This article addresses how health professionals should monitor and safeguard their patients’ ability to participate in making clinical decisions and making subsequent decisions regarding the implementation of their treatment plan. Patient participation in clinical decision-making is essential, e.g. in self-care, where patients are responsible for most ongoing care. We argue that one common, fact-oriented patient education strategy may in practice easily tend to take a destructive form that we call error trawling. Illustrating with empirical findings from a video study of (...) consultations between clinicians and adolescent patients with diabetes, we argue on independent grounds that this strategy not only risks to overlook significant weaknesses in patient decision competence, but also to undermine patient capacity for decision-making and implementing care. In effect, this strategy for clinically monitoring and addressing the problem of fragile decision-making capacity brings hazards in need of address. We clo... (shrink)

This article argues that standard models of person-centred care (PCC) and shared decision making (SDM) rely on simplistic, often unrealistic assumptions of patient capacities that entail that PCC/SDM might have detrimental effects in many applications. We suggest a complementary PCC/SDM approach to ensure that patients are able to execute rational decisions taken jointly with care professionals when performing self-care. Illustrated by concrete examples from a study of adolescent diabetes care, we suggest a combination of moral and psychological considerations to support (...) the claim that standard PCC/SDM threatens to systematically undermine its own goals. This threat is due to a tension between the ethical requirements of SDM in ideal circumstances and more long-term needs actualized by the context of self-care handled by patients with limited capacities for taking responsibility and adhere to their own rational decisions. To improve this situation, we suggest a counseling, self-care, adherence approach to PCC/SDM, where more attention is given to how treatment goals are internalized by patients, how patients perceive choice situations, and what emotional feedback patients are given. This focus may involve less of a concentration on autonomous and rational clinical decision making otherwise stressed in standard PCC/SDM advocacy. (shrink)

In recent years there has been an increasing awareness that a comprehensive understanding of language, cognitive and affective processes, and social and interpersonal phenomena cannot be achieved without understanding the ways these processes are grounded in bodily states. The term ‘embodiment’ captures the common denominator of these developments, which come from several disciplinary perspectives ranging from neuroscience, cognitive science, social psychology, and affective sciences. For the first time, this volume brings together these varied developments under one umbrella and furnishes a (...) comprehensive overview of this intellectual movement in the cognitive-behavioral sciences. (shrink)

Responsibility is a moral quality of caring that is central to child health policies. In contemporary UK these policies are based on behavioural psychology and underpinned by individualism, an ideology central to neoliberal governance. Amid the complexities of “obesity” and inequalities, there is a multi-layered stigmatisation of parents as moral associates. Few studies consider the lived realities of food policy processes from the standpoint of class. This critical qualitative research draws on theorists who explain processes of power and class: Foucault, (...) Gramsci, Bourdieu and Marx. Its objectives are: (a) to understand the lived experience of parents as they interact with food policy; (b) to explore how parents resist stigmatisation; and (c) to reflect on implications for policy and practice. Methods: Using purposive sampling, 31 ethnographically-informed interviews were carried out in a London borough, with policy actors: policymakers, implementers and parents as policy recipients, including 12 working-class mothers. Results: A core theme of “responsibilities” emerged with four interconnecting sub-processes that provide insight into how stigmatisation and resistance evolve through policy. Discussion: As have others, this study reveals the idea of responsibility as fundamental to the processes of soft power. Child health is a priority for participants and a “ruling idea”. The diffusion of responsibility throughout policy leads to confusion about where it lies. New subjectivities are formed in line with ideas of governmentality. Parents engage with policy at multiple sites that elicit symbolic violence, and stigma sows social divisions. Against this background, working-class parents are left in a state of cognitive dissonance between being made responsible (responsibilisation), and feeling responsible (self-blaming) for their children’s weight while lacking the material resources to provide an optimal nutritious diet. Resistance is interwoven and is essentially found in parents’ policy alternatives that diverge from UK government policy. Conclusion: Critical qualitative research using multiple theorists is valuable in understanding how parents interact with policy in a complex social world. With UK policy failing, useful insights are provided into how involving parents in policymaking might determine a meaningful collective responsibility, with a political ethic of care and unity between parents that would advance health equity. (shrink)

Name der Zeitschrift: Kant-Studien Jahrgang: 106 Heft: 4 Seiten: 717-721.

Emotion events are undoubtedly socially constructed and emerge in interactions that take place in relationships; they are dynamic and situated in social-cultural contexts as Boiger and Mesquita (2012) argue. However, such constructions evolve within important limiting conditions set to human functioning. Our understanding of how emotional events are constructed can only be complete by assigning a central role to body, brain, and the social-physical conditions in the construction process, since these are critical constraints to human functioning.

It is argued that the multilayered model offered by the shared circuits model (SCM) falls short of capturing an essential aspect of social cognition, namely, its distributed nature. The SCM therefore falls short of modeling emergent social cognition and behavior.

Chapter 1 Introduction Jennifer Gunning and S0ren Holm Ethics as a discipline has begun to escape the theoretical domains of philosophy and to pervade many ...

Tracing the short film as an alternative to the more familiar feature film, Gunning moves from the shorter films of early cinema to the avant-garde films of Peter Kubelka, discussing Maya Deren’s concept of vertical time and Kubelka’s idea of ecstasy. The claim is made that time in short films can be very different from the time in narrative films, not simply briefer.

Biographical verse work illustrating Jaina ethics and morality; includes translation in Hindi.