What are choices? -- Why are choices important? -- Good choices -- Difficult choices -- At school -- At home -- Other people's choices -- Glossary and index.

Nurses have moral obligations incurred by membership in the profession to participate knowingly in health policy advocacy. Many barriers have historically hindered nurses from realizing their potential to advance health policy. The contemporary political context sets additional challenges to policy work due to polarization and conflict. Nursing education can help nurses recognize their role in advancing health through political advocacy in a manner that is consistent with disciplinary knowledge and ethical responsibilities. In this paper, the authors describe an exemplar of (...) Elizabeth Barrett's “Power as Knowing Participation in Change” theory as a disciplinary lens within a doctoral nursing health policy course. Barrett (radically) emphasizes “power as freedom” instead of “power as control.” This approach is congruent with nursing disciplinary values and enhances awareness of personal freedom and building collaborative relationships in the policy process. The theory was used in concert with other traditional policy content and frameworks from nursing and other disciplines. We discuss the role of nursing ethics viewed as professional responsibility for policy action, an overview of Barrett's theory, and the design of the course. Four student reflections on how the course influenced their thinking about policy advocacy are included. While not specific to policymaking, Barrett's theory provides a disciplinary grounding to increase students' awareness of freedom and choices in political advocacy participation. Our experience suggests that Barrett's work can be fruitful for enhancing nurses' awareness of choices to participate in change across settings. (shrink)

This participatory study, conducted in an introductory psychology class, recounts self-reflections of 22 undergraduate students and their instructor engaging in an GenAI-mediated storyboard generation process. It relies on Gordon Pask’s conversation theory, structuring out the nature of interactions between students, instructor, and GenAI, and then uses a qualitative narrative to describe these conversational feedback loops constituting the creation of draft and final storyboards. Results suggest students engaged in cyclical feedback driven processes to master their creations, used elements of photography related (...) to the relationships between objects in frame, image processing, and cultural objects/themes to generate narratives. Issues were faced with generating text on images, and the consistency and style of generated frames as they interacted with GenAI tools. This study provides guidelines to university teaching professionals to design effective activities mediated by text-to-image GenAI. (shrink)

This essay explores the 'structure of feeling' that is emerging today in tandem with new digital technologies, together with economic globalisation and the financialisation of more and more human activities. The 20th century was the age of film and television; these dominant media shaped and reflected our cultural sensibilities. In the 21st century, new digital media help to shape and reflect new forms of sensibility. Movies (moving image and sound works) continue to be made, but they have adopted new formal (...) strategies, they are viewed under massively changed conditions and they address their spectators in different ways than was the case in the 20th century. The article traces these changes, focusing on three recent moving-image works: Nick Hooker's music video for Grace Jones's song 'Corporate Cannibal'; Olivier Assayas' movie Boarding Gate , starring Asia Argento; and Richard Kelly's movie Southland Tales , featuring Justin Timberlake, Dwayne Johnson and other pop culture celebrities. (shrink)

While the nature-grace debate rages in Thomistic circles, St. Bonaventure's theological anthropology and his theology of grace is paid much less attention, with the exception of his argument that Adam was created apart from gratia gratum faciens, or in modern terms habitual or sanctifying grace.1 For this position he has come under some scrutiny. John Milbank connects Adam's short time without habitual grace to Bonaventure's deficient understanding of illumination as proof of an incipient voluntarism and a (...) suspect pure nature theology.2 Turning Milbank upon his head, Fr. Christopher Cullen, S.J. defends the "suspended middle" in Bonaventure by appealing to Adam's creation without grace; human nature has a... (shrink)

This article examines the account of the relationship between sin and suffering provided by J. L. A. Garcia in “Sin and Suffering in a Catholic Understanding of Medical Ethics,” in this issue. Garcia draws on the (Roman) Catholic tradition and particularly on the thought of Thomas Aquinas, who remains an important resource for Catholic theology. Nevertheless, his interpretation of Thomas is open to criticism, both in terms of omissions and in terms of positive claims. Garcia includes those elements of Thomas (...) that are purely philosophical, such as natural law and acquired virtue, but neglects the theological and infused virtues, the gifts and fruits of the Holy Spirit, and the beatitudes. These omissions distort his account of the Christian life so that he underplays both the radical problem posed by sin (and suffering), and the radical character of the ultimate solution: redemption in Christ through the grace of the Holy Spirit. (shrink)

I argue that the problem of religious luck posed by Zagzebski poses a problem for the theory of hell proposed by Buckareff and Plug, according to which God adopts an open-door policy toward those in hell. Though escapism is not open to many of the criticisms Zagzebski raises against potential solutions to the problem of luck, escapism fails to solve the problem: it merely pushes luck forward into the afterlife. I suggest a hybrid solution to the problem which combines escapism (...) and the claim that God gives enough grace to those in hell to cancel out any bad moral luck. (shrink)

Surgeons are commonly evaluated with respect to outcomes and adherence to rules and regulations, rather than a true holistic examination of the character of the surgeon in question. We sought to examine the character failings of surgeons who faced fitness to practice enquiries under the Medical Practitioner Tribunal Service in the UK. In particular, we examined the absence of virtue as perceived through the lens of Aristotelian ethics using thematic analysis of tribunal hearing transcripts from 2016 to 2020. We identified (...) three overarching themes that are explored in depth: ‘the god complex’, ‘reputation over integrity’ and ‘wounded pride’. We hope to use this as the foundation for a re-examination of the place of phronesis in postgraduate surgical education, which we argue should be perceived as an exercise in character development and reformation rather than the simplistic teaching of skills to standardised outcomes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Womanist-Buddhist Consultation as a Reading CommunityCarolyn M. Jones MedineIn Breaking the Fall, the late Robert Detweiler (1932-2008) imagines what a reading community, "a contemporary version of the old storytelling cultures,"1 might look like. He suggests that in such a community, "The accent on community itself would offer a balance to our excessively privatizing tendencies; the communal interaction could counter our relentless drive to interpret... with attitudes of (...) play and Gelassenheit (abandonment, chance, and relaxation); the writing and reading community especially as a liminal entity, could nurture a respect for the incomprehensibility of form and a reverence for mystery."2 This description offers an entry to the work of the Womanist-Buddhist Consultations. To reach a provisional understanding of the meaning of that work, I shall reflect on first what we mean when we say that we want to read something. Second, I turn to a conversation with Robert Detweiler, who was one of my mentors, as a way to address the form of reading that we do and the form of community that we make in the Womanist-Buddhist Consultations. Third, I want to draw on the thought of the consultations themselves, using Emmanuel Levinas's work on reading and ethics, to examine the capacity the consultations have to hold tensions creatively and to allow multiple meanings to be part of them. Finally, I want to address the goals for the consultations. I am thinking specifically of Melanie Harris's desire to see the consultations as generating practices that promote peace, compassion, and justice, and Charlie Hallisey's desire to generate a more complex reading of Buddhist texts in and of themselves.The Womanist-Buddhist Consultations have met three times between 2009 and 2011. We met at Harvard Divinity School and at Texas Christian University for sessions of four days each, and for an evening at the University of Georgia between the two longer meetings. The Texas Christian meeting included some previous members from the Harvard meeting, and added new ones. The University of Georgia meeting consisted primarily of students who participated in the reading practice.In the meeting at the University of Georgia, Charles Hallisey looked askance at me when I said that Buddhism offers an entry into peace and compassion; yet Melanie Harris, when she constructed the later session at Texas Christian University, deployed the terms "peace" and "justice" as descriptors for the work of the group. Hallisey's ironic glance occurred right before we read, at the University of Georgia, a text that contained magic and murder. His glance and the content of that text have prompted [End Page 47] me to think through Harris's claims and to see how our group achieves both a reading of Buddhism and an ethical practice that generates peace and points to justice.The instructions that Hallisey gives for the reading process describe a practice of "being and reading together" as we encounter a variety of Buddhist texts.3 The group's guide is the bodhisattva Manjushri, who has overseen our work through an image gracing the wall at all our meetings. Manjushri has a sword to cut through obstacles, and holds a book, signifying wisdom. The practice of reading with friends, Hallisey told us, comes from Jewish tradition: we need a friend to help us overcome what we can and to begin to see what we cannot. The work involves three steps:1. To read passages individually.2. To read the same passages together in small groups.3. To gather again as a large group and discuss what we have discovered.The major goal of reading is to encounter levels of ourselves to which we ordinarily have no access, by examining a text that becomes "generous" to us. Reading together, Hallisey asserts, makes the generosity of the text visible to us.This process of reading, I would argue, is different from what we usually do when we read and different from what we mean when we tell students to read. Patricia O'Connell Killen, an AAR Teaching Award winner, has delineated some of what we mean when we say to our students: "Read chapter 2 of 'X' and come to class prepared."4... (shrink)

Williams’ discussion of dilemmas in his classic paper “Ethical consistency” famously focuses on an example that has not bothered commentators on and respondents to Williams as much as it should have bothered them: the example of Agamemnon in Aeschylus’ play. In this paper I try to pick apart what Williams wants to say from what is really going on in the text that he unfortunately chooses for his example. I compare with Williams’ discussion of Agamemnon four other commentators on this (...) crucial passage in Aeschylus’ play: Plato, Socrates, Aristotle—and Bernard Williams’ Greats tutor Eduard Fraenkel, whose epochal Corpus Christi seminars on the play Williams attended (along with Iris Murdoch, Hugh Lloyd Jones, and other rising stars of the time). I shall argue that these commentators led Williams astray. They are surprisingly prone to the same flaws of rationalism, impersonality, and moralism in making sense of Aeschylus’ extraordinarily subtle and brilliant depiction of Agamemnon; and Williams’ discussion inherits these flaws. This is an obviously ironic fact, especially given that a very fruitful reading of the passage—one that I think makes much better sense of what Aeschylus actually says—points a deeply Williamsian moral. It takes Agamemnon at Aulis as a study of a key step in the corruption of a character, a study that gets its power and its horror from its ability to show us how that process looks _from Agamemnon’s own viewpoint._. (shrink)

ABSTRACTIn Leviathan, Hobbes outlines the concept of the ‘Kingdome of God by Nature’ or ‘Naturall Kingdome of God’, terms rarely found in English texts at the time. This article traces the concept back to the Catechism of the Council of Trent, which sets forth a threefold understanding of God’s kingdom – the kingdoms of nature, grace, and glory – none of which refer to civil commonwealths on earth. Hobbes abandons this Catholic typology and transforms the concept of the natural (...) kingdom of God to advance a claim often missed by his interpreters: Leviathan-states are the manifestation of a real, not metaphorical, kingdom of God. This argument plays a key role in Leviathan, which identifies the kingdom of God as the Christian doctrine most subject to abuse. Hobbes harshly criticizes Catholic and Presbyterian clergy for claiming to represent God’s kingdom. This claim, he argues, comes with the subversive implication that the church possesses spiritual and temporal authority, and caused great turmoil during the English Civil War. As an alternative, Hobbes points to civil commonwealths as the manifestation of God’s natural kingdom, which is the only form his kingdom currently takes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS Metaphysics as a Guide to Morals. By IRIS MURDOCH. Harmondsworth: Allen Lane; New York: Viking, 1992. $35.00. Dame Iris Murdoch is familiar to most people as a witty and en· gaging novelist whose twenty-four hooks of fiction can he read on a variety of levels. They are wonderful stories, hut the philosophically acute reader will also enjoy Murdoch's judgments, polemics, and inhouse jokes about philosophers and philosophical (...) views. Comparatively few people are aware of Murdoch's previous scholarly studies: Sartre, Romantic Rationalist, The Sovereignty of the Good, The Fire and the Sun; and Acastos. Even so, those familiar with these hooks will recognize the profound impact she has had on debates within moral philosophy. She has been at the forefront of the move· ment that has rehabilitated the central importance of such notions as goodness, the Good, virtue, and the moral life as a journey. So it is not surprising that Murdoch has returned to the genre of philosophical argument to advance her views on the relationship between metaphysics and morals. But it is surprising that her argument exhibits neither the clarity of thought characteristic of the analytic philosophy in which she was trained nor the dramatic narrative of her novels. Indeed the hook reads like a collage of lecture notes, complete with extensive quotations from other people's thoughts with minimal com· mentary. Further, the chapter titles (e.g., " Fact and Value," " Schopenhauer," " Consciousness and Thought-I," " Derrida and Struc· turalism," " Consciousness and Thought-II," "Notes on Will and Duty," " Axioms, Duties, Eros," " Void ") shed little light on the overall structure or argument of the hook. One cannot help hut have the impression that Murdoch spent less time crafting the argument of this hook than she does in crafting the story line and characters of her novels. This is not to say, of course, that there is not much to he learned from Murdoch's perspective. She is remarkably erudite, and her discussion of various themes, figures, and issues often yields fascinating insights. But the whole is considerably less than the sum of its often interesting parts. I have already suggested that this is partly because of the structure and style in which the hook is written. But the hook 687 688 BOOK REVIEWS is also disappointing, and perhaps more determinatively, because of the overall perspective she seeks to deploy and defend. Readers of Murdoch's work have heretofore often wondered about the relationship between her avowed Platonism and her interest in Christianity. Metaphysics as a Guide to Morals has the virtue of clarifying that relationship, hut the result is unpersuasive. At the heart of Murdoch's Platonism is her recasting of the allegory of the cave from The Republic. The moral life is an arduous struggle to ascend from the cave (represented, as in her earlier works, by " the fat, relentless ego ") by a dispossession of the self so that we can apprehend a little less imperfectly the perfect form of the Good. As Murdoch puts it, Plato assumes the internal relation of value, truth, cogmtion. Virtue (as compassion, humility, courage) involves a desire for and achievement of truth instead of falsehood, reality instead of appearance. Goodness involves truth.seeking knowledge and ipso facto a discipline of desire. ' Getting things right ', as in meticulous grammar or mathematics, is truth-seeking as virtue. Learning anything properly demands (virtuous ) attention. Here the idea of truth plays a crucial role (as it does also in Kant) and reality emerges as the object of truthful vision, and virtuous action as the product of such vision. This is a picture of the omnipresence of morality and evaluation in human life (p. 39). Such a depiction ought to resonate quite deeply with Christians, something not lost on Murdoch when she writes a few pages earlier: "There are innumerable points at which we have to detach ourselves, to change our orientation, to redirect our desire and refresh and purify our energy, to keep on looking in the right direction: to attend upon the grace that comes through faith " (p. 25). But Murdoch's "grace" and her "truth-seeking as virtue," among other themes, involve something quite different from what Christians... (shrink)

This essay explores the relationship between nature and grace and the theological impact of this relationship on feminist anthropological debates. Engaging this debate through an examination and critique of Serene Jones’ ‘eschatological essentialism’, this essay suggests that Jones mistakenly characterizes constructivism, and thus turns too quickly to an essentialist paradigm without considering its risks. Using Judith Butler and Karl Barth, this essay proposes an account of identity that the author calls a ‘Christological constructivism’. Suggesting that the person (...) and work of Christ instantiates a grace that disrupts nature, Daniels argues for an account of identity as ‘more-than’, suggesting that this anthropology engenders healing for women, and men, within communities religious and otherwise. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Sodalism as Open Worldview: Conspiring to Dismantle the White FranchiseSunny Heenenin the introduction to Borderlands/La Frontera: The New Mestiza, Gloria Anzaldúa writes: “Today we ask to be met halfway. This book is our invitation to you—from the new mestizas” (Anzaldúa 20). Mestiza is a specifically feminine descriptor for a Latin female-identifying person of mixed descent. What Anzaldúa proposes in this theory of the new mestiza is a consciousness rooted (...) in “the creation of yet another culture, a new story to explain the world and our participation in it, a new value system with images and symbols that connect us to each other and to the planet” (Anzaldúa 103). Just as the mestiza gracefully learn to navigate their complex multicultural identities, fashioning a new hybrid culture within which to flourish, so can we all develop an enlightened conception of who we are. The invitation extended by Anzaldúa is not meant only for those who identify as mestiza. The who being invited to help build this new culture is the group that identifies as white; Anzaldúa believes that those she invites are capable of learning to improve their behavior and their consciousness regarding their relation to other human beings. In fact, it is this dominant group who is needed for this new story because collectively dismantling hegemonic whiteness is the only path toward the kind of inclusive culture that Anzaldúa envisions. I will argue that a proposal like Anzaldúa’s first requires a new worldview for white people: one that restructures cognition toward communal activity.An ushering in of this new worldview can be made practical, I submit, through Audre Lorde’s theory of difference. Lorde advises that it is the recognition of and embracing of our differences that has the potential to move us forward. To reclaim difference and celebrate our pluralistic world, we require an in-depth look at the ways in which identity is formed through difference, especially white identity. In an essay on defining difference, Lorde worries that it is something we respond to with fear and contempt, when instead, [End Page 32] these differences have the capacity to be the strength of our foundation as social beings: “We have no patterns for relating across our human differences as equals.... Certainly there are very real differences between us of race, age, and sex. But it is not those differences between us that are separating us. It is rather our refusal to recognize those differences, and to examine the distortions which result from our misnaming them and their effects upon human behavior and expectation” (Lorde 115). According to Lorde, we misunderstand and misuse our differences, relying on them to form dualistic identities in negation to one another, identities that sow hatred and division. It is through confronting these identities based on difference that we might begin to approach them in new ways that take us forward together and that build these patterns of relating as equals.The new worldview that I am suggesting must be, primarily, a form of education. In examining the epistemic problems of white identity, I have developed something that I call “sodalism.” The word is derived from the Latin sodalis, which holds various meanings for our purposes, including comrade, fellow, and conspirator. The theory of sodalism connotes a sense of conspiring together toward a collective purpose of betterment, toward a world in which we perceive each other as comrades and fellow humans with beneficial and beautiful differences. Sodalism refrains from becoming totalizing by making visible and celebrating a plurality of identities and experiences. This skill can be developed through educated interchange, of which Anzaldúa writes hopefully: “Whites could allow themselves to share and exchange and learn from us in a respectful way” (90). But how can white people adopt a new open consciousness that will allow this interchange? After all, according to sociologist Anibal Quijano, the colonial structure of power—whiteness—“was, and still is, the framework within which operate the other social relations” (168). If white perceptions are still lodged in these hierarchical epistemologies, where can we begin to break down these mental barriers and decolonize minds? Anzaldúa suggests... (shrink)

A resurgence of interest in inner speech as a core feature of human experience has not yet coincided with methodological progress in the empirical study of the phenomenon. The present article reports the development and psychometric validation of a novel instrument, the Varieties of Inner Speech Questionnaire , designed to assess the phenomenological properties of inner speech along dimensions of dialogicality, condensed/expanded quality, evaluative/motivational nature, and the extent to which inner speech incorporates other people’s voices. In response to findings that (...) some forms of psychopathology may relate to inner speech, anxiety, depression, and proneness to auditory and visual hallucinations were also assessed. Anxiety, but not depression, was found to be uniquely positively related to both evaluative/motivational inner speech and the presence of other voices in inner speech. Only dialogic inner speech predicted auditory hallucination-proneness, with no inner speech variables predicting levels of visual hallucinations/disturbances. Directions for future research are discussed. (shrink)

The predicate-argument approach, focused on perception, is compared with the ease-of-predication (or predicability) approach, focused on encyclopedic knowledge. The latter offers functional prediction and implementation in connectionist models. However, the two approaches characterise predicates in different ways. They thus resemble predicational cantilevers built out from opposite sides of cognition, with a gap that is yet to be bridged.

Not at all self-evident, the so-called isomorphisms between the phenomenology and physiology of dreams have been interpreted by Hobson et al. in an arbitrary manner to state that dreams are stimulated by chaotic brainstem stimulation (an assumption also adopted by Vertes & Eastman). I argue that this stimulation is not chaotic at all; nor does it occur in the absence of control from the cerebral cortex, which contributes complexity to brainstem activity as well as meaningful information worth consolidating in the (...) brain during sleep. [Hobson et al.; Vertes & Eastman]. (shrink)

Utilitarian and deontological moral theories are often accused of failing to develop a convincing account of an agent's moral psychology, and so failing to provide an adequate theory of moral motivation that sustains their conception of morality as involving generally overriding moral duties. As a result of this apparent conflict between an agent's psychology and the demands of morality, many suggest making dramatic revisions to our conception of morality. I argue here that a more promising response is to examine where (...) it is that morality fits into human psychology, and then build a theory of moral motivation that sustains ordinary conceptions of morality from this foundation. To do this, I start by looking at Hume's account of moral motivation, which is grounded in a rich and full moral psychology. In an attempt to show that his theory provides a promising foundation for a contemporary theory of moral motivation, I explore his account of acting from duty and develop a new interpretation of his theory of moral motivation that fits most consistently with both his criticism of other accounts and his more general claims about the virtue of justice. I argue that Hume offers an account of justice as being always valuable in virtue of being a necessary condition to the enjoyment of one's good character. I go on to suggest that pride in one's character, what we might now call personal integrity, commits each agent to acting with a sense of duty, and enables her to attain a level of social interaction that is necessary for her psychological development, yet not possible without a commitment to justice. After defending this interpretation of Hume, I extend this basic notion of personal integrity and demonstrate how this idea, combined with the workings of empathy and the psychological need for positive social interaction, generates a viable theory of moral motivation that maintains the common conception of morality as involving generally overriding moral duties while avoiding threats of alienation. (shrink)

This paper examines the metaphysics of interdependence in the work of the Chinese Buddhist Fazang. The dominant approach of this metaphysics interprets it as a species of metaphysical coherentism wherein everything depends upon everything else, no individual is more fundamental than any other, and so reality itself is non-well-founded in the sense that chains of dependence never terminate. I argue, to the contrary, that Fazang's metaphysics is better interpreted as a novel variety of foundationalism. I argue, as well, using set- (...) and graph-theoretic techniques, that there is a consistent way to model this alternative interpretation, and that this model differs in significant ways from a coherentist model. (shrink)

The purpose of this article is to expose a basic flaw at the root of perennialism as a method for studying mysticism—its distinction between ‘exoteric’ and ‘esoteric’ components of mysticism and religion. Rather than being distinct, the specific ‘exoteric’ doctrines of a given mystic’s tradition penetrate the mystics’ knowledge-claims. Thus, the ‘esoteric’ dimension in a mystical tradition is permeated by that mystical tradition’s ‘exoteric’ doctrines, not by the transcultural and ahistorical perennial spine that perennialists postulate. Contrary to what the perennialists (...) suggest, there is no one underlying esoteric set of beliefs embedded in all traditional religions that all mystics share. Rather, in the different religious traditions of the world, there are genuinely different mysticisms with different beliefs, practices, values, and goals. Thus, the perennialist approach distorts the history of mysticism. It is better seen as a theology of religions than as an alleged discernment of timeless truths presented throughout the history of mysticism. (shrink)

ABSTRACT David Miller has written extensively on the ethical value of the nation. A satisfactory response to Miller's ideas on nationalism requires an assessment of the whole range of his writings on the subject. After stating the outlines of Miller's conception of ‘nationality’, I evaluate the most important arguments for and against any attribution of ethical importance to the nation. Finally, I assess Miller's commitment to conational ethical priority in the context of duties of justributive justice. My main conclusions are (...) as follows. (i) Miller's conservative strategy of justification is unacceptable, and a critical strategy suggests several plausible arguments for valuing national attachments. These arguments are not conclusive, however, (ii) In so far as Miller's position depends on real historical connections between persons, it is susceptible to the objection from historical myth. (iii) Miller offers an unexpected and ultimately unsuccessful response to the claim that national sentiments are partial and hence biased, (iv) Miller provides no good reason to believe that the duties of distributive justice are owed in the first instance to conationals. (shrink)

IntroductionAllocation of research funds relies on peer review to support funding decisions, and these processes can be susceptible to biases and inefficiencies. The aim of this work was to determine which past interventions to peer review and decision-making have worked to improve research funding practices, how they worked, and for whom.MethodsRealist synthesis of peer-review publications and grey literature reporting interventions in peer review for research funding.ResultsWe analysed 96 publications and 36 website sources. Sixty publications enabled us to extract stakeholder-specific context-mechanism-outcomes (...) configurations for 50 interventions, which formed the basis of our synthesis. Shorter applications, reviewer and applicant training, virtual funding panels, enhanced decision models, institutional submission quotas, applicant training in peer review and grant-writing reduced interrater variability, increased relevance of funded research, reduced time taken to write and review applications, promoted increased investment into innovation, and lowered cost of panels.ConclusionsReports of 50 interventions in different areas of peer review provide useful guidance on ways of solving common issues with the peer review process. Evidence of the broader impact of these interventions on the research ecosystem is still needed, and future research should aim to identify processes that consistently work to improve peer review across funders and research contexts. (shrink)

It has become popular to portray the Buddhist Nāgārjuna as an ontological nihilist, i.e., that he denies the reality of entities and does not postulate any further reality. A reading of his works does show that he rejects the self-existent reality of entities, but it also shows that he accepts a "that-ness" to phenomenal reality that survives the denial of any distinct, self-contained entities. Thus, he is not a nihilist concerning what is real in the final analysis of things. How (...) Nāgārjuna’s positions impact contemporary discussions of ontological nihilism and deflationism in Western philosophy is also discussed. (shrink)

Background Nurses in acute care are frequently involved in ethical decision making and experience a higher prevalence of ethical conflicts and dilemmas. Nurses in underresourced rural acute care settings also are likely to face unique ethical challenges. However, rarely have the particular contexts of these experiences in rural acute care settings been researched. A culture of silence and fear in small towns has made exploring these issues difficult. Objectives To explore registered nurses’ experiences of ethical issues and ethical decision making (...) in rural acute care hospitals in northern Ontario, Canada. Research design Guided by an interpretive descriptive approach, data were collected by two nurse researchers using in-depth, individual, and semistructured telephone interviews. Data were managed with NVivo v.11 and analyzed using inductive, comparative, thematic analyses. Participants and research context The participants were eight registered nurses working in two acute care hospitals in northern Ontario. Ethical considerations Ethical protocols were followed in accordance with ethics approval from the researchers’ university and the hospitals. Findings Results identified four themes that culminated in the development of a quadruple helix ethical decision-making framework of power, trust, care, and fear. Discussion and conclusion The participants described complex ethical conflicts and dilemmas in acute care settings that were influenced by the context of working and living in small rural communities in northern Ontario. Nurses described navigating ethics in practice using a tension-based approach to ethical decision making, needing to carry these issues silently and often having no resolution to ethical challenges. These findings have important implications for nursing education, research, and practice. Nurses need safe spaces, formal ethics support, and improved access to resources. Additional ethics education and training specific to the unique contexts of rural settings are needed. (shrink)