The aim of this study is to understand how governance mechanisms in cross-sector collaborations (CSCs) for sustainability affect value creation and capture and subsequently the survival of this organizational form. Drawing on a longitudinal, participatory, single-case study of collaborative action in the textile industry, we identify three governance mechanisms—safeguarding, bundling and connecting—that coevolve with the rising and waning of collaborative tensions and the shifting levels of action in the CSC we studied. These mechanisms aided value creation and helped facilitate private (...) value capture. We integrate these insights into a process model that visualizes the interplay between governance mechanisms of tensions and systems of value creation and capture in CSCs for sustainability. Our study contributes to the cross-sector collaboration literature by providing a dynamic and nuanced understanding of how governance mechanisms influence outcomes in CSCs for sustainability. We also add to the business model for sustainability literature by theorizing the value creation and capture system of collaborative rather than individual organizations. Our findings have important implications for policymakers who fund collaborative organizations and practitioners who manage or participate in them. (shrink)

Background: The global COVID-19 pandemic has imposed challenges on healthcare systems and professionals worldwide and introduced a ´maelstrom´ of ethical dilemmas. How ethically demanding situations are handled affects employees’ moral stress and job satisfaction. Aim: Describe priority-setting dilemmas, moral distress and support experienced by nurses and physicians across medical specialties in the early phase of the COVID-19 pandemic in Western Norway. Research design: A cross-sectional hospital-based survey was conducted from 23 April to 11 May 2020. Ethical considerations: Ethical approval granted (...) by the Regional Research Ethics Committee in Western Norway (131421). Findings: Among the 1606 respondents, 67% had experienced priority-setting dilemmas the previous two weeks. Healthcare workers who were directly involved in COVID-19 care, were redeployed or worked in psychiatry/addiction medicine experienced it more often. Although 59% of the respondents had seen adverse consequences due to resource scarcity, severe consequences were rare. Moral distress levels were generally low (2.9 on a 0–10 scale), but higher in selected groups (redeployed, managers and working in psychiatry/addiction medicine). Backing from existing collegial and managerial structures and routines, such as discussions with colleagues and receiving updates and information from managers that listened and acted upon feedback, were found more helpful than external support mechanisms. Priority-setting guidelines were also helpful. Discussion: By including all medical specialties, nurses and physicians, and various institutions, the study provides information on how the COVID-19 mitigation also influenced those not directly involved in the COVID-19 treatment of patients. In the next stages of the pandemic response, support for healthcare professionals directly involved in outbreak-affected patients, those redeployed or those most impacted by mitigation strategies must be a priority. Conclusion: Empirical research of healthcare workers experiences under a pandemic are important to identify groups at risks and useful support mechanisms. (shrink)

Labyrinth of the world and paradise of the heart belongs to the jewels of Czech literature. The author – Jan Amos Comenius – consciously uses allegorical narrative for didactic purposes – mainly for his own moral self-reflection in the face of suffering. His method proved to be very effective. The goal of this text is to explore the potential of the literary method from the perspective of moral (trans)formation. The key question is: How did Comenius convey the moral content of (...) his “lesson” in the Labyrinth? Or in general: How does allegorical narrative work as a tool of moral (trans)formation – both for the reader and author of the text. Specifically, this paper attempts to show several literary functions of the Labyrinth as a tool of moral (trans)formation: the therapeutic function, the emphatic function, the imitation function, the organizational function, the performative function and the plot function. (shrink)

Indoctrination is a large and important issue in (not only moral) education. It is considered to be one of the capital pedagogical faults. However, the question is, what does it mean to indoctrinate? Educators from the liberal camp of the educational spectrum have had the tendency to criticize the traditional approach as “indoctrinational.” On the other hand, proponents of the traditional approach object that if indoctrination were defined properly then even the liberal approach would not be immune. This raises two (...) fundamental questions that will be the subject of this study: a) what exactly does it mean to indoctrinate? b) is education without indoctrination even possible? (shrink)

First published in 1997. Routledge is an imprint of Taylor & Francis, an informa company.

With more than two million members and supporters, People for the Ethical Treatment of Animals (PETA) is the world’s largest animal-rights organization, and its founder and president, Ingrid Newkirk, is one of the most well-known and most effective activists in America. She has spearheaded worldwide efforts to improve the treatment of animals in manufacturing, entertainment, and elsewhere. Every day, in laboratories, food factories, and other industries, animals by the millions are subjected to inhumane cruelty. In this accessible guide, Newkirk (...) teaches readers hundreds of simple ways to stop thoughtless animal cruelty and make positive choices. For each topic, Newkirk provides hard facts, personal insight, inspiration, ideas, and resources, including: • How to eat healthfully and compassionately • How to adopt animals rather than support puppy mills • How to make their vote count and change public opinion • How to switch to cruelty-free cosmetics and clothing • How to choose amusements that protect rather than exploit animals. With public concern for the well-being of animals greater than ever—particularly among young people—this timely, practical book offers exciting and easy ways to make a difference. (shrink)

Having Too Much is the first academic volume devoted to limitarianism: the idea that the use of economic or ecosystem resources should not exceed certain limits. This concept has deep roots in economic and political thought. One can find similar statements of such limits in thinkers such as Plato, Aquinas, and Spinoza. But Having Too Much is the first time in contemporary political philosophy that limitarianism is explored at length and in detail. Bringing together in one place the best writing (...) from key theorists of limitarianism, this book is an essential contribution to political philosophy in general, and theories of distributive justice in particular. Including some of the key published articles as well as new chapters, Having Too Much is necessary reading for scholars and students of political theory and philosophy, as well as anyone interested in questions of distributive justice. (shrink)

Journal of Political Philosophy, Volume 30, Issue 2, Page 249-270, June 2022.

This monograph on the capability approach does two things. First, it provides an advanced introduction to the capability approach, as an account used in philosophy, as well as other disciplines. Second, it provides an account of the capability approach which is able to encompass all existing views and theories on the capability approach, including the writings on the capability approach by Martha Nussbaum and Amartya Sen.

Human embryos produced in labs since the 1970s have generated layers of uncertainty for law and policy: ontological, moral, and administrative. Ontologically, these lab-made entities fall into a gray zone between life and not-yet-life. Should in vitro embryos be treated as inanimate matter, like abandoned postsurgical tissue, or as private property? Morally, should they exist largely outside of state control in the zone of free reproductive choice or should they be regarded as autonomous human lives and thus entitled to constitutional (...) protection like full-fledged citizens? Administratively, if they deserve protection, what institutional and policy mechanisms are best suited to carrying out the necessary oversight? Using a method termed comparative problematization, this article traces divergent answers to these questions produced in three countries—the United States, United Kingdom, and Germany—across the last twenty-five years. Comparison reveals distinct bioconstitutional foundations that give rise to systematically different understandings of each state’s responsibilities toward human life and hence its particular treatment of claims on behalf of embryonic lives. (shrink)

This article analyses the general ethical milieu in a nursing home for elderly residents and provides a decision-making model for analysing the ethical situations that arise. It considers what it means for the residents to live together and for the staff to be in ethically problematic situations when caring for residents. An interpretative phenomenological approach and Sandman’s ethical model proved useful for this purpose. Systematic observations were carried out and interpretation of the general ethical milieu was summarized as ‘being in (...) the same world without meeting’. Two themes and four subthemes emerged from the analysis. Three different ethical problems were analysed. The outcome of using the decision-making model highlighted the discrepancy between the solutions used and well-founded solutions to these problems. An important conclusion that emerged from this study was the need for a structured tool for reflection. (shrink)

This article is based on an empirical study regarding ethical challenges in intercultural nursing. The focus is on autonomy and disclosure. Autonomy is a human capacity that has become an important ethical principle in nursing. Although the relationship between autonomy and patients’ possibly harmful choices is discussed, the focus is on ‘forced’ autonomy. Nurses seem to equate respect with autonomy; it seems to be hard to cope with the fact that there are patients who voluntarily undergo treatment but who actively (...) participate neither in the treatment offered nor in making choices regarding that treatment. Nurses’ demand for patients to be autonomous may in some cases jeopardize the respect, integrity and human worth that the ethical principle of autonomy is meant to ensure. Even though respect for a person’s autonomy is also respect for the person, one’s respect for the person in question should not depend on his or her capacity or aptitude to act autonomously. Is autonomy necessarily a universal ethical principle? This article negates this question and, through the issues of culture, individualism versus collectivism, first- and second- order autonomy, communication and the use of family interpreters, and respect, an attempt is made to explain why. (shrink)

Todos los humanos, cualquiera sea su edad y en cualquier momento de la historia en que los situemos, se han preguntado de una forma u otra, acerca del origen de nuestra especie, del origen de la tierra, del universo, del origen, en fin, del tiempo y del espacio. Son preguntas eternas que de una forma u otra, reflejan la magia del misterio que envuelve nuestra presencia como especie en este hermoso globo azulado perdido en la inmensidad del universo infinito. Esta (...) Historia del Universo de Thom.. (shrink)

Many older gay men experience diminished psychological well‐being (PWB) due to unique circumstances including discrimination, living with HIV, and aging through the HIV/AIDS crisis. However, there remains ambiguity as to how older gay men define and understand PWB. Our team interviewed and analyzed the accounts of 26 older (50+) self‐identifying English‐speaking men living in southwestern British Columbia, Canada. We drew on tenets of constructivist grounded theory and intersectionality to account for unique contextual considerations and power relations. Semi‐structured Zoom interviews were (...) conducted from August‐October 2022. Interview transcripts were compared to generate high‐order conceptual findings underpinned by processes understood as central to PWB. Three PWB temporal processes highlighted interlocking social and contextual circumstances intersecting with power and maturation: (1) being emotionally balanced, (2) living gratitude (3) and fully embracing self‐acceptance. Being emotionally balanced supported the affective and sustainable state of contentment, living gratitude drew from the wisdom of accrued experiences to cultivate a positive affective state inclusive to recognising social location privileges, whilst fully embracing self‐acceptance redressed the harms of anti‐gay discourses that men endured throughout their lives. The knowledge is relevant to service and resource development to deliver tailored PWB supports to older gay men. (shrink)

This paper offers a critique of Martha Nussbaum’s description of the capability approach, and offers an alternative. I will argue that Nussbaum’s characterization of the capability approach is flawed, in two ways. First, she unduly limits the capability to two strands of work, thereby ignoring important other capabilitarian scholarship. Second, she argues that there are five essential elements that all capability theories meet; yet upon closer analysis three of them are not really essential to the capability approach. I also offer (...) an alternative description of the capability approach, which is called the cartwheel view of the capability approach. This view is at the same time radically multidisciplinary yet also contains a foundationally robust core among its various usages, and is therefore much better able to make the case that the capability approach can be developed in a very wide range of more specific normative theories. Finally, the cartwheel view is used to argue against Nussbaum's claim that all capabilitarian political theory needs to be politically liberal. (shrink)

Abstract:This article employs the concept of “transformative experience” to develop a radical version of aesthetic cognitivism, according to which engaging with literary perspectives might lead the reader to experience not only an epistemic but also a personal transformation. It is argued that the reader’s imaginative and empathic abilities when subjected to the aesthetic norms that govern a literary work can mobilize other aspects of their psychology, eliciting in this way a change in their core values and, consequently, in the way (...) in which they engage with the world. After introducing the topic (section 1), the article discusses the scope of literary perspectives in terms of the character’s subjective experiences (section 2). Next, it offers an analysis of the depth of literary perspectives in terms of the degree of involvement of the reader’s imaginative and empathic abilities (section 3). It proceeds to examine how the interplay between the scope and depth in the reader’s engagement with a literary perspective can explain their epistemic and personal transformation (section 4). In the final part, the article analyzes how the personal transformation changes the reader’s value system (section 5). The main findings are summarized in the conclusion (section 6). (shrink)

Journal of Economic Methodology, Volume 19, Issue 2, Page 159-163, June 2012.

Background: Studies from Western countries show that doctors working in neonatal intensive care units find withdrawal of treatment to be their most difficult ethical dilemma. There is less knowledge of how this is experienced in other economic, cultural, religious and educational contexts.Objectives: To explore and describe how Indian doctors experience ethical dilemmas concerning the withdrawal of treatment among critically sick and/or premature neonates.Method: Qualitative data from interviews was analysed according to Giorgi's phenomenological approach. The subjects were 14 doctors with various (...) levels of neonatal experience, recruited from two state‐owned NICUs in India. Main outcome measures: description reflecting the nature of ethical dilemmas and how they are experienced.Results: All doctors reported situations where the question of withdrawal of treatment was experienced as the worst part of their job. They felt that they lacked training in how to handle such dilemmas, and some had never talked about ethics before. They were especially concerned about non‐medical considerations that do not feature in current treatment guidelines. In describing their personal experiences, the informants mentioned their sense of responsibility in situations where they were aware that their decisions would influence a family's economy and reputation, availability of food and education for siblings, other children's access to equipment in the unit, and the use of resources in an underprivileged population. Sometimes lack of resources, usually ventilators, forced them to make decisions about which babies should get the chance to live. Other reported dilemmas included difficulties co‐operating with uneducated and poor parents.Conclusion: While Western doctors seem to focus on the rights and problems of the individual child, Indian doctors tend to refer to consequences for other children, for parents and society. There is a need for further research in this field, and for the development of guidelines on how to cope with differences in resources, and how to handle different patient groups’ cultural and religious concerns. (shrink)

The aim of this literature study was to suggest a value ground for nursing anchored in two ethical principles: the principle of human value and the right to experience a meaningful life. Previous nursing research between the years 2000 and 2009 was analysed. Presented values suggested in this value ground are thus in line with the nursing context and science of today. Statements within ethical literature have been used in order to formulate arguments aimed at supporting the values that were (...) found in the study. In the literature study six values were found: trust, nearness, sympathy, support, knowledge and responsibility. These values hold equal status and are not presented in hierarchical order. They vary due to the persons involved, nursing situations and cultural surroundings, but have the common requirement of being non-excluding. In order to implement the values within the value ground, two prerequisites are discussed and claimed as essential: ethical dialogue and a caring encounter between care provider and patients. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Wandering the Magnetosphere*Ingrid Koenig (bio)Navigation notes: These emergent drawings–excerpts from a visual essay–take up the complex network of impacts across physical forces entangled with bio-geo-political time. A key element for this work is a living cosmography to depict movement across time, and to visualize wandering on a planet, in the magnetosphere, and between the internal energy of Earth and the solar energy of the cosmos. Physicists say there (...) are no things, there are only relations between things.Q: Hello ancient stone - may I unfold you like a book? Do you carry a message from deep time? A: Yes, what you’re holding is not a thing, but a process. Click for larger view View full resolutionDrawing from Svalbard, Day 17 expedition, 2019[End Page 97]Drifting on a rocky planet, between the internal energy of Earth and the solar energy of the cosmos–we live within a “cosmo-tectonic circulation” —Jerome Gaillardet, geo-chemist. Click for larger view View full resolutionGeocosmic Logic[End Page 98] Click for larger view View full resolutionHow Entropy is Time (detail) Click for larger view View full resolutionMagnetic Story[End Page 99] Click for larger view View full resolutionMessage From Deep Time 3 Click for larger view View full resolutionMessage From Deep Time 1[End Page 100] Click for larger view View full resolutionLooping Matters 1 (Litli-Hrutur, Iceland) Click for larger view View full resolutionLooping Matters 2[End Page 101] Click for larger view View full resolutionMother Rock Waves (Miradalir Valley, Iceland) Click for larger view View full resolutionMother Rock in Time[End Page 102] Click for larger view View full resolutionVolcanic Logic (Miradalir Valley, Iceland) Click for larger view View full resolutionSonic Lava (Miradalir Valley, Iceland)[End Page 103] Click for larger view View full resolutionWaves Across Time (Miradalir Valley, Iceland) Click for larger view View full resolutionDisorientations[End Page 104] Click for larger view View full resolutionMessage From Deep Time 2 Click for larger view View full resolutionGravitational Thought[End Page 105] Click for larger view View full resolutionMagnetic Thought (Miradalir Valley, Iceland) Click for larger view View full resolutionDistance Ladder Collapse[End Page 106] Click for larger view View full resolutionMattering Logic 3 Click for larger view View full resolutionMattering Logic 4[End Page 107] Click for larger view View full resolutionHow We Make Time into Space Click for larger view View full resolutionHow Entropy is Time (detail 2–Svalbard)[End Page 108]Ingrid Koenig Ingrid Koenig is Associate Professor at Emily Carr University of Art + Design, Vancouver, Canada. She was the inaugural Artist in Residence (2011 to 2021) at TRIUMF, Canada’s particle accelerator center, and co-organizes processes of collaboration between artists and physicists in a project called Leaning Out of Windows. Her studio and research practices traverse the fields of physics, social history, feminist theory, and narratives of science. Her drawings explore the complex phenomena of physics and involve intuitive responses to specific sites through fieldwork in Canada’s Rocky Mountains, Germany, Iceland, Arctic Circle art + science expeditions, and through collaborations with physicists. She has received grants from the Canada Council for the Arts, the Goethe Institute, and the Social Science and Humanities Research Council. She co-edited the recently published book, Leaning Out of Windows: An Art and Physics Collaboration (Figure 1 Publishing, 2023).Footnotes* Excerpts from Wandering the Magnetosphere–drawings by Ingrid Koenig, 2019 to 2023, and ongoingCopyright © 2023 Johns Hopkins University Press and SubStance, Inc... (shrink)

Choosing a compassionate lifestyle that makes you feel good and positively impacts on the environment and on animals has never been easier. In this practical and accessible handbook, loaded with resources for all products that are mentioned, Ingrid Newkirk presents fabulous options that will not only enhance your life, but those of your neighbors, your community, animals, and the earth itself. From comfortable home furnishings, to delicious foods, to fashionable clothing there are a myriad of choices to be made (...) that can have a lasting positive effect on the well-being of animals and the environment, including: - recognizing hidden animal ingredients in cosmetics and household products - raising ecologically aware and animal-friendly kids - creating healthy, environmentally-friendly meals for everyday and special occasions - dressing with style without using leather or other animal products - dealing kindly with mice, insects, and other 'pests' in home or garden - adopting the right animal companion for you - volunteering and investing in eco- and animal-friendly companies - traveling with Eco-consciousness. (shrink)

New hardware such as mobile handheld devices and digital cameras; new online social venues such as social networking, microblogging, and online photo sharing sites; and new infrastructures such as the global positioning system are beginning to establish new practices—what the author refers to as “sociolocative”—that combine data about a physical location, such as a geotag, with a virtual social act. This research investigates the phenomenon of documentary broadcasting, whereby individuals curate lasting descriptions and commentaries about a location for a public (...) audience, often using the photo sharing site, Flickr. Unlike many photographs shared online, the subject of a documentary post is always a place and not the activities nor identity of the broadcaster himself or herself. When presented together as curated narratives, posted images transform Flickr into a virtual public “gallery space” that captures, presents, and preserves aspects of a place that may last longer than the physical location itself. (shrink)

Jeffrey Friedman's claim that arbitrariness is the inevitable result of the rejection of objectivist notions of truth misses its mark because it is based on a sense of ?agreement? that is radically at odds with the concept of agreement at work in hermeneutical practice. The rationalist notion of truth Friedman upholds cannot escape the need for agreement any more than the hermeneutical notion; the central distinction between the two senses of ?agreement? is the distinction between coercion and consent. Hermeneutical practice (...) integrally links the rational procedure and universalizing consent, which together constitute a rigorous existential standard that challenges any rationalist discipline. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Expose of a BreakdownIngrid HindellIregard my pension as a social wage, and even though I wish it took my disability and the extra costs that brings into consideration, eighteen years ago, I felt privileged to be able to work in the community, not in a sheltered workshop.At this time, a number of us worked voluntarily for numerous little organizations when the government cut their funding and in effect, took (...) away our jobs.It was around this time that I started a “stress cough.” Foolishly, I didn’t take much notice. I was enjoying “life”—studying, working, taking part in a documentary called “Untold Desires” and being a member of the “Friendship Group”—in which a group of us tackled the subject and nature of friendship for people with and without disabilities....The processes and the cohesion of the group brought up a lot of “stuff” for me that I wasn’t able to articulate. It made me question the wisdom of my lifestyle up to then—of marrying a person without a physical disability, for example.My mother used to tell me to tell him to tidy the flat, not in the least realizing that: i) it was distressing that I couldn’t do this; ii) that given all our interests it was difficult to tidy up. (This situation was also not helped, I now realize, by us trying to live and run home businesses from my small three–roomed accommodation behind my parent’s home, without enough support worker hours....)The flat was always cluttered, not conducive to encouraging a feeling of ease in us bringing clients onto the premises. As Robert’s massage workload grew, so did our underlying tension, I see now. And when I was starting to counsel other people with disabilities the situation was made worse....Added to this, my mother had, just prior to this period in our lives, stopped giving us our main meal because we were becoming more and more interested in eating organic and vegetarian food.At the same time, listening to other group members’ stories made me realize how “undervalued” people with disabilities are in society as I had been brought up in a loving extended family and had not long been “out.”It made me realize how much people with disabilities were constrained by lack of governmental funding for recreational—especially relationship options—with each other and with able–bodied people. The government was trying to close down little advocacy organizations that could keep this issue in the forefront of policy makers’ minds. No wonder I was getting close to breaking point! [End Page E1]When I got really bad, my husband almost went mad himself trying to cope with me. I had been the outgoing partner in the relationship for the past 12 years. Now I was getting panic attacks and clinging like poison ivy....And the therapists I went to at that stage didn’t help. The Naturopath was so expensive she made me much worse. She had told a “friend” of Rob’s that she would treat me for $30.00 a time. She did not say that she would present me with an ever– increasing bill every time I had an appointment—to pay her back when I could! And that her admin assistant would keep commenting, in my hearing, that people wouldn’t pay their bills on time.... At last, when the amount got to $450.00, I paid her all my savings, and managed to quit.I now also believe she treated me with a totally inappropriate therapy—colonic irrigation—for far too long, any natural therapist would say nowadays—five weeks!I believe it made my mental state worse. People say that an unquiet mind can stress the body into illness but I believe losing too much weight too fast as I certainly did, stressed my mind, instead of other way around.By this time I wasn’t only having panic attacks. I had slipped into, what I recently discovered, was a clinical depression. This brought in its wake, a terror so real, so all encompassing that I wonder I lived through a day of it—much less four... (shrink)

Cet article mobilise la notion d’« approche transactionnelle », empruntée à John Dewey et Arthur Bentley, pour nous inviter à concevoir les images circulant sur nos réseaux électroniques au-delà des représentations dont elles sont porteuses à la surface des écrans. Comprendre leur dynamique implique de prendre en compte les multiples couches dont elles se composent, depuis la matérialité des flux électriques, à travers les strates de langages-machine, les protocoles de transfert ou le design des interfaces. L’image que nous identifions et (...) isolons dans ses traits figuraux apparaît comme un leurre cachant les implications multiples des transactions dont elle résulte – et qu’il faut apprendre à repérer pour en déjouer certaines illusions. (shrink)

In the philosophy of well-being, there is hardly anything written on the lives of people with autism or on the question whether existing philosophical theories of well-being are suited for understanding how well the lives of autistic persons are going. This paper tries to make some progress towards filling this gap. I start by giving a concise account of autism, which highlights the huge heterogeneity among autistics. I discuss some basic features of autism, ask whether there are good reasons why (...) we would need an account of well-being specifically for autistics and what philosophical well-being research could learn from being informed by autistic experiences and phenomenology. I then investigate to what extent the capability approach gives us a helpful theory of well-being for autistics, and what looking through an autism-lens can contribute to the further development of the capabilitarian well-being. In particular, I show that some capabilities that are crucially relevant for autistics are also relevant for the lives of non-autistic people. The final part of the paper looks at an important difficulty in using the capabilitarian account of well-being for autistics, namely: should the normative focus be on achievements (functionings) or real opportunities (capabilities)? (shrink)

Based on an empirical study regarding ethical challenges within intercultural health care, the focus of this article is upon autonomy and disclosure, discussed in light of philosophy and anthropology. What are the consequences for patients if the patients’ right to be autonomous and to participate in treatment and care decisions by health care workers is interpreted as an obligation to participate? To force a person to make independent choices who is socio-culturally unprepared to do so, may violate his/her integrity. This (...) may in turn jeopardise the respect, integrity and human worth the principle of autonomy was meant to ensure, and if so, may damage any relationship of trust that may exist between patient and health care worker. There is necessarily a link between autonomy and disclosure. Western disclosure practices may make the relationship between patients and health care workers difficult -- even distrustful. To confront a patient with a very serious diagnosis may be seen not only as a tactless action, but also an unforgivable one. Hence, among many ethnic groups it is a family member’s duty to shield patients from bad or disquieting news, e.g., a cancer diagnosis. If a family member is used to interpret in such situations, will the information given equal the information communicated by that interpreter? Even though respect for a person’s autonomy is part of the respect for a person, one’s respect for the person in question should not depend on his/her ability or aptitude to act autonomously. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:You Can't Say "No" to That!(A "Difficult Patient" Story)Ingrid BergAs a sequela of COVID-19, my rural Wisconsin hospital has been jam-packed for months with patients for whom we routinely provide care and many for whom we do not. An exodus of health care workers and other constraints have made the transfer of critically ill patients very difficult. In this disquieting "new-normal" of our work life, we routinely must (...) call bigger cities throughout our state to find beds for complex patients.So, it was not surprising when a young patient, an IV drug user in sepsis from a heart infection, was admitted to me in the middle of the night. In less disheartening times, before the pandemic, this patient would have been transferred promptly to the big-city hospital. Now, though, the possibility of finding an open bed is next to impossible. Resigned, I placed admission orders, continued antibiotics and fluids, and crossed my fingers. Then the unexpected happened: a bed opened up, and we could send her at once!The patient had a harsh heart murmur. It was likely that a "vegetation" was clinging to the valve, between the right upper and lower chambers of her heart. A vegetation is a clump of debris, such as platelets, clotting proteins, and bacteria that is a menace to the body. Her chest imaging looked like her infection had already spread to her lungs.A definitive diagnosis for endocarditis requires a special ultrasound with a probe that goes down through the esophagus, a procedure performed by cardiologists. It's a serious infection, one that requires weeks of IV antibiotics and is best monitored by infectious disease specialists. Sometimes, cardiothoracic surgeons are called upon to strip away the infection at the site, depending on how badly the valve has been slayed or the size of the vegetation. My only recommendation for a young, otherwise healthy patient in this scenario, is transfer.All of these reasons for transfer were lolling around in my tired head when the night-time [End Page 14] nursing supervisor approached me and said, "We have a problem." When the patient was updated about the transfer, she balked: "She says she is tired and refusing to go," the supervisor began. "She doesn't feel like getting into an ambulance in the middle of the night and she doesn't care if her condition is life-threatening. She knows we can't force her to go and she will only talk about it again in the morning."The cartoon version of myself at that moment had bugged-out eyes, a dropped jaw, fists tight and clenched at my sides, and steam coming out of my head. I can look past a patient's self-neglect, poor medication adherence, abysmal communication, alcohol and drug addiction, and other crimes. But saying no to a bed at a tertiary care facility? Unacceptable!I marched down the quiet hallway and into her room. She was lying on her side, facing the door, one IV in a thin arm. I was confident I could reason with her once I explained the scarcity of beds and the medical necessity of transfer. But she was having none of it. I was calm until I could no longer maintain my cool: "You can't give up this bed!""Maybe in the morning," she insisted, yawning. "But not now. I am tired and want to rest!""But there might not be a bed in the morning," I countered. "And your infection can be life-threatening." (This is true, but we both knew she wasn't dying at this very moment.)"I am not going anywhere!" She raised her voice and then closed her eyes.And she was right. I had no choice but to keep her. I could not kick her out of the hospital because she was making a poor choice, and I was frustrated for having to manage the fallout of that decision. Giving her antibiotics and fluid boluses to bolster her blood pressure was certainly within my scope of practice. And fretting. Fretting is always within my scope of practice; not that my scope of practice matters when all the big... (shrink)

In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and (...) nurses’ ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses’ everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care. (shrink)

This study investigated attitudes toward the use of deception in negotiation, with particular attention to the distinction between deception regarding the informational elements of the interaction (e.g., lying about or misrepresenting needs or preferences) and deception about emotional elements (e.g., misrepresenting one's emotional state). We examined how individuals judge the relative ethical appropriateness of these alternative forms of deception, and how these judgments relate to negotiator performance and long-run reputation. Individuals viewed emotionally misleading tactics as more ethically appropriate to use (...) in negotiation than informational deception. Approval of deception predicted negotiator performance in a negotiation simulation and also general reputation as a negotiator, but the nature of these relationships depended on the kind of deception involved. (shrink)

Are global poverty and inequality on the rise or are they declining? And is the quality of life of the world's poorest people getting worse or better? These questions are often given conflicting answers by economists, the World Bank, and social activists. One reason for this is that assessments of quality of life can be made in terms of people's income, their resources, or their functionings and capabilities. This essay discusses the pros and cons of these evaluative approaches, and it (...) argues that all approaches have complementary strengths and should therefore in principle all be considered. Moreover, being aware that assessments of poverty and inequality can be made using these different frameworks helps us to understand the conflicting claims. (shrink)

Pragmatic difficulties are considered a hallmark of autism spectrum conditions (ASC), but remain poorly understood. We discuss and evaluate existing hypotheses regarding the literalism of ASC individuals, that is, their tendency for literal interpretations of non‐literal communicative intentions. We present evidence that reveals a developmental stage at which neurotypical children also have a tendency for literalism and suggest an explanation for such behaviour that links it to other behavioural, rule‐following, patterns typical of that age. We discuss evidence showing that strict (...) adherence to rules is also widespread in ASC, and suggest that literalism might be linked to such rule‐following behaviour. (shrink)