Being compassionate and empathic while making rational decisions is expected from healthcare workers across different contexts. But the daily challenges that these workers face, aggravated by the recent COVID-19 crisis, can give rise to compassion and decision fatigue, which affects not only their ability to meet these expectations but has a significant negative impact on their wellbeing. Hence, it is vital to identify factors associated to their exhaustion. Here, we sought to describe levels of compassion and decision fatigue during the (...) pandemic, and to identify factors related to these forms of exhaustion. We collected data using self-reported questionnaires to measure compassion fatigue, decision fatigue, and grit in five intervals from April to November, 2020 (N = 856). Our results showed a negative correlation between grit and compassion and decision fatigue. We also found that under the circumstances studied grit tends to be higher in technicians, nurses, other professionals (psychologists, social workers), and workers at the Emergency Room (ER), and lower in general practitioners. Compassion fatigue tend to be higher for technicians, whereas decision fatigue was lower for specialists, general practitioners, and technicians, and higher for those working at private hospitals. (shrink)

The maqālāt of Abū Qāsim al-Balḫī contain several passages devoted to legal theory. The most important source found there is some extracts of K. al-futyā, a legal treatise by al-Ǧāḥiẓ of which until now only fragments remained, containing the criticisms addressed by al-Naẓẓām to the companions of the Prophet. This article provides a translation of these new extracts preceded by a study of the text and its place in the history of legal theory during this formative period of Islamic thought.

Deep brain stimulation (DBS) is a developing technology. New generations of DBS technology are already in the pipeline, yet this particular fact has been largely ignored among ethicists interested in DBS. Focusing only on ethical concerns raised by the current DBS technology is, albeit necessary, not sufficient. Since current bioethical concerns raised by a specific technology could be quite different from the concerns it will raise a couple of years ahead, an ethical analysis should be sensitive to such alterations, or (...) it could end up with results that soon become dated. The goal of this analysis is to address these changing bioethical concerns, to think ahead on upcoming and future DBS concerns both in terms of a changing technology and changing moral attitudes. By employing the distinction between inherent and noninherent bioethical concerns we identify and make explicit the particular limits and potentials for change within each category, respectively, including how present and upcoming bioethical concerns regarding DBS emerge and become obsolete. Many of the currently identified ethical problems with DBS, such as stimulation-induced mania, are a result of suboptimal technology. These challenges could be addressed by technical advances, while for instance perceptions of an altered body image caused by the mere awareness of having an implant may not. Other concerns will not emerge until the technology has become sophisticated enough for new uses to be realized, such as concerns on DBS for enhancement purposes. As a part of the present analysis, concerns regarding authenticity are used as an example. (shrink)

While many scholars have explored the Ciceronian roots of Augustine’s thought, the influence of De Finibus on De ciuitate dei has, as yet, remained unexamined. Dismissed by Testard as abstract and scholastic, De Finibus has long remained in the shadow of Cicero’s other work of moral philosophy, Tusculanae Dispuationes. This article reconsiders the nature of De Finibus and demonstrates its importance for De ciuitate dei. It begins by arguing that the dialogue is actually a meta-commentary on philosophic dogmatism, showing how (...) each of the schools that Cicero’s interlocutors represent—i.e., the Epicureans, Stoics, and Peripatetics—claim certainty about the Wise Man’s happiness. At the heart of the dialogue’s drama is Cicero’s skepticism about this claim. This article then shows how Augustine picks up on Cicero’s explanation as to why the adherents of these schools cling so tightly to their belief in the Wise Man’s happiness. Echoing Cicero, Augustine suggests that the reason for this belief is therapeutic. Going beyond Cicero, however, he diagnoses it as a symptom of pride, arguing that what the philosophers really need is not a model of self-sufficient virtue, but a Mediator. The article ends by briefly considering how Cicero might respond to Augustine’s position. (shrink)

At the outset of an ethnographic inquiry, we navigated national and international resources to search for theoretical and practical guidance on obtaining parents and children’s informed consent/assent. While much theoretical guidance debating ethical issues to children’s participation in research was found, a paucity of published papers offering practical guidance on assent processes and/or visual representations of child assent forms and information sheets was discovered. The purpose of this article is to describe our experiences, both theoretically and practically, of negotiating the (...) process of obtaining informed consent and assent with parents and children for a non-therapeutic qualitative research study. We hope this article instigates a platform for others to explicate their experience and contributes to the construction of a coherent body of knowledge which will clearly delineate important elements that must be considered when negotiating children’s agreement to participate in research. (shrink)

In this essay I compare Nussbaum's and Arendt's approach to narrativity. The point of the comparison is to find out which approach is more adequate for practical philosophy: the approach influenced by cognitive theory or the one influenced by hermeneutic phenomenology. I conclude that Nussbaum's approach is flawed by methodological solipsism, which is due to her application of cognitive theory.

Schools are an essential part of students’ lives and can promote and facilitate their well-being. Although research on well-being among school-aged children and adolescents has distinguished subjective well-being from social well-being, very few studies examined student’s social well-being at school. SWS is understood as students’ valuation of the circumstances and functioning of their school. This framework posits that the context of the schools can shape students’ perception of feeling integrated and making significant contributions to their schools. However, not much is (...) known regarding the joint contribution of individual, family, and school characteristics to students’ SWS. This study analyzed these joint contributions in a nationally representative sample of 6,389 children and adolescents enrolled in 5th–11th grades. Findings show that being female and younger were individual predictors of SWS. Students’ satisfaction with their family and fewer changes of schools were also significant contributors. When students’ perceptions of their schools were incorporated, the individual and family characteristics decreased or lost significance. In the full model, the highest contribution to SWS was explained by the school-level aggregated perception of school climate. These findings call for integrated policies and practices to foster students’ sense of belonging, feeling integrated, and contribution to their schools, with a focus on school-level interventions to improve SWS through positive and engaging school climates that foster students’ sense of agency. (shrink)

On occasion, I am appointed by our local probate court to help make health care decisions for patients who are no longer capable of making these decisions for themselves. I'll visit my client in the hospital and review his or her chart, and I'll have numerous opportunities to talk about the illness and treatment options with attending physicians, residents, and nurses. My phone calls to them will be returned promptly. If doctors arrive at the conclusion that nothing further can be (...) done for the patient, we'll discuss how best to proceed. This end‐of‐life talk never comes as a surprise to me because I will have been included in the team's decision‐making process, in the manner of professionals interacting with another professional. Last fall, I became a family surrogate decision‐maker after my mother was hospitalized over the course of a few months, for a number of reasons, in three hospitals in New York. I assumed I would manage her care as I did my clients’, with a sense of control and involvement in the process, but I quickly learned that I had in fact entered a kind of alternate universe as far as decision‐making was concerned. (shrink)

This chapter explores how what is dismissed as “trans activism” is often public philosophy. It considers how so‐called “public philosophy” on trans issues often does a substantially worse job of living up to the name. The chapter discusses how the dichotomy between “trans activism” and “public philosophy” provides a pretext for marginalizing trans voices. To draw on Black feminist philosophical thought, lived experience is a criterion for knowledge of the needs of marginalized people. Like other marginalized communities, trans communities have (...) encountered many areas in which hermeneutical liberation is needed. Public philosophy as trans activism is often systemically and systematically ignored or willfully misinterpreted as being biased and motivated by self‐interest, whereas anti‐trans (public) philosophy is seen as asking the important questions. (shrink)

Background: Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty. Objectives: The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi. Methodology: A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of (...) 271 clinical nurses. Data were collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0. Ethical consideration: The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi. Results: The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings. Conclusion: The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence. (shrink)

Abstract:Brain–computer interfaces (BCIs) can enable communication for persons in severe paralysis including locked-in syndrome (LIS); that is, being unable to move or speak while aware. In cases of complete loss of muscle control, termed “complete locked-in syndrome,” a BCI may be the only viable solution to restore communication. However, a widespread ignorance regarding quality of life in LIS, current BCIs, and their potential as an assistive technology for persons in LIS, needlessly causes a harmful situation for this cohort. In addition (...) to their medical condition, these persons also face social barriers often perceived as more impairing than their physical condition. Through social exclusion, stigmatization, and frequently being underestimated in their abilities, these persons are being locked out in addition to being locked-in. In this article, we (1) show how persons in LIS are being locked out, including how key issues addressed in the existing literature on ethics, LIS, and BCIs for communication, such as autonomy, quality of life, and advance directives, may reinforce these confinements; (2) show how these practices violate the United Nations Convention on the Rights of Persons with Disabilities, and suggest that we have a moral responsibility to prevent and stop this exclusion; and (3) discuss the role of BCIs for communication as one means to this end and suggest that a novel approach to BCI research is necessary to acknowledge the moral responsibility toward the end users and avoid violating the human rights of persons in LIS. (shrink)

The introduction of new medical treatments based on invasive technologies has often been surrounded by both hopes and fears. Hope, since a new intervention can create new opportunities either in terms of providing a cure for the disease or impairment at hand; or as alleviation of symptoms. Fear, since an invasive treatment involving implanting a medical device can result in unknown complications such as hardware failure and undesirable medical consequences. However, hopes and fears may also arise due to the cultural (...) embeddedness of technology, where a therapy due to ethical, social, political and religious concerns could be perceived as either a blessing or a threat. While Deep Brain Stimulation (DBS) for treatment resistant depression (TRD) is still in its cradle, it is important to be proactive and try to scrutinize both surfacing hopes and fears. Patients will not benefit if a promising treatment is banned or avoided due to unfounded fears, nor will they benefit if DBS is used without scrutinizing the arguments which call for caution. Hence blind optimism is equally troublesome. We suggest that specificity, both in terms of a detailed account of relevant scientific concerns as well as ethical considerations, could be a way to analyse expressed concerns regarding DBS for TRD. This approach is particularly fruitful when applied to hopes and fears evoked by DBS for TRD, since it can reveal if our comprehension of DBS for TRD suffer from various biases which may remain unnoticed at first glance. We suggest that such biases exist, albeit a further analysis is needed to explore this issue in full. (shrink)

The aim of this study was to explore the existence of moral distress among nurses in Lilongwe District of Malawi. Qualitative research was conducted in selected health institutions of Lilongwe District in Malawi to assess knowledge and causes of moral distress among nurses and coping mechanisms and sources of support that are used by morally distressed nurses. Data were collected from a purposive sample of 20 nurses through in-depth interviews using a semi-structured interview guide. Thematic analysis of qualitative data was (...) used. The results show that nurses, irrespective of age, work experience and tribe, experienced moral distress related to patient/nursing care. The major distressing factors were inadequate resources and lack of respect from patients, guardians, peers and bosses. Nurses desire teamwork and ethics committees in their health institutions as a means of controlling and preventing moral distress. There is a need for creation of awareness for nurses to recognize and manage moral distress, thus optimizing their ability to provide quality and uncompromised nursing care. (shrink)

We consider the question of randomness of the probability ΩU[X] that an optimal Turing machine U halts and outputs a string in a fixed set X. The main results are as follows: ΩU[X] is random whenever X is $\Sigma _{n}^{0}$-complete or $\Pi _{n}^{0}$-complete for some n ≥ 2. However, for n ≥ 2, ΩU[X] is not n-random when X is $\Sigma _{n}^{0}$ or $\Pi _{n}^{0}$ Nevertheless, there exists $\Delta _{n+1}^{0}$ sets such that ΩU[X] is n-random. There are $\Delta _{2}^{0}$ sets (...) X such that ΩU[X] is rational. Also, for every n ≥ 1, there exists a set X which is $\Delta _{n+1}^{0}$ and $\Sigma _{n}^{0}$-hard such that ΩU[X] is not random. We also look at the range of ΩU as an operator. We prove that the set {ΩU[X]: X ⊆ 2<ω} is a finite union of closed intervals. It follows that for any optimal machine U and any sufficiently small real r, there is a set X ⊆ 2<ω recursive in ∅′ ⊕ r, such that ΩU[X] = r. The same questions are also considered in the context of infinite computations, and lead to similar results. (shrink)

In this article three viewpoints on the relation of body and language are discussed: the poststructuralist viewpoint of Judith Butler, the phenomenological viewpoint of Maurice Merleau-Ponty and the postmodernist viewpoint of Jean-François Lyotard. The reason juxtaposing for these three accounts is twofold. First, the topic requires a combination of post-structuralist and phenomenological insights, and second, the accounts are supplementary. Butler's account raises questions that can be answered with the help of Merleau-Ponty's work. Lyotard's anthropology of the inhuman offers a perspective (...) of finitude that is missing in the other two. The aim of the article is to outline the necessary ingredients of an adequate conception of the speaking embodied subject. (shrink)

Using possibly infinite computations on universal monotone Turing machines, we prove Martin-Löf randomness in ∅' of the probability that the output be in some set.

Background: Nurses are expected to provide comprehensive, holistic and ethically accepted care according to their code of ethics and practice. However, in Malawi, this is not always the case. This article analyses moral competence concept using the Walker and Avant's strategy of concept analysis. Objective: The aim of this article is to analyse moral competence concept in relation to nursing practice and determine defining attributes, antecedents and consequences of moral competence in nursing practice. Method: Analysis of moral competence concept was (...) done using Walker and Avant's strategy of concept analysis. Results: Deductive analysis was used to find the defining attributes of moral competence, which were kindness, compassion, caring, critical thinking, ethical decision making ability, problem solving, responsibility, discipline, accountability, communication, solidarity, honesty, and respect for human values, dignity and rights. The identified antecedents were personal, cultural and religious values; nursing ethics training, environment and guidance. The consequences of moral competence are team work spirit, effective communication, improved performance and positive attitudes in providing nursing care. Conclusion: Moral competence can therefore be used as a tool to improve care in nursing practice to meet patients' problems and needs and consequently increase public's satisfaction in Malawi. (shrink)

In this paper, we examine the scientific, legal, and ethical foundations for inclusion of transgender women athletes in competitive sport, drawing on IOC principles and relevant Court of Arbitration for Sport decisions. We argue that the inclusion of trans athletes in competition commensurate with their legal gender is the most consistent position with these principles of fair and equitable sport. Biological restrictions, such as endogenous testosterone limits, are not consistent with IOC and CAS principles. We explore the implications for recognizing (...) that endogenous testosterone values are a ‘natural physical trait’ and that excluding legally recognized women for high endogenous testosterone values constitutes discrimination on the basis of a natural physical trait. We suggest that the justificatory burden for such prima facie discrimination is unlikely to be met. Thus, in place of a limit on endogenous testosterone for women, we argue that ‘legally recognized gender’ is most fully in line with IOC and CAS principles. (shrink)

Un invito a vedere nella vita e nelle opere di don Sturzo delle risposte alle difficoltà del mondo attuale, approfondendo le ragioni di un impegno cristiano per il recupero della dimensione etica dell’economia, della politica e delle istituzioni.

Después de exponer sintéticamente sus lineamientos generales y a partir de la problematización de un ejemplo modelo, este artículo se plantea como objetivo ensayar una crítica a la versión bayesiana de la teoría de la decisión individual y la noción de subjetividad aislada del contexto que adopta en el marco de su matriz individualista. Lo hace desde una perspectiva construida en base a diversos aportes de la epistemología feminista que convoca a analizar cómo las relaciones desiguales de poder y los (...) mandatos androcéntricos repercuten en la configuración de los deseos y creencias de las personas que sufren experiencias de subordinación, condicionando – al extremo anular – sus márgenes de elección y actuación. (shrink)

La contribución específica de Hans Kellner a la Nueva Filosofía de la Historia se dirige a dar cuenta del revival de la narrativa a partir de los 80 en términos de un revival de la retórica. Sus relecturas de los textos históricos, metahistóricos, literarios y filosóficos nos invitan a apreciar las estrategias retóricas implicadas en ellos, desplegando aquello que habilitan o imposibilitan decir acerca del pasado. Kellner invita a eludir el planteo fundacionista que se ciñe a la cuestión de la (...) validez epistémica del texto, sin caer por ello en la actitud determinista lingüística que fija las estrategias discursivas en tanto estructuras artificiosas y distorsivas de la realidad. Kellner nos desafía a abandonar la metáfora de la distorsión para caracterizar la relación entre representación y realidad. Si en cuanto filósofxs de la historia nos interesa trazar líneas de continuidad y comunidad en la indagación historiográfica, debemos enfocar en sus fuentes retóricas más que en la evidencia documental o la experiencia del pasado cuyo rasgo manifiesto es la fragmentariedad. Su propuesta promueve que nos focalicemos, por un lado, en las innumerables elecciones tomadas entre las diversas modalidades de conocimiento disponibles. Por el otro, nos advierte de la ansiedad provocada por dicha elección en contra de otras opciones descartadas que podrían habernos hecho pensar las cosas de otra manera. ARK: ark:/s18537960/xdxtang:n. (shrink)

We study probabilistic logic under the viewpoint of the coherence principle of de Finetti. In detail, we explore how probabilistic reasoning under coherence is related to model- theoretic probabilistic reasoning and to default reasoning in System . In particular, we show that the notions of g-coherence and of g-coherent entailment can be expressed by combining notions in model-theoretic probabilistic logic with concepts from default reasoning. Moreover, we show that probabilistic reasoning under coherence is a generalization of default reasoning in System (...) . That is, we provide a new probabilistic semantics for System , which neither uses infinitesimal probabilities nor atomic bound (or big-stepped) probabilities. These results also provide new algorithms for probabilistic reasoning under coherence and for default reasoning in System , and they give new insight into default reasoning with conditional objects. (shrink)

El asesinato de George Floyd en Minneapolis (Estados Unidos) ha desatado múltiples manifestaciones sociales antirracistas en distintos países del mundo, las cuales han adquirido diferentes formatos: marchas, disturbios, pintadas callejeras, militancia hashtag a partir del lema #BlackLiveMatters y el accionar contra diferentes estatuas de personajes históricos polémicos. Dichos monumentos, conmemoraciones a, principalmente, esclavistas y colonizadores, han sido pintados, mutilados o derribados en señal de protesta, pero también como un modo de disputa por los sentidos y las memorias legitimadas en el (...) espacio público, que, además, tiene como antecedente las manifestaciones en Chile a fines de 2019. (shrink)

This paper aims to investigate whether and in what respects the conceptions of the body and of agency that Judith Butler develops in Bodies That Matter are useful contributions to feminist theory. The discussion focuses on the clarification and critical assessment of the arguments Butler presents to refute the charges of linguistic monism and determinism.