Background:Palliative care is acknowledged as an appropriate approach to support older people in nursing homes. Ethical issues arise from many aspects of palliative care provision in nursing homes; however, they have not been investigated in this context.Aim:To explore the ethical issues associated with palliative care in nursing homes in the United Kingdom.Design:Exploratory, sequential, mixed-methods design.Methods:Semi-structured interviews with 13 registered nurses and 10 healthcare assistants (HCAs) working in 13 nursing homes in the United Kingdom were used to explore ethical issues in (...) palliative care. The ‘Ethical Issues in Palliative Care for Nursing Homes’ instrument was used to measure the frequency and level of distress arising from ethical issues through a cross-sectional survey with 69 registered nurses and 129 healthcare assistants. Data collection occurred between December 2014 and November 2015.Ethical considerations:Ethical approval was granted by Queen’s University’s School of Nursing and Midwifery Research Ethics Committee and governance sought from each nursing home’s manager.Findings:The interviews revealed three themes: ethical issues in practice; relational issues; and organisational issues. No significant differences between registered nurses and healthcare assistants were evident, confirming the patterns emerging from the interviews. Relational issues, primarily issues with residents and families, occurred most frequently and caused greater distress.Conclusion:The shared environment is key in the experience of ethical issues; therefore, multidisciplinary education is needed for ethical decision making in palliative care. Addressing staff knowledge and service organisation may reduce ethical issues locally and provide a benchmark for global change. (shrink)

Background:Ethical issues are increasingly being reported by care-providers; however, little is known about the nature of these issues within the nursing home. Ethical issues are unavoidable in healthcare and can result in opportunities for improving work and care conditions; however, they are also associated with detrimental outcomes including staff burnout and moral distress.Objectives:The purpose of this review was to identify prior research which focuses on ethical issues in the nursing home and to explore staffs’ experiences of ethical issues.Methods:Using a systematic (...) approach based on Aveyard (2014), a literature review was conducted which focused on ethical and moral issues, nurses and nursing assistants, and the nursing home.Findings:The most salient themes identified in the review included clashing ethical principles, issues related to communication, lack of resources and quality of care provision. The review also identified solutions for overcoming the ethical issues that were identified and revealed the definitional challenges that permeate this area of work.Conclusions:The review highlighted a need for improved ethics education for care-providers. (shrink)

Late in 1990, the Center for the Study of Ethics in the Professions at Illinois Institute of Technology (lIT) received a grant of more than $200,000 from the National Science Foundation to try a campus-wide approach to integrating professional ethics into its technical curriculum.! Enough has now been accomplished to draw some tentative conclusions. I am the grant's principal investigator. In this paper, I shall describe what we at lIT did, what we learned, and what others, especially philosophers, can learn (...) from us. We set out to develop an approach that others could profitably adopt. I believe that we succeeded. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

The line in question occurs towards the end of Orestes' final exchange with Clytemnestra, after her attempts at self-defence have all met with rebuttal.

The line in question occurs towards the end of Orestes' final exchange with Clytemnestra, after her attempts at self-defence have all met with rebuttal.

Ethics, Policy & Environment, Volume 15, Issue 1, Page 71-76, March 2012.

We argue that the common attribution to Zhuangzi of both perspectivalism or relativism on the one hand, and scepticism on the other is fundamentally mistaken. While granting that it is reasonable to construe Zhuangzi as offering a perspectiva! position on judgement, we argue that Zhuangzi's perspectivalism does not commit him to a relativist position on truth or to scepticism about human knowledge. Rather, we maintain that Zhuangzi's attacks on the concepts of truth and knowledge are better seen as his articulation (...) of a species of epistemological nihilism which rejects, as ultimately meaningless, the concepts of truth, reality, and knowledge. (shrink)

This passage, which appears without variation at the end of four of Euripides' tragedies and with slight variation in a fifth,1 is perhaps the most notorious of the brief sequences of lines, usually anapaestic and usually assigned to the chorus, with which nearly all the extant plays of Sophocles and Euripides conclude.2 Unlike the more varied final speeches of extant Aeschylean tragedy, which are closely integrated with the play's concluding action, these passages often seem almost detachable from such action, a (...) comment upon or merely after finished business rather than a part of its finishing. In some instances there is general scholarly agreement that the concluding lines are relevant to the action of a play, but many of these passages have been variously dismissed by scholars - as interpolations, as mere dramatic conveniences, or as intentional throwaways. (shrink)

This classic collection of essays, first published in 1968, represents H.L.A. Hart's landmark contribution to the philosophy of criminal responsibility and punishment. Unavailable for ten years, this new edition reproduces the original text, adding a new critical introduction by John Gardner, a leading contemporary criminal law theorist.

The idea of public or stakeholder engagement in governance of science and technology is widely accepted in many policy and academic research settings. However, this enthusiasm for stakeholder engagement has not necessarily resulted in changes of attitudes toward the role of stakeholders in the dialogue nor to the value of public knowledge, practical experience, and other inputs (like salient questions) vis-à-vis expert knowledge. The formal systems of evaluation of the stakeholder engagement activities are often focused on showing that the method (...) is efficient and works. In this article, we argue that every stakeholder engagement process should be evaluated beyond a simple assessment of the methodology and that the wider context of the stakeholder engagement activity should also be addressed. We evaluate two different stakeholder engagement activities against the existing method evaluation criteria and demonstrate their limitations for assessing the quality of a stakeholder engagement. We argue that these criteria need to be extended so that engagement processes will have a chance to improve not only policies but also their democratic legitimacy. (shrink)

A representation is a remnant of previous experience that allows that experience to affect later behavior. This paper develops a metatheoretical view of representation and applies it to issues concerning representation in animals. To describe a representational system one must specify the following: thedomainor range of situations in the represented world to which the system applies; thecontentor set of features encoded and preserved by the system; thecodeor transformational rules relating features of the representation to the corresponding features of the represented (...) world; themedium, or the representation's physical instantiation; and thedynamics, or how the system changes with time. In part because of the behaviorist assumption that the hypothetical, covert changes occurring in an organism during learning correspond to the overt physical changes that are observed, issues of representation in animal behavior have been largely ignored as irrelevant or misleading. However, it can be inferred that representations, acting as models of environmental regularities, operate at many levels of behavioral functioning, both cognitive and noncognitive. Objections to the use of this concept in explanations of animal behavior, based on the claim that it is indeterminate and on behaviorist considerations of parsimony, can be answered. Animal representations may be specialized in terms of tasks and species. Data from tasks involving spatial memory, delayed matching-to-sample, and sequence learning suggest some foundations for a general theory of animal representations. (shrink)

In his introduction to these closely linked essays Professor Hart offers both an exposition and a critical assessment of some central issues in jurisprudence and political theory. Some of the essays touch on themes to which little attention has been paid, such as Bentham's identification of the forms of mysitification protecting the law from criticism; his relation to Beccaria; and his conversion to democratic radicalism and a passionate admiration for the United States.

This incisive book deals with the use of the criminal law to enforce morality, in particular sexual morality, a subject of particular interest and importance since the publication of the Wolfenden Report in 1957. Professor Hart first considers John Stuart Mill's famous declaration: "The only purpose for which power can be rightfully exercised over any member of a civilized community is to prevent harm to others." During the last hundred years this doctrine has twice been sharply challenged by two great (...) lawyers: Sir James Fitzjames Stephen, the great Victorian judge and historian of the common law, and Lord Devlin, who both argue that the use of the criminal law to enforce morality is justified. The author examines their arguments in some detail, and sets out to demonstrate that they fail to recognize distinction of vital importance for legal and political theory, and that they espouse a conception of the function of legal punishment that few would now share. (shrink)

Zhuangzi often is portrayed as a kind of ethical relativist. This popular reading has been challenged by Philip Ivanhoe, who argues that Zhuangzi is not a relativist but rather that Zhuangzi articulates a normative theory of benignity. In this paper we argue against Ivanhoe’s interpretation. We further argue that Zhuangzi is an ethical nihilist, who rejects all ethical positions.