The main objective of this study is to eliminate the obstacles that the stylistic, structural, and methodological aspects of the text place in the way of reading and understanding Ludwig Wittgenstein's later work. The characteristic features of these elements are developed and discussed in the context of a close reading of the short section on reading in the Philosophical Investigations. Wittgenstein's aim in this section is the negative one of completely undermining explanatory accounts of the meaning of reading in terms (...) of mental states, experiences, or neurophysiological functions of the brain. In this respect the section on reading forms a clearing ground and a propaedeutic to Wittgenstein's conception of understanding as a rule-following activity. ;The signature of Wittgenstein's style is characterized by a dialogic terseness, an economy of expressions manifest in the brevity of numbered remarks, and a number of strategically indirect rhetorical devices. The structure of the text is shown to be discontinuous and multidirectional. The textual organization forms an overlapping and complex network that mirrors the complexity and multifaceted structure of language. The discontinuity easily inhibits following Wittgenstein's thought, and results in a judgment and dismissal of the text as being fragmented, frayed, and thus lacking structure. ;Wittgenstein's method is contrasted to the application of the scientific method to solving philosophical problems and to the phenomenological method of examining experiences. The argument for the existence of a method at all consists in focussing on and developing three methodological principles: recalling the course of philosophical nonsense; reminding ourselves of what we already know; and arranging and rearranging what already lies open to view. ;Bringing philosophical problems to an end by exposing them as pseudo-problems that often are caused by the forms of our expressions, is reached by an Ubersicht, an overview, of the multiple facets of language. Such an overview is gained by an application of Wittingenstein's method. An analysis of the section on reading in terms of its philosophical purpose and point illuminates the complex interplay of the methodological aspects, the unconventional structure of the text, and the profile of Wittgenstein's unique philosophical style. (shrink)

Background On a daily basis, healthcare professionals deal with various ethical issues and it can be difficult to determine how to act best. Clinical ethics support (CES) has been developed to provide support for healthcare professionals dealing with complex ethical issues. A long-term perspective of participating in inter-professional dialogue and reflective-based CES sessions is seemingly sparse in the literature. Research aim The aim was to describe experiences of impact of Inter-professional Ethics Communication in groups (IEC) based on Habermas’ theory of (...) communicative actions, after 6 months from the perspective of an inter-professional team. Research design A qualitative inductive approach was chosen, and individual interviews ( n = 13) were conducted. Interview data were analysed using qualitative content analysis. Participants The participants, 10 females and two males, represented assistant nurses, registered nurses, physicians, occupational therapists, physiotherapists, welfare officers and psychologists. Each had attended at least four IEC sessions. Ethical considerations The study was approved by the Regional Ethical Review Board in Umeå, Sweden, and it has been undertaken in accordance with the Helsinki Declaration. Findings Overall, the descriptions expressed a perceived achievement of a deepened and integrated ethical awareness that increased the participants’ awareness of ethically difficult situations as well as their own ethical thinking, actions and approaches in daily work. Perspectives were shared and the team become more welded. They carried the memories of the reflections within them, which was perceived as supportive when encountered new ethically situations. Discussion Putting words to unarticulated thoughts may stimulate repeated reflections, leading to new insights and alternative thoughts. Conclusion The outcome of IEC sessions 6 months following the last session can be described as an incorporated knowledge that enables actions in ethically difficult situations based on an ethical awareness both at a ‘We-level’ and an ‘I-level’. (shrink)

Discussion about a dignified death has almost exclusively been applied to palliative care and people dying of cancer. As populations are getting older in the western world and living with chronic illnesses affecting their everyday lives, it is relevant to broaden the definition of palliative care to include other groups of people. The aim of the study was to explore the views on dignity at the end of life of 12 elderly people living in two nursing homes in Sweden. A (...) hermeneutic approach was used to interpret the material, which was gathered during semi-structured interviews. A total of 39 interviews were transcribed. The analysis revealed three themes: (1) the unrecognizable body; (2) fragility and dependency; and (3) inner strength and a sense of coherence. (shrink)

The aim of the present study was to describe variations in patient participation in decisions about care planning during the final phase of life for a group of gravely ill patients, and how the different actors’ manner of acting promotes or impedes patient participation. Thirty-seven qualitative research interviews were conducted with relatives of the patients. The patients’ participation in the decisions could be categorized into four variations: self-determination, co-determination, delegation and nonparticipation. The manner in which patients, relatives and caregivers acted (...) differed in the respective variations; this seemed either to promote or to impede the patients’ opportunities of participating in the decision making. The possibility for participation seems to be context dependent and affected by many factors such as the dying patient’s personality, the social network, the availability of different forms of care, cultural values, and the extent to which nurses and other caregivers of the different forms of care can and want to support the wishes of the patients and relatives in the decision-making process. (shrink)

The aim of the present study was to describe variations in patient participation in decisions about care planning during the final phase of life for a group of gravely ill patients, and how the different actors’ manner of acting promotes or impedes patient participation. Thirty-seven qualitative research interviews were conducted with relatives of the patients. The patients’ participation in the decisions could be categorized into four variations: self-determination, co-determination, delegation and nonparticipation. The manner in which patients, relatives and caregivers acted (...) differed in the respective variations; this seemed either to promote or to impede the patients’ opportunities of participating in the decision making. The possibility for participation seems to be context dependent and affected by many factors such as the dying patient’s personality, the social network, the availability of different forms of care, cultural values, and the extent to which nurses and other caregivers of the different forms of care can and want to support the wishes of the patients and relatives in the decision-making process. (shrink)

Dignity, usually considered an essential ethical value in healthcare, is a relatively complex, multifaceted concept. However, healthcare professionals often have only a vague idea of what it means to respect dignity when providing care, especially for persons with impaired autonomy. This article focuses on two concepts of dignity, human dignity and dignity of identity, and aims to analyse how these concepts can be applied in the care for persons with impaired autonomy and in furthering the practice of respect and protection (...) from harm. Three vignettes were designed to illustrate typical caring situations involving patients with mild to severely impaired autonomy, including patients with cognitive impairments. In situations like these, there is a risk of the patient’s dignity being disrespected and violated. The vignettes were then analysed with respect to the two concepts of dignity to find out whether this approach can illuminate what is at stake in these situations and to provide an understanding of which measures could safeguard the dignity of these patients. The analysis showed that there are profound ethical challenges in the daily care of persons with impaired autonomy. We suggest that these two concepts of human dignity could help guide healthcare professionals to develop practical skills in person-centred, ethically grounded care, where the patient’s wishes and needs are the starting point. (shrink)

This article provides a deeper understanding of how meaning can be created in everyday life at a nursing home. It is based on a primary study concerning dignity involving 12 older people living in two nursing homes in Sweden. A secondary analysis was carried out on data obtained from three of the primary participants interviewed over a period of time (18—24 months), with a total of 12 interviews carried out using an inductive hermeneutic approach. The study reveals that sources of (...) meaning were created by having a sense of: physical capability, cognitive capability, being needed, and belonging. Meaning was created through inner dialogue, communication and relationships with others. A second finding is that the experience of meaning can sometimes be hard to realize. (shrink)

Today, societal decisions in areas of complexity are often dominated by one of three alternative ways: (a) by scientists, nowadays often in combination with commercial interest; (b) by politicians alone; and (c) by simply “laissez-faire,” or “the tyranny of small steps.” None of these three ways of decision making is fully democratic because they do not create enough awareness among the politicians and the general public. One reason is that the decision making basis becomes too narrowly framed and fragmented. Biotechnology (...) will continue to feed society with new democratic challenges for many years, perhaps decades, to come. The initially promising ideas of participative and deliberative democracy do not seem to solve the awareness problem. Instead, the authors propose an approach with more structured efforts for awareness building with transparency and participation taking place within the framework of representative democracy. (shrink)

The patient’s home is a common setting for palliative care. This means that we need to understand current palliative care philosophy and how its goals can be realized in home‐care nursing encounters (HCNEs) between the nurse, patient and patient’s relatives. The existing research on this topic describes both a negative and a positive perspective. There has, however, been a reliance on interview and descriptive methods in this context. The aim of this study was to explore planned HCNEs in palliative care. (...) The design was a multiple case study based on observations. The analysis includes a descriptive and an explanation building phase. The results show that planned palliative HCNEs can be described as a process of co‐creating possibilities for the patient to reach vital goals through shared knowledge in a warm and caring atmosphere, based on good caring relations. However, in some HCNEs, co‐creation did not occur: Wishes and needs were discouraged or made impossible and vital goals were not reached for the patients or their relatives. Further research is needed to understand why. The co‐creative process presented in this article can be seen as a concretization of the palliative care ideal of working with a person‐centered approach. (shrink)

Increasing rates of psychiatric problems like depression and anxiety among Swedish youth, predominantly among females, are considered a serious public mental health concern. Multiple studies confirm that psychological as well as existential vulnerability manifest in different ways for youths in Sweden. This multi-method study aimed at assessing existential worldview function by three factors: 1) existential worldview, 2) ontological security, and 3) self-concept, attempting to identify possible protective and risk factors for mental ill-health among female youths at risk for depression and (...) anxiety. The sample comprised ten females on the waiting list at an outpatient psychotherapy clinic for teens and young adults. Results indicated that both functional and dysfunctional factors related to mental health were present, where the quality and availability of significant interpersonal relations seemed to have an important influence. Examples of both an impaired worldview function and a lack of an operating existential worldview were found. Psychotherapeutic implications are discussed. (shrink)

This research project investigated manifestations of critical thinking in pupils 10 to 12 years of age during their group discussions held in the context of Philosophy for Children Adapted to Mathematics. The objective of the research project was to examine, through the pupils' discussions, the development of dialogical critical thinking processes. The research was conducted during an entire school year. The research method was based on the Grounded Theory approach; the material used consisted of transcripts of verbal exchanges among the (...) pupils. Analysis of the transcripts revealed that: critical thinking appears to the extent that a 'dia-logue' is established among pupils; on the cognitive level, dialogical critical thinking is comprised of four thinking modes: logical, creative, responsible and meta-cognitive; and on the epistemological level, dialogical critical thinking is only manifested in a context where egocentricity of perspective and relativism of beliefs are transcended. (shrink)

_The Cultural Politics of Queer Theory in Education Research_ represents the editors’ intention to disrupt cycles of thinking about the place of queer theory in educational research. The book aims to encourage dialogue about the objects and subjects of queer research, the forms of politics incited by the use of queer theory in education, and the methodological approaches used by scholars when queering. The contributions to this book come from those who find queer theory problematic, as well as from those (...) who continue to see a productive place for queer research in education, however that may be defined. The editors have collected contributions that attend to the boundaries that are placed around queer research in education by researchers themselves, and by peers, ethics committees, funding bodies and university and government bureaucracies. Considering how key researchers in gender and education identify with, or deliberately distance themselves from, queer theory, this collection grapples with the contemporary cultural politics of doing queer theoretical work in different education spaces and places. In short, it seeks to disrupt what people think they already know about the ‘place’ of queer theory in education. This book was originally published as a special issue of _Discourse: Studies in the Cultural Politics of Education. _. (shrink)

Packed with ideas designed to help children learn to sing, this booklet offers criteria for selecting songs, strategies to bring out the best in children's voices, and suggestions for games, ideas, and resources.

Within the rarefied world of art collecting, connoisseurship signifies esoteric knowledge used to judge the quality, exclusivity, desirability and even authenticity of art. As this collection of essays demonstrates, however, connoisseurship is not confined to the art world but rather practised in a variety of settings by elites and consumers alike. This volume presents a fresh approach to connoisseurship, creating a broad international dialogue about its meaning and application. It ranges across such diverse fields as consumer history, sociology and ethnography, (...) earth science, forensic science and art history. It demonstrates that connoisseurship can be both intuitive and scientific, utilizing comparison and tied to measures of value and market dynamics. (shrink)

The amount of data available to healthcare practitioners is growing, and the rapid increase in available patient data is becoming a problem for healthcare practitioners, as they are often unable to fully survey and process the data relevant for the treatment or care of a patient. Consequently, there are currently several efforts to develop systems that can aid healthcare practitioners with reading and processing patient data and, in this way, provide them with a better foundation for decision-making about the treatment (...) and care of patients. There are also efforts to develop algorithms that provide suggestions for such decisions. However, the development of these systems and algorithms raises several concerns related to the privacy of patients, the patient–practitioner relationship, and the autonomy of healthcare practitioners. The aim of this article is to provide a foundation for understanding the ethical challenges related to the development of a specific form of data-processing systems, namely clinical algorithms. (shrink)

Pandemics first and foremost hit those who are most vulnerable, and the COVID-19 pandemic is not different. Although the infection rate in the nation’s poorest neighborhoods is twice as it is in th...

RATIONALE, AIM AND OBJECTIVE: Factors influencing doctors in prescribing of drugs have mostly been studied in primary care. Studies performed in hospital care have primarily focused on new drugs, not prescribing in general. An in-depth understanding of the prescribing process in the more specialized secondary care is not only important for secondary care itself, but because it also influences prescribing in primary care. The aim of this study is therefore to identify factors that secondary care doctors believe influence them in (...) prescribing drugs, using a qualitative approach. (shrink)

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In our target article (Sabatello et al. 2021), we proposed the use of community engagement and the establishment of a Truth and Reconciliation Commission (TRC) as pathways for promoting social just...

The purpose of this research was to understand institutional review board (IRB) challenges regarding youth-focused research submissions and to present advice from administrators. Semistructured self-report questionnaires were sent via e-mail to administrators identified using published lists of universities and hospitals and Internet searches. Of 183 eligible institutions, 49 responded. One half indicated they never granted parental waivers. Among those considering waivers, decision factors included research risks, survey content, and feasibility. Smoking and substance abuse research among children was generally considered more (...) than minimal risk. These findings are consistent with those from a study conducted by Mammel and Kaplan (1995), which investigated IRB practices concerning protocols involving adolescent participants. IRBs and investigators need to become aware of regulations' flexibility to ensure adequate participant protection. Investigators need to limit jargon and assumptions about participants' understanding of research objectives. (shrink)

On July 18, 1988, workers at the Metropolitan YWCA Women's Services, a Chicago-area center designed to assist women and children who are survivors of violence and sexual assault, agreed to record in a journal their thoughts at a chosen hour during that day. Each section was written by a different worker. The purpose was to bring together separate voices, all connected through their common work with survivors to begin to understand the impact of this work on their own lives.

The ethical conduct of research rests largely on researchers, and as such, an understanding of how they perceive and enact their role in research is paramount. However, the literature around ethics and research mostly focuses on researchers’ perception of Research Ethics Boards roles and functions. To fill that gap, we analyzed the perceptions of researchers, REB members, and influential parties about researchers’ role in the ethical conduct of research through discourse analysis. Three discourses emerged: researchers as reflective practitioners, protectors of (...) participants, and technicians. Understanding the commonalities and differences among the discourses may foster a shared and compelling institutional research culture. (shrink)

Previous research has demonstrated that speakers adapt individual characteristics of speech production to the social context, for example via phonetic convergence. Studies have measured the impact of social dynamics on convergence in typical speakers, but the impact of individual differences is less well-explored. The present study measures phonetic convergence before and after a cooperative interaction with an undergraduate student by comparing teens with a history of autism spectrum disorder (ASD) and with typical development. Results revealed a small temporal convergence effect (...) for typically developing dyads; in contrast, dyads including autistic teens showed no convergence. Furthermore, the degree of convergence was negatively related to severity of ASD symptomatology and atypical sensory profiles. While social and sensory processing abilities may play a role in phonetic convergence, high covariance between these measures makes it difficult to differentiate their contributions in isolation. (shrink)

Shows the relevance of Schiller’s thought for contemporary philosophy, particularly aesthetics, ethics, and politics. This book seeks to draw attention to Friedrich Schiller (1759–1805) as a philosophical thinker in his own right. For too long, his philosophical contribution has been neglected in favor of his much-deserved reputation as a political playwright. The essays in this collection make two arguments. First, Schiller presents a robust philosophical program that can be favorably compared to those of his age, including Rousseau, (...) Kant, Schelling, and Hegel, and he proves to be their equal in his thinking on morality, aesthetics, and politics. Second, Schiller can also guide us in our more contemporary philosophical concerns and approaches, such as phenomenology, hermeneutics, aesthetics, and politics. Here, Schiller instructs us in our engagement with figures such as Walter Benjamin, Michel Foucault, Jacques Rancière, Roberto Esposito, and others. (shrink)