The options currently available to women with uterine infertility are adoption or surrogacy. Recently the option of uterine transplantation has been explored which would allow a woman to carry her own genetically related child. Although this type of transplant raises similar ethical considerations to other types of non-life-saving organ transplantation, such as facial tissue and limb, it also raises its own very unique considerations. In this paper, some of the considerations surrounding uterine transplantation, such as informed consent and an individual's (...) rights, and potential limit to reproductive autonomy are explored. (shrink)

Is it ever possible for people to act freely and intentionally against their better judgement? Is it ever possible to act in opposition to one's strongest desire? If either of these questions are answered in the negative, the common-sense distinctions between recklessness, weakness of will and compulsion collapse. This would threaten our ordinary notion of self-control and undermine our practice of holding each other responsible for moral failure. So a clear and plausible account of how weakness of will and self-control (...) are possible is of great practical significance. Taking the problem of weakness of will as her starting point, Jeanette Kennett builds an admirably comprehensive and integrated account of moral agency which gives a central place to the capacity for self-control. Her account of the exercise and limits of self-control vindicates the common-sense distinction between weakness of will and compulsion and so underwrites our ordinary allocations of moral responsibility. She addresses with clarity and insight a range of important topics in moral psychology, such as the nature of valuing and desiring, conceptions of virtue, moral conflict, and the varieties of recklessness (here characterised as culpable bad judgement) — and does so in terms which make their relations to each other and to the challenges of real life obvious. Agency and Responsibility concludes by testing the accounts developed of self-control, moral failure, and moral responsibility against the hard cases provided by acts of extreme evil. (shrink)

Background In the course of the last four decades, the profession of physiotherapy has progressively expanded its scope of responsibility and its focus on professional autonomy and evidence-based clinical practice. To preserve professional autonomy, it is crucial for the physiotherapy profession to meet society's expectations and demands of professional competence as well as ethical competence. Since it is becoming increasingly popular to choose a carrier in private practice in Denmark this context constitutes the frame of this study. Physiotherapy in private (...) practice involves mainly a meeting between two partners: the physiotherapist and the patient. In the meeting, power asymmetry between the two partners is a condition that the physiotherapist has to handle. The aim of this study was to explore whether ethical issues rise during the first physiotherapy session discussed from the perspective of the physiotherapists in private practice. Methods A qualitative approach was chosen and semi-structured interviews with 21 physiotherapists were carried out twice and analysed by using a phenomenological framework. Results Four descriptive themes emerged: general reflections on ethics in physiotherapy; the importance of the first physiotherapy session; the influence of the clinical environment on the first session and; reflections and actions upon beneficence towards the patient within the first session. The results show that the first session and the clinical context in private practice are essential from an ethical perspective. Conclusions Ethical issues do occur within the first session, the consciousness about ethical issues differs in Danish physiotherapy private practice, and reflections and acts are to a lesser extent based on awareness of ethical theories, principles and ethical guidelines. Beneficence towards the patient is a fundamental aspect of the physiotherapists' understanding of the first session. However, if the physiotherapist lacks a deeper ethical awareness, the physiotherapist may reason and/or act ethically to a varying extent: only an ethically conscious physiotherapist will know when he or she reflects and acts ethically. Further exploration of ethical issues in private practice is recommendable, and as management policy is deeply embedded within the Danish public sector there are reasons to explore public contexts of physiotherapy as well. (shrink)

According to a Kantian conception truthfulness is characterised as a requirement of respect for the agency of another. In lying we manipulate the other’s rational capacities to achieve ends we know or fear they may not share. This is paradigmatically a failure of respect. In this paper we argue that the importance of truthfulness also lies in significant part in the ways in which it supports our agential need to make sense of the world, other people, and ourselves. Since sense-making (...) is something we do together, and that we can support or undermine, it generates norms of interaction that constitute a further, distinct, mode of recognition and respect for another’s agency. But the requirements of truthfulness and support for sense-making sometimes conflict. Through a series of cases, we analyze why and when a rigid insistence on truthfulness is disrespectful of the other and undermining of their agency. (shrink)

Psychopaths have long been of interest to moral philosophers, since a careful examination of their peculiar deficiencies may reveal what features are normally critical to the development of moral agency. What underlies the psychopath's amoralism? A common and plausible answer to this question is that the psychopath lacks empathy. Lack of empathy is also claimed to be a critical impairment in autism, yet it is not at all clear that autistic individuals share the psychopath's amoralism. How is empathy characterized in (...) the literature, and how crucial is empathy, so described, to moral understanding and agency? I argue that an examination of moral thinking in high-functioning autistic people supports a Kantian rather than a Humean account of moral agency. (shrink)

The recent, influential Social Intuitionist Model of moral judgment (Haidt, Psychological Review 108, 814–834, 2001) proposes a primary role for fast, automatic and affectively charged moral intuitions in the formation of moral judgments. Haidt’s research challenges our normative conception of ourselves as agents capable of grasping and responding to reasons. We argue that there can be no ‘real’ moral judgments in the absence of a capacity for reflective shaping and endorsement of moral judgments. However, we suggest that the empirical literature (...) indicates a complex interplay between automatic and deliberative mental processes in moral judgment formation, with the latter constraining the expression and influence of moral intuitions. We therefore conclude that the psychological literature supports a normative conception of agency. (shrink)

We have argued elsewhere that moral responsibility over time depends in part upon the having of psychological connections which facilitate forms of self-control. In this chapter we explore the importance of mental time travel - our ordinary ability to mentally travel to temporal locations outside the present, involving both memory of our personal past and the ability to imagine ourselves in the future - to our agential capacities for planning and control. We suggest that in many individuals with dissociative disorders, (...) forms of amnesia, or other frontal lobe damage, our capacity for mental time travel is impaired, resulting in commensurate losses to agency autonomy, and a forensic condition essential for holding persons responsible: in legal terms, the capacity for mens rea. (shrink)

The condition known as Multiple Personality Disorder (MPD) or Dissociative Identity Disorder (DID) is metaphysically strange. Can there really be several distinct persons operating in a single body? Our view is that DID sufferers are single persons with a severe mental disorder. In this paper we compare the phenomenology of dissociation between personality states in DID with certain delusional disorders. We argue both that the burden of proof must lie with those who defend the metaphysically extravagant Multiple Persons view and (...) that there is little theoretical motivation to yield to that view in light of the fact that the core symptoms of DID bear remarkable similarity to the symptoms of these other disorders where no such extravagance is ever seriously entertained. (shrink)

The feature article by Delany, Feldman, Kameniar and Gillam on the deliberative structure of a local Australian clinical ethics consultation programme is important for several reasons. It underscores Walker’s ‘moral spaces’ within healthcare settings and it increases conceptual freedom in dialogue through the bottom-up approach described.1 We concur with their commitment to the advancement of this form of clinical ethics deliberation and agree with many of the notions in the article. Due to limited space, we confine our commentary to the (...) topics of (1) the goal of consultations and (2) the didactic aspect of consultations. We unequivocally second the authors’ critical stance towards principled resolutions and salute their wish to enhance clinicians’ moral understandings. However, our angle is somewhat different. The conceptual freedom of which they speak is, in our view, limited by the premise that clinical ethics issues must be ‘solved’ by a consensus decision. In our experience with cases, it may be more appropriate to seek mutual rather than shared understanding due to the inherent need to balance conflicting values. This approach opens for a dialogue that is not restrained by the imperative of reaching moral consensus. It may better serve to enhance the moral agency of clinical staff and it leaves the decision with …. (shrink)

This article examines the relationship between everyday talk, the reproduction of political ideology and the interactional accomplishment of situated identities through analyzing how institutional members index neoliberal ideology in their everyday interactions. Analysis of audio- and video-recorded data from racially diverse business members of two Texas chambers of commerce illustrates how chamber members indirectly index neoliberal ideology through taking stances toward government policies. White, upper class participants display neoliberal stances through using complaints – constituted by questions, humor, idioms and inference-rich (...) terms – about the Affordable Care Act because it is a form of government interference that increases taxes and the federal deficit. Minority business members use discursive strategies such as double-voiced discourse and self-repairs to balance tensions between criticizing neoliberal ideology because it does not benefit minorities yet still orient to its taken-for-granted value in their business community. Overall, while participants’ interactions generally seem to operate within the structural constraints of neoliberal ideology, our analysis illustrates how participants take up neoliberal ideology in situated ways that, at times, provide avenues for negotiating the relevance of neoliberal ideology to everyday life. (shrink)

Within the Givenness Hierarchy framework of Gundel, Hedberg, and Zacharski (1993), lexical items included in referring forms are assumed to conventionally encode two kinds of information: conceptual information about the speaker’s intended referent and procedural information about the assumed cognitive status of that referent in the mind of the addressee, the latter encoded by various determiners and pronouns. This article focuses on effects of underspecification of cognitive status, establishing that, although salience and accessibility play an important role in reference processing, (...) the Givenness Hierarchy itself is not a hierarchy of degrees of salience/accessibility, contrary to what has often been assumed. We thus show that the framework is able to account for a number of experimental results in the literature without making additional assumptions about form-specific constraints associated with different referring forms. (shrink)

In this commentary on Anneli Jefferson’s Are Mental Disorders Brain Disorders? I endorse her capacitarian approach to responsibility but suggest that the effects of at least some mental/brain disorders on the agent’s psychology show that we cannot neatly separate the epistemic condition from the control condition when assessing agential capacity. I then discuss the labeling issue in the context of rival attributionist accounts of responsibility which hold that agents are responsible if their actions are attributable to them. The incorporation of (...) mental disorders into identity through social processes may open agents with mental or brain disorders open to unfair blame. However, we cannot fully understand the effects of the disorders on agential capacity without closely attending to the social environment that shapes the way the disorder is conceived, enacted, perceived, and responded to over time. (shrink)

It seems to be a truism that whenever we do something - and so, given the omnipresence of trying (Hornsby 1980), whenever we try to do something - we want to do that thing more than we want to do anything else we can do (Davidson 1970). However, according to Frog, when we have will power we are able to try not to do something that we ‘really want to do’. In context the idea is clearly meant to be that (...) what we really want to do and what we most want to do are one and the same. But how is this meant to be so much as possible? It seems to require that our desire not to do what we most want to do is both our strongest desire and not our strongest desire. And that is a blatant contradiction. This is the so-called ‘paradox of self-control’ (Mele 1987). The aim of our paper is to explain how to make sense of the story of Frog and Toad. (shrink)

This study examines cheating behaviors among 422 business students at two public Association to Advance Collegiate Schools of Business-accredited business schools. Specifically, we examined the simultaneous influence of attitudinal characteristics and motivational factors on reported prior cheating behavior, the tendency to neutralize cheating behaviors, and likelihood of future cheating. In addition, we examined the impact of in-class deterrents on neutralization of cheating behaviors and the likelihood of future cheating. We also directly tested potential mediating effects of neutralization on cheating behavior. (...) Using structural equations modeling procedures, we conducted an assessment of the validity of a modified version of the K. J. Smith, Davy, Rosenberg, and Haight model of cheating behavior and its antecedents. The modified model included motivation as a potential predictor of cheating behavior. Results supported the differentiation of the theoretical constructs within the specified process model. Furthermore, tests of the aforementioned theoretical model indicated a significant positive relation between extrinsic motivation and prior cheating and a significant negative relation between both intrinsic motivation and academic performance, and prior cheating. Finally, prior cheating had a significant positive relation, whereas deterrents had a significant negative relation to likelihood of future cheating. (shrink)

The tears of Odysseus -- History : music gives voice to the ineffable -- Tears, chills, and broken bones -- The music itself -- Explaining strong emotional responses to music I -- Explaining strong emotional responses to music II -- The sublime, revisited -- Conclusion : values.

The goal of this study was to construct a valid new instrument to measure the effect of moral intensity on managers' propensity to manage earnings. More specifically, this study is a pilot study of the impact of moral intensity on financial accountants' propensity to manage earnings. The instrument, once validated, will be used in a full-study of managers in the hotel industry. Different ethical scenarios were presented to respondents in the survey; each ethical scenario was designed in both high or (...) low moral intensity form, to reflect the importance of the moral dilemma at hand. The results were analysed by factor analysis. The findings of this study have positively validated the instrument, with three of the five moral intensity components identified as having appropriate eigenvalues. This indicates that they have a significant influence in the study. The first factor captures the social consensus dimension and one scenario of the proximity dimension. The second factor indicates an interaction between the temporal immediacy and the magnitude of consequences dimension. The third dimension is probability of effect and one scenario of the proximity dimension. In addition, t-tests indicated that the manipulation of high and low conditions within each scenario were also successful. One limitation of the study might be the use of undergraduate accounting students as manager proxies, although prior evidence suggests use of accounting students as proxies is a valid approach in this type of study. This is a highly novel project as most prior studies have focussed on moral intensity and the general ethical decision-making process. (shrink)

A central feature of complexity is that it is based on non-linear, recursive relations. However, in most current accounts of complexity such relations, while non-linear, are based on the reductive relations of a Newtonian onto-epistemological framework. This means that the systems that are emergent from the workings of such relations are a narrowly reduced spectrum of complex systems. It is argued that John Dewey’s trans-actional relations, relations that are characterized by an irreducible internal distinction, can function as an exemplar of (...) the less reductive relations seen in living complex systems. Conceptualizing complex relations and complex systems in a less reductive way allows indeterminate concepts such as epistemological limits and the generative production of meaning, which are inextricably linked, to be considered. Methodologically, such lessened reduction highlights functional systems, revealing aspects of the biopsychosocial human ‘complex system of complex systems’ that are hidden from view in a Newtonian framework. (shrink)

In _Philosophy of Song and Singing: An Introduction_, Jeanette Bicknell explores key aesthetic, ethical, and other philosophical questions that have not yet been thoroughly researched by philosophers, musicologists, or scientists. Issues addressed include: The relationship between the meaning of a song’s words and its music The performer’s role and the ensuing gender complications, social ontology, and personal identity The performer’s ethical obligations to audiences, composers, lyricists, and those for whom the material holds particular significance The metaphysical status of isolated (...) solo performances compared to the continuous singing of opera or the interrupted singing of stage and screen musicals Each chapter focuses on one major musical example and includes several shorter discussions of other selections. All have been chosen for their illustrative power and their accessibility for any interested reader and are readily available. (shrink)

ETUDES DE PHILOLOGIE 38 ETD'HISTOIRE JEANETTE MA BEER Narrative Conventions of Truth in the Middle Ages GENEVE ...

This paper investigates reference to clausally introduced entities and proposes an explanation for why these are more readily available to immediate subsequent reference with a demonstrative pronoun than with the personal pronoun,it. New evidence is provided supporting proposals that such entities are typically activated, but not brought into focus, upon their introduction into a discourse. The study also provides further insight into the role of information structure, lexical semantics, presuppositional contexts, and syntactic structure in bringing an entity into focus of (...) attention. (shrink)

The initial purpose of this study is to provide an empirical validation of Victor and Cullen’s ethical-climate model (1987, Frederick (ed.), Research in Corporate Social Performance and Policy, Vol. 9, pp. 51–71; 1988, Administrative Science Quarterly 33, 101–125; 1990, Frederick and Preston (eds.), Business Ethics: Research Issues and Empirical Studies (JAI Press Inc., Greenwich, Connecticut), pp. 77–97). Testing the model on a sample of Danish firms, this study demonstrates that the empirical model as suggested by Victor and Cullen is much (...) stronger than suggested by previous research. Based on a confirmatory factor model, the results of this study suggest a revised ethical structure. Especially a sixth dimension – own interest – is separated from the original instrumental dimension. Further, this study suggests that the ethical-climate model can be enhanced with the dimension of autonomy deriving from Koys and DeCotiis’ (1991, Human Relations 44(3), 265–285.) dimensional psychological climate instrument. (shrink)

What is the role and value of pleasure in addiction? Foddy and Savulescu have claimed that substance use is just pleasure-oriented behavior. They describe addiction as "strong appetites toward pleasure" and argue that addicts suffer in significant part because of strong social and moral disapproval of lives dominated by pleasure seeking. But such lives, they claim, can be autonomous and rational. The view they offer is largely in line with the choice model and opposed to a disease model of addiction. (...) Foddy and Savulescu are sceptical of self-reports that emphasize the ill effects of addiction such as loss of family and possessions, or that claim an absence of pleasure after tolerance sets in. Such reports they think are shaped by social stigma which makes available a limited set of socially approved addiction narratives. We will not question the claim that a life devoted to pleasure can be autonomously chosen. Nor do we question the claim that the social stigma attached to the use of certain drugs increases the harm suffered by the user. However our interviews with addicts reveal a genuinely ambivalent and complex relationship between addiction, value, and pleasure. Our subjects did not shy away from discussing pleasure and its role in use. But though they usually valued the pleasurable properties of substances, and this played that did not mean that they valued an addictive life. Our interviews distinguished changing attitudes towards drug related pleasures across the course of substance use, including diminishing pleasure from use over time and increasing resentment at the effects of substance use on other valued activities. In this paper we consider the implications of what drug users say about pleasure and value over the course of addiction for models of addiction. Well don't get me wrong, I love using mate. If I could use successfully I would. I'd still be using. I love using. I just don't like the shit that comes with it. (shrink)

It is often claimed that the existence of psychopaths undermines moral rationalism. I examine a recent empirically based argument for this claim and conclude that rationalist accounts of moral judgement and moral reasoning are perfectly compatible with the evidence cited.

Recent advancements in therapeutic and diagnostic medicine, along with the creation of large biobanks and methods for monitoring health technologies, have improved the prospects for preventing, treating, and curing illness. These same advancements, however, give rise to a plethora of ethical questions concerning good decision-making and best action. These ethical questions engage policymakers, practitioners, scientists, and researchers from a variety of fields in different ways. Collaborations between professionals in the medical and health sciences and the social sciences and humanities often (...) take an asymmetrical form, as when social scientists use ethnographic approaches to study the moral issues and practices of physicians. The ethics laboratory described in this article is a cross-sectoral and inter-disciplinary forum for collaborative investigation on important moral topics. It offers an experimental way of unpacking implied assumptions, underlying values, and comparable notions from different professional healthcare fields. The aim of this article is to present the ethics laboratory’s methodology. The article offers a model and a hermeneutical framework that rests on a dialogical approach to ethical questions. The model and the framework derive from a Danish research project, _Personalized Medicine in the Welfare State_. This article uses personalized medicine as a point of reference, though it offers an argument for the applicability of the model more broadly. (shrink)

A person suffering a mental illness or disorder may differ dramatically from his or her previous well self. Family and close friends who knew the person before the onset of illness tend to regard the illness as obscuring their loved one's true self and see the goal of treatment as the restoration of that self. ‘He is not really like this,’ they will say with increasing desperation. Treatment teams and others, who have no acquaintance with the person when well, respond (...) to what they see in front of them and do sometimes make harmful judgments of character based on the person's presentation when ill. (shrink)

Long-term cancer survivorship is an emerging field that focuses on physical late-effects and psychosocial implications for the inflicted. This study wishes to cast light on the underlying ontological aspect of long-term survivorship by philosophically exploring how being in life post cancer is perceived by survivors. Sixteen in-depth interviews with 14 Danish cancer survivors were conducted by the author. Having faced a life-threatening disease but no longer being in imminent danger of dying, survivors still considered death a defining yet dynamic component (...) in their approach to life as a moving toward the end, sparking a sense of vitality in mortality. In order to unfold the interviewees’ renewed existential understanding post cancer, this study employs Martin Heidegger’s ontological analysis of death. In survivorship, my participants can thus be understood as being left with the perpetual choice between living in inauthenticity or in authenticity. The difference between the two modes of existence exhibits two diverging ways of relating to death, self, and being-in-the-world. At the same time, the role of death in long-term survivorship reflects back on the magnitude of the initial existential and moral upheaval triggered by the cancer diagnosis. Understanding the role of death in long-term survivorship can positively inform the field of cancer rehabilitation and long-term survivor care. (shrink)

This article introduces _the Ethics Laboratory_ as an inter-sectorial and cross-disciplinary dialogical forum which can be viewed as an educational tool for moral learning. _The Ethics Laboratory_ represents a platform for the informal, collaborative investigation, in strict confidentiality, of ethical questions that have social consequences and/or legal concerns and bridges boundaries between research communities, institutions and patients. Its methodological structure proposes an experimental, open-ended way of unpacking implied assumptions, underlying values, comparable notions and observations from different professional fields. In connection (...) with a large social science project on precision medicine, we conducted four Ethics Laboratories followed by eight interviews with a selected number of participants. Through these interviews we learnt how this exploratory dialogical forum heighten moral awareness on issues that are shared among stakeholders who work to implement precision medicine in Denmark. Though the framework was developed specifically to foster ethical reflection within precision medicine, its dialogical structure lends itself to other professional areas and can easily be adopted and carried out. (shrink)

:The spread of demands by physicians and allied health professionals for accommodation of their private ethical, usually religiously based, objections to providing care of a particular type, or to a particular class of persons, suggests the need for a re-evaluation of conscientious objection in healthcare and how it should be regulated. I argue on Kantian grounds that respect for conscience and protection of freedom of conscience is consistent with fairly stringent limitations and regulations governing refusal of service in healthcare settings. (...) Respect for conscience does not entail that refusal of service should be cost free to the objector. I suggest that conscientious objection in medicine should be conceptualized and treated analogously to civil disobedience. (shrink)

In this chapter I argue that there is a normative aspect to self-control that is not captured by the purely procedural account to be drawn from dual process theories of cognition – which we only uncover when we consider what self-control is for and why it is valuable. For at least a significant sub-group of addicts their loss of control over their drug use may not be due to a lack or depletion of cognitive resources. Rather it may be that (...) they have little confidence in their ability to exert control over their circumstances and shape the life they would value having and the person they would value being. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 36.1 (2003) 22-38 [Access article in PDF] Descartes's Rhetoric:Roads, Foundations, and Difficulties in the Method Jeanette Bicknell Descartes's Discours de la méthode is an extremely rich text for anyone interested in the rhetorical and literary aspects of philosophical works, as well as for those interested in the history of scientific discourse. 1 Commentators have tended to stress the inclusive and possibly emancipatory aspects of the (...) text: Descartes's use of the vernacular and inclusion of autobiographical elements. 2 Without denying the democratic potential of the Discours, I will argue that close attention to its rhetorical and literary features reveals an unacknowledged tension in Descartes's thought between the individual and the social or communal aspects of method. This tension seems to have been overlooked by commentators.Briefly, the tension I have identified is manifest in the conflicting metaphors Descartes uses to characterize scientific and epistemological progress. The best known and most studied of these metaphors are from architecture and town-planning. Less attention has been paid to the metaphor of the road or path (chemin) in the Discours. Descartes sees cognitive and scientific progress as ultimately the work of a solitary individual. We can call this the "heroic" or "great individual" view of scientific progress. This is clear in his architectural metaphors. Yet recurrent metaphors characterizing cognitive progress as a road point to a more social or communal view of science as the work of many hands (or feet). Roads are social entities par excellence. They pre-exist those who travel them and are available to all who want to travel them. Although roads may be planned and built according to specifications, they may arise simply from the aggregated actions of individuals. I suggest that this tension between two fundamentally different characterizations and conceptions of cognitive progress indicates a deep division in Descartes's thought, unresolved in the Discours.What is at issue, philosophically, in my analysis of Descartes's rhetoric? First and most generally is the problem of bringing together all the [End Page 22] elements of a philosophical text, especially a text with the seminal importance of the Discours. What status and significance should we give to those elements of a text that do not seem to be directly part of the arguments? These elements include the author's self-presentation and indications as to the implied audience, as well as figurative language and illustrative and explicatory metaphors. I shall show how these elements repay close attention, and that it is fruitful to test them for consistency with the text's explicit claims and arguments.More specifically, my interpretation has implications for Descartes's program. Descartes's work is generally taken to be the basis of strict traditional autonomism and reductionist individualism. One critique of such individualism is that methods, not to mention the languages in which they are expressed, are social rather than private. A close examination of Descartes's own language supports this critique, as his rhetoric can be seen to undercut his avowed position in the text. It is open to debate whether or not Descartes was aware of the tension between his autonomism and individualism on one hand, and his hopes for cognitive and scientific progress founded upon method on the other. Thus, it is entirely possible that the quintessentially modern philosopher of the self had excessive expectations of that self, not to mention an incoherent picture of it.Finally, the implications of my analysis reach beyond Descartes's text to broader conceptual issues. The tension I have identified in the Discours is not limited to Descartes's work, but it points to underlying difficulties in trying to think through the problems he discusses. While methods are social, an individualistic element may be ineliminable. But the social is not just the aggregation of asocial selves. The self, its education and development, and its ability to participate in a method, must all be social. Another issue is the nature of scientific and epistemological progress, and the relationship between their individual and more communal aspects. And whatever their relationship, we... (shrink)

Introduction: Mental health nursing is dependent on nurses’ ability to engage in therapeutic relationships with patients. The ability to manage professional boundaries is equally important, but less explored. This study aims to address the following research questions: How do nurses define their professional, personal, and private roles? What are nurses’ experiences with professional boundaries? What are the implications of nurses’ understanding of these boundaries? Background: Nurse–patient relationships are characterized by asymmetrical power dynamics, which places the responsibility of delineating professional boundaries (...) on the nurse. While ethical codes offer guidance, nurses must identify appropriate boundaries in a dynamic process that relies on the clinical context. Research design: This study used critical discursive psychological analysis to examine data from participant observations, individual interviews, and focus group discussions. Participants and research context: We included 16 nurses working in mental health care in this study, comprising 12 in specialist mental health care and 4 in community mental health care. Ethical considerations: The study was registered with Norwegian Social Science Data Services. Results: Nurses defined professionalism as being an educated caregiver who prioritizes patients’ needs. Professionalism involves personal engagement, while some personal matters remain private. However, nurses experienced challenges in maintaining professional boundaries, facing dilemmas due to the subjective nature of boundaries and patients’ unpredictable responses. Conclusions: While nurses prioritize patients’ needs and best interests, this study demonstrated that personal engagement is considered part of professionalism. However, nurses encounter complex dilemmas in setting professional boundaries. Additionally, these boundaries can either emphasize or de-emphasize the power differential in nurse-patient relationships. (shrink)

ABSTRACT Choice theorists such as George Ainslie and Gene Heyman argue that the drug-seeking behaviour of addicts is best understood in the same terms that explain everyday choices. Everyday choices, they claim, aim to maximise the reward from available incentives. Continuing drug-use is, therefore, what addicts most want given the incentives they are aware of but they will change their behaviour if and when better incentives become available. This model might explain many typical cases of addiction, but there are hard (...) cases that pose a problem. In these hard cases the addicted individual does not cease using drugs in the face of consequences that are so adverse it is implausible that they are unaware of more rewarding paths of action. These cases force the choice theorist into a dilemma: either these addicts? drug use does not count as action and so is best described by a neurobiological model, or reference to ?reward? in these cases means merely ?motivated? and so provides no explanatory power. We propose a different model of motivation that takes self-conception into account. We show how that can better explain the hard cases of addiction and also inform our understanding of recovery and self-control. (shrink)

From an informal group of a dozen faculty and graduate students at Temple University, the Jean Piaget Society grew in seven years to 500 members who have interests in the application of genetic epistemology to their own disciplines and professions. At the outset Piaget endorsed the concept of a society which bore his name and presented a major address on equilibration at the society's first symposium in May, 1971. Had he not done so the society would no doubt have remained (...) a small parochial group, like so many others throughout the country, interested in Piaget and his theory. With the encouragement of Genevans and the leadership of its first four presidents, Lois Macomber, Barbara Press eisen, Marilyn Appel, and John Mickelson, the society undertook a number of programs to collect and disseminate the results of scholarly work in genetic epistemology. Particular emphasis was placed upon applications of Piaget's theory to developmental psychology, philos ophy, and education. One of these programs was the publication of an annual series on the development of knowing, of which this volume is the first. In 1973, the society asked Hans Furth with the assistance of Willis Overton and Jeanette Gallagher to initiate and plan a series of yearbooks with the result that in addition to this volume, a second volume on education was commissioned, and a third one on the decalage issue was planned. (shrink)

Dissociative Identity Disorder (DID) (formerly known as Multiple Personality Disorder) is a condition in which a person appears to possess more than one personality, and sometimes very many. Some recent criminal cases involving defendants with DID have resulted in "not guilty" verdicts, though the defense is not always successful in this regard. Walter Sinnott-Armstrong and Stephen Behnke have argued that we should excuse DID sufferers from responsibility, only if at the time of the act the person was insane (typically delusional); (...) otherwise the presumption should be that persons with DID are indeed responsible for their actions. We find their interpretation of DID and of the way in which the requirements for criminal insanity relate to this condition worrying and likely to result in injustice to DID sufferers. Our thesis is that persons with DID cannot be responsible for their actions if the usual features of the condition are present. A person with DID is a single person in the grip of a very serious mental disorder. By focusing on the features of DID which have, as we argue, the effect of deluding the patient, we try to show that such a person is unable to fulfill the ordinary conditions of responsible agency (namely, autonomy and self-control). (shrink)

“Oversinging” is singing that is excessive in one or more dimensions: too loud, too ornamented, too melismatic, too expressive, or employing too much vibrato. I begin with a characterization of oversinging and establish a context for discussion (Section I). Next I consider performances by Christina Aguilera and Michael Bolton as examples (Section II). In light of these examples, I consider how oversinging might be both aesthetically and morally problematic (Section III). Along the way I raise concerns about authenticity and sincerity (...) (Section IV). Finally (Section V), I consider a “paradox” of oversinging involving the role of skill in artistic performance. My discussion touches on the aesthetics of performance, aesthetic judgment, virtuosity, and taste. (shrink)