Opportunities for practical, hospital-based training in those skills demanded by clinical ethics consultation (CEC) have been limited. Given the number of individuals who provide part-time CEC, greater access to condensed, practical training such as the clinical ethics immersion course offered by the Washington Hospital Center, is necessary.Two participants in the initial cohort evaluate their CE training at a busy, urban referral center, exploring prior expectations, perceptions of its utility and suggestions for improvement. Such training will prove valuable not only (...) for bioethicists who lack practical CEC experience “at the bedside” but also for ethics consultants whose ethics services have a low consult volume who wish to sharpen their skills. (shrink)

Urban and agricultural communities are interdependent but often differ on approaches for improving water quality impaired by nutrient runoff waterbodies worldwide. Current water quality governance involves an overlapping array of policy tools implemented by governments, civil society organizations, and corporate supply chains. The choice of regulatory and voluntary tools is likely to influence many dimensions of the relationship between urban and agricultural actors. These relationships then influence future conditions for collective decision-making since many actors participate for multiple years (...) in water quality improvement. In this policy analysis, we draw on our professional experiences and research, as well as academic and practitioner literatures, to investigate how different types of water quality interventions influence urban-agricultural relationships, specifically examining policy tools on a regulatory to voluntary spectrum. Interactions between farmers and other rural agricultural interests on one hand, and urban residents and their stormwater managers and wastewater treatment plants on the other, influence dynamics relevant for water quality improvement. We suggest that the selection of policy tools within complex governance contexts influence urban–agricultural relationships through financial exchange, political coalitions, knowledge exchange, interpersonal relationships, and shared sense of place. Policy tools that provide a means to build relationships and engage with people’s emotions and identities have potential to influence personal and community change and adaptive capacity, while processes such as lawsuits can catalyze structural change. Engaging these relationships is particularly critical given the need to move out of polarized positions to solve collective problems. (shrink)

In the past decade, significant social movements emerged in South Africa, in response to specific urban challenges of injustice or exclusion. This article will interrogate the meaning of such urban social movements for theological education and the church. Departing from a firm conviction that such movements are irruptions of the poor, in the way described by Gustavo Gutierrez and others, and that movements of liberation residing with, or in a commitment to, the poor, should be the locus (...) of our theological reflection, this article suggests that there is much to be gained from the praxis of urban social movements, in disrupting, informing and shaping the praxis of both theological education and the church. I will give special consideration to Ndifuna Ukwazi and the Reclaim the City campaign in Cape Town, the Social Justice Coalition in Cape Town, and Abahlali baseMjondolo based in Durban, considering these as some of the most important and exciting examples of liberatory praxes in South Africa today. I argue that theological education and educators, and a church committed to the Jesus who came ‘to liberate the oppressed’, ignore these irruptions of the Spirit at our own peril. (shrink)

This article sets out to describe how churches have responded and continue to respond to fast-changing urban environments in Pretoria Central and Mamelodi East, animating Henri Lefebvre’s sociological perspective of citadins or urban inhabitants. We make tentative interpretations and offer critical appreciation. Churches, which were historically separated from the city centre, now directly participate in claiming a right to the city. With necessary fluidity, churches express lived African urbanisms through informality, place-making, spatial innovation and everyday rituals. Though not (...) exhaustive, the article focuses on rituals shared among historic urban Christians and contemporary African urban Christians, namely prayer, listening to the Bible and worship. These rituals, when combined with the churches’ spatial innovation, to a certain degree contribute to place-making. (shrink)

Name der Zeitschrift: Neue Zeitschrift für Systematische Theologie und Religionsphilosophie Jahrgang: 57 Heft: 3 Seiten: 342-367.

The legacy of apartheid spatial planning can still be seen in the dynamics of spaces in South Africa today. The elite (according to research is racialised and mostly white people) lives in well-located city areas, close to economic activity and rule social life that defines cities as stated in 2016 by the Socio Economic Rights Institute of South Africa (SERI). Alternatively, mostly black South Africans are confined to urban margins in densified and poorly serviced areas, with low rates of (...) home ownership. The effects of these policies extend beyond the urban nature, as spaces on the margin by design tend to have fewer opportunities for education compared to urban areas, and there are spatial limits to black business ownership. This article seeks to discuss a case study on a church’s use of space during coronavirus disease 2019 (COVID-19), to show an inclusionary spatial dynamic that may be used in South African spaces. Firstly, it presents an overview of the unequal spatial dynamics in South Africa, particularly Cape Town, and dynamics during COVID-19. Secondly, it provides a historical overview of the Church of the Nazarene and its foundational beliefs. Moreover, it discusses a case study of renewed spatial dynamic in church using the Church of the Nazarene in Khayelitsha. Furthermore, the case study will be used to show the innovative way they reached their community during this time. The final part will discuss how this inclusive spatial dynamic reveals an innovative dynamic in the concept of the missional church, one that goes beyond the going out contextually, but allowing the outside in as well. Contribution: This article discusses the new spatial dynamic of the missional church which inspires inclusivity. The article uses literature around space, COVID-19, mission studies and church history. Furthermore, a semi-structured interview with a church leader at the Church of the Nazarene in Khayelitsha is used for a contextual case study. (shrink)

After describing the challenges, myths, exclusions and opportunities of urban regeneration, this article explores the potential interface between faith-based action and different forms of urban regeneration. Focusing on different South African cities, it considers how faith-based action could participate in regenerative urban work. Faith-based action will refer to the varied responses of churches and faith-based organisations to urban challenges and transitions. It interrogates whether faith-based action only represents many similar approaches that address urban problems superficially (...) without mediating long-term, systemic change, or whether it indeed contributes to urban transformation in the sense of radical inclusivity and socio-structural spatial justice. Finally, it considers socio-theological sources that could potentially ground urban faith-based action theologically – such as an urban spirituality, an understanding of regeneration as integral liberation and mobilising socio-spiritual capital – whilst making a distinctive contribution to the processes of socially inclusive urban regeneration. (shrink)

This article demonstrates how white Christianity in urban South Africa is fated by demographic change. The repeal of apartheid in 1994 enacted some sociocultural changes in urban South Africa. The white population exited the city and town centres, followed by the black South Africans. The historical relationship of the government under the National Party (NP) and the Dutch Reformed Church (DRC) led to latters’ redundancy in the cities. The cultural development towards multiculturalism led to polycentric focus where (...) the suburban peripheries and the city centres experience some form of socio- and cultural-economic developments. Two proposals are made to redress the situation. Firstly, a rethinking was suggested of the theology of the city, which should always demonstrate solidarity with the poor and the marginalised trapped within the decadent city culture. Secondly, a missiological refocus was suggested, which should pursue, embrace and include activities that are not paternalistic. (shrink)

The church-funded CARFO or KARFO (Afrikaans Christian Filmmaking Organisation) was established in 1947, and aimed to ‘[socialise] the newly urbanized Afrikaner into a Christian urban society’ (Tomaselli 1985:25; Paleker 2009:45). This initiative was supported and sustained by the Dutch Reformed Church (DRC), which had itself been part of the sociopolitical and ideological fabric of Afrikaans religious life for a while and would guide Afrikaners through tensions between religious conservatism and liberalism and into apartheid. Given Afrikaans cinema’s ties (...) with Christian religious and political conservatism, we explore the role – even the centrality – of the Afrikaans church in cultural activity before 1994, and then after 1994. Here, Afrikaans church is an inclusive term that brings together various denominations of Afrikaans-speaking churches, but which mainly suggests the domination of the DRC. After establishing the role of the Afrikaans church in the way described above, we move towards the primary focus of our study: exploring the representation of clergy in the contemporary Afrikaans film Faan se Trein in order to describe certain theological implications of this representation. With reference to Faan se Trein, our article notes and comments on the shifts that have occurred in clergy representation in Afrikaans cinema over the past decades. Osmer’s four tasks of practical theology, namely, descriptive, interpretive, normative and strategic are used for theological reflection. With due contextual reference to Afrikaans film dramas such as Broer Matie [Brother Matie], Saak van Geloof [A Matter of Faith], Roepman [Stargazer], Stilte [Silence], Suiderkruis [Southern Cross] and Faan se Trein, we arrive at some preliminary conclusions about the representation of clergy in mainly contemporary Afrikaans cinema. (shrink)

Starting mostly with the second half of the 20th century, the churches and the religious communities are facing the challenges raised by the process of secularization, which is considered by some sociologists of religion as irreversible. The most affected ones were / are the traditional churches and the most obvious area where this phenomenon has become very visible is the Western Europe. This study aims to analyze the situation of the traditional churches in Romania, with a special focus on the (...) Greek-Catholic Church, from the same perspective: the impact of post-modernity over a church which is very much orientated towards the West, which is becoming more and more urban and is still passing through a complicated process of structuring and transition. The study underlines the fact that one of the answers to the problems raised by the process of secularization is based on the way in which the ecclesiastical community is built and on how deep is the consciousness of the confessional identity rooted in the mind and the soul of the believers. (shrink)

Urban cities in the sub-Saharan Africa have witnessed unprecedented transformation because of the proliferation of religious orders within the social landscape. From Nigeria, Ghana and Cameroon to Uganda, religious practitioners are actively involved in the spatial transformation through the construction of sacred spaces or prayer camps. The Redeemed Christian Church of God (RCCG) typifies one of the several examples of African Pentecostal denominations with transnational status in 200 countries across the world with the hub of its international office (...) situated at the Redemption Camp, Mowe, Nigeria. The sacralisation of forest areas spanning 1600 ha of land has redefined religious institutions such as RCCG as perhaps one of the largest owners of private estate in Nigeria. However, there seems to be an intentional replication of the Redemption Camp, Mowe across Nigeria as well as across the Atlantic as part of the RCCG missionary enterprise. This study aims to utilise the ethnography of the Redemption Camps in Nigeria and Floyd, Texas, United States. The theoretical framework of social worlds is employed to examine the dynamics of religious creativity, innovations, contextual challenges of place-making involved in creating Redemption Camps across borders by the leadership of RCCG through the appropriation of religious capital of its community of sentiments. (shrink)

This book examines the relationship between race, religion, and economics within the black church. The book features unheard voices of individuals experiencing economic deprivation and the faith communities who serve as their refuge. Thus, this project examines the economic ethics of black churches in the rural South whose congregants and broader communities have long struggled amidst persistent poverty. Through a case study of communities in Alabama's Black Belt, this book argues that if the economic ethic of the Black (...) class='Hi'>Church remains accommodationist, it will continue to become increasingly irrelevant to communities that experience persistent poverty. Despite its historic role in combatting racial oppression and social injustice, the Church has also perpetuated ideologies that uncritically justify unjust social structures. Wilson shows how the Church can shift the conversation and reality of poverty by moving from a legacy of accommodationism and toward a legacy of empoweri ng liberating economic ethics. (shrink)

In this article, we are exploring a methodological approach to research on faith and religious expressions in urban Africa. We are committed to trans-disciplinary work that pursues research methods mutually liberating for researchers, co-researchers and community participants and that results in long-term benefits and strengthened agency on the part of the host communities. Our reflections in this article are based on a collaborative research project1 in two regions of Pretoria, Tshwane2 – Pretoria Central and Mamelodi East – in which (...) we explore how religious innovation and competition in and amongst churches contribute to the healing or perpetuation of urban fractures. (shrink)

Robustness properties of three equality of variances tests, the jackknife procedure, the k-sample Box-Andersen test, and Levene’s z test, were investigated and compared in a Monte Carlo study employing small samples from underlying gamma distributions and gamma mixtures. Overall, the jackknife test yielded rejection proportions usually closer to nominal levels under departures from normality, but the Box-Andersen test performed relatively well when departures from normality were not extreme. Four recommendations regarding testing variances were offered.

This volume began as a remembrance of Alonzo Church while he was still with us and is now finally complete. It contains papers by many well-known scholars, most of whom have been directly influenced by Church's own work. Often the emphasis is on foundational issues in logic, mathematics, computation, and philosophy - as was the case with Church's contributions, now universally recognized as having been of profound fundamental significance in those areas. The volume will be of interest (...) to logicians, computer scientists, philosophers, and linguists. The contributions concern classical first-order logic, higher-order logic, non-classical theories of implication, set theories with universal sets, the logical and semantical paradoxes, the lambda-calculus, especially as it is used in computation, philosophical issues about meaning and ontology in the abstract sciences and in natural language, and much else. The material will be accessible to specialists in these areas and to advanced graduate students in the respective fields. (shrink)

The purpose of the study is to reveal the influence of articles about the spontaneous renewal of icons and church domes on the formation of the concept of a miracle among the population of Ukraine on the basis of publications in the Ukrainian press of the early 20s of the XX century. The scientific novelty of the study lies in the fact that for the first time a layer of poorly accessible newspaper publications was analyzed, on the basis of (...) which it was established what information background was formed around rumors about miracles that occurred in 1920-1925, and how it could influence the emergence of the corresponding narratives. As a result, it was revealed that stories about miracles in Ukraine during this period were characteristic of both rural and urban environments, and affected almost all layers of society, including the emergence of a stratum of the population that ironically laughed at miracles. It is shown that miracles very quickly entered into everyday reality, and they ceased to see supernatural features. Concrete examples demonstrate that miracles in this period increasingly began to be left to the mercy of science and technology. (shrink)

South Africa in which we are living is characterised by unparalleled social and political change and apparently enormous differences of option. However, there is one aspect of our society that most of us would probably agree about and that is the decline of morality in our cities. Apart from the economic and political crisis, and the erosion of the core competence to actually get things done in the municipalities, South Africa is an ailing society with disturbing pathologies in terms of (...) indiscipline, violence, rape, assault, fraud and a failure to accept personal accountability for the high levels of crime, corruption, xenophobic attacks, gender-based violence and disintegration of families. The main aim of this study is to outline the profile of moral decay in the South African urban community and to define the calling of the Church towards moral regeneration. The conclusion arrived at is that there are definite signs of moral degeneration over a wide sphere of human endeavour in South African urban community, and that the church has a particular role to play as a driving agent for moral renewal.Contribution: Whilst there are many postive things brought by urbanisation in our cities, however, moral decay in our South African cities is one of the biggest threats to South Africa’s hard earned, freedom and democracy and merits closer attention. This study in ethics joins the voices of those people who are propagating moral regeneration in our times. (shrink)

Already in the thirteenth and fourteenth centuries, the Minorite and Dominican orders (or Poor Clares and Dominican women) played an important role in town building in terms of religion and social ties, as well as in architecture and urban development. In the late fifteenth and sixteenth centuries, the Franciscan Order became important in the same urban environment, contributing with other monasteries to shaping the changing religiosity. This article studies the relationship of Mendicants’ priories – both male and female (...) – to their urban milieux, for which these orders’ monasteries are typical. The area of interest, however, is not the monastic church but the chapter house and the cloister. Despite the presumed rules of enclosure, a lay public can also be envisioned in these spaces, enabling the study of a partial interconnection between the “outer” secular and the “inner” sacred monastic worlds. A combined historical, art historical, archaeological, and anthropological analysis furthers understanding of the conditions under which these interconnections developed. Urban “artistic” and memorial presentations in the monastic context can be traced, along with activities organized in both the cloister (e.g., funerals and processions) and the chapter house, which also served for other types of lay gatherings (e.g., court or guild chapel). (shrink)

The city of Puebla was put on the UNESCO list of Cultural Heritage of Humanity in 1987; its history dates back to the sixteenth century allowing for the preservation of various important buildings, such as churches with baroque and neoclassical facades, buildings from the period known as Novo Hispanics, when some of its historic neighbourhoods were founded, including the Barrio el Refugio, hereinafter referred to as BR, where indigenous people employed in the lime manufacture used to live. Since those times, (...) however, the neighbourhood has become a place with bad reputation, “a den of thieves”. The traditional, religious commemoration, the “Fiesta Patronal de la Virgen del Refugio,” is the most important celebration in the neighbourhood. In the Church of La Virgen del Refugio, built in the seventeenth century after an inhabitant painted a mural with the image of the virgin, the “mañanitas” are sung with the Mariachi. During the patronal feast, the “El Refugio Cultural Festival” is held with more than a hundred artists taking part and creating about a thousand murals according to the organiser’s estimation. This happens in the city where a project “Puebla Ciudad Mural” was started, as an initiative of the “Colectivo Tomate,” which sought to regenerate the neighbourhood through art, in alliance with the government and private companies. However, these policies are more tourist oriented rather than benefit the neighbourhood. For this reason, the graffiti movement “Festival Cultural el Refugio” is becoming a meeting point for urban artists from Mexico and Puebla, accustomed to taking up public or private space, as they demand space where they can live and express themselves. For ten years the festival has realised more than one thousand pieces of urban art, including Wild Style graffiti, bombs, stickers, stencil, and murals. All this is done under the patronage of the artists themselves, as three hundred of them come from all over the country to take part in every edition of the festival that does not receive any government support or other form of sponsorship. (shrink)

Im Transit ist eine subjektorientierte Analyse von Transnationalisierungsprozessen in der Wissenschaft.In dieser exploariven Studie werden das Lehr- und Lernsetting eines außergewöhnlichen Rahmen-Experiments zur Transnationalisierung der ...

Frogtown is a discerning portrait of an ethnically mixed neighbourhood that lies within the shadow of the Minnesota State Capital near downtown St. Paul. Wing Young Huie combines 130 compelling black-and-white photographs, some 50 quotes from talks with residents, and his own commentary to produce a powerful depiction of life on Frogtown's streets and front porches, in its kitchens and backyards, shops and churches. The images are documentary in nature, but the perspective is that of an artist who leaves meanings (...) open to interpretation. Drawn to Frogtown by his own abiding curiosity, Huie spent two years photographing and getting to know its people -- working class whites, Southeast Asian immigrants, African Americans, American Indians, and Latinos. These exquisitely rendered images of Frogtown show the multiple realities that make up a dynamic urban neighbourhood. At the same time, they reflect the changing faces of American cities. (shrink)

When pandemics hit communities, women are bound to suffer as most of the responsibilities of ensuring food security lie on them. This article assesses the impact of the COVID-19 pandemic on the role that church-going women play in food provision. The qualitative study used interviews and focus group discussions to examine the toll of the pandemic-induced restrictions, especially with regard to their disruption of activities that ensure the provision of food for the family. They sought to identify how an (...) environment as restrictive as the one that was imposed during the COVID-19 pandemic affects those largely responsible for food provision in urban Marondera – the women, in this case. The focus was extended to factor in how disasters and pandemics affect women and detract from their normative food procurement and provision roles in marginal societies and how these effects can be mitigated to allow women to carry on with their roles even in restrictive environments. This research was motivated by the recent COVID-19-imposed regulations that restricted the movement of people, restrictions that have only recently been relaxed and (in some cases) removed. We also sought to establish how gender roles are played out, together with whether they are exacerbated by pandemics, and in what ways these pandemics result in higher workloads on women. By utilising the Africana womanist theory, the study analysed women roles in food provision and food security in their societies within the restrictive environments of the pandemics.Contribution: This study concluded that there are gender inequalities that are exacerbated by these pandemics that result in higher workloads for women. It foregrounded how existing gender inequalities were exacerbated by the pandemic, resulting in higher workloads on women. It therefore recommended that women should form empowerment groups to help focus attention on food provision to mitigate challenges women face in this role. Finally, we averred that there ought to be consultation and participation of women on issues to do with pandemics to allow for their full and productive participation in critical roles of providing food. (shrink)

In The Decline and Fall of the Catholic Church in America, the sociologist David Carlin offers insightful explanations for why Catholicism began to unravel in the 1960s. Facing the aftershocks of Vatican II, the collapse of their cohesive urban neighborhoods, and the onslaught of the cultural revolution, American Catholics experienced a “perfect storm” from which they have yet to recover. Carlin sees little reason for optimism about the future. Among other things, he notes thebishops’ “appallingly poor” handling of (...) the sex abuse scandal and their tolerance of homosexuality in the seminaries. While agreeing with mostof Carlin’s analysis, this reviewer is more optimistic about the future prospects of the Church in America. (shrink)

Leadership development is an ongoing need in Africa. Good leadership is key to the building of any society. This article is written from the perspective of someone who lives in an African community of poverty. As he or she observes the many problems the African continent faces, he or she wonders about the role of the church to participate in seeking solutions to these problems. The article stresses that effective leadership development should equip people to be participants of the (...) flourishing of their communities. It discusses the theological and missiological foundations of leadership as avenues to align leadership formation with the improvement of the quality of life of Africans living in communities of poverty. The researcher belongs to a missional community which focuses on discipling local residents, with the hope of nurturing agency from inside out. He uses the autoethnographic methodology to describe this case study of his missional community efforts. (shrink)

Approaching the subject from an interdisciplinary point of view, in the present article I will suggest an interpretation of several capitals in the Romanesque church at the monastery of San Martín de Frómista in light of the urban revolts at the beginning of the twelfth century in León-Castile. I will also claim a later chronology for the church, whose construction frequently has been located in the second half of the eleventh century. A document making reference to the (...) construction of the monastery of Frómista is dated 1066; it states that an ample donation of land was included along with a subordinate neighborhood of townspeople. Through an architectural and iconographic analysis of the building and the close reading of a narrative source, the so-called Primera crónica anónima de Sahagún , I will propose that the church of San Martín was constructed around 1120, after the subordination of the monastery to Cluny two years earlier. (shrink)

This article discusses the foundation ceremony of the church of Sant’Ignazio di Loyola in Rome, the new chapel of the Collegio Romano. The ceremony was held in the Collegio’s existing smaller chapel, dedicated to the Annunziata, in 1626. The ceremony was led by the sponsor of the new church, Cardinal Ludovico Ludovisi, the nephew of the late Pope Gregory XV and one of the greatest art collectors of his time. The extraordinary apparato of the foundation ceremony focussed on (...) the personifications of a wide range of artistic disciplines that exalted the patronage of Cardinal Ludovisi, as described in an anonymous contemporary pamphlet entitled Ragguaglio della solennita. It was an exercise in self-promotion and a failed attempt by Cardinal Ludovisi to regain some of the power he lost when Urban VIII succeeded his uncle as pope in 1623. The article will reconstruct the iconography of the apparato in relation to the texts on a set of commemorative medals, copies of which were deposited in the foundations and distributed among the attendees and reproductions of which were included in the apparato. (shrink)

In this era of suburban mega-churches and televised Sunday morning services, it is easy to forget that many Americans worship in small, community churches whose sanctuaries are often repurposed commercial spaces. In Articles of Faith, photographer Dave Jordano documents the at once humble and dynamic storefront churches of Chicago’s African American neighborhoods. These churches, which dot the south and west sides of the city, are truly community churches—individualized and idiosyncratic, they cater to the specific needs and wants of their members. (...) For the last five years, Jordano has spent his weekends traveling to different churches in the city, getting to know their pastors and parishioners. And this attention to personal detail is highly evident in his exquisite photographs that capture the identity and personalities of each church, from the hand-lettered signs to the icons. His interior images of the sacred spaces illustrate how the congregants create a comforting environment of affirmation, hope, and family for members who often live in neighborhoods marked by high crime and troubled homes. Infused in the space of these makeshift churches is also a sense of history that traces back to a time in the nineteenth and early twentieth centuries when one of the only forms of open expression available to African Americans was religious practice. These powerful and reverent images illuminate a vital component of urban life for many African Americans and speak to the links between the past and present African American experience. (shrink)

Many psychiatric disorders involve problems with the recognition and preservation of personal boundaries. Philosophy can help to clarify what is at stake, both socially and phenomenologically, in drawing such boundaries. In particular, assignments of responsibility and determinations of loss are deeply implicated in the determination of personal boundaries. Understanding these implications can help make sense of the volatile emotions of borderline personality disorder, for example, and it can clarify what is missing from DSM descriptions more generally.

Context: Philosophical and - more recently - empirical approaches to the study of mind have recognized the research of lived experience as crucial for the understanding of their subject matter. Such research is faced with self-referentiality: every attempt at examining the experience seems to change the experience in question. This so-called “excavation fallacy” has been taken by many to undermine the possibility of first-person inquiry as a form of scientific practice. Problem: What is the epistemic character and value of reflectively (...) acquired phenomenological data? Can the study of experience, despite the excavation fallacy, rely on the act of reflection on lived experience and make sense and use of its results? Method: Through a philosophical discourse, informed by empirical first-person inquiry, we explore the experiential structure of the act of reflection and the formation of the corresponding belief about past experience. Results: We present a provisional first-person model of the experiential dynamics of retrospective reflection, in which the reflective act is characterized as enaction of belief about past experience that co-determines - rather than distorts - its results. From a constructivist perspective on the inevitable interdependence between the act of observing and the observed, the excavation “fallacy” is recognized as an intrinsic characteristic of reflection. Reflection is described as an iterative, self-referential process, guided by a context- and subject-specific horizon of expectations. Implications: Knowing the characteristics of the formation of beliefs about experience is essential for understanding first-person data and for the possibility of their acquisition and use in scientific practice, particularly in the context of second-person approaches to the study of experience. Constructivist content: We relate the proposed understanding of reflection to constructivist epistemology and argue that constructivism provides an epistemological foundation for the empirical study of experience more suitable than the traditional epistemological objectivism of cognitive science. We suggest that the constructive nature of the process of reflection calls for a collaboration between the fields of constructivism, phenomenology, and first-person research, and points towards the potential for their mutual enrichment. (shrink)

Background: Informal coercion, that is, situations where caregivers use subtle coercive measures to impose their will on patients, is common in adult psychiatric inpatient care. It has been described as ‘a necessary evil’, confronting nurses with an ethical dilemma where they need to balance between a wish to do good, and the risk of violating patients’ dignity and autonomy. Aim: To describe nurses’ experiences of being involved in informal coercion in adult psychiatric inpatient care. Research design: The study has a (...) qualitative, inductive design. Participants and research context: Semi-structured interviews with 10 Swedish psychiatric nurses were analysed with qualitative content analysis. Ethical considerations: The study was performed in accordance with the Declaration of Helsinki. In line with the Swedish Ethical Review Act, it was also subject to ethical procedures at the university. Findings: Four domains comprise informal coercion as a process over time. These domains contain 11 categories focusing on different experiences involved in the process: Striving to connect, involving others, adjusting to the caring culture, dealing with laws, justifying coercion, waiting for the patient, persuading the patient, negotiating with the patient, using professional power, scrutinizing one’s actions and learning together. Discussion: Informal coercion is associated with moral stress as nurses might find themselves torn between a wish to do good for the patient, general practices and ‘house rules’ in the caring culture. In addition, nurses need to be aware of the asymmetry of the caring relationship, in order to avoid compliance becoming a consequence of patients subordinating to nurse power, rather than a result of mutual understanding. Reflections are thus necessary through the process to promote mutual learning and to avoid violations of patients’ dignity and autonomy. Conclusion: If there is a need for coercion, that is, if the coercion is found to be an ‘unpleasant good’, rather than ‘necessary evil’ considering the consequences for the patient, it should be subject to reflecting and learning together with the patient. (shrink)