships between humans and computers and by different “augmentation” conceptions corresponding much more to (...) our present condition. Man has never been trapped by an artificial experience coming from living in virtual reality generated by computers. More likely we are trapped by our own constructions of reality. We have always to keep in mind the relativity of the value of the natural experience of basic reality. (shrink)

The main goal of the paper was to obtain insights into how gender measures can be incorporated into quantitative research on risk-related behaviour. We explored relations between the measures (short versions of Bem Sex Role Inventory (BSRI), Personal Attributes Questionnaire (PAQ), and Traditional Masculinity-Femininity (TMF) scale) and their explanatory power in relation to risky behaviours (Decision Outcome Inventory, DOI). The sample consisted of 470 adults (238 men). The corresponding BSRI and PAQ subscales correlated significantly, while TMF correlated positively with the (...) femininity subscales. All the instruments demonstrated good internal consistency and the measures explained a significant portion of risky behaviour. The results suggest that, although sex is a proxy of behaviour, using a measure of the gender-related aspects of identity could enhance understanding of risk-related behaviour. Finally, men and women viewed themselves as equally masculine, indicating that gender stereotypes about desirability of agentic characteristics change. (shrink)

predators stalk their chosen prey, and so forth. The genius of “instinct†comes in abundant variety, and breeds true. “It must be in the genesâ€â€“that’s what we tend to conclude. But when we do, we may be jumping to conclusions, because there are other possibilities: the clever behavior we observe could be the do-it-yourself invention or discovery of the individual behaver or it could be a clever trick copied from an elder member of its species, most likely one of its (...) parents. This last possibility is an ancient doctrine, enshrined in folklore about animal parents sternly but lovingly training their young, and in countless anecdotes, but this appealing idea of animals benefitting from hand-me-down wisdom from earlier generations much the way we do has recently languished in the shadow of the genes, an oversight this book seeks to correct. The folklore is not all fanciful; some of it can be supported by good science, which moreover will open up surprising vistas on the role of individual behavior in evolution. The book is fascinating on at least three levels: first, it provides a vivid and insightful survey.. (shrink)

In den USA haben sich im Wesentlichen drei verschiedene Organisationsformen klinischer Ethikberatung entwickelt: der einzelne Berater, das große Komitee und das Beratungsteam teilweise mit Rückbindung an ein größeres Komitee. Bislang gibt es jedoch weder empirische Daten noch ein Ergebnis der anfänglichen theoretischen Diskussion, ob es ein favorisiertes Modell für die klinische Ethikberatung geben sollte und welches dieses sei. Dieser Artikel argumentiert, dass die Vorzüge, Nachteile und die Erfolgsfaktoren der verschiedenen Organisationsformen in Abhängigkeit von der Zielsetzung klinischer Ethikdienste (KED) bewertet werden (...) müssen. Diese Zielsetzung kann auf einem Spektrum vom „Patientenanwalt“ bis zum „Gewissen der Institution“ angesiedelt sein. Die Zielsetzung bestimmt dabei Aufgabenschwerpunkte, Zusammensetzung, die favorisierte Organisationsform und wünschenswerte Standards. Die Untersuchung stützt sich zum einen auf die Analyse von Interviews mit fünf Vorsitzenden klinischer Ethikkomitees von Harvard Lehrkrankenhäusern in Boston, die jeweils etwa 20 Jahre Erfahrung in klinischer Ethikberatung mit den drei unterschiedlichen Modellen gemacht haben. Zum anderen basiert sie auf der Rezeption der Literatur und empirischen Studien zu KEDs in den USA und Deutschland. Insgesamt scheint das Konsilteam mit Rückbindung an ein Komitee am besten geeignet, die Behandlung einzelner Patienten und das ethische Bewusstsein einer ganzen Organisation zu verbessern. Es vereint die Vorteile der anderen beiden Modelle auf sich, ohne unter deren Schwächen zu leiden. (shrink)

Topos quantum theory represents a whole new approach to the formalization of non-relativistic quantum theory. It is well known that TQT replaces the orthomodular quantum logic of the traditional Hilbert space formalism with a new intuitionistic logic that arises naturally from the topos theoretic structure of the theory. However, it is less well known that TQT also has a dual logical structure that is paraconsistent. In this paper, we investigate the relationship between these two logical structures and study the implications (...) of this relationship for the definition of modal operators in TQT. (shrink)

Neste artigo, propomos uma leitura do argumento cartesiano do sonho segundo a qual ele deveria ser analisado como um entimema, isto é, como um argumento retórico portador de premissas elípticas. Mais precisamente, o princípio da dúvida hiperbólica, embora formulado no início das Meditações , desempenharia um papel crucial na inferência contida nesse argumento, que o leitor comum que Descartes teria em mente tende a desconsiderar. Tentamos mostrar que este ponto poderia nos propiciar não apenas uma melhor compreensão do papel do (...) argumento nas Meditações, mas uma diferente compreensão da relação entre a filosofia cartesiana e a tradição cética. (shrink)

What does a confrontation between philosophy and psychoanalysis look like? My task is a philosophical investigation of a psychoanalytic concept. Thus, I offer a conceptual analysis of a concept that is used both clinically and as a part of a metapsychology. The concept that I investigate in this article is regression. I work with the following two problems: What does a conceptual analysis of the phenomenon called regression look like? Regression can be regarded as an instrument that can give us (...) knowledge about ourselves. What does this mean? I compare two ways of analyzing regression, an atomistic as well as an holistic approach. This comparison is made by way of a discussion of the conceptual analysis of the infant. Can we construct the inner life of the infant? How should we conceptualize the primitive? Using concepts like ‘conceptual holism’ and ‘holism of attributes’, I draw parallell conclusions about the construction of the infant's inner life and the analysis of the concept of regression. (shrink)