Abstract2020 saw the rapid onset of a global pandemic caused by the SARS‐CoV‐2 virus. For healthcare systems worldwide, the pandemic called upon quick organization ensuring treatment and containment measures for the new virus disease. Nurses were seen as constituting a vital instrumental professional component in this study. Due to the pandemic's unpredictable and potentially dangerous nature, nurses have faced unprecedented risks and challenges. Based on interviews and free text comment from a survey, this study explores how ethical challenges related to (...) “being a nurse” during the COVID‐19 pandemic was experienced and understood by Danish hospital‐based nurses. Departing from anthropologist Jarett Zigon's notion of moral breakdown, the study demonstrates how the rapid onset of the pandemic constitutes a moral breakdown raising ethical demands for nurses. Analytically we identify three different ethical demands experienced by the nurses. These ethical demands are Nursing and societal ethical demands, Nursing and personal ethical demands, and Nursing and conflicting ethical demands. These demands represent not only very different understandings of ethical demands but also different understandings of ethical acts that are seen as necessary to respond to these demands. (shrink)

Relational egalitarianism is a theory of justice according to which people must relate as equals. In this article, we develop relational sufficientarianism – a view of justice according to which people must relate as sufficients. We distinguish between three versions of this ideal, one that is incompatible with relational egalitarianism and two that are not. Building on this, we argue that relational theorists have good reason to support a pluralist view that is both egalitarian and sufficientarian.

Cytoplasmic messenger ribonucleoprotein particles (mRNPs) represent the cellular transcriptome, and recent data have challenged our current understanding of their architecture, transport, and complexity before translation. Pre‐translational mRNPs are composed of a single transcript, whereas P‐bodies and stress granules are condensates. Both pre‐translational mRNPs and actively translating mRNPs seem to adopt a linear rather than a closed‐loop configuration. Moreover, assembly of pre‐translational mRNPs in physical RNA regulons is an unlikely event, and co‐regulated translation may occur locally following extracellular cues. We envisage (...) a stochastic mRNP transport mechanism where translational repression of single mRNPs—in combination with microtubule‐mediated cytoplasmic streaming and docking events—are prerequisites for local translation, rather than direct transport. (shrink)

What does it entail to study the climate crisis from – or consistently with – a critical realist perspective? The paper addresses this question in three steps. First, it considers the boundaries of critical realism in relation to climate crisis research. In this context it identifies climate science as a field that in important respects resonates implicitly with critical realism. Conversely, a book by human ecologist Andreas Malm is introduced as an example of a work that, while sympathetic to critical (...) realism, in key respects contradicts core features of it. Second, to illustrate what an analysis of the crisis informed by critical realism can look like, the paper brings into focus the main causes of the climate crisis – including the capitalist growth imperative, neoliberalism, and consumer culture. Finally, the status quo project, the green growth project and the degrowth project are identified as fundamentally different ways of approaching the climate crisis. (shrink)

The evolutionary theory of threat simulation during dreaming indicates that themes appropriate to ancestral survival concerns (threats) should be disproportionately represented in dreams. Our studies of typical dream themes in students and sleep-disordered patients indicate that threatening dreams involving chase and pursuit are indeed among the three most prevalent themes, thus supporting Revonsuo's theory. However, many of the most prevalent themes are of positive, not negative, events (e.g., sex, flying) and of current, not ancestral, threat scenarios (e.g., schoolwork). Moreover, many (...) clearly ancestral themes (e.g., snakes, earthquakes) are not prevalent at all in dreams. Thus, these findings challenge the specificity of the threat simulation theory. [Revonsuo]. (shrink)

Hursthouse :57–68, 1991) argues that arational actions—e.g. kicking a door out of anger—cannot be explained by belief–desire pairs. The Humean Response to Hursthouse :25–38, 2000b) defends the Humean model from Hursthouse’s challenge. We argue that the Humean Response fails because belief–desire pairs are neither necessary nor sufficient for causing emotional actions. The Emotionist Response is to embrace Hursthouse’s conclusion that emotions provide an independent source of explanation for intentional actions. We consider Döring’s :214–230, 2003) feeling-based Emotionist account and argue that (...) it fails to explain arational actions. Finally, we develop our own Emotionist account, grounded in the Motivational Theory of Emotions one of us has developed. On our account, arational actions form a non-homogeneous class, some members of which must be understood as instrumental actions and some members of which must be understood as displacement behaviors of the kind animals display when their motivations are thwarted or in conflict. (shrink)

Background: Ethical climate and moral distress have been shown to affect nurses’ ethical behaviour. Despite the many ethical issues in paediatric oncology nursing, research is still lacking in the field. Research aim: To investigate paediatric oncology nurses’ perceptions of ethical climate and moral distress. Research design: In this cross-sectional study, data were collected using Finnish translations of the Swedish Hospital Ethical Climate Survey–Shortened and the Swedish Moral Distress Scale–Revised. Data analysis includes descriptive statistics and non-parametric analyses. Respondents and research context: (...) Ninety-three nurses, working at paediatric oncology centres in Finland, completed the survey. Ethical considerations: According to Finnish legislation, no ethical review was needed for this type of questionnaire study. Formal research approvals were obtained from all five hospitals. Return of the questionnaire was interpreted as consent to participate. Results: Ethical climate was perceived as positive. Although morally distressing situations were assessed as highly disturbing, in general they occurred quite rarely. The situations that did appear often reflected performing procedures on school-aged children who resist such treatment, inadequate staffing and lack of time. Perceptions of ethical climate and frequencies of morally distressing situations were inversely correlated. Discussion: Although the results echo the recurrent testimonies of busy work shifts, nurses could most often practise nursing the way they perceived as right. One possible explanation could be the competent and supportive co-workers, as peer support has been described as helpful in mitigating moral distress. Conclusion: Nurturing good collegial relationships and developing manageable workloads could reduce moral distress among nurses. (shrink)

In his paper, ‘Regarding the ‘Hole Argument”, Weatherall suggests that models of general relativity related by a hole diffeomorphism must be regarded as being physically equivalent. At a later stage in the paper, however, he also argues that there is a sense in which two such models may be regarded as being empirically distinct—a fortiori physically distinct. We attempt to delineate the logic behind these two prima facie contradictory claims. We argue that the latter sense rests upon a misunderstanding of (...) the import of shift arguments in the foundations of spacetime theories. (shrink)

In recent literature, there has been much debate about whether and how luck egalitarianism, given its focus on personal responsibility, can justify universal health care. In this paper we argue that, whether or not this is so, and in fact whether or not egalitarianism should be sensitive to responsibility at all, the question of personal responsibilization for health is not settled. This is the case because whether or not individuals are responsible for their own health condition is not all that (...) is relevant when considering whether we should somehow hold them responsible for their own health condition, e.g. cost-wise. There may also be efficiency-based reasons to hold them responsible, and there may even be egalitarian reasons. Defining universal health care as an insurance system where everyone’s deductible and premium is 0, we will argue that efficiency-based reasons for cost-responsibilization are not convincing, but that there are egalitarian reasons for cost-responsibilization. Luck egalitarianism, therefore, cannot, at least not on its own term, justify universal health care. (shrink)

Western philosophy’s relationship with prisons stretches from Plato’s own incarceration to the modern era of mass incarceration. Philosophy Imprisoned: The Love of Wisdom in the Age of Mass Incarceration draws together a broad range of philosophical thinkers, from both inside and outside prison walls, in the United States and beyond, who draw on a variety of critical perspectives (including phenomenology, deconstruction, and feminist theory) and historical and contemporary figures in philosophy (including Kant, Hegel, Foucault, and Angela Davis) to think about (...) prisons in this new historical era. All of these contributors have experiences within prison walls: some are or have been incarcerated, some have taught or are teaching in prisons, and all have been students of both philosophy and the carceral system. The powerful testimonials and theoretical arguments are appropriate reading not only for philosophers and prison theorists generally, but also for prison reformers and abolitionists. (shrink)

Este estudio presenta las evidencias psicométricas de la Escala de Aprendizajes Percibidos, basada en los elementos didácticos y pedagógicos del proceso de enseñanza-aprendizaje de una Experiencia Curricular en formulación y ejecución de «Programas de Intervención en Psicología». Investigación instrumental-psicométrica, de enfoque cuantitativo-transversal, con recolección de datos post-EC, en 117 estudiantes universitarios. Su contraste estadístico se realizó en el entorno R para Análisis Factorial Confirmatorio y Análisis Factorial de Componentes Principales, entre otros. Los resultados indican un adecuado ajuste orientado a 5 (...) factores, ratificado en análisis paralelos. Se concluye en la conformación de un constructo robusto, fiable y válido, que explora la conciencia de los aprendizajes en materia de promoción prevención en salud, y susceptible de adaptación. (shrink)

There is limited knowledge about sleep in adolescents with elevated levels of anxiety treated within primary health care settings, potentially resulting in sleep problems not being sufficiently addressed by primary health care workers. In the current study self-reported anxiety, insomnia, sleep onset latency, sleep duration, and depressive symptoms were assessed in 313 adolescents referred to treatment for anxiety within primary health care. Results showed that 38.1% of the adolescents met criteria for insomnia, 34.8% reported short sleep duration, and 83.1% reported (...) long sleep onset latency. Total anxiety symptoms were related to all sleep variables after controlling for age and sex. Furthermore, all anxiety symptom sub-types were associated with insomnia and sleep onset latency, whereas most anxiety subtypes were associated with sleep duration. Adolescents’ depressive symptoms accounted for most of the anxiety-sleep associations, emphasizing the importance of depressive symptoms for sleep. However, anxiety was associated with insomnia and sleep onset latency also among youth with low levels of depressive symptoms. The findings suggests that primary health care workers should assess sleep duration, sleep onset latency, and insomnia in help-seeking adolescents with anxiety. (shrink)

Background: Background: In general, qualitative research design often involves merging together various data collection strategies, and researcher’s may need to be prepared to spend longer periods in the field to pursue data collection opportunities that were not foreseen. Furthermore, nurse researchers performing qualitative research among patients and their relatives often experience unforeseen ethical dilemmas. Aim: This paper aimed to explore aspects of ethical dilemmas related to qualitative nursing research among patients and their relatives in the intensive care unit (ICU). Research (...) design: This paper is based on a qualitative researcher’s personal experience during a hermeneutic phenomenological study involving close observation and in-depth interviews with 11 intensive care nurses. Data were collected at two ICUs in two Norwegian university hospitals. Ethical considerations: The study was approved by the Norwegian Social Science Data Services (NSD). The Regional Committee for Medical and Health Research Ethics (REK) granted dispensation to the project regarding health personnels confidentiality of the patients who were present during the observation (2012/622-4). Findings: Close observation with nurses in the ICU requires the researcher to balance being a qualitative researcher, an ICU nurse and a sensitive fellow human being open to the suffering of the other—that is, being embodied, engaged and affected by sensitive situations and simultaneously constantly stepping back and reflecting on the meaning of those situations. Conclusions: The qualitative researcher’s ethical awareness also entails knowing and acknowledging his or her own vulnerability, which becomes apparent in the researcher-participant relationship and settings in which being a fellow human always overrules the researcher’s role in ethical dilemmas. (shrink)

AimRapid eye movement (REM) sleep, non-rapid eye movement (NREM) sleep, and sleep spindles are all implicated in the consolidation of procedural memories. Relative contributions of sleep stages and sleep spindles were previously shown to depend on individual differences in task processing. However, no studies to our knowledge have focused on individual differences in experience with Vipassana meditation as related to sleep. Vipassana meditation is a form of mental training that enhances proprioceptive and somatic awareness and alters attentional style. The goal (...) of this study was to examine a potential role for Vipassana meditation experience in sleep-dependent procedural memory consolidation.MethodsGroups of Vipassana meditation practitioners (N = 22) and matched meditation-naïve controls (N = 20) slept for a daytime nap in the laboratory. Before and after the nap they completed a procedural task on the Wii Fit balance platform.ResultsMeditators performed slightly better on the task before the nap, but the two groups improved similarly after sleep. The groups showed different patterns of sleep-dependent procedural memory consolidation: in meditators, task learning was positively correlated with density of slow occipital spindles, while in controls task improvement was positively associated with time in REM sleep. Sleep efficiency and sleep architecture did not differ between groups. Meditation practitioners, however, had a lower density of occipital slow sleep spindles tha... (shrink)

We shall have to evolve problem-solvers—galore since each problem they solve creates ten problems more— Piet HeinThe new reproductive technologies, especially in vitro fertilization, have extended the possi- bilities of assisted reproduction to the benefit of the childless couples. At the same time these technologies and their added techniques, however, have fragmented reproduction and exposed the human egg to intervention yet unknown:The embryo may be divided into several embryos; may be sold; donated; cryopreserved; borne by another woman and returned; or (...) used for research;Genetic parentage may be present without sexual intercourse, may be different from social parentage and the natural time-span between fertilization and birth may be interrupted. (shrink)

Collected here for the first time are the responses of several prominent Canadian philosophers to Nielsen's outspoken work in the philosophy of religion, including their responses to Hart's criticisms of Nielsen. New replies by Hart and Nielsen to these added voices are also included.

The complex health and social circumstances of living-at-risk, frequent users of emergency departments (aREDFUs) in the health jurisdictions of high-income countries, and the related, significant challenges posed for emergency departments and the health care providers working within them, are identified and explored in the paper. Ethical analyses of a set of relevant domains are performed, i.e., individual and relational autonomy considerations, relevant social construction and personal responsibility conceptions, patient welfare principles (beneficence, nonmaleficence, continuity of care), harm reduction methodologies and their (...) applications, health equity, and justice considerations of the distributive, formal and social types. The outcomes of these analyses demonstrate that there are ethically compelling reasons for emergency departments to adopt an ethics-informed, policy-based approach to the longitudinal care and management of living-at-risk, frequent users of emergency departments. From a formal justice perspective, the development and uses of such an approach are justified by a demonstrable relevant difference between living-at-risk, frequent users of emergency departments and other persons and groups of patients who visit emergency departments. We propose an example of such a policy-based approach. Examples of possible, pragmatic applications of this approach, which help ensure that aREDFUs who present to the ED are managed in a fair and optimally consistent manner, are provided for the consideration of an urban emergency department’s policymaking working group. (shrink)

Two studies are reported in which participants’ reports of altered states of consciousness were manipulated using priming methods. Study 1 used both subtle and blunt supraliminal priming methods, while Study 2 used a subliminal priming method. Across the two studies, two different methods for inducing ASC were used. In both studies a direct and an indirect measure of ASC was employed in order to separate the more nonconscious and spontaneous from the more conscious and directive reports of ASC. As predicted, (...) results indicated that the indirect measures of ASC were consistent with the ASC primes participants received. Implications and future research directions are discussed. (shrink)

Person‐specific evidence was developed as a grounded theory by analyzing 20 selected case descriptions from interventions using the guided self‐determination method with people with various long‐term health conditions. It explains the mechanisms of mobilizing relational capacity by including person‐specific evidence in shared decision‐making. Person‐specific self‐insight was the first step, achieved as individuals completed reflection sheets enabling them to clarify their personal values and identify actions or omissions related to self‐management challenges. This step paved the way for sharing these insights and (...) challenges in a relationship with a supportive health professional, who could then rely on person‐specific evidence instead of assumptions or a narrow disease perspective for shared decision‐making. Trust in the evidence encouraged the supportive health professional to transfer it to the interdisciplinary team. Person‐specific evidence then enhanced the ability of team members to apply general evidence in a meaningful way. The increased openness achieved by individuals through these steps enabled them to eventually share their new self‐insights in daily life with other people, decreasing loneliness they experienced in self‐management. Relational capacity, the core of the theory, is mobilized in both people with long‐term health conditions and healthcare professionals. Further research on person‐specific evidence and relational capacity in healthcare is recommended. (shrink)

This book examines doping in Germany, with primary attention given to West Germany, from 1950 to the present, including what societal, cultural, and institutional pressures arose after WWII to bring about such prevalence of doping in the country.

ZusammenfassungEinhergehend mit den Fortschritten in der Reanimationsmedizin beschäftigen sich seit den 80er Jahren viele Studien mit der prognostischen Güte von reanimations- und patientenbezogenen Akutmarkern. Generell sollen Prognosemarker die Vorhersagbarkeit des Heilungspotenzials erlauben, sie besitzen dadurch eine Steuerfunktion für das weitere Therapiekonzept. Die Wertigkeit dieser Prädiktoren verändert sich jedoch, wenn sie als Determinanten bei Non-Treatment-Entscheidungen herangezogen werden. Dies aus zwei Gründen: 1. Nach Sichtung der Literatur und eingedenk eigener Studienresultate fehlt bislang ein 100%- sicherer Prognose-Algorithmus für Patienten im posthypoxischen Koma. 2. (...) Der komatöse Patient kann an der Beurteilung der Prognoseaussagen selbst nicht teilnehmen. Es stellt sich somit die Frage: Dürfen Prognosemarker unser moralisches Handeln an der Grenze des Lebens leiten? Die Autoren bejahen diese Frage und sehen eine adäquat moralische Handlungsoption in der Durchführung einer diskurs-pragmatischen Patientenkonferenz. Den Prognosemarkern kommt hier eine Stellvertreterfunktion im Sinne eines „stillen Patientenargumentes“ zu, wodurch die potenzielle Dialogfähigkeit des Patienten als moralisches Anspruchsobjekt gewahrt wird. Im Rahmen einer diskursiven Erörterung wird dann der Einfluss der Prognosedaten an der Entscheidung gewichtet. (shrink)

Having the ability to understand emotionally how other people feel and see things is an essential fabric for building and sustaining functional interpersonal relationships. Without such an ability, social interaction crumbles, engagement fails, and learning is eroded. Yet, empirical evidence on the relationship between study burnout and study engagement, and empathy between upper secondary school students is limited. We are tackling the challenge by exploring the association between empathy between peers and study engagement and study burnout among upper secondary school (...) students. Two hundred and eighty upper secondary education students took part in our cross-sectional study. Structural equation modeling was used to analyze the association between empathy, and study burnout and study engagement. The results showed that cognitive empathy contributed to affective empathy, which was further related to increased levels of study engagement, and decreased levels of cynicism, and sense of inadequacy. The role of cognitive empathy seemed to be more complicated: while cognitive empathy contributed directly to increased levels of cynicism, and inadequacy and decrease in study engagement, the indirect effects of cognitive empathy on cynicism and inadequacy were negative, and positive on study engagement. Neither of the empathy dimensions explained students’ emotional exhaustion. The results indicate that merely teaching students to recognize and identify their peers’ emotions is not sufficient to enhance study wellbeing, but they need to learn to share emotions and to tune into each other’s emotions. (shrink)

Kai Nielsen is one of Canada's most distinguished political philosophers. In a career spanning over 40 years, he has published more than 400 papers in political philosophy, ethics, meta-philosophy, and philosophy of religion. Pessimism of the Intellect presents a thoughtful collection of Nielsen's essays complemented by an extended reflective interview with Nielsen. This collection allows the reader to grasp the systematic scope of his thought and methodology.

This study examines social desirability bias in the context of ethical decision-making by accountants. It hypothesizes a negative relation between social desirability bias and ethical evaluation. It also predicts an interaction effect between religiousness and gender on social desirability bias. An experiment using five general business vignettes was carried out on 121 accountants (63 males and 58 females). The results show that social desirability bias is higher (lower) when the situation encountered is more (less) unethical. The bias has religiousness and (...) gender main effects as well as an interaction effect between these two independent variables. Women who were more religious recorded the highest bias scores relative to less religious women and men regardless of their religiousness. (shrink)

In this article, I focus on possibly impaired self-determination in addiction. After some methodological reflections, I introduce a phenomenological description of the experience of being self-determined. I argue that being self-determined implies effectivity of agency regarding three different behavioural domains. Such self-referential agency shall be called ‘self-effectivity’ in this article. In a second step, I will use this phenomenological description to understand the impairments of self-determination in addiction. While addiction does not necessarily imply a basic lack of control over one’s (...) life, this can well be the case during certain periods of time or in special situations. Addiction is herein described as an embodied custom—highly effective with respect to changing one’s lived experience—which is learned and developed while becoming addicted. Such a repeatedly performed custom, called a ‘psychotropic technique’, implies deep changes in one’s personal identity and alters an agent’s ‘self-effectivity’. In the closing section, I discuss the possible implications of a phenomenological approach to personal responsibility. (shrink)

Nudging refers to the subtle design of the context of choice in a way that mobilises the unconscious mind and alters human behaviour predictably. Nudging has been criticised for entailing numerous practical and ethical problems, including manipulation, elitism and cultural insensitivity. To respond to the problems, participatory and deliberative procedures have been proposed that would enable the questioning of the power relations embedded in behavioural governance. Yet participation and deliberation are themselves characterised by unconscious behavioural influences. I argue that awareness (...) of the prevalence of unconscious behavioural influences in environmental governance is a prerequisite for tackling the complex practical and ethical issues of nudging. I show that unconscious behavioural influences permeate environmental governance and outline analytical approaches for revealing them. (shrink)

Metaphilosophy is itself philosophy about philosophy. It is not something before or independent of philosophy. Both Kai Nielsen and Richard Rorty are deeply concerned (someone might say obsessively preoccupied) with metaphilosophy. They both are thoroughly historicist and contextualist resolutely rejecting any form of a transcendental or metaphysical turn. They argue against claims to absolute validity (as well as against absolutism in any form) and a natural order of reasons: some 'Reason' to which any rational agent must be committed. They (...) both see philosophy as a transitional genre first (historically speaking) from religion then metaphysics and more latterly from scientistic conceptions of the world. But they differ about what philosophy is transitional to. For Rorty it is historical narrative and utopian proposals; for Nielsen it is critical theory. Rorty claims this, Nielsen's intentions to the contrary notwithstanding, commits him to enlightenment rationalism. Nielsen replies that his form of critical theory is deeply historicist and contextual without being resolutely atheoretical. This plays out in political orientation to Nielsen's being a socialist while Rorty is a social democrat. (shrink)

An educated healthcare professional or student is sensitive and able to make good judgements, understanding existential challenging issues. It is argued that the ideas within phenomenology and hermeneutics can function as a basis for comprehension. This article focuses on how choice of perspective and knowledge is of importance to what we do in practice. However, education does not consist of mere accumulation of knowledge and ways of explanation. We do not become competent practitioners by being able to reproduce philosophical ideas. (...) These are merely perspectives by means of which we can seek to go beyond what we take for granted, or what we assume to know, thus enabling us to take a new direction understanding problems and issues that until now may have been hidden to us. In other words, understanding is of an existential character, whereas an observing healthcare professional must be aware and open to the mental aspects of life. It is therefore important to attune ourselves to being sensitive to and aware of experiences from our lifeworld, understanding what they imply. It is argued that literature provides insight into human nature through the written depiction of real or imagined experiences. To develop such narrative imagination, it is suggested that literature should be part of the curriculum of various educations. This is relevant to healthcare professionals who thereby can get an important insight into human nature and begin to develop the self‐awareness and sensitivity to others that is so central to care. (shrink)

Friendly persuasion, in contrast to deterrent measures like tax audits and penalties on underreported taxes, is a positive and possibly a cost effective method of increasing taxpayer compliance. However, prior studies have failed to show that friendly persuasion has a significant impact on compliance (Blumenthal et al., 2001; McGraw and Scholz, 1991). In our study, in contrast to prior studies, we examine the impact of generating and reading reasons supporting compliance as friendly persuasion on individuals' income reporting behavior as well (...) as control for gender effects. Specifically, we predict an interaction effect between friendly persuasion and gender on compliance behavior. We carried out a 2 (friendly persuasion and control) × 2 (men and women) full factorial experiment, where participants earned $30 by completing two questionnaires. Participants in the friendly persuasion group were required first to generate and second to read a list of reasons why they should comply fully. Afterwards, participants in both groups were asked to report the income they earned and pay tax on the reported income. The results show a significant main effect for gender as well as a significant interaction effect between gender and friendly persuasion on income reported. Women in the friendly persuasion group reported significantly higher income compared to men in that group. Other comparisons were not significant. Policy implications for increasing taxpayers' ethics and compliance are highlighted. (shrink)