Nurses facing impediments to what they perceive as moral practice may experience moral distress. The purpose of this descriptive, cross-sectional study was to determine similarities and differences in moral distress and avoidance behavior between critical care nurses and non-critical care nurses. Sixty-eight critical care and 28 non-critical care nurses completed the Moral Distress Scale and Impact of Event Scale. There were no differences in moral distress scores or impact of event scores between groups after adjusting for age. There was a (...) small positive correlation between moral distress and avoidance behaviors for both the groups. Moral distress is present in both critical care and noncritical care nurses. It is important that nurses are provided with opportunities to cope with this distress and that retention strategies include ways to reduce suffering and mitigate the effects on professional practice. (shrink)

Dans ce livre richement illustré et documenté, Marie-Jo Bonnet s'interroge sur la symbolique du couple de femmes dans l'art, en privilégiant l'exemple français, et ressuscite des figures d'artistes oubliées, comme Louise Janin, ou méconnues, telles Louise Abbéma ou Claude Cahun. Tribades, précieuses, amazones et garçonnes sont conviées à livrer leurs secrets : Marie-Jo Bonnet s'intéresse à la mise en scène du désir, longtemps orchestrée en fonction des attentes du spectateur masculin, ..

Kollaboration und Konkurrenz gibt es in der Wissenschaft zwischen Individuen oder verschiedenen Gruppen, größeren Organisationen, Schauplätzen und Nationalstaaten. Die Spannung zwischen individuellem Ansehen und Gruppenmeriten oder individuellem Ehrgeiz und Gruppenleistung ist der wissenschaftlichen Arbeit inhärent und trägt zu ihrem Erfolg bei. Die Autorin vergleicht zwei soziale Modelle der Wissenschaft, die entwickelt wurden, als Wissenschaftler im 20. Jahrhundert zunehmend begannen kollaborativ zu forschen: Michael Polanyis individualistische Freie-Markt-Republik der Wissenschaft und Ludwik Flecks Denkkollektiv. Diese beiden Modelle sollten Praktiken beschreiben und Ideale für (...) die Wissenschaft im allgemeinen auf der Grundlage der Erfahrungen spezialisierter Forschungsgruppen vorschreiben. Die Arbeitsgruppen von Linus Pauling und Dorothy Crowfoot Hodgkin dienen hier der Erläuterung der beiden Modelle. Die Autorin untersucht verschiedene Auswirkungen von Paulings und Hodgkins Praktiken auf das persönliche Ansehen des Direktors und der Mitarbeiter, und schließt mit der Frage, ob eine kollektive Wissenschaft möglich ist. (shrink)

Kollaboration und Konkurrenz gibt es in der Wissenschaft zwischen Individuen oder verschiedenen Gruppen, größeren Organisationen, Schauplätzen und Nationalstaaten. Die Spannung zwischen individuellem Ansehen und Gruppenmeriten oder individuellem Ehrgeiz und Gruppenleistung ist der wissenschaftlichen Arbeit inhärent und trägt zu ihrem Erfolg bei. Die Autorin vergleicht zwei soziale Modelle der Wissenschaft, die entwickelt wurden, als Wissenschaftler im 20. Jahrhundert zunehmend begannen kollaborativ zu forschen: Michael Polanyis individualistische Freie-Markt-Republik der Wissenschaft und Ludwik Flecks Denkkollektiv. Diese beiden Modelle sollten Praktiken beschreiben und Ideale für (...) die Wissenschaft im allgemeinen auf der Grundlage der Erfahrungen spezialisierter Forschungsgruppen vorschreiben. Die Arbeitsgruppen von Linus Pauling und Dorothy Crowfoot Hodgkin dienen hier der Erläuterung der beiden Modelle. Die Autorin untersucht verschiedene Auswirkungen von Paulings und Hodgkins Praktiken auf das persönliche Ansehen des Direktors und der Mitarbeiter, und schließt mit der Frage, ob eine kollektive Wissenschaft möglich ist. (shrink)

L’article évoque les interrogations nouvelles autour de la responsabilité dans le domaine médical. Le caractère intolérable de la fragilité, le mouvement de médicalisation, l’individualisation de la perception des risques, l’évolution de la relation médecin-malade, etc., ont grandement complexifié la prise de décision et l’évaluation éthique en médecine et, plus largement, dans les questions relatives à la santé. L’Église catholique, comme toutes les institutions touchant de près ou de loin à la santé, ne manque pas d’être interrogée. La réflexion voudrait le (...) montrer à partir de l’épidémie de sida. Finalement, la responsabilité moderne ne se meut-elle pas nécessairement dans l’ambiguïté ? (shrink)

L'exposition Berthe Morisot organisée conjointement par le Palais des Beaux-Arts de Lille et la fondation Pierre Gianadda, à Martigny, ainsi que son catalogue peuvent être regardés comme un véritable événement. D'abord, saluons la fondation suisse qui fait un travail de fond remarquable depuis de nombreuses années en exposant (avec catalogue) des artistes françaises comme Camille Claudel, Suzanne Valadon, Marie Laurencin, en collaboration avec des musées de province. Notons ensuite que..

Obtener el consentimiento válido, libre e informado no siempre es fácil. Presupone, por un lado, la divulgación de información justa, clara y apropiada, y, por otro, la capacidad de comprenderla lo más adecuadamente posible y luego tomar una decisión. Entonces, cuando un paciente tiene impedimentos cognitivos en el largo plazo y carece de la capacidad independiente para tomar o comunicar una decisión, y cuando esta decisión se trata del final de su vida, el consentimiento puede ser muy complejo. ¿Cómo hacerlo (...) bien? El presente artículo no ofrece «la» solución, pero analiza el tema en el marco legal y ético francés. El desafío es encontrar una línea divisoria entre la beneficencia, el respeto a la autonomía y el rechazo de la «obstinación irrazonable» (que define lainutilidad en la legislación francesa). La beneficencia podría significar retirar (o retener) los tratamientos médicos en curso (quimioterapia, radioterapia, etcétera) cuando se vuelven cada vez más ineficaces y, además, son agresivos e intrusivos para el paciente (lo que conlleva una disminución de su calidad de vida). Pero cuando el paciente no puede consentir o parece estar en desacuerdo, ¿cómo podemos seguir adelante? La contribución examinará, primero, el valor de la toma de decisiones y del consentimiento del paciente en la atención médica y, luego, el papel que la familia y los cuidadores pueden desempeñar para apoyarlos. Dado que la muerte es un momento único y definitivo, no debemos olvidar que, a menudo, la experiencia de los familiares con el paciente condiciona tanto el proceso de toma de decisiones como su proceso de duelo. Finalmente, se examinarán y discutirán tres situaciones clínicas específicas, en las que se debe tomar una decisión con respecto a la retención y retirada de los tratamientos: cuando un paciente está consciente, cuando está inconsciente y no tiene instrucciones anticipadas, cuando rechaza el tratamiento a sabiendas. La lucha consiste en saber qué es lo que realmente le importa a la persona moribunda, para poder respetar sus deseos. (shrink)

In _Michael Polanyi and His Generation_, Mary Jo Nye investigates the role that Michael Polanyi and several of his contemporaries played in the emergence of the social turn in the philosophy of science. This turn involved seeing science as a socially based enterprise that does not rely on empiricism and reason alone but on social communities, behavioral norms, and personal commitments. Nye argues that the roots of the social turn are to be found in the scientific culture and political (...) events of Europe in the 1930s, when scientific intellectuals struggled to defend the universal status of scientific knowledge and to justify public support for science in an era of economic catastrophe, Stalinism and Fascism, and increased demands for applications of science to industry and social welfare. At the center of this struggle was Polanyi, who Nye contends was one of the first advocates of this new conception of science. Nye reconstructs Polanyi’s scientific and political milieus in Budapest, Berlin, and Manchester from the 1910s to the 1950s and explains how he and other natural scientists and social scientists of his generation—including J. D. Bernal, Ludwik Fleck, Karl Mannheim, and Robert K. Merton—and the next, such as Thomas Kuhn, forged a politically charged philosophy of science, one that newly emphasized the social construction of science. (shrink)

Scientific culture in Europe and the refugee generation -- Germany and Weimar Berlin as the City of Science -- Origins of a social perspective: doing physical chemistry in Weimar Berlin -- Chemical dynamics and social dynamics in Berlin and Manchester -- Liberalism and the economic foundations of the "Republic of Science" -- Scientific freedom and the social functions of science -- Political foundations of the philosophies of science of Popper, Kuhn, and Polanyi -- Personal knowledge: argument, audiences, and sociological engagement (...) -- Epilogue: SSK, scientific constructivism, and the paradoxical legacy of Polanyi and the 1930s generation. (shrink)

Utilizing a decade's worth of clinical experience gained since its original publication, Mary Jo Peebles builds and expands upon exquisitely demonstrated therapeutic approaches and strategies in this second edition of _Beginnings_. The essential question remains the same, however: How does a therapist begin psychotherapy? To address this delicate issue, she takes a thoughtful, step-by-step approach to the substance of those crucial first sessions, delineating both processes and potential pitfalls in such topics as establishing a therapeutic alliance, issues of trust, (...) and history taking. Each chapter is revised and expanded to include the latest treatment research and modalities, liberally illustrated with rich case material, and espouse a commitment to the value of multiple theoretical perspectives. Frank and sophisticated, yet eminently accessible, this second edition will be an invaluable resource for educators, students, and seasoned practitioners of any therapeutic persuasion. (shrink)

Introduction/Background: Moral distress and related concepts surrounding morality and ethical decision-making have been given much attention in nursing. Despite the general consensus that moral distress is an affective response to being unable to act morally, the literature attests to the need for increased clarity regarding theoretical and conceptual constructs used to describe precisely what the experience of moral distress involves. The purpose of this study is to understand how student nurses experience morally distressing situations when caring for patients with different (...) values and beliefs than their own in the clinical environment -/- Methods: This study is based on secondary analysis of participant data. The stories of eight student nurses who completed the original study were reviewed following Yin’s multiple-case study design. -/- Results: Findings suggest there is a subtle form of moral distress that has been under appreciated in the literature and differs from Jameton’s classic definition. While traditional institutional triggers to moral distress are pervasive, personal conflict as a result of differing value systems may be a moral challenge faced by nursing students working with culturally diverse patients. -/- Conclusion: Ethics education is needed in nursing school to reduce moral distress in the clinical environment. Nursing students need opportunities to develop moral reasoning skills in addition to their clinical skills. A philosophical approach to ethics education may be needed to prevent and alleviate moral distress. (shrink)

An ambitious and highly engaging history of ideas, Feminism and Its Discontents brings together far-flung intellectual tendencies rarely seen in intimate ...

This book represents a collaborative effort among the Christians and Jewish religious thinkers. They all focus on a bioethical moment at the beginning or the end of life. As members of a distinct tradition that has addressed the subject in a formal way, each one attempts an explanation of that tradition's position on the subject and suggests further developments. Healthcare issues are complex to begin with and these analyses and discussions make it a bit more likely they will be dealt (...) with on sound moral grounds. (shrink)

Odon Lottin, O.S.B. was an historian and a moral theologian. As an historian, he studied the scholastic attention to human psychology and morality. As a theologian, he studied the roles that thought and action play in the development of the moral agent. His influence in historical and moral theology has been significant. Nonetheless, moralists and medievalists independently have appropriated his insights. No one has yet studied the relationship between his historical investigations and his moral theology. This work accomplishes that study. (...) ;This dissertation considers Lottin's contributions to both historical and moral theology. Lottin studies the medieval history and understanding of free choice, moral action, the acquired virtues and conscience. He traces this history to uncover specific ideas, expose the development of thought, recognize the emergence of consensus, and find whether satisfying resolutions were achieved. Many of his contemporaries in the manual tradition misinterpreted this history. This misinterpretation was due to their inaccurate or undeveloped historical method. And, just as there was deficiency in their method, there were significant shortcomings in the scope of their theological investigations. Thus, by looking back to history, Lottin presents a moral theology more substantive than the manuals. Each of the first four chapters of this dissertation presents Lottin's historical studies of the major debates, examines his incorporation of that material into his own contribution to the debates' resolutions, and concludes with how his work has been appropriated and where it may yet lead. The final chapter considers Lottin's contribution to the discipline of moral theology. ;Moral theology can neither be ahistorical nor impersonal. Lottin's work demonstrates the necessity of accurate history for interpretation and of critical reflection on the cause of human action. His return to medieval moral theology is a return to human agency. His agent-centered moral theology retrieves prudence and the moral virtues as dynamic means for rightly forming consciences and determining action. Historical and agent-centered moral theology is concerned with theory and practice. The theory of the moral life looks at human intentionality, the practice is its free expression; together they comprise the meaning of self-determination. (shrink)

Scholars in the field of social studies of science marked the year 2012 as the 50th anniversary of the publication of Thomas S. Kuhn’s The Structure of Scientific Revolutions. Kuhn’s book is routinely cited as the beginning of a new intellectual movement that jettisoned logical and empiricist accounts of scientific progress in favor of sociological and psychological explanations of scientific practice. In contrast, this essay argues that the roots of the social construction of science lie earlier, in the 1930s, in (...) the political milieu, scientific careers, and intellectual debates of a generation in which Michael Polanyi was a central figure. Crucial elements in the development of Polanyi’s philosophy of science are examined, with comparisons to J. D Bernal, Karl Mannheim and others of their generation, as well as to the younger Thomas Kuhn and to Karl Popper. (shrink)

The convening of the first three Solvay Chemistry Conferences in Brussels from 1922–1928 marked an important turning point for the discipline of chemistry. Whereas much of nineteenth-century chemical endeavour had focused on compositional and functional analysis of chemical compounds, many leaders in chemistry were turning to questions of molecular dynamics by the early twentieth century. Two competing schools of chemical dynamics, which were represented at the Solvay Conferences, were a predominantly English group who worked out electron and ionic interpretations of (...) organic reaction mechanisms, and a French group who developed a generalized radiation hypothesis of reaction activation. While differences in conceptual and stylistic approach separated the two schools, they agreed on the need to apply contemporary physical theory to old chemical problems, and to develop a theoretical chemistry complementary to theoretical physics. (shrink)