This study explores child health care nurses’ pedagogical knowledge when supporting parents in their parenthood using various teaching practices, that is how to organise and process the content during parent education groups in primary health care. The aim is to identify teaching practices used by child health care nurses and to analyse such practices with regard to Aristotle's three forms of knowledge to comprehensively examine child health care nurses’ use of knowledge in practice. A qualitative methodological design alongside the analysis (...) of video‐recordings was used. The results showed that child health care nurses used four teaching practices: lecturing, demonstration, conversation and supervision. Their use of episteme was prominent, but they also seemed to master techne in combination with episteme during the first three teaching practices. During the conversation teaching practice, the child health nurses rarely succeeded. Consequently, they missed opportunities to identify mothers’ expressed concerns and to act in the best interests of both the mothers and their infants by the use of phronesis. In health care, however, theoretical episteme is superordinate to productive knowledge or phronesis, which also became evident in this study. Nevertheless, more interactive pedagogical practices are needed if more use of phronesis is to become a reality in parent education groups. (shrink)

Graphical AbstractIn article number 1900223, Lennart Randau and co-workers present an overview of 2019's annual meeting of the German Genetics Society (Gesellschaft für Genetik GfG) with the topic “Genome editing using CRISPR” was held from September 4–6, at the Humboldt-Universität zu Berlin, organized by Ann Ehrenhofer-Murray, Anita Marchfelder, and Emmanuelle Charpentier.

Theoretical Laws and Normative Rules: Kant and Bolzano's Views on Logic'"1" Anita Von Duhn, Genf Does logic instruct us how to think correctly? ...

To design effective strategies to improve ethics consultation (EC) practices, it is important to understand the views of ethics practitioners. Previous U.S. studies of ethics practitioners have overrepresented the views of academic bioethicists. To help inform EC improvement efforts, we surveyed a random stratified sample of U.S. hospitals, examining ethics practitioners’ opinions on EC in general, on their own EC service, on strategies to improve EC, and on ASBH practice standards. Respondents across all categories of hospitals had very positive perceptions (...) of their own ethics consultation service (ECS) and few concerns about quality. Our findings suggest that the ethics-related needs of small, rural, non-teaching hospitals may be very different from those of academic medical centers, and therefore, different approaches to addressing ethical issues might be warranted. (shrink)

Background: After over 4 years since medical assistance in dying legalization in Canada, there is still much uncertainty about how this ruling has affected Canadian society. Objective: To describe the positive aspects of medical assistance in dying legalization from the perspectives of hospice palliative care providers engaging in medical assistance in dying. Design: In this qualitative descriptive study, we conducted an inductive thematic analysis of semi-structured interviews with hospice palliative care providers. Participants and setting: Multi-disciplinary hospice palliative care providers in (...) acute, community, residential, and hospice care in Vancouver and Toronto, Canada, who have engaged in end-of-life care planning with patients who have inquired about and/or requested medical assistance in dying. Ethical considerations: The research proposal was approved by University of British Columbia Research Ethics Board in Vancouver and University Health Network in Toronto. Participants were informed regarding the research goals, signed a written consent, and were assigned pseudonyms. Results: The 48 participants included hospice palliative care physicians, nurses, social workers, and allied health providers. The average interview length was 50 min. Positive aspects of medical assistance in dying legalization were identified at the individual level: a new end-of-life option, patients’ last chance to express control over their lives, patient and family comfort and relief, and a unique learning experience for hospice palliative care providers; the team level: supportive collegial relationships, broadened discussions about end-of-life and palliative care, and team debriefs provide opportunities for education and support; and the institutional level: improved processes to facilitate the implementation logistics. Conclusion: While being involved in the medical assistance in dying process is complex and challenging, this study sheds light on the positive aspects of medical assistance in dying legalization from the hospice palliative care provider’s perspectives. Medical Assistance in Dying legalization has resulted in improved end-of-life conversations between hospice palliative care providers, patients, and their families. Improved communication leads to a better understanding of patients’ end-of-life care plans and bridges some of the existing gaps between hospice palliative care and medical assistance in dying. (shrink)

Recent findings indicate that frontal brain asymmetry may be a marker of for depression. However, the psychological predispositions that account linkage between frontal brain asymmetry and depression are unclear. approach-withdrawal hypothesis is the primary framework that has been to account for the linkages between frontal brain asymmetry and or emotional disorders. We review evidence consistent with this and suggest several directions for its extension. One such direction is to constrain the approach-withdrawal hypothesis by linking frontal asymmetry to the known functions (...) of the prefrontal cortex. On this we propose that frontal brain asymmetry may be preferentially linked processes that promote the temporal continuity and shifting of or emotional priorities and the suppression of interference by sources of motivation or emotion. We review evidence from and neurobiological studies of depression that is broadly consistent with these predictions. We emphasise the need for future studies testing our hypotheses. (shrink)

A significant amount of discussion in the bioethics community has been devoted to the question of whether individuals performing ethics consultations in healthcare institutions have any special expertise. In addition, articles in the lay press have questioned the “added value” that bioethicists bring to ethical dilemmas. Those at the forefront of the bioethics community have argued repeatedly that those doing ethics consults cannot simply be well-intentioned individuals, that some training in bioethics, group process, and facilitation is necessary to competently execute (...) a consult. As one bioethicist commented:if you approach any endeavor as an amateur activity, you will get, in the end, an amateurish version of the activity. Without a sufficient commitment of personnel, time, support, and financial resources, a healthcare organization will get the ‘ethics’ program … it set out to create: an inept, unskilled, inefficient, and highly risky ‘program’ in healthcare ethics and bioethics. (shrink)

A significant amount of discussion in the bioethics community has been devoted to the question of whether individuals performing ethics consultations in healthcare institutions have any special expertise. In addition, articles in the lay press have questioned the “added value” that bioethicists bring to ethical dilemmas. Those at the forefront of the bioethics community have argued repeatedly that those doing ethics consults cannot simply be well-intentioned individuals, that some training in bioethics, group process, and facilitation is necessary to competently execute (...) a consult. As one bioethicist commented:if you approach any endeavor as an amateur activity, you will get, in the end, an amateurish version of the activity. Without a sufficient commitment of personnel, time, support, and financial resources, a healthcare organization will get the ‘ethics’ program … it set out to create: an inept, unskilled, inefficient, and highly risky ‘program’ in healthcare ethics and bioethics. (shrink)

To the woman, God said, “I will greatly multiply your pain in child bearing; in pain you shall bring forth children, yet your desire shall be for your husband, and he shall rule over you.”Genesis 3:16There is now a well-established body of literature documenting the pervasive inadequate treatment of pain in this country. There have also been allegations, and some data, supporting the notion that women are more likely than men to be undertreated or inappropriately diagnosed and treated for their (...) pain.One particularly troublesome study indicated that women are more likely to be given sedatives for their pain and men to be given pain medication. Speculation as to why this difference might exist has included the following: Women complain more than men; women are not accurate reporters of their pain; men are more stoic so that when they do complain of pain, “it's real”; and women are better able to tolerate pain or have better coping skills than men. (shrink)

The article introduces readers to the study of disability, both with respect to the interdisciplinary field of disability studies and the field of philosophy of disability. We then offer an overview of three central areas of philosophical inquiry where feminist work in philosophy and disability has made significant contributions: (1) metaphysics and ontology, (2) epistemology and phenomenology, and (3) ethical, social, and political philosophy.

The proliferation of big data analytics in criminal justice suggests that there are positive frames and imaginaries legitimising them and depicting them as the panacea for efficient crime control. Criminological and criminal justice scholarship has paid insufficient attention to these frames and their accompanying narratives. To address the gap created by the lack of theoretical and empirical insight in this area, this article draws on a study that systematically reviewed and compared multidisciplinary academic abstracts on the data-driven tools now shaping (...) decision-making across several justice systems. Using insights distilled from the study, the article proposes three frames for understanding how the technologies are portrayed. Inherent in the frames are a set of narratives emphasising their ostensible status as vital crime control mechanisms. These narratives obfuscate the harms of data-driven technologies and evince idealistic imaginaries of their capabilities. The narratives are bolstered by unequal structural arrangements, specifically the unevenly distributed digital capital with which some are empowered to participate in technology development for criminal justice application and other forms of penal governance. In unravelling these issues, the article advances current understanding of the dynamics that sustain the depiction of data-driven technologies as prime crime prevention and law enforcement tools. (shrink)

State medical boards are beginning to take a more balanced approach to monitoring and disciplining for prescribing of pain medications, according to this survey of state medical boards across the country. Overall, respondents indicated that they are becoming more educated and more sophisticated in their approach to complaints of opioid overprescribing. In addition, their responses reflect a heightened awareness of the appropriateness of treating chronic pain with controlled substances.Yet, despite these inroads, boards generally demonstrate a continued tolerance of pain undertreatment, (...) the survey found. There is a discrepancy in the weight given to violation of standard of care, patient harm, and gross negligence for opioid overprescribing versus undertreatment of pain. Boards appear to have a higher threshold for patient harm in cases involving pain undertreatment — particularly for chronic nonmalignant pain. (shrink)

ABSTRACT Most pharmaceutical research carried out today is focused on the treatment and management of the lifestyle diseases of the developed world. Diseases that affect mainly poor people are neglected in research advancements in treatment because they cannot generate large financial returns on research and development costs. Benefit sharing arrangements for the use of indigenous resources and genetic research could only marginally address this gap in research and development in diseases that affect the poor. Benefit sharing as a strategy is (...) conceptually problematic, even if one, as we do, agrees that impoverished indigenous communities should not be exploited and that they should be assisted in improving their living conditions. The accepted concept of intellectual property protection envisages clearly defined originators and owners of knowledge, whereas the concept of community membership is fluid and indigenous knowledge is, by its very nature, open, with the originator(s) lost in the mists of time. The delineation of ‘community’ presents serious conceptual and practical difficulties as few communities form discrete, easily discernable groups, and most have problematic leadership structures. Benefit sharing is no substitute for governments’ responsibility to uplift impoverished communities. Benefit sharing arrangements may be fraught with difficulties but considerations of respect and equity demand that prior informed consent and consultation around commercialisation of knowledge take place with the source community and their government.1. (shrink)

Uncertainty regarding potential disciplinary action may give physicians pause when considering whether to accept a chronic pain patient or how to treat a patient who may require long-term or high doses of opioids. Surveys have shown that physicians fear potential disciplinary acrion for prescribing controlled substances and that physicians will, in some cases, inadequately prescribe opioids due to fear of regulatory scrutiny. Prescribing opioids for long-term pain management, particularly noncancer pain management, has been controversial; and boards have investigated and, in (...) some cases, disciplined physicians for such prescribing. While in virtually all of these cases the disciplinary actions were successfully appealed, news of the success was not often as well-publicized as news of the disciplinary actions, leaving some physicians confused about their potential liability when prescribing opioids for pain. The confusion has perhaps increased as a result of two relatively recent cases, one where a physician was successfully disciplined by a state medical board for undertreatment of his patients’ pain, and another where the physician was successfully sued for inadequate pain treatment. (shrink)

Using data from interviews, student work, and classroom observations in a “History of Race” course at a private predominantly White high school, this article examines the racialized tensions that led the teacher (first author) to create an unofficial affinity group for students of color that met outside of class. The authors argue that the teacher's attempt to implement a curriculum that was culturally affirming for students of color by de-centering Whiteness led to White students’ resistance that necessitated the creation of (...) an unofficial “safe space” outside of the classroom for the students of color. The need for such a group demonstrates the difficulties inherent in presenting a more honest account of the role of race and racism in the United States that challenges narratives of historical progress. The article concludes that while students of color ideally should have access to culturally affirming knowledge inside social studies classrooms, this experience demonstrates why that kind of knowledge can only be engaged effectively within learning spaces that challenge the norms of conventional social studies education. (shrink)

Concerns have been raised around the alleged commercialisation of South African genetic material by various research institutes nationally and abroad. We consider whether the Protection of Personal Information Act in South Africa will conflict with or complement existing protections in health law and research ethics. The Act is not applicable to de‐identified samples that cannot be re‐identified but we question whether genetic samples can ever be truly de‐identified. The research participants in this matter provided consent for use of their samples (...) for research but did not consent to commercialisation by global research institutions, and neither did the researchers. We suggest that consent models incorporating broad consent as an option should include explicit discussions around benefit sharing and commercialisation. Mistrust between researchers and participants impedes scientific research and can harm relationships built up over the years between South African researchers and local communities. (shrink)

Since the sharing economy is a rather new phenomenon, there is still no official definition of it in the legal framework of Croatia. The continuous development of sharing economy started a few years after the 1998 global and domestic economic crisis stroked Croatia. Namely, a total of eight platforms in the sectors of transportation, accommodation, finance, and online skills could be identified. The total market share of these platforms amounts to estimated market revenue of roughly 106 million EUR. When compared (...) to the other EU Member States, it could be noticed that Croatia falls within the group of countries with a below-average performance by a number of platforms per 1 million population, as well as in the level of revenues compared to national GDP. Figures that are more promising can be detected regarding the collaborative economy’s contribution to national employment, which positions Croatia within the EU average. Future studies should explain in greater depth how the sharing economy poses several new challenges for regulators in Croatia and countries across the EU. In particular, policymakers must comprehend the big picture and provide regulatory guidelines to manage the long-term changes in job markets, public safety, competition, and digital trust. (shrink)

Management has tended to be established as science (Episteme) by using scientific methodologies and techniques. Although the era of Grand Theories has passed some time ago in social sciences, management has been still indicating the tendencies to develop ‘Grand Theories’. However, economic developments associated with globalization and the ‘Lehman brothers’ big bang in financial sector has shaken some assumptions about the nature of management as science and also about the methodologies by which management and entrepreneurship can or could be studied. (...) Specific shift to the future developments through Aristoteles’s intellectual virtue Phronesis has been traced in the work of theorists, such as Flyvbjerg, and others. They indicate new approach to organization studies, called phronetic organization research. In this paper, our exploration of research methodologies builds on Phronesis. Based on results of empirical study of business models in small and medium size companies in Slovenia, and extensive literature review we inductively build theoretical foundations for phronetic studies in the field of management and entrepreneurship and introduce the concept, called ‘phronetic bricolage’. It is based on understanding of management as ‘practical activity’ of ‘wise managers’ and bricolage—the research design (or approach) that builds knowledge from pieces of research from different fields, with different methods and various sources of data. We argue that phronetic bricolage is approach in management studies that links wisdom with complexity and variety of methods and sources of data. (shrink)

A main objective of this study is to assess the opinions of 50 behavioral health patients on selective control over their behavioral and physical health information. We explored patients' preferences regarding current consent models, what health information should be shared for care and research and whether these preferences vary based on the sensitivity of health information and/or the type of provider involved. The other objective of this study was to solicit opinions of 8 behavioral health providers on patient-driven granular control (...) of health information and potential impact on care.Electronic surveys were implemented at an outpatient Behavioral Health facility that provides care for behavioral health patients with non-serious mental illnesses. The Patient Survey included questions regarding patients' demographics and about their concerns and preferences for data sharing for care and research. The Provider Survey included questions about their view on the current consent process and perceptions on barriers and facilitators to implement patient-controlled granular consent models.This novel study provides valuable preliminary data that can help guide future studies to better understand privacy choices of this underrepresented patient group. (shrink)

The research reported in this paper set out to investigate ethics in the initial stages of construction projects. Briefing is the first real contact stage between the commissioner (client/employer) of a project — at this stage a potential project — and those involved in project realization — the designers and, subsequently, the constructors. It is well known that early decisions are of greatest impact and so, the importance of the initial contacts, communications and consequent decisions are paramount. Different project participants (...) are known to pursue individual objectives to varying degrees as well as possessing different perspectives and perceptions and operating/behaving in different ways. Hence, determination of the appropriate form, content etc. of a project is, inevitably, a matter of exercising value judgements and compromises and so, involves ethical considerations. A case study of a project through the briefing stage is reported and analysed, from initial contacts to scheme approval. It is apparent that a number of ethical concerns are manifest through the various actions of the major participants. (shrink)

The American Journal of Bioethics, Volume 12, Issue 4, Page 15-17, April 2012.

BackgroundThe COVID-19 pandemic has magnified pre-existing challenges in healthcare in Africa. Long-standing health inequities, embedded in the continent over centuries, have been laid bare and have raised complex ethical dilemmas. While there are very few clinical ethics committees (CECs) in Africa, the demand for such services exists and has increased during the COVID-19 pandemic. The views of African healthcare professionals or bioethicists on the role of CECs in Africa have not been explored or documented previously. In this study, we aim (...) to explore such perspectives, as well as the challenges preventing the establishment of CECs in Africa.MethodsTwenty healthcare professionals and bioethicists from Africa participated in this qualitative study that utilized in-depth semi-structured interviews with open-ended questions. Themes were identified through thematic analysis of interviews and open-ended responses.ResultsKenya and South Africa are the only countries on the continent with formal established CECs. The following themes emerged from this qualitative study: (1) Lack of formal CECs and resolution of ethical dilemmas; (2) Role of CECs during COVID-19; (3) Ethical dilemmas presented to CECs pre-COVID-19; (4) Lack of awareness of CECs; (5) Lack of qualified bioethicists or clinical ethicists; (6) Limited resources to establish CECs; (7) Creating interest in CECs and networking.ConclusionsThis study illustrates the importance of clinical ethics education among African HCPs and bioethicists, more so now when COVID-19 has posed a host of clinical and ethical challenges to public and private healthcare systems. The challenges and barriers identified will inform the establishment of CECs or clinical ethics consultation services (CESs) in the region. The study results have triggered an idea for the creation of a network of African CECs. (shrink)

Social interactions are essential for animals to reproduce, defend their territory, and raise their young. The conserved nature of social behaviors across animal species suggests that the neural pathways underlying the motivation for, and the execution of, specific social responses are also maintained. Modern tools of neuroscience have offered new opportunities for dissecting the molecular and neural mechanisms controlling specific social responses. We will review here recent insights into the neural circuits underlying a particularly fascinating and important form of social (...) interaction, that of parental care. We will discuss how these findings open new avenues to deconstruct infant‐directed behavioral control in males and females, and to help understand the neural basis of parenting in a variety of animal species, including humans. (shrink)

In this paper I try to consider the question of understanding as a special mental capacity in the light of the neuroscientific approach and the philosophical tradition. I assert that it is not sufficient to explain the process of understanding on the subpersonal level. The understanding has several dimensions that are revealed only in the aspect of interpretation, communication and social interaction. This kind of understanding implies the meta-representational knowledge, which we wanted to present on the example of rational and (...) hermeneutic thinking. It should be clear that in these cases, the reduction of holistic higher mental states gathered in the form of the mind theory to the neuronal level is not possible. (shrink)

Głównym celem niniejszej książki jest filozoficzno-kognitywistyczna analiza trzech zdolności poznawczych, intencjonalności, rozumienia i samowiedzy, które odgrywają kluczową rolę w ludzkim poznaniu. Analiza odbywać się będzie w odwołaniu do wybranych koncepcji, głoszonych na gruncie epistemologii i kognitywistyki. Poznanie będzie tu ujmowane jako efekt połączenia owych zdolności, jakimi są intencjonalne odniesienie podmiotu do świata zewnętrznego i własnych stanów mentalnych, rozumienie siebie i innych podmiotów oraz samowiedza, definiowana jako wiedza (prawdziwe, uzasadnione przekonanie) o własnych stanach mentalnych."--Fragment of Introduction, p.9.

Celem niniejszego artykułu jest przedstawienie psychologicznego portretu kobiety końca dziewiętnastego wieku, mistrzowsko uchwyconego w opowiadaniach Arthura Schnitzlera: Die Braut, Fräulein Else i Die griechische Tänzerin. Artykuł odwołuje się do interpretacji filozoficznych, w których dominuje dualistyczny opis nawiązujący do problemu umysłu i ciała rozważanego na gruncie Freudowskiej psychoanalizy. Z jednej strony kobieta jest tu charakteryzowana jako indywiduum determinowane napięciem między psyche a somą, z drugiej zaś strony jako jednostka funkcjonująca w społeczeństwie zdominowanym przez mężczyzn.

The question of subject's cognitive access to his own mental states contains an assumption, that this cognition is direct and authoritative, what is also a condition of subject's self-knowledge. The directness means, that this kind of cognition is not burdened by the intermediaries as Fregean senses or representations. Now arises the problem, how the self-knowledge, which has a propositional character can be direct, hence nonrepresentational. In this paper I considered the three kinds of representations, which are present in self-knowledge and (...) I have tried to answer the question, whether it is possible to preserve the directness of self-knowledge, despite of its representational constituents. First I have asked about the representation of self, then I assumed that to have self-knowledge a subject has to conceptualise his state as a belief or other experience of a certain kind and he has to think about himself as a subject of this state. Then I considered the representation of the modality of the state. Finally I analysed the representational character of the content of mental states. The conclusion of these investigations was that even if the self-knowledge in its epistemological aspect is representational (for example because of its propositional structure) it preserves its directness in its essential form, i.e. psychological aspect. (shrink)