Patient centred diagnosis is best practised through shared decision making; an iterative dialogue between doctor and patient, whichrespects a patient’s needs, values, preferences, and circumstances. -/- Shared decision making for diagnostic situations differs fundamentally from that for treatment decisions. This has important implications when considering its practical application. -/- The nature of dialogue should be tailored to the specific diagnostic decision; scenarios with higher stakes or uncertainty usually require more detailed conversations.

The aim of this study was to explore the existence of moral distress among nurses in Lilongwe District of Malawi. Qualitative research was conducted in selected health institutions of Lilongwe District in Malawi to assess knowledge and causes of moral distress among nurses and coping mechanisms and sources of support that are used by morally distressed nurses. Data were collected from a purposive sample of 20 nurses through in-depth interviews using a semi-structured interview guide. Thematic analysis of qualitative data was (...) used. The results show that nurses, irrespective of age, work experience and tribe, experienced moral distress related to patient/nursing care. The major distressing factors were inadequate resources and lack of respect from patients, guardians, peers and bosses. Nurses desire teamwork and ethics committees in their health institutions as a means of controlling and preventing moral distress. There is a need for creation of awareness for nurses to recognize and manage moral distress, thus optimizing their ability to provide quality and uncompromised nursing care. (shrink)

BackgroundThe potential contribution of community engagement to addressing ethical challenges for international biomedical research is well described, but there is relatively little documented experience of community engagement to inform its development in practice. This paper draws on experiences around community engagement and informed consent during a genetic cohort study in Kenya to contribute to understanding the strengths and challenges of community engagement in supporting ethical research practice, focusing on issues of communication, the role of field workers in 'doing ethics' on (...) the ground and the challenges of community consultation.MethodsThe findings are based on action research methods, including analysis of community engagement documentation and the observations of the authors closely involved in their development and implementation. Qualitative and quantitative content analysis has been used for documentation of staff meetings and trainings, a meeting with 24 community leaders, and 40 large public and 70 small community group meetings. Meeting minutes from a purposive sample of six community representative groups have been analysed using a thematic framework approach.ResultsField workers described challenges around misunderstandings about research, perceived pressure for recruitment and challenges in explaining the study. During consultation, leaders expressed support for the study and screening for sickle cell disease. In community meetings, there was a common interpretation of research as medical care. Concerns centred on unfamiliar procedures. After explanations of study procedures to leaders and community members, few questions were asked about export of samples or the archiving of samples for future research.ConclusionsCommunity engagement enabled researchers to take account of staff and community opinions and issues during the study and adapt messages and methods to address emerging ethical challenges. Field workers conducting informed consent faced complex issues and their understanding, attitudes and communication skills were key influences on ethical practice. Community consultation was a challenging concept to put into practice, illustrating the complexity of assessing information needs and levels of deliberation that are appropriate to a given study. (shrink)

The importance of communities in strengthening the ethics of international collaborative research is increasingly highlighted, but there has been much debate about the meaning of the term ‘community’ and its specific normative contribution. We argue that ‘community’ is a contingent concept that plays an important normative role in research through the existence of morally significant interplay between notions of community and individuality. We draw on experience of community engagement in rural Kenya to illustrate two aspects of this interplay: (i) that (...) taking individual informed consent seriously involves understanding and addressing the influence of communities in which individuals’ lives are embedded; (ii) that individual participation can generate risks and benefits for communities as part of the wider implications of research. We further argue that the contingent nature of a community means that defining boundaries is generally a normative process itself, with ethical implications. Community engagement supports the enactment of normative roles; building mutual understanding and trust between researchers and community members have been important goals in Kilifi, requiring a broad range of approaches. Ethical dilemmas are continuously generated as part of these engagement activities, including the risks of perverse outcomes related to existing social relations in communities and conditions of ‘half knowing’ intrinsic to processes of developing new understandings. (shrink)

The purpose of the article is the analysis of the causes of the systemic crisis that hit modern civilization through the description of its main structures, identifying the relationship between its elements, assessments of their heuristic potential. This will open up opportunities for finding ways to resolve this crisis, new directions of civilizational development. Theoretical basis of the research are the systems analysis, socio-philosophical and philosophical-anthropological approaches as well as the analysis of scientific developments in the field of global studies. (...) Originality lies in the fact that this article is the first to show the connection between the main structural elements of human civilization as a system. Change in one of the parameters leads to a change in all the others, together with a change in civilization as a whole. Conclusions. The reason for the deep crisis that hit modern civilization is its imbalance as a system. The most important elements of this system are population size, resources and technology, and the core is consciousness in its individual and collective forms. The perception, processing, and use of information, which is a defining civilizational resource, as well as the stability of the entire system depend on the state of consciousness. Consciousness, based on old, obsolete principles and stereotypes, is unable to cope with the most acute challenges of time. New consciousness, since it is formed, will mark the transition to a new theoretical picture of the world and a model of human behavior, in which people will act, driven by proven knowledge, and not willfulness and prejudice. The idea of forming a productive information environment where the ideas of constructiveness and creative work will dominate rather than consumerism and destruction, as is the case at present, must become the categorical imperative of the new consciousness. (shrink)

The concept of interpretation is applicable to any forms of knowledge, including systems of religious knowledge, designing the ideal model of the subject of religious veneration. The author analyzes the epistemological features of theology as a form of spiritual culture, its formation in ancient culture. It is shown that the epistemological basis for overcoming mythological consciousness was the decentralization of thinking, i.e. development of the ability of consciousness in the construction of the image, the picture of the world to correct (...) the position of the subject, to take into account the relativity of the reference system, from the standpoint of which the subject perceives the object and transforms it into an operational system of thinking. Decentration of thinking provided the overcoming of the subjective mental boundaries of the field, giving the thinking nature of universality. Historical stages and moments of this process - the transformation of mythology into forms of folk art, mythopoetic epic, in the form of religious consciousness. In line with such transformations of archaic consciousness, cultural and historical prerequisites of theology emergence were formed. They are represented in mythopoetic art, ancient mythography, early traditions of critical and rationalistic interpretation of the myth, etc. The article shows the formation of allegorical theology, which became possible in the era of individualization of artistic creativity, when the visible was the difference between the motive and the purpose of activity, creative idea and its embodiment, figuratively-poetic and rationally-conceptual ways of reflecting the world, when the image of reality and its personal meaning began to be realized as different States of consciousness. The main function of any theology is the interpretation of abstract models of the subject of religious veneration. (shrink)

В монографии рассматривается соотношение индивидуальных и универсальных начал в праве как эффективное средство решения многих правовых проблем, как руководство в законодательной и судебной деятельности.

Мета роботи полягає у постметафізичній концептуалізації суб’єкта у клінічному дискурсі філософської антропології. Теоретичний базис дослідження поєднує засоби дискурсивної аналітики і загальні принципи історико-філософської науки. Логіка дослідження збігається із парадигмальним розумінням трансформацій суб’єкта та передбачає перехід від діагностичних стратегій аналізу індивідуального буття як основи патологічності суб’єкта до дослідження терапевтичних моделей концептуалізації комунікації як детермінанти патології та, нарешті, до аналітики суб’єкта в горизонті полісуб’єктної соціальності. Наукова новизна полягає у розкритті основних антропологічних моделей суб’єкта, що відповідають функціям діагностики й терапії. Показано, що, попри (...) революційність певних проектів, що дозволяє їх віднести до постметафізичних, у них залишаються рецидиви метафізичності, які існують в образі суб’єкта, що мислиться як основа справжності. Відповідно до критеріїв практичної імплементації ключовою є трансформація теорій суб’єкта, орієнтованих на самопокладання і автономію, у концепції, сфокусовані на відповідальності, турботі про суще і здійсненні у якості людини. Висновки. Доведено, що образ посткласичного суб’єкта, зосередженого на ідеалі власної автентичності, мусить діагностуватися як патологічний. Показана недоцільність акцентуації виключно на дискурсивності, розмові, результатом якої стає ствердження незалежності внутрішнього, хоч і маргінального світу девіантного суб’єкта. Обґрунтована необхідність доведення проблеми до логіки соціальної взаємодії, у якій виникає та форма смислової організації феноменів, що є нормальною структурою життєвого світу і на основі якої виникає повноцінний суб’єкт із уявленнями про власну самодостатність, і з турботою про суще. (shrink)

The struggle for peace and social progress was and remains a strategic policy of the Soviet state. As the General Secretary of the CPSU Central Committee, M.S. Gorbachev, stated it at the Extraordinary March Plenum of the Central Committee, it is now vital to reach agreement "on an immediate end to the arms race—particularly nuclear arms—on earth and the banning of it in space.".

В монографии проводится системный анализ социальной философия одного из самых значительных отечественных социальных мыслителей Б. Н. Чичерина. Для читателей, интересующихся историей отечественной социально-философской мысли.

t. 1. Ėlementnyĭ sostav -- t. 2. Logika pravovogo issledovanii͡a -- t. 3. Sovremennoe pravoponimanie.

Some are inclined to perceive the liberation of our philosophical thought from the rule of official ideology as a total break with the Marxian tradition of investigating and interpreting historical reality, as the destruction of everything that had been developed and formulated in the mainstream of this tradition. The collapse of the totalitarian system has given rise to a fashion of "criticizing Marx," specializing in exposing theoretical mistakes and miscalculations, demonstrating his scientific bankruptcy, and even searching for evil intentions in (...) his writings. Marx's doctrine is described as false from the beginning, definitively obsolete, and compromised by the experience of its practical application in the twentieth century. (shrink)

Ideas of activity are widely used in the contemporary literature on psychology and methodology. It seems that everyone understands well what is being said. Nevertheless, one can claim that there is a methodological problem in connection with the idea of activity. Various researchers not only interpret activity differently but, what is more important, assess of the place of this category in knowledge differently. From the perspective of some researchers, activity is one way of describing and explaining reality. Others believe that (...) the category of activity presents reality itself, that there is nothing but activity. If we adhere to the former point of view, we can raise the question, for example, of studying certain types of activity, as V.V. Davydov does. (shrink)

This article is devoted to the study of the peculiarities of the functioning of the connection between the brain and the body, the analysis of possible disturbances in the transmission of information impulses from the brain to the body and consideration of the causes of distortion and defects in the implementation of this connection. The specifics of the connection between the brain and the body are considered from the point of view of various areas: neurophysiological, anatomical, psychological. Examples of communication (...) distortion and reasons for incorrect transmission of the reaction are given. An analysis of all possible factors influencing the implementation of the connection under consideration is carried out, various types of violations are listed, and methods for correcting these violations are also presented. The result of this study is the structuring of information about the functioning of the connection between the brain and the body, consideration of all special cases of defectiveness of this connection and an explanation of the reasons for their occurrence. The article will be of practical benefit to specialists in the field of neurobiology. (shrink)

Purpose. The article deals with the problem of mutual perception of individuals, which implies the analysis of the anthropological prerequisites for the study of interpersonal communication. The work emphasizes the need to identify the gnoseological lacuna of the possibility and relevance of knowing someone else’s "I". As well as the need to point out implicit metaphysical attitudes, universal for many worldviews, which are implicitly included in the theory of personal communication. Theoretical basis. The author proceeds from the logical consequences of (...) the evolutionary premise in anthropology. He compares the psychophysical goals of the interpersonal communication task with its ideological theory, monitors the impossibility of the realizing the communication level declared in the consciousness. As an opposite evolutionary premise, the author cites the postulates of the "philosophy of dialogue" by F. Rosenzweig, F. Ebner, M. Buber, and others. The correlation of these philosophical positions reveals the inconsistency of materialistic reduction in anthropology. Originality. The author identifies four levels of communication: background, obstacle, function and dialogue. He represents the rationale for the fact that the first three levels do not need the existence of an individual "I". The first three levels leave the existential "I" unnecessary and therefore unclaimed. The philosophy of dialogue with the Other raises an equally important question about the conditions for the possibility of a metaphysical continuum in ontology, and in turn, suggests the acceptance of a philosophical premise about God as the space of subjectivity in the "I-You" dialogue. Conclusions. Philosophical understanding of the communication of two existential "I" demanded in communication is possible only within the framework of religious discourse. The phenomenal consciousness can enter into communication with a specific other phenomenal consciousness only when there is a metaphysical space between them, allowing for the possibility of communication of such a level. The materialistic conditioning by the human evolutionary needs in all its conceivable forms produces a reduction of the communicative inquiry, which makes the mutual perception of the two "I" impossible. In this psychophysiological anthropological model, there is no space for the possibility of a dialogue of individuals. (shrink)

Man's relation to culture is not limited simply to knowing it. There are other modalities of this relationship. For one, man in some way lives in culture, he exists in it, even if for some time he does notwardrealize this. Second, he participates in one way or another in the process of forming it, he creates it. Only later does culture become an object of knowledge for him. What makes him study and understand culture if previously he had gotten along (...) without it? Why, in general, does knowledge of culture appear? It is necessary to distinguish between the history of culture, the roots of which are in the distant past, and the history of the knowledge of culture, the source of which is man's discovery of culture. Why and when did this discovery occur? (shrink)