Forensic psychiatry is pervaded by moral dilemmas. Although professionals in forensic psychiatry are trained in law and psychiatry and are certainly aware of ethical issues in the care for patients, they tend to make decisions in an implicit way and not to discuss their moral concerns or doubts. More structural attention for ethics seems to be required. In this paper, we show the value of moral case deliberation in forensic psychiatry. Moral case deliberation is a specific kind of clinical ethics (...) support in which healthcare professionals discuss a moral issue from practice in a structured way, facilitated by an ethicist or specifically trained facilitator. It is applicable to a wide array of situations in healthcare practice. In contrast to other models of clinical ethics support, such as individual consultation, the focus is on the moral experience of professionals and using a structured method to foster dialog and joint moral learning. In this paper, an example of case on a forensic ward is presented. The case shows that moral case deliberation leads to reflection on values and stimulates openness and honesty regarding uncertainties. Moreover, the deliberation provides room for new insights and creates a basis for a joint decision on how to proceed further, recognizing the tensions and difficulties involved. (shrink)

Background: The increasing number of elderly people in nursing homes with failing competence to give consent represents a great challenge to healthcare staff’s protection of patient autonomy in the issues of life-prolonging treatment, hydration, nutrition and hospitalisation. The lack of national guidelines and internal routines can threaten the protection of patient autonomy. Objectives: To place focus on protecting patient autonomy in the decision-making process by studying how relatives experience their role as substitute decision-makers. Design: A qualitative descriptive design with analysis (...) of the contents of transcribed in-depth interviews with relatives. Participants: Fifteen relatives of 20 patients in 10 nursing homes in Norway. Results and Interpretations: The main findings reveal deficient procedures for including relatives in decision-making processes. Relatives have poor knowledge about the end of life, and there is little discussion about their role as substitute decision-makers for patients who are not competent to give consent. Few relatives understand the concept of patient autonomy. In Norway the treating physician is responsible for patient treatment. When relatives are included in discussions on treatment, they perceive themselves as responsible for the decision, which is a burden for them afterwards. This qualitative study describes relatives’ experiences, thus providing important information on the improvement potential with the main objective of safeguarding patient autonomy and caring for relatives. Conclusion: The study reveals failing procedures and thus a great potential for improvement. Both ethical and legal aspects must be addressed when considering patient autonomy. (shrink)

La critique de Micheline Dumont soulève la question de la légitimité des Cercles de Fermières à figurer comme ancêtres du féminisme contemporain, et conteste à l'auteur de leur histoire de prétendre présenter dans le volume cinq de l'Histoire des femmes un article sur le Québec à partir de sa recherche. Ce texte vise autant à minimiser le rôle des Cercles de Fermières dans l'avènement de la modernité québécoise qu'à isoler l'auteur d'une telle interprétation du reste des chercheurs qui...

La critique de Micheline Dumont soulève la question de la légitimité des Cercles de Fermières à figurer comme ancêtres du féminisme contemporain, et conteste à l'auteur de leur histoire de prétendre présenter dans le volume cinq de l'Histoire des femmes un article sur le Québec à partir de sa recherche. Ce texte vise autant à minimiser le rôle des Cercles de Fermières dans l'avènement de la modernité québécoise qu'à isoler l'auteur d'une telle interprétation du reste des chercheurs qui...

From the viral social media feeds showing Chief Justice Mogoeng Mogoeng in fervent prayer for the nation, to professed Christian Thuli Madonsela’s careful expression of the separation between religion and state, faith identity in the public sphere emerges as anything but a straightforward matter. By placing ‘Christian’ in parenthesis, the 2019 theme of the Theological Society of South Africa conference acknowledged that leaders operate in negotiated spaces and confirmed the complexity of the context in which we attempt to conceptualise leadership (...) from a theological perspective. This raises the question of the role that personal faith convictions play and may be allowed to play in public life. While conceptualising leadership from a faith perspective in a context that is at once secular and post-secular may be complex, evidence emerging from leadership studies of the importance of spirituality in leadership necessitates such a reflection. This article considers the problem from a theological point of view, drawing on Schleiermacher and Bonhoeffer’s later letters from prison to provide a theological foundation for a public spirituality of leadership. (shrink)

This article presents hospitality as a pivotal value in the context of increasing diversity that characterises the complex relations in which leadership emerges. After reviewing the concept of Otherness in philosophy, the notion of hospitality as developed by Richard Kearney in relation to his philosophy of religion is introduced. The case of Nobel Peace Prize Laureate Chief Albert Luthuli is then presented as a biographical leadership study from the African context to illustrate how hospitality as open response to radical Otherness (...) may inspire collaboration and foster positive change. The article then addresses ways in which the notions of hospitality and Otherness present new opportunities to leadership studies for responding to the relational challenges of the globalised world. Amidst an increased scholarly focus on relationality and the need for relational intelligence, globalisation routinely confronts leaders and their followers with radical Otherness. Through dialogue between theology, philosophy of religion and leadership studies and by presenting a case from the African context, the article offers in print what is called for in the global context, namely an open response to the alterity of the Other that enables collaboration amidst increasing diversity. CONTRIBUTION: Proceeding from a transdisciplinary engagement, the article illustrates that leadership studies stood to benefit from dialogue with theology and philosophy of religion, which offers ways of addressing the Otherness that characterise the globalised context of leadership. (shrink)

This article provides an overview of Richard Kearney’s attempt at re-imagining God post-metaphysically. In the context of a continental dialogue on the topic, Kearney has responded to onto-theology with a hermeneutic and phenomenologically informed attempt to rethink God post-metaphysically. This eschatological understanding of God is expounded in the article and is placed in relation to Kearney’s more recent concept of Anatheism. The article closes with a few remarks on what may be gained by Kearney’s work, as well as outlining a (...) few critical questions. (shrink)

Cet article aborde, à partir de la répétition des maltraitances sur enfant dans la relation mère-fille, la fonction du processus de cette répétition selon la théorie freudienne et lacanienne dans un dispositif de soin dans le cadre de la pjj. Une vignette clinique met en évidence que l’insistance de la répétition du fantasme d’infanticide dans la généalogie féminine ne se réduit pas à la narration du traumatisme infantile mais devient une interrogation à l’adresse du Grand Autre pour se définir comme (...) sujet désirant, différent, afin de se soustraire à ce fantasme. Si cette demande sous-jacente à cette répétition n’est pas entendue par les professionnels, les institutions qui sont mis à l’épreuve, dans le transfert et le contretransfert, au profit de la fonction victimaire chez le sujet, les réponses apportées dans la réalité ne pourront que contribuer à assurer la jouissance mortifère de ce dernier dans la transgression, mettant en échec la fonction symbolique de la Loi. Les auteurs montrent, à travers l’efficacité du transfert et de la fonction symbolique de la Loi, que la psychanalyse sans divan peut s’adapter à une clinique du réel, clinique qui peut parfois réinterroger la théorie. (shrink)

In this article we address the social value of bioethics research and show how a participatory approach can achieve social impact for a wide audience of stakeholders, involving them in a process of joint moral learning. Participatory bioethics recognizes that research co-produced with stakeholders is more likely to have impact on healthcare practice. These approaches aim to engage multiple stakeholders and interested partners throughout the whole research process, including the framing of ideas and research questions, so that outcomes are tailored (...) to the interests and context, and the type of impact stakeholders envisage. There is an emphasis on realizing social change through the conduct of the research, and it is believed that the engagement of stakeholders in the research process will promote their intrinsic motivation to change their practice. Another distinctive feature of participatory bioethics research is that its central normative commitment is to reflection and dialogue, not to a particular substantive ethical approach. In reflection and dialogue there is an emphasis on inclusion and the co-production of knowledge. Furthermore, empirical and normative research are combined, and there is a deliberate attempt to give voice to otherwise marginalized positions. This provides a model of social impact which is relevant not only for bioethics research, but also for other areas of health care research. We will show the merits of a participatory approach to bioethics research with a case example. It concerns the reduction of coercion and in particular seclusion in Dutch mental healthcare. (shrink)

Dreyer Kruger, now in his eighties, was asked to reflect on the years of his active professional experience, especially while at Rhodes University from 1974 to 1989. Considered by many to be the doyen of phenomenological psychology in South Africa, he introduced what, at that time, was a revolutionary view in the social sciences of understanding what it means to be human.During his tenure as an academic psychologist, a cohort of doctoral level phenomenologically-oriented psychologists emerged, many of whom emigrated (...) from South Africa during its apartheid era to take up high-raking positions elsewhere in the academic arena in the USA, UK, Australia and New Zealand, while those remaining in South Africa continued his legacy of promoting phenomenology as a field of interrogation in the social and human sciences. (shrink)

This article analyses how recent critiques of secularism in political philosophy and cultural anthropology might productively be combined and contrasted with each other. I will show that Jürgen Habermas' postsecularism takes insufficient account of elementary criticisms of secularism on the part of anthropologists such as Talal Asad and Saba Mahmood. However, I shall also criticize Saba Mahmood’s reading of secularism by arguing that, in the end, she replaces the secular–religious divide with a secularity–piety divide; for example, in her reading of (...) Nasr Abu Zayd’s secular Islamic hermeneutics. This inhibits the use of her framework of analysis for a criticism of a problem central to Habermas' postsecularism, namely that it remains focused on specific intensities of belief. I shall then argue that, combined with the anthropological critiques of the secular, the political-historical nature of the fanaticism–piety–violence nexus should be integrated into political philosophical debates on secularism and postsecularism. (shrink)

Résumé Cet article met en évidence la complexité des enjeux psychiques familiaux et individuels dans différentes cultures. La variabilité de la notion de famille et de celle de parenté fondée sur le tabou de l’inceste consanguin et symbolique introduit ces enjeux complexes. Les enjeux familiaux sont aussi différents selon le rang de l’enfant dans la fratrie, la différence des sexes ne manquant pas d’influer sur les relations fraternelles et les enjeux psychiques individuels.

Cet article tente de mettre en évidence que ce n’est pas le trouble du sommeil de l’enfant et le mode de coucher, objets de controverses dans les études épidémiologiques, qui favorisent le contexte incestuel ou encore entravent l’autonomie de l’enfant. Mais ce contexte incestuel au sens où l’entend Racamier s’inscrit dans la phase de séduction narcissique mutuelle dans l’interaction intersubjective mère-enfant (ou parent maternant-enfant) et favorise la distorsion de cette relation à cause du déni d’un manque imaginaire chez le parent, (...) déni qui contamine l’enfant. Il se perpétue alors une relation fusionnelle de nature incestueuse qui transforme les liens entre les deux partenaires en alliances narcissiques perverties pouvant mener à l’inceste génitalisé ou psychique. Des études cliniques montrent que cette distorsion relationnelle se retrouve aussi bien dans le contexte incestuel père maternant-fille que dans l’inceste père-fille. (shrink)

Cet article tente de mettre en évidence que ce n’est pas le trouble du sommeil de l’enfant et le mode de coucher, objets de controverses dans les études épidémiologiques, qui favorisent le contexte incestuel ou encore entravent l’autonomie de l’enfant. Mais ce contexte incestuel au sens où l’entend Racamier s’inscrit dans la phase de séduction narcissique mutuelle dans l’interaction intersubjective mère-enfant (ou parent maternant-enfant) et favorise la distorsion de cette relation à cause du déni d’un manque imaginaire chez le parent, (...) déni qui contamine l’enfant. Il se perpétue alors une relation fusionnelle de nature incestueuse qui transforme les liens entre les deux partenaires en alliances narcissiques perverties pouvant mener à l’inceste génitalisé ou psychique. Des études cliniques montrent que cette distorsion relationnelle se retrouve aussi bien dans le contexte incestuel père maternant-fille que dans l’inceste père-fille. (shrink)

De tous les professeurs ayant participé à l'expérience viennoise, René Scherer apparaît comme le philosophe hospitalier par excellence, c'est-à-dire celui qui invite à philosopher ensemble dans une communauté de réflexion et de discussion. Mais ce recueil rappelle que la communauté homogène est impossible, fantasmatique du seul fait que l'homogène est la destruction de la communauté. C'est pourquoi le philosophe hospitalier convie à une "communauté de singularités" constituée par la diversité et la pluralité.

South Africa suffers a scourge of domestic violence. Colonial oppression upset the delicate balance between 'discipline' and 'protection' in traditional cultures. The full consequence of a patriarchal mindset of male control is unleashed on girls and women. The aim of this article is to investigate how the cycle of domestic violence can be broken and what role pastoral counsellors can play with regard to both victims and offenders in order to prevent history from repeating itself. The article also investigates the (...) extent to which legislation has succeeded in protecting individuals. Pastoral care and counselling comprise both spiritual and emotional support. The combination of two counselling methods compatible with religious themes such as 'hope' and 'new life', namely logotherapy and narrative pastoral counselling, is presented as an effective response to domestic violence. (shrink)

Wrestling and arguing with God: between insider and outsider African perspectives -- Introduction to Richard Kearney's intellectual autobiography: where do you come from, Richard Kearney? -- Where I speak from: a short intellectual autobiography -- Phenomenology in South Africa: an indirect encounter with Richard Kearney -- Transcendence and anatheism -- Response to Richard Kearney's Anatheism: Anatheism and holy folly -- Kearney between poles: is too much lost in the middle? -- Strangers, Gods and Africa: in dialogue with Richard Kearney on (...) Otherness -- Approaching the threshold: hospitality as a pedagogical wager in the work of Richard Kearney -- God-talk, the biblical prophets and Richard Kearney -- 'Strange' theology: engaging with Richard Kearney -- Trinitarian theology and Richard Kearney's anatheism: an engagement -- After God but behind the Cross: the procession as a way to re-encounter God in a culture beyond classical liturgy -- Touch gives rise to thought: Paul Ricoeur and Pumla Gobodo-Madikizela on mutual recognition and carnal hermeneutics -- Towards hospitality between enemies -- Across oceans: a conversation on otherness, hospitality and welcoming a strange God. (shrink)

In this volume, the world's foremost Scotus scholars collaborate to present the latest research on his work.

In this much-anticipated work, distinguished authors Mary Beth Ingham and Mechthild Dreyer present an accessible introduction to the philosophy of the thirteenth century Franciscan John Duns Scotus.

In Mozambique, poverty is pervasive because of factors such as the civil war and its aftermath, political instability, food scarcity and natural disasters. This article elucidates the situation of post-civil war Mozambique from a socio-political perspective with a specific focus on children and the youth as a particularly vulnerable group. Many children and young people have been displaced and are subject to work exploitation and sexual abuse. Female children also fall victim to the cultural practice of child marriage. The absence (...) of comprehensive social measures for the protection of vulnerable young persons has a detrimental effect on their welfare and future prospects. The aim of the article is to explore the role that faith communities and church institutions can play in this context. From an inclusive congregational perspective, the inclusion of youth in all aspects of faith communities as a strategy for development is discussed. From a human rights and theological perspective, participatory action is required for faith communities and church institutions to contribute to making a life of human dignity possible for children and young people. (shrink)

De senere år har pleie- og omsorgstjenesten i mange norske kommuner startet med ulike former for etikkarbeid, oftest initiert av KS’ prosjekt “Samarbeid om etisk kompetanseheving”. Hensikten med vår studie var å evaluere innsatsen i de kommunene som deltok i prosjektet fra starten av, med vekt på hvilke tiltak som var iverksatt, hvilke virksomheter dette omfattet, og om tiltakene har fortsatt utover prosjektperioden. Studien har et kvalitativt design. Materialet er hovedsakelig basert på telefonintervjuer med kontaktpersoner for etikksatsingen i 34 kommuner. (...) Det transkriberte materialet er analysert ved kvalitativ innholdsanalyse. Med unntak av fem kommuner som aldri kom i gang med etikkarbeidet, hadde de fleste startet etikkrefleksjon innenfor flere tjenester, oftest i sykehjem og hjemmetjenester. Noen kommuner hadde imidlertid ikke klart å videreføre etikkarbeidet utover en prosjektperiode. Det var stor variasjon både i etikkarbeidets forankring i kommunen, omfang, hyppighet og metoder. Et gjennomgående funn er vektlegging av behovet for etikkkompetanse og oppfølging av dem som skal lede etikkarbeidet. Flertallet av kommunene som fortsatt gjennomfører etikkrefleksjon, tar utgangspunkt i egen praksis, men et mindretall anvender strukturerte metoder. Dersom etikkarbeidet i kommunen skal være levedyktig over tid, bør arbeidet forankres på flere nivåer i organisasjonen, og de som skal lede dette arbeidet, bør få styrket sin kompetanse i etikk og etikkrefleksjon.Nøkkelord: etikk, evaluering, kommunehelsetjenestenEnglish summary: Building ethical competence in Norwegian municipalities: What has been done and what has been sustainable?“Cooperation for building ethics competence” is a national project aimed to stimulate moral reflection and build competence in ethics in community health services in Norway. This article is based on an evaluation of the activities implemented by the first 34 participating municipalities, exploring which measures were implemented, which services and employees were involved, and if the measures are sustainable. The study has a qualitative design, and the data mainly consists of telephone interviews with “key” persons in 34 municipalities. With the exception of five municipalities that never really started ethics work, the majority had implemented ethical reflection in several areas, most often in nursing homes and home care services. There was great variation with regard to the implementation. Many had tried a variety of reflection models, and only a minority of the municipalities were using a structured method of ethical reflection. A consistent finding is the need for more competence; many of those who run ethical reflection are reported to need more competence both in ethics and methods for systematic reflection. There were also great variations in how well the ethics projects were anchored within the municipality. To make ethical interventions sustainable, this study indicates the importance of strong anchoring within the municipality, the need for ethical competence, as well as good methods for structuring ethical reflection. (shrink)

The aim of the article is to critically question whether the church is still able to guide people to make meaningful choices with regard to marriage and sexuality when values keep shifting. This question is especially relevant where the church still tends to uphold premodern values (heteronormative, patriarchal, monogamous) with regard to sexuality and marriage as the only (prescriptive) model for marriage in a postmodern world. The article consists of the following sections: changing values versus traditional values; marriage and sexuality (...) from biblical times to the present; church in crisis; and eco-feminist family ethics. (shrink)

In the context of giving this year’s Christian Wolff Lecture, Agnes Heller - looking back on her eventful life and the current political situation in Hungary - reflects on the relationship between philosophy and politics. The changes in her concept of freedom are closely related to her experience of various kinds of political oppression. However, Heller expresses wariness concerning the role of philosophical thought in politics, arguing that philosophy and politics are based on two distinct, incommensurate concepts of truth. She (...) defends a pluralistic approach to truth against the allegation of relativism and subsequently characterizes philosophy as a unique form of storytelling. Heller shares with us her observations on philosophy under modern conditions and closes the interview with a very personal tale. (shrink)

Volume 20, Issue 4, May 2020, Page 78-80.

Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence‐based fast‐track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients’ individual perspectives in an evidence‐based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence‐based recommendations, which specify a set (...) of rules that the patient must follow rigorously. The other is a course of democratization based on patients’ involvement in care. Referring to the analysis of the narrative, we argue that, in the current implementation of evidence‐based practice, the proposed involvement of patients resembles empty rhetoric. We argue that the principles and values from evidence‐based medicine are being lost in the transformation into the current evidence‐based hospital culture which potentially leads to a McDonaldization of nursing practice reflected as ‘one best way’. We argue for reviving ethics of care perspectives in today's evidence practice as the fundamental values of nursing may potentially bridge conflicts between evidence‐based practice and the ideals of patient participation thus preventing a practice of ‘McNursing’. (shrink)

Linda Clark produit avec ce livre un essai remarquable, par l'ampleur de sa recherche et des résultats qu'elle en tire. Fermement inscrite dans la tradition désormais solidement établie de l'histoire des femmes, cette étude a pour objet de reconstruire l'histoire de l'accès des femmes à l'administration publique française depuis 1830 et de leur difficile intégration dans cette vaste machine jusqu à l'aube des grands chamboulements de l'après seconde guerre mondiale. Établie sur des sour...