Conscientious objections (CO) can be disruptive in a variety of ways and may disadvantage patients and colleagues who must step-in to assume care. Nevertheless, nurses have a right and responsibility to object to participation in interventions that would seriously harm their sense of integrity. This is an ethical problem of balancing risks and responsibilities related to patient care. Here we explore the problem and propose a nonlinear framework for exploring the authenticity of a claim of CO from the perspective of (...) the nurse and of those who must evaluate such claims. We synthesized the framework using Rest’s Four Component Model of moral reasoning along with tenets of the International Council of Nursing’s (ICN) Code of Ethics for Nurses and insights from relevant ethics and nursing ethics literature. The resulting framework facilitates evaluating potential consequences of a given CO for all involved. We propose that the framework can also serve as an aid for nurse educators as they prepare students for practice. Gaining clarity about the sense in which the concept of conscience provides a defensible foundation for objecting to legally, or otherwise ethically, permissible actions, in any given case is critical to arriving at an ethical and reasonable plan of action. (shrink)

Much attention has been paid to the role of the nurse in recognizing and addressing ethical dilemmas. There has been less emphasis, however, on the issue of whether or not nurses understand the ethical nature of everyday practice. Awareness of the inherently ethical nature of practice is a component of nurse ethical sensitivity, which has been identified as a component of ethical decision-making. Ethical sensitivity is generally accepted as a necessary precursor to moral agency, in that recognition of the ethical (...) content of practice is necessary before consistent action on behalf of patient interests can take place. This awareness is also compulsory in ensuring patient good by recognizing the unique interests and wishes of individuals, in line with an ethic of care. Scholarly and research literature are used to argue that bolstering ethical awareness and ensuring that nurses understand the ethical nature of the role are an obligation of the profession. Based on this line of reasoning, recommendations for education and practice, along with directions for future research, are suggested. (shrink)

One antidote to moral distress is stronger moral agency—that is, an enhanced ability to act to bring about change. The Clinical Ethics Residency for Nurses, an educational program developed and run in two large northeastern academic medical centers with funding from the Health Resources and Services Administration, intended to strengthen nurses’ moral agency. Drawing on Improving Competencies in Clinical Ethics Consultation: An Education Guide, by the American Society for Bioethics and Humanities, and on the goals of the nursing profession, CERN (...) sought to change attitudes, increase knowledge, and develop skills to act on one's knowledge. One of the key insights the faculty members brought to the design of this program is that knowledge of clinical ethics is not enough to develop moral agency. In addition to lecture‐style classes, CERN employed a variety of methods based in adult learning theory, such as active application of ethics knowledge to patient scenarios in classroom discussion, simulation, and the clinical practicum. Overwhelmingly, the feedback from the participants (sixty‐seven over three years of the program) indicated that CERN achieved transformative learning. (shrink)

Philosophical foundations of applied and professional ethics -- Nursing ethics -- Advanced practice nursing : the nurse patient relationship and general ethical concerns -- Professional responsibility, social justice, human rights, and njustice -- Leadership in advanced practice roles : CNM, CNS, CRNA, DNP, NP -- Research ethics : advanced practice roles and responsibilities -- Nursing ethics and advanced practice : neonatal issues -- Nursing ethics and advanced practice : children and adolescents -- Nursing ethics and advanced practice : women's health (...) -- Nursing ethics and advanced practice : adult-gerontology health -- Nursing ethics and advanced practice : psychiatric and mental health issues -- Nursing ethics and advanced practice : anesthesia and periop period -- Nursing ethics and advanced practice : palliative care and end of life care across the lifespan. (shrink)

Background: The Clinical Ethics Residency for Nurses was offered selectively to nurses affiliated with two academic medical centers to increase confidence in ethical decision-making. Research Question/Aim: To discover how effective the participants perceived the program and if their goals of participation had been met. Research design: A total of 65 end-of-course essays (from three cohorts) were analyzed using modified directed content analysis. In-depth and recursive readings of the essays by faculty were guided by six questions that had been posed to (...) graduates. Ethical considerations: Institutional review board approval was granted for the duration of the program and its reporting period. Confidentiality was maintained via the use of codes for all evaluations including the essays and potentially identifying content redacted. Findings: An umbrella theme emerged: participants had developed ethical knowledge and skills that provided a “moral compass to navigate the many gray areas of decision-making that confront them in daily practice.” Six major themes corresponding to questions posed to the participants included the ability to advocate for good patient care; to support and empower colleagues, patients, and families; they experienced personal and professional transformation; they valued the multimodal nature of the program; and were using their new knowledge and skills in practice. However, they also recognized that their development as moral agents was an ongoing process. Discussion: Findings support that enhancing nurse confidence in their moral agency with a multimodal educational approach that includes mentored practice in ethical decision-making, enhancing communication skills and role-play can mitigate moral distress. A majority found the program personally and professionally transformative. However, they recognized that ongoing ethics discussion involvement and supportive environments would be important in their continued development of ethical agency. Conclusion: Multimodal ethics education programs have potential to be transformative and enhance nurse confidence in their ethical decision-making. (shrink)

This article summarizes a virtual live‐streamed panel event that occurred in August 2020 and was cosponsored by the International Philosophy of Nursing Society (IPONS) and the University of California, Irvine's Center for Nursing Philosophy. The event consisted of a series of three self‐contained panel discussions focusing on the past, present and future of IPONS and was moderated by the current Chair of IPONS, Catherine Green. The first panel discussion explored the history of IPONS and the journal Nursing Philosophy. The second (...) panel involved a reflection on the challenges of doing nursing philosophy in a research‐intensive context of a Canadian university and the history and current movements in nursing philosophy in the Nordic countries. The final panel involved presentations on the future potential for philosophy in/and for nursing, the critical connections between nursing philosophy and nursing theory, dismantling racism in nursing and the potential for process philosophy to help explore nursing's unique efficacy in creating possibilities for health. The panels were followed by a lively Q&A session with participants, of which there were 252 registrants from across the globe. The event underscored the wide and diverse interests of nurses in philosophical discussion and the need for more virtual events and other connective modalities bringing nurses together to discuss and analyze the value and potential of philosophy to better understand and advance nursing theory and practice. (shrink)

Macphail’s “null hypothesis,” that there are no differences in intelligence, qualitative, or quantitative, between non-human vertebrates has been controversial. This controversy can be useful if it encourages interest in acquiring a detailed understanding of how non-human animals express flexible problem-solving capacity (“intelligence”), but limiting the discussion to vertebrates is too arbitrary. As an example, we focus here on Portia, a spider with an especially intricate predatory strategy and a preference for other spiders as prey. We review research on pre-planned detours, (...) expectancy violation, and a capacity to solve confinement problems where, in each of these three contexts, there is experimental evidence of innate cognitive capacities and reliance on internal representation. These cognitive capacities are related to, but not identical to, intelligence. When discussing intelligence, as when discussing cognition, it is more useful to envisage a continuum instead of something that is simply present or not; in other words, a continuum pertaining to flexible problem-solving capacity for “intelligence” and a continuum pertaining to reliance on internal representation for “cognition.” When envisaging a continuum pertaining to intelligence, Daniel Dennett’s notion of four Creatures (Darwinian, Skinnerian, Popperian, and Gregorian) is of interest, with the distinction between Skinnerian and Popperian Creatures being especially relevant when considering Portia. When we consider these distinctions, a case can be made for Portia being a Popperian Creature. Like Skinnerian Creatures, Popperian Creatures express flexible problem solving capacity, but the manner in which this capacity is expressed by Popperian Creatures is more distinctively cognitive. (shrink)

Growing evidence suggests that nurses and other clinicians often feel insufficiently equipped to manage ethical issues that arise in their practice (Truog et al. 2015; Woods 2005; Darmon et al. 201...

This book sets out in plain language ethical questions of direct relevance to business today. This new edition expands the range of issues covered and includes a chapter on international business ethics, drawing extensively from Asian examples.

In the current digital era, reliance on technology for communication and the gathering and dissemination of information is growing. However, the information disseminated can be misleading or false. Nurses tend to be trusted by the public, but not all information brought to the public forum is well-informed. Ill-informed discussions have resulted in harm to individuals who take such information as fact and act on it. As technology continues to evolve and fact versus fiction becomes more challenging to discern, it is (...) critical that nurses recognize their ethical responsibility to the public in providing information for which sound evidence exists. This analysis will explore medical misinformation through concepts such as confirmation bias and the politicization of science. Also, the impact of nurses not recognizing the power and responsibility associated with using their credentials in public fora, even when the central motivator is that they believe they are helping other individuals. Using nursing goals and perspectives, we will discuss the ethical responsibility of nurses to be aware of the soundness of what they think they know. Utilizing ideas of professional responsibilities, as outlined by professional codes of ethics as well as the ethical principles of non-maleficence and veracity, we explore the problem of nurses propagating misinformation and suggest strategies to enhance nurse awareness of their ethical responsibilities for veracity and transparency regarding what is known and what is not. (shrink)

Advocacy has proven a slippery concept for nursing. Although the nursing profession has adopted the term ‘patient advocacy’ to denote an ideal of practice, the meaning, scope and implications of the concept have not yet been adequately defined. Poorly defined concepts lead to practice problems and these ultimately impact patient care. This article clarifies some basic underlying assumptions of the term ‘advocacy’ in the interest of facilitating the goals of nursing. The origins and meanings of the term are traced. It (...) is noted that ‘advocacy’ as descriptive of verbal actions on behalf of others is an expression initially used in legal settings. Nursing's use of this term is explored and because the term is also discovered in the literature of other disciplines to denote either a standard (Law) or ideal (Medicine) of practice it proved helpful to compare the various perspectives. Additionally, the link between advocacy and notions of professional responsibility, obligation and accountability is investigated. Although advocacy for nurses is discovered to be a broad concept it has typically been seen as applying to individual situations and immediate contexts. However, actions taken with the purpose of advocating for a given patient (or group of patients) necessarily affect more than the person for the sake of whom the actions are taken. Thus, patient advocacy commits nurses to an examination both of the immediate practice environment and of the wider context in which nursing occurs. This is because nursing's purpose of furthering ‘health’ extends both to individuals and society. For these reasons it is suggested that the term ‘professional advocacy’ viewed as actions stemming from professional role objectives more accurately captures the scope of nursing responsibilities than does either ‘advocacy’ or ‘patient rights advocacy’. (shrink)

In this manuscript I revisit the late John Drummond's article on Relativism published in Nursing Philosophy (2005, volume 4). His was a very carefully developed look at relativism and its implications for healthcare work. Using John's account as a springboard, I contrast the philosophical approaches to knowledge acquisition and moral action of absolutism, relativism and pragmatism. I argue that pragmatism has more utility for ethical decision‐making in healthcare than either absolutist or relativist approaches by permitting the conceptualization of probable good (...) actions for individual patients, and evaluating the rigor of underlying data‐gathering. Pragmatist methods also allow for evaluating the consequences of actions in terms of how well they achieved their goals, and accounting for this knowledge as pertinent when planning future actions. Because each healthcare profession has goals related to patient care, their practitioners need to be able to figure out how to meet those goals even in the face of obstacles. While restricted in their applicability, insights from both Immanuel Kant's moral absolutism and moderate moral relativism are useful in widening the scope of considerations and provide insights into the human condition. Pragmatism does not rule out this possibility unlike relativist and absolutist views which taken alone are mutually exclusive. (shrink)

In this paper we respectfully present a counter argument to Jesse Michael Kay’s thesis, as we understand it, in his article titled, “The Nurse Practitioner Ethicist: Distinct from a Nurse Ethicist?” Foundational to our analysis is that we take the distinction between nursing as a discipline and a practice profession, and clinical ethics as an emerging discipline seriously. The distinctions between them are well described in the literature. The two have different reasons for existence. While we agree that one’s professional (...) background can inform a secondary endeavor such as clinical ethics the goals are incommensurable. Moreover, we present an expanded definition of nursing ethics to explain the historical development of nursing goals and perspectives and its codes of ethics or conduct. Importantly, we provide support for the assertion that nurse practitioners are nurses in expanded roles but still accountable to nursing codes of ethics. Additionally, nurses who are working in the role of clinical ethicist are accountable to the goals of clinical ethics. (shrink)

Since the 1960s, it has been recognized that “medical ethics,” the area of inquiry about the obligations of practitioners of medicine, is inadequate for capturing and addressing the complexities associated with modern medicine, human health, and wellbeing. Subsequently, a new specialty emerged which involved scholars and professionals from a variety of disciplines who had an interest in healthcare ethics. The name adopted is variously biomedical ethics or bioethics. The practice of bioethics in clinical settings is clinical ethics and its primary (...) aim is to resolve patient care issues and conflicts. Nurses are among these clinical ethicists. They are drawn to the study and practice of bioethics and its applications as way to address the problems encountered in practice. A significant number are among the ranks of clinical ethicists. However, in the role of bio- or clinical ethicist, some retained the title of their original profession, calling themselves nurse ethicists, and some did not. In this article, we explore under which conditions it is permissible or preferable that one retains one’s prior profession’s nomenclature as a prefix to “ethicist,” under which conditions it is not, and why. We emphasize the need for transparency of purpose related to titles and their possible influence on individual and social good. (shrink)

Background: Written reflections on practice are frequently requirements of nursing curricula. They are widely accepted as necessary for improving critical thinking and problem-solving skills. Faculty, are expected to review reflections and provide feedback that helps professional development and facilitates good practice. It is less clear what the actions of nurse educators should be when ethical infractions are revealed in the narratives. Objectives: We had two aims: 1) To combine insights from a literature review of empirical and theoretical research related to (...) responding to ethical issues revealed in student reflections with our experiences reviewing the reflections of undergraduate nursing and midwifery students, and 2) to construct and analyze a hybrid case from these insights in order to develop guidelines for nurse educators. Research Design: A literature review was conducted using CINAHL, MEDLINE, PsycINFO, SocINDEX and ERIC databases and pertinent key words. A hybrid case was constructed of commonly encountered ethical issues using insights from the literature review and the authors’ experiences. The case was analyzed by combining Beauchamp and Childress’ principlist approach with Campbell and McCarthy’s ethical decision-making tool (Table 1). Participants and Research Context: No human participants Findings: A gap in the literature exists related to addressing ethical issues revealed in student practice reflections. However, a combination of insights from the literature and the authors’ experiences facilitated the development of a hybrid case. Subsequent case analysis facilitated the development of a series of guidelines that can be utilized to address a range of issues commonly emerging in the reflections of nursing students during practice experiences. Discussion: A number of recommendations and guidelines are provided to enable the safeguarding of students and staff and support them in practicing ethically. Conclusion: Structured ethical analysis of a constructed hybrid reflection of commonly revealed ethical issues was useful in developing guidelines for educators. (shrink)

Jean Baudrillard is a pivotal figure in contemporary cultural theory. Without doubt one of the foremost European thinkers of the last fifty years, his work has provoked debate and controversy across a number of disciplines, yet his significance has so far been largely ignored by feminist theorists.

How should business deal with society's increasing demands for ethical and social responsibility? In plain language this book considers these and other ethical questions of direct relevance to business in the 1990s. It discusses the nature of ethics, ethical reasoning, the use of stakeholder analysis, and other central concepts used in business ethics. Using mainly, but not exclusively, Australian cases and specific examples, the book covers issues such as fairness in business dealings, advertising ethics, discrimination, and codes of ethics.

Nurses have moral obligations incurred by membership in the profession to participate knowingly in health policy advocacy. Many barriers have historically hindered nurses from realizing their potential to advance health policy. The contemporary political context sets additional challenges to policy work due to polarization and conflict. Nursing education can help nurses recognize their role in advancing health through political advocacy in a manner that is consistent with disciplinary knowledge and ethical responsibilities. In this paper, the authors describe an exemplar of (...) Elizabeth Barrett's “Power as Knowing Participation in Change” theory as a disciplinary lens within a doctoral nursing health policy course. Barrett (radically) emphasizes “power as freedom” instead of “power as control.” This approach is congruent with nursing disciplinary values and enhances awareness of personal freedom and building collaborative relationships in the policy process. The theory was used in concert with other traditional policy content and frameworks from nursing and other disciplines. We discuss the role of nursing ethics viewed as professional responsibility for policy action, an overview of Barrett's theory, and the design of the course. Four student reflections on how the course influenced their thinking about policy advocacy are included. While not specific to policymaking, Barrett's theory provides a disciplinary grounding to increase students' awareness of freedom and choices in political advocacy participation. Our experience suggests that Barrett's work can be fruitful for enhancing nurses' awareness of choices to participate in change across settings. (shrink)

Given the nature of the discipline, it might be assumed that clinical psychology is an ethical profession, within which effective ethical decision-making is integral. How then, does this ethical decision-making occur? This paper describes a systematic review of empirical research addressing this question. The paucity of evidence related to this question meant that the scope was broadened to include other professions who deliver talking therapies. This review could support reflective practice about what may be taken into account when making ethical (...) decisions and highlight areas for future research. Using academic search databases, original research articles were identified from peer-reviewed journals. Articles using qualitative ( n = 3), quantitative ( n = 8) and mixed methods ( n = 2) were included. Two theoretical models of aspects of ethical decision-making were identified. Areas of agreement and debate are described in relation to factors linked to the professional, which impacted ethical decision-making. Factors relating to ethical dilemmas, which impacted ethical decision-making, are discussed. Articles were appraised by two independent raters, using quality assessment criteria, which suggested areas of methodological strengths and weaknesses. Comparison and synthesis of results revealed that the research did not generally pertain to current clinical practice of talking therapies or the particular socio-political context of the UK healthcare system. There was limited research into ethical decision-making amongst specific professions, including clinical psychology. Generalisability was limited due to methodological issues, indicating avenues for future research. (shrink)

BackgroundReferencing is an integral part of scientific writing and professional research conduct that requires appropriate acknowledgement of others’ work and avoidance of plagiarism. University students should understand and apply this as part of their academic development, but for this, it is essential that supervisors also display proper research integrity and support.MethodsThis study used an online educative questionnaire to understand the knowledge and attitudes of students and supervisors at two institutes in Europe and Africa. The results were then used to create (...) discussion around education of students and faculty in workshops and lectures.ResultsOverall, 138 students and 14 supervisors participated: most were Swedish (89) and Kenyan (11). Overall, 98% had heard about plagiarism, and 35% believed it was common. Only 45% had heard about self-plagiarism, and when explained what it was, 44.5% considered it morally wrong. Europeans and North Americans had more knowledge than other nationalities. Most (85%) had received some training on referencing, but there was little consensus about principles, with more than 30% considering it acceptable to cite a reference in a paper they had not read. Discussing these results and the questions in workshops was helpful; it was also clear that there was no consensus among supervisors on what constituted correct behavior.ConclusionsThis survey shows a need for greater consensus on appropriate referencing, and that there is need for more discussions and training on the topic for both students and faculty. (shrink)

Advocacy is an important concept in nursing practice; it is frequently used to describe th nurse-client relationship. The term advocacy, however, is subject to ambiguity of interpretation. Such ambiguity was evidenced recently in criticisms levelled at the nursing profession by hospital ethicist Ellen Bernal. She reproached nursing for using 'patient rights advocate' as a viable role for nurses. We maintain that, for nursing, patient advocacy may encompass, but is not limited to, patient rights advocacy. Patient advocacy is not merely the (...) defence of infringements of patient rights. Advocacy for nursing stems from a philosophy of nursing in which nursing practice is the support of an individual to promote his or her own well-being, as understood by that individual. It is an ethic of practice. La défense des malades joue un grand rôle dans la pratique des infirmiers/ères. Le terme est souvent utilisé pour définir les rapports entre malades et soignants. Le mot 'defénse' pourtant, peut être mal compris. Une ambiguïté était évidente récemment dans la critique de la profession infirmière faite par la philosophe éthique Ellen Bernal. Elle reproche à la profession d'utiliser le terme 'avocat des droits des malades' pour désigner le rôle primordial des infirmiers/ères. Nous croyons que pour les soignants, la défense des malades peut comprendre le rôle 'd'avocat des droits des malades' mais elle ne s'y borne pas. La défense n'est pas limitée à la défense des infractions des droits des malades. La défense dans la profession infirmière est basée sur une philosophie où la pratique infirmière est le soutien des malades dans leur quête de promouvoir leur propre bien-être. Die Fürsprache spielt eine wichtige Rolle in der Krankenpflege. Sie wird oft als kennzeichnend für die Beziehung zwischen Patient und Pflegepersonal beschrieben. Der Ausdruck 'Fürsprache' kann aber auch mehrdeutig interpretiert werden. Das wurde letzthin in der Kritik der Ethikerin Ellen Bernal an der Krankenpflege sichtbar. Sie machte den Pflegenden den Vorwurf, dass sie sich die Rolle des 'Rechts-Advokat des Patienten' aneignen. Wir sind der Meinung, dass es die Aufgabe des Pflegepersonals ist, auch die Rechte der Patienten zu vertreten, aber dass das nur ein Teil der Fürsprache ist. Sie ist nicht nur Verteidignung von verletzten Patientenrechten. Die Fürsprache in der Krankenpflege stammt von einer Philosophie, deren Ausübung die Unterstützung der Patienten für ihr Wohlergehen zum Ziel hat, so wie die Patienten selbst ihr Wohlergehen verstehen. Sie ist eine Ethik der Tat. (shrink)

Confusion remains about the concept “nursing science.” Definitions vary, depending on country, context and setting. Even among nurse scholars and scientists there is disagreement about the content and boundaries of nursing science. There is an urgent need for an acceptable definition that can guide nursing knowledge development, education, and practice. In this article, we highlight the problems for the profession of this sort of conceptual ambiguity, arguing that it is an ethical responsibility for the profession to gain clarity about the (...) meaning and apt focus of our knowledge development initiatives. We parse out nursing and science as separate concepts and synthesize from this analysis a simple yet comprehensive definition of nursing science. We propose that this definition is capable of unifying ongoing nursing endeavors and should serve as the basis for evaluating nursing's knowledge development and educational initiatives. (shrink)

Jean- Jacques Rousseau is a major figure in Western Philosophy and is one of the most widely read and studied political philosophers of all time. His writings range from abstract works such as On the Social Contract to literary masterpieces such as The Reveries of the Solitary Walker as well as immensely popular novels and operas. The Rousseauian Mind provides a comprehensive survey of his work, not only placing it in its historical context but also exploring its contemporary significance. Comprising (...) over forty chapters by a team of international contributors the Handbook covers: The predecessors and contemporaries to Rousseau's work The major texts of the "system" Autobiographical texts including Confessions, Reveries of the Solitary Walker and Dialogues Rousseau's political science The successors to Rousseau's work Rousseau applied today. Essential reading for students and researchers in philosophy, Rousseau's work is central to the study of political philosophy, the Enlightenment, French studies, the history of philosophy and political theory. (shrink)

Certain moral beliefs and/or values about what is good or harmful can cause nurses and other healthcare professionals to object to participating in some clinical actions. Such objections are also called conscientious objections. Invocation of a conscientious objection (CO) can produce complexities in patient care and health care delivery and must be mindfully evaluated for its soundness. In this manuscript, a recently developed framework, The Ethical Evaluation of a Nurse’s Conscientious Objection (EENCO), is applied to expose hidden elements and nuances (...) in a proposed or actual CO by nurses or other healthcare professionals, thereby illuminating strategies that can lessen associated harms. The EENCO is utilized to explore two types of situations where a nurse makes a CO claim. Scenario 1 involves a nurse’s reluctance to follow provider medication orders intended to relieve pain and suffering at the end-of-life. In scenario 2, nurses object to a visitation policy during the COVID-19 pandemic. Additionally, we provide a summary of the necessary elements of institutional policy to address claims of CO using the EENCO. Drawing on the EENCO, the two scenarios were analyzed for their ethical implications. This framework contributes to the exposure, scrutiny, and clarification of potentially unappreciated aspects of CO claims. Steps for developing institutional policy are identified. Application of the EENCO guides the analysis of the two scenarios. CO claims are explored more deeply, thereby revealing implications for those involved. Additionally, the EENCO provides guidance for the development of institutional CO policies. (shrink)

One of the most complex areas of Foucault's work is his relationship to Freudian psychoanalysis. Foucault consistently argued for the historical specificities of the two principal human objects of psychoanalysis – madness and sexuality. He now stands starkly removed from Freudian thought, which cannot countenance ethnographic or cultural versions of madness or sexuality. Foucault welcomed the extra‐psychoanalytic potentials of the Freudian unconscious for undermining existentialist and phenomenological accounts of the subject and knowledge. Foucault in fact celebrated the political divergences of (...) psychoanalysis as one of its strengths. The critique of desire is really the climax of Foucault's efforts to develop an alternative Nietzschean genealogy of the modern subject as a historical and cultural reality – a domain that had hitherto excluded sexual identity, while the Freudian and feminist traditions had perhaps seen only sexuality and not the wider political domains. (shrink)

In this ground-breaking book, Gerald Grace addresses the dilemmas facing Catholic education in an increasingly secular and consumer-driven culture. The book combines an original theoretical framework with research drawn from interviews with sixty Catholic secondary head teachers from deprived urban areas. Issues discussed include: *Catholic meanings of academic success *tensions between market values and Catholic values *threats to the mission integrity of Catholic schools *the spiritual, moral and social justice commitments of contemporary Catholic schools This book will be equally useful (...) to leaders of Catholic and other schools and to all those interested in values and leadership in schooling. (shrink)

Ethical awareness enables nurses to recognize the ethical implications of all practice actions, and is an important component of safe and high quality nursing care (Milliken 2016; Milliken and Grac...

Temporal binding via 40-Hz synchronization of neuronal discharges in sensory cortices has been hypothesized to be a necessary condition for the rapid selection of perceptually relevant information for further processing in working memory. Binocular rivalry experiments have shown that late stage visual processing associated with the recognition of a stimulus object is highly correlated with discharge rates in inferotemporal cortex. The hippocampus is the primary recipient of inferotemporal outputs and is known to be the substrate for the consolidation of working (...) memories to long-term, episodic memories. The prefrontal cortex, on the other hand, is widely thought to mediate working memory processes, per se. This article reviews accumulated evidence for the role of a subcortical matrix in linking frontal and hippocampal systems to select and ''stream'' conscious episodes across time (hundreds of milliseconds to several seconds). ''Streaming'' is hypothesized to be mediated by the selective gating of reentrant flows of information between these cortical systems and the subcortical matrix. The physiological mechanism proposed for this temporally extended form of binding is synchronous oscillations in the slower EEG spectrum (< 8 Hz). (shrink)

In the metaphor of behavioral momentum, the rate of a free operant in the presence of a discriminative stimulus is analogous to the velocity of a moving body, and resistance to change measures an aspect of behavior that is analogous to its inertial mass. An extension of the metaphor suggests that preference measures an analog to the gravitational mass of that body. The independent functions relating resistance to change and preference to the conditions of reinforcement may be construed as convergent (...) measures of a single construct, analogous to physical mass, that represents the effects of a history of exposure to the signaled conditions of reinforcement and that unifies the traditionally separate notions of the strength of learning and the value of incentives. Research guided by the momentum metaphor encompasses the effects of reinforcement on response rate, resistance to change, and preference and has implications for clinical interventions, drug addiction, and self-control. In addition, its principles can be seen as a modern, quantitative version of Thorndike's (1911) Law of Effect, providing a new perspective on some of the challenges to his postulation of strengthening by reinforcement. Key Words: behavioral momentum; clinical interventions; drug addiction; preference; reinforcement; resistance to change; response strength; self-control. (shrink)

To enhance patient care in the inevitable conditions of complexity that exist in contemporary healthcare, collaboration among healthcare professions is critical. While each profession necessarily has its own primary focus and perspective on the nature of human healthcare needs, these alone are insufficient for meeting the complex needs of patients (and potential patients). Persons are inevitably contextual entities, inseparable from their environments, and are subject to institutional and social barriers that can detract from good care or from accessing healthcare. These (...) are some of the reasons behind current movements to develop competency frameworks that can enhance cross‐disciplinary communication and collaboration. No single profession can claim the big picture. Effective teamwork is essential and requires members of diverse professions to understand the nature of each other's knowledge, skills, roles, perspectives, and perceived responsibilities so that they are optimally utilized on behalf of patients and their families. Interdisciplinary approaches to care permit different aspects of a person's needs to be addressed seamlessly and facilitate the removal of obstacles by engaging the range of resources exemplified by the different professions. Additionally, collaborative efforts are needed to influence policy changes on behalf of individual and social good and to address root causes of poor health especially as these impact society's most vulnerable. Here, we explore both the benefits and the risks of an uncritical acceptance of competency frameworks as a way to enhance interdisciplinary communication. We highlight the importance of anchoring proposed competency domains in the reason for being of a given profession and exemplify one way this has been accomplished for advanced practice nursing. Additionally, we argue that having this mooring, permits integration of the various competencies that both enhances professional moral agency and facilitates interdisciplinary collaboration to further the mutual goals of the healthcare professions on behalf of quality patient care. (shrink)

The idea that acquired brain injury (ABI) caused by stroke, hemorrhage, infection or traumatic insult to the brain can result in post-traumatic growth (PTG) for individuals is increasingly attracting psychological attention. However, PTG also attracts controversy as a result of ambiguous empirical findings. The extent that demographic variables, injury factors, subjective beliefs, and psychological health are associated with PTG following ABI is not clear. Consequently, this systematic review and meta-analysis explores the correlates of variables within these four broad areas and (...) PTG. From a total of 744 published studies addressing PTG in people with ABI, eight studies met inclusion criteria for detailed examination. Meta-analysis of these studies indicated that growth was related to employment, longer education, subjective beliefs about change post-injury, relationship status, older age, longer time since injury, and lower levels of depression. Results from homogeneity analyses indicated significant inter-study heterogeneity across variables. There is general support for the idea that people with ABI can experience growth, and that various demographics, injury-related variables, subjective beliefs and psychological health are related to growth. The contribution of social integration and the forming of new identities post-ABI to the experience of PTG is explored. These meta-analytic findings are however constrained by methodological limitations prevalent in the literature. Clinical and research implications are discussed with specific reference to community and collective factors that enable PTG. (shrink)

The nursing profession has a responsibility to ensure that nursing goals and perspectives as these have developed over time remain the focus of its work. Explored in this paper is the potential problem for the nursing profession of recognizing both the promises and pitfalls of informational technologies so as to use them wisely in behalf of ethical patient care. We make a normative claim that maintaining a critical stance toward the use of informational technologies in practice and in influencing the (...) thought patterns of the younger generations of nurses is a moral imperative of the discipline, because without this practice can become subverted from professional goals in various ways. We use a synthesized concept we call “intentional authenticity” derived from the writing of Heidegger and Feminist care ethics to provide a foundation for the development of nurses who understand the importance of the nurse‐patient relationship and how the unthoughtful use of informational and other technologies can militate against effective or good nursing care. (shrink)

Michel Foucault and Gilles Deleuze are regarded as French “Nietzscheans” par excellence. By drawing attention to the articulation of “difference” in contemporary thought, this paper attempts to go beyond the label ‘Nietzschean’ in an effort to discern two distinct philosophical trajectories inspired by Nietzsche. I suggest that Deleuze reads Nietzsche as an empiricist whose philosophy of nature critically undermines representational modes of thought from Plato to Hegel and beyond. Difference is therefore given in itself. Foucault, on the other hand, reads (...) Nietzsche primarily as a historian of culture, whose radical reflection on language pushes philosophy into new interpretative forms of analysis that seriously confronts the role of political power in the production of truth. Difference is thus invented and only known within the contours of these fabrications. While no judgement is made about the accuracy or otherwise of their respective interpretations of Nietzsche, this paper implicitly asks whether a Nietzschean genealogical ethos can inform those political struggles today for which the meaning of difference is contested. (shrink)

Photographs of violence carry an implicit critique of the social order from which they emerge. This necessitates the systemic management of their affect. Recognition of the experience carried by these signals has the potential to catalyse and contribute to emancipatory thought and action. The apparatus of epistemic control – characterized here as the Archive – has evolved to neutralize their affective potential. Certain artworks that reconfigure photographs of violence illuminate the nature of this neutralizing mechanism. They mimic and subvert the (...) forms of representational archivization and suggest a counter-Archive – a repository of traumatic representation which serves to release affective trauma from its epistemic suppression. One example of this counter-archival practice is – War Primer 2. A body of work from 2011 by artists Adam Broomberg and Oliver Chanarin, which uses Bertolt Brecht’s Kreigsfibel or War Primer (1955) as a point of departure for examining the representation of twenty-first century violence. (shrink)

The focus of this study was on adolescent mental health. More specifically, the relationship between strength-based parenting (SBP) and subjective wellbeing (SWB) during adolescence, as assessed by a sample of adolescents, was examined at three time points over 14 months (N = 202, Mage = 12.97, SDage =.91, 48% female). SBP was positively related to life satisfaction and positive affect at each of the three time points, and was negatively related to negative affect. SBP and SWB both declined significantly over (...) time. When examining the causal relationships between SBP and SWB, two different statistical models were applied: latent growth-curve models (LGM) and random-intercept cross-lagged panel models (RI-CLPM). The LGM revealed a strong positive relationship between changes in SBP and SWB. Specifically, this model showed that SBP at one time point predicted adolescent SWB at future time points. However, when the more stringent statistical test was completed through RI-CLPMs, no cross-lagged paths reached significance. Thus, while parenting is a significant predictor of wellbeing for pre-teens and teens in real time, it is not predictive of wellbeing at future time points. Parents, thus, cannot assume that their current levels of SBP are ‘banked’ by their children to support future wellbeing. Instead, SBP needs to be an ongoing, contemporary parenting practice. Furthermore, the fact that perceptions of SBP decline in this age bracket suggest that SBP interventions may be helpful in supporting adolescent mental health. (shrink)