Background: In accordance with ethical guidelines for nurses, leaders for nurse services in general are responsible for facilitating professional development and ethical reflection and to use ethical guidelines as a management tool. Research describes a gap between employees’ and nurse leaders’ perceptions of priorities. Objective: The purpose of this article is to gain deeper insight into how nurses as leaders in somatic hospitals describe ethical challenges. Design and method: We conducted individual, quality interview with 10 nurse leaders, nine females and (...) one male nurse aged 34–64 years. We used a hermeneutical approach to analyse the data. Ethical considerations: The participants received oral and written information about the study. Participation in the study was voluntary, and the participants were given the opportunity to withdraw. All of them gave written consent. The Norwegian Centre for Research Data approved the research project. In addition, the head of the hospitals gave permission to conduct our study. Findings: Four main areas were identified: deficient ethical language, conflicting demands on nurse leaders regarding staff management, concerns regarding young nurses’ ethical consciousness and restricting factors on the creation of a climate of ethics. The nurse leaders experienced considerable pressure. An unexpected finding was the lack of – and even disregard for – an ethical language. Discussion and conclusion: It is crucial to recognise ethics in all types of nursing approaches and to make it explicit. Ethical language must be implemented in nursing education. It must be recognised and used in clinical practice. Recommendations: We recommend further research be conducted into how nurses understand the concept of ethics and how to incorporate ethical principles into clinical nursing and nurse leadership. (shrink)

Background: School nurses have great responsibilities as the connecting link between school, children/adolescents, parents, and other healthcare services. Being in this middle position, and handling complex situations and problems related to children in school, may be demanding and also lead to ethical challenges. Clinical ethics support, such as ethics reflection groups, may be of help when dealing with ethical challenges. However, there is little research on experiences with ethics reflection groups among school nurses. Aim: The aim of this research was (...) to explore how nurses in school healthcare experience their role, and how they experience participation in ethics reflection groups, using a model for systematic ethics reflection, the Centre for Medical Ethics model. Research design: The project had a qualitative design, using focus group interviews and thematic analysis. Ethical considerations: The study was evaluated by the Data Protection Official at the Norwegian Centre for Research Data (project no. 57373). The participants were given oral and written information about the study and signed a written consent. Participants and context: Twelve participants from school healthcare were recruited to the interviews. Findings: School nurses described their role as extremely challenging. How the school nurses experienced their role also influenced how they experienced participating in ethics reflection groups. The Centre for Medical Ethics model was experienced as both challenging and comprehensive. However, they also experienced that the model helped them to clarify their role and could also help them to find better solutions. Conclusion: The role as school nurse is complex and demanding, with several ethical challenges. Ethics reflection groups may be of great help when dealing with these challenges. However, it is of great importance that the methods used are adjusted to the professionals’ needs and context. (shrink)

Background: Empathy and moral courage are important virtues in nursing and nursing ethics. Hence, it is of great importance that nursing students and nurses develop their ability to empathize and their willingness to demonstrate moral courage. Research aim: The aim of this article is to explore third-year undergraduate nursing students’ perceptions and experiences in developing empathy and moral courage. Research design: This study employed a longitudinal qualitative design based on individual interviews. Participants and research context: Seven undergraduate nursing students were (...) interviewed during or immediately following their final clinical placement. Ethical considerations: The Norwegian Social Science Data Services (NSD) approved the study. Participants were informed that their participation was voluntary and were assured confidentiality. They were informed that they could withdraw from the study at any time, without providing reasons. Findings: Affective empathy seemed to be strong among third-year undergraduate nursing students. However, they tried to handle the situations in a ‘professional’ way, and to balance their emotions. At the same time, they expressed how difficult it can be to show moral courage when confronted with poor patient care. In addition, they spoke about a lack of role models during clinical practice and supervision. Conclusions: Undergraduate nursing students are in a vulnerable position throughout their journey to become professional and to develop empathy and moral courage. The professional socialisation and forming of professional empathy and moral courage among nursing students, may be seen as a complex interaction of formal and hidden curriculum, where role models play an important role. We argue that the main theme ‘Vulnerable students – a journey towards professional empathy and moral courage’ may cover the longitudinal project as a whole. This vulnerability is something both teachers and supervisors should be aware of when following up with students in their clinical placements. (shrink)

Because of the transfer of responsibility from hospitals to community-based settings, providers in home-based care have more responsibilities and a wider range of tasks and responsibilities than before, often with limited resources. The increased responsibilities and the complexity of tasks and patient groups may lead to several ethical challenges. A systematic search in the databases MEDLINE, CINAHL, and SveMed+ was carried out in February 2019 and August 2020. The research question was translated into a modified PICO (Population, Intervention, Comparison, and (...) Outcome) worksheet. A total of 40 articles were included. The review is conducted according to the Vancouver Protocol. The main findings from the systematic literature review show that ethical challenges experienced by healthcare and social care providers in home-based care are related to autonomy and balancing ethical principles, decisions regarding intensity of care, challenges related to priority settings, truth-telling, and balancing the professional role. Findings regarding ethical challenges within home-based care are in line with findings from institutional healthcare and social care settings. However, some significant differences from the institutional context are also highlighted. (shrink)

Background The concept of “health security” is often used to motivate public health responses, yet the ethical values that underpin this concept remain largely unexamined. The recent Australian responses to COVID-19 serve as an important case study by which we can analyse the pre-existing literature to see what ethical values shaped, and continue to shape, Australia’s response. Methods We conducted a critical interpretive literature review of academic and grey literatures within key databases, resulting in 2,220 sources. After screening for duplicates (...) and relevance, we analysed ninety-six sources. Results First, risk and uncertainty are a leading focus, with a heavy concentration on risks to life and health. Second, free movement, safety, and security were recurringly emphasized, albeit narrowly focused upon the safety of the population. Third, legitimacy was a recurring theme, and it is here that discussions of “health security” figured highly. Conclusion Discussions of harm from government and associated official bodies fail to adequately distinguish between various senses of harm. Moreover, while the literature often discusses the balancing of rights, the steps involved in the weighing of these rights is rarely adequately explained and defended. We suggest that decision-makers should endeavour to clearly identify and defend the values undergirding their decisions in the public sphere. (shrink)

The aim of this article is to show the importance of moral sensitivity when including persons with dementia in research. The article presents and discusses ethical challenges encountered when a total of 15 persons with dementia from two nursing homes and seven proxies were included in a qualitative study. The examples show that the ethical challenges may be unpredictable. As researchers, you participate with the informants in their daily life and in the interviews, and it is not possible to plan (...) all that may happen during the research. A procedural proposal to an ethical committee at the beginning of a research project based on traditional research ethical principles may serve as a guideline, but it cannot solve all the ethical problems one faces during the research process. Our main argument in this article is, therefore, that moral sensitivity is required in addition to the traditional research ethical principles throughout the whole process of observing and interviewing the respondents. (shrink)

The aim of this article is to investigate how life in Norwegian nursing homes may affect experiences of dignity among persons with dementia. The study had a qualitative design and used a phenomenological and hermeneutic approach. Participant observation in two nursing home units was combined with qualitative interviews with five residents living in these units. The study took place between March and December 2010. The residents feel that their freedom is restricted, and they describe feelings of homesickness. They also experience (...) that they are not being seen and heard as individual autonomous persons. This lack of freedom, experiences of homesickness and feelings of not being confirmed and respected as individual autonomous persons may be a threat to their personal dignity. In order to protect and enforce the dignity of persons with dementia living in nursing home, we should confirm them as whole and as individual persons, and we should try to make the nursing homes less institutional and more home like. (shrink)

What kind of thing is a psychiatric disorder? At present, this is the central question in the philosophy of psychiatry. Answers tend toward one of two opposing views: realism, the view that psychiatric disorders are natural kinds, and constructivism, the view that disorders are products of classificatory conventions. The difficulties with each are well rehearsed. One compelling third-way solution, developed by Peter Zachar, holds that disorders are practical kinds. Proponents of this view are left with the difficult task of explaining (...) what makes practical kinds practical. Kendler, Zachar, and Craver have recently developed a new third-way solution, according to which psychiatric disorders are mechanistic property cluster kinds. This account, already influential in the philosophy of psychiatry, holds that the usefulness of psychiatric kinds is explained by the stability of multilevel mechanisms that generate psychiatric symptoms. We argue that this account, like any that purports to address the central question in the philosophy of psychiatry without first attending carefully to the nature of psychiatry and the difference between its constituent scientific and philosophical parts, will ultimately be committed to untenable views about the nature of psychiatric science, the aims and limitations of scientific inquiry and mechanistic explanations, and the role of values in psychiatry. (shrink)

Increasingly, functional and evolutionary research has highlighted the important contribution emotion processing makes to complex human social cognition. As such, it may be asked whether neural structures involved in emotion processing, commonly referred to as limbic structures, have been impacted in human brain evolution. To address this question, we performed an extensive evolutionary analysis of multiple limbic structures using modern phylogenetic tools. For this analysis, we combined new volumetric data for the hominoid (human and ape) amygdala and 4 amygdaloid nuclei, (...) hippocampus, and striatum, collected using stereological methods in complete histological series, with previously published datasets on the amygdala, orbital and medial frontal cortex, and insula, as well as a non-limbic structure, the dorsal frontal cortex, for contrast. We performed a parallel analysis using large published datasets including many anthropoid species (human, ape, and monkey), but fewer hominoids, for the amygdala and 2 amygdaloid subdivisions, hippocampus, schizocortex, striatum, and septal nuclei. To address evolutionary change, we compared observed human values to values predicted from regressions run through a) nonhuman hominoids and b) nonhuman anthropoids, assessing phylogenetic influence using phylogenetic generalized least squares regression.Compared with other hominoids, the volumes of the hippocampus, the lateral nucleus of the amygdala, and the orbital frontal cortex were, respectively, 50%, 37%, and 11% greater in humans than predicted for an ape of human hemisphere volume, while the medial and dorsal frontal cortex were, respectively, 26% and 29% significantly smaller. Compared with other anthropoids, only human values for the striatum fell significantly below predicted values. Overall, the data present support for the idea that regions involved in emotion processing are not necessarily conserved or regressive, but may even be enhanced in recent human evolution. (shrink)

In this paper, the authors describe an aspect of a program of research around grief and clinical practice. The first phase of the study involves examination of experiences of grief with attention to troublesome or problematic beliefs that fuel the extent of suffering in the bereaved. The data, obtained from a review of videotaped clinical interviews with families seen in the Family Nursing Unit at the University of Calgary, were analyzed according to philosophical hermeneutic tradition. Findings suggest that grief is (...) an experience that is ongoing, that changes in nature over time, but that involves a continuing relationship with the deceased; it is a graceful, periodic, deliberate walk backwards while keeping a sure foot in living forward. (shrink)

A major part of police work consists in providing services and information to the general public. A stated goal of such police work is to be service-minded and contribute to a positive encounter. This article analyses service requests in calls to the duty desk of a large police station and focuses on how officers deal with requests that have to be rejected. It reveals a general pattern in which officers produce the rejection in a dispreferred format and include displays of (...) empathy, accounts for the rejection and suggestions for alternative solutions. However, in certain types of requests the rejections are not infrequently produced in a direct and unmitigated fashion, without accounts or explanations.This is especially notable in requests that touch upon institutional constraints, such as professional secrecy. And in certain cases the rejections are even delivered in an aggravated form, involving an explicit or implicit challenge to the legitimacy of the request. These rejections cast the caller in an oppositional role, infringing the professional constraints of the police. However, the constraints in question may not be accessible to the callers. The officers will consequently be experienced as hostile and will subvert their own objectives of showing service-mindedness. (shrink)

Many countries are now implementing human papillomavirus vaccination. There is disagreement about who should receive the vaccine. Some propose vaccinating both boys and girls in order to achieve the largest possible public health impact. Others regard this approach as too costly and claim that only girls should be vaccinated. We question the assumption that decisions about human papillomavirus vaccination policy should rely solely on estimates of overall benefits and costs. There are important social justice aspects that also need to be (...) considered. Policy makers should consider how to best protect individuals who will remain unvaccinated through no fault of their own. This is especially important if these individuals are already disadvantaged in other ways and if vaccinating other people increases their risk of infection. (shrink)

Background: Empathy is of great importance in nursing, as it helps us to see and meet the needs of patients and hence to care for patients in an appropriate way. Therefore, it is of great importance that nursing students and nurses develop their ability to empathize. Objective: The study aimed at gaining knowledge on what characterizes undergraduate nursing students’ ability to empathize with patients during their first practice in a nursing home. In addition, the aim of the study was to (...) investigate what nursing students think is important with regard to upholding their ability to empathize with patients in a professional way. Research design: This research has a phenomenological and hermeneutic design, based on qualitative interviews. Participants and research context: A total of 11 undergraduate nursing students participated in interviews during or right after their first practice in a nursing home. Ethical considerations: Norwegian Social Science Data Services approved the study. Participants were informed that their participation was voluntary. The participants were also assured confidentiality, and they were informed that they could withdraw from the study at any time, without providing any reasons. Findings: What the findings show is that affective empathy is strong among undergraduate nursing students in their first practice. They think the emotions are important to be able to empathize, and they are afraid of becoming indifferent. At the same time, they are afraid that the feelings will hinder them from acting in a professional manner. Discussion: The findings are discussed in light of previous theories on empathy, and especially perspectives on empathy, emotions, and morality. Conclusion: Affective empathy seems to be strong among nursing students, and this may be of great importance to be sensitive to patients’ well-being. However, affective and cognitive empathy should be balanced if nurses will have to meet patients in a professional way. (shrink)

This narrative case study, created from several qualitative sources, portrays a young woman’s life experiences and an eight yearlong therapy process with Norwegian Psychomotor Physiotherapy. It is analyzed retrospectively from an analytical angle, where NPMP theory is expanded with Løgstrup’s phenomenology of sensation and Ricoeur’s narrative philosophy. Understanding Rita’s narrative through this window displayed some foundational phenomena in a singular way, illuminating embodied experiences in inter-subjective relationships in movement, sensation and time entwined. It illustrates how traumatic life experiences may cause (...) pain, suffering and ruptured narratives with fragmented physical and sensuous reactions, chaos and loss of temporal coherence with consequences for a person’s sense of identity. Rita’s narrative also illuminates how intersubjective interaction has healing potentials when there is time and space for trust to emerge and to support new bodily-based experiences. Embodied sensuous experiences in present time may help clarify past and present and support chronology in narration and the sense of identity. With this exemplary case study, we argue that Løgstrup’s and Ricoeur’s thinking may add valuable perspectives to understanding suffering and healing processes in the field of embodied therapies like NPMP. (shrink)

We consider academic freedom in the context of broader developments in higher education. We suggest that the tenor of contemporary debates on the subject is a manifestation of pervasive forms of authoritarianism that undermine the university as a home of adventure, a place and space that is conducive to the conduct of free inquiry.It is evident that some champions of academic freedom engage in dangerously polarized forms of spectacle, engendered by a management culture that embraces showmanship and routinely favours talking (...) over listening. As such, they represent a force for conformity rather than dissent; division rather than collective action. These forms of spectacle jeopardize rather than promote the principles of academic freedom by polarizing the terms of the debate for maximum ‘impact’. We explore the implications of conceptualizations of academic freedom that focus on the rights of everyone in the university. We also suggest that the notion might usefully be extended to those on precarious contracts, and to students facing normative expectations about what constitutes ‘progress’ in academic practice. Drawing upon Timothy Snyder’s On Tyranny: Twenty Lessons from the Twentieth Century and an essay by Vaclav Havel, we reassess the notion of the ‘pursuit of truth’ that underlies conventional definitions of academic freedom.We conclude with a brief vignette, a rousing endorsement of the ineffable and irreducible qualities of friendship. This entails slaying a fictitious, three-headed dragon and embracing a form of spectacle that transcends attempts to capture why it moves us. We leave the reader with warm-blooded traces of energy, curiosity, liveliness, and quiet determination. (shrink)

The election of Donald J. Trump as the 45th President of the United States reminded us that climate deniers are anything but endangered species. In this short paper, we discuss President Trump’s position on climate change in the wider context of climate controversies and denial. In particular, we put it into perspective with other notorious contrarian leaders and their influence on national and international climate politics. Finally, we provide a brief analysis of President Trump discourses on climate change and discuss (...) them in light of reflections about post-truth politics. (shrink)

This study elaborates on narrative resources emerging in the treatment of longlasting musculoskeletal and psychosomatic disorders in Norwegian psychomotor physiotherapy. Patients’ experiences produced in focus group interviews were analyzed from a narrative perspective, combining common themes across groups with in depth analysis of selected particular stories. NPMP theory expanded by Løgstrup’s and Ricoeur’s philosophy, and Mattingly’s and Frank’s narrative approach provided the theoretical perspective. Patients had discovered meaning imbued in muscular tension. Control shifted from inhibiting discipline and cognitive strategies, towards (...) more contingence with gravity and sensation, and increased freedom to be what and who they were. Trust, time, open speech, and being respectfully listened to were described as therapeutic pre-conditions. The body was experienced as the source of their voice as their own. As tension patterns transformed, novel experience in sensation appeared to feed narrative imagination, reshaping past plots, embodied identity and future prospects. NPMP was disclosed as a treatment integrating detection, battle and repair as narrative subplots, but the core narrative was the journey of transformation. Novel embodied narrative resources nourished the quest for a life and identity in tune with the body as one’s own. (shrink)

The aim of this article is to show the importance of moral sensitivity when including persons with dementia in research. The article presents and discusses ethical challenges encountered when a total of 15 persons with dementia from two nursing homes and seven proxies were included in a qualitative study. The examples show that the ethical challenges may be unpredictable. As researchers, you participate with the informants in their daily life and in the interviews, and it is not possible to plan (...) all that may happen during the research. A procedural proposal to an ethical committee at the beginning of a research project based on traditional research ethical principles may serve as a guideline, but it cannot solve all the ethical problems one faces during the research process. Our main argument in this article is, therefore, that moral sensitivity is required in addition to the traditional research ethical principles throughout the whole process of observing and interviewing the respondents. (shrink)

Purpose The popularity of Facebook photo sharing has not only seen a surge in the number of photos shared but also has raised various issues concerning user privacy and self-disclosure. Recent literature has documented the increasing interest of the research community in understanding various privacy issues concerning self-disclosures on Facebook. However, little is known about how different privacy issues, trust and activity influence users’ intentions to share photos on Facebook. To bridge this gap, a research model was developed and tested (...) to better understand the impact of privacy concerns, privacy awareness and privacy-seeking on trust and actual photo sharing activity and subsequently on photo sharing intentions. This study aims to examine the consequences of various facets of privacy associated with photo sharing activity on Facebook. Design/methodology/approach A cross-sectional data from 378 respondents were collected and analysed using partial least squares modelling. Findings The results revealed a significant relationship between various aspects of privacy, including awareness and protective behaviour, with trust and activity. Furthermore, trust and users’ photo sharing activity significantly impact photo sharing intentions on Facebook. Originality/value This study contributes new knowledge concerning various privacy issues and their impact on photo sharing activity and trust. The study also proposes implications that are highly relevant for social networking sites, media agencies and organisations involved in safeguarding the privacy of online users. (shrink)

This collection of essays on the social history of disciplinary practices in education in North America, Northern Europe, and Colonial Bengal coverage upon an understanding that schools regulate the behavior of beliefs of students, teachers, and parents by enforcing certain disciplinary social norms.

Alcohol and other drug-related stigma is a growing concern. Many organizations have called for a reduction in such stigma through law reform, but there is little sense of how, precisely, this might be achieved. This paper reports on a new method to examine the relationship between stigma and the law and establish a framework that can guide and inform future law reform efforts.

(1994). Exchange on professionalization as marginalization: The American home economics movement and the rhetoric of legitimation. Social Epistemology: Vol. 8, No. 2, pp. 123-132.

There are several compelling reasons to expect that gender equality may serve to foster state environmentalism. However, most previous research on environmental politics has neglected gender. To help further our understanding of the connection between gender and environmental politics, the authors empirically assess the association between the representation of women in national Parliament and environmental treaty ratification, using a large sample of nations. The findings indicate that nations with higher proportions of women in Parliament are more prone to ratify environmental (...) treaties than are other nations. The results point to the importance of considering the role of gender in analyses of state behavior and environmental politics and are consistent with the argument of some feminist theorists that the exploitation of nature and the exploitation of women are interconnected. (shrink)