Background: Troubled conscience among nurses and other healthcare workers represents a significant contributor to healthcare worker moral distress, burnout and attrition. While research in this area has examined critical care in hospitals, less knowledge has been obtained from long-term care contexts such as nursing homes, despite widely recognised challenges with regard to vulnerable patients, increasing workload and maintaining workforce sustainability among nurses. Objective: The aim of this study was to illuminate and interpret the meaning of the lived experience of troubled (...) conscience among registered nurses (RNs) working in nursing homes. Research design: This qualitative research employed narrative interviews with eight nurses to obtain essential meanings of their lived experiences of troubled conscience. The interview texts were analysed using a phenomenological hermeneutic approach. Ethical considerations: Participation was voluntary, informed and was conducted with written consent. The Norwegian Centre for Research Data approved the data processing of personal data. Findings: The analysis uncovered two themes: (1) troubled conscience means abandoning ideals, with the subthemes: failing dependent patients; being disloyal to colleagues; being inadequate in the performance of work tasks and (2) troubled conscience means facing realities, with the subthemes: accepting being part of the system; responding to barriers. Discussion: Troubled conscience meant experiencing continuous and simmering tension between one’s ideals and realities and feeling a drive to preserve accountability and one’s moral integrity. Endangered ideals were often under cross-pressure and included humanistic values, professional values, working life values and the values of the organisation. Conclusion: Nurses’ troubled conscience refers to a struggle, but also a force that plays out at various levels and arenas in long-term care. Openness and dialogue about how professional values and the welfare state’s intentions can be realised within the given framework are important for individual nurses’ occupational health as well as the quality of care provided to patients. (shrink)

Au cours de l'année 1934, une jeune philosophie et mathématicienne allemande, Grete Hermann, se rend à Leipzig pour participer au séminaire organisé par l'un des plus célèbres pionniers de la physique quantique, W. Heisenberg. C.F. von Wizsäcker y est présent, entre autres éminents scientifiques. Fervente adepte de la philosophie kantienne réinterprétée par J.F. Fries et L. Nelson, G. Hermann arrive avec un objectif précis : démontrer la compatibilité entre physique quantique et philosophie kantienne. En particulier, concilier la catégorie de (...) causalité, forme a priori de la pensée selon Kant, avec les prédictions statistiques de la nouvelle physique. Après une année de débats avec ses interlocuteurs, G. Hermann publie le présent opuscule, traduit ici pour la première fois. Elle y développe une interprétation tout à fait originale de la mécanique quantique, et réfute, trente ans avant J. Bell, la démonstration de J. von Neumann contre les variables cachées. -- 4ème de couverture. (shrink)

Sehr verehrter Herr Professor! Ihrem Buch über die Prinzipien der Quantenmechanik verdanke ich das Verständnis für die Geschlossenheit und Schönheit dieser Theorie, einer Schönheit, die, wie mir scheint, in der abstrakt symbolischen Art Ihrer Darstellung überhaupt erst richtig zur Geltung kommt. Die starken Anregungen, die ich von Ihnen erhalten habe und für die ich Ihnen dankbar bin, haben zugleich in mir den Wunsch geweckt, Ihre Meinung über einige Gedankengänge kennen zu lernen, die sich mir beim Studium der Quantenmechanik mehr und (...) mehr aufgedrängt haben. (shrink)

Lieber Herr Weizsäcker! Wo Sie sich jetzt zur Zeit der Semesterferien aufhalten, weiss ich zwar nicht. Aber ich hoffe, dass Ihnen von Ihrer Leipziger Wohnung Post nachgeschickt wird und dass Ihre Leipziger Adresse noch die alte ist, die ich vom Sommer her kenne. Immerhin sind das einige Unsicherheitsfaktoren und ich bitte Sie daher, mir eine Postkarte zu schreiben, wenn dieser Brief Sie erreicht und Sie nicht gleich dazu kommen, auf meine physikalischen Fragen einzugehen.

Erlauben Sie bitte, dass ich Ihnen, mit Hilfe eines Durchschlags, beiden gemeinsam für den Brief von Herrn Scholz und die von ihm mir übersandte Arbeit von Herrn Kratzer danke. Ich habe die Arbeit mit grossem Interesse gelesen – auf einige inhaltliche Schwierigkeiten, die sie mir macht, will ich nachher noch eingehen –, und fände es sehr schön, wenn diese Überlegungen zu den Einstein-Schrödingerschen Bedenken im September in unserem Kreis diskutiert werden. Ich danke Ihnen, Herr Kratzer, also herzlich für Ihre Bereitschaft, (...) ein Referat für unsere Tagung zu übernehmen, und bitte Sie, mir möglichst bald und möglichst genau mitzuteilen, wie Sie Ihr Thema formulieren möchten. (shrink)

Background In long-term care, registered nurses and other care providers often experience tensions between ideals and realities in the delivery of services, which can result in stress of conscience. Burnout, low quality of care and a tendency to leave the profession are perceived as consequences. Objectives This study aimed to identify the socio-demographic and work-related factors associated with a high level of stress of conscience, particularly between nursing occupations. Research design A cross-sectional survey was conducted among care providers who worked (...) in Norwegian nursing homes and home care services in the spring of 2021. The sample consisted of 950 registered nurses and 1143 other care providers. Data were collected online using the Stress of Conscience Questionnaire (SCQ). Ethical considerations Participation was voluntary and based on consent. The study was approved by the Norwegian Center for Research Data. Results Registered nurses were nearly twice as likely to report high levels of stress of conscience compared to other care providers in long-term care. In addition, being a female, living alone, caring for their own children, working in an institution (versus home based), working >75% time, working shifts, not having scheduled meetings for ethical reflection and working in municipalities with a higher population density were factors associated with a high level of SCQ score. Discussion Knowledge of factors that increase the risk of high SCQ scores in registered nurses provides opportunities for prevention. Managers in long-term care should pay more attention to how work is distributed between the occupational groups and should facilitate real opportunities for ethical reflection. Conclusions The results of this study show that registered nurses have particular exposure to high levels of stress of conscience compared to other care providers in long-term care. Particular attention should be paid to registered nurses working in nursing homes. (shrink)

//718// Das physikalische Ergebnis der Quantenmechanik, von dem die Erschütterung altgewohnter naturphilosophischer Auffassungen, insbesondere der Kausalvorstellungen ausgeht, besagt, daß der Vorausberechnung künftiger Naturvorgänge eine scharfe, unüberwindbare Schranke gezogen ist. Die Idee des LAPLACEschen Dämons, der den augenblicklichen Zustand der Natur vollständig kennt, sämtliche Naturgesetze überschaut und auf Grund dieser Kenntnis den zukünftigen Gang der Ereignisse vorhersagen kann, verliert damit jede Anwendung auf die Natur. Und doch war diese Idee nur der Ausdruck der Überzeugung, daß jedes Naturgeschehen in allen seinen Zügen (...) durch vorangehende Ereignisse verursacht worden ist und daher für einen der Naturgesetze Kundigen aus diesen Ursachen vorausberechenbar sein müsse. (shrink)

The following article by Grete Hermann arguably occupies an important place in the history of the philosophical interpretation of of quantum mechanics. The purpose of Hermann's writing on natural philosophy is to examine the revision of the law of causality which quantum mechanics seems to require at a fundamental level of theoretical description in physics. It is Hermann's declared intention to show that quantum mechanics does not disprove the concept of causality, "yet has clarified [it] and has removed from (...) it other principles which are not necessarily connected to it." She attempts to show that this most "obvious" counter-example to the aprioricity of causality, quantum theory, is in fact not a counter-example at all. (shrink)

Outsourcing clinical trials sponsored by pharmaceutical companies from industrialized countries to low- -income countries – summarized as transnational biomedical research – has lead to many concerns about ethical standards. Whether study participants are particularly vulnerable is one of those concerns. However, the concept of vulnerability is still vague and varies in its definition. Despite the fact that important international ethical guidelines such as the Declaration of Helsinki by the World Medical Association or the Ethical Guidelines for Biomedical Research Involving Human (...) Subjects by the Council of International Organizations of Medical Sciences refer to vulnerability as ethical principle, each of their approaches are different. To overcome these shortcomings, we analyze and unite different approaches of vulnerability and develop practical criteria in order to operationalize the concept especially for the context of TBR. These criteria refer to the context of a study as well as the characteristics and the current living situation of study participants. Based on a case study of an HIV-vaccine-trial conducted in India we demonstrate how those criteria can be applied in a retrospective way to identify potential ethical conflicts. The criteria can also indicate a prospective function for ethical pre-assessment. For this, we provide an outlook for three major topics: 1. Vulnerability as a normative concept: Different ways of protection; 2. The relevance of transparency and 3. Vulnerability as an instrument to increase decision participation of human subjects. (shrink)

Grete Hermann, Zum Vortrag Schlicks: //342// Das naturphilosophische Problem, das mit der Quantenmechanik gestellt ist, läßt sich durch zwei Paare von Sätzen charakterisieren, die in Schlicks Ausführungen aufgetreten sind, ohne daß allerdings der zwischen den Sätzen jedes Paares anscheinend vorliegende Widerspruch hervorgehoben, geschweige denn aufgelöst worden ist: 1a. Die Unbestimmtheitsrelationen bezeichnen keine nur subjektiven Schranken der möglichen Beobachtung derart, daß physikalisch reale Merkmale eines Systems unbeobachtbar wären.

Die moderne Entwicklung der Physik hat das naturphilosophische Problem der Möglichkeit und der Voraussetzungen der Naturerkenntnis in neuem Licht erscheinen lassen. Sah es in den Zeiten der klassischen Theorien vielfach so aus, als stehe die Physik auf dem festen Boden der Beobachtung und bahne sich von dort aus den Weg zum kausalen Verständnis des Beobachteten, so zeigte sich mehr und mehr, daß nicht nur in dieser Richtung Probleme liegen. Mit der Entwicklung der Theorien wurden vielmehr von neuem die Grundlagen problematisch, (...) die, wie es bis dahin schien, der physikalischen Forschung die Voraussetzungen und die Stellung der Aufgabe als sicheren Ausgangspunkt geboten hatten. (shrink)

Die Ringbereiche, in denen die in der vorliegenden Arbeit auftretenden Ideale definiert sind, sollen Polynombereiche sein. Ein Ideal soll gegeben heißen, wenn eine Basis des Ideals bekannt ist, es heißt berechenbar, wenn sich eine Basis berechnen läßt. In dieser Arbeit soll es sich darum handeln, die für ein gegebenes Ideal m charakteristischen Ideale und Polynome zu berechnen.

Cette étude montre comment, malgré les changements qu’elle а introduits, la physique moderne maintient certaines idées fondamentales de la physique classique. Sacrifiant beaucoup de l'idéal d’une physique mécaniste, elle reste pourtant liéе à cette thèse de Kant, que les formes de l'intuition et les catégories sont les suppositions nécessaires de la connaissance de la nature.

SOMMAIRE. – Gette étude montre comment, malgré les changements qu’elle a introduits, la physique moderne rnaintient certaines idées fondamentales de la physique classique. Sacrifiant beaucoup de l’idéal d’une physique mécaniste, elle reste pourtant liée a cette thèse de Kant, que les formes de l’intuition et les catégories sont les suppositions nécessaires de la connaissance de la nature.

Der fruchtbare Fortschritt naturphilosophischer Untersuchungen war von jeher davon abhängig, daß die in der Entwicklung der physikalischen Theorien auftauchenden philosophischen Schwierigkeiten im engen Kontakt mit den physikalischen Erwägungen bearbeitet werden – eine Bedingung, die bei der heute weithin eingerissenen Entfremdung zwischen Physik und Philosophie um so schwerer erfüllt wird, als sie ein wechselseitiges Verständnis zwischen den Vertretern beider Forschungsgebiete voraussetzt.

Diese Arbeit ist den Bedenken gewidmet, die von seiten der Quantenmechanik gegen das Kausalgesetz erhoben werden.

//211// Eine gründliche Auseinandersetzung der nativistischen mit der empiristischen Theorie ist kürzlich erschienen in dem Werk von HILLEBRAND über die Gesichtsempfindungen. HILLEBRAND geht hier ausführlich ein auf einen Einwand, der im Vorigen gegen den Nativismus geltend gemacht worden ist. Wir haben uns darum hier noch mit HILLEBRANDs Argumentation auseinanderzusetzen.

Background Equal access to healthcare is a core principle in Norway’s public healthcare system. The COVID-19 pandemic challenged healthcare systems in the early phase – in particular, related to testing and hospital capacity. There is little knowledge on how older people experienced being infected with an unfamiliar and severe disease, and how they experienced the need for healthcare early in the pandemic Aim To explore the experiences of older people infected by COVID-19 and their need for testing and hospitalisation. Research (...) design An explorative and descriptive approach, with qualitative interviews conducted in October 2020. Participants and research context Seventeen participants above 60 years of age hospitalised due to COVID-19 during spring 2020 were recruited 6 months after discharge. Ethical considerations Ethical approval was granted by the Regional Committee for Medical and Health Research Ethics in South-Eastern Norway (155425). Findings The main finding was that the informants experienced vulnerability and arbitrariness. This finding was supported by three sub-themes: experiences with a severe and unfamiliar disease, the strict criteria and the importance of someone advocating needs. Discussion Participants described varying access to healthcare. Those who did not meet the national criteria to be tested or hospitalised struggled against the system. Findings reveal arbitrary access to healthcare, in contrast to Norway’s ethical principle of fair and just access to health services. Moreover, to access and receive necessary healthcare, informants were dependent on their next-of-kin’s advocacy. Conclusion Even when dealing with an unfamiliar disease, health professionals’ assessments of symptoms must be performed with an ethical obligation to applicate competent appraisal and the exercise of discernment; this is in line with care ethics and ethical standards for nurses. These perspectives are a significant part of caring and the intension of doing good. (shrink)

We have recently found that nondirective meditation facilitates stress reduction. This supplementary study investigated whether defensive functioning would moderate these beneficial effects. We explored the occurrence of defense mechanisms and the impact of defensive functioning on the outcome of companies’ stress management programs regarding worries nervousness, mental distress, sleep problems, and muscle pain. The sample was a population of active, working professionals recruited from Norwegian companies. The intervention group obtained significant benefits on all outcome measures, but there were no effects (...) in the control group. We analyzed defensive functioning with the self-report questionnaire, Life Style Index, at four time points. The healthy adults who participated had a low level of defense scores at the outset. There was a significant reduction in the level of defenses in both groups over the study period, 6 months. Defensive functioning significantly moderated the change of the outcome measures from baseline to follow-up in the intervention group, but not in the control group. (shrink)

This chapter is about Grete Hermann, a philosopher-mathematician who productively and mutually beneficially interacted with the founders of quantum mechanics in the early period of that theory's elaboration. Hermann was a neo-Kantian philosopher. At the heart of Immanuel Kant's critical philosophy lay the question of the conditions under which we can be said to know something objectively, a question Hermann found to be particularly pressing in quantum mechanics. Hermann's own approach to Neo-Kantianism was Neo-Friesian. Jakob Friedrich Fries, like Kant, (...) had understood critical philosophy to be an essentially epistemic project. Fries departed from Kant in his account of the elements involved in our cognition. In this chapter it is discussed how, beginning from a neo-Friesian understanding of critical philosophy, Hermann is led to conclude that quantum mechanics shows us that physical knowledge is fundamentally split; that the objects of quantum mechanics are only objects from a particular perspective and in the context of a particular physical interaction. It will be seen how Hermann's solution to the problem of objectivity in quantum mechanics is a natural one from a neo-Friesian point of view, even though it disagrees with those offered by more orthodox versions of Kantian doctrine. (shrink)

This publication is an appreciation of the natural philosophy and epistemology of the philosopher Grete (Henry-)Hermann. A student of the mathematician Emmy Noether and the philosopher Leonard Nelson, she was one of the early interpreters of quantum mechanics. Werner Heisenberg memorialized her in his book "The Part and the Whole". For the first time, her writings on natural philosophy and epistemology are collected in one volume. An extensive introduction by various authors introduces the work of Grete Henry-Hermann. This (...) edition is supplemented by excerpts from correspondence on natural philosophical and epistemological topics, including correspondence with Carl Friedrich von Weizsäcker, Werner Heisenberg, and Gustav Heckmann. Contents ● Grete Henry-Hermann's contribution to the interpretation of quantum mechanics ● Grete Henry-Hermann's work on the relationship between modern physics and transcendental philosophy ● Grete Hermann's dissertation: The Question of the Finitely Many Steps in the Theory of Polynomial Ideals (1925) ● Discussions on the question of free will and the significance of behavioral research for the critique of reason ● Excerpts from correspondence from 1925 to 1982. (shrink)

Grete Hermann was a pupil of mathematical physicist Emmy Noether, follower and co-worker of neo-Kantian philosopher Leonard Nelson, and an important intellectual figure in post-war German social democracy. She is best known for her work on the philosophy of modern physics in the 1930s, some of which emerged from intense discussions with Heisenberg and Weizsäcker in Leipzig. Hermann’s aim was to counter the threat to the Kantian notion of causality coming from quantum mechanics. She also discussed in depth the (...) question of ‘hidden variables’ and provided an extensive analysis of Bohr’s notion of complementarity. This volume includes translations of Hermann’s two most important essays on this topic: one hitherto unpublished and one translated here into English for the first time. It also brings together recent scholarly contributions by historians and philosophers of science, physicists, and philosophers and educators following in Hermann’s steps. Hermann's work places her in the first rank among philosophers who wrote about modern physics in the first half of the last century. Those interested in the many fields to which she contributed will find here a comprehensive discussion of her philosophy of physics that places it in the context of her wider work. (shrink)

Grete Hermann’s essay “Die naturphilosophischen Grundlagen der Quantenmechanik” has received much deserved scholarly attention in recent years. In this paper, I follow the lead of Elise Crull who sees in Hermann’s work the general outlines of a neo-Kantian interpretation of quantum theory. In full support of this view, I focus on Hermann’s central claim that limited spatio-temporal, and even analogically causal, representations of events exist within an overall relational structure of entangled quantum mechanical states that defy any unified spatio-temporal (...) description. In my view, Hermann also advances an important transcendental argument that perspectival spatio-temporal representations of nature have their foundations in general relational networks that are not spatio-temporal. The key point is that the adoption of a perspectival system within the general network induces the representation but only for that context. These ideas are consistent with a perspectival subject–object principle in Kant and also with Weyl’s work on Lie groups and their representations. (shrink)

This paper for an upcoming journal volume examines Grete Hermann's Naturphilosophischen Grundlagen der Quantenmechanik (1935) and the relative context, or perspectival, interpretation of standard quantum mechanics found therein. I find an argument for the emergence of limited spatio-temporal and retrocausal stories, from a chosen experimental perspective, within a larger set of entangled systems not subject to a spatio-temporal interpretation. This argument can be read in reverse as giving some of the necessary preconditions of spatio-temporal representations as based upon perspectival (...) relations, carrying on a Kantian transcendental argument on one hand, and on the other hand, looking forward to Weyl's use of symmetry groups, Lie algebras and their representations in quantum mechanics. (shrink)