The neonatal nurse forges a unique partnership with parents of a critically ill infant who are often, unexpectedly, exposed to the bewildering and complex environment that is neonatal intensive care, helping navigate them through this unchartered territory. Our role is multifaceted, with the primary focus of providing care in the best interests of our patients.1 This is realised through the provision of high-quality evidence-based care, advocating for the needs of the baby and family, and when required acting as a linchpin (...) bridging communication channels between medical and nursing teams, other allied health professionals, and the family.1 2 Ordinarily, the birth of an extremely preterm infant is a distressing, life-changing event for parents; this is further complicated by a number of additional factors in this complex scenario3. (shrink)

ObjectiveTo present (1) the ethical concepts related to the debate on resuscitation of extremely premature infants (EPIs) as they are described in the ethical literature; and (2) the ethical arguments based on these concepts.DesignWe conducted a systematic review of the ethical literature. We selected articles based on the following predefined inclusion/exclusion criteria: (1) English language articles (2) presenting fully elaborated ethical arguments (3) on resuscitation (4) of EPIs, that is, infants born before 28 weeks of gestation.AnalysisAfter repeated reading of articles, (...) we developed individual summaries, conceptual schemes and an overall conceptual scheme. Ethical arguments and concepts were identified and analysed.ResultsForty articles were included out of 4709 screened. Personhood, best interest, autonomy and justice were concepts grounding the various arguments. Regarding these concepts, included authors agreed that the best interest principle should guide resuscitation decisions, whereas justice seemed the least important concept. The arguments addressed two questions: Should we resuscitate EPIs? Who should decide? Included authors agreed that not all EPIs should be resuscitated but disagreed on what criteria should ground this decision. Overall, included authors agreed that both parents and physicians should contribute to the decision.ConclusionsThe included publications suggest that while the best interest is the main concept guiding resuscitation decisions, justice is the least important. The included authors also agree that both parents and physicians should be actively involved in resuscitation decisions for EPIs. However, our results suggest that parents’ decision should be over-ridden when in contrast with the EPI’s best interest. (shrink)

BackgroundDeciding whether to resuscitate extremely preterm infants (EPIs) is clinically and ethically problematic. The aim of the study was to understand neonatologists’ clinical–ethical decision-making for resuscitation of EPIs.MethodsWe conducted a qualitative study in Belgium, following a constructivist account of the Grounded Theory. We conducted 20 in-depth, face-to-face, semi-structured interviews with neonatologists. Data analysis followed the qualitative analysis guide of Leuven.ResultsThe main principles guiding participants’ decision-making were EPIs’ best interest and respect for parents’ autonomy. Participants agreed that justice as resource allocation (...) should not be considered in resuscitation decision-making. The main ethical challenge for participants was dealing with the conflict between EPIs’ best interest and respect for parents’ autonomy. This conflict was most prominent when parents and clinicians disagreed about births within the gray zone (24–25 weeks). Participants’ coping strategies included setting limits on extent of EPI care provided and rigidly following established guidelines. However, these strategies were not always feasible or successful. Although rare, these situations often led to long-lasting moral distress.ConclusionsParticipants’ clinical–ethical reasoning for resuscitation of EPIs can be mainly characterized as an attempt to balance EPIs’ best interest and respect for parents’ autonomy. This approach could explain why neonatologists considered conflicts between these principles as their main ethical challenge and why lack of resolution increases the risk of moral distress. Therefore, more research is needed to better understand moral distress in EPI resuscitation decisions.Clinical Trial Registration: The study received ethical approval from the ethics committee of UZ/ku Leuven (S62867). Confidentiality of personal information and anonymity was guaranteed in accordance with the General Data Protection Regulation of 25 May 2018. (shrink)

G e moore and ludwig wittgenstein were very different teachers, both because of their differing views on the nature and aims of philosophical investigation, and because of the differences in the way they thought, their educational backgrounds, and the kind of persons they were. this paper records experiences of the two philosophers as teachers and as personalities, and indicates the features of their teaching which stemmed from their views and from their personalities.

The aim of this article is to demonstrate the usefulness of qualitative research for studying the ethics of care, bringing to light the lived experience of health care recipients, together with the importance of methods that allow reconstruction of the processes underlying this lived experience. Lived experiences of families being approached for organ donation, parents facing the imminent death of their child and patients being treated using stem cell transplantation are used to illustrate how ethical principles are differentiated, modified or (...) contradicted by the narrative context of persons concerned. The integration of empirical data into ethics will help caregivers in their ethical decision making and may enrich care ethics as a narrative and interpretative field. (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)

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

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)

En racontant de très belle manière la vie de Madame Luce, enseignante française et arabophone dans l’Algérie de la fin du xixe siècle, Rebecca Rogers enrichit les travaux, de plus en plus nombreux, sur les Européennes installées dans la colonie dans les premières décennies de la colonisation. Centré sur une femme ordinaire, qui a laissé peu de traces dans les archives publiques, ce travail est en réalité une étude plus large, consacrée à l’histoire sociale des changements de pratiques éducati...

This interpretive study proposes a framework with which to explore the ethical significance of classroom-based literacy practices. Overly narrow views of literature as a source of role models or moral precepts take insufficient account of the complexity of text and experience. Through analyses of telling examples from student writing and discussion in response to literature, the occurrence and interaction of six forms of ethical engagement are documented: judging, distancing, empathizing, affiliating, disclosing and resisting. The study concludes that ethical matters are (...) interwoven with the socially accomplished, situated work of engaging with literature and with specific pedagogical structures. (shrink)

This study aims to develop systems of belief revision in which acquisition of knowledge and interactive aspects of meaning are captured as a set of questions and answers with respect to an initial set of assumptions expressed in the object language. This process is performed by a progressive deployment of hypothetical insights contained in a context of interaction of information received by an agent. This study also gives the opportunity to express interactive aspects of meaning in semantics tableaux. And thus (...) highlights the notions of speech acts by the connection between tableaux and dialogues in the context of belief revision. (shrink)

The author reviews the contents of the ten articles by j l austin which appear in the volume "philosophical papers". She tries to "single out what is unique about his contribution, In particular what features of his procedure, Falling as it does under the general classification 'linguistic analysis', Were so distinctive as to win for it the attention accorded to a new departure." (staff).

This paper investigates the way in which the sexuality of women has been posited in relation to rats as experimental subjects, exploring the stakes of a scientific debate that takes the social world of female sexuality as its focus and as a political problem. Studies that purport to understand female sexuality by investigating rat behavior rely on problematic assumptions about sovereign agents motivating sexual behavior. Such studies also aim to do away with so-called deviant sexual behaviors and, as a consequence, (...) gay people. Theories of agential realism and hybridity serve as counterforces to these inherently repressive perspectives by insisting on the multiple determinations of sexuality and subjectivity among women. (shrink)

Much has changed since the beginnings of the gay liberation movement and the feminist movement in the 1970s in Aotearoa/New Zealand. Yet, to a degree, the invisibility of gay male, lesbian and transsexual lifestyles as well as individual struggles for rights and recognition remains. The diverse contributions in this book discuss how the reframing of ‘queer’ as a proud, border-crossing identity challenges conventional views of gay, lesbian, transsexual and heterosexual identities. At the heart of queer politics and theory lies the (...) double irony that ‘queers’ still experience different social positions and are confronted differently by public challenges, and they also seldom agree about how, and for what political reasons, sexuality should be defined and categorised. In this book, 'queer' brings together wide-ranging commentaries on the history, politics and culture of thirty years of sexual history in Aotearoa/New Zealand. (shrink)

The ArgumentThis paper applies the approach developed by the congnitive sciences to a classical field of social anthropology—i.e., the analysis of represetations and behaviors relative to misfortune in “traditional” societies.The initial argument is that the conceptual division and the modes of description and explanation of anthropology suffer from serious weaknesses: these concepts cannot serve to understand empirical phenomena ; they rely on a confused and erroneous conception of the different domains involved and the causalities between them; and they use simplistic (...) hypotheses about the existence and causal status of the entities that usually form the ultima ratio of anthropological reasoning. These entities would directly “cause” other individual representations or behaviors. This simplification also affects the analysis of states of belief in these entities, to which individuals would supposedly “adhere”.I argue here that the cognitivist approach, within a “methodological individualism” framework, provides a more adequate description of phenomena observed in the field. This enables the various levels and domains to be more finely defined. The analysis of “typical” utterances and inferences in a “tranditional” society, the Senufo of the Ivory Coast, is here used to clarify these anthropological problems. Two levels can be distinguished: a priori representations, which are underdetermined, enabling them to occur within valid inferences; perception and/or action, which obeys different cognitive constraints. The existential status of unobservable entities appearing in causal inferences is not equivalent depending on whether they are determined as antecedent or consequent.This paper suggests a theory of interpretive processes and beliefs having flexible references, because they are incomplete and domain-specific. It allows a comparison with facts observed in Western societies. It is also in contrast to the ordinary conception of religious states of belief — i.e., these states would be purely psychological, states of “adherence,” collective, autonomous, obligatory, part of a systemized set of knowledge; collective notions would here logically precede individual representations. (shrink)

The essays collected in this volume, appearing between the years 1939 and 1958, include all of the late Professor J. L. Austin's published papers, and in addition two unpublished papers, ‘The Meaning of a Word’ and ‘Unfair to Facts’, as well as an unscripted talk, ‘Performative Utterances’, given in the Third Programme of the B.B.C. in 1956. The editors, J. O. Urmson and G. J. Warnock, have performed a real service in making these papers available in one volume; for the (...) cumulative impact of the method Austin pursued in doing philosophy, and the questions this method raises, can be felt and appreciated more fully when a considerable assemblage of illustrative papers is brought together. The debt Austin owes to the tradition to which G. E. Moore and Wittgenstein contributed is quite clear, and the divergences from them are equally clear. In reviewing the contents of the ten articles in this volume I shall try to single out what is unique about his contribution, in particular what features of his procedure, falling as it does under the general classification ‘linguistic analysis’, were so distinctive as to win for it the attention accorded to a new departure. (shrink)