A decade after the completion of the Human Genome Project, the widespread appeal of personalized genomic medicine's vision and potential virtues for health care remains compelling. Advocates argue that our current medical regime “is in crisis as it is expensive, reactive, inefficient, and focused largely on one size fits all treatments for events of late stage disease.” What is revolutionary about this kind of medicine, its advocates maintain, is that it promises to resolve that crisis by simultaneously increasing the ability (...) to be “personalized,” “predictive,” “preventive,” and “participatory.” Some call personalized genomic medicine “P4 Medicine,” inscribing these cardinal virtues into the movement's name. All of these putative virtues have interesting implications for the future of health care. In this essay, we are especially interested in the claims that personalized medicine will lead to a more “participatory” or “patient‐centered” approach to health care, in which patients are “empowered” to take more personal control over their care. The rhetoric of patient empowerment is nothing new in health care, but personalized medicine is an interesting case study because it portrays empowerment as one of its key virtues and as a mechanism for fixing the health care “crisis.”. (shrink)

The development of electronic personal health records by independent vendors and national health systems is understood to empower patients and create a new kind of consumerism in healthcare. With more personal health information at hand, active participation in the management of health and rational purchasing of healthcare services will be possible. Healthcare systems will also be able to contain costs and achieve sustainability. Based on a careful examination of the literature, we argue that many of the declared benefits (...) of this technology are rather unattainable. As the boundaries between the public and private healthcare sectors become blurred and as employers struggle to reduce health insurance expenses, this proclaimed ‘consumer empowerment in healthcare’ is an attempt to introduce a technology and a business model for centralising all relevant PHI to render them economic. We reflect on the consequences for the ‘empowered’ user and we suggest that this new market device has to separate and individually address sufficiently issues of privacy, confidentiality and security before it can claim a place in the digital healthcare ecosystem. (shrink)

“Democratization” has recently become a popular trope in Western public discourses on medicine, where it refers to patient participation in the gathering and distribution of health-related data using various digital technologies, in order to improve healthcare technically and socially. We critically analyze the usage of the term from the perspective of the “politics of buzzwords.” Our claim is that the phrase works primarily to publicly justify the dramatic increase in the application of information and data technologies in healthcare and therefore (...) fosters the corresponding industry. As a buzzword, “democratizing healthcare” is characterized by vagueness, which is why it receives meaning only through a word collective—a group of words that provide it with a context and are often used together with it. We examine key terms associated with “democratization” in the healthcare discourse—participation, empowerment, and personalized medicine—and show that the buzzword receives rhetorical power through the ambiguous reference to these concepts. As a consequence, the idea of “democracy” becomes diluted into meaning merely “access to,” and “healthcare” is reduced to the notion of a preventive, nonacute, monitored form of medical care. (shrink)

In this article, an attempt was made to identify the level of community social participation according to age, gender and the structural characteristics of the personal support networks in a population displaced by floods in the Colombian Caribbean. The research was based in a non-experimental methodology with an associative-relational strategy. An intentional non-probabilistic sample of 151 people affected by the winter wave in the south of the Department of Atlántico (Colombia) was selected. In total, the study included 42 males (...) (27.8 %) and 109 females (72.2 %) participants, with an average age of 37.48 (±14, Range 18 - 80) and average relocation time of 21.79 months (± 8.22, Range 5-36). The Arizona Social Support Interview Schedule (ASSIS) and Community Empowerment instruments were responded to with an instrument adapted from the leadership competence factor. The results show lower rates of intermediation in the older population, and the relationship between social participation and gender shows equally cohesive social support networks in men and women. This evidence is discussed to promote psychosocial interventions aimed to increase community engagement and empowerment of people that have experienced non-voluntary mobility processes. (shrink)

The philosophy of empowerment, which is based on the premises that clients must be active, equal and collaborative participants, who are aware and commited to change, has guided research in empowerment interventions. This article reports on a small part of a research study that sought to understand Chinese cancer patients’ conceptualization of empowerment. Qualitative delineation of the concept of empowerment by means of in-depth interviews was carried out with 12 Chinese patients with cancer. The findings showed (...) that empowerment is a process whereby patients develop a sense of inner strength through connection with others, including families, friends and health care professionals. It is also a process of transformation through which they actively develop new perspectives by reframing and reinterpreting their illness. Acceptance of illness was shown to result from a realization of a lack of control in the situation, which is then enhanced by the beliefs of Confucianism and Taoism. In the cancer context, personal control comprises both primary and secondary processes. Active involvement, awareness of the situation, partnership, self-determination and self-reliance are important values in empowerment. The concept and therapeutic foundations of empowerment provide ample legitimacy for its vigorous pursuit in nursing. (shrink)

This study examined how leaders’ moral competence is linked to employees’ task performance and organizational citizenship behaviors. Based on a sample of 102 employee–supervisor pairs from seven organizations in South Korea, the results of this study revealed that leaders’ moral competence was positively associated with employees’ task performance and organizational citizenship behaviors toward leaders (OCBS). As expected, employees’ psychological empowerment partially mediated the relationship between leaders’ moral competence and employees’ task performance and OCBS. Furthermore, person–supervisor fit (PS fit) moderated (...) the relationship between leaders’ moral competence and employees’ psychological empowerment such that the relationships became stronger for individuals higher rather than lower in PS fit. (shrink)

This study proposed and examined a conceptual framework on the influence of real estate brokers’ personalities, psychological empowerment, social capital, and knowledge sharing on their innovation performance, and used moral hazard as a moderating variable. We used structural equation modeling for data analysis and estimation. The participants were real estate brokers in Kaohsiung City. A total of 1,000 questionnaires were administered to 100 branch offices of real estate companies, 571 of which were later recovered from 80 branch offices. After (...) removing 52 for being invalid, we were left with 519 valid questionnaires, indicating a 51.9% recovery rate. The empirical results suggest that the real estate brokers’ personalities and psychological empowerment positively and significantly influence social capital; personality and psychological empowerment also positively and significantly influence their innovation performance; and social capital significantly influences knowledge sharing, which in turn positively and significantly influences the brokers’ innovation performance. In environments with higher levels of moral hazard, the influence of social capital on the brokers’ knowledge sharing is significantly diminished. (shrink)

While the link between servant leadership and organizational citizenship behavior has been established, the individual-level mechanisms underlying this relationship and its boundary conditions remain poorly understood. In this study, we investigate the salience of the mediating mechanisms of leader–member exchange and psychological empowerment in explaining the process by which servant leaders elicit discretionary OCB among followers. We also examine the role of followers’ proactive personality in moderating the indirect effects of servant leadership on OCB through LMX and psychological (...) class='Hi'>empowerment. Analysis of survey data collected from 446 supervisor–subordinate dyads in a large Chinese state-owned enterprise suggests that while servant leadership is positively related to subordinate OCB through LMX, psychological empowerment does not explain any additional variance in OCB above that accounted for by LMX. Moderated mediation tests confirm the moderating effect of proactive personality through LMX. By providing a nuanced understanding of how and when servant leadership leads followers to go above and beyond their job role, our study assists organizations in deciding how to develop and utilize servant leaders in their organizations. (shrink)

Empowerment in healthcare is becoming increasingly popular, including in obstetrics, because of its benefits for both individual health and health promotion. Many authors and organizations, such as the World Health Organization, advocate it as a means of engaging communities in the adoption of health-promoting behaviors and fostering patient-centered care. It aims to enable patients to assert their decisions and choices while respecting their personal values. This desire to respect the uniqueness and autonomy of each individual echoes a number (...) of ethical principles and theories. In this article, the authors aim to answer the question, How can the concept of empowerment in healthcare contribute to bioethics? They argue that it has important links with feminist bioethics, notably the theory of relational autonomy, as well as with the capability theory of economist and philosopher Amartya Sen. (shrink)

Nurse engagement, empowerment and strong relationships among staff, residents and families, are essential to attract and retain a suitably qualified and skilled nursing workforce for safe, quality care. There is, however, limited research that explores engagement, empowerment and relational coordination in long‐term care (LTC). Nurses from an older persons’ mental health and dementia LTC unit in Australia participated in this study. Forty‐one nurses completed a survey measuring psychological empowerment, work engagement and relational coordination. Twenty‐nine nurses participated in (...) individual interviews to further explore these concepts. Although nurses reported high psychological empowerment and work engagement, their relationships with key stakeholders varied. Our findings suggest that nurses in LTC require both supports and opportunities to contribute as active members of the multiprofessional care team that includes tailored education, professional development and positive interactions within the care team. Regular support is needed to enable nurses to feel empowered, foster relationships and communication, and facilitate work engagement. Based on these findings, we suggest that it is important to find ways to ensure that all who provide care perceive that they are part of the whole care team and able to contribute to the care and well‐being of people in LTC. (shrink)

Developed here is a Confucian balance between two key democratic ideals, liberty and community, by focusing on the Confucian notion of li (ritual), which has often been considered hostile to liberty. By adopting a semiotic approach to li and relating it to recent studies of ritual in various Western disciplines, li's contribution to communication and its aesthetic dimension are explored to show how emphasizing harmony without sacrificing reflective experience and personal fulfillment renders li a concept of moral empowerment (...) of free individuals in community. (shrink)

The dominant discourse in chronic disease management centres on the ideal of person-centred healthcare, with an empowered patient taking an active role in decision-making with their healthcare provider. Despite these encouraging developments toward healthcare democracy, many person-centred conceptions of healthcare and programming continue to focus on the healthcare institution’s perspective and priorities. In these debates, the patient’s voice has largely been absent. This article takes the example of patient empowerment to show how the concept has been influenced by a (...) variety of competing and shifting influences that have led to conceptualisations and programming designed for the patient, but developed without the patient. The framework of epistemic injustice is proposed to unravel the complexity of these omissions. The concept can be defined as a wrong done to someone specifically in their capacity as a knower. It occurs when a person is ignored or not believed due to a prejudice of some kind. It has been applied to healthcare in order to better understand barriers for patient participation and will be used to better understand the problems with current empowerment definitions and implementation strategies. The article will end by proposing some methodologies to facilitate patient-developed concepts of empowerment. (shrink)

Social identity is a factor that is associated with well-being and community participation. Some studies have shown that ethnic identity goes along with empowerment, and that interaction between the two leads to greater indices of well-being and community participation. However, other works suggest a contextual circumstance (i.e., perceiving one’s own group as a minority and/or being discriminated) may condition the nature of these relations. By means of a cross-sectional study, we analyzed the relations of social identification (or identity fusion) (...) and collective psychological empowerment with personal well-being, social well-being and community participation in a sample of Basques. A total of 748 Basques participated (63.1% women; ageM= 39.28;SD= 12.13). Individuals who were highly identified or fused with Basque speakers and who were highly empowered showed higher indices of well-being (both personal and social) and of community participation than non-fused individuals with low empowerment. The results also suggest that social identification (or identity fusion) offsets the negative effects of perceiving the group as a linguistic minority. Collective psychological empowerment proved to be an especially relevant factor that needs to continue to be explored. (shrink)

Empowerment and user participation represents an ideal of power with a strong position in the health sector. In this article we use text analysis to investigate notions of power in a program plan for health workers focusing on empowerment. Issues addressed include: How are relationships of power between users and helpers described in the program plan? Which notions of user participation are embedded in the plan? The analysis is based on Foucault’s idea that power which is made subject (...) to attempts of redistribution will re-emerge in other forms. How this happens, and with what consequences, is our analytical concern. The analysis is contrasted with ‘snapshots’ from everyday life in a nursing home. The program plan communicates empowerment as a democracy-building instrument that the users need. It is a tool for providing expert assistance to the user’s self-help. User participation is made into a tool which is external to the user him-/herself. Furthermore, the analysis shows that the plan’s image of empowerment presupposes an ‘élite user’ able to articulate personal needs and desires. This is not very applicable to the most vulnerable user groups, who thereby may end up in an even weaker position. By way of conclusion, we argue that an exchange of undesirable dominating paternalism for a desirable empowerment will not abolish power, but may result in more covert and subtle forms of power that are less open to criticism. The paper offers insights that will facilitate reflections on the premises for practising empowerment-oriented health care. (shrink)

The idea of empowerment has gained a significant role in the discourse of poverty. I outline a restricted conception of empowerment inspired by Kant’s idea of rightful honour. According to this conception, empowerment consists in enabling individuals to assert their own human rights (juridical empowerment). I apply this conception to impoverished persons and argue that it is crucial to their self-respect, their so-called ‘power-[from-]within,’ and their political agency, and has a teleological primacy regarding our efforts to (...) reduce poverty. I also defend the idea that there is a moral right to this form of empowerment and a corresponding duty to empower the impoverished as rights-asserters. Juridical empowerment will be compatible with a pluralism of substantive accounts of the moral wrongs of poverty and with broader conceptions of empowerment. (shrink)

: Developed here is a Confucian balance between two key democratic ideals, liberty and community, by focusing on the Confucian notion of li (ritual), which has often been considered hostile to liberty. By adopting a semiotic approach to li and relating it to recent studies of ritual in various Western disciplines, li's contribution to communication and its aesthetic dimension are explored to show how emphasizing harmony without sacrificing reflective experience and personal fulfillment renders li a concept of moral (...) class='Hi'>empowerment of free individuals in community. (shrink)

Social prescriptions are one term commonly used to describe non-pharmaceutical approaches to healthcare and are gaining popularity in the community, with evidence highlighting psychological benefits of reduced anxiety, depression and improved mood and physiological benefits of reduced risk of cardiovascular disease and reduced hypertension. The relationship between human health benefits and planetary health benefits is also noted. There are, however, numerous barriers, such as duration and frequencies to participate in activities, access, suitability, volition and a range of unpredictable variables impeding (...) a comprehensive approach to their use on a wider scale. From a multidisciplinary perspective, this commentary incorporates a salutogenic and nature-based approach to health, we also provide a range of recommendations that can be undertaken at the patient level to assist in shifting the acknowledged systemic barriers currently occurring. These include using simple language to explain the purpose of health empowerment scripts, ensuing personal commitment to a minimum timeframe, enabling ease of access, co-designing a script program, providing ongoing motivational support and incorporating mindfulness to counter unexpected disruptions. (shrink)

This book offers an innovative introduction to the psychological basis of mathematics and the nature of mathematical thinking and learning, using an approach that empowers students by fostering their own construction of mathematical structures. Through accessible and engaging writing, award-winning mathematician and educator Anderson Norton reframes mathematics as something that exists first in the minds of students, rather than something that exists first in a textbook. By exploring the psychological basis for mathematics at every level - including geometry, algebra, calculus, (...) complex analysis and more - Norton unlocks students' personal power to construct mathematical objects based on their own mental activity, and illustrates the power of mathematics in organizing the world as we know it. Including reflections and activities designed to inspire awareness of the mental actions and processes coordinated in practicing mathematics, the book is geared towards current and future secondary and elementary mathematics teachers who will empower the next generation of mathematicians and STEM majors. Those interested in the history and philosophy that underpins mathematics will also benefit from this book, as well as those informed and curious minds attentive to the human experience more generally. Anderson Norton is Professor in the Department of Mathematics at Virginia Tech, USA, where he has been teaching mathematics courses for future teachers for 15 years. He is the editor of Constructing Number, and the co-author of Developing Fractions Knowledge and Numeracy for All Learners. (shrink)

Managers are expected to actively build their role, shaping and adjusting it day after day on their own company needs and on market upheaval. In our society development became one of the keywords: development at all costs, continuous growth, economic growth, professional development, purchasing power growth. Inside this logic a self-empowerment or coaching project are frequntly required, and really often the consultant acts inside the same logic of development at all cost. When the adviser agrees to this request without (...) opening a space to analyze the question, but simply working on the given target in order to supply the comforting answer, he acts inside the same weird and directive logic leading to the prevalence of the role on the person. Working through an effective empowerment perspective means working together with the person in the role: improving his self-awareness, promoting a reflection on targets and values, ensuring an elaboration space for emotions and experiences. The aim is to bring into question the answer taken for granted, trying to look from a different perspective what we do, what we are, what we say. (shrink)

This article extends property-owning democracy to the digital realm and introduces “data-owning democracy,” a new political economic regime characterized by the wide distribution of data as capital among citizens. Drawing on republican theory and acknowledging data's unique role in the digital economy, it proposes a two-tier model that combines different modes of data ownership and corresponding rights. The first layer of “data-owning democracy” is characterized by a digital public infrastructure that enables citizens to collectively generate data and have a say (...) in how their citizen data are used. In the second layer, individuals automatically receive machine-readable copies of their data whenever they are generated—a slightly more advanced form of the European Union's existing right to data portability (Art. 20). With its focus on empowerment, data-owning democracy is designed to be complementary to existing data protection regulations. It also illustrates how political theory more broadly, and republican theory specifically, can be instructive for specifying the normative components of a new political economy dealing with questions of empowerment and digital rights. (shrink)

In a world where paid work is touted as a development panacea, empowering women has started to look a lot like burdening them. I argue here that this burdening of women is a predictable result of the conception of empowerment as choice or agency. Dominant conceptions of empowerment characterize empowerment as the increase in a person’s ability to do what they choose. Yet conditions of gender equality and poverty structure women’s options such that choosing, doing, and doing (...) more are often both women’s best option and modes of disempowerment. Seeing the way increased agency can be disempowering requires shifting away from the view that social structures disempower by constraining individual agency. We instead need a conception of power as a constraint on individual action to a conception of power as structuring the field of available actions in ways that affect the relative position of social groups. Through a discussion of the gender division of labor and the feminization of responsibility, I argue that a more feminist conception of empowerment will weaken the link between empowerment and individual agency. (shrink)

This paper examines how gender and identity function in the personal memoirs of female Holocaust survivors. The memoirs of Nanda Herbermann and Sara Tuvel Bernstein, two survivors of Ravensbrück, the Nazis' concentration camp for women, are explored as case studies of how feminine gender identity influenced female inmates' experiences and recollections of life in Nazi concentration camps. The different backgrounds of these women, as a German Catholic and a Jew, respectively, also affected their lives as inmates, and influenced how (...) they constructed their personal narratives and identities through memoirs. Thus, gender and other aspects of personal identity intertwined both during their time in Ravensbrück and in their writings of their experiences. Their memoirs, moreover, serve as means of personal empowerment as they rewrote themselves into history on their own terms. These memoirs, therefore, enhance our understanding of the gendered and the personal dimensions of the Nazi concentration camp systems and the Holocaust. (shrink)

Trust relations in the health services have changed from asymmetrical paternalism to symmetrical autonomy-based participation, according to a common account. The promises of personalized medicine emphasizing empowerment of the individual through active participation in managing her health, disease and well-being, is characteristic of symmetrical trust. In the influential Kantian account of autonomy, active participation in management of own health is not only an opportunity, but an obligation. Personalized medicine is made possible by the digitalization of medicine with an ensuing (...) increased tailoring of diagnostics, treatment and prevention to the individual. The ideal is to increase wellness by minimizing the layer of interpretation and translation between relevant health information and the patient or user. Arguably, this opens for a new level of autonomy through increased participation in treatment and prevention, and by that, increased empowerment of the individual. However, the empirical realities reveal a more complicated landscape disturbed by information ‘noise’ and involving a number of complementary areas of expertise and technologies, hiding the source and logic of data interpretation. This has lead to calls for a return to a mild form of paternalism, allowing expertise coaching of patients and even withholding information, with patients escaping responsibility through blind or lazy trust. This is morally unacceptable, according to Kant’s ideal of enlightenment, as we have a duty to take responsibility by trusting others reflexively, even as patients. Realizing the promises of personalized medicine requires a system of institutional controls of information and diagnostics, accessible for non-specialists, supported by medical expertise that can function as the accountable gate-keeper taking moral responsibility required for an active, reflexive trust. (shrink)

The growth of information acquisition, storage and retrieval capacity has led to the development of the practice of lifelogging, the undiscriminating collection of information concerning one’s life and behaviour. There are potential problems in this practice, but equally it could be empowering for the individual, and provide a new locus for the construction of an online identity. In this paper we look at the technological possibilities and constraints for lifelogging tools, and set out some of the most important privacy, identity (...) and empowerment-related issues. We argue that some of the privacy concerns are overblown, and that much research and commentary on lifelogging has made the unrealistic assumption that the information gathered is for private use, whereas, in a more socially-networked online world, much of it will have public functions and will be voluntarily released into the public domain. (shrink)

This paper presents a mediation–moderated model of the relationship between psychological empowerment, work engagement, age, and task performance. I seek to provide a more nuanced understanding of the mediating role of work engagement in the positive effect of psychological empowerment on task performance. Further, I explore employee age as a moderating factor in this mediation. I used online surveys among a sample of Latin American textile industry employees to capture individual perceptions about psychological empowerment, work engagement, and (...) task performance. I modeled a mediation–moderated model using Hayes’ Process macro. The results confirm that the positive impact of employee psychological empowerment on task performance is partially mediated by work engagement. In addition, age was a significant moderator of the mediation effect. This study expands knowledge about how the psychological empowerment–work engagement relationship can predict task performance, including age as a boundary condition. Following the Job Demands–Resources theory, I also prove that conceptualizing psychological empowerment as a personal resource can benefit the integration of psychological empowerment and the work engagement stream of research. Moreover, the findings may help human resources management researchers and practitioners acknowledge contextual differences in understanding the combined effects of psychological empowerment and work engagement. For instance, textile industry human resources managers can develop specific age–based human resource systems that empower and engages employees from emerging economies. (shrink)

The fiduciary nature of the patient-physician relationship requires clinicians to act in the best interest of their patients. Patients are vulnerable due to their health status and lack of medical knowledge, which makes them dependent on the clinicians’ expertise. Competent patients, however, may reject the recommendations of their physician, either refusing beneficial medical interventions or procedures based on their personal views that do not match the perceived medical indication. In some instances, the patients’ refusal may jeopardize their health or (...) life but also compromise the clinician’s moral responsibility to promote the patient’s best interests. In other words, health professionals have to deal with patients whose behavior and healthcare decisions seem counterproductive for their health, or even deteriorate it, because of lack of knowledge, bad habits or bias without being the patients’ free voluntary choice. The moral dilemma centers on issues surrounding the limits of the patient’s autonomy (rights) and the clinician’s role to promote the well-being of the patient (duties). In this paper we argue that (1) the use of manipulative strategies, albeit considered beneficent, defeats the purpose of patient education and therefore should be rejected; and (2) the appropriate strategy is to empower patients through patient education which enhances their autonomy and encourages them to become full healthcare partners as opposed to objects of clinical intervention or entities whose values or attitudes need to be shaped and changed through education. First, we provide a working definition of the concept of patient education and a brief historical overview of its origin. Second, we examine the nature of the patient-physician relationship in order to delineate its boundaries, essential for understanding the role of education in the clinical context. Third, we argue that patient education should promote self-rebiasing, enhance autonomy, and empower patients to determine their therapeutic goals. Finally, we develop a moral framework for patient education. (shrink)

Because they are right under our nose, taken-for-granted, and essential to every person everywhere, personal names have often eluded the theoretical and analytical scrutiny they deserve. To what extent do naming practices exemplify or parallel the biopolitics of bodily inscriptions and markings such as tattoos, birthmarks, and presumed racial signatures? To what extent do names represent “technologies of the self” in the broadest sense, as both means of domination and empowerment, facilitating collective surveillance and subjugation, and the individual (...) fashioning of identity and subjectivity? Partly drawing upon indigenous contexts in the North American Arctic, this commentary discusses personal names and genealogies in relation to other technologies of belonging. Practices of naming, it is argued, are not only key elements of identification and personhood, embodied in the biosocial habitus much like other biomarkers, also they situate people in genealogies, social networks, and states. Clashes, I suggest, between different traditions and practices of naming, especially in the context of slavery and empires, illuminate with striking clarity the relevance of names as technologies of exclusion, subjugation, and belonging. (shrink)

Although the topic of value congruence has attracted considerable attention from researchers and practitioners, evidence for the link between person–supervisor value congruence and followers’ reactions is less robust than often assumed. This study addresses three central issues in our understanding of person–supervisor value congruence by assessing the impact of objective person–supervisor value congruence rather than subjective value congruence, by examining the differential effects of value congruence in strongly versus moderately held values, and by exploring perceived empowerment as a central (...) mediating mechanism. Results of a multi-source study comprising 116 person–supervisor dyads reveal that objective value congruence relates to followers’ job satisfaction and affective commitment and that this link can be explained by followers’ perceived empowerment. Moreover, polynomial regression and response surface analyses reveal that congruence effects vary with the importance that leaders and followers ascribe to a certain value: Congruency in strongly held values have more robust relations with followers’ outcomes than congruence in moderately held values. (shrink)

Background: Personal genomic testing (PGT) offers individuals genetic information about relationships, wellness, sporting ability, and health. PGT is increasingly accessible online, including in emerging markets such as Australia. Little is known about what consumers expect from these tests and whether their reflections on testing resonate with bioethics concepts such as autonomy. Methods: We report findings from focus groups and semi-structured interviews that explored attitudes to and experiences of PGT. Focus group participants had little experience with PGT, while interview participants (...) had undergone testing. Recordings were transcribed and analyzed using thematic analysis. Findings were critically interpreted with reference to bioethics scholarship on autonomy. Results: Fifty-six members of the public participated in seven focus groups, and 40 individuals were interviewed separately. Both groups valued the choice of PGT, and believed that it could motivate relevant actions. Focus group themes centered on the perceived value of choices, knowledge enabling action and knowledge about the self. Interview themes suggest that participants reflexively engage with their PGT information to make meaning, and that some appreciate its shortcomings. Critical interpretation of findings shows that while consumers of PGT are able to exercise a degree of autonomy in choosing, they may not be able to achieve a substantive conceptualization of autonomy, one that promotes alignment with higher-order desires. Conclusions: PGT consumers can critically reason about testing. However, they may uncritically accept test results, may not appreciate drawbacks of increased choice, or may overestimate the potential for information to motivate behavioral change. While consumers appear to be capable of substantive autonomy, they do so without ongoing support from companies. PGT companies promote a problematic (“default”) account of autonomy, reliant on empowerment rhetoric. This leaves consumers vulnerable to making decisions inconsistent with their higher-order desires. As PGT expands, claims about its power and value need to be carefully drawn. (shrink)

We develop and test a process model demonstrating how leader charisma and constructive and destructive forms of narcissism interact to influence follower psychological empowerment and moral identity, using survey data from 667 direct reports of leaders from 13 different industries. Study results revealed that leader narcissism moderates the relationship between leader charisma and follower psychological empowerment such that when leaders possess a more constructive and less destructive narcissistic personality, their charisma has a stronger positive relationship with follower psychological (...) empowerment. Study results also revealed that follower psychological empowerment mediates the differential interactive effects of leader charisma and constructive and destructive narcissism on follower moral identity. Implications of these results for future theory development, research, and practice are discussed. (shrink)

`Authority', `competence' and other related concepts are determined on the basis of the concept of law as a dynamic order of norms. The norms which regulate the processes of norm creation establish empowerments (Ermächtigungen). The material domain of validity of the empowering norm is called `competence'. The concept of `person' in relation to empowering norms yields the concepts of `organ' and `authority'. The spatial domain of the validity of these norms is the spatial or territorial jurisdiction. This paper analyses the (...) basic norm and its legal functions; it considers the irregularity of legal acts and norms, as well as the legal consequences thereof, namely nullity and annulment. Additionally, the Kelsenian `Tacit Alternative Clause' is criticized and a possible solution to the problem of irregular norms is offered through new definitions of the existence, validity and legitimacy of norms. (shrink)

This open peer commentary explores the ethical implications of direct-to-consumer (DTC) genomics through an analysis of an online educational project in the United Kingdom. The paper examines several key ethical concerns, including the lack of clinical integration in DTC genetic testing, the challenges of interpreting genetic information without professional guidance, and the problematic concept of "empowerment" promoted by genomics companies. Using a case study of a participant who underwent DTC genetic testing, the commentary highlights issues such as the difficulty (...) of understanding genetic risk, the potential psychological impact on individuals and their families, and the need for careful consideration of how genetic information is shared. While acknowledging potential benefits like increased health awareness and new social connections, the paper ultimately calls for more robust theoretical and empirical research to create a comprehensive ethical framework for personal genomics, emphasizing the importance of critically examining the broader implications of these emerging technologies. (shrink)

In my paper I seek to advance and defend a theory of empowerment. I follow recent theorists by privileging the concept of power in thinking about empowerment. In doing so, I consider the failures of previous accounts to consider adequately the role that the concept of power plays in current thinking about empowerment, and I seek to advance our understanding of empowerment. I conclude by offering a theory of empowerment that brings our intuitions about the (...) conditions of empowerment in line with our intuitions about the agency of the person(s) to whom the theory applies. (shrink)

Definition of the problemHealth Apps are becoming increasingly important for a preventive and responsible orientation of the health system. Currently, most of these digital health applications (DiGA) are based on so-called self-tracking technologies which record physiological and psychological data via sensors, usually combined with personalized everyday information. In the last few years, these digital developments have launched an intense and clearly polarized debate about the opportunities and dangers of self-tracking in healthcare.ArgumentsAfter a brief overview of medical self-tracking, this essay wants (...) to systematize and check the polarized discourse on the basis of its decisive individual and social potentials. It turns out that self-measurement techniques have long been an integral part of medical practice in diagnostics and therapy.ConclusionThe area of tension between individual empowerment and potential loss of control by the users will be emphasized as being especially important for the implementation of health Apps in primary health care. Finally, possible implications for the current design of the new German Digital Care Law (Digitale-Versorgung-Gesetz) are shown and some existing “blind spots” are highlighted. (shrink)

In this essay several virtues are discussed that are needed in people who work in participatory design (PD). The term PD is used here to refer specifically to an approach in designing information systems with its roots in Scandinavia in the 1970s and 1980s. Through the lens of virtue ethics and based on key texts in PD, the virtues of cooperation, curiosity, creativity, empowerment and reflexivity are discussed. Cooperation helps people in PD projects to engage in cooperative curiosity and (...) cooperative creativity. Curiosity helps them to empathize with others and their experiences, and to engage in joint learning. Creativity helps them to envision, try out and materialize ideas, and to jointly create new products and services. Empowerment helps them to share power and to enable other people to flourish. Moreover, reflexivity helps them to perceive and to modify their own thoughts, feelings and actions. In the spirit of virtue ethics—which focuses on specific people in concrete situations—several examples from one PD project are provided. Virtue ethics is likely to appeal to people in PD projects because it is practice-oriented, provides room for exploration and experimentation, and promotes professional and personal development. In closing, some ideas for practical application, for education and for further research are discussed. (shrink)

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

Human organizations’ adoption of the paradigm of the Fourth Industrial Revolution is associated with the growth of techno-empowerment, which is the process of transferring autonomy in decision-making to intelligent machines. Particular persuasive strategies have been identified that may coax people to use intelligent devices. However, there is a substantial research gap regarding what antecedents influence human intention to assign decision-making autonomy to artificial agents. In this study, ethological and evolutionary concepts are applied to explain the drivers for autonomous assistants’ (...) techno-empowerment. The method used in the study was a 4 × 2 between-subject experiment made with 278 persons. The research tool used to collect the data was an online survey. The results show that more positive attitudes and higher trust, perceived usefulness, and perceived ease of use are correlated with higher intention to allow the autonomous assistant independence in decision-making. Second, the results suggest that the more human-like a non-human agent is, the higher the intention to empower it—but only if this agent simultaneously provides functional and visual anthropomorphic cues explainable by the mimicry effect. (shrink)

There is an ongoing increase in the use of mobile health technologies that patients can use to monitor health-related outcomes and behaviours. While the dominant narrative around mHealth focuses on patient empowerment, there is potential for mHealth to fit into a growing push for patients to take personal responsibility for their health. I call the first of these uses ‘medical monitoring’, and the second ‘personal health surveillance’. After outlining two problems which the use of mHealth might seem (...) to enable us to overcome—fairness of burdens and reliance on self-reporting—I note that these problems would only really be solved by unacceptably comprehensive forms of personal health surveillance which applies to all of us at all times. A more plausible model is to use personal health surveillance as a last resort for patients who would otherwise independently qualify for responsibility-based penalties. However, I note that there are still a number of ethical and practical problems that such a policy would need to overcome. The prospects of mHealth enabling a fair, genuinely cost-saving policy of patient responsibility are slim. (shrink)

The article focuses on the impact of the concept of self-care on persons who are understood as incapable of self-care due to their physical and/or mental ‘incapacity’. The article challenges the idea of this health care concept as empowerment and highlights the difficulties for persons who do not fit into this concept. To exemplify this, the self-care concept is discussed with regard to persons with Alzheimer’s disease (AD). In the case of persons with AD, self-care is interpreted in many (...) different ways—depending on the point of view, for instance as an affected person or a carer. To prevent a marginalisation of the growing group of elderly persons with dementia, the article argues that concepts such as those of personhood, wellbeing, autonomy, rationality and normality have to be re-thought with regard to an increasingly ageing population. Taking into account that AD as a socio-medical construct has to be understood in the context of power relations, the article focuses on the mutual influence between the concepts of self-care and of AD and its possible impact on governing dementia and AD in particular. Michel Foucault’s considerations on ‘technologies of the self’ provide the basis for the discussion of the self-care concept within existing societal power relations. (shrink)

Kindergarten climate has been reported to be closely associated with teachers' retention intention, yet the underlying mechanism of this association remains unclear in some ethnic minority areas in China. Based on the Personal-Environment Fit Theory and Organizational Support Theory, the research aims to examine the correlation between kindergarten climate and retention intention of Chinese kindergarten teachers in ethnic minority areas and the chain mediating role of perceived organizational support, as well as the psychological empowerment. In total, 1,199 Chinese (...) kindergarten teachers were recruited from ethnic minority areas to complete the questionnaires. Based on their responses, the main findings of the study were listed as follows: A supportive kindergarten climate has a positive correlation with perceived organizational support, psychological empowerment, and retention intention. A positive kindergarten climate would increase the retention intention only through the indirect path of perceived organizational support, psychological empowerment, as well as the chain mediating path between these two variables. Taken together, these results further explained the interplay between kindergarten climate and teachers' retention intention. Implications for research on retention intention were discussed. Theoretically, it enriches the theoretical basis related to the external environmental resources and individual cognition. Practically, it means that educational policymakers will need to issue new guidelines to ensure that more kindergarten teachers are retained in China's ethnic minority areas. (shrink)

The phrase ‘person‐centred care’ (PCC) reminds us that the fundamental philosophical goal of caring for people is to uphold or promote their personhood. However, such an idea has translated into promoting individualist notions of autonomy, empowerment and personal responsibility in the context of consumerism and neoliberalism, which is problematic both conceptually and practically. From a conceptual standpoint, it ignores the fact that humans are social, historical and biographical beings, and instead assumes an essentialist or idealized concept of personhood (...) in which a person is viewed as an individual static object. From a practical standpoint, the application of such a concept of personhood can lead to neglect of a person's fundamental care needs and exacerbate the problems of social inequity, in particular for older people and people with dementia. Therefore, we argue that our understanding of PCC must instead be based on a dynamic concept of personhood that integrates the relevant social, relational, temporal and biographical dimensions. We propose that the correct concept of personhood in PCC is one in which persons are understood as socially embedded, relational and temporally extended subjects rather than merely individual, autonomous, asocial and atemporal objects. We then present a reconceptualization of the fundamental philosophical goal of PCC as promoting selfhood rather than personhood. Such a reconceptualization avoids the problems that beset the concept of personhood and its application in PCC, while also providing a philosophical foundation for the growing body of empirical literature that emphasizes the psychosocial, relational, subjective and biographical dimensions of PCC. (shrink)

The convergence of increasingly efficient high throughput sequencing technology and ubiquitous Internet use by the public has fueled the proliferation of companies that provide personal genetic information direct-to-consumers. Companies such as 23andme and Navigenics are emblematic of a growing market for PGI that some argue represents a paradigm shift in how the public values this information and incorporates it into how they behave and plan for their futures. This new class of social networking business ventures that market the science (...) of the personal genome illustrates the new trend in collaborative science. In addition to fostering a consumer empowerment movement, it promotes the trend of democratizing information—openly sharing of data with all interested parties, not just the biomedical researcher—for the purposes of pooling data and escalating the innovation process. This target article discusses the need for new approaches to studying DTC genomics using social network analysis to identify the impact of obtaining, sharing, and using PGI. As a locus of biosociality, DTC personal genomics forges social relationships based on beliefs of common genetic susceptibility that links risk, disease, and group identity. Ethical issues related to the reframing of DTC personal genomic consumers as advocates and research subjects and the creation of new social formations around health research may be identified through social network analysis. (shrink)

BackgroundThe landscape of clinical research has evolved over the past decade. With technological advances, the practice of using electronic informed consent (eIC) has emerged. However, a number of challenges hinder the successful and widespread deployment of eIC in clinical research. Therefore, we aimed to investigate the views of various stakeholders on the potential advantages and challenges of eIC.MethodsSemi-structured interviews were conducted with 39 participants from 5 stakeholder groups from across 11 European countries. The stakeholder groups included physicians, patient organization representatives, (...) regulator representatives, ethics committee members, and pharmaceutical industry representatives, and all were involved in clinical research. Interviews were analyzed using the framework method.ResultsInterviewees identified that a powerful feature of eIC is its personalized approach as it may increase participant empowerment. However, they identified several ethical and practical challenges, such as ensuring research participants are not overloaded with information and offering the same options to research participants who would prefer a paper-based informed consent rather than eIC. According to the interviewees, eIC has the potential to establish efficient long-term interactions between the research participants and the research team in order to keep the participants informed during and after the study. Interviewees emphasized that a personal interaction with the research team is of utmost importance and this cannot be replaced by an electronic platform. In addition, interviewees across the stakeholder groups supported the idea of having a harmonized eIC approach across the European Member States.ConclusionsInterviewees reported a range of design and implementation challenges which needs to be overcome to foster innovation in informing research participants and obtaining their consent electronically. It was considered important that the implementation of eIC runs alongside the face-to-face contact between research participants and the research team. Moreover, interviewees expect that eIC could offer the opportunity to enable a personalized approach and to strengthen continuous communication over time. If successfully implemented, eIC may facilitate the engagement of research participants in clinical research. (shrink)

This article explores traditional views of advance care planning in the broader context of advance personal planning, which also accounts for legal and financial matters. Criticisms of existing processes are noted, while the significance of interprofessional collaboration is highlighted. Reframing the purpose of advance personal planning as planning for the rest of life, rather than the end-of-life, and adopting a more holistic perspective informed by theory may help individuals to view advance personal planning as a routine, preventative (...) exercise that safeguards their autonomy and well-being. Both lawyers and healthcare providers have an important role to play in reframing the purpose of advance personal planning. This revised approach is underpinned by the unification of two separate theoretical lenses: Preventive Law Theory and Therapeutic Jurisprudence. This combination enhances our understanding of what it means for people to truly achieve “the good result” (Holtz 2017) when planning ahead for their future legal, financial, health, and personal interests. Preventive Law Theory encourages an ongoing, collaborative relationship between lawyers and their clients, or healthcare providers and their patients, while Therapeutic Jurisprudence ensures an ethical approach to advance personal planning that accounts for all aspects of the individual’s well-being, including consideration of vulnerability, autonomy, and empowerment. (shrink)

This is the story of Lisa 1 —a woman like so many others who has been abused—and of her healing journey using music and creative arts experiences. It is also a story about how music, song, poetry, art, and dance awakened her to a new consciousness and provided the necessary empowerment she needed in order to reclaim the woman she had been before experiencing the trauma of abuse. While the question of how utilization of music and the creative arts (...) encourages personal transformation and healing is also deserving of a theoretical exploration, in this article I have chosen to foreground Lisa's story as narrative, in order to also engage the reader with the transformative potential of empowerment that comes through listening. I have chosen an approach that foregrounds Lisa's experience over theory explicitly, for, it is with the process of "finding voice" and of engaging the listener in that process, that transformation of consciousness and empowerment occurs. (shrink)

This study explores the impact of teachers? perception of trust in colleagues on their sense of empowerment in Mainland China, with a particular focus on the mediating role of teacher efficacy. The results of a survey of 1646 teachers indicate that although teachers scored positively on trust in colleagues, efficacy and empowerment, they had relatively lower scores on general teaching efficacy (GTE) and participation in decision-making. Trust in colleagues was a significant predictor of teacher empowerment. In addition, (...) personal teaching efficacy had a significant mediation effect on the relationship between trust in colleagues and teacher empowerment, while GTE had not. These findings lead to some implications for understanding the nature of GTE and the relationship between trust and teacher empowerment. (shrink)