Research ethics committees (RECs) have a crucial role in protecting children in research. However, studies on REC members’ perspectives on paediatric research are scarce. We conducted a qualitative study to explore Swedish scientific REC members’ perspectives on ethical aspects in applications involving children with severe health conditions. The REC members considered promoting participation, protecting children and regulatory adherence to be central aspects. The results underscored the importance of not neglecting ill children’s rights to adapted information and participation. REC members supported (...) a contextual and holistic approach to vulnerability and risk, which considers the child’s and parents’ psychological wellbeing and the child’s integrity, both short and long term. The ethical complexity of paediatric research requires continuous ethical competence development within RECs. (shrink)

Background Research is crucial to improve treatment, survival and quality of life for children with cancer. However, recruitment of children for research raises ethical challenges. The aim of this study was to explore and describe ethical values and challenges related to the recruitment of children with cancer for research, from the perspectives and experiences of healthcare professionals in the Swedish context. Another aim was to explore their perceptions of research ethics competence in recruiting children for research. Methods An explorative qualitative (...) study using semi-structured interviews with key informants. Seven physicians and ten nurses were interviewed. Interviews were analysed using inductive qualitative content analysis. Results The respondents’ ethical challenges and values in recruitment mainly concerned establishing relationships and trust, meeting informational needs, acknowledging vulnerability, and balancing roles and interests. Ensuring ethical competence was raised as important, and interpersonal and communicative skills were highlighted. Conclusion This study provides empirical insight into recruitment of children with cancer, from the perspectives of healthcare professionals. It also contributes to the understanding of recruitment as a relational process, where aspects of vulnerability, trust and relationship building are important, alongside meeting informational needs. The results provide knowledge on the complexities raised by paediatric research and underpin the importance of building research ethics competence to ensure that the rights and interests of children with cancer are protected in research. (shrink)

Research about codes of corporate ethics has hitherto taken a hypothetical, correct meaning of codes for granted. The article problematises the dichotomous categories intrinsic and subjective meanings of codes. I address the question if professionals in finance accept codes of business. The particular mentality of stockbrokers and traders constructs the way they judge restrictions such as company codes of ethics. While neglecting dimensions of ethics beyond known rules, brokers and traders distrust good ethics as a possible end in itself. Many (...) professionals in the financial market perceive efforts to integrate ethical reasoning in work as only means for maximising business opportunities. (shrink)

We give a new account of Björling’s contribution to uniform convergence in connection with Cauchy’s theorem on the continuity of an infinite series. Moreover, we give a complete translation from Swedish into English of Björling’s 1846 proof of the theorem. Our intention is also to discuss Björling’s convergence conditions in view of Grattan-Guinness’ distinction between history and heritage. In connection to Björling’s convergence theory we discuss the interpretation of Cauchy’s infinitesimals.

In this paper we discuss visualizations in mathematics from a historical and didactical perspective. We consider historical debates from the 17th and 19th centuries regarding the role of intuition and visualizations in mathematics. We also consider the problem of what a visualization in mathematical learning can achieve. In an empirical study we investigate what mathematical conclusions university students made on the basis of a visualization. We emphasize that a visualization in mathematics should always be considered in its proper context.

In lieu of an abstract, here is a brief excerpt of the content:The Crisis of Authority From Holy Obedience to Bold Moral Imagination in European ChristianityKajsa AhlstrandIf we speak of a crisis of authority in Christianity we need to have some kind of common understanding of Christianity. The religion called Christianity is found in all inhabited continents and in a great variety of cultural forms. Two recent lists of countries with the greatest number of Christians show that the United States (...) is the country with the greatest number of Christians, followed by Brazil and Mexico.1 The Americas are on the top of the lists, but among the top ten we also find three Asian countries (China, India, and the Philippines), two African countries (Nigeria and the Democratic Republic of Congo), and four European countries (France, Russia, Germany, and Italy). (Australia is not on any of the lists since the total number of Australian citizens is smaller than the number of Christians in the top ten countries.) Although Christians live on all continents, it is a well-known fact that the majority of Christians now live in the Southern Hemisphere.When we talk about Christianity as an entity we have to be aware that there are enormous variations within Christianity with regard to cultural traditions, standard of living, level of education, and so on. A French Roman Catholic professor of theoretical physics may have very few convictions in common with a Pentecostal Nigerian peasant, although they both regard themselves as Christians.One way of looking at this diversity of values within Christianity is to go to the Inglehart-Welzel cultural map of the world.2 This map shows eight different “fields” of values located within a grid determined by two axes. The vertical axis goes from traditional to rational-secular values, the horizontal axis from survival values to self-expression values.The traditional values to secular-rational values dimension is described as “...the contrast between societies in which religion is very important and those in which it is not. [...] Societies near the traditional pole emphasize the importance of parent-child ties and deference to authority, along with absolute standards and traditional family values [...]. Societies with secular-rational values have the opposite preferences on all of these topics.” [End Page 49]The other dimension, survival values to self-expression values, is described thus: “Self-expression values give high priority to environmental protection, tolerance of diversity and rising demands for participation in decision making in economic and political life. These values also reflect mass polarization over tolerance of outgroups, including foreigners, gays and lesbians and gender equality. The shift from survival values to self-expression values also includes a shift in child-rearing values, from emphasis on hard work toward emphasis on imagination and tolerance as important values to teach a child.”When we apply this to the geographical dimensions of Christianity, we find that societies dominated by Christianity or in which there are significant numbers of Christians are found in every field of the map. This makes it difficult to speak of “Christian values” as if there were any values held by all or even a majority of Christians. Instead we find Christians in Africa who tend to embrace survival and traditional values—that is, religion is very important in their lives and they emphasize the importance of obedience to authority, especially within the family—whereas in the opposite diagonal corner (secular-rational values coupled with self-expression values) we find the Nordic countries, where, although the majority of the population belong to a church, religion plays a very limited role in day-to-day life and children are encouraged to rely on their empathy and imagination rather than to obey their parents and teachers.When we, in the following, move to the topic of a possible crisis of authority in Christianity, we have to remember that the suggested crisis is by no means a universal one. If we use Inglehart’s value map, the crisis of authority is located in the societies that score high on self-expression values, and if they also score high on secular-rational values the “crisis” is further aggravated. What the map does not show, however, is that there are individuals and groups within every... (shrink)

Conflicts between labor unions and nongovernmental organizations often impede private labor regulatory attempts to protect worker rights at supplier factories. Based on a study of a failed private regulatory attempt for Swedish garment retailers, we contribute to existing research into union–NGO relations by demonstrating how conflict arises because unions and NGOs act upon different institutional logics. We also contribute to the institutional logics perspective by challenging the current emphasis on either coexistence or conflict among multiple logics, and showing the heterogeneity (...) in how multiple logics manifest on a local level, how this could shift over time, and suggesting an empirically derived typology of manifestations of multiple logics. (shrink)

In this paper we consider the major development of mathematical analysis during the mid-nineteenth century. On the basis of Jahnke’s (Hist Math 20(3):265–284, 1993 ) distinction between considering mathematics as an empirical science based on time and space and considering mathematics as a purely conceptual science we discuss the Swedish nineteenth century mathematician E.G. Björling’s general view of real- and complexvalued functions. We argue that Björling had a tendency to sometimes consider mathematical objects in a naturalistic way. One example is (...) how Björling interprets Cauchy’s definition of the logarithm function with respect to complex variables, which is investigated in the paper. Furthermore, in view of an article written by Björling (Kongl Vetens Akad Förh Stockholm 166–228, 1852 ) we consider Cauchy’s theorem on power series expansions of complex valued functions. We investigate Björling’s, Cauchy’s and the Belgian mathematician Lamarle’s different conditions for expanding a complex function of a complex variable in a power series. We argue that one reason why Cauchy’s theorem was controversial could be the ambiguities of fundamental concepts in analysis that existed during the mid-nineteenth century. This problem is demonstrated with examples from Björling, Cauchy and Lamarle. (shrink)

Every day situations arising in health care contain ethical issues influencing care providers' conscience. How and to what extent conscience is influenced may differ according to how conscience is perceived. This study aimed to explore the relationship between perceptions of conscience and stress of conscience among care providers working in municipal housing for elderly people. A total of 166 care providers were approached, of which 146 (50 registered nurses and 96 nurses' aides/enrolled nurses) completed a questionnaire containing the Perceptions of (...) Conscience Questionnaire and the Stress of Conscience Questionnaire. A multivariate canonical correlation analysis was conducted. The first two functions emerging from the analysis themselves explained a noteworthy amount of the shared variance (25.6% and 17.8%). These two dimensions of the relationship were interpreted either as having to deaden one's conscience relating to external demands in order to be able to collaborate with coworkers, or as having to deaden one's conscience relating to internal demands in order to uphold one's identity as a `good' health care professional. (shrink)

The purpose of this phenomenological-hermeneutic study was to illuminate the meaning of being in ethically difficult care situations. The participants were 20 enrolled nurses employed in six intensive care units in Sweden. The results reveal a complex human process manifested in relation to one’s inner self and the other person, which transforms desolation into consolation through becoming present to the suffering other when perceiving fragility rather than tragedy. The main point of significance here is for all health professionals to create (...) an ethical work environment and strive for praxis that fosters ‘athomeness’, which renders us free to transform desolation into consolation. Consolation is of significance in ethics because it makes us available and helps us to fulfil the demands of life, while desolation makes us unavailable to others. (shrink)

Understanding between care providers and patients with stroke and aphasia: a phenomenological hermeneutic inquiry The present study illuminates the understanding in communication between formal care providers and patients with stroke and aphasia. Five care providers and three such patients participated in the study. Video recordings were made during conversations about pictures (n = 15), and the care providers were also interviewed (n = 15) after the video‐recorded conversations. A phenomenological hermeneutic method of interpretation of the interview text was used. The (...) findings showed that a range of conditions for ‘understanding and being understood’ in the communication on the part of the care providers exists. These different conditions are: lacking both knowledge and understanding; having knowledge but not necessarily accompanied by understanding; and being in understanding. Within the condition ‘being in understanding’, the care providers create a feeling of at‐homeness in a relaxed atmosphere and thus have the opportunity to be in ‘understanding and being understood’ together with the patient. The condition ‘being in understanding’ appears in connection with the care providers’ creating of a ‘calm liturgy of caring’ by mediating humility and calm vitality affects to the patients, and further, when needed, being present on the level of mystery, i.e. caring communion. (shrink)

The finance industry is required to respond to public criticism of perceived immoral behaviour. To create legitimacy, financial firms not only undertake corporate social responsibility activities, but also support such activities with precise justifications. In this paper, we study CSR justifications appearing in annual and sustainability reports from the Swedish finance industry. Our objective is to investigate the ethical character of CSR justifications in the finance industry. This is an interesting topic, both because CSR carries ethical meaning and because CSR (...) justifications play a role in actual business activities. A secondary aim of this article is to test whether decoupled corporate claims about CSR can be recoupled, which would potentially help companies to act responsibly. The observed CSR justifications avoided the fundamental question of whether the finance industry does in fact have responsibilities, and they did not manifest awareness of stakeholders’ demands for CSR. Seemingly value-based CSR activities often lacked ethical justifications. These characteristics do not harmonize with the responsible image that the contemporary finance industry wants to portray. Our counterintuitive finding is that amorality prevails in the justifications that banks give for undertaking CSR activities. (shrink)

Physicians, registered nurses (RNs) and enrolled nurses (ENs) engaged in geriatric (n = 49) and surgical (n = 59) care at a large hospital in Sweden gave 180 accounts of morally difficult care episodes. In total, the ENs (n = 40) gave 78, the RNs (n = 38) 55 and the physicians (n = 30) 47 accounts; there were 83 from geriatric care and 97 from surgical care. Forty-nine participants were male, and 59 were female; there were no differences in (...) gender in the form and content of the moral reasoning disclosed in either morally difficult care episodes or in the complete interviews when coded as mainly narrative or propositional, or as showing a care or a justice orientation. The ENs showed a care orientation, while RNs and physicians, to an equal degree, showed both a justice and a care orientation. The ENs also used narrative reasoning more often than RNs and physicians. No differences were seen between the two health care specialties. (shrink)

Twelve retired nurses were asked to narrate a care situation in which it had been difficult for them as nurses to know what was the right and good thing to do. The transcribed interviews were examined by content analyses. Physicians were the central coactors in the nurses’ stories. Colleagues were seldom mentioned. Other ward staff were mainly called ‘the girls’. The patient was central and referred to with respect. All the nurses focused on experiential learning. Guiding ethical principles are listed.

Structured interviews were held with 149 registered nurses in seven countries in America, Asia, Australia and Europe concerning the feeding of severely demented patients who do not accept food. The most common reasons for nurses being willing to change their decision to feed or not to feed were an order from the medical head, a request from the patient's husband and/or the staff meeting. There was a connection between the willingness to feed and the ranking of ethical principles. Nurses who (...) were most prone to feed the patient most often gave a high rank to the ethical principle of sanctity of life, while those who primarily chose not to feed the patient gave a high rank to the ethical principle of autonomy. All nurses stressed the ethical principle of beneficence. Des interviews structurés ont eu lieu avec 149 infirmiers/ères dans sept pays en Amérique, Asie, Australie et Europe concernant l'alimentation des malades gravement dément qui refusent de manger. La raison la plus générale pour des infirmiers/ères d'être prêt à changer leures décisions de donner à manger ou non sont: un ordre du médecin, la demande du mari de la malade ou de la réunion du personnel. Il y avait un lien entre la volonté de nourir et le rang des principes éthiques. Les infirmiers/ères les plus enclins de nourir la malade le plus souvent donnaient un rang supérieur au principe éthique de la sainteté de vie, pendant que ceux et celles qui choisissaient de ne pas nourrir la malade donnaient un rang supérieur au principe éthique de l'autonomie. Tous insistaient sur l'importance du principe éthique de la bienfaisance. Konstruktive Interviews wurden mit 149 ausgebildeten Krankenschwestern und Pfleger in sieben Ländern in Amerika, Asien, Australien und Europa gehalten über die Ernährung von schwer von Dementia praecox leidenden Patienten, die das Essen verweigern. Die gewöhnlichsten Gründe des Pflegepersonals für die Bereitwilligkeit, ihre Entscheidung, zu ernähren oder nicht, zu ändern, waren Anordnungen vom medizinischen Chef, Anfragen vom Ehemann der Patientin und/oder einer Personalsitzung. Es bestand ein Zusammenhang zwischen der Bereitwilligkeit zur Ernährung und dem Rang der ethischen Prinzipien. Die Pflegenden, die sich am meisten neigten, die Patientin zu ernähren, gaben dem ethischen Prinzip der Heiligkeit des Lebens einen hohen Rang, während die, die meistens vorzogen, die Patientin nicht zu ernähren, gaben dem ethischen Prinzip der Autonomie einen hohen Rang. Alle Pflegenden legten grossen Wert auf das ethische Prinzip der Wohltätigkeit. (shrink)

How to achieve sustainable communities with decent work and economic growth without negative environmental impact, is at the heart of the United Nations Sustainable Development Goals and a top priority of many governments around the world. This article critically explores the role of government intervention for achieving sustainable local prosperity in frontier markets of developing countries, where such advancement is especially crucial. More specifically, we explore by an in-depth case study how multiple stakeholders cooperate to enhance local development and export (...) from firms in the leather and leather products industry in Ethiopia. From a multistakeholder engagement perspective, including representatives of local businesses, United Nations, Ministry of Trade and Industry, and other development partners, we analyze how government interventions have resulted in unintended outcomes despite their good intention. We contribute with a new understanding of why development initiatives in frontier markets struggle with stakeholder integration, caused by power asymmetry and lack of institutional trust which prevents the achievements of sustainable development goals. Contextualized implications for firms, government, and non-governmental actors on how to improve collaboration are provided, and policy implications are proposed. (shrink)

Research about codes of corporate ethics has hitherto taken a hypothetical, correct meaning of codes for granted. The article problematises the dichotomous categories intrinsic and subjective meanings of codes. I address the question if professionals in finance accept codes of business. The particular mentality of stockbrokers and traders constructs the way they judge restrictions such as company codes of ethics. While neglecting dimensions of ethics beyond known rules, brokers and traders distrust good ethics as a possible end in itself. Many (...) professionals in the financial market perceive efforts to integrate ethical reasoning in work as only means for maximising business opportunities. (shrink)

Business Ethics: A European Review, EarlyView.

Defined as patients who ‘lack decision-making capacity and a surrogate decision-maker’, the unrepresented present a major quandary to clinicians and ethicists, especially in handling errors made in their care. A novel concern presented in the care of the unrepresented is how to address an error when there is seemingly no one to whom it can be disclosed. Given that the number of unrepresented Americans is expected to rise in the coming decades, and some fraction of them will experience a medical (...) error, creating protocols that answer this troubling question is of the utmost importance. This paper attempts to begin that conversation, first arguing that the precarious position of unrepresented patients, particularly in regards to errors made in their care, demands their recognition as a vulnerable patient population. Next, it asserts that the ethical obligation to disclose error still exists for the unrepresented because the moral status of error does not change with the presence or absence of surrogate decision-makers. Finally, this paper concludes that in outwardly acknowledging wrongdoing, a clinician or team leader can alleviate significant moral distress, satisfy the standards of a genuine apology, and validate the inherent and equivalent moral worth of the unrepresented patient. (shrink)

While American physicians have traditionally practised as non-unionised professionals, there has been increasing debate in recent years over whether physicians in training (known also as interns, residents or house staff) are justified in unionising and using collective action. This paper examines specific ethical criteria that would permit union action, including a desire to ameliorate patient care as well as the goal of improving the conditions of working physicians. We posit that traditional rebuttals to physician unionisation often lean on an infinite (...) conception of a doctor’s energies and obligations, one that promotes burnout and serves to advance the financial motives of hospital management and administration. Furthermore, this paper explores the empirical justifications for collective action, which include substantial reductions in medical error. Finally, we address the free-rider problem posed by non-union physicians who might benefit from working improvements garnered through union action. We conclude that in order to maintain a notion of justice as fairness, resident physicians who benefit from union deliberations are impelled to acquire union membership or make a commensurate donation and that the healthcare organisations for which they work ought to share in the responsibility to improve patient care. (shrink)

In order to reach a more comprehensive understanding of the dynamics in violent situations in institutional care for elderly people the aim of this study was to explore involved parties’ positions, and to illuminate forces and moves related to these positions. One involved care provider's narrative was analysed using narrative analysis and positioning theory. In the narrative the involved parties’ positions were fluid and often overlapping, and not exclusively as victim or perpetrator. Across the narrative the narrator altered the involved (...) parties’ positions by using available discourses. We understand that the altered positions were a salient way for the care provider to make sense of her experiences. By reading the care provider's narrative we further understand that she was much more than just a perpetrator, which was the origin for her narrative. This study led us to two assumptions important for implications in nursing practice. First, it is of significance how we position ourselves and others in narratives and conversations. Second, there is a difference between being categorised in advance and getting the opportunity to narrate one's own story. (shrink)

The aim of this study was to explore and interpret the diverse subject of positions, or roles, that nurses construct when caring for patients in their own home. Ten interviews were analysed and interpreted using discourse analysis. The findings show that these nurses working in home care constructed two positions: `guest' and `professional'. They had to make a choice between these positions because it was impossible to be both at the same time. An ethics of care and an ethics of (...) justice were present in these positions, both of which create diverse ethical appeals, that is, implicit demands to perform according to a guest or to a professional norm. (shrink)

From his return to Europe in 1949 to his death in 1969, Adorno was one of the most prominent public voices in West Germany. As a professor and institute director, a frequently heard expert on radio, a prolific cultural critic, and even a sort of public counselor, he helped shape the self‐image of German postwar society. The very term “postwar society” is partly an achievement: Adorno approached Germany sociologically, as a configuration of organizations and groups, as opposed to a community (...) of blood, race, and fate, and he sought to encourage an earnest postwar and post‐genocide reckoning with the crimes committed under National Socialism, against widespread tendencies of evasiveness and disavowal. More insistently and effectively than most, Adorno reminded Germans that they lived “after Auschwitz.”. (shrink)

Sociability and Its Enemies contributes both to contemporary studies of political theory and to discourse on postwar Germany by reconstructing the arguments concerning the nature and value of sociability as a form of interaction and interconnection particular to modern bourgeois society. Jakob Norberg argues that the writings of Hannah Arendt, Jürgen Habermas, Carl Schmitt, and the historian Reinhart Koselleck present conflicting responses to a hitherto neglected question or point of contention: whether bourgeois sociability should serve as a therapeutic practice (...) and politically relevant ideal for postwar Germany. The book sheds light on previously neglected historical and conceptual connections among political theorists, and it enriches established narratives of postwar intellectual history. (shrink)

Tape-recorded semi-structured interviews were conducted with 21 nursing aides and enrolled nurses in the geriatric clinic in Umeå, Sweden. The interviews focused on the difference between the care of demented and non-demented patients and ethical conflicts in dementia care. The results indicate that caregivers have problems in providing the demented patients with opportunities to act autonomously in everyday matters on the ward, mainly due to the difficulty of understanding what the patients wish and the fact that their wishes, when understood, (...) often seem irrational. Measures to provide the demented patients with more opportunities to act autonomously in everyday matters are suggested. (shrink)

The aim of this study was to illuminate nurses’ reflections on obstacles to and possibilities for providing care as desired by people with malodorous exuding ulcers. Six nurses who took part in a previous study were interviewed. The participants were shown an illustration with findings from a study that elucidated the meaning of living with malodorous exuding ulcers. They were asked to reflect on the obstacles to and possibilities of providing the care desired by the patients. Twelve audio-recorded transcribed interviews (...) were analysed using qualitative content analysis. Our interpretations of participants’ reflections on the obstacles and possibilities while caring for such patients revealed one theme: striving to ‘do good’ and ‘be good’. The obstacles were formulated as subthemes: experiencing clinical competence constraints, experiencing organizational constraints, experiencing ineffective communication, fearing failure, and experiencing powerlessness. The possibilities were formulated by the subthemes: spreading knowledge about ulcer treatments, considering wholeness, and creating clear channels of communication. A multiprofessional team could overcome the identified obstacles and provide structure, competencies, commitment and support to ‘do good’ for patients and ‘be good’ nurses. (shrink)

Consolation is needed when a human being suffers (i.e. feels alienated from him-or herself, from other people, from the world or from his or her ultimate source of meaning). The aim of this study was to illuminate the meaning of consolation. Tape-recorded narrative interviews were carried out with 18 professionals from various spheres. The transcribed interviews were interpreted hermeneutically. A model of consolation is outlined in a drawing. It states that the mediator and the receiver of consolation must become ready (...) for consolation before it can take place. To be ready means to be present and available. Availability means expressing suffering and listening respectively, and thereby opening up for communion and consoling dialogue. Communion brings about contact with the sacred dimension that human beings share and thus with goodness, light, joy, beauty and life. Consolation involves a shift of perspective and an experience of meaning in spite of suffering. (shrink)

Physicians, registered nurses and enrolled nurses engaged in geriatric and surgical care at a large hospital in Sweden gave 180 accounts of morally difficult care episodes. In total, the ENs gave 78, the RNs 55 and the physicians 47 accounts; there were 83 from geriatric care and 97 from surgical care. Forty-nine participants were male, and 59 were female; there were no differences in gender in the form and content of the moral reasoning disclosed in either morally difficult care episodes (...) or in the complete interviews when coded as mainly narrative or propositional, or as showing a care or a justice orientation. The ENs showed a care orientation, while RNs and physicians, to an equal degree, showed both a justice and a care orientation. The ENs also used narrative reasoning more often than RNs and physicians. No differences were seen between the two health care specialties. (shrink)

ExcerptA number of Carl Schmitt's diaries have already been published, and more are being prepared for future publication.1 Naturally, readers of Schmitt hope that these voluminous journals will shed light on his controversial work and biography.2 Yet for reasons that I will seek to make clear in this essay, Schmitt's diaries must be approached with some interpretive caution, for the diarist himself was deeply skeptical of and even averse to his chosen medium. Early on in his career, Schmitt produced a (...) satire of diary writing as the matrix of a self-obsessed human existence, and this critical attitude also comes through…. (shrink)

El autor partiendo de la concepciónun habitar poéticamentequécómo lo hace es la cuestión a deslindarque su propósito no era ofrecer unaauténtico.