Terms such as ‘cultural competence’ and ‘transcultural nursing’ have comfortably taken their place in the lexicon of health care. Their high profile is a reflection of the diversity of western societies and health care’s commitment to provide care that is responsive to the values and beliefs of all who require treatment. However, the relationship between cultural competence and familiar ethical concepts such as patient autonomy has been an uneasy one. This article explores the moral foundations of cultural competence, ultimately locating (...) them in patient autonomy and patient good. The discussion of patient good raises questions about the moral relevance of a value’s rootedness in a particular culture. I argue that the moral justification for honoring cultural values has more to do with the fact that patients are strongly committed to them than it does with their cultural rootedness. Finally, I suggest an organizational approach to cultural competence that emphasizes overall organizational preparedness. (shrink)

Due to the enormous disparity of power in the child welfare professional-client relationship, a high level of trust is necessary for this relationship to achieve its intended benefits, including protecting, caring for, terminating parental rights to, and finding appropriate adoptive homes for, abused and neglected children. This paper first defines conflicts of interest as necessarily including the exercise of judgment, and then argues that contractual relationships between private child welfare agencies and public departments of child welfare often betray their fiduciary (...) responsibilities through conflicts of interest inherent in these contracts, particularly as regarding incentives for and against finding permanent homes for abused and neglected children. Finally, I propose an evidence-based strategy to ameliorate conflicts of interest when making permanent placement decisions for foster children. (shrink)

In the case of an intellectually disabled patient, the attending physician was restricted from writing a Do-Not-Resuscitate (DNR) order. Although the rationale for this restriction was to protect the patient from an inappropriate quality of life judgment, it resulted in a worse death than the patient would have experienced had he not been disabled. Such restrictions that are intended to protect intellectually disabled patients may violate their right to equal treatment and to a dignified death.

Through the analysis of forty ethical dilemmas drawn from real-life situations, _Ethics in Action_ guides the reader through a process of moral deliberation that leads to the resolution of a variety of moral dilemmas. Fosters critical thinking by evaluating the reasons people give to support their choices and actions Challenges the paradigm of moral relativism that often impedes efforts to resolve moral dilemmas Incorporates international perspectives often lacking in texts published for a U.S. audience.

The issue of advocacy has dominated discussion of the ethical dilemmas facing nurses. However, despite this, nurses seem to be no further towards a solution of how they can be effective advocates for patients without compromising their working identity or facing conflicts of loyalty. This article considers some of the problems around advocacy and, by the use of critical incidents written by nurses involved in a diploma module, attempts to highlight where the problem could lie. A communications model is outlined, (...) using a theoretical framework taken from the work of Jürgen Habermas, and applied to nursing practice. Finally, two examples are given from the research, which illustrate how the model could be used, highlighting the problems and pitfalls that still have to be overcome. The conclusion is a positive one, in that it suggests that advocacy is possible if nurses re-examine their practice in the light of the model proposed.Copyright of Nursing Ethics is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (shrink)

Kant’s remark that the first Kritik should be read as a treatise on method rather than a system of doctrine lends support to recent forays against his theory of proof, for the comment promotes the mistaken supposition that his method can be studied independently of his commitments in ontology and other areas. Irony infects the criticisms in question because they set transcendental logic against a standard that Kant repudiates. The point will be illustrated by showing how Kant anticipates and blunts (...) a strong attack against his position on method. (shrink)

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Why do we watch and like horror films? Despite a century of horror film-making and en-tertainment, little research has examined the human motivation to watch fictional horror and how horror film influences individuals’ behavioural, cognitive and emotional re-sponses. This review provides the first synthesis of the empirical literature on the psy-chology of horror film using multi-disciplinary research from psychology, psychotherapy, communication studies, development studies, clinical psychology, and media studies. The paper considers the motivations for people’s decision to watch horror, why (...) people enjoy horror, how individual differences influence responses to, and preference for, hor-ror film, how exposure to horror film changes behaviour, how horror film is designed to achieve its effects, why we fear and why we fear specific classes of stimuli, and how lik-ing for horror develops during childhood and adolescence. The literature suggests that (1) low empathy and fearfulness are associated with more enjoyment and desire to watch horror film but that specific dimensions of empathy are better predictors of people’s re-sponses than are others; (2) there is a positive relationship between sensation-seeking and horror enjoyment/preference but this relationship is not consistent; (3) men and boys prefer to watch, enjoy and seek our horror more than do women and girls; (4) women are more prone to disgust sensitivity or anxiety than are men and this may mediate the sex difference in the enjoyment of horror; (5) younger children are afraid of symbolic stimuli whereas older children become afraid of concrete or realistic stimuli; (6) in terms of coping with horror, physical coping strategies are more successful in younger children; priming with information about the feared object reduces fear and increases children’s enjoyment of frightening television and film. A number of limitations in the literature are identified, including the multifarious range of horror stimuli used in studies, disparities in methods, small sample sizes, and a lack of research on cross-cultural differences and similarities. Ideas for future research are explored. (shrink)