This paper reports four experiments investigating whether model construction of linear reasoning problems is open to strategic decisions. A reversed choice/nochoice paradigm was used in which reasoners first had to apply two model construction strategies (acronym and rehearsal strategy) to two problem sets. Next, they could choose freely among the two strategies to apply to a new problem set. Experiment 1 showed that reasoners selected the strategy that they experienced as the most accurate one in the no-choice phase. Moreover, in (...) Experiment 2, it was found that reasoners adapted their strategy choice to changing problem features, to use the most suitable strategy for premise encoding. Experiments 3 and 4 generalised these findings to more complex linear reasoning problems with a mixed sentence frame and a semi-continuous presentation of the premises, and to two-model problems. On the basis of these results, we argue that strategic decisions influence model construction in linear reasoning. (shrink)
According to the mental models theory, reasoning performance is primarily influenced by the number of models of a problem that can be constructed. This study investigates whether the content of the model may also influence performance. Linear reasoning problems were devised that either described a believable (script-consistent) or an unbelievable (script-inconsistent) order of actions. The results of two experiments showed that conclusions were inferred more slowly and less accurately on the basis of an unbelievable model than on a believable one. (...) Experiment 2 revealed that script knowledge facilitated as well as impeded reasoning performance. Conclusion evaluation was faster and more accurately for script-consistent problems than for neutral problems, whereas model construction and conclusion evaluation occurred respectively more slowly and less accurately for script-inconsistent problems than for neutral problems. These results show that the content of the model is a noteworthy factor influencing reasoning performance. (shrink)
: Discussions of ethical approaches in nursing have been much enlivened in recent years, for instance by new developments in the theory of care. Nevertheless, many ethical concepts in nursing still need to be clarified. The purpose of this contribution is to develop a fundamental ethical view on nursing care considered as moral practice. Three main components are analyzed more deeply--i.e., the caring relationship, caring behavior as the integration of virtue and expert activity, and "good care" as the ultimate goal (...) of nursing practice. For the development of this philosophical-ethical interpretation of nursing, we have mainly drawn on the pioneering work of Anne Bishop and John Scudder, Alasdair MacIntyre, Lawrence Blum, and Louis Janssens. We will also show that the European philosophical background offers some original ideas for this endeavor. (shrink)
: This response to the preceding article by Gastmans, Dierckx de Casterle, and Schotsmans challenges the notion of "good care" as the ultimate goal of nursing practice, explores further the possible goals of nursing and how they may be identified, and presents six elements of professional caring along with their related virtues and moral obligations.
Despite the burgeoning of publications in nursing ethics, only more recently has empirical evidence on nursing ethics been published. How nursing ethics can be empirically studied as well as enriched by empirical data will be the focus of this paper. Two empirical studies will be briefly presented and their contribution to ethics discussed. The first one is a quantitative research project about nurses' ethical behavior in daily practice. Using an adapted version of Kohlberg's theory of moral development, this study tried (...) to describe and explore nurses' responses to ethical dilemmas in daily nursing practice. The second study attempted to describe the specificity of residential palliative care. A qualitative approach was used to explore and describe the processes that take place on an inpatient palliative care unit, and the experiences of patients, relatives and palliative care team members. The analysis of the value of both research projects for ethics underlines the power of empirical understanding in the relationship between research and ethics. The need for integration of both qualitative and quantitative research methodologies is argued. (shrink)
The aim of this study was to explore and describe how Flemish nurses experience their involvement in the care of hospitalized patients with dementia, particularly in relation to artificial nutrition or hydration (ANH). We interviewed 21 hospital nurses who were carefully selected from nine hospitals in different regions of Flanders. ‘Being touched by the vulnerability of the demented patient’ was the central experience of the nurses, having great impact on them professionally as well as personally. This feeling can be described (...) as encompassing the various stages of the care process: the nurses' initial meeting with the vulnerable patient; the intense decision-making process, during which the nurses experienced several intense emotions influenced by supporting or hindering contextual factors; and the final coping process, a time when nurses came to terms with this challenging experience. From our examination of this care process, it is obvious that nurses' involvement in ANH decision-making processes that concern patients with dementia is a difficult and ethically sensitive experience. On the one hand, the feeling of ‘being touched’ can imply strength, as it demonstrates that nurses are willing to provide good care. On the other hand, the feeling of ‘being touched’ can also imply weakness, as it makes nurses vulnerable to moral distress stemming from contextual influences. Therefore, nurses have to be supported as they carry out this ethically sensitive assignment. Practical implications are given. (shrink)
This article describes the findings of a mixed method literature review that examined the perceptions of elderly patients and residents of a good nurse in nursing homes, hospitals and home care. According to elderly patients and residents, good nurses are individuals who have the necessary technical and psychosocial skills to care for patients. They are at their disposal, promptly recognising the patients' needs. Good nurses like their job and are sincere and affectionate. They are understanding and caring. They do not (...) hesitate to enter into a trust-based relationship with their patients. Knowing and understanding how elderly patients and nursing home residents perceive ‘the good nurse’ is crucial for providing quality care and for promoting better patient outcomes in geriatric care. (shrink)
The purpose of this article is to clarify both the role of nurses in ethics meetings and the way in which ethics meetings can function as a catalyst for good nursing care. The thoughts presented are practice based; they arose from our practical experiences as nurses and ethicists with ethics meetings in health care organizations in Belgium. Our reflections are written from the perspective of the nurse in the field who is participating in (inter)professional ethical dialogue. First, the difficulties that (...) nurses experience while participating in ethics meetings are described. Then the possibilities for support of nurses in their ethical responsibility are explored. (shrink)
In literature as well as in nursing practice a growing concern about nurses’ ethical competence can be observed. Based on the cognitive theory of moral development by Kohlberg, this research examined nursing students’ ethical behaviour in five nursing dilemmas. Ethical behaviour refers not only to the ethical reasoning of nursing students but also to the relationship between reasoning and behaviour. Kohlberg’s definition of morality was refined by adding a care perspective. The results show that the majority of students can be (...) located in the fourth moral stage according to Kohlberg’s theory, that is, the conventional level of moral development. This finding implies that students are still guided by professional rules, norms and duties, and have not (yet) succeeded in making personal ethical decisions on the basis of their own principles and acting according to such decisions. (shrink)
The Belgian Act on Euthanasia came into force on 23 September 2002, making Belgium the second country—after the Netherlands—to decriminalize euthanasia under certain due-care conditions. Since then, Belgian nurses have been increasingly involved in euthanasia care. In this paper, we report a qualitative study based on in-depth interviews with 18 nurses from Flanders (the Dutch-speaking part of Belgium) who have had experience in caring for patients requesting euthanasia since May 2002 (the approval of the Act). We found that the care (...) process for patients requesting euthanasia is a complex and dynamic process, consisting of several stages, starting from the period preceding the euthanasia request and ending with the aftercare stage. When asked after the way in which they experience their involvement in the euthanasia care process, all nurses described it as a grave and difficult process, not only on an organizational and practical level, but also on an emotional level. “Intense” is the dominant feeling experienced by nurses. This is compounded by the presence of other feelings such as great concern and responsibility on the one hand, being content in truly helping the patient to die serenely, and doing everything in one’s power to contribute to this; but also feeling unreal and ambivalent on the other hand, because death is arranged. Nurses feel a discrepancy, because although it is a nice death, which happens in dignity and with respect, it is also an unnatural death. The clinical ethical implications of these findings are discussed. (shrink)
In their practice, nurses make daily decisions that are ethically informed. An ethical decision is the result of a complex reasoning process based on knowledge and experience and driven by ethical values. Especially in acute elderly care and more specifically decisions concerning the use of physical restraint require a thoughtful deliberation of the different values at stake. Qualitative evidence concerning nurses’ decision-making in cases of physical restraint provided important insights in the complexity of decision-making as a trajectory. However a nuanced (...) and refined understanding of the reasoning process in terms of ethical values is still lacking. A qualitative interview design, inspired by the Grounded Theory approach, was carried out to explore nurses’ reasoning process in terms of ethical values. We interviewed 21 acute geriatric nurses from 12 hospitals in different regions in Flanders, Belgium in the period October 2009–April 2011. The Qualitative Analysis Guide of Leuven was used to analyse interview data. Nurses’ decision-making is characterized as an ethical deliberation process where different values are identified and where the process of balancing these values forms the essence of ethical deliberation. Ethical decision-making in cases of physical restraint implies that nurses have to choose which values receive priority in the process, which entails that not all values can be respected to the same degree. As a result, decision making can be experienced as difficult, even as a dilemma. Driven by the overwhelming goal of protecting physical integrity, nurses took into account the values of dignity and justice more implicitly and less dominantly. (shrink)
The objective of this article is to show that Hannah Arendt’s understanding of totalitarianism is indebted to the analysis of National Socialism elaborated by Franz Neumann in Behemoth: The Structure and Practice of National Socialism . It is argued that Arendt adopted the central thesis of Neumann according to which Nazi Germany is a ‘non-state’ and that this thesis as well as its presuppositions are discernible in her overall approach, developed in The Origins of Totalitarianism.
When people see a snake, they are likely to activate both affective information (e.g., dangerous) and non-affective information about its ontological category (e.g., animal). According to the Affective Primacy Hypothesis, the affective information has priority, and its activation can precede identification of the ontological category of a stimulus. Alternatively, according to the Cognitive Primacy Hypothesis, perceivers must know what they are looking at before they can make an affective judgment about it. We propose that neither hypothesis holds at all times. (...) Here we show that the relative speed with which affective and non-affective information gets activated by pictures and words depends upon the contexts in which stimuli are processed. Results illustrate that the question of whether affective information has processing priority over ontological information (or vice versa) is ill posed. Rather than seeking to resolve the debate over Cognitive vs. Affective Primacy in favor of one hypothesis or the other, a more productive goal may be to determine the factors that cause affective information to have processing priority in some circumstances and ontological information in others. Our findings support a view of the mind according to which words and pictures activate different neurocognitive representations every time they are processed, the specifics of which are co-determined by the stimuli themselves and the contexts in which they occur. (shrink)
The aim of this article is to take relational ethics concepts and apply them to the context of application to research ethics committees for approval to carry out research. The process of a multinational qualitative research application is described. The article suggests that a relational ethics approach can address two issues: how qualitative proposals are interpreted by research ethics committees and how this safeguards potentially vulnerable respondents. In relational terms, the governance of a research project may be enhanced by shared (...) ownership and willingness to engage in mutual dialogue. This challenges both researchers and research ethics committees to reframe their understanding of roles and functions in the assessment of research protocols, particularly those of a qualitative nature and those that address end-of-life issues. (shrink)
Objectives To describe the form and content of ethics policies on euthanasia in Flemish nursing homes and to determine the possible influence of religious affiliation on policy content. Methods Content analysis of euthanasia policy documents. Results Of the 737 nursing homes we contacted, 612 (83%) completed and returned the questionnaire. Of 92 (15%) nursing homes that reported to have a euthanasia policy, 85 (92%) provided a copy of their policy. Nursing homes applied the euthanasia law with additional palliative procedures and (...) interdisciplinary deliberations. More Catholic nursing homes compared to non-Catholic nursing homes did not permit euthanasia. Policies described several phases of the euthanasia care process as well as involvement of caregivers, patients, and relatives; ethical issues; support for caregivers; reporting; and procedures for handling advance directives. Conclusion Our study revealed that euthanasia requests from patients are seriously considered in euthanasia policies of nursing homes, with great attention for palliative care and interdisciplinary cooperation. (shrink)
The image of “the good nurse” is mainly studied from the perspective of nurses, which often does not match the image held by patients. Therefore, a descriptive study was conducted to examine oncology patients’ perceptions of “the good nurse” and the influence of patient- and context-related variables. A cross-sectional, comparative, descriptive design was used. The sample comprised 557 oncology patients at one of six Flemish hospitals, where they were treated in an oncology day-care unit, oncology hospital ward, or palliative care (...) unit. Data were collected using the Flemish Care-Q instrument. Factor analysis summarised the most important characteristics of “the good nurse”. We reassessed the reliability and construct validity of the Flemish Care-Q and examined the influence of patient- and context-related variables on patient perceptions. Using factor analysis, we grouped the different items of the Flemish Care-Q according to three characteristics: “the good nurse” (I) has a supportive and communicative attitude towards patient and family, (II) is competent and employs a professional attitude, and (III) demonstrates personal involvement towards patient and family. Median factor scores of Factors I, II, and III, respectively, were 8.00, 9.00, and 8.00 (varying from 1, not important, to 10, very important). In order of importance, Factors II, I, and III were identified as valuable characteristics of “the good nurse”. Gender, care setting, and province were influential variables. As perceived by oncology patients, “the good nurse” has a broad range of qualities, of which competence and professionalism are the most valuable. (shrink)
In this paper we examine whether experience with spatial metaphors for time has an influence on people’s representation of time. In particular we ask whether spatiotemporal metaphors can have both chronic and immediate effects on temporal thinking. In Study 1, we examine the prevalence of ego-moving representations for time in Mandarin speakers, English speakers, and Mandarin-English (ME) bilinguals. As predicted by observations in linguistic analyses, we find that Mandarin speakers are less likely to take an ego-moving perspective than are English (...) speakers. Further, we find that ME bilinguals tested in English are less likely to take an ego-moving perspective than are English monolinguals (an effect of L1 on meaning-making in L2), and also that ME bilinguals tested in Mandarin are more likely to take an ego-moving perspective than are Mandarin monolinguals (an effect of L2 on meaning-making in L1). These findings demonstrate that habits of metaphor use in one language can influence temporal reasoning in another language, suggesting the metaphors can have a chronic effect on patterns in thought. In Study 2 we test Mandarin speakers using either horizontal or vertical metaphors in the immediate context of the task. We find that Mandarin speakers are more likely to construct front-back representations of time when understanding front-back metaphors, and more likely to construct up-down representations of time when understanding up-down metaphors. These findings demonstrate that spatiotemporal metaphors can also have an immediate influence on temporal reasoning. Taken together, these findings demonstrate that the metaphors we use to talk about time have both immediate and long-term consequences for how we conceptualize and reason about this fundamental domain of experience. (shrink)
Philosophy should and can contribute to bioethics Content Type Journal Article DOI 10.1007/s11016-010-9476-2 Authors Vicki Langendyk, School of Medicine, University of Western Sydney, Locked Bag 1797, Penrith South DC, NSW 1797, Australia Journal Metascience Online ISSN 1467-9981 Print ISSN 0815-0796.
Dr. Fouts began his lecture with the story of how he and his wife Deborah became involved with Washoe—the first non-human to acquire the signs of American Sign Language (ASL). Project Washoe began in 1966 with Drs. Allen and Beatrix Gardner in Reno, Nevada. There had been other experiments that attempted to get chimpanzees to speak. These experiments were not successful due to anatomical and neurological differences between humans and chimpanzees. (Fouts showed some video of the chimpanzee Vicki trying to (...) say the four words she had learned—mama, papa, up, cup.) Part of the issue is the construction of the chimpanzee’s vocal box while another part of the issue is that chimpanzee vocalizations are tied to their .. (shrink)
In Telling Flesh: the Substance 0f the C0rporeul, Vicki Kirby suggests, among other things, that it is not in the interests of feminism to propound what she describes as an ‘inessentialist’ position in regards to embodiment. While she objects to undifferentiating biological givens that might, for example, attempt to construe women as confined to a nurturing role, she also does not want to simplistically insist that embodiment has nothing to do with subjectivity. To pose the problem in terms more closely (...) aligned with her own, Kirby is wary of the tendency to simply reverse binary oppositions, to swap nature for culture, reality for representation, and originary cause for interpretive effect. According to her, themes like ‘textuality’, and linguistic ideality have all but replaced the notion of ‘reality’. As arguably the pre-eminent ‘continental’ philosopher of our generation, the work of Derrida is invariably associated with this reversal of binary oppositions that seem to prohibit recourse to questions concerning embodiment. Several critics have even suggested that deconstruction is nothing but semiological reductionism in disguise. However, Kirby’s thesis, via an extended meditation upon Derrida’s claim that "there is nothing outside of the text," constitutes an important attempt to redeem him from such criticism. Rather than eschewing any and every reference to the body, she wants to insist that deconstruction cannot be contained within such a framework, and that it makes sense, within the logic of Of Grummutology (and she also pays cursory attention to Derrida’s ""Eating Well," or the Calculation of the Subject"), to conceive of embodiment in deconstructive terms. Examining the coherence of this claim will be the main focus of this paper, though in order to facilitate this task, this paper will also compare the notion of embodiment that Kirby espouses, to a curiously similar conception of the body that Merleau-Ponty theorizes in his unfinished text The Wsible und the Invisible.. (shrink)
This article explores Derrida's suggestion in Of Grammatology that deconstruction might be considered a positive science. The implication here is that ‘no outside of text’ does not evoke an enclosure whose limits can't be breached, an enclosure that discovers human exceptionalism in linguistic and technological capacities. Instead, this sense of a system and its involvements (différance) is already entangled in any ‘atom’ of its expression, whereby ‘no outside of text’ can be read as ‘no outside of Nature’. The logic that (...) informs and justifies the conventional separations between nature and culture, ideation and matter, and human and non-human, are thereby confounded; the dimensions of efficacy, as well as the vexed question of intention appear as non-local (systemic); and the very notion of language – what it is and how it works – is distributed in ways that give rise to the same quandaries that surround the quantum problematic. Indeed, at the end of this meditation the difference between the humanities and the sciences, especially in its current configuration as the impasse of ‘the two cultures’, can no longer be sustained. (shrink)
This study of philanthropy among large Black-owned businesses provides insights into a sector of business giving which has not been studied. Results indicate that philanthropy and ethical justifications play a more important role in minority business enterprises than in non-minority firms studied previously.