Buddhist ethics on environment protection.

Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts in long-term (...) care of patients in VS/UWS. A qualitative study of transcripts on 2 Moral Deliberations (MD’s) in 2 cases of patients in VS/UWS in long-term care facilities. Six themes emerged: 1) Vision on VS/UWS; 2) Treatment and care plan; 3) Impact on relationships; 4) Feelings/attitude; 5) Communication; 6) Organizational aspects. These themes are related to professionals and to what families had expressed to the professionals. We found conflicts as well as contradictory feelings and thoughts to be a general feature in 4 of these themes, both in professionals and families. Conflicts were found in several actors: within families concerning all 6 themes, in nurse teams concerning the theme treatment and care plan, and between physicians concerning all 6 themes. Different visions, different expectations and hope on recovery, deviating goals and contradictory feelings/thoughts in families and professionals can lead to conflicts over a patient with VS/UWS. Key factors to prevent or solve such conflicts are a carefully established diagnosis, clarity upon visions, uniformity in treatment goals and plans, an open and empathic communication, expertise and understanding the importance of contradictory feelings/thoughts. Management should bridge conflicts and support their staff, by developing expertise, by creating stability and by facilitating medical ethical discourses. Shared compassion for the patient might be a key to gain trust and bridge the differences from non-shared to shared decision making. (shrink)

Researchers have identified the phenomena of moral distress through many studies in Western countries. This research reports the first study of moral distress in Iran. Because of the differences in cultural values and nursing education, nurses working in intensive care units may experience moral distress differently than reported in previous studies. This research used a qualitative method involving semistructured and in-depth interviews of a purposive sample of 31 (28 clinical nurses and 3 nurse educators) individuals to identify the types of (...) moral distress among clinical nurses and nurse educators working in 12 cities in Iran. A content analysis of the data produced four themes to describe the nurses’ moral distress. The four themes were as follows: (a) institutional barriers and constraints; (b) communication problems; (c) futile actions, malpractice, and medical/care errors; (d) inappropriate responsibilities, resources, and competencies. The results demonstrate that moral distress for intensive care unit nurses is different and that the nursing leaders must reduce moral distress among nursing in intensive care. (shrink)

Philosophy, social problems, and global environmental change.

This paper argues that kant's general epistemology incorporates a theory of algebra which entails a less constricted view of kant's philosophy of mathematics than is sometimes given. To extract a plausible theory of algebra from the "critique of pure reason", It is necessary to link kant's doctrine of mathematical construction to the idea of the "schematism". Mathematical construction can be understood to accommodate algebraic symbolism as well as the more familiar spatial configurations of geometry.

The discussion on the phenomenology of life will continue to be crucial to the general outlook and direction of phenomenological investigations. The imp- tance of it is not only the fact that it is an innovation in the philosophical circle, but it is also an effort that contributes to the re-reading of the hitherto ex- gerated differences between phenomenology and metaphysics. What is new and signi?cant about life is that even though it is evident in the?ow of the history of (...) philosophy, no philosopher has seriously addressed it. Not many philosophers have said something in particular about life in serious philoso- ical re?ection. The discussion on life by Henri Bergson attests to this and one 3 can hardly point to other deep re?ections elsewhere about the subject. The advantage here about our area is not only that it has extended the horizon of phenomenological thinking, it has also helped to lead phenomenology from the constitutive analysis to a creative impetus that has brought a new point of view to the?eld, hence raising questions about the general philosophical t- dition from ancient times. This is a reading which my philosophy attempts to investigate about Tymienieckan thought. The emphasis in philosophy till now has been more on reason in its int- lection and pure rational dimension based on the earliest conception of the human person distinguished by rationality. (shrink)

From Aristotle to the present, memory has been grasped as a trace or impression of lost reality – bridging physiological experience and consciousness. Philosophers have vainly sought the nature of this bridge. The present-day physiologizing/naturalizing of consciousness is not resolving their congenital continuity, in which the very existence and practice of life is rooted. We have to change our approach. The Aristotelian congenital ties between memory and temporality, acquire crucial significance in our primogenital ontopoiesis of life. It reveals memory to (...) be the factor that carries this coalescence and the becoming of life itself. This can be the fruit only of the generative springs of life, first phenomenology/philosophy, the ontopoietic logos of life. In this collection we explore memory in the constitution of reality: rememorizing and interpretation, consciousness/action, facts/imagination, history/myths, self-realization/metamorphosis. (shrink)