Este artículo analiza las condiciones a través de las cuales las matemáticas pasan de un estado de subordinación a desempeñar un papel rector frente a la filosofía natural. Esta transformación se manifestó esencialmente en un cambio de actitud frente al pensamiento tradicional, mediante la sustitución de la explicación cualitativa de los fenómenos naturales por una explicación cuantitativa. En el texto se abordarán los aspectos epistemológicos e institucionales que están implicados en el debate sobre la cientificidad de las matemáticas. A su (...) vez, se hará un recorrido historiográfico señalando las diferentes posturas que tuvieron lugar en la polémica, para ofrecer elementos históricos y conceptuales de análisis respecto de las matemáticas como herramienta de la ciencia moderna. (shrink)

This short paper aims to present some philosophical considerations about the relationship between credibility and the uses of evidence. The point of view regarding evidence and scientific and political decisions in this paper focuses on the current world situation of the COVID-19.

The fate of cellular RNAs is largely dependent on their structural conformation, which determines the assembly of ribonucleoprotein (RNP) complexes. Consequently, RNA‐binding proteins (RBPs) play a pivotal role in the lifespan of RNAs. The advent of highly sensitive in cellulo approaches for studying RNPs reveals the presence of unprecedented RNA‐binding domains (RBDs). Likewise, the diversity of the RNA targets associated with a given RBP increases the code of RNA–protein interactions. Increasing evidence highlights the biological relevance of RNA conformation for recognition (...) by specific RBPs and how this mutual interaction affects translation control. In particular, noncanonical RBDs present in proteins such as Gemin5, Roquin‐1, Staufen, and eIF3 eventually determine translation of selective targets. Collectively, recent studies on RBPs interacting with RNA in a structure‐dependent manner unveil new pathways for gene expression regulation, reinforcing the pivotal role of RNP complexes in genome decoding. (shrink)

Hidden cluster problems can manifest when broad ethnic categories are used as proxies for cultural traits, especially when traits are assumed to encode cultural distances between groups. We suggest a granular understanding of cultural trait distributions within and between ethnic categories is fundamental to the interpretation of heritability estimates as well as general behavioral outcomes.

The last years of the 20th Century have been somewhat contradictory with respect to values like loyalty, trust or truthfulness. On the one hand, (often implicitly, but sometimes very explicitly), self-interest narrowly defined seems to be the dominant force in the business world, both in theory and in practice. On the other hand, alliances, networks and other forms of cooperation have shown that self-interest has to be at least "enlightened".The academic literature has reflected both points of view, but frequently in (...) an ambiguous way, since the concepts of loyalty and trust are somewhat elusive and equivocal. This paper attempts to analyze the concept of loyalty in depth, examining the different conceptions about the word that can be found in the literature. We begin by going to the management classics (specifically, Follett, Barnard and Simon), and we then turn to the anthropological approach of Pérez López (1993), with its built-in ethical analysis, and show how trust and loyalty are crucial to the development of organizations. We end by suggesting in what ways loyalty and trust can be created and fostered in organizations. (shrink)

In this paper, we review the conventional analyses of management control systems, to conclude, first, that the illusion of control can mislead managers into believing that everything can be controlled and monitored, and, second, that no incentive system based only on extrinsic rewards can motivate individuals properly. Then, we investigate the philosophical foundations of the basic assumptions that, implicitly or explicitly, are made about the nature of the acting person. Based on personalist phenomenology, we show how the development of technical (...) and moral values is crucial to the long-run survival of organizations. We end by offering some guidelines as to what control systems should be like in order to be compatible with the nature of human persons. (shrink)

This document describes the implementation of a conical tank control system using an adaptive neurofuzzy system. For implementation, an indirect approach is used where the controller is optimized using the model obtained during the plant identification carried out using data obtained during the system operation. Furthermore, implementation includes training of neuro fuzzy-systems and application to control a conical tank. Regarding plant identification, preliminary training takes place using data obtained for different input values. The controller configuration is established considering the analogy (...) with a discrete-time linear system. The simulation shows that the control system manages to approach the desired response given by the considered reference model. (shrink)

This article focusses on corporate attitudes to stakeholder environmental pressures in Argentina. It uses a cross section survey of 505 CEOs of Argentinean firms to gather information on environmental attitudes and a stakeholder theory framework to design and interpret the statistical analyses. It is underpinned by theoretical and empirical findings in the literature on stakeholder management, targeting in particular studies that deal with corporate social responsibility (CSR) in Latin America. Its general aim is to gain a deeper empirical understanding of (...) the coherence between managers' perceptions of stakeholder pressures and the importance they are given in corporate CSR strategies through an empirical investigation of environmental management (EM) decisions. In doing so, it uncovers general differences in the way firms perceive and treat groups of stakeholders. It also detects variations across firms, observing that some are typically proactive in their response to stakeholder pressures whilst others are less responsive. Profiling the various stakeholder networks and the corporate response strategies in this way encourages the development of stakeholder-focussed policies and corporate strategies that emphasise communications, awareness and a clear sense of direction. It concludes that CSR appears to be more effective in the protection of the environment than previously reported. Although this study focusses on EM in Argentina, the findings are more generally applicable. (shrink)

Stakeholder Theory combines the pursuance of business goals and responsibility toward a firm's stakeholders. Despite the wealth of research on Stakeholder Orientation, we still have much to learn about specific measurements for several related constructs. In this study, we draw on two samples of 129 and 151 Spanish firms, respectively, to investigate CEOs' perceptions on Stakeholder Integration (SI), leading to the identification of three dimensions of the construct. In this respect, our study suggests that Knowledge of Stakeholders, Interactions between a (...) firm and its stakeholders, and the adaptation of a firm's behavior to stakeholders' demands constitute the main dimensions of SI. This construct has the potential to connect the stakeholder and strategy literatures. (shrink)

Healthcare workers who are on the front line of coronavirus disease 2019 and are also undergoing shift schedules face long work hours with few pauses, experience desynchronization of their circadian rhythm, and an imbalance between work hours effort and reward in saving lives, resulting in an impact on work capacity, aggravated by the lack of personal protective equipment, few resources and precarious infrastructure, and fear of contracting the virus and contaminating family members. Some consequences are sleep deprivation, chronic insomnia, stress-related (...) sleep disorders, and post-traumatic stress disorder. These sleep alterations critically affect mental health, precipitating or perpetuating anxiety, stress, and depression, resulting in the inability to regulate positive and negative emotions. Pre-existing sleep disorders are an important risk factor for the development and maintenance of PSTD when individuals are exposed to an important stressor such as a COVID-19 pandemic. At the same time, how an individual regulates the emotion associated with worries during daytime functioning impacts nighttime sleep, precipitating and perpetuating difficulties in sleeping. All of these changes in sleep and emotional regulation also alter the immune system. Sleep deprivation is commonly associated with chronic inflammatory diseases, due to the desynchronizations in circadian rhythms, causing possible psychophysiological disorders and impaired neuroimmune-endocrine homeostasis. From this perspective, we clarify in this article how sleep disorders affect the immune system and emotional regulation, explaining their phenomenological and neurobiological mechanisms, and discussing elements of cognitive and behavioral coping for health professionals to adopt and manage a healthier sleep pattern in the COVID-19 outbreak. (shrink)

The concept of polarity is pervasive in natural language. It relates syntax, semantics and pragmatics narrowly, Semantics: an international handbook of natural language meaning, De Gruyter Mouton, Berlin, 2011; Israel in The grammar of polarity: pragmatics, sensitivity, and the logic of scales, Cambridge studies in linguistics, Cambridge University Press, Cambridge, 2014), it refers to items of many syntactic categories such as nouns, verbs and adverbs. Neutral polarity items appear in affirmative and negative sentences, negative polarity items cannot appear in affirmative (...) sentences, and positive polarity items cannot appear in negative sentences. A way of reasoning in Natural Language is through Natural Logic. This logic is based on the concept of polarity in order to make the meaning of a sentence weaker o stronger without changing its truth value. There exist many proposals to compute polarity in the Natural Logic context, the most widely known are the ones by: van Benthem, Sánchez-Valencia, Dowty, and van Eijck, 6th international Tbilisi symposium on logic, language, and computation, Batumi, Georgia, Springer, 2007). If Natural Logic is going to be used, as an inferential mechanism between text fragments, in Natural Language Processing applications such as text summarization, question answering, and information extraction, it is a priority to know what the existing relationship among the aforementioned algorithms is; for example, to implement the most general. We show in this paper the equivalence among the analyzed algorithms, filling a gap in Natural Logic research, particularly in computing polarity, and the soundness of their algorithms. (shrink)

ObjectiveThe impact of the mindfulness-based stress reduction program on psychological outcomes and quality of life in lung cancer patients remains unclear. This meta-analysis aimed to evaluate the effectiveness of the MBSR program on psychological states and QoL in lung cancer patients.MethodsEligible studies published before November 2021 were systematically searched from PubMed, EMBASE, Cochrane Library, PsycINFO, China National Knowledge Infrastructure, and Wanfang databases. The risk of bias in eligible studies was assessed using the Cochrane tool. Psychological variables and QoL were evaluated (...) as outcomes. We used the Grading of Recommendations Assessment, Development and Evaluation system to grade the levels of evidence. Statistical analysis was conducted using RevMan 5.4 and STATA 14.0.ResultsA total of 17 studies involving 1,680 patients were included for meta-analysis eventually. MBSR program significantly relieved cancer-related fatigue and negative psychological states, enhanced positive psychological states, and improved quality of sleep. Evidence on MBSR programs' overall treatment effect for QoL revealed a trend toward statistical significance.ConclusionBased on our findings, the MBSR program shows positive effects on psychological states in lung cancer patients. This approach should be recommended as a part of the rehabilitation program for lung cancer patients.Systematic Review Registrationhttps://archive.org/details/osf-registrations-mwvbq-v1, identifier: 10.17605/OSF.IO/MWVBQ. (shrink)

The COVID‐19 pandemic triggered an unprecedented health crisis that impacted healthcare systems worldwide. This study explores how Spanish healthcare workers learned, internalised and integrated values and work behaviours during the COVID‐19 pandemic and their impact on the personal sphere. This documentary research, using images, narratives and audiovisual content, was framed within the interpretative hermeneutic paradigm. Categories and subcategories emerged after a final theoretical sampling that focused on the analysis. Data triangulation between researchers favoured theoretical saturation. A total of 117 images (...) and 27 texts were selected. The analysis identified three stages: bewilderment, seeking functionality in the chaos and integrating chaos into care. The data reflects how the need for security and knowledge, and the exhaustion and frustration caused by the initial working conditions, prompted adaptive responses. These responses involved focusing on problem‐solving and strengthening group sentiments and solidarity. Subsequently, the data indicates the acceptance of new structural, organisational and communication aspects. The findings of the analysis will contribute towards finding a framework that can help understand community health crisis events. (shrink)

Background Changes in health needs led to an increase in virtual care practices such as telemedicine. Nursing plays an essential role in this practice as it is the key to accessing the healthcare system. It is important that this branch of nursing is developed considering all the ethical aspects of nursing care, and not just the legal concepts of the practice. However, this question has not been widely explored in the literature and it is of crucial relevance in the new (...) concept of care. Objective The purpose of this scoping review is to identify the ethical aspects of the development of telemedicine from a nursing practice perspective. Methods A scoping review of the literature based on Arksey and O’Malley’s framework. The search was conducted in Scopus, PubMed/MEDLINE and CINAHL databases, from 2012 to 2022. A total of 1322 articles were retrieved, of which 12 met the inclusion criteria. Ethical considerations The research was conducted in accordance with the best scientific practices. Findings The most relevant aspects were the safety of the patient, the benefits for the user and the digital competence of the professionals. Informed consent and patient’s willingness to use new technologies were relevant to the practice, as was person-centered care and how telemedicine can influence the quality of the therapeutic relationship. Another relevant issue was the concern about professional competence for optimal outcomes. Conclusion It is necessary to further explore and develop the ethical aspects of the new practices, disassociating them from the legal aspects only. Professionals demand more training providing them with more competence and confidence. (shrink)

En este documento presentamos el resultado de una investigación documental que permitió la contextualización cognitiva de la interactividad soportada en la teoría de la actividad como una perspectiva holística de la actividad humana.Contextualizar cognitivamente la interactividad busca brindar fundamentos de diseño de Objetos Interventivos de Aprendizaje-OIA- desde los procesos cognitivos de la taxonomía de Marzano y Kendall, analizando las estructuras categoriales de un diseño interactivo y los componentes que intervienen en los procesos mentales que generan aprendizaje durante la interactividad: la (...) activación de la memoria y la transformación de la información captada durante el proceso interventivo durante la interactividad. (shrink)

El propósito del presente artículo es abordar la siguiente pregunta: ¿cuál es la relación entre la noción de víctima y la violencia que se ejerce sobre su cuerpo? Para estudiar esta pregunta se parte de los estudios de Giorgio Agamben y Roberto Esposito para proponer un marco hermenéutico que permita ofrecer una nueva comprensión de la condición de víctima ejemplificada en dos contextos: los campos de concentración nazis (con base en los testimonios recopilados por Primo Levi) y el conflicto armado (...) en Colombia (con base en los testimonios recogidos por el Centro de Memoria Histórica). Entre los resultados más interesantes que se encuentran en esta reflexión cabe destacar el rol del lenguaje en el despojo de la calidad de persona de la víctima y la ideología subyacente a todo proceso de victimización que se materializa en el cuerpo de la víctima. (shrink)

The quality of life of rural populations in Colombia is affected by various problems, including poor living conditions related to limited access to basic services, education, health and economic opportunities. Thus, the purpose of this study is to identify the most impacted dimensions in these rural contexts and to formulate guidelines to address the difficulties faced by their inhabitants. Methodologically, the research is framed within the qualitative paradigm, with a descriptive scope and is based on a review of existing academic (...) literature. The findings emerging from the literature review show that the most affected dimensions are access to public services, infrastructure, employment and education, which has a direct impact on the general welfare of rural communities. It is concluded that there is a need to implement public policies that promote the integral development of these areas, improving their infrastructure, strengthening access to basic services and promoting educational and economic strategies that favor a better standard of living in rural areas of Colombia. (shrink)

El objetivo de esta contribución es detallar el proceso para realizar un estudio sobre la población de un municipio que permita la elaboración de un diagnóstico sociológico. Para ello, se identificarán variables demográficas, económicas, sociales y de participación pública. El proceso permite alcanzar la información mínima y necesaria para el desarrollo de la primera fase de un proyecto enfocado hacia la planificación de políticas públicas: la fase de diagnóstico sociológico. El estudio de dichos elementos estructurales permite obtener resultados detallados de (...) la población y confeccionar las tesis fundamentales sobre las necesidades y problemáticas sociales que se presentan. (shrink)

Este artículo se propone abordar el fenómeno de la alteridad humana a partir de la obra de Maurice Merleau-Ponty. Cabe mencionar que el tema fue asignatura pendiente en la fenomenología de Husserl. Una de las estrategias que implementa Merleau-Ponty para establecer la ¿normalidad¿ en la interacción ..

The Coronavirus Disease 2019 pandemic prompted the need for a teleneuropsychology protocol for the cognitive assessment of older adults, who are at increased risk for both COVID-19 and dementia. Prior recommendations for teleneuropsychological assessment did not consider many of the unique challenges posed by COVID-19. The field is still in need of clear guidelines and standards of care for the assessment of older adults under the current circumstances. Advantages of teleneuropsychological assessment during the COVID-19 pandemic include reduced risk of contracting (...) the virus, eliminating travel time and reducing cost, and more rapid access to needed services. Challenges include disparities in technology access among patients, reduced control over the testing environment, impeded ability to make behavioral observations, and limited research on valid and reliable cognitive assessment measures. The aim of this perspective review is to propose a teleneuropsychological protocol to facilitate neuropsychological assessment utilizing a virtual platform. The proposed protocol has been successful with our clinical and research populations and may help neuropsychologists implement teleneuropsychology services without compromising validity or reliability. However, there is increasing need for research on teleneuropsychological assessment options for both clinical and research purposes. (shrink)

La lectura de mapas es una competencia pendiente para los estudiantes universitarios. Es el caso de los del Grado en Turismo de las universidades de Las Palmas de G.C., en España, y Autónoma de Juárez, en México, que usan los mapas para la comprensión de la realidad turística sin que hayan adquirido una alfabetización cartográfica suficiente.Esta comunicación presenta un diagnóstico del pensamiento geográfico de este alumnado centrado en las capacidades de localización, interpretación y análisis relacional de variables territoriales. Se ha (...) corroborado que solo alcanzan un nivel descriptivo y que es necesario poner en macha estrategias didácticas específicas. (shrink)

La discusión sobre el �orgullo gordo� y la supuesta pandemia de la obesidad han encontrado un espacio político y comercial receptivo en nuestras sociedades occidentales, y poco a poco amenaza con extenderse por todo el mundo. Siguiendo con anteriores trabajos, interpretamos y comentamos aquí los envíos remitidos por un grupo de lectores en respuesta a un artículo polémico publicado en las páginas de un periódico digital de difusión nacional. Más que intentar descifrar las supuestas motivaciones o intenciones de los lectores, (...) nuestro objetivo es desarrollar algunas ideas sobre el modo en que las personas obesas resultan posicionadas o caracterizadas a través de los mensajes al foro del periódico: como personas enfermas, anormales, asociados con otros grupos socialmente mal considerados, discriminados, perjudiciales para la sociedad y condenados a resignarse con su estado obeso. Nuestro trabajo persigue poner de manifiesto el trato desconsiderado y estigmatizador que nuestra sociedad depara a las personas gordas, así como explorar algunas claves de actuación que sirvan para reducir el estigma. (shrink)

This book presents a novel interpretation of Aristotle's account of how shame instils virtue, and defends its philosophical import. Shame is shown to provide motivational continuity between the actions of the learners and the virtuous dispositions that they will eventually acquire.

Aristotle ’s claim that we become virtuous by doing virtuous actions raises a familiar problem: How can we perform virtuous actions unless we are already virtuous? I reject deflationary accounts of the answer given in _Nicomachean Ethics_ 2.4 and argue instead that proper habituation involves doing virtuous actions with the right motive, i.e. for the sake of the noble, even though learners do not yet have virtuous dispositions. My interpretation confers continuity to habituation and explains in a non-mysterious way how (...) we become virtuous by doing virtuous actions in the right way. (shrink)

Luis Jiménez Moreno murió en octubre de 2007 a los 77 años de edad. Durante los últimos 30 años perteneció a la Universidad Complutense, de la que llegó a ser catedrático. Había estudiado en Salamanca, Roma, Valencia y Munich. Su tesis doctoral sobre el pensamiento antropológico de Nietzsche fue dirigida por Aranguren. Fue catedrático de instituto en Andújar, Ávila y Badalona, y profesor de universidad en Barcelona y Madrid. El presente artículo recoge los datos fundamentales de su vida, así (...) como toda su obra dividida en libros, artículos, ensayos, conferencias, ponencias y comunicaciones en congresos, seminarios, simposios, reuniones científicas, etc. (shrink)

A través de su historia, la práctica de la medicina ha estado imbuida de diversas concepciones sobre la naturaleza humana, así como sobre los elementos, estados o procesos (tanto internos como externos) que dan origen a la enfermedad y aquellos que propician la salud. Si se consideran seriamente, tales concepciones se pronuncian sobre cuestiones ontológicas y metafísicas. En la medida en que sean dignas de crédito, sus pronunciamientos ontológicos y metafísicos resultan relevantes para múltiples facetas de la práctica médica, como (...) el diagnóstico, el tratamiento, la investigación, la prevención y el control de enfermedades, pero también para el cuidado y la promoción de la salud. En este capítulo se exploran cuestiones metafísicas generales en torno a la concepción de la práctica médica más influyente en el mundo actual: la biomedicina. Sostengo que, a pesar de que el asombroso éxito de las ciencias biomédicas nos ofrece razones para creer en la verdad (aproximada) de las representaciones que toman como base, esa confianza no debería estar asociada selectivamente a pronunciamientos específicos sobre qué cosas existen y cómo se conectan; además, nuestro grado de convicción en los resultados de la investigación biomédica debería estar calibrado al tomar en cuenta vulnerabilidades ampliamente reconocidas de este ámbito de indagación. Comienzo caracterizando la biomedicina como la aplicación de los resultados de la investigación científica a la práctica médica. Examino razones generales para creer en la verdad de las representaciones con las que opera este modelo de la práctica médica, recapitulando de manera panorámica el debate en torno al realismo científico. Luego consideraro aspectos relevantes para este debate que conciernen específicamente a las ciencias biomédicas, así como algunas consecuencias para el ámbito de la biomedicina que se desprenden de adoptar varias posiciones en torno al realismo científico. Concluyo ofreciendo una defensa del realismo carte blanche como la posición más sensata que puede adoptarse en este ámbito. (shrink)

The specific role of empeiria in Aristotle’s ethics has received much less attention than its role in his epistemology, despite the fact that Aristotle explicitly stresses the importance of empeiria as a requirement for the receptivity to ethical arguments and as a source for the formation of phronêsis.1 Thus, while empeiria is an integral part of all explanations that scholars give of the Aristotelian account of the acquisition of technê and epistêmê, it is usually not prominent in explanations of the (...) acquisition of phronêsis.2 The abundant mentions of empeiria in Aristotle’s ethical treatises are often eclipsed in the secondary literature... (shrink)

Reactivity, or the phenomenon by which subjects tend to modify their behavior in virtue of their being studied upon, is often cited as one of the most important difficulties involved in social scientific experiments, and yet, there is to date a persistent conceptual muddle when dealing with the many dimensions of reactivity. This paper offers a conceptual framework for reactivity that draws on an interventionist approach to causality. The framework allows us to offer an unambiguous definition of reactivity and distinguishes (...) it from placebo effects. Further, it allows us to distinguish between benign and malignant forms of the phenomenon, depending on whether reactivity constitutes a danger to the validity of the causal inferences drawn from experimental data. (shrink)

In what ways and how far does virtue shield someone against suffering evils? In other words, how do non-moral evils affect the lives of virtuous people and to what extent can someone endure evils while staying happy? The central purpose of this chapter is to answer these questions by exploring what Aristotle has to say about the effects of evils in human well-being in general and his treatment of extreme misfortunes.

Much of the methodological discussion around experiments in economics and other social sciences is framed in terms of the notions of internal and external validity. The standard view is that internal validity and external validity stand in a relationship best described as a _trade-off_. However, it is also commonly held that internal validity is a _prerequisite_ to external validity. This article addresses the problem of the compatibility of these two ideas and analyzes critically the standard arguments about the conditions under (...) which a trade-off between internal and external validity arises. Our argument stands against common associations of internal validity and external validity with the distinction between field and laboratory experiments and assesses critically the arguments that link the artificiality of experimental settings done in the laboratory with the purported trade-off between internal and external validity. We conclude that the idea of a trade-off or tension between internal and external validity seems, upon analysis, far less cogent than its intuitive attractiveness may lead us to think at first sight. (shrink)

A series of recent debates in experimental economics have associated demand effects with the artificiality of the experimental setting and have linked it to the problem of external validity. In this paper, we argue that these associations can be misleading, partly because of the ambiguity with which “artificiality” has been defined, but also because demand effects and external validity are related in complex ways. We argue that artificiality may be directly as well as inversely correlated with demand effects. We also (...) distinguish between the demand effects of experimentation and the reactions that they may trigger and that might endanger experimental validity. We conclude that economists should pay more attention to the way in which subjects construe the experimental task and learn to exploit subjects’ reactivity to expectations in their experiments. (shrink)

Our philosophical understanding of mental illness is being shaped by neuroscience. However, it has the paradoxical effect of igniting two radically opposed groups of philosophical views. On one side, skepticism and denialism assume that, lacking clear biological mechanisms and etiologies for most mental illnesses, we should infer they are constructions best explained by means of social factors. This is strongly associated with medical nihilism: it considers psychiatry more harmful than benign. On the other side of the divide, naturalism and reductionism (...) are on the look for failures in the biological functioning of the organism whenever a genuine mental illness occurs. Psychiatry as currently practiced, accordingly, exhibits the gaps of an ongoing research programme; a yet to be completed neuroscience would link mental illnesses with identifiable biological mechanisms. Both sides of this divide claim to be fostered by scientific discoveries and advances in neuroscience, when taken at face value. Against this background, we argue instead for a modest view. To that end, we draw attention to some nuances in the scientific realism debate. While contending that neuroscientific theories and models aim to provide true representations of their target systems, and can justifiably claim to have attained some, we argue that our confidence should not be placed beforehand in specific features of these scientific representations. Hence, it would be unwarranted to extract morals for psychiatry from posits (or their absence) in neuroscientific explanations of mental illnesses. To illustrate our position, we examine some recent discoveries in neuroscience concerning bipolar disorder. We conclude by linking our topic to a broader issue in the philosophy of medicine: insofar as psychiatry is a biomedical specialty, its classifications of health and disease are guided by pragmatic concerns, as well as by scientific discoveries. (shrink)

Background: Decision-making and assessment in emergency situations are complex and result many times in ethical conflicts between different healthcare professionals. Aim: To analyse and describe situations that can generate ethical conflict among nurses working in emergency situations. Methods: Qualitative analysis. A total of 16 emergency nurses took part in interviews and a focus group. Ethical considerations: Organisational approval by the University Hospital, and informed consent and confidentiality were ensured before conducting the research. Result/conclusion: Two categories emerged: one in ‘ethical issues’ (...) and one in ‘emotions and feelings in caring’. The four ethical subcategories are presented: Autonomy, the first sub category: first, the nurse’s ability to practise care on an emergency ward and, second, to support the patient and/or relatives in terms of care and medical treatment. The conflicts arise when the nurse ends up in the middle between the patient and the physician responsible for the diagnosis and treatment from a nature scientific perspective. Reification of injured body: patient was often reified and fragmented, becoming just a leg or arm. Different factors contributed in this perspective. Pain: pain relief was often inadequate but more effectively treated in the emergency medical services than at the emergency department. The nurses highlighted the phenomenon of suffering because they felt that pain was only an object, forgetting the patients’ care need, like separating mind from body. Death: the nurses felt that the emergency services are only prepared to save lives and not to take care of the needs of patients with ‘end-of-life’ care. Another issue was the lack of ethical guidelines during a cardiac arrest. Resuscitation often continues without asking about the patient’s ‘previous wishes’ in terms of resuscitation or not. In these situations, the nurses describe an ethical conflict with the physician in performing their role as the patient’s advocate. The nurses express feelings of distress, suffering, anger and helplessness. (shrink)