La construcción de la nación y la transformación de lo político / Ingrid Johanna Bolívar.

Background:The global COVID-19 pandemic has imposed challenges on healthcare systems and professionals worldwide and introduced a ´maelstrom´ of ethical dilemmas. How ethically demanding situations are handled affects employees’ moral stress and job satisfaction.Aim:Describe priority-setting dilemmas, moral distress and support experienced by nurses and physicians across medical specialties in the early phase of the COVID-19 pandemic in Western Norway.Research design:A cross-sectional hospital-based survey was conducted from 23 April to 11 May 2020.Ethical considerations:Ethical approval granted by the Regional Research Ethics Committee in (...) Western Norway (131421).Findings:Among the 1606 respondents, 67% had experienced priority-setting dilemmas the previous two weeks. Healthcare workers who were directly involved in COVID-19 care, were redeployed or worked in psychiatry/addiction medicine experienced it more often. Although 59% of the respondents had seen adverse consequences due to resource scarcity, severe consequences were rare. Moral distress levels were generally low (2.9 on a 0–10 scale), but higher in selected groups (redeployed, managers and working in psychiatry/addiction medicine). Backing from existing collegial and managerial structures and routines, such as discussions with colleagues and receiving updates and information from managers that listened and acted upon feedback, were found more helpful than external support mechanisms. Priority-setting guidelines were also helpful.Discussion:By including all medical specialties, nurses and physicians, and various institutions, the study provides information on how the COVID-19 mitigation also influenced those not directly involved in the COVID-19 treatment of patients. In the next stages of the pandemic response, support for healthcare professionals directly involved in outbreak-affected patients, those redeployed or those most impacted by mitigation strategies must be a priority.Conclusion:Empirical research of healthcare workers experiences under a pandemic are important to identify groups at risks and useful support mechanisms. (shrink)

During the past decade, screening tests using computed tomography have disseminated into practice and been marketed to patients despite neither conclusive evidence nor professional agreement about their efficacy and cost-effectiveness at the population level. This phenomenon raises questions about physicians' professional roles and responsibilities within the setting of medical innovation, as well as the appropriate scope of patient autonomy and access to unproven screening technology. This article explores how physicians ought to respond when new screening examinations that lack conclusive evidence (...) of overall population benefit emerge in the marketplace and are requested by individual patients. To this end, the article considers the nature of evidence and how it influences decision-making for screening at both the public policy and individual patient levels. We distinguish medical and ethical differences between screening recommended for a population and screening considered on an individual patient basis. Finally, we discuss specific cases to explore how evidence, patient risk factors and preferences, and physician judgment ought to balance when making individual patient screening decisions. (shrink)

Camill Leberer (geb. 1953) gehört zu den profiliertesten deutschen Bildhauern seiner Generation. Das vorliegende Buch untersucht seine durch die Verwendung von Stahl und Glas ausgezeichneten Plastiken erstmals unter dem Aspekt der Immaterialität. Dazu werden Bezüge zur amerikanischen Light and Space Bewegung, zu amerikanischen wie deutschen Stahlkünstlern und zur Gruppe Zero erarbeitet. Unter anderem durch diese wird das ästhetische Prinzip Immaterialität im Werk Leberers anhand der Informationsästhetik Max Benses kunsthistorisch eingeordnet.

The aim of this study was to obtain an increased understanding of the experiences of elderly people in geriatric care, with special reference to integrity. Data were collected through qualitative interviews with elderly people and, in order to obtain a description of caregivers’ integrity-promoting or non-promoting behaviours, participant observations and qualitative interviews with nursing students were undertaken. Earlier studies on the integrity of elderly people mainly concentrated on their personal and territorial space, so Kihlgren and Thorsén opened up the possibility (...) of considering the concept of integrity from a broader view by recognizing its relationship to the larger framework of the self-concept. Based on this, findings in the present study indicate that elderly people’s integrity relating to their corporal self were the least violated. On the other hand, their psycological, information and cultural selves were the most exposed. The study also identified a further dimension (i.e. one relating to social self), which should be included in the concept of integrity because respecting elderly people’s social self reduces their feelings of loneliness, isolation and seclusion. In summary, the results indicate that the concept of integrity is complex and has several dimensions. (shrink)

This article analyses the general ethical milieu in a nursing home for elderly residents and provides a decision-making model for analysing the ethical situations that arise. It considers what it means for the residents to live together and for the staff to be in ethically problematic situations when caring for residents. An interpretative phenomenological approach and Sandman’s ethical model proved useful for this purpose. Systematic observations were carried out and interpretation of the general ethical milieu was summarized as ‘being in (...) the same world without meeting’. Two themes and four subthemes emerged from the analysis. Three different ethical problems were analysed. The outcome of using the decision-making model highlighted the discrepancy between the solutions used and well-founded solutions to these problems. An important conclusion that emerged from this study was the need for a structured tool for reflection. (shrink)

In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and (...) nurses’ ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses’ everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care. (shrink)

Ontic structural realists hold that structure is all there is, or at least all there is fundamentally. This thesis has proved to be puzzling: What exactly does it say about the relationship between objects and structures? In this article, I look at different ways of articulating ontic structural realism in terms of the relation between structures and objects. I show that objects cannot be reduced to structure, and argue that ontological dependence cannot be used to establish strong forms of structural (...) realism. At the end, I show how a weaker, but controversial, form of structural realism can be articulated on the basis of ontological dependence. (shrink)

In “Obligations of the Gift,” Lee argues that ethical thinking regarding return of genetic research results has been too narrowly focused on individual consent and participants’ “right to kn...

This article reveals a 91-year-old cognitively intact man’s lived experiences of being cared for in a geriatric context in which the majority of the patients were cognitively impaired. A narrative patient story was analysed phenomenologically. The findings indicate that this patient’s basic needs for ethical care were not met. The staff did not see him as a unique individual with his own preferences, resources and abilities to master his life. In order to survive this lack of ethical care, he played (...) the role of an ‘old cognitively impaired man’, which provided him with at least the understanding and attention the cognitively impaired patients received from the staff. The findings also indicate that ethical care is independent of whether or not older cognitively intact and impaired patients stay or live in the same unit, but it is more dependent on a caregiver’s ability to respect and confirm each and every patient for who he or she is and would like to be. (shrink)

A growing number of decision theorists have, in recent years, defended the view that rationality is permissive under risk: Different rational agents may be more or less risk-averse or risk-inclined. This can result in them making different choices under risk even if they value outcomes in exactly the same way. One pressing question that arises once we grant such permissiveness is what attitude to risk we should implement when choosing on behalf of other people. Are we permitted to implement any (...) of the rationally permissible risk attitudes, is there some specific risk attitude that is required when choosing for others, or are we required to defer to the risk attitudes of the people on whose behalf we are choosing? This article elaborates on this question, explains its wider practical and theoretical significance, provides an overview of existing answers, and explores how to go about providing a more systematic account of how to choose on behalf of others in risky contexts. (shrink)

This paper offers a critique of Martha Nussbaum’s description of the capability approach, and offers an alternative. I will argue that Nussbaum’s characterization of the capability approach is flawed, in two ways. First, she unduly limits the capability to two strands of work, thereby ignoring important other capabilitarian scholarship. Second, she argues that there are five essential elements that all capability theories meet; yet upon closer analysis three of them are not really essential to the capability approach. I also offer (...) an alternative description of the capability approach, which is called the cartwheel view of the capability approach. This view is at the same time radically multidisciplinary yet also contains a foundationally robust core among its various usages, and is therefore much better able to make the case that the capability approach can be developed in a very wide range of more specific normative theories. Finally, the cartwheel view is used to argue against Nussbaum's claim that all capabilitarian political theory needs to be politically liberal. (shrink)

In this paper I aim to answer two questions: Can spin be treated as a determinable? Can a treatment of spin as a determinable be used to understand quantum indeterminacy? In response to the first question I show that the relations among spin number, spin components and spin values cannot be captured by a single determination relation; instead we need to look at spin number and spin value separately. In response to the second question I discuss three ways in which (...) the determinables model might be modified to account for indeterminacy, and argue that none of them is fully successful in helping us to understand quantum indeterminacy. (shrink)

This article argues that Lara Buchak’s risk-weighted expected utility (REU) theory fails to offer a true alternative to expected utility theory. Under commonly held assumptions about dynamic choice and the framing of decision problems, rational agents are guided by their attitudes to temporally extended courses of action. If so, REU theory makes approximately the same recommendations as expected utility theory. Being more permissive about dynamic choice or framing, however, undermines the theory’s claim to capturing a steady choice disposition in the (...) face of risk. I argue that this poses a challenge to alternatives to expected utility theory more generally. (shrink)

En quoi le corps participe-t-il de l'entente que l'homme a du monde? Que signifie dès lors écouter? Comment établir un rapport juste à l'animal? Quel sens prêter aux couleurs? Pourquoi la tonalité décisive de notre rapport au monde peut-elle advenir à la faveur d'expériences olfactives et gustatives? En quoi la tactilité incite-t-elle à considérer le corps vif comme une donnée originaire et à reconnaître qu'il est bien une vulnérabilité dotée d'aptitudes qui nous dispose au monde? Comment l'angoisse, révélée et cachée (...) tout à la fois par la maladie, est-elle chevillée au corps de l'être-au-monde, le Dasein? Qu'en est-il du corps dans la nostalgie, dans la mélancolie, dans l'ennui et dans la joie? Pourquoi la coexistence, supposant relations et rencontres, implique-t-elle l'articulation des corporéités vives comme dans le tact sensitif ou dans la jalousie amoureuse et dans l'amour pensé en terme de tonalité érotique? Comment comprendre la mobilité et parvenir ainsi jusqu'à l'éminente dignité ontologique du mouvement? De quoi la pensée est-elle redevable au corps? Telles sont les questions qui jalonnent cet ouvrage. Par son orientation résolument phénoménologique, l'Intelligence du corps entend renouveler l'entente du phénomène le plus proprement humain et, cependant, le plus malmené par la métaphysique. Prenant librement appui sur les vues inouïes de Martin Heidegger, consciente de l'actuelle soumission du corps de l'homme à l'arraisonnement technique, Ingrid Auriol ouvre une voie d'accès à l'intelligence du corps libérée de cette violence. (shrink)

Intensified job demands originate in the general accelerated pace of society and ever-changing working conditions, which subject workers to increasing workloads and deadlines, constant planning and decision-making about one’s job and career, and the continual learning of new professional knowledge and skills. This study investigated how individual characteristics, namely negative and positive affectivity related to competence demands, and multitasking preference moderate the association between IJDs and cognitive stress symptoms among media workers. The results show that although IJDs were associated with (...) higher cognitive stress symptoms at work, that is, difficulties in concentration, thinking clearly, decision-making, and memory, competence demands-related negative affectivity explained the most variance in cognitive stress symptoms. In addition, IJDs were more strongly associated with cognitive stress symptoms at work in individuals with high competence demand-related negative affectivity, and low multitasking preference. Altogether, the present findings suggest that HR practices or workplace interventions to ease employees’ negative affectivity from increasing competence demands at work could usefully support employees’ effective cognitive functioning when confronted with IJDs. (shrink)

This study describes the ways in which professionals in two contexts of health care: general practice and homeopathic consultations, respond to patients' affective expressions of a trouble or a problem. The focus is on the turns of professionals that display understanding, compassion or agreement with the patient's account. Different types of affiliative turns are described and their consequences for the following interaction are scrutinized in relation to the institutional task of solving the patients' health-related problems. It is shown that in (...) both contexts, affiliation is oriented to as working towards closing the sequence of troubles-telling and serves to shift back to problem-solving activity, whilst in homeopathy, it may also serve as a means to problem-solving and thus help to complete the institutional task at hand. Some implications of these observations for professional—client interaction will be described. To conclude, the role of emotion in institutional interaction will also be discussed. (shrink)

Some scientists are happy to follow in the footsteps of others; some like to explore novel approaches. It is tempting to think that herein lies an epistemic division of labor conducive to overall scientific progress: the latter point the way to fruitful areas of research, and the former more fully explore those areas. Weisberg and Muldoon’s model, however, suggests that it would be best if all scientists explored novel approaches. I argue that this is due to implausible modeling choices, and (...) I present an alternative ‘epistemic landscape’ model that demonstrates the alleged benefits from division of labor, with one restriction. (shrink)

A neuropsychological perspective on auditory verbal hallucinations links key phenomenological features of the experience, such as voice location and identity, to functionally separable pathways in normal human audition. Although this auditory processing stream framework has proven valuable for integrating research on phenomenology with cognitive and neural accounts of hallucinatory experiences, it has not yet been applied to other symptoms presumed to be closely related to AVH – such as thought insertion. In this paper, I propose that an APS framework offers (...) a useful way of thinking about the experience of TI as well as AVH, providing a common conceptual framework for both. I argue that previous self-monitoring theories struggle to account for both the differences and similarities in the characteristic features of AVH and TI, which can be readily accommodated within an APS framework. Furthermore, the APS framework can be integrated with predictive processing accounts of psychotic symptoms; makes predictions about potential sites of prediction error signals; and may offer a template for understanding a range of other symptoms beyond AVH and TI. (shrink)

Introduction -- The freedom of philosophy -- Reason and madness -- The death of man -- The anonymity of literature -- From archaeology to genealogy -- The prison -- Repressed sexuality -- A true sex -- Political power, rationality, and critique -- Practices of the self.

Realists about science tend to hold that our scientific theories aim for the truth, that our successful theories are at least partly true, and that the entities referred to by the theoretical terms of these theories exist. Antirealists about science deny one or more of these claims. A sizable minority of philosophers of science prefers not to take sides: they believe the realism debate to be fundamentally mistaken and seek to abstain from it altogether. In analogy with other realism debates (...) I will call these philosophers quietists. In the philosophy of science quietism often takes a somewhat peculiar form, which I will call naturalistic quietism. In this paper I will characterize Maddy’s Second Philosophy as a form of naturalistic quietism, and show what the costs for making it feasible are. (shrink)

This paper defends revealed preference theory against a pervasive line of criticism, according to which revealed preference methodology relies on appealing to some mental states, in particular an agent’s beliefs, rendering the project incoherent or unmotivated. I argue that all that is established by these arguments is that revealed preference theorists must accept a limited mentalism in their account of the options an agent should be modelled as choosing between. This is consistent both with an essentially behavioural interpretation of preference (...) and with standard revealed preference methodology. And it does not undermine the core motivations of revealed preference theory. (shrink)

Background Moral courage means courage to act according to individual’s own ethical values and principles despite the risk of negative consequences for them. Research about the moral courage of whistle-blowers in health care is scarce, although whistleblowing involves a significant risk for the whistle-blower. Objective To analyse the moral courage of potential whistle-blowers and its association with their background variables in health care. Research design Was a descriptive-correlational study using a questionnaire, containing Nurses Moral Courage Scale©, a video vignette of (...) the wrongdoing situation with an open question about the vignette, and several background variables. Data were analysed statistically and inductive content analysis was used for the narratives. Participants and research context Nurses as healthcare professionals (including registered nurses, public health nurses, midwives, and nurse paramedics) were recruited from the membership register of the Nurses’ Association via email in 2019. A total of 454 nurses responded. The research context was simulated using a vignette. Ethical considerations Good scientific inquiry guidelines were followed. Permission to use the Nurses’ Moral Courage Scale© was obtained from the copyright holder. The ethical approval and permission to conduct the study were obtained from the participating university and the Nurses’ Association. Findings The mean value of potential whistle-blowers’ moral courage on a Visual Analogue Scale (0–10) was 8.55 and the mean score was 4.34 on a 5-point Likert scale. Potential whistle-blowers’ moral courage was associated with their socio-demographics, education, work, personality and social responsibility related background variables. Discussion and conclusion In health care, potential whistle-blowers seem to be quite morally courageous actors. The results offer opportunities for developing interventions, practices and education to support and encourage healthcare professionals in their whistleblowing. Research is needed for developing a theoretical construction to eventually increase whistleblowing and decrease and prevent wrongdoing. (shrink)

Paradoxically, the practical necessity of love seems to combine the personal character of psychological necessity with the inescapable and authoritative quality of moral necessity. Traditionally, philosophers have avoided this paradox by treating love as an amalgam of impersonal evaluative judgments and affective responses. On my account, love participates in a different form of practical necessity, one characterized by a non-moral yet normative type of expectation. This expectation is best understood as a kind of second-personal address that does not support derivative (...) third-personal demands. It is revealed when we react with hurt feelings instead of resentment upon its disappointment. (shrink)

The main purpose of this dissertation is to examine critically and discuss the role of imagination in science and religion, with particular emphasis on its possible epistemic, creative, and meaning-making functions. In order to answer my research questions, I apply theories and concepts from contemporary philosophy of mind on scientific and religious practices. This framework allows me to explore the mental state of imagination, not as an isolated phenomenon but, rather, as one of many mental states that co-exist and interplay (...) in our cogntive architecture. Based on the philosophical discourse of philosophy of mind, four types of imagination are indentified and conceptualized: sensory, propositional, experiential, and creative imagination. These categories are then employed on five phenomena that can be found in scientific and religious environments: metaphors, models, thought experiments, aspect perception, and - in the religious case - rituals. In relation to the concept of religious "seeing" I consider how imaginings may influence visionary experiences and visualization, and compare these phenomena with cases of scientific visualization and eureka experiences. In regard to scientific and religious models, a distinction is made between, on the one hand, two notions of truth and, on the other hand, truth-independent meaning-making. In light of these categories, I differentiate between, and critically discuss, the use of imagination in doxastic, non-doxastic and fictionalist accounts. In light of this investigation, I formulate and defend the position of interactivism, which acknowledges a constant interplay between different attitudes and mental states. In my examination of rituals and scientific and religious thought experiments, special attention is given to the mental capacity to recreate the experiences that are entailed in an imagined scenario. At the end of the investigation, I consider the possible impact that my study might have on how we view science and religion as well as the dialogue bewteen these two fields. (shrink)

Continuing medico-technical progress has led toan increasing medicalisation of pregnancy andchildbirth. One of the most common technologiesin this context is ultrasound. Based on someidentified `pro-technology feminist theories',notably the postmodernist feminist discourse,the technology of ultrasound is analysedfocusing mainly on social and political ratherthan clinical issues. As empirical researchsuggests, ultrasound is welcomed by themajority of women. The analysis, however, showsthat attitudes and decisions of women areinfluenced by broader social aspects. Furthermore, it demonstrates how the visualtechnology of ultrasound, in addition to otherreproductive technology (...) in maternity care, islinked to the `personification' of the foetusand has therefore contributed to a new image ofthe foetus. The exploration of these issueschallenges some arguments of feministdiscourse. It draws attention to possibleadverse implications of the technology forwomen's reproductive freedom and indicates theimportance of the topic for politicaldiscussions. (shrink)

This first book of the series, contains the theory and technique on how to recognize your own presence and your connectedness to everything else, experiencing oneness, through the state of awareness. Making emphasis on how to clear the soul from any blockages, emotions or other filters that may affect that experience of recognizing the true self.

A IDENTIFICAÇÃO DO DIREITO AMBIENTAL MARÍTIMO.

A IMPORTÂNCIA DE TRATAMENTO DE ÁGUAS RESIDUAIS ATRAVÉS DA BIORREMEDIAÇÃO: UMA ANÁLISE PRINCIPIOLÓGICA.

Discourse ethics represents an exciting new development in neo-Kantian moral theory. William Rehg offers an insightful introduction to its complex theorization by its major proponent, Jürgen Habermas, and demonstrates how discourse ethics allows one to overcome the principal criticisms that have been leveled against neo-Kantianism. Addressing both "commun-itarian" critics who argue that universalist conceptions of justice sever moral deliberation from community traditions, and feminist advocates of the "ethics of care" who stress the moral significance of caring for other individuals, Rehg (...) shows that discourse ethics combines impartiality with solidarity. He provides the first systematic reconstruction of Habermas's theory and explores its relationship to the work of such contemporary philosophers as Charles Taylor. His book articulates a bold alternative to the split between the "right" and the "good" in moral theory and will greatly interest philosophers, social and legal scholars, and political theorists. (shrink)

In 'How Should We Aggregate Competing Claims', Alex Voorhoeve suggests accommodating intuitions about duties in rescue cases by combining aggregative and non-aggregative elements into one theory. In this paper, I discuss two problems Voorhoeve’s theory faces as a result of requiring a cyclic pattern of choice, and argue that his attempt to solve them does not succeed.

Are laws of nature necessary, and if so, are all laws of nature necessary in the same way? This question has played an important role in recent discussion of laws of nature. I argue that not all laws of nature are necessary in the same way: conservation laws are perhaps to be regarded as metaphysically necessary. This sheds light on both the modal character of conservation laws and the relationship between different varieties of necessity.

Against the background of high demand for protein-rich feed in the EU and the environmental degradation associated with intensive livestock farming, insect-based feed is discussed as a potential sustainable alternative to conventional feed. However, the establishment of such an innovation depends not only upon technical and economic feasibility, but also on social factors impacting acceptability. The aim of this paper was to determine the acceptability of different social actor groups towards the use of insects as livestock feed, and to gain (...) insights into value-based arguments leading to positive or negative attitudes and perceived benefits and risks. By means of qualitative content analysis, we analysed responses of an EU public consultation process linked to the authorization of insect protein in pig and poultry feed. We found a broad range of value-based arguments that influence the complex judgement process of acceptability that have been neglected in prior quantitative surveys. In particular, our results bring forward more critical voices, such as animal welfare concerns and scepticism that insect-based feed can contribute to a more sustainable livestock system. Based on these findings, we discuss whether insects as feed are a viable contribution to a sustainability-oriented transformation of the agri-food system. We conclude that under certain conditions (when raised on low-value organic side streams such as manure) insect-based livestock feed may contribute to incremental sustainability improvements. Overall, however, the innovation has limitations, not only in terms of regulatory conditions but especially with regard to ethical concerns. (shrink)

Ethical dilemmas are part of medicine, but the type of challenges, the frequency of their occurrence and the nuances in the difficulties have not been systematically studied in low-income settings. The objective of this paper was to map out the ethical dilemmas from the perspective of Ethiopian physicians working in public hospitals. A national survey of physicians from 49 public hospitals using stratified, multi-stage sampling was conducted in six of the 11 regions in Ethiopia. Descriptive statistics were used and the (...) responses to the open-ended question “If you have experienced any ethical dilemma, can you please describe a dilemma you have encountered in your own words?” were analyzed using a template analysis process. A total of 587 physicians responded, and 565 met the inclusion criteria. Twelve of 24 specified ethically challenging situations were reported to be experienced often or sometimes by more than 50% of the physicians. The most frequently reported challenge concerned resource distribution: 93% agreed that they often or sometimes had to make difficult choices due to resource limitation, and 83% often or sometimes encountered difficulties because patients were unable to pay for the preferred course of treatment. Other frequently reported difficulties were doubts about doing good or harming the patient, relating to conflicting views, concern for family welfare, disclosure issues and caring for patients not able to consent. Few reported dilemmas related to end-of-life issues. The 200 responses to the open-ended question mirrored the quantitative results. Ethiopian physicians report ethical challenges related more to bedside rationing and fairness concerns than futility discussions and conflicts about autonomy as described in studies from high-income countries. In addition to the high report of experienced challenges, gravity of the dilemmas that are present in their narratives are striking. Recognition of the everyday experiences of physicians in low-income settings should prompt the development of ethics teaching and support mechanisms, discussion of ethical guidelines as well as increase our focus on how to improve the grave resource scarcity they describe. (shrink)