A closer look at the lived illness experiences of medical professionals themselves shows that shared decision making is in need of a logic of care. This paper underlines that medical decision making inevitably takes place in a messy and uncertain context in which sharing responsibilities may impose a considerable burden on patients. A better understanding of patients’ lived experiences enables healthcare professionals to attune to what individual patients deem important in their lives. This will contribute to making medical decisions in (...) a good and caring manner, taking into account the lived experience of being ill. (shrink)

Good nursing is more than exercising a specific set of skills. It involves the personal identity of the nurse. The aim of this article is to answer two questions: (1) what kind of person should the hospice nurse be? and (2) how should the hospice nurse engage in caring conversations? To answer these questions we analyse a nurse’s story that is intended to be a profile of an exemplary hospice nurse. This story was constructed from an analysis of five semistructured (...) interviews with hospice nurses, based on the ‘ethics of the caring conversation’, which is inspired by the ethical perspective of Paul Ricoeur. The research questions concentrate on the norms of respect, responsibility and reciprocity, which are integral parts of the ‘ethics of the caring conversation’. (shrink)

The main measure of quality of life is well-being. The aim of this article is to compare insights about well-being from contemporary philosophy with the practice-related opinions of palliative care professionals. In the first part of the paper two philosophical theories on well-being are introduced: Sumner’s theory of authentic happiness and Griffin’s theory of prudential perfectionism. The second part presents opinions derived from interviews with 19 professional palliative caregivers. Both the well-being of patients and the well-being of the carers themselves (...) are considered in this empirical exploration. In the third part the attention shifts from the description of “well-being” to prescriptions for the promotion of well-being. Our interview data are analysed in light of the theories of Sumner and Griffin for clues to the promotion of “well-being.” The analysis (1) underscores the subject-relativity of well-being, (2) points out that values that are considered important in every life still seem to be relevant (at least in palliative care practice), and (3) shows the importance of living a certain sort of life when aiming to enhance dying patients’ well-being. (shrink)

This study presents a first assessment of the challenges faced by Dutch health care providers dealing with the increasing cultural diversity in Dutch society. Qualitative interviews with 24 Dutch caregivers and policy-makers point to a number of important difficulties encountered when confronted with the growing diversity of patient populations. The study focuses explicitly on the challenges health care providers perceive in their direct interactions with patients. On the basis of the observations of the 24 respondents five strategies were formulated to (...) improve the delivery of care in a multicultural environment. Their findings were further evaluated by confronting the empirical data with care-ethical notions (attentiveness, responsibility, competence, and responsiveness) and intercultural communication-theory. (shrink)

Patient participation in healthcare is highly promoted for democratic reasons. Older patients make up a large part of the hospital population but their voices are less easily heard by most patient participation instruments. The client council can be seen as an important medium to represent the interests of this increasing group of patients. Every Dutch healthcare institution is obliged to have a client council and its rights are legally established. This paper reports on a case study of a client council (...) in a hospital and shows how equality as the core democratic value manifests itself in practice and marginalizes the voices of older patients. Based on the work of Joan Tronto we show that sameness is the driving force behind the functioning of the client council which leads the council to operate as part of the hospital system. Consequently, important aspects of the hospital practice remain out of sight. To be of greater value for all patients we argue that successful patient participation requires not only equal opportunities but also ‘the condition of equal voice’. (shrink)

This study presents a first assessment of the challenges faced by Dutch health care providers dealing with the increasing cultural diversity in Dutch society. Qualitative interviews with 24 Dutch caregivers and policy-makers point to a number of important difficulties encountered when confronted with the growing diversity of patient populations. The study focuses explicitly on the challenges health care providers perceive in their direct interactions with patients. On the basis of the observations of the 24 respondents five strategies were formulated to (...) improve the delivery of care in a multicultural environment. Their findings were further evaluated by confronting the empirical data with care-ethical notions (attentiveness, responsibility, competence, and responsiveness) and intercultural communication-theory. (shrink)

Patient participation in healthcare is highly promoted for democratic reasons. Older patients make up a large part of the hospital population but their voices are less easily heard by most patient participation instruments. The client council can be seen as an important medium to represent the interests of this increasing group of patients. Every Dutch healthcare institution is obliged to have a client council and its rights are legally established. This paper reports on a case study of a client council (...) in a hospital and shows how equality as the core democratic value manifests itself in practice and marginalizes the voices of older patients. Based on the work of Joan Tronto we show that sameness is the driving force behind the functioning of the client council which leads the council to operate as part of the hospital system. Consequently, important aspects of the hospital practice remain out of sight. To be of greater value for all patients we argue that successful patient participation requires not only equal opportunities but also ‘the condition of equal voice’. (shrink)

Hospitalization significantly impacts the lives of older people, both physically and psychosocially. There is lack of observation studies that may provide an embodied understanding of older patients’ experiences in its context. The aim of this single case study was to reach a deeper understanding of one older patient’s lived experiences of hospitalization. The study followed a phenomenological embodied enquiry design and the qualitative observation method of shadowing was used. In April 2011, one older patient was shadowed for 7 days, 5–7 (...) h per day. To facilitate understanding in the reader the experiences are first presented in a story and subsequently analyzed by means of the lifeworld framework. The findings show that hospitalization is experienced as ambiguous safety, disconnected time, the feeling of being partially involved, and the struggle to re-attune to the body. (shrink)

Phenomenological healthcare research should include the lived experiences of a broad group of healthcare users. In this paper it is shown how shadowing can give a voice to people in vulnerable situations who are often excluded from interview studies. Shadowing is an observational method in which the researcher observes an individual during a relatively long time. Central aspects of the method are the focus on meaning expressed by the whole body, and an extended stay of the researcher in the phenomenal (...) event itself. Inherent in shadowing is a degree of ambivalence that both challenges the researcher and provides meaningful insights about the phenomenon. A case example of a phenomenological study on the experiences of elderly hospital patients is used to show what shadowing yields. (shrink)

This article discusses the relationship between personal and professional qualities in hospice nurses. We examine the notion of self-esteem in personal and professional identity. The focus is on two questions: (1) what is self-esteem, and how is it related to personal identity and its moral dimension? and (2) how do self-esteem and personal identity relate to the professional identity of nurses? We demonstrate it is important that the moral and personal goals in nurses' life coincide. If nurses' personal view of (...) the good life is compatible with their experiences and feelings as professionals, this improves their performance as nurses. We also discuss how good nursing depends on the responses that nurses receive from patients, colleagues and family; they make nurses feel valued as persons and enable them to see the value of the work they do. (shrink)

Considered by many to be Abraham Robinson's magnum opus, this book offers an explanation of the development and applications of non-standard analysis by the mathematician who founded the subject. Non-standard analysis grew out of Robinson's attempt to resolve the contradictions posed by infinitesimals within calculus. He introduced this new subject in a seminar at Princeton in 1960, and it remains as controversial today as it was then. This paperback reprint of the 1974 revised edition is indispensable reading for anyone interested (...) in non-standard analysis. It treats in rich detail many areas of application, including topology, functions of a real variable, functions of a complex variable, and normed linear spaces, together with problems of boundary layer flow of viscous fluids and rederivations of Saint-Venant's hypothesis concerning the distribution of stresses in an elastic body. (shrink)

Prologue: on the weakness of education -- Creativity -- Communication -- Teaching -- Learning -- Emancipation -- Democracy -- Virtuosity -- Epilogue: for a pedagogy of the event -- Appendix: coming into the world, uniqueness, and the beautiful risk of education: an interview with Gert Biesta by Philip Winter.

Written in response to John Caputo's The Prayers and Tears of Jacques Derrida, this work gathers together cutting-edge theologians and philosophers to examine the relationship between Derridan deconstruction and religion. Containing a lengthy counter-response by Caputo, as well as an interview, Religion With/Out Religion will be required reading for all those involved in contemporary theological debate.

How do we deal with difference personally, interpersonally, nationally? Can we weave a cohesive social fabric in a religiously plural society without suppressing differences? This collection of significant essays suggests that to truly honour differences in matters of faith and religion we must publicly exercise and celebrate them. The secular/sacred, public/private divisions long considered sacred in the West need to be dismantled if Canada (or any nation state) is to develop a genuine mosaic that embraces fundamental differences instead of a (...) melting pot that marginalizes. An ethics of difference starts with a recognition of difference, not as deviance or deficit that threatens but as otherness to connect with, cherish, and celebrate. The book begins with the suggestion that our inability to come to terms with social plurality is not fundamentally the fault of religious differences, and that a public/private split inadequately deals with matters of basic difference. It then explores how encouraging people to live out their respective faiths may open new possibilities for respectful, honourable, and just negotiations of contemporary dilemmas arising out of the multicultural fabric of Canadian life. Towards an Ethics of Community introduces readers to some of the most challenging and divisive dilemmas we face in this increasingly pluralistic, postmodern world — issues such as family and domestic violence, Aboriginal rights, homosexuality and public policy, and female genital mutilation. This is a book truly global in scope and significance. (shrink)

This article reports on moral problems that were raised by medical students as the basis for an ethical case-conference in an obstetrics and gynaecology clerkship. After introducing the issue of teaching clinical ethics, the method of our case-conference is explained. Next, the variety of topics and related moral problems are presented. The article continues with a discussion of three distinct and challenging aspects that characterise obstetrics and gynaecology as a domain for teaching clinical ethics. The conclusion puts forward three significant (...) points our review raises. (shrink)

In contemporary societies, there is a strong push toward seeing education as an instrument for the delivery of particular societal agendas. On such a view, the only questions that remain are how effective education is at delivering such agendas and how its effectiveness can be increased. While this might be a desirable way forward for those who believe that a consensus about the agenda for education can easily be achieved, it is at odds with the idea that a democratic society (...) is characterized by a fundamental plurality of visions about what schools are supposed to be for. Yet the democratic critique of educational instrumentalism cannot be confined to giving each and every vision its own school, as this would simply multiply educational instrumentalism rather than oppose it. A true democratic response thus needs to take education's own interest seriously as well, which, as Gert Biesta argues in this paper, amounts to a defense of the school as institution. (shrink)

Background Several studies suggest that deviations from proper authorship practices are commonplace in medicine. The aim of this study was to explore experiences of and attitudes towards the handling of authorship in PhD theses at medical faculties in Denmark, Norway, and Sweden. Methods Those who defended their PhD thesis at a medical faculty in Scandinavia during the second half of 2020 were offered, by e-mail, to participate in an online survey. Survey questions dealt with experiences of violations of the first (...) three of the ICMJE authorship criteria and misuse of authorship order in the thesis articles, as well as respondents’ attitudes to these matters. Both questions with fixed response alternatives and questions with free-text responses were used. Quantitative data were analysed statistically using the Table functions in SPSS 25 and Chi-2 tests. Free-text responses were analysed qualitatively using manifest content analysis. Results 287 valid questionnaires were returned (response rate: 34.1%). Almost half (46.0%) of the respondents reported that the ICMJE authorship criteria were not fully respected in at least one of the papers in their thesis, while a vast majority (96.7%) found it important that authorship is handled according to the ICMJE authorship criteria. 24.4% reported inadequate handling of authorship order in at least one paper. The qualitative results provide a wide spectrum of examples of how the ICMJE authorship criteria are circumvented. Conclusion Despite increasing educational efforts to reduce deviations from good research practice at Scandinavian universities, the handling of authorship in medical papers remains problematic. (shrink)

The Gaza War is a watershed moment not only in the Middle East. It has also increased political divisions in Germany, where Israel’s security and the fight against anti-Semitism are part of its historical legacy and political and moral identity. Incidents of anti-Semitism have increased dramatically, as have overdrawn accusations of it. An analysis of controversies about the definition of anti-Semitism, about the use of the term apartheid for the situation in the West Bank, of the BDS movement (Boycott, Divestment, (...) Sanctions), and particularly the characterization of Israel as a settler-colonial state shows how difficult it has become to maintain a fair, honest, and frank discussion considering different points of view. The current crisis should be used as an opportunity for Germany to, on the one hand, face the unavoidable contradictions in its responsibilities stemming from the crimes of its Nazi past and, on the other hand, come to grips not only with Arab and Iranian terrorism and eliminationist rhetoric but also with the deficiencies in Israel’s policies toward the Palestinians. Germany’s new leitmotiv ought to be: ‘Between the River and the Sea, Jews and Arabs should be free.’. (shrink)

Philosophy and Phenomenological Research, EarlyView.

In this paper I argue that there is a need to reconnect with the question of purpose in education, particularly in the light of a recent tendency to focus discussions about education almost exclusively on the measurement and comparison of educational outcomes. I first discuss why the question of purpose should always have a place in our educational discussion. I then explore some reasons why this question seems to have disappeared from the educational agenda. The central part of the paper (...) is a proposal for addressing the question of purpose in education—the question as to what constitutes good education—in a systematic manner. I argue that the question of purpose is a composite question and that in deliberating about the purpose of education we should make a distinction between three functions of education to which I refer as qualification, socialisation and subjectification. In the final section of the paper I provide examples of how this proposal can help in asking more precise questions about the purpose and direction of educational processes and practices. (shrink)

This paper defends the right not to know personal health information, while it discards the right of research participants to receive individual research results. Disagreement regarding the right not to know stems from two different conceptions of autonomy, leading to opposing normative conclusions. Researchers occasionally have good reason to inform research participants about incidental findings in spite of the absence of a right to know such information. Such decisions have to be made by health care personnel and researchers on a (...) case by case basis, although external support for the decisions may be available. (shrink)

Philosophy and Phenomenological Research, EarlyView.

Adverbialism is the view that to have a conscious perceptual experience is to be consciously experiencing in a certain way, and that this way is not to be understood in relational or representational terms. We might compare what it is for a conscious being to be experiencing in a certain way with what it is for a string to be vibrating in a certain way. This paper makes a new case for adverbialism by appealing to the fact that we can (...) pick out ways of experiencing by treating them as information-bearing signals. In both presenting and defending the view, it will be crucial that information is not the same as representational content, but can still concern objects and the properties of those objects. The resulting information-theoretic adverbialism can answer or deflect the most influential objections to adverbialism. (shrink)

Providing proper protection of confidentiality, by preventing personal data from falling into the hands of third parties, is one of the core responsibilities of researchers towards research participants. However, even if researchers do their best in this regard, it does not guarantee that breaches of confidentiality will be avoided. This paper addresses the case of small qualitative studies, arguing that researchers cannot guarantee their informants’ confidentiality, since that confidentiality may be compromised by actions taken by the informants themselves. In order (...) to reduce the risk of this specific threat to confidentiality, additional precautions need to be taken. Some potential solutions to the problem are suggested and discussed. (shrink)

The second volume in Joel Feinberg's series The Moral Limits of the Criminal Law, Offense to Others focuses on the "offense principle," which maintains that preventing shock, disgust, or revulsion is always a morally relevant reason for legal prohibitions. Feinberg clarifies the concept of an "offended mental state" and further contrasts the concept of offense with harm. He also considers the law of nuisance as a model for statutes creating "morals offenses," showing its inadequacy as a model for understanding "profound (...) offenses," and discusses such issues as obscene words and social policy, pornography and the Constitution, and the differences between minor and profound offenses. (shrink)

Fifty-eight years ago Max Scheler, one of the founders of modern philosophical anthropology, wrote: “Man is more of a problem to himself at the present time than ever before in all recorded history. ... the increasing multiplicity of the special sciences that deal with man, valuable as they are, tend to hide his nature more than they reveal it.”1 In 1944, some sixteen years later, Ernst Cassirer comments that even though “no former age was ever in such a favorable position (...) with regard to the sources of our knowledge of human nature,” we are still looking for a clue which will provide “real insight into the general character of human culture.”2 In his famous 1958 book, Irrational Man,3 William Barrett looked to existentialism to recover the whole and integral, suffering and dying human being from the abstract image of humankind as logical operators dominant in modern philosophy. However, in a new book William Barrett concludes that the concrete human self was not in fact recovered in existentialism and laments its disappearance in modern thought. He talks of the Death of the Soul.4 I would add: and Elimination of the Body. (shrink)

The idea that ethics is a matter of personal feeling is a dogma widespread among medical students. Because emotivism is firmly rooted in contemporary culture, the authors think that focusing on personal feeling can be an important point of departure for moral education. In this contribution, they clarify how personal feelings can be a solid basis for moral education by focusing on the analysis of compassion by the French phenomenologist Emmanuel Housset. This leads to three important issues regarding ethics education: (...) the necessity of a continuous attention for and interpretation of the meaning of language, the importance of examining what aspect of “the other” touches one and what it is that evokes the urge to act morally and the need to relate oneself to the community, both to the medical community and to collectively formulated rules and laws. These issues can have a place in medical education by means of an ethical portfolio that supports students in their moral development. First, keeping a portfolio will improve their expression of the moral dimension of medical practice. Second, the effects of self-knowledge and language mastery will limit the pitfalls of emotivism and ethical subjectivism and will stimulate the inclination to really encounter the other. Third, it will show medical students from the start that their moral responsibility is more than following rules and that they are involved personally. (shrink)

Slippery-slope arguments typically question a course of action by estimating that it will end in misery once the first unfortunate step is taken. Previous studies indicate that estimations of the long-term consequences of certain debated actions, such as legalizing physician-assisted suicide, may be strongly influenced by tacit personal values. In this paper, we suggest that to the extent that slippery-slope arguments rest on estimations of future events, they may be mere rationalizations of personal values. This might explain why there are (...) proponents even for strikingly poor slippery-slope arguments. (shrink)

Modern Christianity has failed to update its myths and has even eliminated them, thus, excluding the metaphysical experience indispensable to religion. Myths should be interpreted, not eliminated. Answering the question about how to interpret myths without eliminating them or their intended effect is the object of this paper. The study investigates the possibility of interpreting myths as metaphors, thus, in a non-literal way. Various definitions of metaphor and myth, and theories for their interpretation are discussed, with focus on their relationship (...) to symbolic universes. Finally, a non-mythical symbolic universe structured by root-metaphors is suggested as a framework for the existential interpretation of mythical concepts in the New Testament. (shrink)

This essay explores concepts of evolution and progress in exemplary nineteenth and twentieth century contributions to cultural historiography: Theodor Mommsen, Andrea Carandini, Max Weber, Isaiah Berlin. How are such concepts related to the ways these scholars position themselves epistemologically within the theory and history of science? In a critical confontation with these examples Ernst Cassirer's model of historiography is discussed as a cultural science of action.