Volume 24, Issue 12, December 2024, Page 48-51.

Volume 25, Issue 2, February 2025, Page 23-25.

Volume 25, Issue 2, February 2025, Page 145-148.

Volume 25, Issue 6, June 2025, Page 90-92.

Volume 24, Issue 7, July 2024, Page 127-128.

Is inpatient psychiatric hospitalisation a proportionate intervention to prevent harm in non-psychotic adolescents? Analysing the effects of inpatient psychiatric hospitalisation and comparing them to outpatient settings, we argue that when adolescents do not suffer from disorders of a psychotic nature, care providers should balance the expected benefits and potential negative consequences associated with inpatient psychiatric hospitalisation. In particular, the decrease in autonomy that comes with hospitalisation is associated with an increased risk of harm and suicidogenic effects, which are lower in (...) outpatient settings. Consequently, psychiatric hospitalisation – particularly of an involuntary nature – with the aim to prevent harm to self or others is likely not a proportionate measure for non-psychotic adolescents. Outpatient treatment should be offered instead. (shrink)

Volume 24, Issue 12, December 2024, Page 71-73.

Volume 19, Issue 10, October 2019, Page 90-92.

Men who are victimized in their intimate different-sex (DS) and same-sex (SS) relationships often report not having information to help them escape their abusive situations. To overcome this lack of information, public awareness campaigns have been created. But thus far, there is no clear understanding of how these campaigns reflect theoretical principles central to improve message effectiveness and avoid undesired negative effects. This study aims to review the content of intimate partner violence (IPV) pictorial campaigns focusing on victimized men in (...) DS and SS relationships. Specifically, it aims to understand the campaigns’ global characteristics and if their content represents constructs from different theoretical models. Online search engines were used to extract pictorial campaigns in English, Spanish, and Portuguese, released up until 2019. They must have had to be promoted by a formal organization, and were coded according to a theoretically grounded taxonomy, using thematic analysis. Our results indicate that out of the 57 campaigns collected, most were aimed at men without specifying the relationship they were in (i.e., DS or SS) ( n = 22, 39%) and intended to change attitudes, beliefs, and behaviors about IPV (in line with the Theory of Planned Behavior) ( n = 47, 82%). Additionally, four campaigns adequately integrated fear appeal constructs of the Extended Parallel Processing Model ( n = 4, 7%), while 41 campaigns highlighted dissonant states in line with the Elaboration Likelihood Model ( n = 41, 72%). Following the Transtheoretical Model, most campaigns targeted victims in the Maintenance stage ( n = 52, 92%). The campaigns under analysis may prove useful for some victimized men, mostly presenting messages designed to elicit a beneficial attitude and behavior change. Our analysis highlights different limitations as well, such as the lack of information on susceptibility to IPV ( n = 13, 23%) and the effectiveness of the recommended responses that the campaigns provide ( n = 20, 38%), which may interfere with adequate fear appeal processing. Additionally, presenting more diverse victims may be beneficial, along with social norms change information regarding gender roles, violence, and help-seeking. This may guide the development of improved and tailored campaigns to better facilitate help-seeking in victimized men that mostly avoid undesired negative effects on the viewer. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Narrative SymposiumPersonal Narratives Experiences of Psychiatric HospitalizationV. Barnard, J. Carson, Eugene Doe, Robin Driben, Anonymous One, Anonymous Two, Charles Kelley, Michael Kerins, D. Millman, Anonymous Three, Viesia Novosielski, Ben Zion, and Anonymous Four• Dreaming: A Recovery Story• The Intervention of the Demon• Bent but Not Broken• Tortured Souls Do Not Rest• Homesick• A Professional Patient No More• My Spiritual Journey• Personal Account of Psychiatric Hospitalization• Psychiatric Hospitalization (...) Story• As Ice Is to Water• The Power Of Human-To-Human Contact• Dignity• HospitalizationCopyright © 2011 The Johns Hopkins University Press... (shrink)

Nurses who attend patients with psychiatric disorders often encounter ethical dilemmas and experience difficulties in making the right decision. The present study aimed to evaluate the decisions of psychiatric nurses regarding their duty to warn third parties about the dangerousness of the patient, the need for compulsory hospitalization, and the competence of patients. In total, 111 nurses working in the field of psychiatry in Turkey completed a questionnaire form consisting of 33 questions. The nurses generally assessed the decision-making competency (...) of the patient correctly. However, their decisions regarding whether the patient should be compulsorily hospitalized and their understanding of their duty to warn/protect were less consistent. A significant relationship was found between the decisions of the psychiatric nurses and their work experience, them having children, and them having postgraduate education in psychiatric nursing. The nurses stated their desire to be part of the team that decided on ethical problems in psychiatry. (shrink)

Suicide is the 10th leading cause of death in the United States and the second cause of death among those ages 15–24 years. The current standard of care for suicidality management often involves an involuntary hospitalization deemed necessary by the attending psychiatrist. The purpose of this article is to reexamine the ethical tradeoffs inherent in the current practice of involuntary psychiatric hospitalization for suicidal patients, calling attention to the often-neglected harms inherent in this practice and proposing a path (...) for future research. With accumulating evidence of the harms inherent in civil commitment, we propose that the relative value of this intervention needs to be reevaluated and more efficacious alternatives researched. Three arguments are presented: (1) that inadequate attention has been given to the harms resulting from the use of coercion and the loss of autonomy, (2) that inadequate evidence exists that involuntary hospitalization is an effective method to reduce deaths by suicide, and (3) that some suicidal patients may benefit more from therapeutic interventions that maximize and support autonomy and personal responsibility. Considering this evidence, we argue for a policy that limits the coercive hospitalization of suicidal individuals to those who lack decision-making capacity. (shrink)

Hospitalization is a unique health-illness transition for most elderly people. Whether the patient's health-related needs are met or not often iiifluence his or her appraisal of quality of life during hospitalization. This qualitative study explored the health needs of elderly Chinese male cardiac patients during their hospitalization. Eighteen subjects were recruited from a veterans' hospital in northern Taiwan. These men all lived alone before their hospital admission. Data were gathered using semistructured interviews and then analysed by content (...) analysis. Ninety-four per cent of the subjects described up to three categories of needs: met needs (72%), unmet needs (78%), and expected needs (50%0). Needs that participants believed were met were those for psychological support, spiritual support, tangible support and information. Unmet needs were those for participation in decision making, maintaining daily activities and resuming a preadmission lifestyle. The expected needs included those for learning self-care strategies to maintain their daily activities after discharge from the hospital. The factors that framed the participants' perceptions of different health needs were identified to be lack of family support and locus of control. Finally, a discussion of the context background of this phenomenon, as well as some suggestions for its implications, are provided from a culturally sensitive ethical aspect. (shrink)

When ethics committees are consulted about patients who have or need court-appointed guardians, they lack empirical evidence about several common issues, including the relationship between guardianship and prolonged, potentially medically unnecessary hospitalizations for patients. To provide information about this issue, we conducted quantitative and qualitative analyses using a retrospective cohort from Veterans Healthcare Administration. To examine the relationship between guardianship appointment and hospital length of stay, we first compared 116 persons hospitalized prior to guardianship appointment to a comparison group (n (...) = 348) 3:1 matched for age, diagnosis, date of admission, and comorbidity. We then compared 91 persons hospitalized in the year following guardianship appointment to a second matched comparison group (n = 273). Mean length of stay was 30.75 days (SD = 46.70) amongst those admitted prior to guardianship, which was higher than the comparison group (M = 7.74, SD = 9.71, F = 20.75, p. (shrink)

Patients are supposed to be given care according to their needs. This concept is, however, difficult to define and patients and caregivers may have different opinions about a patient’s needs. Twenty patients were interviewed and asked to give a definition of need, describe their needs while hospitalized and depict what they do to make sure their needs are fulfilled. Ten groups of needs were identified: communication, basic care, contact with other people, behaviour of staff, empathy, competent caregivers, continuity, integrity, participation (...) in decision making, and pain relief. The descriptions patients gave of how they ensured their needs were met could be divided into two groups: openly seeking attention; or not wanting to disturb the staff. Interviews with patients emphasized the importance of recognizing that they have individual needs and varying abilities to see that their needs are fulfilled. (shrink)

The lung allocation score system in the United States and several European countries gives more weight to risk of death without transplantation than to survival following transplantation. As a result, centers transplant sicker patients, leading to increased length of initial hospitalization. The care of patients who have accumulated functional deficits or additional organ dysfunction during their prolonged stay can be ethically complex. Disagreement occurs between the transplant team, patients and families, and non-transplant health care professionals over the burdens of (...) ongoing intensive intervention. These cases highlight important ethical issues in organ transplantation, including the nature and requirements of transplant informed consent, the limits of physician prognostication, patient autonomy and decision-making capacity following transplant, obligations to organ donors and to other potential recipients, and the impact of program metrics on individualized recipient care. We outline general ethical principles for the care of lung transplant recipients with prolonged hospitalization and give regulatory, research, and patient-centered recommendations for these cases. (shrink)

IntroductionAnimal Assisted Interventions are increasingly common in pediatric care settings as a means to promote the physical, mental, and emotional well-being of hospitalized children and adolescents.ObjectivesThe aim of this work was to review published studies implementing AAIs in hospital settings and to assess the effects of AAIs on the biobehavioral response to stress and pain, social behavior, quality of life and level of satisfaction with hospitalization in children and adolescents. Stress and burden, quality of life, mood and level of (...) satisfaction with hospitalization in parents/caregivers as well as stress and burden, perception of the work environment and job satisfaction in hospital staff were also reviewed.MethodsAll published studies reporting quantitative assessments were systematically searched using PubMed, Scopus, ProQuest and Web of Science databases in accordance with PRISMA guidelines. The aim was to identify studies examining the effects of AAIs on behavioral, psychological and physiological responses to stress in children and adolescents formally admitted to a hospital for a stay, as well as in those undergoing a visit for treatments or medical examinations.ResultsOf the 350 studies screened, 21 were eligible for inclusion. Most of them focused on stress, pain, and anxiety reduction in pediatric patients, and used both physiological parameters and behavioral and psychological observations/scales. All studies employed dogs. Results show the potential of AAIs to reduce anxiety and behavioral distress in pediatric patients while acting on physiological measures associated with arousal.ConclusionAlthough further, more rigorous studies are still needed, the findings of this review may have implications for clinical practices suggesting appropriate planning of AAIs by pediatric healthcare professionals.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=178993], identifier [CRD42020178993]. (shrink)

When a child is hospitalized, the parents find themselves in an unfamiliar environment and their parental role changes. They are in a stressful and often anxiety-filled situation and it may be difficult for them to participate in decisions. The purpose of this study was to examine the extent to which parents participate in decisions during the course of events when their child is hospitalized. Thirty-five parents of 24 children (aged 5 months to 18 years) were followed by mobile observation during (...) their child’s hospitalization in a paediatric department in Sweden. Three researchers analysed field notes in three steps, using manifest and latent coding. In step 1, 119 situations that included a decision process were identified. In step 2, the situations were assessed according to a five-level scale concerning how the parents’ wishes, desires or values had been respected. In step 3, each situation was scrutinized with respect to factors influencing the extent of the parents’ participation. The results showed that parents have varying ability to be involved in decision making. Professionals need to communicate more openly with them in order to identify and satisfy their needs because some parents are unwilling or incapable of expressing them. (shrink)

This study investigated subjective experiences of nine men who had been psychiatrically hospitalized upon being assessed as "dangerous-to-others-due-to-a-mental-illness." Using a phenomenological interviewing approach, researchers helped subjects construct narratives of their pre-hospitalization experiences. The research illuminated aspects of life-contexts that were shared among all or nearly all subjects: feeling ostracized and alone; struggling with longstanding and pervasive feelings of inadequacy; experiencing a sense or a fear of having little or no control or options in life; and feeling emotionally depressed, misunderstood, (...) and uncared for. Situations immediately preceding hospitalization were characterized by subjects experiencing threats to their sense of self-esteem that were of heightened intensity. In five cases, subjects reported anxiety related to self-fragmentation or becoming "nothing." Perceived threats to self-worth and self-structure were accompanied by anger and aggressive acts or impulses. In all cases, aggressive impulses and threats, and violence appeared to be in the service of self-validation and self-empowerment. In cases of violent behavior, an apparent function of the subjects' behaviors was toward self-consolidation. Based on findings, the researchers discuss implications consistent with humanistic psychology and existential psychotherapy principles and practices. (shrink)

Background Physical morbidity is rife among patients with serious mental illness. When they are involuntarily hospitalized and even treated, they may still refuse treatment for physical illness leading clinicians to wonder about the ethics of coercing such treatments. Research aim This survey study explored psychiatric caregivers’ perceptions on whether compulsory treatment of physical illness is legal and whether it is justifiable in patients with serious mental illness and under what circumstances. Research design A questionnaire that included two case vignettes of (...) an involuntarily hospitalized psychiatric patient with diabetes refusing treatment with insulin for various reasons. The cases differed in terms of diabetes severity. Participants answered questions regarding the appropriateness of involuntary treatment. Participants and research context Psychiatric medical doctors and nurses working in a mental health center. ( N = 89, 50 female, ages 26–66). Ethical considerations The study was approved by the Medical Centre Institutional Review Board (IRB) and the University Ethics Committee. The respondents’ anonymity was kept. Participation was voluntary and consent was obtained. Results The severity of the patient’s medical condition and their reason for refusing treatment were associated with participants’ willingness to give insulin despite patient objection [( F(1, 87) = 49.41, p <.01; ( F(1, 87) = 33.44, p <.01), respectively]. Participants were more inclined to support compulsory treatment if the patient’s refusal was “illness-oriented” (i.e. directly related to psychiatric illness). Participants presented diverse views regarding the perceived legality of compulsory treatment of physical illness in such situations (illegal 63.09%; legal 23.8%; 13% unsure). The majority (53.5%–55.3%) of those who thought it was illegal supported compulsory treatment in high-severity, illness-oriented refusal situations. Conclusions The severity of the medical condition and the reason for treatment refusal influence psychiatric caregivers’ willingness to provide compulsory treatment for physical illness in involuntary hospitalized psychiatric patients. Beyond the legal framework, ethical guidelines for these situations are warranted, while decisions should be made on a case-by-case basis. (shrink)

These two lectures by Jacques Derrida, "Foreigner Question" and "Step of Hospitality/No Hospitality," derive from a series of seminars on "hospitality" conducted by Derrida in Paris, January 1996. His seminars, in France and in America, have become something of an institution over the years, the place where he presents the ongoing evolution of his thought in a remarkable combination of thoroughly mapped-out positions, sketches of new material, and exchanges with students and interlocutors. As has become a pattern in Derrida's recent (...) work, the form of this presentation is a self-conscious enactment of its content. The book consists of two texts on facing pages. "Invitation" by Anne Dufourmantelle appears on the left (an invitation that of course originates in a response), clarifying and inflecting Derrida's "response" on the right. The interaction between them not only enacts the "hospitality" under discussion, but preserves something of the rhythms of teaching. The volume also characteristically combines careful readings of canonical texts and philosophical topics with attention to the most salient events in the contemporary world, using "hospitality" as a means of rethinking a range of political and ethical situations. "Hospitality" is viewed as a question of what arrives at the borders, in the initial surprise of contact with an other, a stranger, a foreigner. For example, Antigone is revisited in light of the question of impossible mourning; _Oedipus at Colonus_ is read via concerns that also apply to teletechnology; the trial of Socrates is brought into conjunction with the televised funeral of François Mitterrand. (shrink)

Adolescents with Autism Spectrum Disorder (ASD) are admitted to inpatient psychiatric hospitalization (IPH) at an alarmingly high rate. IPH is often intended for the immediate benefit and betterment of the individual, however, the result often incurs a degree of harm on the adolescent. With the rising prevalence of ASD and lack of physicians with ASD care experience, the adolescent is left with inadequate treatment, causing heightened anxiety and behavioral regression. While IPH may offer temporary relief and behavior management, it (...) lacks sustainable long-term benefits while conflicting with the bioethical principle of beneficence. Here, we argue for a paradigm shift toward outpatient preventative resources (OPR), providing individualized, community-based care aimed at preventing the need of IPH, using it as mainly a last resort. By reallocating funding from IPH to OPR, the overall patient outcomes and support for caregivers will improve and effectively will reduce the harm on the ASD adolescent. (shrink)

Background Ethical decision-making ability is critical for senior nursing interns in addressing complex clinical dilemmas. However, the mediating role of hospital ethical climate in the relationship between moral sensitivity and ethical decision-making remains unexamined. This gap limits evidence-based strategies for enhancing interns’ ethical decision-making and the delivery of high-quality care. Research Aims To examine the mediating role of hospital ethical climate in the relationship between moral sensitivity and ethical decision-making among senior nursing interns, and to determine the relationship among these (...) three variables. Research Design The study is a cross-sectional correlational design. Participants and Research Context Between August 2023 and January 2024, 1096 senior nursing interns from 44 universities across seven Chinese regions participated. The general information questionnaire, Judgement About Nursing Decision scale, Chinese Moral Sensitivity Questionnaire-Revised Version, and Hospital Ethical Climate Survey were distributed online. SPSS 27.0 was used for descriptive statistics and Pearson correlation analysis, while PROCESS macro handled mediation analysis. Ethical Considerations This study was approved by the Ethical Review Board of Xiangya School of Nursing, Central South University (No. E2023125). Findings A total of 935 valid questionnaires were collected, with a response rate of 85.3%. Participants demonstrated moderate levels in ethical decision-making ability (276.41 ± 18.51), moral sensitivity (42.01 ± 7.61), and perceived hospital ethical climate (102.17 ± 14.63). There were significant positive correlations between each pair of these three variables (r = 0.248–0.474, p < 0.05). Moral sensitivity was associated with hospital ethical climate and ethical decision-making; hospital ethical climate mediated the relationship between moral sensitivity and ethical decision-making (β = 0.252–0.580, p < 0.05). Discussions Comparing our findings with international research, this study highlights the influence of hospital ethical climate and moral sensitivity on ethical decision-making, emphasizing the mediating role of ethical climate and its implications. Conclusions Hospital ethical climate played a mediating role between moral sensitivity and ethical decision-making among senior nursing interns. Interventions targeting both are recommended to enhance ethical decision-making ability. Future research should explore specific measures for this population. (shrink)

According to UNESCO guidelines, one of the four forms of bioethics committees in medicine are the Hospital Ethics Committees. The purpose of this study was to evaluate how the above guidelines are implemented in real practice. There were 111 hospitals selected out of 176 Polish clinical hospitals and hospitals accredited by Center of Monitoring Quality in Health System. The study was conducted by the survey method. There were 56 hospitals that responded to the survey. The number of HECs members fluctuated (...) between 3 and 16 members, where usually 5 members were part of the board committee. The composition of the HECs for professions other than physicians was diverse and non-standardized. Only 55 % of HECs had a professional set of standards. 98 % of HECs had specific tasks. 62 % of HECs were asked for their expertise, and 55 % prepared <6.88 % of the opinions were related to interpersonal relations between hospital personnel, patients and their families with emphasis on the interactions between superiors and their inferiors or hospital staff and patients and their families. Only 12 % of the opinions were reported by the respondents as related to ethical dilemmas. In conclusion, few Polish hospitals have HECs, and the structure, services and workload are not always adequate. To ensure a reliable operation of HECs requires the development of relevant legislation, standard operating procedures and well trained members. (shrink)

Background: Adolescents can be vulnerable to diminished dignity in the hospital because young people have significantly different healthcare needs than children and adults. They like to cooperate with caregivers only when they get respectful and dignified care. Care without considering dignity can adversely influence the adolescents’ recovery. However, many studies have been conducted on exploring the concept of the patients’ dignity from the adult patients and fewer studies still have explored the dignity of young people. Objective: This study explores the (...) hospitalized adolescents’ perception about dignity. Research design: A conventional qualitative content analysis method was used to explore the meaning of hospitalized adolescents’ dignity. Participants and research context: Hospitalized adolescents in general medical and surgical pediatric units were eligible to participate. Data were obtained through unstructured interviews. Purposive sampling was used and adolescents were recruited until data saturation was reached (n = 13). Ethical considerations: Ethical approval for the study was granted by the Ethics Committee of Shiraz University of Medical Sciences. Participants were provided with information about the purpose, reasons for recording interviews, voluntary participation, and confidentiality of data and interviewees. Findings: Dignity was reflected in four themes: (1) protection of personal privacy, (2) protection of autonomy, (3) respect for identity, and (4) intimate communication. Discussion and conclusion: Hospitalized adolescents stated that healthcare services should protect their personal privacy and autonomy. Also, they should respect the adolescent’s identity and communicate intimately with them to provide the dignity. Adolescence is a discrete developmental stage, with specific healthcare needs which must be addressed effectively by healthcare providers especially nurses. (shrink)

Derrida's work on hospitality presents particular local conventions of hospitality as in a necessary but impossible relationship with an absolute hospitality, the obligation to welcome the other without conditions. Although this absolute hospitality is commonly read as the aspiration to which all of our practices of hospitality should tend, Derrida proposes a series of examples that show the dangers implicit in an automatic or limitless welcoming. The most famous of these is that of the Old Testament patriarch, Lot. The aim (...) of this paper is to show, however, that the Genesis story is not primarily a parable about correct and incorrect practices of hospitality. In fact, what is at stake in the visit of the angels to Lot is the covenant between Abraham's line and the divine and the coming into the world of God's absolute sovereign violence. Derrida's account of hospitality is thus part of his discussion of sovereignty, its limitlessness, force and danger. (shrink)

Twenty-four children (aged 5 months to 18 years) who were admitted to a university hospital were observed for a total of 135 hours with the aim of describing their degree of participation in decisions concerning their own care. Grading of their participation was made by using a 5-point scale. An assessment was also made of what was considered as optimal participation in each situation. The results indicate that children are not always allowed to participate in decision making to the extent (...) that is considered optimal. In no case was it judged that a child participated in or was forced to make a decision that was too difficult for the child. The interactions between children, parents and staff were also described in connection with discussions and decision-making processes. This showed that parents do not always support their children in difficult situations and that health care staff often inform children about what is going to happen without presenting alternatives or asking for their views. Staff may, however, find themselves facing an ethical conflict in deciding between supporting a child’s view or following hospital routine. It is of great importance that children are looked upon as potentially autonomous individuals and that staff members realize that one of their core duties is to facilitate children’s participation in decision making concerning their health care. (shrink)

This short paper responds to the essays by Shilpi Sinha, Shaireen Rasheed, and Lyudmila Bryzzheva. It considers how racial inequality between teachers and students affects the possibilities of educational hospitality, both in cases of white teachers teaching racialized students and in cases of racialized teachers teaching white students. The response takes a phenomenological turn, considering the relative vulnerability of bodies that encounter each other in educational spaces which, themselves, are not neutral.

Health systems contribute to the environmental crisis. Yet, addressing this problem seems to generate a resource allocation dilemma for hospitals: investing in healthcare delivery seems to mean sacrificing environmental goods, and vice versa. We question this zero‐sum thinking. After presenting the benefits of investing in the two seemingly competing goods—environmental goods and health goods—we propose that the apparent dilemma arises due to a tendency to think in dualisms. Consequently, health and environmental goods seem, respectively, to correspond to opposing sides of (...) four dualisms: human/nature, local/global, present/future and therapy/prevention. We argue, instead, that a relational frame that considers the human person in their relational context should be used to approach the problem. A relational understanding of the human person as a meaning‐making subject in relationship to all that is shows us that choosing between either health goods or environmental goods is frequently a false dichotomy: both can serve the well‐being of human beings adequately understood. Such an approach, then, widens our conception of health and healthcare to include environmental goods. This wider conception of health and healthcare means that hospitals should (1) look for co‐benefits in the first instance when allocating resources, thereby often resolving zero‐sum thinking that gives rise to the competing goods dilemma, and (2) in the remaining cases where co‐benefits are not achievable, use classic resource allocation principles, such as proportionality of benefits and burdens, to reach allocation decisions about a now wider range of goods (i.e., health and environmental, rather than merely health goods). (shrink)

In Hospitality, Volume I, Jacques Derrida continues a seminar series he inaugurated in 1991 under the general title of "Questions of Responsibility." Delivered at the École des Hautes Études en Sciences Sociales (EHESS) in Paris from November 1995 through June 1996, the seminar is guided by questions that focus on responsibility and "the foreigner": How is the foreigner welcomed and/or repressed? What does the notion of the foreigner reveal about kinship, ethnicity, the city, the state, and the nation? What are (...) the stakes of the opposition between friend and enemy? How should we think of this in relation to borders, citizenship, displaced populations, immigration, exile, asylum, integration, assimilation, xenophobia, and racism? Derrida approaches these questions through readings of several classical texts as well as more modern texts from Heidegger, Arendt, and Camus, among others. Central to his project is a rigorous distinction between conventional hospitality (always finite and conditional) and the idea of a hospitality open unconditionally to the newcomer. (shrink)

Kant’s theory of international politics and his right of hospitality are commonly associated with expansive projects of securing human rights or cosmopolitan governance beyond state borders. This article shows how this view misunderstands Kant’s criticism of the law of nations ( ius gentium) tradition as handed down into the eighteenth century as well as the logic of his radical alternative, which was designed to explain the conditions of possibility of global peace as a solution to the Hobbesian problem of a (...) war of all against all in the state of nature. I resolve longstanding confusion over the meaning and justification of Kant’s right of “hospitality” by showing how it functions not as a freestanding positive claim demanding enforcement but as a way of ruling out specious justifications for war against those the traditional law of nations permitted one to label “enemies.” This poses important questions for contemporary theories of global justice. (shrink)

Research relating to patients’ views of the good nurse has mainly focused on the perspectives of adult patients, with little exploring the perceptions of children. This article presents findings from a qualitative study that explored views of the good nurse from the perspective of hospitalized children. The aims of the study were threefold: to remedy a gap in the literature; to identify characteristics of the good nurse from the perspective of children in hospital; and to inform children’s nursing practice. Twenty-two (...) children were interviewed using an adapted ‘draw and write’ technique. Five themes relating to children’s views of the good nurse emerged from the analysis: communication; professional competence; safety; professional appearance; and virtues. Each of these will be discussed in relation to good nurse literature and recommendations made for children’s nursing practice. (shrink)

BackgroundAn ethics reflection group is one of a number of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the significance of ERGs in psychiatric and general hospital departments in Denmark.MethodsThis is a qualitative action research study, including systematic text condensation of 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. Short written descriptions of the ethical challenges presented in the ERGs also informed the analysis (...) of significance.ResultsA recurring ethical challenge for clinicians, in a total of 63 cases described and assessed in 3 ethical reflection groups, is to strike a balance between respect for patient autonomy, paternalistic responsibility, professional responsibilities and institutional values. Both in psychiatric and general hospital departments, the study participants report a positive impact of ERG, which can be divided into three categories: 1) Significance for patients, 2) Significance for clinicians, and 3) Significance for ward managers. In wards characterized by short-time patient admissions, the cases assessed were retrospective and the beneficiaries of improved dialogue mainly future patients rather than the patients discussed in the specific ethical challenge presented. In wards with longer admissions, the patients concerned also benefitted from the dialogue in the ERG.ConclusionThis study indicates a positive significance and impact of ERGs; constituting an interdisciplinary learning resource for clinicians, creating significance for themselves, the ward managers and the organization. By introducing specific examples, this study indicates that ERGs have significance for the patients discussed in the specific ethical challenge, but mostly indirectly through learning among clinicians and development of clinical practice. More research is needed to further investigate the impact of ERGs seen from the perspectives of patients and relatives. (shrink)

The role of Hospital Ethics Committees is to support patients and their relatives as well as medical staff in solving ethical issues that arise in relation to the implementation of medical care. In Poland there are no clearly formulated legal regulations concerning the establishment and functioning of hospital ethics committees. Hospitals applying for accreditation are obliged to present solutions defining the way of solving ethical issues in a given institution, some of them appoint HECs for this purpose. The aim of (...) this study was to analyze information concerning the functioning of hospital ethics committees in Poland on the basis of publicly available data published on the websites of accredited hospitals. Very few accredited hospitals make public information about functioning in their ethics consulting facilities through hospital ethics committees. In most cases, the information provided on the functioning of HECs is general, both in terms of the committees’ functioning, type of cases under consideration and the composition of personnel. (shrink)