Modes of rationality in nursing documentation: biology, biography, and the ‘voice of nursing’ This article is based on a discourse analysis of the complete nursing records of 45 patients, and concerns the modes of rationality that mediated text‐based accounts relating to patient care that nurses recorded. The analysis draws on the work of the critical theorist, Jürgen Habermas, who conceptualised rationality in the context of modernity according to two types: purposive rationality based on an instrumental logic, and value rationality based (...) on ethical considerations and moral reasoning. Our analysis revealed that purposive rationality dominated the content of nursing documentation, as evidenced by a particularly bio‐centric and modernist construction of the workings of the body within the texts. There was little reference in the documentation to central themes of contemporary nursing discourses, such as notions of partnership, autonomy, and self‐determination, which are associated with value rationality. Drawing on Habermas, we argue that this nursing documentation depicted the colonisation of the sociocultural lifeworld by the bio‐technocratic system. Where nurses recorded disagreements that patients had with medical regimes, the central struggle inherent in the project of modernity became transparent — the tension between the rational and instrumental control of people through scientific regulation and the autonomy of the subject. The article concludes by problematising communicative action within the context of nursing practice. (shrink)

David Chalmers supports his contention that there is a possible world populated by our zombie twins by arguing for the assumption that conceivability entails possibility. But, I argue, the modal epistemology he sets forth, ‘modal rationalism,’ ignores the problem of incompleteness and relies on an idealized notion of conceivability. As a consequence, this epistemology can’t justify our quotidian judgments of possibility, let alone those judgments that concern the mind/body connection. Working from the analogy that the imagination is to the possible (...) as perception is to the actual, I set forth a competing epistemology, ‘modal empiricism.’ This epistemology survives the incompleteness objection and allows some of our everyday modal judgments to be justified. But this epistemology can’t justify the claim that Zombie World is possible, which leaves Chalmers’s property dualism without the support it needs. (shrink)

We can safely infer that a proposition is possible if p is the case. But, I argue, this inference from the actual to the possible is merely explicative in nature, though we employ it at times as if it were ampliative. To make this inference ampliative, we need to include an inference to the best explanation. Specifically, we can draw a substantive conclusion as to whether p is possible from the fact that p is the case, if via our best (...) explanation we can explain how p could occur again in the complete and coherent set of propositions that describes the actual world. (shrink)

Feminism is an antiauthoritarian movement that has sought to unmask many traditional “authorities” as ungrounded. Given this, it might seem as if feminists are required to abandon the concept of authority altogether. But, we argue, the exercise of authority enables us to coordinate our efforts to achieve larger social goods and, hence, should be preserved. Instead, what is needed and what we provide for here is a way to distinguish legitimate authority from objectionable authoritarianism.

Burgess-Jackson argues that the duties we have to our companion animals are similar to the duties we have to our children. Specifically, he argues that a person who takes custody of either a nonhuman animal or a child elevates the moral status of the child or animal, endowing each with rights neither had before. These rights obligate that person to provide for the well being of the creature—animal or child—in question. This paper offers two arguments against this position. First, a (...) creature's rights rest solely on the creature's intrinsic properties. Thus, the person taking custody of a creature does not endow the creature with new rights. Rather, the custodian assumes the responsibilities associated with ensuring that the creature's rights are protected and preserved. Second, our children possess intrinsic properties and, hence, rights—most important, the right to life—that our pets lack. This difference undermines the analogy on which Burgess-Jackson's argument depends. Our pets are not like our children, as Burgess-Jackson claims. Instead, they are more akin to our slaves. (shrink)

ABSTRACT: Recently the discussion surrounding the conceivability thesis has been less about the link between conceivability and possibility per se and more about the requirements of a successful physicalist program. But before entering this debate it is necessary to consider whether conceivability provides us with even prima facie justification for our modal beliefs. I argue that two methods of conceiving—imagining that p and telling a story about p—can provide us with such justification, but only if certain requirements are met. To (...) make these arguments, I consider those of Paul Tidman, whose position I use as a foil.RÉSUMÉ: Dernièrement, le débat sur la thèse de la concevabilité a peu porté sur le lien entre la concevabilité et la possibilité per se et s’est plutôt intéressé aux conditions requises pour la réalisation du programme physicaliste. Toutefois, avant d’entrer dans ce débat, il est nécessaire de se demander si la concevabilité offre une justification même élémentaire des croyances modales. Je soutiens que deux méthodesde concevoir — imaginer que p et raconter une histoire à propos de p — sont susceptibles de nous fournir cette justification, mais seulement dans la limite de certaines conditions. À l’appui de mon propos, j’envisage la position de Paul Tidman, qui me sert de repoussoir. (shrink)

Hélène Cixous has written a substantial body of writings about art. This article borrows Derrida's conception of the countersignature to explore the relationship she envisages in them between the plastic arts and writing. It argues that the works to which Cixous is drawn, many of which involve copying words, are driven by the desire to capture what is essentially uncapturable in the artist's idiom. Recognizing in them a displacement of her own concerns, Cixous suggests in these texts that all art (...) speaks a common language in so far as it represents the same attempt to pass beyond its own limits, visual or verbal. Writing and painting are thus as much translations of each other as one language is of another. In particular, their status as translations or copies profoundly troubles the possibility of determining the signatory of the text. (shrink)

This article discusses Glas in the light of Derrida's notion of the countersignature as both affirmation and betrayal of the countersigned. It explores how the two columns of Glas confirm as well as oppose each other, notably in relation to sexual difference, and examines how Derrida in turn is both faithful and unfaithful towards Hegel and Genet. Tracing the complexity of Derrida's signature, it reflects on its broader implications for his deconstructive project.

Consider the claim: Our actions are free if and only if we could have done otherwise; or the claim, We are essentially mental substances because we can exist without our bodies. Both of these claims, along with countless others, employ a notion of possibility. If this notion is to have a place in philosophy, we must be able to justify our modal claims. We need an epistemology of possibility. It is often assumed that the imagination is the key here. The (...) assumption is this; if I can imagine that a proposition is the case, then p is possible. Suppose I am wondering whether Kant Critique could float above my desk; if I can imagine this book floating, then it is possible. But is the imagination a guide to the modal status of propositions? ;To answer this question we must first consider what it is to imagine a proposition. We can distinguish five main methods of imagining: to imagine is to form a mental image, to evoke experiences, to suppose, to pretend, or it is to tell a story. Can any of these methods provide us with a guide to possibility? I contend that only the last two methods are up to this task insofar as they provide us with evidence of p's modal status. Moreover, how good that evidence is depends on our ability to satisfy the requirements of completeness, coherence, and accuracy. Finally, I argue that we will have the best evidence for the possibility of p, if we combine these two methods. For by combining our evoked experiences with a story, we will generate experiences of p, the best possible explanation of a world in which p is true, and an account of p's truth that complements this explanation. Thus, given explanationist standards, we will have what we need to be justified in concluding that p is possible. (shrink)

Some hold that if we can imagine God creating a world in which a particular proposition (p) is true, then we can conclude that p is possible. I argue that such appeals to God can’t provide us with a guide to possibility. For either God’s powers aren’t co-extensive with the possible or they are. And if they are, these appeals either beg the question or court a version of Euthyphro’s Dilemma. Some may argue that such appeals were only intended to (...) prompt us to think broadly about the modal claim at issue. I argue instead that these appeals must be understood as more than mere prompts. For it is these appeals that would, if successful, render the conceivability principle viable. (shrink)

Is a woman ever morally obligated to forgo an abortion for the sake of the man who has impregnated her? In “Fathers and Fetuses,” George Harris contends that in some situations women are so obligated. Harris argues that a woman who lies to her partner about her desire to have children, becomes pregnant, and then decides to abort, will, if she acts on this decision, violate her partner’s autonomy and harm him in so far as she will harm his fetus. (...) To avoid these wrongs, a woman must therefore carry this fetus to term. I argue that this conclusion depends on a principle for which Harris offers no argument, namely that the conditions under which a fetus is to be considered a man’s are the same conditions under which a fetus is to be considered a woman’s. Evaluating this principle andconsidering related cases leads to important conclusions about a parent’s relationship with the fetus. Specifically, I challenge the notion that we should ever consider a fetus ‘his’ or even ‘hers.’. (shrink)

Hélène Cixous and Jacques Derrida position themselves very differently in relation to literature. This article analyses that difference in the light of their relation to the symptom, the fundamentally unanalysable form through which the unconscious manifests itself. While Derrida dwells more on the impossibility of ever accessing the original secret wound to whose existence the symptom opaquely attests, Cixous tends to focus more on the effect, the symptom itself. For both, the ‘chance’ of literature lies in the fact that neither (...) the source nor the destination of letters can be determined. I argue that the difference between Derrida's relative resignation to this condition and Cixous's celebration of it helps to explain the contrast between his position at the margins of literature and her unequivocal embrace of it. (shrink)

Until recently, moral case deliberation (MCD) sessions have mostly been facilitated by external experts, mainly professional ethicists. We have developed a train the facilitator programme for healthcare professionals aimed at providing them with the competences needed for being an MCD facilitator. In this paper, we present the first results of a study in which we evaluated the programme. We used a mixed methods design. One hundred and twenty trained healthcare professionals and five trainers from 16 training groups working in different (...) healthcare organisations throughout the Netherlands were included. After completion of the programme, participants feel sufficiently confident and equipped to facilitate an MCD session. Feeling competent does not mean that participants have no doubts or questions left. Rather, they are aware of their limitations and see the need for continuous learning. According to the respondents, the actual exercise of facilitating MCD during and in between the training sessions contributed most to the development of competences necessary for being an MCD facilitator. Respondents without prior experience of participating in MCD sessions felt less competent after the training than those who had participated in MCD sessions before. Self-attributed competence varied between participants with different professional backgrounds. (shrink)

This paper draws on the economics of ethical compliance model to examine the association between ethical reasoning, perceived risk of detection, perceived levels of penalties and Chinese auditors'' ethical behavior in an audit conflict situation. Using 53 Chinese auditors from Shenzen as subjects, and a survey questionnaire, this study found that there is a significant negative association between ethical reasoning and the likelihood of unethical behavior and that this negative association is weaker for auditors who perceive higher risks of detection.

It is not uncommon that nurses are unable to meet the normative expectations of chronically ill patients. The purpose of this article is to describe and illustrate Walker’s expressive-collaborative view of morality to interpret the normative expectations of two women with multiple sclerosis. Both women present themselves as autonomous persons who make their own choices, but who also have to rely on others for many aspects of their lives, for example, to find a new balance between work and social contacts (...) or to find work. We show that their narratives of identity, relationship and value differ from the narratives that others use to understand and identify them. Since identities, relationships and values give rise to normative expectations, in both cases there is a conflict between what the women expect of their caregivers and vice-versa. The narratives also show that two similar persons with multiple sclerosis may need very different care. This implies that nurses caring for such persons should listen carefully to their stories and reflect on their own perceptions of self. (shrink)

The precarious rights of senior citizens, especially those who are highly educated and who are expected to counsel and guide the younger generations, has stimulated the creation internationally of advocacy associations and opinion leader groups. The strength of these groups, however, varies from country to country. In some countries, they are supported and are the focus of intense interest; in others, they are practically ignored. For this is reason we believe that the creation of a network of all these associations (...) is essential. The proposed network would act as a support for the already-existing policies of the United Nations’ High Commission for Human Rights, of independent experts, and of the Global Alliance for the Rights of Older People. All three have long ago recommended the creation of a recognized instrument for uniting presently scattered efforts. The proposed network, therefore, will seek to promote the international exchange of relevant expertise, and it will reinforce the commitments and actions that single countries are currently taking to meet these objectives. For example, informative public events can be organised to promote particular support initiatives and to provide an opportunity for new members of the network to be presented. The network will promote health for senior citizens, disease prevention, senior mobility, safe free time for seniors, alimentary education, protection against new risks and dangers, as well as equity in the services necessary for seniors to adopt new information and communication technologies. In the case of retired academic members, the network will promote equality with respect to continuing use of digital technologies (particularly email), continuing access to research libraries, and the guaranteed ability for seniors to fund their own research programs and to deliver free seminars. (shrink)

Little research has explored the possible effects of government institutions in emerging economies on ethical reviews of multinational research. We conducted semi-structured, in-depth telephone interviews with 15 researchers, Research Ethics Committees personnel, and a government agency member involved in multinational HIV Prevention Trials Network research in emerging economies. Ministries of Health or other government agencies often play pivotal roles as facilitators or barriers in the research ethics approval process. Government agency RECs reviewing protocols may face particular challenges, as they can (...) lack resources, be poorly organized, have inconsistent review processes and limited expertise, and use differing definitions of national interests, including upholding national reputation and avoiding potential exploitation and stigma of the country's population. The MOH/governmental review body may be affected by power dynamics and politics in study reviews; may consider issues both related and unrelated to research ethics as understood elsewhere; and may prioritize particular diseases, treatments, or interventions over other topics/types of research. Poor communication and deeply-rooted tensions may exist between sponsor and host countries, impeding optimal interactions and reviews. Investigators must understand and plan for the potential effects of governmental agencies on multinational collaborative research, including preserving adequate time for agency review, and contacting these agencies beforehand to address issues that may arise. Better understanding of these issues can aid and advance appropriate global scientific collaboration. (shrink)

This paper presents the results of qualitative research on academic inbreeding in Czech higher education, the first of its kind. Its focus is on exploring the significance of academic inbreeding, its types, practices, and possible solutions. The research for this paper was done among academic staff at eight institutions of higher education in the Czech Republic. It was conceptually informed by ideas about different types of inbred employees (immobile, mobile, silver-corded, and adherent) and available policy tools. The results show that (...) academic inbreeding has long flown under the radar as an issue. Its impact is perceived ambivalently, as both positive and negative, by academics and experts alike. Generally, its avoidance has not been taken into account in staff recruitment, which has allowed it to become widespread among Czech higher education institutions. The policy tools for combatting academic inbreeding include nodality (open recruitment), reorganization of recruitment procedures, capacity-building (including stays abroad), and hortatory proclamations (paying attention to the issue). Overall, the evidence gathered in the course of research suggests that some progress has been made in limiting academic inbreeding at some workplaces, and that what we would call purely immobile inbred employees are giving way to mobile and “silver-corded” inbred academic staff. Finally, Czech higher education institutions register few cases of pseudo-inbreeding, combining work at the same institution where a PhD was taken with an academically relevant position in a state research institute or the Academy of Sciences. (shrink)

Background: Patients at the end-of-life and their families experience a strong emotional impact. The wellbeing of the patient at the end-of-life and their family caregiver are related. Aim: to explore the elements related with the emotional wellbeing of patients with and without cognitive impairment at the end-of-life and that of their primary family caregivers. Design: Cross- sectional study. Participants: data was collected from 202 patients at the end of life with different diagnosis (COPD, cancer and frail elderly) as well as (...) from their respective 202 primary family caregivers. Results: Structural equation models indicated that the emotional state of the patients was best predicted by their functional independence and the burden of their family caregivers. At the same time, the emotional state of the primary family caregiver was predicted by their burden and not by the cognitive state or the functional independence of the patient. Nevertheless, the burden of the family caregiver, which is the only variable predicting both the emotional state of the patient and that of the caregiver, was directly related with the functional independence of the patient and indirectly with the patient’s cognitive state. Conclusions: The burden of the family caregiver stands out as a key factor in the reduction of the emotional distress of patients at the end-of-life –whether or not they present significant cognitive impairment- and that of their family caregivers. (shrink)

Making adaptive choices between solution strategies is a central element of contemporary mathematics education. However, previous studies signal that students make suboptimal choices between mental and written strategies to solve division problems. In particular, some students of a lower math ability level appear inclined to use mental strategies that lead to lower performance. The current study uses a pretest-training-posttest design to investigate the extent to which these students’ choices for written strategies and performance may be increased. Sixth graders of below-average (...) mathematics level (N = 147) participated in one of two training conditions: an explicit-scaffolding training designed to promote writing down calculations or a practice-only training where strategy use was not explicitly targeted. Written strategy choices and performance increased considerably from pretest to posttest for students in both training conditions, but not in different amounts. Exploratory results suggest that students’ strategy choices may also be affected by their attitudes and beliefs and the sociocultural context regarding strategy use. (shrink)

Borrett, Kelly and Kwan [ Phenomenology, dynamical neural networks and brain function, Philosophical Psychology, 13, 000-000] claim that unbiased, self-evident, direct description is possible, and may supply the data that brain theories account for. Merleau-Ponty's [ Phenomenology of perception, London: Routledge] description of Schneider's apraxia is offered as a case in point. According to the authors, Schneider's apraxia justifies brain components of predicative and pre-predicative experience. The description derives from a bias, however, that parallels modularity's morphological reduction. The presence of (...) biasing presuppositions contradicts the goal of direct description. Moreover, the authors' brain account is not necessary to explain Schneider's apraxia, and morphological reduction is not sufficient to explain emergent phenomena of motor control. (shrink)

They reject the correspondence theory, insist truth is anemic, and advance an "anti-theory" of truth that is essentially a collection of platitudes: "Snow is white" is true if and only if snow is white; "Grass is green" is true if and only if grass is green. According to disquotationalists, the only profound insight about truth is that it lacks profundity. David contrasts the correspondence theory with disquotationalism and then develops the latter position in rich detail - more than has been (...) available in previous literature - to show its faults. (shrink)