BackgroundNon-technical skills are cognitive and interpersonal skills underpinning technical proficiency. Ethical values and respect for human dignity make operating room nurses responsible for nursing decisions that are clinically and technically sound and morally appropriate.AimTo learn what ethical issues operating room nurses perceive as important regarding non-technical skills.Research designQualitative individual in-depth interviews were conducted. The interviews were analysed using Braun and Clarke’s six phases for thematic analysis.Participants and research contextEleven experienced perioperative/operating room nurses working in an operating unit at a Norwegian (...) university hospital.Ethical considerationsApproval was given by The Norwegian Social Science Data Service in care of the hospital’s Data Protection Officer.FindingsThree main themes were found: respect and care for the patient, making the patient feel safe, and respect within the perioperative team. These features or themes, which incorporate collaboration and communication, are closely connected to patient safety.DiscussionDefending the patient’s dignity is part of caring for and respecting the patient. The manner in which the operating room team collaborates is important for the patient to feel safe and secure. Poor teamwork may have dire consequences. Reciprocal respect within the team includes respect for each other’s tasks and responsibilities and to talk to one another in a friendly manner.ConclusionBeing respectful and contributing to a caring atmosphere are central ethical skills in the operating room. To patients, harmonious teamwork translates into a feeling of safety and being cared for. The nurses see respect and patient safety, and respect and reciprocal politeness among the members of the perioperative team as central ethical non-technical skills. Lack of respect influences the team negatively and is detrimental for patient safety. Good communication is an important safety measure during surgery and creates a feeling of good ‘flow’ within the operating room team. (shrink)
This document presents the Bonn PRINTEGER Consensus Statement: Working with Research Integrity—Guidance for research performing organisations. The aim of the statement is to complement existing instruments by focusing specifically on institutional responsibilities for strengthening integrity. It takes into account the daily challenges and organisational contexts of most researchers. The statement intends to make research integrity challenges recognisable from the work-floor perspective, providing concrete advice on organisational measures to strengthen integrity. The statement, which was concluded February 7th 2018, provides guidance on (...) the following key issues: § 1. Providing information about research integrity§ 2. Providing education, training and mentoring§ 3. Strengthening a research integrity culture§ 4. Facilitating open dialogue§ 5. Wise incentive management§ 6. Implementing quality assurance procedures§ 7. Improving the work environment and work satisfaction§ 8. Increasing transparency of misconduct cases§ 9. Opening up research§ 10. Implementing safe and effective whistle-blowing channels§ 11. Protecting the alleged perpetrators§ 12. Establishing a research integrity committee and appointing an ombudsperson§ 13. Making explicit the applicable standards for research integrity. (shrink)
This document presents the Bonn PRINTEGER Consensus Statement: Working with Research Integrity—Guidance for research performing organisations. The aim of the statement is to complement existing instruments by focusing specifically on institutional responsibilities for strengthening integrity. It takes into account the daily challenges and organisational contexts of most researchers. The statement intends to make research integrity challenges recognisable from the work-floor perspective, providing concrete advice on organisational measures to strengthen integrity. The statement, which was concluded February 7th 2018, provides guidance on (...) the following key issues: § 1.Providing information about research integrity § 2.Providing education, training and mentoring § 3.Strengthening a research integrity culture § 4.Facilitating open dialogue § 5.Wise incentive management § 6.Implementing quality assurance procedures § 7.Improving the work environment and work satisfaction § 8.Increasing transparency of misconduct cases § 9.Opening up research § 10.Implementing safe and effective whistle-blowing channels § 11.Protecting the alleged perpetrators § 12.Establishing a research integrity committee and appointing an ombudsperson § 13.Making explicit the applicable standards for research integrity. (shrink)
The expansion of livestock production throughout the world has led to increased demand for high protein animal feed. This expansion has created economic benefits for livestock farmers and other actors in the chain, but also resulted in environmental and social side effects. This study aims to identify a set of sustainability issues that cover the environmental, economic and social dimensions of soymeal and beef production chains. The method applied combines the results of multiple studies, including a literature review and stakeholder (...) surveys. Stakeholder surveys were conducted for three different interest groups and two geographical regions . Our results reveal that the selection of issues in most sustainability assessment studies is a relatively arbitrary decision, while the literature also states that identifying issues is an important step in a sustainability assessment. Defining sustainability issues from a whole chain perspective is important, as issues of sustainability emerge at various stages along the production chain, and are found to vary across stakeholders’ interests. Business stakeholders, for example, perceived economic issues to be more important, whereas the majority of consumer stakeholders and other stakeholders perceived social and environmental issues, respectively, to be more important. Different education levels, knowledge, and living patterns in various geographical regions can affect the stakeholders’ perceptions. The combination of a heterogeneous group of stakeholders and the consideration of multiple chain stages constitutes a useful approach to identify sustainability issues along food chains. (shrink)
Having Too Much is the first academic volume devoted to limitarianism: the idea that the use of economic or ecosystem resources should not exceed certain limits. This concept has deep roots in economic and political thought. One can find similar statements of such limits in thinkers such as Plato, Aquinas, and Spinoza. But Having Too Much is the first time in contemporary political philosophy that limitarianism is explored at length and in detail. Bringing together in one place the best writing (...) from key theorists of limitarianism, this book is an essential contribution to political philosophy in general, and theories of distributive justice in particular. Including some of the key published articles as well as new chapters, Having Too Much is necessary reading for scholars and students of political theory and philosophy, as well as anyone interested in questions of distributive justice. (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)
It is a common mistake, especially, perhaps, among students of the religions and philosophies of India, to assume that the word prakṛti, best known as the ultimate material principle in the Sāṃkhya and Yoga systems of religious thought, the material cause of the world in Hindu theologies and, as such, an epithet of the goddesses in Hinduism, always refers to an ultimate principle. Even in Sāṃkhya and Yoga texts the word prakṛti is used in various ways. Prakṛti does not always (...) refer to the ultimate principle. Translators often leave the word prakṛti untranslated and mislead the reader to assume that the ultimate principle is referred to, when it is not. This article discusses the use of prakṛti in the Sāṃkhya-Yoga texts the Yogasūtra and the Vyāsabhāṣya and criticises some translation practices. (shrink)
Mental time travel is the ability to mentally project oneself backward in time to relive past experiences and forward in time to pre-live possible future experiences. Previous work has focused on MTT in its voluntary form. Here, we introduce the notion of involuntary MTT. We examined involuntary versus voluntary and past versus future MTT in a diary study. We found that involuntary future event representations—defined as representations of possible personal future events that come to mind with no preceding search attempts—were (...) as common as involuntary autobiographical memories and similar to them regarding cuing and subjective qualities. Future MTT involved more positive and idyllic representations than past MTT. MTT into the distant future/past involved more representations of cultural life script events than MTT into the immediate past/future. The findings are discussed in relation to cultural learning and MTT considered as a higher mental process. (shrink)
This monograph on the capability approach does two things. First, it provides an advanced introduction to the capability approach, as an account used in philosophy, as well as other disciplines. Second, it provides an account of the capability approach which is able to encompass all existing views and theories on the capability approach, including the writings on the capability approach by Martha Nussbaum and Amartya Sen.
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)
In this article we introduce an argument developed in Borch-Jacobsen and Shamdasani (2006). We attempt to draw some consequences from several decades of work in Freud history. We argue that such work has had the cumulative effect of showing up the legendary nature of Freud's epistemology, and has demonstrated the direct linkages between his interpretive procedures and rewriting of history. The Freud legend was by no means a supplementary accessory which accompanied substantive advances, akin to the legend of Newton's (...) apple: rather, it was constitutive of the very identity of psychoanalysis, and enabled its differentiation from rival psychologies and psychotherapies, and promoted the claim that it formed the only viable science of mind and the most advanced form of psychotherapy. Historical research enables one to grasp the legendary nature of Freud's achievement. (shrink)
How can we understand God's work in a world permeated with evil? Narrating her own wrestling with evil as well as engaging in biblical and philosophical analysis, biblical scholar Ingrid Faro explores the many dimensions to evil in a way that is soberly honest, biblically engaged, and theologically nuanced.
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)
____Remembering Anna O.__ offers a devastating examination of the very foundations of psychoanalytic theory and practice, which was born with the publication of Breuer and Freud's ____Studies on Hysteria__ in 1895. Breuer described the case of Anna O., a young woman afflicted with a severe hysteria whom he had cured of her symptoms by having her recount under hypnosis the traumatic events that precipitated her illness. Drawing on the most recent Freud scholarship and on long-secret documents, Borch-Jacobsen demonstrates, however, (...) that Anna O. was never cured by Breuer's "talking cure" and that both Breuer and Freud knowingly falsified the historical record. Borch-Jacobsen points out the numerous inconsistencies in Breuer's account that suggests that Anna O.'s symptoms were simulated to meet Breuer's theoretical expectations and that her famed "reminiscences" were in fact fictitious memories induced by Breuer in the course of a hypnotic treatment. (shrink)
This collection examines the complex intersection where art and philosophy merge. Topics for discussion include the criticism of Robert Wolfe, the minimalist sculpture of the 1960s, the metaphysics of photography, the paintings of Jackson Pollock, and some reflections on why women have been denied entrance to the pantheon of great artists.
From the co-founder and president of PETA, Ingrid Newkirk, and bestselling author Gene Stone comes Animalkind, a book that offers both a tour of the wonderful world of animals and a guide to simple ways in which we can reduce the harm we cause them in our everyday lives.
From the co-founder and president of PETA, Ingrid Newkirk, and bestselling author Gene Stone comes Animalkind, a book that offers both a tour of the wonderful world of animals and a guide to simple ways in which we can reduce the harm we cause them in our everyday lives.
Choosing a compassionate lifestyle that makes you feel good and positively impacts on the environment and on animals has never been easier. In this practical and accessible handbook, loaded with resources for all products that are mentioned, Ingrid Newkirk presents fabulous options that will not only enhance your life, but those of your neighbors, your community, animals, and the earth itself. From comfortable home furnishings, to delicious foods, to fashionable clothing there are a myriad of choices to be made (...) that can have a lasting positive effect on the well-being of animals and the environment, including: - recognizing hidden animal ingredients in cosmetics and household products - raising ecologically aware and animal-friendly kids - creating healthy, environmentally-friendly meals for everyday and special occasions - dressing with style without using leather or other animal products - dealing kindly with mice, insects, and other 'pests' in home or garden - adopting the right animal companion for you - volunteering and investing in eco- and animal-friendly companies - traveling with Eco-consciousness. (shrink)
With more than two million members and supporters, People for the Ethical Treatment of Animals (PETA) is the world’s largest animal-rights organization, and its founder and president, Ingrid Newkirk, is one of the most well-known and most effective activists in America. She has spearheaded worldwide efforts to improve the treatment of animals in manufacturing, entertainment, and elsewhere. Every day, in laboratories, food factories, and other industries, animals by the millions are subjected to inhumane cruelty. In this accessible guide, Newkirk (...) teaches readers hundreds of simple ways to stop thoughtless animal cruelty and make positive choices. For each topic, Newkirk provides hard facts, personal insight, inspiration, ideas, and resources, including: • How to eat healthfully and compassionately • How to adopt animals rather than support puppy mills • How to make their vote count and change public opinion • How to switch to cruelty-free cosmetics and clothing • How to choose amusements that protect rather than exploit animals. With public concern for the well-being of animals greater than ever—particularly among young people—this timely, practical book offers exciting and easy ways to make a difference. (shrink)
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)
Pragmatic difficulties are considered a hallmark of autism spectrum conditions (ASC), but remain poorly understood. We discuss and evaluate existing hypotheses regarding the literalism of ASC individuals, that is, their tendency for literal interpretations of non‐literal communicative intentions. We present evidence that reveals a developmental stage at which neurotypical children also have a tendency for literalism and suggest an explanation for such behaviour that links it to other behavioural, rule‐following, patterns typical of that age. We discuss evidence showing that strict (...) adherence to rules is also widespread in ASC, and suggest that literalism might be linked to such rule‐following behaviour. (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)
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)
Why do 'maladies of the soul' such as hysteria, anxiety disorders, or depression wax and wane over time? Through a study of the history of psychiatry, Mikkel Borch-Jacobsen provocatively argues that most mental illnesses are not, in fact, diseases but the product of varying expectations shared and negotiated by therapists and patients. With a series of fascinating historical vignettes, stretching from Freud's creation of false memories of sexual abuse in his early hysterical patients to today's promotion and marketing of (...) depression by drug companies, Making Minds and Madness offers a powerful critique of all the theories, such as psychoanalysis and biomedical psychiatry, that claim to discover facts about the human psyche while, in reality, producing them. Borch-Jacobsen proposes such objectivizing approaches should be abandoned in favor of a constructionist and relativist psychology that recognizes the artifactual and interactive character of psychic productions instead of attempting to deny or control it. (shrink)
Human embryos produced in labs since the 1970s have generated layers of uncertainty for law and policy: ontological, moral, and administrative. Ontologically, these lab-made entities fall into a gray zone between life and not-yet-life. Should in vitro embryos be treated as inanimate matter, like abandoned postsurgical tissue, or as private property? Morally, should they exist largely outside of state control in the zone of free reproductive choice or should they be regarded as autonomous human lives and thus entitled to constitutional (...) protection like full-fledged citizens? Administratively, if they deserve protection, what institutional and policy mechanisms are best suited to carrying out the necessary oversight? Using a method termed comparative problematization, this article traces divergent answers to these questions produced in three countries—the United States, United Kingdom, and Germany—across the last twenty-five years. Comparison reveals distinct bioconstitutional foundations that give rise to systematically different understandings of each state’s responsibilities toward human life and hence its particular treatment of claims on behalf of embryonic lives. (shrink)