In July 2019, Stella Creasy MP and her team succeeded in attaching an amendment to a largely administrative bill which would require the UK government to liberalise abortion laws in Northern Ireland by 21 October 2019, provided the Northern Ireland government does not resume before that date.1 The amendment succeeded in the Commons, 332 votes to 99 and later, with some adjustments, in the Lords, 182 votes to 37. The Bill received Royal Assent on 24 July 2019. In Northern Ireland, (...) abortion remains a criminal offence punishable by up to life imprisonment in all except exceptional circumstances, that is, where it is ‘necessary to preserve the life of the woman’ or where there is a ‘risk of serious adverse effect which is either long term or permanent’.2 The law makes no provision for women who are pregnant as a result of rape, incest or in the case of fatal fetal abnormality. Because there is a lack of clarity around which circumstances or conditions would have a sufficiently ‘serious and long-term adverse effect’, it has been argued that the law has had a ‘chilling effect’ on service provision.3 As a result, only 13 abortions were performed in Northern Ireland in 2018/2019.4 Instead, more than 1000 women travelled from Northern Ireland to England to access legal abortion services.5 A recent review of the law in Northern Ireland concluded that this situation disadvantages women who cannot afford to or are unable to travel.3 Women are also reportedly purchasing abortifacients unlawfully online, exposing them to the risk of prosecution as well as to risks where the pills are unsafe or lead to complications. Creasey’s amendment requires the Secretary of State for …. (shrink)

The British Medical Association and Royal College of Physicians have published new guidance, endorsed by the General Medical Council, on decision-making about clinically assisted nutrition and hydration and adults who lack capacity to consent. The development of the guidance follows a series of legal cases which has created confusion about the precise circumstances in which an application to the court is required before CANH is withdrawn which has culminated with the decision of the Supreme Court in National Health Service Trust (...) versus Y. 1 This confirmed that there is no requirement to go to court, providing there is agreement as to the patient’s best interests, the provisions of the Mental Capacity Act 2005 have been observed, and the relevant professional guidance has been followed. The new guidance covers all decisions to start, restart, continue, or stop providing CANH in patients who are not imminently dying, in circumstances where CANH is the primary life-sustaining treatment being provided. It goes beyond the category of patients in permanent vegetative state or minimally conscious state who have previously been the subject of court applications, and also covers decisions for patients with neurodegenerative conditions and patients who have suffered a sudden onset brain injury in addition to having multiple comorbidities or general frailty which is likely to impact on life expectancy. It provides a clear statement of doctors’ legal responsibilities, covers the importance of robust best interests’ assessments and sets out the process to be followed for sufficient independent scrutiny of decisions. In light of some of the identified problems with decisions about CANH, a particular focus of the guidance is on the importance of regular best interests’ assessments, and it provides detailed practical guidance about how to approach these. The development of …. (shrink)

In mid-2018, following a survey of lesbian, gay, bisexual and transgender groups, the UK government issued a consultation on the proposed reform of the Gender Recognition Act for England and Wales.1 When it was first introduced in 2004, the GRA was considered innovative, even world-leading legislation.2 The act enables any adult to seek to change their legal gender provided several criteria are met. These include: If the applicant is successful, he or she is issued with a ‘gender recognition certificate’, their (...) birth certificate is changed and ‘for all purposes’ they become, legally, their acquired or affirmed gender. Since 2004, cultural change in relation to gender identity has been rapid. During the government’s preliminary survey, several concerns were raised about the GRA, particularly among those who have changed, or who may be seeking to change, their gender. These included: The government has stated that being trans is not a mental illness—more a fact of human diversity. It points to the World Health Organisation’s revision of the International Classification of Diseases, in which ‘gender incongruence’, another term for gender dysphoria, is no longer classed under ‘mental and behavioural disorders’.3 ### Draft proposals for change The government considers the reform of the GRA …. (shrink)

On 26 February 2019, the Organ Donation Bill completed its passage through the Westminster Parliament, creating the legislative basis to introduce an opt-out system for organ donation in England. The Bill now awaits Royal Assent, following which it is anticipated that the new system will come into effect in spring 2020. In the intervening period, there will be a significant publicity campaign to inform the public about the change in the law and the options open to them, which are to: (...) The family will continue to be consulted and as an additional safeguard, will be able to provide information about any unregistered objections held by the individual before they died. The legislation follows a similar model to that which was introduced in Wales on 1 December 2015. While it is too early to draw firm conclusions from the experience in Wales, the early signs are positive. The latest full-year data show an increase from 61 to 74 deceased donors over the previous 12 months;1 and in the first three-quarters of 2018/2019, there have been 72 deceased donors.2 Given the number of donors is small and subject to natural variation year-on-year, National Health Service Blood and Transplant has been analysing cumulative data to identify …. (shrink)

### Royal College of Physicians adopts neutral position on assisted dying In March 2019, the RCP announced that it would adopt a neutral position on assisted dying, following a survey of its UK fellows and members.1 The College had previously polled members and fellows on what the RCP position should be in 2014, at that time 44.4% of respondents thought the RCP should be opposed to assisted dying; 31% thought it should be neutral or have no position; and 24.6% thought (...) it should be in favour. On the basis of these figures, the College reaffirmed its position opposing assisted dying.2 In announcing the 2019 survey, the College’s Council resolved that they would require a ‘supermajority’ of 60% to adopt a position either supporting or opposing a change in the law; if no such majority was received, the College would move to a position of neutrality. This approach was not without controversy, and a legal challenge to the Council’s decision is pending.3 In response to the question of what the RCP’s position should be, 43.4% thought the RCP should be opposed; 31.6% thought the RCP should be supportive; and 25% thought the RCP should adopt a neutral position. Without a supermajority of 60% either way, the College’s position became one of neutrality.1 ### New Jersey legalises assisted suicide for the terminally ill New Jersey has become the ninth jurisdiction in the USA to legalise physician-assisted suicide after legislation was passed by the State senate in April 2019.4 The Medical Aid in Dying for the Terminally Ill Act will permit terminally ill adults, with 6 months or less to live, to request physician assistance in ending their life. Two doctors must confirm the patient’s diagnosis, prognosis, decision-making capacity and the voluntariness of their request, and if satisfied, can prescribe lethal medication, which the patient must self-administer. …. (shrink)

A imaginação é um sentido interno que reúne as impressões dos sentidos externos, afirma Leibniz em uma carta à rainha Sophie Charlotte. Esta é uma das únicas definições da imaginação formulada explicitamente por Leibniz. Não temos as cartas escritas por SophieCharlotte, o que é uma marca do silenciamento imposto às mulheres ao longo de séculos, por isso propomos um exercício de imaginação para reconstituir a importância desse diálogo. Outras raras ocorrências do termo “imaginação” em textos de Leibniz mostram (...) a importância que o filósofo atribui ao poder de criação da imaginação. Seria possível sugerir a partir de uma relação entre memória e imaginação um sentido político para a criação imaginativa? (shrink)

LEIBNIZ AND THE TWO SOPHIES is a critical edition of all of the philosophically important material from the correspondence between the philosopher Gottfried Wilhelm Leibniz (1646-1716) and his two royal patronesses, Electress Sophie of Hanover (1630-1714), and her daughter, Queen Sophie Charlotte of Prussia (1668-1705). In this correspondence, Leibniz expounds in a very accessible way his views on topics such as the nature and operation of the mind, innate knowledge, the afterlife, ethics, and human nature. The correspondence (...) also contains the only known philosophical writings by Sophie and Sophie Charlotte, and thus provides a valuable insight into their views and concerns, as well as throwing light on their characters. The texts are accompanied by a substantial introductory essay which sets the context for the correspondence and analyzes its main philosophical themes. (shrink)

Aristotle's defense of Dunamis -- Power and potentiality -- Rational and nonrational powers -- The priority of actuality -- Ontological hierarchy, normativity, and gender.

The received wisdom in statistical mechanics is that isolated systems, when left to themselves, approach equilibrium. But under what circumstances does an equilibrium state exist and an approach to equilibrium take place? In this paper we address these questions from the vantage point of the long-run fraction of time definition of Boltzmannian equilibrium that we developed in two recent papers. After a short summary of Boltzmannian statistical mechanics and our definition of equilibrium, we state an existence theorem which provides general (...) criteria for the existence of an equilibrium state. We first illustrate how the theorem works with a toy example, which allows us to illustrate the various elements of the theorem in a simple setting. After a look at the ergodic programme, we discuss equilibria in a number of different gas systems: the ideal gas, the dilute gas, the Kac gas, the stadium gas, the mushroom gas and the multi-mushroom gas. In the conclusion we briefly summarise the main points and highlight open questions. (shrink)

This article focuses on three themes concerning determinism and indeterminism. The first theme is observational equivalence between deterministic and indeterministic models. Here I discuss several results about observational equivalence and present an argument on how to choose between deterministic and indeterministic models involving indirect evidence. The second theme is whether Newtonian physics is indeterministic. I argue that the answer depends on what one takes Newtonian mechanics to be, and I highlight how contemporary debates on this issue differ from those in (...) the nineteenth century. The third major theme is how the method of arbitrary functions can be used to make sense of deterministic probabilities. I discuss various ways of interpreting the initial probability distributions and argue that they are best understood as physical, biological etc. quantities characterising the particular situation at hand. Also, I emphasise that the method of arbitrary functions deserves more attention than it has received so far. (shrink)

The general theme of this article is the actual practice of how definitions are justified and formulated in mathematics. The theoretical insights of this article are based on a case study of topological definitions of chaos. After introducing this case study, I identify the three kinds of justification which are important for topological definitions of chaos: natural-world-justification, condition-justification and redundancy-justification. To my knowledge, the latter two have not been identified before. I argue that these three kinds of justification are widespread (...) in mathematics. After that, I first discuss the state of the art in the literature about the justification of definitions in the light of actual mathematical practice. I then go on to criticize Lakatos’s account of proof-generated definitions—the main account in the literature on this issue—as being limited and also misguided: as for topological definitions of chaos, in nearly all mathematical fields various kinds of justification are found and are also reasonable. (shrink)

It is a genuine pleasure to engage with the insightful and generous comments of my colleagues. I have learned a lot from them, and I hope to continue our conversations in the future. The range of c...

This article focuses on three recent discussions on determinism in the philosophy of science. First, determinism and predictability will be discussed. Then, second, the paper turns to the topic of determinism, indeterminism, observational equivalence and randomness. Finally, third, there will be a discussion about deterministic probabilities. The paper will end with a conclusion.

Many views rely on the idea that it can never be rational to have high confidence in something like, “P, but my evidence doesn’t support P.” Call this idea the “Non-Akrasia Constraint”. Just as an akratic agent acts in a way she believes she ought not act, an epistemically akratic agent believes something that she believes is unsupported by her evidence. The Non-Akrasia Constraint says that ideally rational agents will never be epistemically akratic. In a number of recent papers, the (...) Non-Akrasia Constraint has been called into question. The goal of this paper is to defend it... for the most part. (shrink)

Believing rationally is epistemically valuable, or so we tend to think. It’s something we strive for in our own beliefs, and we criticize others for falling short of it. We theorize about rationality, in part, because we want to be rational. But why? I argue that how we answer this question depends on how permissive our theory of rationality is. Impermissive and extremely permissive views can give good answers; moderately permissive views cannot.

Epistemologists often assume that rationality bears an important connection to the truth. In this paper I examine the implications of this commitment for permissivism: if rationality is a guide to the truth, can it also allow some leeway in how we should respond to our evidence? I first discuss a particular strategy for connecting permissive rationality and the truth, developed in a recent paper by Miriam Schoenfield. I argue that this limited truth-connection is unsatisfying, and the version of permissivism that (...) supports it faces serious challenges; so, for mainstream permissivism, the truth problem is still unsolved. I then discuss a strategy available to impermissivists, according to which rationality bears a quite strong connection to truth. I argue that this second strategy is successful. (shrink)

Charlotte Witt extracts from this text a coherent and provocative view about sensible substance by focusing on Aristotle's account of form or essence.

The philosophical difficulties presented by self-deception are vexed and multifaceted. One such difficulty is what I call the ‘doxastic problem’ of self-deception. Solving the doxastic problem involves determining whether someone in a state of self-deception that ∼p both believes that p and believes that ∼p, simply holds one or the other belief, or, as I will argue, holds neither. This final option, which has been almost entirely overlooked to-date, is what I call ‘ nondoxasticism ’ about self-deception. In this article, (...) I present a negative case for nondoxasticism according to which, in the paradigm case of self-deception, there is no explanatory need to attribute the self-deceived person either their undesired belief that p, or their desired belief that ∼p. Folk psychology is replete with concepts other than belief, and if we bear this in mind, it becomes clear that the explanatory roles for which the self-deceived person's purported beliefs have traditionally been enlisted can be comfortably filled without recourse to belief. (shrink)

Credences, unlike full beliefs, can’t be true or false. So what makes credences more or less accurate? This chapter offers a new answer to this question: credences are accurate insofar as they license true educated guesses, and less accurate insofar as they license false educated guesses. This account is compatible with immodesty; : a rational agent will regard her own credences to be best for the purposes of making true educated guesses. The guessing account can also be used to justify (...) certain coherence constraints on rational credence, such as probabilism. The chapter concludes by discussing some advantages of the guessing account over rival accounts of accuracy. (shrink)

William James famously tells us that there are two main goals for rational believers: believing truth and avoiding error. I argues that epistemic consequentialism—in particular its embodiment in epistemic utility theory—seems to be well positioned to explain how epistemic agents might permissibly weight these goals differently and adopt different credences as a result. After all, practical versions of consequentialism render it permissible for agents with different goals to act differently in the same situation. -/- Nevertheless, I argue that epistemic consequentialism (...) doesn’t allow for this kind of permissivism and goes on to argue that this reveals a deep disanalogy between decision theory and the formally similar epistemic utility theory. This raises the question whether epistemic utility theory is a genuinely consequentialist theory at all. (shrink)

Objective To explore attitudes towards conscientious objections among medical students in the UK. Methods Medical students at St George's University of London, Cardiff University, King's College London and Leeds University were emailed a link to an anonymous online questionnaire, hosted by an online survey company. The questionnaire contained nine questions. A total of 733 medical students responded. Results Nearly half of the students in this survey stated that they believed in the right of doctors to conscientiously object to any procedure. (...) Demand for the right to conscientiously object is greater in Muslim medical students when compared with other groups of religious medical students. Discussion Abortion continues to be a contentious issue among medical students and this may contribute to the looming crisis in abortion services over the coming years. This project sheds some light on how future doctors view some of their ethical rights and obligations. Using empirical evidence, it reveals that conscientious objection is an issue in the UK medical student body today. These data could help anticipate problems that may arise when these medical students qualify and practise medicine in the community. Conclusion Clearer guidance is needed for medical students about the issue of conscientious objection at medical school. (shrink)

ABSTRACT When does a state of affairs constitute a harm to someone? Comparative accounts say that being worse off constitutes harm. The temporal version of the comparative account is seldom taken seriously, due to apparently fatal counterexamples. I defend the temporal version against these counterexamples, and show that it is in fact more plausible than the prominent counterfactual version of the account. Non-comparative accounts say that being badly off constitutes harm. However, neither the temporal comparative account nor the non-comparative account (...) can correctly classify all harms. I argue that we should combine them into a hybrid account of harm. The hybrid account is extensionally adequate and presents a unified view on the nature of harm. (shrink)

In the wake of the Supreme Court Decision, Dobbs v. Jackson Women’s Health Organization, Minkoff, Vullikanti, and Marshall (2024) argue that the unraveling of the constitutional right to abortion t...

In March 2020, the Government produced a document entitled “Responding to COVID-19: The Ethical Framework for Adult Social Care”. In this article, we summarise the key features of the proposed ethical framework and subject it to critical analysis. We highlight three primary issues. First, the emphasis placed on autonomy as the primary ethical principle. We argue if ever there was a context in which autonomy should dominate the ethical analysis, this is not it. Second, we examine the interface between ethics (...) and law which is largely overlooked in the document. Finally, we explore the surprising lack of attention paid to the concept of responsibility and communal obligations within the framework. (shrink)

This anecdote illustrates the juxtaposition of tribe and state in the modern world. Human beings are united into what we call 'societies' by common beliefs ...

This book develops a unique phenomenology of plurality by introducing Hannah Arendt’s work into current debates taking place in the phenomenological tradition. Loidolt offers a systematic treatment of plurality that unites the fields of phenomenology, political theory, social ontology, and Arendt studies to offer new perspectives on key concepts such as intersubjectivity, selfhood, personhood, sociality, community, and conceptions of the "we." _Phenomenology of Plurality_ is an in-depth, phenomenological analysis of Arendt that represents a viable third way between the "modernist" and (...) "postmodernist" camps in Arendt scholarship. It also introduces a number of political and ethical insights that can be drawn from a phenomenology of plurality. This book will appeal to scholars interested in the topics of plurality and intersubjectivity within phenomenology, existentialism, political philosophy, ethics, and feminist philosophy. (shrink)

Preterm birth is defined as delivery occurring before 37 weeks gestation.1 Infants born prematurely have increased risks of morbidity and mortality throughout life, especially during the first year. These risks increase as the gestational age at birth decreases.2 Additionally, there are significant racial and ethnic differences in preterm birth rates. In 2022, the rate of preterm birth among non-Hispanic black women was approximately 50% higher than that observed in non-Hispanic white women.1 The outcomes for these infants are also disparate–preterm birth (...) and low birth weight are the second-leading causes of infant mortality (deaths before 1 year of age). Notably, among preterm neonates, infants born to non-Hispanic black women have a mortality rate more than double that of infants born to non-Hispanic white mothers.3 Importantly, there is a small but significant group of neonates that can be classified as severely premature (those born <28 weeks). Infants born before 28 weeks have varied and uncertain outcomes. While this group accounts for only 0.4% of preterm births, it also accounts for 40% of deaths among preterm neonates.4 As noted by Romanis and Adkins, the advent of artificial amnion and placenta technology (AAPT) holds promise for its potential to address the physiologic complications and mortality risks of extreme prematurity by introducing amniotic substitutes that mimic in vivo placental oxygenation and substrate delivery. In contrast …. (shrink)

With Hegel’s metaphysics attracting renewed attention, it is time to address a long-standing criticism: Scholars from Marx to Popper and Habermas have worried that Hegel’s metaphysics has anti-individualist and authoritarian implications, which are particularly pronounced in his Philosophy of History, since Hegel identifies historical progress with reason imposing itself on individuals. Rather than proposing an alternative non-metaphysical conception of reason, as Pippin or Brandom have done, this article argues that critics are broadly right in their metaphysical reading of Hegel’s central (...) concepts. However, they are mistaken about what Hegel’s approach entails, when one examines the specific types of states discussed by the philosopher in his Philosophy of History. Even on a traditional metaphysical reading, Hegel is not only non-authoritarian; he also makes a powerful argument concerning freedom, whereupon the freest society involves collective oversight and the shaping of social structures so as to ensure that they benefit everybody. (shrink)

Picking up on Marx’s and Hegel’s analyses of human beings as social and individual, the article shows that what is at stake is not merely the possibility of individuality, but also the correct conception of the universal good. Both Marx and Hegel suppose that individuals must be social or political as individuals, which means, at least in Hegel’s case, that particular interests must form part of the universal good. The good and the rational is not something that requires sacrificing one’s (...) interests for the community or denying one’s particular character so as to become an equal rational agent. Very much to the contrary, the rational or the common good is nothing but the harmonious structuring of particular interests. While Section I introduces Marx’s and Hegel’s conceptions of individual and social beings, Sections II and III discuss their respective views of individuality, and Sections IV and V discuss the notion of a universal good containing individual interests. (shrink)

In a criminal trial, a judge or jury needs to reason about what happened based on the available evidence, often including statistical evidence. While a probabilistic approach is suitable for analysing the statistical evidence, a judge or jury may be more inclined to use a narrative or argumentative approach when considering the case as a whole. In this paper we propose a combination of two approaches, combining Bayesian networks with scenarios. Whereas a Bayesian network is a popular tool for analysing (...) parts of a case, constructing and understanding a network for an entire case is not straightforward. We propose an explanation method for understanding a Bayesian network in terms of scenarios. This method builds on a previously proposed construction method, which we slightly adapt with the use of scenario schemes for the purpose of explaining. The resulting structure is explained in terms of scenarios, scenario quality and evidential support. A probabilistic interpretation of scenario quality is provided using the concept of scenario schemes. Finally, the method is evaluated by means of a case study. (shrink)

Does motor behavior early in development have the same signatures of habituation, dishabituation, and Spencer-Thompson dishabituation known from infant perception and cognition? And do these signatures explain the choice preferences in A not B motor decision tasks? We provide new empirical evidence that gives an affirmative answer to the first question together with a unified neural dynamic model that gives an affirmative answer to the second question.In the perceptual and cognitive domains, habituation is the weakening of an orientation response to (...) a stimulus over perceptual experience. Switching to a novel stimulus leads to dishabituation, the re-establishment of the orientation response. In Spencer-Thompson dishabituation, the renewed orientation response transfers to the original stimulus. The change in orientation responses over perceptual experience explains infants' behavior in preferential looking tasks: Familiarity preference early during exposure and novelty preference late during exposure. In the motor domain, perseveration in the A not B task could be interpreted as a form of familiarity preference. There are hints that this preference reverses after enough experience with the familiar movement. We provide a unified account for habituation and patterns of preferential selection in which neural dynamic fields generate perceptual or motor representations. The build-up of activation in excitatory fields leads to familiarity preference, the build-up of activation in inhibitory fields leads to novelty preference. We show that the model accounts for the new experimental evidence for motor habituation, but is also compatible with earlier accounts for perceptual habituation and motor perseveration. We discuss how excitatory and inhibitory memory traces may regulate exploration and exploitation for both orientation to objects and motor behaviors. (shrink)

Garrett Cullity contends that fairness is appropriate impartiality (See Cullity (2004) Chapters 8 and 10 and Cullity (2008)). Cullity deploys his account of fairness as a means of limiting the extreme moral demand to make sacrifices in order to aid others that was posed by Peter Singer in his seminal article ‘Famine, Affluence and Morality’. My paper is founded upon the combination of (1) the observation that the idea that fairness consists in appropriate impartiality is very vague and (2) the (...) fact that psychological studies show the self-serving bias is especially likely to infect one’s judgements when the ideas involved are vague. I argue that Cullity’s solution to extreme moral demandingness is threatened by these findings. I then comment on whether some other theories of fairness are vulnerable to the same objection. (shrink)

Diverse agricultural technologies are promoted to increase yields and incomes, save time, improve food and nutritional security, and even empower women. Yet a gender gap in technology adoption remains for many agricultural technologies, even for those that are promoted for women. This paper complements the literature on gender and technology adoption, which largely focuses on reasons for low rates of female technology adoption, by shifting attention to what happens within a household after it adopts a technology. Understanding the expected benefits (...) and costs of adoption, from the perspective of women users in households with adult males, can help explain observed technology adoption rates and why technology adoption is often not sustained in the longer term. Drawing on qualitative data from Ethiopia, Ghana, and Tanzania, this paper develops a framework for examining the intrahousehold distribution of benefits from technology adoption, focusing on small-scale irrigation technologies. The framework contributes to the conceptual and empirical exploration of joint control over technology by men and women in the same household. Efforts to promote technology adoption for agricultural development and women’s empowerment would benefit from an understanding of intrahousehold control over technology to avoid interpreting technology adoption as an end in and of itself. (shrink)

In this article we explore an argumentative pattern that provides a normative justification for expected utility functions grounded on empirical evidence, showing how it worked in three different episodes of their development. The argument claims that we should prudentially maximize our expected utility since this is the criterion effectively applied by those who are considered wisest in making risky choices (be it gamblers or businessmen). Yet, to justify the adoption of this rule, it should be proven that this is empirically (...) true: i.e. that a given function allows us to predict the choices of that particular class of agents. We show how expected utility functions were introduced and contested in accordance with this pattern in the 18th century and how it recurred in the 1950s when Allais made his case against the neo-Bernoullians. (shrink)

The aim of the article is to illustrate concrete problems in the asymmetrical nurse–patient power relationship. It is an ethical demand that the nurse is faced with the challenges that the power in the relation is administered so that the patient's room for action is expanded and trust maintained. It is an essential message in care philosophy, but in clinical practice, success is not always achievable. A hidden and more or less unconscious restriction of the patient's room for action may (...) result in the excesses of care. Three selected aspects: dependence, trust, and power described by the Danish philosopher K.E. Løgstrup and the Norwegian nursing philosopher Kari Martinsen's care philosophy has inspired this empirically based examination of some current barriers in the asymmetrical nurse–patient relationship. On the basis of qualitative interviews with six patients and six nurses, the research thus provides an identifying and problem‐exploratory examination of some current obstacles in which the handling of trust and power reflects the excesses of care. The findings develop three themes. ‘Being a burden’ acknowledges that the balance of power will always tip to the nurse's advantage. The second theme, ‘Doing only what's absolutely necessary’, shows how a fixation with ‘technicalism’ creates a distance between people that may constrain the patient's room for action. The last theme is concerning the nurse's ability to navigate between closeness and distance is essential in avoiding ‘the excesses of care’, paternalism, and overprotectiveness. A situation in which distance takes the upper hand and care turns into paternalism. A different situation would arise if the nurse's emotions became sentimental or intimate with the result that closeness gets the upper hand. To avoid a harmful exercise of power and the excesses of care, the findings have demonstrated that a relationship‐based caring is a demand for situation‐specific sensitive attention skills. (shrink)