This article explores morality and credibility struggles in connection to two officially sanctioned public Swedish experiments launched in the late 1960s to investigate the (ab)use of alcohol and illicit drugs, especially in relation to young people, and the subsequent decisions to terminate the experiments and research. We argue that these 1960s struggles on how to analyze the effects of increased availability of psychoactive substances must be understood in the light of a simultaneous development of modern (social) science studies. The public (...) display of conflicting expert views on how to investigate and interpret questions of alcohol and drugs in modern society played out in concordance with the growth of social science alcohol and drug research and expertise. The article focuses on the 1960s, a decade that was characterized by profound transformations in Swedish society. In so doing, the article contributes from the perspective of history to debates on the nexus between knowledge production and policy in modern societies. (shrink)

This paper seeks to explore the processes involved in becoming a teacher in this particular historical moment of global pandemic in Brazil. What are the challenges, limitations, possibilities and opportunities that the pandemic presents to the process of teaching work and teacher formation? A review of the literature that included contributions from Caponi, Kohan, Larrosa, Neuscharank, Vaz, Arroyo and Abramowicz suggests a dialogue between pedagogic theory, philosophy of education and the contemporary experience of political and social events in the pandemic (...) period The discussions reviewed explore the profound extent to which Covid-19 has affected our way of living, working and relating to others, and the psychological effects of social isolation. The situation demands from the Brazilian teacher an attitude of openness to change, specifically in the use of new technologies, and the extent to which they are or are not able to replace face-to-face interactions. The situation also challenges us to reconstruct, beyond the logic of neoliberalism, our notions of the type of school we have and type of school we want, the type of teachers we are and the type of teacher we want to be. We conclude that this process of thinking school again depends, if it is to escape neoliberal logic, on the capacity of understanding the vocation of the teacher to be one of “becoming-child” in the sense of experiencing an openness to and a desire for the new. As such, the “becoming-teacher” is one who allows herself to be addressed by another logic, another more sensitive and more aesthetic temporality, and who finds, in encounter with others, with art, with childhood, with becoming itself, the capacity to think, to resist, to fight for the realization of that logic. (shrink)

A growing body of literature critical of ethics review boards has drawn attention to the processes used to determine the ethical merit of research. Citing criticism on the bureaucratic nature of ethics review processes, this literature provides a useful provocation for (re)considering how the ethics review might be enacted. Much of this criticism focuses on how ethics review boards _deliberate,_ with particular attention given to the lack of transparency and opportunities for researcher recourse that characterise ethics review processes. Centered specifically (...) on the conduct of ethics review boards convened within university settings, this paper draws on these inherent criticisms to consider the ways that ethics review boards might enact more communicative and deliberative practices. Outlining a set of principles against which ethics review boards might establish strategies for engaging with researchers and research communities, this paper draws attention to how _Deliberative communication_, _Engagement with researchers_ and the _Distribution of responsibility_ for the ethics review might be enacted in the day-to-day practice of the university human ethics review board. This paper develops these themes via a conceptual lens derived from Habermas’ (The theory of communicative action. Volume 1: Reason and the rationalization of society, 1984 ) articulation of ‘communicative action’ and Fraser’s (Social Text, 25(26), 56–80, 1990 ) consideration of ‘strong publics’ to cast consideration of the role that human ethics review boards might play in supporting university research cultures. _Deliberative communication_, _Engagement with researchers_ and the _Distribution of responsibility_ provide useful conceptual prompts for considering how ethics review boards might undertake their work. (shrink)

Caring for older persons is both rewarding and consuming. Work with older people in Finland has been shown to be more burdensome than in the other Nordic countries. The aim of this study was to try out a Finnish version of the Stress of Conscience Questionnaire (SCQ) and explore stress of conscience in staff caring for older persons in Finland. The data were collected from the nursing staff (n = 350) working with older people in health centre wards, municipal and (...) private nursing homes, and municipal and private dementia care units in Finland. It emerged clearly from the results that Finnish nursing staff mostly felt that they did not have enough time to provide good care to patients, and this gave them a troubled conscience. They also felt that the demanding work taxed their energy, a consequence being that they could not give their own families and loved ones the attention they would have liked. (shrink)

Collegiality is one of the fundamental values of the nursing profession. During the nursing history, collegiality has been described as part of a nurse’s relationship with their peers and it influences the quality of care they provide and job satisfaction and commitment to their work. Despite earlier definitions, the concept of collegiality in nursing has remained unclear. The aim of this study was to clarify the concept of collegiality in the nursing profession, using Rodger’s evolutionary concept analysis. We carried out (...) electronic searches using the CINAHL, PubMed, Scopus, Web of Science, SocINDEX, PsycINFO and Eric databases and manual searches of the reference lists of the selected papers. The searches were limited to peer-reviewed papers published in English language from the inception of database to November 2022. This identified 25 papers. Based on our analysis, the attributes of the concept of collegiality were achieving mutual goals together with equality, reciprocity, trusted advocacy, powerful self-regulation and engaged belongingness. Antecedents of the concept included existing professional group, connection between professionals and professional self-esteem. The consequences were strengthening nurses’ professional status, job satisfaction and their ability to provide the best possible patient care. We found that nurses’ collegiality was a value-based concept, with a unique character based on professional connections. The concept brought together ethical and pragmatic strategies to achieve the best possible results for the nursing profession. Provided knowledge can be applied for further development of the concept and applying it in clinical research and practice. The concept of nurses’ collegiality should also be studied in the future because both the profession and their working environment are constantly changing. (shrink)

Conducting nursing research in long-term care facilities and with samples of older people requires careful attention to research ethics and the ethical conduct of the study. This review analysed the research ethics of the empirical studies that focus on older people in long-term care settings as research participants. Articles (n = 66) focussing on older people in long-term care settings as research informants were retrieved from an electronic search of MEDLINE (1990 to February 2012) using the MESH terms ‘Nursing’ AND (...) ‘Long-term care’ (578 citations) and ‘Institutionalization’ and ‘Nursing’ (89 citations). Ethical approval procedure was reported in more than half of the studies (58%) and informed consent in two-thirds of the studies (70%). Ethical issues in data collection were described in most of the articles, but only a few reported ethics in problem statement, reporting or presenting implications. There is a need to focus on reporting research ethics and procedures in empirical research on vulnerable people. (shrink)

This study in the context of short-stay surgery is based on a definition according to which informed consent consists of five elements: consent, voluntariness, disclosure of information, understanding and competence. The data were collected in four district hospitals in southern Finland by using a structured questionnaire. The population consisted of short-stay and one-day surgery patients (n = 107). Data analysis was based on statistical methods. The results indicated some problems in the realization of informed consent. Most commonly, consent was expressed (...) by voluntary admission. Most patients had indicated their voluntary consent by making their decision independently. There were also certain problems with information. The respondents were least well informed about the drawbacks of anaesthesia and about alternative forms of treatment. The patients had not understood all the information they had received; problems of understanding were greatest with information about the advantages and disadvantages of anaesthesia. Problems were also reported with competence. These patients had the most difficulty in assessing the advantages and drawbacks of different treatments and anaesthesia. (shrink)

Background:Women's health has received renewed attention in the last few years including health rehabilitation options for women affected by breast cancer. Dancing has often been regarded as one attractive option for supporting women's well-being and health, but research with women recovering from breast cancer is still in its infancy. Dancing with Health is multi-site pilot study that aimed to evaluate a dance programme for women in recovery from breast cancer across five European countries.Methods:A standardized 32 h dance protocol introduced a (...) range of Latin American dances presented within a sports and exercise framework with influences from dance movement therapy. Fifty-four women (M age 53.51; SD 7.99) participated in the study who had a breast cancer diagnosis 6 weeks, no indication of metastasis, or scheduled surgery/chemotherapy/radiation treatment for the duration of the intervention. Primary outcome data was collected for anthropometric and fitness measures next to cancer-related quality of life.T-tests and Wilcoxon signed ranked tests were used to establish differences pre and post intervention. Cohen's d was also calculated to determine the effect size of the intervention.Results:Statistically significant changes were found for: (i) weight, right and left forearm circumference and hip; (ii) 6 min walking, right and left handgrip, sit-to-stand and sit-and-reach; (iii) the EORTC-QLQ C30 summary score as well as the subscales of emotional and social functioning and symptoms. In all cases the direction of change was positive, while Cohen's d calculated showed that the effect of the intervention for these parameters ranged from intermediate to large.Conclusion:Changes on the above anthropometric, fitness and quality of life measures suggest that the intervention was of value to the participating women recovering from breast cancer. Results also advocate collaborative efforts across countries to further research. (shrink)

Este trabajo aborda el pacto librepensador suscri­to por las autoras Rosario de Acuña y Ángeles López de Ayala. Se examinan sus contribuciones en la prensa librepensadora y su activismo feminista a través de un análisis de sus colabora­ciones en Las dominicales del librepensamiento, El gladiador: órgano de la “Sociedad progresiva femenina” y El gladiador del librepensamiento. La ideología de estas publicaciones les permitió vincular la lucha feminista con la agenda política de ideología progresista. Se parte de dos ejes complementarios cuya (...) intersección permite abordar su pacto de compromiso y transgresión: la lucha por la igualdad social y por la igualdad de género. Se estudian sus reflexiones sobre la explotación del pueblo por las castas, el empoderamiento de la mujer como agente constructor del progreso y la denuncia vehemente de su sometimiento. Se concluye que los escritos de Acuña y Ayala evidencian con el paso de los años una radicalización que pro­picia una postura cada vez más trasgresora y un feminismo más combativo, reflejando así su descontento con la actitud pater­nalista u hostil del librepensamiento y el republicanismo mas­culino en lo que respecta a los derechos de la mujer. (shrink)

This survey set out to explore occupational health professionals' courses of action with respect to privacy in a situation of dual loyalty between employees and employers. A postal questionnaire was sent to randomly selected potential respondents. The overall response rate was 64%: 140 nurses and 94 physicians returned the questionnaire. Eight imaginary cases involving an ethical dilemma of privacy were presented to the respondents. Six different courses of action were constructed within the set alternatives proposed. The study indicated that privacy (...) as an absolute value is not in the interest of either employees or employers. It also showed that, where dual loyalty is concerned, the most valid course of action in dealing with sensitive subjects such as drug and work community problems, sexual harassment and sick leave is to rely on tripartite co-operation. If they maintain their professional independence and impartiality, health professionals are well placed to succeed in this challenging task; if not, there are bound to be severe violations of privacy. (shrink)

This study aimed to determine the extent to which the principles of privacy and equality were observed during diagnostic genetic testing according to views held by patients or child patients' parents (n = 106) and by staff (n = 162) from three Finnish university hospitals. The data were collected through a structured questionnaire and analysed using the SAS 8.1 statistical software. In general, the two principles were observed relatively satisfactorily in clinical practice. According to patients/parents, equality in the post-analytic phase (...) and, according to staff, privacy in the pre-analytic phase, involved the greatest ethical problems. The two groups differed in their views concerning pre-analytic privacy. Although there were no major problems regarding the two principles, the differences between the testing phases require further clarification. To enhance privacy protection and equality, professionals need to be given more genetics/ethics training, and patients individual counselling by genetics units staff, giving more consideration to patients' world-view, the purpose of the test and the test result. (shrink)

The teleosemantic indeterminacy problem has generated much discussion but no consensus. One possible solution is to accept indeterminacy as a real feature of some representations. I call this view “indeterminacy realism.” In this paper, I argue that indeterminacy realism should be treated as a serious option. By drawing an analogy with vagueness, I try to show that accepting the reality of indeterminacy would not be catastrophic for teleosemantics. I further argue that there are positive reasons to endorse indeterminacy realism. I (...) end the paper by arguing that indeterminacy realism need not generalize viciously to the case of propositional attitudes. (shrink)

Pulmonary rehabilitation has demonstrated patients’ physiological and psychosocial improvements, symptoms reduction and health-economic benefits whilst enhances the ability of the whole family to adjust to illness. However, PR remains highly inaccessible due to lack of awareness of its benefits, poor referral and availability mostly in hospitals. Novel models of PR delivery are needed to enhance its implementation while maintaining cost-efficiency. We aim to implement an innovative community-based PR programme and assess its cost-benefit. A 12-week community-based PR will be implemented in (...) primary healthcare centres where programmes are not available. Healthcare professionals will be trained. 73 patients with CRD and their caregivers will compose the experimental group. The control group will include dyads age- and disease-matched willing to collaborate in data collection but not in PR. Patients/family-centred outcomes will be dyspnoea, fatigue, cough and sputum, impact of the disease, emotional state, number of exacerbations, healthcare utilisation, health-related quality of life and family adaptability/cohesion. Other clinical outcomes will be peripheral and respiratory muscle strength, muscle thickness and cross sectional area, exercise capacity, balance and physical activity. Data will be collected at baseline, at 12 weeks, at 3- and 6-months post-PR. Changes in the outcome measures will be compared between groups, after multivariate adjustment for possible confounders, and effect sizes will be calculated. A cost-benefit analysis will be conducted. This study will enhance patients access to PR, by training healthcare professionals in the local primary healthcare centres to conduct such programmes and actively involving caregivers. The cost-benefit analysis of this intervention will provide an evidence-based insight into the economic benefit of community-based PR in chronic respiratory diseases. The trial was registered in the ClinicalTrials. gov U.S. National Library of Medicine, on 10th January, 2019. (shrink)

Acting for the good of the patient is the most fundamental and universally acknowledged principle of medical ethics. However, given the complexity of modern medicine as well as the moral fragmentation of contemporary society, determining the good is far from simple. In his philosophy of medicine, Edmund Pellegrino develops a conception of the good that is derived from the internal morality of medicine via the physician-patient relationship. It is through this healing relationship that rights, duties, and privileges are defined for (...) both physicians and patients. Moreover, this relationship determines the characteristics or virtues that are necessary to engage in the medical telos. This paper addresses the role of the moral virtues in clinical medicine and the physician-patient relationship. First, it provides a brief background of the Aristotelian foundations of virtue-ethics. Second, it delves into Pellegrino’s philosophy of medicine understood as a practice oriented towards a teleological goal. Third, it relates the telos of medicine to the notion of the medical community as a fundamentally moral community. Finally, it concludes with a section that creates a dialogue between virtue ethics and principlism. (shrink)

A social conception of science -- The pursuit of forms -- Beyond the doctrine of signs -- Structures of mediation -- Signs in action -- Prospects of communication -- From a rhetorical point of view.

Provability, Computability and Reflection.

This article describes, analyzes, and advocates for management of clinical healthcare conflict by a process commonly referred to as bioethics mediation. Section I provides a brief introduction to classical mediation outside the realm of clinical healthcare. Section II highlights certain distinguishing characteristics of bioethics mediation. Section III chronicles the history of bioethics mediation and references a number of seminal writings on the subject. Finally, Section IV analyzes barriers that have, thus far, limited the widespread implementation of bioethics mediation.

Consider the opening sentence of Tolkien’s The Hobbit: In a hole in the ground there lived a hobbit. By writing this sentence, Tolkien is making a fictional statement. There are two influential views of the nature of such statements. On the pretense view, fictional discourse amounts to pretend assertions. Since the author is not really asserting, but merely pretending, a statement such as Tolkien’s is devoid of illocutionary force altogether. By contrast, on the alternative make-believe view, fictional discourse prescribes that (...) the reader make-believe the content of the statement. In this paper, we argue that neither of these views is satisfactory. They both fail to distinguish the linguistic act of creating the fiction, for instance Tolkien writing the sentence above, from the linguistic act of reciting it, such as reading The Hobbit out loud for your children. As an alternative to these views, we propose that the essential feature of the author’s speech act is its productive character, that it makes some state of affairs obtain in the fiction. Tolkien’s statement, we argue, has the illocutionary force of a declaration. (shrink)

The two books on which this study is based represent the two branches of linguistic philosophy. One an anthology, the other an original work, they differ also in kind. In Logic and Language A.G.N. Flew has collected and ably prefaced nine essays by British analysts, the earliest of which, Ryle's "Systematically Misleading Expressions," appeared exactly twenty years ago. Nelson Goodman's The Structure of Appearance is a new reconstruction; not to recognize its vigor and impressiveness would be most ungracious even if (...) one rejects as radically as I do this particular Aufbau. Naturally, I shall say more about Goodman's book than about the essays. Yet I shall begin with the latter and say about Ryle's as much as about all the rest together. To justify this strategy I must put my own cards on the table, indicating where I stand on this controversy or near controversy between formalists and antiformalists. To my mind, then, it is gray against gray, not white against black. Both sides agree, and I agree with them, that there is no experience or, if you please, no experiment that decides what is presumably at issue between phenomenalists and realists. In this important sense, both sides agree, and I agree with them, that all philosophical problems are verbal. But in another equally important sense they are not verbal. This sense both formalists and antiformalists have lost or stand in danger of losing if what they do is no better than what they say they do. Now for my reasons for singling out and starting off with the essay that marks Ryle's sober-eyed and reluctant conversion to the linguistic philosophy. It so happens that he there states very aptly a body of doctrine on which both sides could still agree and from which they in fact branched off at about the time the paper was first published. Also, the doubts and dissatisfactions to which he there confessed contain the starting points of the peculiar dialectics by which both formalists and antiformalists may be driven to extremes. Even better than that, I believe I can make use of these hesitancies to lend color to my own argument for a middle position which, as one is tempted to say on such occasions, does justice to both sides. That Ryle himself has in the meantime become a hero of the antiformalists is merely a piquant detail and does not deter me. (shrink)

The concept of inreducible complexity is central to the origins controversy. Ineducible complexity (IC) may be defined as any machine or system that requires two or more parts in order to function. Examples range from molecules to mousetraps, organelles, and organisms such as humans. This essay explores the relationship between IC and complexity, clarifying the levels of IC such as the irreducible core and its mode of function. IC has been used in a wide variety of disciplines for over a (...) century. Objections to irreducibte complexity include co-option, the "junk DNA" theory, and the scaffolding argument. Co-option, a major argument against IC, attempts to explain how IC can be achieved through natural means by utilizing existing parts to construct a new biological machine or structure. Yet examples of IC in both the biological and non-biological wortds show that such common objections do not invalidate the concept. IC is firmly established. (shrink)

Leave it to the boob tube to explain the meaning of existence. Let Gilligan's Island teach you about situational ethics. Learn about epistemology from The Brady Bunch. Explore Aristotle's Poetics by watching 24. Television has grappled with a wide range of philosophical conundrums. According to the networks, it's the ultimate source of all knowledge in the universe. So why not look at the small screen for answers to all of humanity's dilemmas? There's not a single issue discussed by the great (...) thinkers of the past that hasn't been hashed out between commercials in shows like Mad Men and Leave It To Beaver..."--P. [4] of cover. (shrink)

Teleosemantics has an indeterminacy problem. In an earlier publication, I argued that teleosemanticists may afford to be realists about indeterminacy, pointing to the phenomenon of vagueness as a case of really-existing semantic indeterminacy. Here, I continue that project by proposing two criteria of adequacy that a semantically indeterminate theory should meet: a criterion of theoretical adequacy and a criterion of extensional adequacy. I present reasons to think that indeterminate versions of teleosemantics can meet these criteria. I end by discussing vagueness, (...) concluding that it most likely is not the same kind of phenomenon as the semantic indeterminacy afflicting teleosemantics. (shrink)

According to internalism about rationality, the ir/rationality of a subject depends only on how things appear from her subjective perspective. According to culpabilism, rationality is a normative standard such that violations of rationality are (at least sometimes) blameworthy. According to a classical line of reasoning, culpabilism entails internalism. I argue that, to the contrary, culpabilism entails that internalism is false. The internalist cannot accommodate the possibility of culpable irrationality.

This paper investigates the role of a pre-existing body-model that is an enabling constraint for the incorporation of objects into the body. This body-model is also a basis for the distinction between body extensions (e.g., in the case of tool-use) and incorporation (e.g., in the case of successful prosthesis use). It is argued that, in the case of incorporation, changes in the sense of body-ownership involve a reorganization of the body-model, whereas extension of the body with tools does not involve (...) changes in the sense of body-ownership. (shrink)

Background: Dignity is a multidimensional construct that includes perception, knowledge, and emotions related to competence or respect. Attitudes to aging are a comprehensive personal view of the experience of aging over the course of life, which can be influenced by various factors, such as the levels of health and self-sufficiency and social, psychological, or demographic factors. Aim: The purpose of this study was to explore the attitudes to aging of home-dwelling and inpatient older adults, and whether dignity and other selected (...) factors belong among the predictors influencing attitudes to aging in these two different groups of older adults. Research design: Cross-sectional study using a set of questionnaires: Patient Dignity Inventory, Attitudes to Aging Questionnaire, and Barthel Index. Pearson and Spearman correlation analyses and multivariable linear regression were used for statistical processing. Participants and research context: 233 inpatients and 237 home-dwelling older adults participated in the research in two regions of the Czech Republic. Ethical considerations: Institutional Review Board approval was received from the authors’ university. Findings: The inpatients had more negative attitudes to aging (M = 74.9±10.9; P <0.0001). The predictors of their attitudes to aging were gender and dignity. Women ( β = −2.969, P = 0.045) and inpatients with poor dignity ratings ( β = −0.332, P <0.0001) had more negative attitudes to aging. The predictors for home-dwelling older adults were education, living arrangement, and dignity. More negative attitudes to aging were found in older adults with lower levels of education ( β = 2.716, P = 0.007) who lived alone ( β = 2.163, P = 0.046) and rated their dignity as low ( β = −0.325, P <0.0001). Discussion and Conclusions: The results of this study add to the understanding that a sense of dignity is an important predictor of attitudes to aging for both home-dwelling older adults and inpatients. (shrink)