In Western countries a considerable number of older people move to a residential home when their health declines. Institutionalization often results in increased dependence, inactivity and loss of identity or self-worth (dignity). This raises the moral question as to how older, institutionalized people can remain autonomous as far as continuing to live in line with their own values is concerned. Following Walker's meta-ethical framework on the assignment of responsibilities, we suggest that instead of directing all older people towards more autonomy (...) in terms of independence, professional caregivers should listen to the life narrative of older people and attempt to find out how their personal identity, relations and values in life can be continued in the new setting. If mutual normative expectations between caregivers and older people are not carefully negotiated, it creates tension. This tension is illustrated by the narrative of Mr Powell, a retired successful public servant now living in a residential home. The narrative describes his current life, his need for help, his independent frame of mind, and his encounters with institutional and professional policies. Mr Powell sees himself as a man who has always cared for himself and others, and who still feels that he has to fulfil certain duties in life. Mr Powell's story shows that he is not always understood well by caregivers who respond from a one-sided view of autonomy as independence. This leads to misunderstanding and an underestimation of his need to be noticed and involved in the residential community. (shrink)
Practical implementation of notions such as patient-orientation, client-centredness, and demand-driven care is far from straightforward in care and service supply to elderly clients living independently. This paper aims to provide preliminary insights into how it is possible to bridge the gap between policy intent, which reflects an increasing client orientation, and actual practice of care and service provision. Differences in personal objectives and characteristics generate different sets of needs among elderly clients that must have an appropriate response in the daily (...) routines of care and service providers. From a study of the available literature and by conceptual reasoning, we identify several important operational implications of client-oriented care and service provision. To deal with these implications the authors turn to the field of operations management. This field has deepened the understanding of translating an organisation’s policy into daily activities and working methods. More specifically, we elaborate on the concept of modularity, which stems from the field of operations management. With respect to elderly people who live independently, this concept, among others, seems to be particularly useful in providing options and variation in individual care and service packages. Based on our line of reasoning, we propose that modularity provides possibilities to enhance the provision of demand-based care and services. Furthermore, our findings offer direction on how organisations in housing, welfare and care can be guided in translating demand-based care to their operational processes. (shrink)
Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and were organized (...) apart from existing institutional communication structures. As part of a naturalistic evaluation, systematic observations, interviews and focus groups were completed. The findings indicate that the heterogeneous composition and MCD meetings separate from existing structures have benefits. However, the participants also reported negative experiences. This gives rise to the question whether a mixed MCD group which meets separately is an effective way to embed MCD as an instrument for reflection on moral issues in daily practice. We conclude that there is no single answer to that question. In the end, the two implementation strategies (i.e. within existing communication structures and a mixed MCD group) can be complementary to each other. (shrink)
The contribution of Octavia Butler's fiction to utopian studies is becoming more widely recognized, particularly in the wake of a special issue of Utopian Studies (vol. 19, no. 3) devoted to her work. The Parable of the Sower and Parable of the Talents provide an especially effective exploration of perennial issues in political philosophy, cultural studies, and psychology.1 Civil society and the cultural norms that underlay social and political institutions have crumbled. Crime, violence, and addiction are rampant. Environmental degradation and (...) economic collapse have pushed most to roam about the country searching for food, while others take refuge in walled compounds run by corporations whose power is unchecked. .. (shrink)
This book is for those searching for an ethics engine with enough philosophical power to drive healthcare reform toward a balance between medical technology and human compassion. Jos Welie's project is to This is an important goal that has eluded others. Jos Welie has more nearly succeeded in this book than any other author who has come to my attention.
Udruga Mala filozofija kreirala je i provela projekt »Tko se boji korupcije još?!« u dvanaest škola i dvije knjižnice, s ukupno 122 učenika u školskoj godini 2010./2011. Projekt se sastojao od pet radionica u kojima se s učenicima raspravljalo o korupciji. Cilj je bio prvenstveno razjašnjenje pojma korupcije, ali i ukazivanje na razne načine na koje korupcija uništava neke temeljne vrijednosti poput dostojanstva, ljubavi, prijateljstva, obitelji i društva. Članak donosi evaluacijske rezultate u kojima se pokazuje koliko su učenici 3. i (...) 4. razreda osnovne škole razumjeli pojam korupcije te koliko su promijenili svoje stavove tijekom provođenja projekta.Society Petit Philosophy has created and implemented a project “Who’s Afraid of Corruption?!” in twelve elementary schools and two libraries, with a total of 122 students in the school year 2010/2011. The project consists of five workshops in which students primarily clarified the concept of corruption, but also the ways in which corruption is destroying the society, dignity, love, friendship, and family. Article presents the results of the evaluation, which show how 3rd and 4th graders understood the concept of corruption, and how they changed their views about corruption in the course of the project. (shrink)
In einer Reihe von philosophischen Meditationen setzt sich der Verfasser mit dem im modernen gesellschaftlichen Leben so schmerzlich empfundenen Mangel an Intimität auseinander und mit dem verschiedenen Versuchen, diesem Übel abzuhelfen. Das Buch des Flamen Van Ussel „Intimiteit” bildet seinen Ausgangspunkt. Sorgfältig abwägende kritische Betrachtungen bieten dem Verfasser Gelegenheit, Probleme zu behandeln, die indirekt mit der Initimität zusammenhängen und dabei der Sichtweise einiger bedeutender Philosophen und Humanwissenschaftler Rechnung zu tragen : Probleme, die u. a. die menschliche Leiblichkeit, das Wohnen und (...) die Institutionalisierung menschlicher Beziehungen betreffen. Auch die Frage, ob Scham eine Art Schuldgefühl ist, das mittels Psychotherapie eliminiert werden soll, oder ein natürlicher Schutz der Intimität, wird erörtert. - Mit der letzten Meditation begibt sich der Verfasser auf das Gebiet der Ethik. Van Ussel ist ja auf der Suche nach „alternative Formen des Zusammenleben”, die an die Stelle der „bürgerlichen Familie” treten sollen. Die philosophische Frage wird diskutiert, was in diesem Zusammenhang die Begriffe „ alternativ” und „bürgerlich” eigentlich bedeuten. Ist eine rein ethische Kritik der „bürgerlichen Einstellung” möglich ? Ist eine Ethik denkbar, die die bürgerliche Moral transzendiert, ohne sie zu verwerfen ? (shrink)