This article will be concerned with the phenomenon of vitality, which emerged as one of the main findings in a larger grounded theory study about life and death decisions in hospitals' neonatal units. Definite signs showing the new-born infant's energy and vigour contributed to the clinician's judgements about life expectancy and the continuation or termination of medical treatment. In this paper we will discuss the normative importance of vitality as a diagnostic cue and will argue that vitality, as a sign (...) perceived by doctors and nurses, has moral significance and represents a legitimate contribution to clinical decision-making in difficult cases where the child's life is at stake. We will argue that these clinical intuitions can be justified on a moral basis but only with certain qualifications that accounts for a certain objectivity and intersubjective reliability in the therapeutic judgements. (shrink)
Background: Although fair distribution of healthcare services for older patients is an important challenge, qualitative research exploring clinicians’ considerations in clinical prioritisation within this field is scarce. Objectives: To explore how clinicians understand their professional role in clinical prioritisations in healthcare services for old patients. Design: A semi-structured interview-guide was employed to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis. Participants: 20 physicians and 25 nurses working in public hospitals and nursing homes (...) in different parts of Norway. Results and interpretations: The clinicians struggle with not being able to attend to the comprehensive needs of older patients, and being unfaithful to professional ideals and expectations. There is a tendency towards lowering the standards and narrowing the role of the clinician. This is done in order to secure the vital needs of the patient, but is at the expense of good practice and holistic role modelling. Increased specialisation, advances and increase in medical interventions, economical incentives, organisational structures, and biomedical paradigms, may all contribute to a narrowing of the clinicians’ role. Conclusion: Distributing healthcare services in a fair way is generally not described as integral to the clinicians’ role in clinical prioritisations. If considerations of justice are not included in clinicians’ role, it is likely that others will shape major parts of their roles and responsibilities in clinical prioritisations. Fair distribution of healthcare services for older patients is possible only if clinicians accept responsibility in these questions. (shrink)
The aim of this study was to explore the ethical challenges in home mechanical ventilation based on a secondary analysis of qualitative empirical data. The data included perceptions of healthcare professionals in hospitals and community health services and family members of children and adults using home mechanical ventilation. The findings show that a number of ethical challenges, or dilemmas, arise at all levels in the course of treatment: deciding who should be offered home mechanical ventilation, respect for patient and family (...) wishes, quality of life, dignity and equal access to home mechanical ventilation. Other challenges were the impacts home mechanical ventilation had on the patient, the family, the healthcare services and the allocation of resources. A better and broader understanding of these issues is crucial in order to improve the quality of care for both patient and family and assist healthcare professionals involved in home mechanical ventilation to make decisions for the good of the patient and his or her family. (shrink)
The aim of this study was to explore neonatal nurses’and mothers of preterm infants’experiences of daily challenges. Interviews took place asking for good, bad and challenging experiences. Data were analysed using qualitative content analysis and findings were clustered in two categories: good and challenging experiences, each containing three themes. The good experiences were: managing with success as a nurse, small things matter for mothers, and a good day anyhow for mothers and nurses. The challenging experiences were: mothering in public, being (...) pulled between responsibilities, and adverse things stick under the nurses’skin. The study shows that small daily clinical matters become big issues and could lead to moral distress, and that nurses integrate ethics of justice and ethics of care while mothers are concerned about health and well-being of their specific infant only. The challenge for nursing to integrate fairness and sensitive care in family-oriented neonatal care is discussed. (shrink)
The aim of this study was to explore and reflect upon mental health nursing and first-episode psychosis. Seven multidisciplinary focus group interviews were conducted, and data analysis was influenced by a grounded theory approach. The core category was found to be a process named ‘working behind the scenes’. It is presented along with three subcategories: ‘keeping the patient in mind’, ‘invisible care’ and ‘invisible network contact’. Findings are illuminated with the ethical principles of respect for autonomy and paternalism. Nursing care (...) is dynamic, and clinical work moves along continuums between autonomy and paternalism and between ethical reflective and non-reflective practice. ‘Working behind the scenes’ is considered to be in a paternalistic area, containing an ethical reflection. Treating and caring for individuals experiencing first-episode psychosis demands an ethical awareness and great vigilance by nurses. The study is a contribution to reflection upon everyday nursing practice, and the conclusion concerns the importance of making invisible work visible. (shrink)
. This article argues that within the retail setting any aesthetic influence employed by the retailer is ultimately going to result in utilitarian outcomes for the clientele of that store. Indeed, that in pursuing such an aesthetic appeal, the retailer can be perceived as akin to an artist with his or her primary responsibility not to the larger society but to the store and the statement that it makes. This argument is re-inforced by the historical experience of department store operators (...) in pre-war Nazi Germany. The article also contemplates Alan Gewirth’s Theory of Justice, and argues that it is only applicable in a retail setting. (shrink)
The chain store game is a simple game in extensive form which produces an inconsistency between game theoretical reasoning and plausible human behavior. Well-informed players must be expected to disobey game theoretical recommendations.The chain store paradox throws new light on the well-known difficulties arising in connection with finite repetitions of the prisoners’ dilemma game. Whereas these difficulties can be resolved by the assumption of secondary utilities arising in the course of playing the game, a similar approach to the chain store (...) paradox is less satisfactory.It is argued that the explanation of the paradox requires a limited rationality view of human decision behavior. For this purpose a three-level theory of decision making is developed, where decisions can be made on different levels of rationality. This theory explains why insight into the rational solution of a decision problem does not necessarily mean that the corresponding course of action will be taken. (shrink)
Considerable attention is currently being directed to ethics in business, government and academia in both the professional and popular media. Most of these studies propound that ethics have eroded over time, resulting in their current low state. However, few, if any, of these articles provide comparative or longitudinal data to support their arguments. In this investigation, both comparative and longitudinal data were collected between 1976 and 1986 from retail store managers and retail students concerning their current perceptions of ethical retail (...) practices. The results indicate a significant increase in the ethics of retail store managers, and a significant decrease in the ethics of retail students. (shrink)
All recent memory theories of hippocampal function have incorporated the idea that the hippocampus is required to process items only of some qualitatively specifiahle kind, and is not required to process items of some complementary set. In contrast, it is now proposed that the hippocampus is needed to process stimuli of all kinds, but only when there is a need to associate those stimuli with other events that are temporally discontiguous. In order to form or use temporally discontiguous associations, it (...) is essential to maintain some memory of the first component until the second component has occurred. When the temporal gap to he spanned is small, and the number of items to be temporarily retained is low, a limited-capacity, short-term store is sufficient to allow associations to be formed. Such a store is presumed to operate in parallel with the hippocampus in normal animals. Hippocampal damage disrupts a much higher-capacity store that has a slower decay rate, and so leaves animals with only a very limited ability to form temporally discontiguous associations. Hippocampal damage, however, is not held to affect the long-term storage of associations of any kind, if they can be formed. Analyses of both new and existing data are presented to show that by classifying tasks in terms of the need to use a temporary memory store to retain temporally discontiguous information one can cut right across existing classifications as well as achieve a better fit to the data. The hippocampus thus seems best described as a high-capacity, intermediate-term memory store. (shrink)
The rationality of predatory practices has been extensively debated among economists and lawyers. Selten (1978) considered a fictitious chain-store confronted with potential entrances of local competitors. In his formal analysis via an extensive game with complete and perfect information predatory behavior is precluded by the unique sequential (and perfect) equilibrium. Kreps and Wilson (1982b) and Milgrom and Roberts (1982) established in modified models with incomplete information that predation against early entrants may be rational since it creates a reputation to the (...) effect that later potential entrants are deterred. The present paper offers a modification of Selten's model with complete but imperfect information which renders possible reputation and deterrence. (shrink)
I compare the concepts of “activation” and “storage” as foundations of short-term memory, and suggest that an attention-based view of STM does not need to posit specialized short-term stores. In particular, no compelling evidence supports the hypothesis of time-limited stores. Identifying sources of activation, examining the role of activated procedural knowledge, and studying working memory development are central issues in modelling capacity-limited focal attention.
In a departure from traditional Western political theory that is reminiscent of left?wing anarchism, contemporary libertarianism rejects the necessity of making political choices based on a value hierarchy, instead claiming that it is possible for all individuals to pursue their divergent values simultaneously?as long as each respects the equal rights of others to do the same. The caveat, however, hides a conflict of loyalties that would plague a libertarian society: on the one hand are the particular loyalties of one's preferred (...) Utopian community; on the other hand, loyalty to the larger ?framework for utopias?; within which one's utopia exists. The second loyalty implies a value relativism incompatible with the first one, meaning either that loyalty to the libertarian framework will undermine the utopias within it, or that the particular values of the utopias will destabilize the libertarian framework. The durability of a libertarian society, then, requires a mentality best characterized as nihilistic. In this, libertarianism differs from liberalism but is surprisingly similar to the cultural diversity movement. The thesis is illustrated by examining John Gray's attempt to eschew both a hierarchy of values and moral relativism. (shrink)
EXPLANATION OF THE DESIGN AND ARRANGEMENTS of the Cooperative Magazine, which has recently been commenced in Cincinnati. Whoever can for a moment, so far abstract his thoughts from his pecuniary concerns,:as to Look around him, and observe the evils which the established laws and. customs, with respect to the administration of property, are daily producing in what is called Civilized Society, must, if he is possessed of the least degree of sensibility, feel a strong desire, to remove these evils.
Genetically modified food crops have been called ‘frankenfoods’ since 1992. Although some might dismiss the phenomena as clever marketing by anti-GM groups, of no philosophic interest, its resonance with the general public suggests otherwise. I argue that examination of the intersection of popular conceptions of monsters, nature, and food at which ‘frankenfood’ stands reveals significant and disturbing trends in our relationship to organic nature of interest to moral and social philosophy and to environmental ethics.
There are two competing views of knowledge-how: Intellectualism and anti-intellectualism. According to the reductionist varieties of intellectualism defended by Jason Stanley and Timothy Williamson (2001) and Berit Brogaard (2007, 2008, 2009), knowledge-how simply reduces to knowledge-that. To a first approximation, s knows how to A iff there is a w such that s knows that w is a way to A. For example, John knows how to ride a bicycle if and only if there is a way w such (...) that John knows that w is a way to ride a bicycle. John Bengson and Marc Moffett (2007) defend an anti-reductionist version of intellectualism which takes knowledge-how to require, in addition, that s understand the concepts involved in her belief. According to the anti-intellectualist accounts originally defended by Gilbert Ryle (1946) and many others after him, knowledge-how requires the possession of a practical ability and so knowing that w (for some w) is a way to A does not suffice for knowing-how. For example, John knows how to ride a bicycle only if John has the ability to ride it; if John merely knows that w (for some w) is a way to ride a bicycle, John does not know how to ride a bicycle. Here I will argue for a conciliatory position that is compatible with the reductionist variety of intellectualism: knowledge-how is reducible to knowledge-that. But, I argue, there are knowledge states which are not justification-entailing and knowledge states which are not belief-entailing. Both kinds of knowledge state require the possession of practical abilities. I conclude by arguing that the view defended naturally leads to a disjunctive conception of abilities as either essentially involving mental states or as not essentially involving mental states. Only the former kind of ability is a kind of knowledge-state, viz. a knowledge-how state. (shrink)
Are conscious states conscious in virtue of representing themselves? Content Type Journal Article Pages 1-8 DOI 10.1007/s11098-011-9762-x Authors Berit Brogaard, Department of Philosophy, University of Missouri, St. Louis, 599 Lucas Hall, One University Blvd., St. Louis, MO 63121-4400, USA Journal Philosophical Studies Online ISSN 1573-0883 Print ISSN 0031-8116.
The study of culture and cultural selection from a biological perspective has been hampered by the lack of any firm theoretical basis for how the information for cultural traits is stored and transmitted. In addition, the study of any living system with a decentralized or multi-level information structure has been somewhat restricted due to the focus in genetics on the gene and the particular hereditary structure of multicellular organisms. Here a different perspective is used, one which regards living systems as (...) self-constructing energy users that utilize their genome as a library of information, making the genetic system just another component that adds fitness to the overall integrated unit. In this framework, basic fitness is measured as the ability to gather energy for growth and reproduction, and the fitness of the genetic system is broken down into two aspects: first, the effectiveness in searching for new somatic functional information, and second, the effectiveness in searching for better structures to store and process information. With this more generalized perspective, major evolutionary transitions to higher levels of organization become competitions between different information structures; furthermore the functioning and fitness of cultural systems can be more easily described and compared with other modes of information storage within biological systems. Modern technological societies are self-constructing systems that rely on written (symbolic) information storage and very complex algorithms that effectively search for variation with a high probability of successful selection. These systems are currently competing with traditional organic systems, and this competition constitutes the latest major evolutionary transition. Upon comparison of the energy-gathering potential of symbolic-based systems with DNA-based life, it appears that symbolic systems have a tremendous fitness potential and the current shift to a higher level of selection may be as significant and far-reaching as any of the previous major evolutionary transitions. (shrink)
This paper deals with certain ethical problems inherent in psychological research based on internet communication as stored information. Section 1 contains an analysis of research on Internet debates. In particular, it takes into account a famous example of deception for psychology research purposes. In section 2, the focus is on research on personal data in texts published on the Internet. Section 3 includes an attempt to formulate some ethical principles and guidelines, which should be regarded as fundamental in research on (...) stored information. (shrink)
In light of growing concerns about obesity, Winson (2004, Agriculture and Human Values 21(4): 299–312) calls for more research into the supermarket foodscape as a point of connection between consumers and food choice. In this study, we systematically examine the marketing of ready-to-eat breakfast cereals to children in Toronto, Ontario supermarkets. The supermarket cereal aisle is a relatively unstudied visual collage of competing brands, colors, spokes-characters, and incentives aimed at influencing consumer choice. We found that breakfast cereal products with higher-than-average (...) levels of sugar, refined grains, and trans-fats are more likely to feature child-oriented marketing in the form of spokes-characters, themed cereal shapes/colors, and child incentives on cereal boxes. These forms of visual communication are consistent with a “health exploitive” pattern of targeted marketing to children in the supermarket setting. Only one aspect of visual communication is consistent with a “health protective” pattern of marketing to children—cereals shelved within reach of children aged 4–8 had less sugar per serving and were less likely to contain trans-fats than less reachable products. We discuss the implications of our findings for the measurement and regulation of marketing to children in North American supermarkets. (shrink)