This paper discusses a challenge to normative ethics motivated by experimental philosophy. Experimental philosophers object to the perceived “armchair” or a priori nature of philosophy, claiming it should rather be empirical or naturalistic. The paper investigates the application of this claim to normative ethics. Dubbing the application of the experimental philosophers’ contention to normative ethics “the Armchair Claim,” I distinguish descriptive and normative versions of this challenge, and consider their merits as comments on the method of normative ethics (descriptive versions), (...) and as comments on how normative ethics should be done (normative versions). Characterizing normative ethics as essentially involving the use of the method of reflective equilibrium, I show how the versions of the Armchair Claim that I distinguish either misconstrue normative ethics, or are committed to metaethical views that are controversial. To bring home the latter point, I contrast two meta-ethical positions, and show how, on one such view, naturalism, the descriptive version could be correct, whereas on another, intuitionism, it would be false. The normative version, in turn, is consistent with naturalism, but begs the question against the intuitionist since she argues that normative ethics cannot be empirical. The upshot is that a conclusive assessment of the Armchair Claim will have to await the resolution of disputed issues in meta-ethics. However, normative ethicists can get on with their work since reflective equilibrium is unaffected by such debates. (shrink)

We investigated the cognitive structure of emotions in Indonesia and The Netherlands in a series of three studies. Sets of 120 emotion terms were selected based on local ratings of prototypicality for "emotion". With similarity sortings a three-dimensional (evaluation, arousal, dominance) and a four-cluster (positive emotion, sadness, fear, anger) structure was found in each group. Of 50 pairs of translation-equivalent terms, 42 pairs were also found to be cognitively equivalent. With these equivalent terms a good fit of a common cognitive (...) emotion structure was demonstrated in both countries. In a fourth and final study, the location of two social emotions, "shame" and "guilt", in the common structure was found to be closer to "fear" and somewhat further away from "anger" in Indonesia than in the Netherlands. (shrink)

Emotional intelligence can be comprehensively redefined based on the componential emotion approach. The componential emotion approach defines emotions as processes that are elicited by goal-relevant situations and that consist of an interplay between appraisals, action tendencies, bodily reactions, expressions, and feelings. Within the componential emotion approach, emotional intelligence can be redefined as the ability to identify emotions based on information from one or more of the five emotion components, to understand emotions in terms of the likely appraisals, action tendencies, bodily (...) reactions, expressions, and feelings that are elicited by goal-relevant situations, and to know how to regulate emotions by modifying one or more of these five components. (shrink)

In his 1916 preface to Democracy and Education, John Dewey comments that the main goal of his book was “to detect and state the ideas implied in a democratic society and to apply these ideas to the problems and enterprise of education. The discussion includes an indication of the constructive aims and methods of public education as seen from this point of view.”1 More than 100 years later, Sarah M. Stitzlein confirms Dewey’s ideas and expands his scholarship to defend the (...) political legitimacy of public education in the United States. She argues that public schools should enable children to become good citizens who engage in the pursuit of individual happiness, while fighting for social justice. Stitzlein contends... (shrink)

ABSTRACTAppraisal theories of emotion, and particularly the Component Process Model, claim that the different components of the emotion process are essentially driven by the results of cognitive appraisals and that the feeling component constitutes a central integration and representation of these processes. Given the complexity of the proposed architecture, comprehensive experimental tests of these predictions are difficult to perform and to date are lacking. Encouraged by the “lexical sedimentation” hypothesis, here we propose an indirect examination of the compatibility of the (...) theoretical assumptions with the semantic structure of a set of major emotion words as measured in a cross-language and cross-cultural study. Specifically, we performed a secondary analysis of the large-scale data set with ratings of affective features covering all components of the emotion process for 24 emotion words in 27 countries, constituting... (shrink)

The current theoretical paper presents a comprehensive overview of findings from research attempting to understand what happens with expatriates and their families while living abroad. Our paper draws on research on adjustment of individual family members (expatriates, their partners, and children) and families as a whole, across different literatures (e.g., cultural psychology, family psychology, stress literature). The key challenges of expatriation are discussed, as well as family members’ resources. Our findings lead to the following conclusions: First, there is lack of (...) systematic research as studies are either missing a theoretical background or largely neglect the multi-informant approach. A comprehensive theory of expatriate family adjustment integrating multiple theoretical perspectives, including the culture identity formation and the impact of home country and host country culture, is called upon. Second, the majority of studies paid little attention to define the concept of family or failed to take into account the cultural aspect of relocation. Third, there is a call for more longitudinal studies including all family members as adjustment is a process that unfolds over time and therefore cannot be sufficiently explained by cross-sectional studies. Suggestions for future research and practical implications are provided, with a special focus on how families could be assisted during their adjustment process. (shrink)

Little is known about the impact of context on the meaning of emotion words. In the present study, we used a semantic profiling instrument to investigate features representing five emotion components of 11 emotion words in situational contexts involving success or failure. We compared these to the data from an earlier study in which participants evaluated the typicality of features out of context. Profile analyses identified features for which typicality changed as a function of context for all emotion words, except (...) contentment, with appraisal features being most frequently affected. Those context effects occurred for both hypothesised basic and non-basic emotion words. Moreover, both data sets revealed a four-dimensional structure. The four dimensions were largely similar. The results suggest that context may not change the underlying dimensionality but affects facets of the meaning of emotion words. (shrink)

The internal structure of ability emotional intelligence tests at item level has been hardly studied, and if studied often the predicted structure did not show. In the present study, an a priori model for responses to EI ability items using Likert response scales with a Situational Judgement Test format is investigated with confirmatory factor analysis. The model consists of a target EI ability factor, an acquiescence factor, which is a method factor induced by the Likert response scales, and design-based error (...) covariances, which are induced by the SJT format. It is investigated whether this a priori model can account for the observed associations between the raw item responses of the Components of Emotion Understanding Test-24. The CEUT-24 is a new test developed to assess emotion understanding, a key aspect of the EI ability construct, based on the componential emotion framework. The sample consisted of 1184 participants from four European countries speaking four different languages. Findings showed that the a priori model fitted the data well in all four languages. Furthermore, measurement invariance testing gave evidence for a well-fitting configural, metric, and partial scalar invariance model. The conclusion is that within a regular CFA framework using raw observed items responses, method factors can be disentangled from the targeted EI ability factor. (shrink)

There is growing interest in clinical ethics. However, we still have sparse knowledge about what is actually going on in the everyday practice of clinical ethics consultations. This paper introduces a descriptive evaluation tool to present, discuss and compare how clinical ethics case consultations are actually carried out. The tool does not aim to define ‘best practice’. Rather, it facilitates concrete comparisons and evaluative discussions of the role, function, procedures and ideals inherent in clinical ethics case consultation practices. The tool (...) was developed during meetings of the European Clinical Ethics Network. Based on written reports and participation in the network meetings, the development and the content of the tool and the results of its application in presenting and discussing 10 case consultations are summarized. The tool facilitated understanding of the details of clinical ethics case consultations across individuals and institutions with various experiences and cultures, and comparison between various practices. (shrink)

Background: A fair distribution of healthcare services for older patients is an important challenge, but qualitative research exploring clinicians’ consideration in daily clinical prioritisation in healthcare services for the aged is scarce.Objectives: To explore what kind of criteria, values, and other relevant considerations are important in clinical prioritisations in healthcare services for older patients.Design: A semi-structured interview-guide was used to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis and template organising style.Participants: 20 (...) physicians and 25 nurses working in public hospitals and nursing homes in different parts of Norway.Results and interpretations: Important dilemmas relate to under-provision of community care and comprehensive approaches, and over-utilisation of certain specialised services. Overt ageism is generally not reported, but the healthcare services for the aged seem to be inadequate due to more subtle processes, for example, dominating considerations and ideals and operating conditions that do not pay sufficient attention to older patients’ needs and considerations of justice. Clinical prioritisations are described as being dominated by adapting traditional biomedical approaches to the operating conditions. Many of the clinicians indicate that there is a potential for improving end of life decisions and for reducing exaggerated use of life-prolonging treatment and hospitalisations.Conclusion: The interviews in this study indicate that considerations of justice and patients’ perspectives should be given more attention to strike a balance between specialised medical approaches and more general and comprehensive approaches in healthcare services for older patients. (shrink)

Although research has examined factors influencing understanding of informed consent in biomedical and forensic research, less is known about participants' attention to details in consent documents in psychological survey research. The present study used a randomized experimental design and found the majority of participants were unable to recall information from the consent form in both in-person and online formats. Participants were also relatively poor at recognizing important aspects of the consent form including risks to participants and confidentiality procedures. Memory effects (...) and individual difference characteristics also appeared to influence recall and recognition of consent form information. (shrink)

Background: Clinical ethics consultation services have been established in many countries during recent decades. An important task is to discuss concrete clinical cases. However, empirical research observing what is happening during such deliberations is scarce. Objectives: To explore clinical ethics committees’ deliberations and to identify areas for improvement. Design: A pilot study including observations of committees deliberating a paper case, semistructured group interviews, and qualitative analysis of the data. Participants: Nine hospital ethics committees in Norway. Results and interpretations: Key elements (...) of the deliberations included identifying the ethical problems; exploring moral values and principles; clarifying key concepts and relevant legal regulation; exploring medical facts, the patient’s situation, the therapists’ perspective, analogous clinical situations, professional uncertainties, the patient’s and relatives’ perspective, and clinical communication; identifying the involved parties and how to involve them; identifying possible courses of action, and possible conclusion and follow-up. The various elements were closely interwoven. The content and conclusions varied and seemed to be contingent on the committee members’ interpretations, experience and knowledge. Important aspects of a clinical ethics deliberation were sometimes neglected. When the committees used a deliberation procedure and a blackboard, the deliberations tended to become more systematic and transparent. Many of the committees were insecure about how to include the involved parties and how to document the deliberations. Conclusion: Clinical ethics committees may provide an important arena for multidisciplinary discussions of complex clinical ethics challenges. However, this seems to require adequate composition, adoption of transparent deliberation procedures, and targeted training. (shrink)

Background: Although fair distribution of healthcare services for older patients is an important challenge, qualitative research exploring clinicians’ considerations in clinical prioritisation within this field is scarce. Objectives: To explore how clinicians understand their professional role in clinical prioritisations in healthcare services for old patients. Design: A semi-structured interview-guide was employed to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis. Participants: 20 physicians and 25 nurses working in public hospitals and nursing homes (...) in different parts of Norway. Results and interpretations: The clinicians struggle with not being able to attend to the comprehensive needs of older patients, and being unfaithful to professional ideals and expectations. There is a tendency towards lowering the standards and narrowing the role of the clinician. This is done in order to secure the vital needs of the patient, but is at the expense of good practice and holistic role modelling. Increased specialisation, advances and increase in medical interventions, economical incentives, organisational structures, and biomedical paradigms, may all contribute to a narrowing of the clinicians’ role. Conclusion: Distributing healthcare services in a fair way is generally not described as integral to the clinicians’ role in clinical prioritisations. If considerations of justice are not included in clinicians’ role, it is likely that others will shape major parts of their roles and responsibilities in clinical prioritisations. Fair distribution of healthcare services for older patients is possible only if clinicians accept responsibility in these questions. (shrink)

Sexual morality is not keeping up with the new sexual practices of young people, even in cultures oriented toward gender equality. The Norwegian high school graduation celebration constitutes an exceptionally liberal context for sexual practices. Many of the 18-year-old participants in this three-week-long celebration engage in “hookup” activities, involving kissing, fondling, and sexual intercourse. Through an analysis of qualitative interviews with 25 women and 16 men, we argue that while they avoided overt slut-shaming, the morally abject position of the “slut” (...) was still sustained by implication. The young women drew symbolic boundaries against anonymous other women who failed to value safety, hygiene, and self-control. This boundary-work was combined with declarations of tolerance of hookup practices, reflecting a sexually liberal culture geared toward gender equality. That young women who hooked up also drew boundaries against “other” women indicates a lack of alternative gender beliefs that allow young women to positively associate with hooking up. The young men also drew symbolic boundaries in their talk about sex, but enjoyed more freedom in their moral positioning. Although the liberal context was evident, the gendered difference in sexual boundary-work may contribute to the persistence of a sexual double standard among young people. (shrink)

I dette bogkapitel skrevet sammen med Ingeborg Ilkjær fremlægges tre etiske positioner herunder dydsetik, pligtetik og konsekvensetik. Disse teorier er sammen med eksempler på etiske principper og værdier det grundlag, som sygeplejersker kan benytte sig af i arbejdet med patientinvolvering og etiske dilemma, hvor der skal foretages et valg, der har betydning for patienter, pårørrende og de klinisk involverede. -/- For at kunne træffe valg af denne art er det vigtigt at kunne gøre det på et oplyst grundlag samt at (...) kunne påtage sig et klinisk lederskab. Derfor er det nødvendigt at benytte sig af en etisk refleksionsmodel. Dette arbejde kan være med til at skabe klarhed over en given situation, der rummer vanskelige etiske dilemmaer. -/- Bogkapitlet findes i bogen Sygepleje & Patientinvolvering Bind 3 redigeret af Steen Hundborg og udgivet på FADL’s Forlag I 2019. (shrink)

Although we find Gangestad & Simpson's argument intriguing, we question some of its underlying assumptions, including: (1) that fluctuating asymmetry (FA) is consistently heritable; (2) that symmetry is driving the effects; (3) that use of parametric tests with FA is appropriate; and (4) that a short-term mating strategy produces more offspring than a long-term strategy.

Rapid individual cognitive phenotyping holds the potential to revolutionize domains as wide‐ranging as personalized learning, employment practices, and precision psychiatry. Going beyond limitations imposed by traditional lab‐based experiments, new efforts have been underway toward greater ecological validity and participant diversity to capture the full range of individual differences in cognitive abilities and behaviors across the general population. Building on this, we developed Skill Lab, a novel game‐based tool that simultaneously assesses a broad suite of cognitive abilities while providing an engaging (...) narrative. Skill Lab consists of six mini‐games as well as 14 established cognitive ability tasks. Using a popular citizen science platform (N = 10,725), we conducted a comprehensive validation in the wild of a game‐based cognitive assessment suite. Based on the game and validation task data, we constructed reliable models to simultaneously predict eight cognitive abilities based on the users’ in‐game behavior. Follow‐up validation tests revealed that the models can discriminate nuances contained within each separate cognitive ability as well as capture a shared main factor of generalized cognitive ability. Our game‐based measures are five times faster to complete than the equivalent task‐based measures and replicate previous findings on the decline of certain cognitive abilities with age in our large cross‐sectional population sample (N = 6369). Taken together, our results demonstrate the feasibility of rapid in‐the‐wild systematic assessment of cognitive abilities as a promising first step toward population‐scale benchmarking and individualized mental health diagnostics. (shrink)

This article discusses how existential phenomenology may serve as a frame in a mixed‐methods study of changes in weight and body composition among women in adjuvant treatment for breast cancer. In accordance with ontologically and epistemologically fundamental assumptions in nursing, we link mixed‐methods and existential phenomenology from the perspective of the French philosopher Maurice Merleau‐Ponty and his notion of a unified body subject. Letting this perspective permeate our philosophy, methodology and issues at the method level in mixed‐method research undermines the (...) distinction between first‐ and third‐person perspective when applying and integrating different data sources in a mixed‐methods study. Applying Merleau‐Ponty's third way, the women's bodily experiences appear as gestalt; a ‘figure’ against a ground of existential threats that are grasped through insight from data integrating in joint displays, which revealed the women's experiences on a deep existential level. Existential phenomenology as a frame in mixed‐method studies can speak not only to nurses but also to a multidisciplinary audience in a shared attempt to deepen the understanding of a patient's healthcare problem. (shrink)

In this study, we build on a recent social data scientific mapping of Danish environmentalist organizations and activists during the COVID-19 lockdown in order to sketch a distinct genre of digital social research that we dub a quali-quantitative micro-history of ideas in real-time. We define and exemplify this genre by tracing and tracking the single political idea and activist slogan of grøn genstart across Twitter and other public–political domains. Specifically, we achieve our micro-history through an iterative and mutual attuning between (...) computational and netnographic registers and techniques, in ways that contribute to the nascent field of computational anthropology. By documenting the serial ways in and different steps through which our inquiry was continually fed and enhanced by crossing over from ethnographic observation to computational exploration, and vice versa, we offer up our grøn genstart case account as exemplary of wider possibilities in this line of inquiry. In particular, we position the genre of micro-history of ideas in real-time within the increasingly wide and heterogeneous space of digital social research writ large, including its established concerns with ‘big and broad’ social data, the repurposing of computational ‘interface’ techniques for socio-cultural research, as well as diverse aspirations for deploying digital data within novel combinations of qualitative and quantitative methods. (shrink)

Research in which participants report potentially dangerous health-related behaviors raises ethical and professional questions about what to do with that information. Policies and laws regarding reportable behaviors vary across states and Institutional Review Boards (IRB). In alcohol research, IRBs often require researchers to respond to participants who report dangerous drinking practices. Researchers have little guidance regarding how best to respond in such cases. Personalized feedback or general nonpersonalized information may prove differentially effective as a function of gender and/or level of (...) self-determination. This study evaluated response strategies for reducing peak blood alcohol concentration (BAC) among participants reporting dangerous BACs (≥ .35%) in the context of a two-year longitudinal intervention trial with 818 heavy drinking college students. After each assessment, participants who reported drinking to estimated BACs at or greater than .35% were sent either a personalized letter expressing concern and indicating their reported BAC or a nonpersonalized pamphlet that included general information about alcohol and other substances, referral information, and a BAC handout. Hierarchical linear modeling results revealed that both strategies were associated with reduced peak BAC when controlling for previous BAC. The personalized letter was more effective for women and for students who tend to regulate their behavior based on others' expectations and contingencies in the environment. This research provides some guidance for researchers considering appropriate responses to participants who report dangerous health behavior in the context of a research trial. (shrink)

Uncoupling proteins (UCPs) regulate mitochondrial function, and thus cellular metabolism. Angiotensin‐converting enzyme (ACE) is the central component of endocrine and local tissue renin–angiotensin systems (RAS), which also regulate diverse aspects of whole‐body metabolism and mitochondrial function (partly through altering mitochondrial UCP expression). We show that ACE expression also appears to be regulated by mitochondrial UCPs. In genetic analysis of two unrelated populations (healthy young UK men and Scandinavian diabetic patients) serum ACE (sACE) activity was significantly higher amongst UCP3‐55C (rather than (...) T) and UCP2 I (rather than D) allele carriers. RNA interference against UCP2 in human umbilical vein endothelial cells reduced UCP2 mRNA sixfold (P < 0·01) whilst increasing ACE expression within a physiological range (<1·8‐fold at 48 h; P < 0·01). Our findings suggest novel hypotheses. Firstly, cellular feedback regulation may occur between UCPs and ACE. Secondly, cellular UCP regulation of sACE suggests a novel means of crosstalk between (and mutual regulation of) cellular and endocrine metabolism. This might partly explain the reduced risk of developing diabetes and metabolic syndrome with RAS antagonists and offer insight into the origins of cardiovascular disease in which UCPs and ACE both play a role. (shrink)

The aim of the study was to compare the acute effects of traditional resistance training and superset training on training duration, training volume and different perceptive measures. Twenty-nine resistance-trained participants performed a whole-body workout traditionally and as supersets of exercises targeting different muscle groups, in a randomized-crossover design. Each session was separated by 4–7 days, and consisted of eight exercises and three sets to failure. Training duration and number of repetitions lifted were recorded during the sessions. Rate of perceived exertion (...) for effort, rate of perceived exertion for discomfort, session displeasure/pleasure, and exercise enjoyment were measured 15 min after each session. Forty-eight hours after the final session participants reported which session they preferred. The superset session led to significantly higher values for RPE and RPD and tended to be higher for sPDF, i.e., more pleasurable, compared to the traditional session. There was no difference in EES. The traditional session led to significantly increased training volume and lasted 23 min longer than the superset session. Eighteen of the participants preferred the superset session, while 11 preferred the traditional session. In conclusion, performing a whole-body workout as a superset session was more time-efficient, but reduced the training volume and was perceived with greater exertion for effort and discomfort than a traditional workout. (shrink)

Aim: This study explores priority dilemmas in dialysis treatment and care offered elderly patients within the Norwegian public healthcare system.Background: Inadequate healthcare due to advanced age is frequently reported in Norway. The Norwegian guidelines for healthcare priorities state that age alone is not a relevant criterion. However, chronological age, if it affects the risk or effect of medical treatment, can be a legitimate criterion.Method: A qualitative approach is used. Data were collected through semistructured interviews and analysed through hermeneutical content analysis. (...) The informants were five physicians and four nurses from dialysis wards.Findings: Pressing priority dilemmas centre around decision-making concerning withholding and withdrawal of dialysis treatment. Advanced age is rarely an absolute or sole priority criterion. It seems, however, that advanced age appears to be a more subtle criterion in relation with, for example, comorbidity, functional status and cognitive impairment. Nurses primarily prioritise specialised dialysis care and not comprehensive nursing care. The complex needs of elderly patients are therefore often not always met.Conclusions: Clinical priorities should be made more transparent in order to secure legitimate and fair resource allocation in dialysis treatment and care. Difficult decisions concerning withholding or withdrawal of dialysis ought to be openly discussed within the healthcare team as well as with patients and significant others. The biomedical focus and limitations on comprehensive care during dialysis should be debated. (shrink)

Abstract2020 saw the rapid onset of a global pandemic caused by the SARS‐CoV‐2 virus. For healthcare systems worldwide, the pandemic called upon quick organization ensuring treatment and containment measures for the new virus disease. Nurses were seen as constituting a vital instrumental professional component in this study. Due to the pandemic's unpredictable and potentially dangerous nature, nurses have faced unprecedented risks and challenges. Based on interviews and free text comment from a survey, this study explores how ethical challenges related to (...) “being a nurse” during the COVID‐19 pandemic was experienced and understood by Danish hospital‐based nurses. Departing from anthropologist Jarett Zigon's notion of moral breakdown, the study demonstrates how the rapid onset of the pandemic constitutes a moral breakdown raising ethical demands for nurses. Analytically we identify three different ethical demands experienced by the nurses. These ethical demands are Nursing and societal ethical demands, Nursing and personal ethical demands, and Nursing and conflicting ethical demands. These demands represent not only very different understandings of ethical demands but also different understandings of ethical acts that are seen as necessary to respond to these demands. (shrink)

From a cultural-historical perspective, the impairments of a child with a condition like cerebral palsy have biological origins, but the disability evolves from the mismatch between the child and his/her social conditions for development. One example of this dialectical production of disability can be seen in the challenge of the 21st-century welfare state: How to provide economically feasible health and educational services anchored in evidence-based methods and practices. Standardized social service pathways for children with CP illustrates an attempt to address (...) this challenge and moderate the mismatch by acting in the intersection between impairment and society. The aim of the article is to analyze challenges in the practice of connecting research and practice-based knowledge with societal practices in order to diminish the disability of the child. A multidisciplinary group assembled by the Danish National Board of Social Services engaged in a practice of developing a guideline for a social service pathway. Agendas and minutes from their series of meetings provide insight in how the work evolved through conflictual discussions. Rather than a neutral transformation of knowledge into practice, the practice revealed itself as a value-laden process in which the needs of the child and family were at times decentred and the focus shifted to how social services could be realised in complex, structured social practices. While the group managed to overcome several conflicts and agree of a social service pathway, a socio-economic analysis was unable to argue for the comprehensive social service pathway as an economic sound choice for municipal decision-makers. The conflict between the welfare ideology and economic feasibility remains unresolved and can be expected to limit the extent that impairments can be remedied and the mismatch decreased. Overcoming or diminishing the mismatch might never become economic worthwhile. As the political pendulum oscillates between welfare and economic concerns, the experience of disability will likewise diminish or expand. (shrink)

This introduction to the Common Knowledge symposium titled “Comparative Relativism” outlines a variety of intellectual contexts where placing the unlikely companion terms comparison and relativism in conjunction offers analytical purchase. If comparison, in the most general sense, involves the investigation of discrete contexts in order to elucidate their similarities and differences, then relativism, as a tendency, stance, or working method, usually involves the assumption that contexts exhibit, or may exhibit, radically different, incomparable, or incommensurable traits. Comparative studies are required to (...) treat their objects as alike, at least in some crucial respects; relativism indicates the limits of this practice. Jensen argues that this seeming paradox is productive, as he moves across contexts, from Lévi-Strauss's analysis of comparison as an anthropological method to Peter Galison's history of physics, and on to the anthropological, philosophical, and historical examples offered in symposium contributions by Barbara Herrnstein Smith, Eduardo Viveiros de Castro, Marilyn Strathern, and Isabelle Stengers. Comparative relativism is understood by some to imply that relativism comes in various kinds and that these have multiple uses, functions, and effects, varying widely in different personal, historical, and institutional contexts that can be compared and contrasted. Comparative relativism is taken by others to encourage a “comparison of comparisons,” in order to relativize what different peoples—say, Western academics and Amerindian shamans—compare things “for.” Jensen concludes that what is compared and relativized in this symposium are the methods of comparison and relativization themselves. He ventures that the contributors all hope that treating these terms in juxtaposition may allow for new configurations of inquiry. (shrink)

BackgroundAn ethics reflection group is one of a number of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the significance of ERGs in psychiatric and general hospital departments in Denmark.MethodsThis is a qualitative action research study, including systematic text condensation of 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. Short written descriptions of the ethical challenges presented in the ERGs also informed the analysis (...) of significance.ResultsA recurring ethical challenge for clinicians, in a total of 63 cases described and assessed in 3 ethical reflection groups, is to strike a balance between respect for patient autonomy, paternalistic responsibility, professional responsibilities and institutional values. Both in psychiatric and general hospital departments, the study participants report a positive impact of ERG, which can be divided into three categories: 1) Significance for patients, 2) Significance for clinicians, and 3) Significance for ward managers. In wards characterized by short-time patient admissions, the cases assessed were retrospective and the beneficiaries of improved dialogue mainly future patients rather than the patients discussed in the specific ethical challenge presented. In wards with longer admissions, the patients concerned also benefitted from the dialogue in the ERG.ConclusionThis study indicates a positive significance and impact of ERGs; constituting an interdisciplinary learning resource for clinicians, creating significance for themselves, the ward managers and the organization. By introducing specific examples, this study indicates that ERGs have significance for the patients discussed in the specific ethical challenge, but mostly indirectly through learning among clinicians and development of clinical practice. More research is needed to further investigate the impact of ERGs seen from the perspectives of patients and relatives. (shrink)

The aim of this article is to give more insight into what ethical challenges clinicians in mental healthcare experience and discuss with a Clinical Ethics Committee in psychiatry in the Region of Southern Denmark. Ethical considerations are an important part of the daily decision-making processes and thereby for the quality of care in mental healthcare. However, such ethical challenges have been given little systematic attention – both in research and in practices. A qualitative content analysis of 55 written case-reports from (...) the Clinical Ethics Committee. The Committee offers clinicians in mental healthcare structured ethical analyses of ethical challenges and makes a thorough written case-report. The ethical challenges are grouped into three overarching topics: 1. Clinicians and their relation to patients and relatives. 2. Clinicians and institutional aspects of mental healthcare 3. Clinicians and mental healthcare in a wider social context. Through presentation of illustrative examples the complexity of daily clinical life in mental healthcare becomes evident, as well as typical interests, values and arguments. This qualitative study indicates that difficult ethical challenges are an inherent part of mental healthcare that requires time, space and competence to be dealt with adequately. (shrink)

Managing aggression in mental health hospitals is an important and challenging task for clinical nursing staff. A majority of studies focus on the perspective of clinicians, and research mainly depicts aggression by referring to patient-related factors. This qualitative study investigates how aggression is communicated in forensic mental health nursing records. The aim of the study was to gain insight into the discursive practices used by forensic mental health nursing staff when they record observed aggressive incidents. Textual accounts were extracted from (...) the Staff Observation Aggression Scale-Revised (SOAS-R), and Fairclough’s Critical Discourse Analysis was used to identify short narrative entries depicting patients and staffs in typical ways. The narratives contained descriptions of complex interactions between patient and staff that were linked to specific circumstances surrounding the patient. These antecedents, combined with the aggression incident itself, created stereotyping representations of forensic psychiatric patients as deviant, unpredictable and dangerous. Patient and staff identities were continually (re)produced by an automatic response from the staff that was solely focused on the patient’s behavior. Such response might impede implementation of new strategies for managing aggression. (shrink)

Dette kapitel fokuserer på ’etik og patientinddragelse’, men søger med afsæt i devisen ‘sapere aude’ også at skabe interesse for filosofi og etik blandt sygeplejestuderende. Kapitlet er en opfordring til sygeplejestuderende om at betjene sig af egen forstand og finde mod til at filosofere over problematikker i forbindelse med patientinddragelse frem for at falde tilbage i umyndighedens bekvemmelighed og vente på at andre træder til. Kapitlet starter med at se nærmere på, hvordan patientinddragelse italesættes i vor tid efterfulgt af en (...) kort eksposition af to af oplysningstidens vigtigste libera- le filosoffer, herunder pligtetikeren Immanuel Kant og nytteetikeren John Stuart Mill, hvis syn på henholdsvis autonomi og frihed influerer debatten om patientinddragelse. Efterfølgende præsenteres og diskuteres to eksempler, hvor patientinddragelse og etik er i rampelyset. Mere specifikt rettes fokus på 1) etik, patientinddragelse og den psykiatriske patient og 2) etik, patientinddragelse og unge mennesker. Eksemplerne er udvalgte med henblik på at belyse, hvad der kan komme på spil i sundhedsfaglige situationer udspændt mellem individuel frihed, herunder også ideen om autonomi; sygehusvæsenet, inklusive personale, som autoritær vi- dens-institution/aktør og det etiske, herunder ideen om ’det gode’ eller efterstræbelsesværdige. Afslutningsvis argumenteres der for, at sundhedsarbejdere med blik for etik og patientinddragelse kan udgøre en positiv kraft for den inddragede patient, men at det kræver, at denne vover at være vis. Afsnit: Resume Patientinddragelse i vor tid Autonomi, frihed og patientinddragelse Etik, patientinddragelse og den psykiatriske patient Etik, patientinddragelse og den unge Afslutning . (shrink)

De senere år har pleie- og omsorgstjenesten i mange norske kommuner startet med ulike former for etikkarbeid, oftest initiert av KS’ prosjekt “Samarbeid om etisk kompetanseheving”. Hensikten med vår studie var å evaluere innsatsen i de kommunene som deltok i prosjektet fra starten av, med vekt på hvilke tiltak som var iverksatt, hvilke virksomheter dette omfattet, og om tiltakene har fortsatt utover prosjektperioden. Studien har et kvalitativt design. Materialet er hovedsakelig basert på telefonintervjuer med kontaktpersoner for etikksatsingen i 34 kommuner. (...) Det transkriberte materialet er analysert ved kvalitativ innholdsanalyse. Med unntak av fem kommuner som aldri kom i gang med etikkarbeidet, hadde de fleste startet etikkrefleksjon innenfor flere tjenester, oftest i sykehjem og hjemmetjenester. Noen kommuner hadde imidlertid ikke klart å videreføre etikkarbeidet utover en prosjektperiode. Det var stor variasjon både i etikkarbeidets forankring i kommunen, omfang, hyppighet og metoder. Et gjennomgående funn er vektlegging av behovet for etikkkompetanse og oppfølging av dem som skal lede etikkarbeidet. Flertallet av kommunene som fortsatt gjennomfører etikkrefleksjon, tar utgangspunkt i egen praksis, men et mindretall anvender strukturerte metoder. Dersom etikkarbeidet i kommunen skal være levedyktig over tid, bør arbeidet forankres på flere nivåer i organisasjonen, og de som skal lede dette arbeidet, bør få styrket sin kompetanse i etikk og etikkrefleksjon.Nøkkelord: etikk, evaluering, kommunehelsetjenestenEnglish summary: Building ethical competence in Norwegian municipalities: What has been done and what has been sustainable?“Cooperation for building ethics competence” is a national project aimed to stimulate moral reflection and build competence in ethics in community health services in Norway. This article is based on an evaluation of the activities implemented by the first 34 participating municipalities, exploring which measures were implemented, which services and employees were involved, and if the measures are sustainable. The study has a qualitative design, and the data mainly consists of telephone interviews with “key” persons in 34 municipalities. With the exception of five municipalities that never really started ethics work, the majority had implemented ethical reflection in several areas, most often in nursing homes and home care services. There was great variation with regard to the implementation. Many had tried a variety of reflection models, and only a minority of the municipalities were using a structured method of ethical reflection. A consistent finding is the need for more competence; many of those who run ethical reflection are reported to need more competence both in ethics and methods for systematic reflection. There were also great variations in how well the ethics projects were anchored within the municipality. To make ethical interventions sustainable, this study indicates the importance of strong anchoring within the municipality, the need for ethical competence, as well as good methods for structuring ethical reflection. (shrink)

Paul Ricoeur's hermeneutic phenomenology has proved to be very helpful in guiding nursing researchers’ qualitative analysis of interview transcripts. Modifying Ricoeur's philosophy, a number of nursing researchers have developed their own interpretive methods and shared them, along with their experience, with research community. Major contributors who published papers directly presenting their modifications of Ricoeur's theory include Rene Geanellos (2000), Lena Wiklund, Lisbet Lindholm and Unni Å. Lindström (2002), Anders Lindseth and Astrid Norberg (2004) and Pia Sander Dreyer and Birthe D (...) Pedersen (2009). The aim of this article was to delineate differences among these methods. Descriptive presentation of each method side by side makes clear the differences among them. In addition, Ricoeur's hermeneutic theory is portrayed and compared with the modifications. It is believed that differences that are found can stimulate further thoughts on how to apply Ricoeur's theory in qualitative research in nursing. (shrink)