Publications of the series include the official proceedings of the ALWS-conferences and of their special workshops. The series is open also for other high-quality publications, especially on the philosophy of Ludwig Wittgenstein and its influence on contemporary analytic philosophy.

This study focuses on how moral aspects of purpose shape collaborative processes. It does so by analyzing the unfolding of 21 relationships between four nonprofits and their funders using a framework based on French pragmatist sociology to help uncover the deeply held, ideological and moral beliefs that underscore assumptions about what the overarching purpose of a collaborative effort is or should be. This study contributes to the literature on single and cross-sectoral collaboration by showing that the way partners handle and (...) reconcile differences about purpose is related to the forms of agreement likely to be achieved. It also suggests that certain forms of agreement are inherently more enduring than others. Taken as a whole, this study provides some plausible explanations as to why so many collaborations fail despite their seeming benefits for all the parties involved. (shrink)

Background In 2001 a report on the provision of clinical ethics support in UK healthcare institutions identified 20 clinical ethics committees. Since then there has been no systematic evaluation or documentation of their work at a national level. Recent national surveys of clinical ethics services in other countries have identified wide variation in practice and scope of activities. Objective To describe the current provision of ethics support in the UK and its development since 2001. Method A postal/electronic questionnaire survey administered (...) to the chairs of all 82 clinical ethics services registered with the UK Clinical Ethics Network in July 2010. Results Response rate was 62% with the majority of responding services situated in acute trusts. All services included a clinical ethics committee with one service also having a clinical ethicist. Lay members were present in 72% of responding committees. Individual case consultation has increased since 2001 with 29% of chairs spending more than 50% of their time on this. Access to and involvement in the process of case consultation is less for patients and families than for clinical staff. There is wide variation in committee processes and levels of institutional support. Over half of the responding committees undertook some form of evaluation. Conclusion Clinical ethics services in the UK are increasing as is their involvement in case consultation. However, the significant variation in committee processes suggests that further qualitative research is needed to understand how these committees function and the role they play in their institution. (shrink)

The concept of legitimacy is often used and emphasized in the context of setting limits in health care, but rarely described is what is actually meant by its use. Moreover, it is seldom explicitly stated how health-care workers can contribute to the matter, nor what weight should be apportioned to their viewpoints. Instead the discussion has focused on whether they should take on the role of the patients’ advocate or that of gatekeeper to the society’s resources. In this article, we (...) shed light on the role of health-care workers in limit setting and how their conferred legitimacy may support subordinators’ (i.e. citizens’) conferred legitimacy. We argue that health-care workers have an important role to play as both moral and political agents in limit setting, and delineate normative conditions that justify and facilitate health-care workers in conferring legitimacy on this kind of decision. Their role and potential impact on political limit setting does not—theoretically—affect the idea of democratic legitimacy negatively. Rather, as we suggest, by designing for limit-setting policymaking accordingly, health-care workers, as well as citizens, are more justified in conferring democratic legitimacy to health-care limit-setting decisions than if these concerns were not addressed. (shrink)

BackgroundWhen rationing health care, a commonly held view among ethicists is that there is no ethical difference between withdrawing or withholding medical treatments. In reality, this view does not generally seem to be supported by practicians nor in legislation practices, by for example adding a ‘grandfather clause’ when rejecting a new treatment for lacking cost-effectiveness. Due to this discrepancy, our objective was to explore physicians’ and patient organization representatives’ experiences- and perceptions of withdrawing and withholding treatments in rationing situations of (...) relative scarcity.MethodsFourteen semi-structured interviews were conducted in Sweden with physicians and patient organization representatives, thematic analysis was used.ResultsParticipants commonly express internally inconsistent views regarding if withdrawing or withholding medical treatments should be deemed as ethically equivalent. Participants express that in terms of patients’ need for treatment withholding and withdrawing should be deemed ethically equivalent. However, in terms of prognostic differences, and the patient-physician relation and communication, there is a clear discrepancy which carry a moral significance and ultimately makes withdrawing psychologically difficult for both physicians and patients, and politically difficult for policy makers.ConclusionsWe conclude that the distinction between withdrawing and withholding treatment as unified concepts is a simplification of a more complex situation, where different factors related differently to these two concepts. Following this, possible policy solutions are discussed for how to resolve this experienced moral difference by practitioners and ease withdrawing treatments due to health care rationing. Such solutions could be to have agreements between the physician and patient about potential future treatment withdrawals, to evaluate the treatment’s effect, and to provide guidelines on a national level. (shrink)

While justifications are used frequently by young children in their everyday interactions, their use has not been examined to any great extent. This article examines the interactional phenomenon of justification used by young children as they manage social organization of their peer group in an early childhood classroom. The methodological approaches of conversation analysis and membership categorization analysis were used to analyse video-recorded and transcribed interactions of young children in a preparatory classroom in a primary school in Australia. The focus (...) is an episode that occurred within the play area of the classroom and involved a dispute of ownership relating to a small, wooden plank. Justifications were frequent occurrences as the young participants drew upon justificatory devices to support their stances. The justifications related to the concepts of ownership and were used by those engaged in the particular dispute to support their positions and provide reasons for their actions. Four types of justificatory responses using child-constructed rules are highlighted. They are: justification based on the rule of transferred ownership; the rule of first possession; rules associated with custodianship; and the rule of third-party verification. The justifications are practices that work to build and reinforce individual children's status within the group, which in turn contributes to the social order of the classroom. (shrink)

In Sweden, palliative care has, over the past decades, been object to policies and guidelines with focus on how to achieve “good palliative care”. The aim of this study has been to analyse how experts make sense of the development and the current state of palliative care. Departing from this aim, focus has been on identifying how personal experiences of ‘the self’ are intertwined with culturally available meta-level concepts and how experts contribute to construct new scripts on palliative care. Twelve (...) qualitative interviews were conducted. Four scripts were identified after analysing the empirical material: 1. script of paths towards working within palliative care; 2. script of desirable and deterrent reference points; 3. script of tensions between improvement and bureaucracy; and 4. script of low status and uncertain definitions. The findings of this study illustrate how experts in complex ways intertwine experiences of ‘the self’ with meta-levels concepts in order to make sense of the field of palliative care. The participants did not endorse one “right way” of “good” deaths. Instead, palliative care was considered to be located in a complex state where the historical development, consisting of both desirable ideals, death denials and lack of guidelines, and more recent developments of strives towards universal concepts, “improvement” and increased bureaucracy altogether played a significant role for how palliative care has developed and is organised and conducted today. (shrink)

In this article, we conceptualize the under investigated and under theorized relationship between intimate partner violence (IPV) and business responsibility. As an urgent social issue, IPV—understood as abuse of power within the context of an intimate partner relationship, mainly perpetrated by men and involving a pattern of behavior—has been studied for decades in many disciplines. A less common yet vital research perspective is to examine IPV as it relates to the business and to ask how organizations should engage with IPV. (...) In response to this question, we contribute a framework drawing from two distinctions in the business responsibility scholarship: the assumed role of the organization (responsibility to the firm/market; responsibility to the broader socio-political-economic environment); and the second focused on the approach to conceptualizing ethics (justice/fairness; ethics of care). Thus, we explicate four approaches to business responsibility and IPV, which serve the purposes of mapping three selected contributions, identifying limitations of these approaches, and opening up future research opportunities. (shrink)

The provision of informed consent is a prerequisite for inclusion of a patient in a clinical research project. In some countries, the legislation on clinical research authorizes a third person to provide informed consent if the patient is unable to do so directly . This is the case during acute stroke, when the symptoms may prevent the patient from providing informed consent and thus require a third party to be approached. Identification of factors associated with the medical team’s decision to (...) resort to surrogate consent may help the care team during the inclusion process and enable the patient’s family circle to be better informed about providing surrogate consent. (shrink)

This systematic review synthesises the available evidence regarding the European understanding of workplace spirituality (definitions), the importance of spirituality and religion (evidence) as well as spiritual leadership (meaning and practice) in for-profitorganizations. The search for eligible studies was conducted in OPAC Plus, SCOPUS, Science Direct, JSTOR, EBSCO, and Google Scholar from 2007/01 to 2017/07. Three independent scholars extracted the data. Twenty studies were included (two mixed-methods, eight quantitative, ten qualitative) for the final quality assessment. A study quality assessment and thematic (...) analysis was conducted. This review gives suggestions for study quality improvement and reporting. Thematically, two different approaches to religion and spirituality (R/S) were detected: a) work has a spiritual dimension and b) religious and spiritual orientation as “spiritual capital”. Studies demonstrated positive effect on job satisfaction, health, commitment, company productivity and sustainability; Christian leadership does not address personal religious orientation; the spiritual dimension may lead to a change of perspective; workplace spirituality may exploit people for profit-oriented business goals; non-white Muslims experience discrimination. This systematic review provides robust evidence and findings for evidence-informed policymaking and encourages a more rigorous research in this field of study. (shrink)

Introduction : kith, kin, and family / Sally Haslanger and Charlotte Witt Adoption and its progeny : rethinking family law, gender, and sexual difference / Drucilla Cornell Open adoption is not for everyone / Anita L. Allen Methods of adoption : eliminating genetic privilege / Jacqueline Stevens Several steps behind : gay and lesbian adoption / Sarah Tobias A child of one’s own : property, progeny, and adoption / Janet Farrell Smith Family resemblances : adoption, personal identity, and genetic (...) essentialism / Charlotte Witt Being adopted and being a philosopher : exploring identity and the "desire to know" differently / Kimberly Leighton Real othering : the metaphysics of maternity in children’s literature / Shelley Park Accidents and contingencies of love / Songsuk Hahn ; comments by Harry Frankfurt Abuse and neglect, foster drift, and the adoption alternative / Elizabeth Bartholet Feminism, race, and adoption policy / Dorothy Roberts Racial randomization / Hawley Fogg-Davis You Mixed?: racial identity without racial biology / Sally Haslanger. (shrink)

Ongoing changes in many Western countries have resulted in more healthcare services being transferred to municipalities and taking place in patients’ homes. This greatly impacts nurses’ work in home care, making their work increasingly diverse and demanding. In this study, we explore home‐care nursing through a critical discourse analysis of focus group interviews with home‐care nurses. Drawing on insights from positioning theory, we discuss the content and delineation of their work and the interweaving of contextual changes. Nurses hold a crucial (...) position in home healthcare, particularly in ensuring care for sicker patients with complex needs. Assessing health needs, performing advanced care, and at the same time, providing customized solutions in various homes were identified as distinctive for home‐care nurses’ work. Changes have made nurses’ work become driven by comprehensive tasks and acute medical needs that require much of their competence and time. Urgent care seems to take precedence in nurses’ work, leaving less time and attention for other tasks such as conversations and support for coping with everyday life. This underlines the need to investigate and discuss the content and scope of nurses’ work to help shape the further development of home‐care nursing. (shrink)

This paper presents the intelligent virtual animals that inhabit Omosa, a virtual learning environment to help secondary school students learn how to conduct scientific inquiry and gain concepts from biology. Omosa supports multiple agents, including animals, plants, and human hunters, which live in groups of varying sizes and in a predator-prey relationship with other agent types (species). In this paper we present our generic agent architecture and the algorithms that drive all animals. We concentrate on two of our animals to (...) present how different parameter values affect their movements and inter/intra-group interactions. Two evaluations studies are included: one to demonstrate the effect of different components of our architecture; another to provide domain expert validation of the animal behavior. (shrink)

This paper reports on an ongoing ARC Discovery Project that is conducting design research into learning in collaborative virtual worlds (CVW).The paper will describe three design components of the project: (a) pedagogical design, (b)technical and graphics design, and (c) learning research design. The perspectives of each design team will be discussed and how the three teams worked together to produce the CVW. The development of productive failure learning activities for the CVW will be discussed and there will be an interactive (...) demonstration of the project's CVW. (shrink)

Several quantitative studies (e.g. Kidd & Castano, 2013a; Djikic et al., 2013) have shown a positive correlation between literary reading and empathy. However, the literary nature of the stimuli used in these studies has not been defined at a more detailed, stylistic level. In order to explore the stylistic underpinnings of the hypothesized link between literariness and empathy, we conducted a qualitative experiment in which the degree of stylistic foregrounding was manipulated. Subjects (N = 37) read versions of Katherine Mansfield's (...) 'The Fly', a short story rich in foregrounding, while marking striking and evocative passages of their choosing. Afterwards, they were asked to select three markings and elaborate on their experiences in writing. One group read the original story, while the other read a 'non-literary' version, produced by an established author of suspense fiction for young adults, where stylistic foregrounding was reduced. We found that the non-literary version elicited significantly more (p < 0.05) explicitly empathic responses than the original story. This finding stands in contradiction to widely accepted assumptions in recent research, but can be assimilated in alternative models of literariness and affect in literary reading (e.g. Cupchik et al., 1998). We present an analysis of the data with a view to offering more than one interpretation of the observed effects of stylistic foregrounding. (shrink)

Internationally, primary health care has in recent years gained a more central position in political priorities to ensure sustainable health care for the population. Thus, more people receive health care locally and in their own homes, where home‐care nursing plays a large role. In this article, we investigate how home‐care nursing is articulated and made visible in contemporary Norwegian policy documents. The study is a Fairclough‐inspired critical discourse analysis seeking to uncover the position of nursing in the prevailing political ideologies (...) on current primary health care. In the documents, we identified several complementary and conflicting understandings about home‐care nursing. Home‐care nursing is presented as a basic part of a municipality's health services, but at the same time, its content and contribution are unclear and almost invisible. We argue that the absence of nursing leads to significant perspectives being left out and tie this to the fact that some patient groups and tasks seem to be disadvantaged. The political placement of home‐care nursing in the health‐care landscape is thus not just about nursing as a professional practice but also concerns fundamental care values in our society in relation to disadvantaged groups and work tasks. (shrink)

This paper explores ethical concerns arising in healthcare integration. We argue that integration is necessary imperative for meeting contemporary and future healthcare challenges, a far stronger evidence base for the conditions of its effectiveness is required. In particular, given the increasing emphasis at the policy level for the entire healthcare infrastructure to become better integrated, our analysis of the ethical challenges that follow from the logic of integration itself is timely and important and has hitherto received insufficient attention. We evaluated (...) an educational intervention which aims to improve child health outcomes by making transitions between primary to secondary care more efficient, ensuring children and parents are better supported throughout. The programme provided skills for trainee paediatricians and general practitioners in co-designing integrated clinical services. The key ethical challenges of integrated care that arose from a clinical perspective are: professional identity and autonomy in an integrated working environment; the concomitant extent of professional responsibility in such an environment; and the urgent need for more evidence to be produced on which strategies for integrating at scale can be based. From our analysis we suggest a tentative way forward, viewed from a normative position broadly situated at the intersection of deontology and care ethics. We adopt this position because the primary clinical ethical issues in the context of integrated care concern: how to ensure that all duties of care to individual patients are met in a newly orientated working environment where clinical responsibility may be ambiguous; and the need to orientate care around the patient by foregrounding their autonomous preferences and ensuring good patient clinician relationships in clinical decision-making. (shrink)

In Sweden, efforts to govern end-of-life care through policies have been ongoing since the 1970s. The aim of this study is to analyse how policy narratives on palliative care in Sweden have been formulated and have changed over time since the 1970s up to 2018. We have analysed 65 different policy-documents. After having analysed the empirical material, three policy episodes were identified. In Episode 1, focus was on the need for norms, standards and a psychological end-of-life care with the main (...) goal of solving the alleged deficiencies within end-of-life care in hospital settings. Episode 2 was characterised by an emphasis on prioritising end-of-life care and dying at home, and on the fact that the hospice care philosophy should serve as inspiration. In Episode 3, the need for a palliative care philosophy that transcended all palliative care and the importance of systematic follow-ups and indicators was endorsed. Furthermore, human value and freedom of choice were emphasised. In conclusion, the increase of policy-documents produced by the welfare-state illustrate that death and dying have become matters of public concern and responsibility. Furthermore, significant shifts in policy narratives display how notions of good palliative care change, which in turn may affect both the practice and the content of care at the end of life. (shrink)

This article reflects on the contribution that stakeholder involvement could give to circular bioeconomy transformation (CBE). By comparing argument for stakeholder involvement in literature as well as on our own experiences in six stakeholder involvement workshops, we argue that it is probably unrealistic to fully achieve both normative and co-design goals in a single workshop. Furthermore, stakeholder involvement can help to acquire insight into dependencies in the market and offer an opportunity to connect people to deal with them. Therefore we (...) propose for future stakeholder involvement initiatives for CBE to focus on (1) identify relationships of dependency which make it hard for players in the market to change, (2) develop strategies to change while mitigating the detrimental effects on already existing relationships and (3) gradually breaking down relationships and building new ones that support CBE. (shrink)

Background Ethical principles behind prioritization in healthcare are continuously relevant. However, applying ethical principles during times of increased need, such as during the COVID-19 pandemic, is challenging. Also, little is known about nursing home nurses’ prioritizations in their work to achieve well-being and health for nursing home residents. Aim The aim of this study was to explore nursing home nurses’ priority-setting for older nursing home residents in Sweden during the COVID-19 pandemic. Research design, participants, and research context We conducted a (...) qualitative interview study. Data were collected through in-depth interviews (retrospective self-reports) between February and May 2021 with 21 nursing home nurses. To help respondents to recall their memories, we used the critical incident technique (CIT). We analyzed data within the theoretical framework and the methodological orientation of content analysis. Ethical considerations Written and verbal consent was obtained before the interviews, and information was given to participants informing them that participation was entirely voluntary. The Swedish Ethical Review Agency gave an advisory opinion stating that there were no ethical objections to the research project (Dnr. 2020-05649). Findings We identified an overarching theme—nursing home nurses struggling on multiple fronts, “just do it”—and seven categories: striving for survival and caring about a dignified death; responding sensitively to relatives’ expectations; ranking the urgency of needed care; responding to input from different actors; combating the spread of infection in unconventional ways; taking the lead and doing what is required; and following the ideals of person-centered nursing. Conclusions Nurses’ priority-setting for older nursing homes residents during the COVID-19 pandemic meant strain and struggle. In some cases, nurses had taken responsibility for priorities falling outside their statutory powers. Different demands and interests affected nurses’ priorities. Nursing home nurses need organizational and managerial support to prioritize. (shrink)

Clinical Ethics, Ahead of Print. This paper is a response to a recent BMJ Blog: ‘The duty to treat: where do the limits lie?’ Members of the Surrey Heartlands Integrated Care Service Clinical Ethics Group reflected on arguments in the Blog in relation to resuscitation during the COVID-19 pandemic.Clinicians have had to contend with ever-changing and conflicting guidance from the Resuscitation Council UK and Public Health England regarding personal protective equipment requirements in resuscitation situations. St John Ambulance had different guidance (...) for first responders.The situation regarding resuscitation led the CEG to consider ethical aspects of health care professionals’ responses to the need for resuscitation during COVID-19. Members agreed that professionals should, ideally, have the level of PPE required for an aerosol generating procedure. However, there was no consensus regarding professionals’ duty to care when this is not available. On the one hand, it was agreed that the casualty/patient’s interests regarding resuscitation should be prioritised due to professionals’ contract with the public and professional privilege. On the other hand, risk thresholds were considered relevant to individual decision-making and professionals’ duty to care. All agreed that decision-making should not be influenced by rewards or reprimands. It was agreed also that decisions to resuscitate should not be considered as moral heroism or supererogatory - regardless of PPE availability - but rather as ‘minimally decent’. We agreed that it may be acceptable for professionals, with good reasons, to opt out of resuscitation attempts and these should be reflected on and discussed before the event. (shrink)

Background The first COVID-19 wave started in February 2020 in France. The influx of patients requiring emergency care and high-level technicity led healthcare professionals to fear saturation of available care. In that context, the multidisciplinary Ethics- Support Cell (EST) was created to help medical teams consider the decisions that could potentially be sources of ethical dilemmas. Objectives The primary objective was to prospectively collect information on requests for EST assistance from 23 March to 9 May 2020. The secondary aim was (...) to describe the Cell’s functions during that period. Research design This observational, real-time study of requests for Cell consultations concerned ethical dilemmas arising during a public health crisis. The EST created a grid to collect relevant information (clinical, patient’s/designated representative’s preferences and ethical principles strained by the situation), thereby assuring that each EST asked the same questions, in the same order. Participants and research context Only our university hospital’s clinicians could request EST intervention. Ethical considerations The hospital Research Ethics Committee approved this study (no. CER-2020-107). The patient, his/her family, or designated representative was informed of this ethics consultation and most met with EST members, which enabled them to express their preferences and/or opposition. Findings/results 33 requests (patients’ mean age: 80.8 years; 29 had COVID-19: 24 with dyspnea, 30 with comorbidities). 17 Emergency Department solicitations concerned ICU admission, without reference to resource constraints; others addressed therapeutic proportionality dilemmas. Discussion Intervention-request motives concerned limited resources and treatment intensity. Management revolved around three axes: the treatment option most appropriate for the patient, the feasibility of implementation, and dignified care for the patient. Conclusions COVID-19 crisis forced hospitals to envisage prioritization of ICU access. Established decision-making criteria and protocols do not enable healthcare professionals to escape ethical dilemmas. That acknowledgement highlights ethical risks, enhances the added-value of nursing and encourages all players to be vigilant to pursue collective deliberations to achieve clear and transparent decisions. (shrink)

Second person social cognition cannot be restricted to dyadic interactions between two persons (the and the ). Many instances of social communication are triadic, and involve a third person (the ), which is the object of the interaction. We discuss neuropsychological and brain imaging data showing that triadic interactions involve dedicated brain networks distinct from those of dyadic interactions.

Every year medical researchers make contact with a large number of cancer survivors with the aim of evaluating cancer treatment. For this reason we decided to investigate how Swedish cancer survivors perceived their participation in research studies focusing on the long-term consequences of being a survivor of gynaecological or urinary bladder cancer. Data were collected by means of two study-specific postal questionnaires, both consisting of questions covering physical symptoms, well-being and the experience of being a cancer survivor. Both questionnaires also (...) included questions evaluating the participants’ experience of being research subjects. The questionnaires were developed in close co-operation with cancer survivors. The study population consisted of 1068 cancer survivors. Of these, 95% (n=1003) reported that they thought the study was valuable and 54% (n=559) that they had been positively affected by participating. Four per cent (n=39) expressed that they had been negatively affected by their participation in the study. The vast majority of the cancer survivors thought that participating in their particular study was valuable. (shrink)

Michel de Montaigne begins his magisterial ESSAIS by telling his readers that he, himself, is the matter of his book. He says that he has written himself so that after death he could remain in the world with those who knew and loved him. Montaignes intimate project, meant to be read by friends, has emerged as one of the most surprising and compelling accounts of the human condition ever written. Although Montaigne famously retired from public life to write his essais, (...) neither his concerns nor the activities recounted in ESSAIS is purely private. This volume of essays, based on papers presented at The A.V. Elliott Conference for Great Books and Ideas sponsored by Mercer Universitys McDonald Center for Americas Founding Principles, focuses on the outward oriented political philosophy of Montaigne. Contributors include Ann Hartle, Daniel Cullen, Christine Henderson, Eduardo Velasquez, Kevin Honeycutt, and Christopher Edelman. (shrink)

The Archaeology of Bhakti II: Royal Bhakti, Local Bhakti. Edited by Emmanuel Francis and Charlotte Schmid. Collection Indologie, no. 132. Pondicherry: Institut Français de Pondichéry; Paris: École Française d’Extrême-Orient, 2016. Pp. x + 609, illus.

On behalf of the society for the Advancement of American Philosophy and with pride and pleasure, I offer to the readers of the journal a selection of papers presented at the 37th meeting of the society, sponsored by the University of North Carolina, Charlotte, and Queens University of Charlotte and held in Charlotte, North Carolina, on March 11-13, 2010. This Proceedings Issue represents the first of such issues to be published in The Pluralist, which is now the (...) official journal of our society.The Pluralist and the Society for the Advancement of American Philosophy share a similar mission, namely to focus on pluralism and inclusion in philosophical conversation of many different points of view. In carrying out. (shrink)

Freundschaft, so Arendt in ihrem Denktagebuch,gehört zu den ”tätigen Modi des Lebendigseins“, und Briefe sind deren herausragende Zeugnisse. Dieser Band versammelt weitgehend unveröffentlichte Briefwechsel der politischen Philosophin mit ihren langjährigen Freundinnen Charlotte Beradt, Rose Feitelson, Hilde Fränkel, Anne Weil-Mendelsohn und Helen Wolff. Neben den gemeinsamen Projekten prägte die Freundschaften auch, dass alle Frauen die Wirklichkeiten von Emigration und Immigration kannten. Die Briefwechsel führen mitten hinein in Arendts Gedanken- und Arbeitswelt, sie erzählen Privates und Alltägliches aus fünf sehr unterschiedlichen, intensiv (...) gelebten Freundschaften. (Quelle: www.buchhandel.de). (shrink)

Aristotle's defense of Dunamis -- Power and potentiality -- Rational and nonrational powers -- The priority of actuality -- Ontological hierarchy, normativity, and gender.

Patients in around 20 countries worldwide are now offered online access to at least some of their medical records. Access includes test results, medication lists, referral information, and/or the very words written by clinicians (so-called ‘open notes’). In this paper, I discuss the possibility of one unintended negative consequence of patient access to their clinical notes—the potential to increase ‘nocebo effects’. A growing body of research shows that nocebo effects arise by engaging perceptual and cognitive processes that influence negative expectancies, (...) and as a consequence, adverse health effects. Studies show that increased awareness about the side effects of medications, the framing of information and the socioemotional context of care can increase the risk of nocebo effects. Connecting research into the nocebo effect with open notes provides preliminary support for the hypothesis that patient access to clinical notes might be a forum for facilitating unwanted nocebo effects. Furthermore, current findings indicate that we might expect to see systematic differences in how nocebo effects are experienced among different patient populations. The ethical implications of the tension between transparency and the potential for harm are discussed, with an emphasis on what open notes might mean for justice and equity in clinical care for a range of already marginalised patient populations. I argue that to resolve these challenges does not thereby justify ‘closed notes’, and conclude with suggestions for how health systems and clinicians might adapt to this innovation to reduce the risk of potential nocebo effects arising via this novel route. (shrink)

In this paper I argue that from a feminist perspective well-being is most productively defined in relation to freedom, and it is with regard to questions of freedom that well-being should be pursued. Pursuing well-being from a starting point of oppression and working towards an ideal of freedom, involves two things: a reconception of the self as fundamentally relational and an emphasis on the importance of self-understanding for well-being. The former is something that has been widely acknowledged in the feminist (...) literature, where relational conceptions of the self figure centrally, and the notion of a socially situated self has been identified as one of the key contributions to living well from a feminist perspective. Self-understanding, however, has been largely ignored in feminist accounts of well-being, where the social aspects of well-being are often emphasised to the detriment of individual considerations. I argue that this can cause problems for well-being as the pursuit of freedom, but that such problems can be overcome by supplementing the relational account of the self with an emphasis on self-understanding and highlighting the interrelation between them in the pursuit of well-being qua freedom from oppression. (shrink)

This paper argues that close personal relationships play an important role in our judgments about what is fair. I start with an explanation of leading theories of fairness, highlighting the potential for further work on the grounds of fairness. Next, I offer an account of close personal relationships as having the ability to generate legitimate and reasonable expectations of one or other party to a judgment about fairness, or both. I show how and when close personal relationships can ground fairness.

This article focuses on three themes concerning determinism and indeterminism. The first theme is observational equivalence between deterministic and indeterministic models. Here I discuss several results about observational equivalence and present an argument on how to choose between deterministic and indeterministic models involving indirect evidence. The second theme is whether Newtonian physics is indeterministic. I argue that the answer depends on what one takes Newtonian mechanics to be, and I highlight how contemporary debates on this issue differ from those in (...) the nineteenth century. The third major theme is how the method of arbitrary functions can be used to make sense of deterministic probabilities. I discuss various ways of interpreting the initial probability distributions and argue that they are best understood as physical, biological etc. quantities characterising the particular situation at hand. Also, I emphasise that the method of arbitrary functions deserves more attention than it has received so far. (shrink)