BackgroundCommentators believe that the ethical decision-making climate is instrumental in enhancing interprofessional collaboration in intensive care units. Our aim was twofold: to determine the perception of the ethical climate, levels of moral distress, and intention to leave one's job among nurses and physicians, and between the different ICU types and determine the association between the ethical climate, moral distress, and intention to leave.MethodsWe performed a cross-sectional questionnaire study between May 2021 and August 2021 involving 206 nurses and physicians in a (...) large urban academic hospital. We used the validated Ethical Decision-Making Climate Questionnaire and the Measure of Moral Distress for Healthcare Professionals tools and asked respondents their intention to leave their jobs. We also made comparisons between the different ICU types. We used Pearson's correlation coefficient to identify statistically significant associations between the Ethical Climate, Moral Distress, and Intention to Leave.ResultsNurses perceived the ethical climate for decision-making as less favorable than physicians. They also had significantly greater levels of moral distress and higher intention to leave their job rates than physicians. Regarding the ICU types, the Neonatal/pediatric unit had a significantly higher overall ethical climate score than the Medical and Surgical units and also demonstrated lower moral distress scores and lower “intention to leave” scores compared with both the Medical and Surgical units. The ethical climate and moral distress scores were negatively correlated ; moral distress and "intention to leave" was positively correlated ; and ethical climate and “intention to leave” were negatively correlated.ConclusionsSignificant differences exist in the perception of the ethical climate, levels of moral distress, and intention to leave between nurses and physicians and between the different ICU types. Inspecting the individual factors of the ethical climate and moral distress tools can help hospital leadership target organizational factors that improve interprofessional collaboration, lessening moral distress, decreasing turnover, and improved patient care. (shrink)

In classical philosophy of time, present time mainly has been considered in its fleetingness: it is transition, in the Platonic meaning of the sudden or in the Aristotelian sense of discreet moment and isolated intensity that escapes possible perception. Through the idea of subjective constitution of time, Husserl’s phenomenology tries to spread the moment. He transcends the idea of linear and empty time in modern philosophy. Phenomenological description of time experience analyses the filled character of the moment that can be (...) detained in the performance of consciousness. As a consequence of the temporality of consciousness, he nevertheless remains in the temporal conception of presence. The phenomenology of Merleau-Ponty, however, is able to grasp the spacial meaning of presence. In his perspective of a phenomenology of perception, presence can be understood as a space surrounding the body, as a field of present things given in perception. Merleau-Ponty recovers the ancient sense of ‘praesentia’ as a fundamental concept of being in the world. (shrink)

Frequent public uproar over forms of data science that rely on information about people demonstrates the challenges of defining and demonstrating trustworthy digital data research practices. This paper reviews problems of trustworthiness in what we term pervasive data research: scholarship that relies on the rich information generated about people through digital interaction. We highlight the entwined problems of participant unawareness of such research and the relationship of pervasive data research to corporate datafication and surveillance. We suggest a way forward by (...) drawing from the history of a different methodological approach in which researchers have struggled with trustworthy practice: ethnography. To grapple with the colonial legacy of their methods, ethnographers have developed analytic lenses and researcher practices that foreground relations of awareness and power. These lenses are inspiring but also challenging for pervasive data research, given the flattening of contexts inherent in digital data collection. We propose ways that pervasive data researchers can incorporate reflection on awareness and power within their research to support the development of trustworthy data science. (shrink)

ZusammenfassungDie Geschichte der genetischen Pränataldiagnostik ist bislang als Teil der Geschichte der Humangenetik und deren Neuorientierung als klinisch-laborwissenschaftliche Disziplin in der zweiten Hälfte des 20. Jahrhunderts betrachtet worden. Anhand neuen Quellenmaterials soll in diesem Beitrag gezeigt werden, dass das Interesse an der Pränataldiagnostik in Westdeutschland auch im Kontext von Forschungen entstand, die sich mit Gefahren für den Menschen in der Umwelt befassten. Anhand der Debatten um die Einrichtung des DFG-Schwerpunktprogramms „Pränatale Diagnostik genetischer Defekte“ 1970 untersuchen wir, wie die Technik der (...) Amniozentese in Westdeutschland von einer interdisziplinären Forschungsgruppe eingeführt wurde, die sich mit Schädigungen des Organismus durch Strahlen, Arzneimittel und andere Gebrauchsstoffe und Konsumgüter befasste. In einer als ökologische Wende bezeichneten Zeit wachsenden Umweltbewusstseins, so unsere These, sollte durch die Förderung der Pränataldiagnostik eine wahrgenommene Lücke in der Prävention umweltbedingt auftretender genetischer Anomalien geschlossen werden. Für die Pränataldiagnostik als „Schutzmaßnahme“ sprach unter anderem ihre erwartete Finanzierung als Krankenkassenleistung im Zuge der Reform des Abtreibungsrechts. Erst in einem zweiten Schritt führten Veränderungen von Strukturen der Forschung, vor allem aber Erfahrungen in der gynäkologischen Praxis zu einer Neuausrichtung auf die Diagnostik und Prävention mehrheitlich erblicher oder spontan auftretender Anomalien. Die Pränataldiagnostik, so wie sie schließlich in Westdeutschland ab den frühen 1980er Jahren routinemäßig Einsatz fand, hatte mit Fragen der „Umwelt“ kaum noch zu tun. Diese Fallstudie zur Frühgeschichte der genetischen Pränataldiagnostik handelt von dem noch wenig untersuchten Verhältnis von humangenetischer Forschung, klinischer Praxis und Umweltforschung und hat zum weiteren Ziel, den bisher in anderen Kontexten beschriebenen Wandel von Perspektiven in der Vorsorge um 1970 zu beleuchten. (shrink)

It is not uncommon for activists to use the language of colonization or occupation to describe the social dynamics at work in cities undergoing gentrification. Should these claims be regarded as ou...

Der indische Mythos.--Der Brauch der Fische.--Yoga und Māyā.--Buddha.

Originally published in 1973. The volume is divided into four sections: The introduction places the position of the Buddhist Tantras within Mahayana Buddhism and recalls their early literary history, especially the Guhyasamahatantra; the section also covers Buddhist Genesis and the Tantric tradition. The foundations of the Buddhist Tantras are discussed and the Tantric presentation of divinity; the preparation of disciples and the meaning of initiation; symbolism of the mandala-palace Tantric ritual and the twilight language. This section explores the Tantric teachings (...) of the inner Zodiac and the fivefold ritual symbolism of passion. The bibliographical research contains an analysis of the Tantric section of the Kanjur exegesis and a selected Western Bibliography of the Buddhist Tantras with comments. (shrink)

Leibniz was probably the last universal scholar in modern times who made original and innovative achievements in all the essential fields of knowledge of his time: as a reform-oriented lawyer, a multilateral thinking diplomat, as a mathematician of infinitesimal calculus, as the inventor of a calculating machine and in the mining of horizontal wind power, as an organizer of science and as one of the first historians who strived for source-critical methodical objectivity. However, this baroque diversity can only be understood (...) from the center of a monadological philosophy, which wants to establish the unity of scientific worldview and metaphysical concept of the world. It is distorted in the classical reception because only Leibniz the Theodicy was known. The topicality of Leibniz today consists in re-exposing the original basic idea of unity in diversity and asking how it can be made fruitful for philosophical and political thought in the 21st century. This book is a translation of the original German 1st edition Leibniz und die Folgen by Jörg Zimmer, published by J.B. Metzler, imprint of Springer-Verlag GmbH, part of Springer Nature in 2018. The translation was done with the help of artificial intelligence. A subsequent human revision was done primarily in terms of content, so that the book will read stylistically differently from a conventional translation. Springer Nature works continuously to further the development of tools for the production of books and on the related technologies to support the authors. (shrink)

Originally published in 1973. The volume is divided into four sections: The introduction places the position of the Buddhist Tantras within Mahayana Buddhism and recalls their early literary history, especially the Guhyasamahatantra; the section also covers Buddhist Genesis and the Tantric tradition. The foundations of the Buddhist Tantras are discussed and the Tantric presentation of divinity; the preparation of disciples and the meaning of initiation; symbolism of the mandala-palace Tantric ritual and the twilight language. This section explores the Tantric teachings (...) of the inner Zodiac and the fivefold ritual symbolism of passion. The bibliographical research contains an analysis of the Tantric section of the Kanjur exegesis and a selected Western Bibliography of the Buddhist Tantras with comments. (shrink)

Rather than adopting a view of Fichte as a “proto-existentialist,” as some scholars have suggested, I instead aim to develop an account which articulates a fundamental existential structure which helps to elucidate and situate later notions of existential subjectivity by accounting for its condition of possibility. In this vein, existentialism not only articulates a certain kind of being in the world but a logical condition of the structure of subjectivity itself. I call this structuring condition existential logic, and locate it (...) in Fichte's Wissenschaftslehre. I develop the term existential logic instead of merely attributing to Fichte the term existential-ism or existentialist, insofar as I aim to locate an operative structure within the being who then becomes an existential subject for whom existential engagement is only then possible. The term existential logic suggests that the striving of the self both with and against the world—as existential phenomenology would have it—is a structure inherent within Fichte's logical deduction and formulation of the Absolute I. (shrink)

Background Teamwork in emergency medical services is a very important factor in efforts to improve patient safety. The potential differences of staff gender on communication, patient safety, and teamwork were omitted. The aim of this study is to evaluate these inadequately examined areas. Methods A descriptive and anonymous study was conducted with an online questionnaire targeting emergency physicians and paramedics. The participants were asked about teamwork, communication, patient safety and handling of errors. Results Seven hundred fourteen prehospital professionals from all (...) over Germany participated. A total of 65.7% of the women harmed a patient (men 72.9%), and 52.6% were ashamed when mistakes were made (men 31.7%). 19.0% of the female participants considered their communication skills to be very good, compared to 81% of the men. More women than men did not want to appear incompetent (28.4%, 15.5%) and therefore did not speak openly about mistakes. Both genders saw the character of their colleagues as a reason for poor team communication (women 89.4%, men 84.9.%). Under high stress, communication decreased (women 35.9%, men 31.0%) and expression became inaccurate (women 18.7%, men 20.1%). Conclusions Team communication problems and teamwork in rescue services are independent of gender. Women seem to have more difficulty with open communication about mistakes because they seem to be subject to higher expectations. Work organization should be adapted to women’s needs to enable more effective error management. We conclude that it is necessary to promote a positive error and communication culture to increase patient safety. (shrink)

ABSTRACT Between the first two Critiques, Kant wrote what he called a “conjectural history” of the development of human freedom through a reading of Genesis. In the essay, reason itself is conceived of in terms of its “genesis,” and Kant primarily reads “Genesis” as an account of reason’s ascension or becoming. Just as humankind becomes itself through the Fall, so too does reason simultaneously come into its own. Adam indeed acts as a template for the conception of moral agency that (...) Kant will go on to develop in much more detail in the second critique. More significantly, however, as I argue below, the “genesis” and ascension of reason is only made possible through Eve’s covering up of herself. I argue that the act naturalizes both shame and clothing onto a feminine body conceived as un-reasonable. It is against this foil of unreason that reason is able to reach its own heights. I argue that Kant’s reading of Genesis in the “Conjectures” naturalizes women and clothing as superfluous: to humankind and to the ascent of reason alike. However, their function as the condition of possibility for Kant’s own system will show that they are anything but superfluous. Rather, they are essential. (shrink)

Background Teamwork in emergency medical services is a very important factor in efforts to improve patient safety. The potential differences of staff gender on communication, patient safety, and teamwork were omitted. The aim of this study is to evaluate these inadequately examined areas. Methods A descriptive and anonymous study was conducted with an online questionnaire targeting emergency physicians and paramedics. The participants were asked about teamwork, communication, patient safety and handling of errors. Results Seven hundred fourteen prehospital professionals from all (...) over Germany participated. A total of 65.7% of the women harmed a patient (men 72.9%), and 52.6% were ashamed when mistakes were made (men 31.7%). 19.0% of the female participants considered their communication skills to be very good, compared to 81% of the men. More women than men did not want to appear incompetent (28.4%, 15.5%) and therefore did not speak openly about mistakes. Both genders saw the character of their colleagues as a reason for poor team communication (women 89.4%, men 84.9.%). Under high stress, communication decreased (women 35.9%, men 31.0%) and expression became inaccurate (women 18.7%, men 20.1%). Conclusions Team communication problems and teamwork in rescue services are independent of gender. Women seem to have more difficulty with open communication about mistakes because they seem to be subject to higher expectations. Work organization should be adapted to women’s needs to enable more effective error management. We conclude that it is necessary to promote a positive error and communication culture to increase patient safety. (shrink)

Keine ausführliche Beschreibung für "Über das Wesen der Naturgesetze" verfügbar.

Purpose Existing algorithms for predicting suicide risk rely solely on data from electronic health records, but such models could be improved through the incorporation of publicly available socioeconomic data – such as financial, legal, life event and sociodemographic data. The purpose of this study is to understand the complex ethical and privacy implications of incorporating sociodemographic data within the health context. This paper presents results from a survey exploring what the general public’s knowledge and concerns are about such publicly available (...) data and the appropriateness of using it in suicide risk prediction algorithms. Design/methodology/approach A survey was developed to measure public opinion about privacy concerns with using socioeconomic data across different contexts. This paper presented respondents with multiple vignettes that described scenarios situated in medical, private business and social media contexts, and asked participants to rate their level of concern over the context and what factor contributed most to their level of concern. Specific to suicide prediction, this paper presented respondents with various data attributes that could potentially be used in the context of a suicide risk algorithm and asked participants to rate how concerned they would be if each attribute was used for this purpose. Findings The authors found considerable concern across the various contexts represented in their vignettes, with greatest concern in vignettes that focused on the use of personal information within the medical context. Specific to the question of incorporating socioeconomic data within suicide risk prediction models, the results of this study show a clear concern from all participants in data attributes related to income, crime and court records, and assets. Data about one’s household were also particularly concerns for the respondents, suggesting that even if one might be comfortable with their own being used for risk modeling, data about other household members is more problematic. Originality/value Previous studies on the privacy concerns that arise when integrating data pertaining to various contexts of people’s lives into algorithmic and related computational models have approached these questions from individual contexts. This study differs in that it captured the variation in privacy concerns across multiple contexts. Also, this study specifically assessed the ethical concerns related to a suicide prediction model and determining people’s awareness of the publicness of select data attributes, as well as which of these data attributes generated the most concern in such a context. To the best of the authors’ knowledge, this is the first study to pursue this question. (shrink)

Jiva.--Samsara.--Karman.--Naman und Brahman.--Yoga.--Prajna paramita.--Trivarga. Schakti. Maya.

While universal healthcare provisions are the global norm rather than the exception, the United States exists in the latter category. The paradox remains that while the right to health is both increasingly implemented and recognized on a global scale, the United States seems to run farther away from the arguments and global examples that might pave its way. I suggest that an understanding of the imposition of healthcare as “coercive,” and hence as an impingement on individual agency, activates its criticism (...) as an inhibition of freedom that in turn motivates the libertarianism at the heart of the dominant, market‐based approach to health insurance provisions. At least one of the underlying assumptions of this view is that universal healthcare would impose or impinge on individual rights, and that such an impingement is a violation of autonomy. In this article, I aim to challenge this assumption by suggesting that the pitting of individual health rights against collective burdens stems in part from a related assumption of general health or welfare on the part of the collective: that disability and debility alike are anomalies or anomalous to the general health of the population. In other words, it will be my contention that individual health rights are only at odds with “collective rights” when the collective is perceived to be able‐bodied. (shrink)

Keine ausführliche Beschreibung für "Spiel um den Elefanten" verfügbar.

Die Meisterwerke der Moralistik haben Millionen von Menschen als philosophische Lebensbegleiter gedient. Doch worum geht es in der Moralistik eigentlich? 0Die Moralistik befasst sich mit der Natur des Menschen und mit Möglichkeiten kluger, individueller Selbstbehauptung. Sie führt die antiken Ansätze einer philosophischen Klugheitslehre fort und besetzt damit einen in der neuzeitlichen Ethik vernachlässigten Teil der praktischen Philosophie. Ihre Meisterwerke vermitteln uns Menschenkenntnis und soziale Orientierung und stehen uns auf dem Weg eines gelingenden Lebens beratend zur Seite. In ihnen liegt der (...) Ursprung der modernen Philosophie der Lebenskunst. Das Buch stellt sowohl die Entwicklung der Moralistik als auch ihr philosophisches Anliegen anschaulich und gut lesbar dar. (shrink)

Examines the diverse cultural influences which have shaped the basic philosophical traditions of India "Indian philosophy was at the heart of Zimmer's interest..