The overall purpose of this cross-country Nordic study was to gain further knowledge about maintaining and promoting dignity in nursing home residents. The purpose of this article is to present results pertaining to the following question: How is nursing home residents’ dignity maintained, promoted or deprived from the perspective of family caregivers? In this article, we focus only on indignity in care. This study took place at six different nursing home residences in Sweden, Denmark and Norway. Data collection methods in (...) this part of this study consisted of individual research interviews. Altogether, the sample consisted of 28 family caregivers of nursing home residents. The empirical material was interpreted using a hermeneutical approach. The overall theme that emerged was as follows: ‘A feeling of being abandoned’. The sub-themes are designated as follows: deprived of the feeling of belonging, deprived of dignity due to acts of omission, deprived of confirmation, deprived of dignity due to physical humiliation, deprived of dignity due to psychological humiliation and deprived of parts of life. (shrink)

In recent scholarship, a widely agreed upon definition of post-truth has proved elusive, particularly because the term is used in tandem with so-named alternative facts, fake news, misinformation, and references to an anti-expert, anti-intellectual climate. This paper will consider recent educators’ efforts in the Australasian region to address the political and cultural disruption that post-truth has evoked, by inquiring into how their pedagogy mirrors or differs from that used in public spaces by protest movements. In the first section, scholarship on (...) post-truth will be examined for how it constitutes a form of revisionist history, in which the present has been corrupted over time by comparison to a more idealised and distant past. The second section will focus on how theories about the construction of knowledge, such as Latour’s notion of hybridised modernity and notions of historical consciousness, can be used to frame forms of activism as means to educate the public and disrupt the dominant political ideologies. The focus in the last section will be on examining how educators might enable learners’ critical literacy so they can accommodate and overcome the negativity, cynicism, and disempowerment which characterises a post-truth paradigm. (shrink)

This article concerns the electronic archive, in relation to the academy and to culture. It explores the metaphors by which the archive is con ceived, proposing as an exploratory and imaginative device an installa tion of the archived material from a contemporary newspaper database. The debates over the electronic archive are then viewed through four voices, each with a distinctive ethos, voices which draw on the other voices of Kant, Baudrillard and Derrida, of the Bible and contempor ary social theory.

Starting from the often-used metaphor of the “horizon of experience” this article discusses three different types of intercultural hermeneutics, which respectively conceive hermeneutic interpretation as a widening of horizons, a fusion of horizons, and a dissemination of horizons. It is argued that these subsequent stages in the history of hermeneutics have their origin in—but are not fully restricted to—respectively premodern, modern and postmodern stages of globalization. Taking some striking moments of the encounter between Western and Chinese language and philosophy as (...) example, the particular merits and flaws of these three types of hermeneutics are being discussed. The claim defended is that although these different types of hermeneutics are mutually exclusive from a theoretical point of view, as interpreting beings in the current era we depend on each of these distinct hermeneutic practices and cannot avoid living them simultaneously. (shrink)

Meaning in literary texts such as poetry and novel etc., is not determined on the basis of a literal understanding of the words in it, but through a total evaluation of the devices such as metaphors and similes. This paper deals with metaphor to show its significance, to make us aware that metaphoric expressions do give a different kind of knowledge, and to pave the way to disclose a different kind of truth which is perhaps, more valuable than what the (...) literal sense provides. Ordinarily metaphorical use is taken for rhetorical purposes. Literalists of the Western and Indian philosophical traditions believe that it is only the literal or primary meaning that can give us a precise account of language. Metaphors are viewed by them as fuzzy, lies, not corresponding to actual states of affairs, non-propositional in character, not having truth-conditions, and thus not providing us with any knowledge or truth. However, this paper tries to work out the fundamentality of metaphor, how metaphor widens our experience of the world, and how it has the power to take us to an alternative world to introduce with some new truth by exploring certain notions of the Indian aestheticians. (shrink)

This article reports findings of a hermeneutic phenomenological study that explored the clinical learning experience for Malawian undergraduate student nurses. The study revealed issues that touch on both nursing education and practice, but the article mainly reports the practice issues. The findings reveal the emotions that healthcare workers in Malawi encounter as a consequence of practising in resource-poor settings. Furthermore, there is severe nursing shortage in most clinical settings in Malawi, and this adversely affects the performance of nurses because of (...) the excess workload it imposes on them. The results of the study also illustrate loss of professional pride among some of the nurses, and the article argues that such a demeanour is a consequence of burnout. However, despite these problems, the study also reveals that there are some nurses who have maintained their passion to care. (shrink)

As nursing continues to develop as a professional discipline, it is important for nurses to have a central question to guide their research. Since the 1800s, nursing practice and research have covered a wide scope in cooperation with other disciplines. This wide area of nursing practice and research has led to the proposal that the central question be: How can the well‐being of a person, family, community, or population be improved? The proposed question must remain flexible and open to revision (...) because nurses will continue to adapt to the changing needs of their patients and populations and to their complex and evolving work environments. (shrink)

Nursing on paper: therapeutic letters in nursing practice This paper offers a selected piece of interpretive research extracted from the context of a larger research study. The hermeneutic research inquiry described in this paper involved the examination of the nursing and family therapy intervention of therapeutic letters. It incorporated the textual interpretation of 11 therapeutic letters, clinical sessions with three families, clinical team discussions, and research interviews with four family members and three nurse clinicians who participated in the writing of (...) the letters. This particular paper extracts segments of the research related to the letters received by two participants, as well as some general findings, with a focus on the possibilities and influences of therapeutic letters in nursing practice. The findings of this research offer suggestions, not as a template, but as an inspiration and evocation to write therapeutic letters that address the obligation of meeting people experiencing illness at the point of their suffering, with words and questions that invite relationship, reflection, and are large enough to sustain a meeting. (shrink)

In this paper, the authors describe an aspect of a program of research around grief and clinical practice. The first phase of the study involves examination of experiences of grief with attention to troublesome or problematic beliefs that fuel the extent of suffering in the bereaved. The data, obtained from a review of videotaped clinical interviews with families seen in the Family Nursing Unit at the University of Calgary, were analyzed according to philosophical hermeneutic tradition. Findings suggest that grief is (...) an experience that is ongoing, that changes in nature over time, but that involves a continuing relationship with the deceased; it is a graceful, periodic, deliberate walk backwards while keeping a sure foot in living forward. (shrink)

The ArgumentThis article compares the corresponding effects in science and art of a change in the intuition of time at the beginning of this century. McTaggart's distinction between linear time and tense time is applied to the question of whether linear perspective requires a notion of time as succession. It is argued that the problem of self-representation is a basic problem for this kind of uniform space-time because of the contradiction between this model's need for a privileged point of view (...) and its simultaneous denial of such a possibility. (shrink)

Through the study of Richard Gruneau and Gunter Gebauer’s respective works, this article examines the social significance and theoretical implications of sport’s capacity to represent social life in a theatrical manner. The drama-like images and representations sporting practices produce, institutions codify, and television programs enhance is considered in relation to ideology’s integrative, legitimating, and distorting functions . Acknowledging the filiations of ‘theatre’ with ‘theory’ – both words stand for ‘to contemplate, to see, to observe’ – this study considers theatricality as (...) a valuable theoretical notion that enables a synthetic and reflexive understanding of athletic practices’ bodily dimension, symbolic representations, and institutional determinants. (shrink)

Background Interest in strengthening residents’ autonomy in nursing homes is intensifying and professional caregivers’ experience ethical dilemmas when the principles of beneficence and autonomy conflict. This increased focus requires expanded knowledge of how residents experience decision-making in nursing homes and how being subject to paternalism affects residents’ dignity. Research question/aim This study explored how residents experience paternalism in nursing homes. Research design This study involved a qualitative interpretive design with participant observations and semi-structured interviews. The interpretations were informed by Gadamer’s (...) hermeneutics. Participants and research context Eleven residents were interviewed after a period of participant observation in two nursing homes. Ethical considerations The study was performed in accordance with the Helsinki declaration. The Regional Ethics Committee (REK) permitted the researcher to perform participant observation in the nursing homes. The use of audio recordings of interviews was registered and supervised by Sikt - Norwegian Agency for Shared Services in Education and Research. The resident’s consent was assessed continuously. Three interviews were terminated for ethical reasons. Findings The resident interviews revealed that residents found it obvious for caregivers to possess the decision-making authority in nursing homes. When residents explained their views, three main themes emerged: (1) To be included even though caregivers make the decisions, (2) Surrender to dependency, and (3) Adherence to nursing home norms. Conclusions Residents submit to their caregivers and give caregivers the responsibility and function as leaders. Paternalism was experienced as dignifying in situations where it contributed to residents being able to live according to second order desires and values, and when it implied respect and appraisal of residents’ capabilities. Paternalism was experienced as debasing when residents felt left out, and when residents felt that their capabilities were underestimated. This also included their capability to withstand paternalistic influence. (shrink)

To claim that there is a politics to or expressed within media technology is of course by no means new, but it remains controversial and not always well understood. Walter Benjamin’s (1986b) essay from 1936 on the political import of media technology is often regarded as the starting point of such discussions, since it foregrounds a key theme in critical theory, namely the politics of perception. In what follows, I would like to review the importance of the politics of perception (...) by first outlining Benjamin’s political analysis of cinema and then engaging with a critique of Benjamin by recent American cognitivist philosophy. This will allow a consideration of the competing phenomenological cognitive science of embodied cognition that I argue offers a better account of the mind and cognition than cognitivism. As a result of this analysis of cognition, I conclude that the philosophy of embodied cognition supports Benjamin's political theory of media technology. (shrink)

Background Middle managers play a key role in promoting a caring culture in nursing homes. However, there is limited knowledge about middle managers’ inner motives and their experiences of their responsibility in developing a caring culture. Research aim The aim of the study is to get a deeper understanding of middle managers’ motives and their experiences of their responsibility to develop a caring culture in nursing homes. Research design A qualitative design with a hermeneutic approach inspired by Gadamer was chosen (...) which guided the interpretation of data. Qualitative semi-structured interviews were conducted. Participants and research context Data were collected from thirteen middle managers in nursing homes, in six municipalities in northern Norway in September and October 2021. Ethical considerations The study was approved by the Norwegian Centre for Research Data. Oral and written informed consent was obtained from participants. Findings The findings show that the middle managers had non- egoistic motives to promote a caring culture as expressed in their attitudes and actions. They felt responsible to promote a caring culture where both patients and staff experienced care and were respected and recognized as unique individuals. Middle managers as good role models are responsible for being present and raising awareness of the importance of care in the nursing home culture by systematically reflecting on care values. However, a strong focus on the financial and administrative demands limits the middle managers’ possibilities to promote a caring culture and prevented them from always acting as they wanted to act, which often causes moral distress. Conclusion Being in contact with inner motives, enables the leader to promote a homelike and caring culture where both patients and staff feels respected and recognized as unique individuals. This study highlights the importance of systematic reflection on caring values in nursing homes which leads to value awareness among all actors. (shrink)

Metabletics was first introduced by J.H. Van den Berg as a systematic study of the changing nature of human existence. It gives special focus to phenomena within their specific historical and social-cultural contexts, and inside a complex matrix of relationships. Metabletics provide a uniquely interdisciplinary approach through the analysis of simultaneous events to identify patterns in human experience. Most central to the metabletic method is that, while the world of science is constant, the landscape of human existence is continually changing (...) and causing humans to change. This article outlines the central principles and applications of the metabletic method and addresses tensions and possible challenges within the approach. (shrink)

In recent years, there has been a marked increase in the use of imaginative play in child psychotherapy, yet the theoretical conceptualization of the meaning of play is lacking behind its application in practice. In search of a deeper understanding of the phenomenon of imaginative play, the author turns to Merleau-Ponty's ontology and to his phenomenology of structure, of the lived body, of perception, and of expression. In light of his work, play is an embodied mode of being in the (...) world and a body-world phenomenon. Imaginative play in particular exemplifies the human order in that it enables the child to create and re-create his own meanings within his play world. In a therapeutic context, the evocation of play imagery and the expressive shaping and reshaping of play meanings lead to surprising insights and new discoveries relevant to the child's life-world. A central therapeutic value of imaginative play lies in its promise for facilitating change and healing. A clinical case illustration of a young boy is provided, and the meaning of his imaginative play is exemplified in light of Merleau-Ponty's thought. Some implications are drawn for the theory of play in child psychotherapy. (shrink)

This paper describes four plays which illustrate ethical themes relevant to engineers and which could be used as a resource for engineers who wish to explore ethical topics and their relationship with professional practice. The plays themselves have been chosen because a character in the play is involved in engineering activities. Each play is analysed to highlight some of the ethical issues the play raises. Often ethical topics are presented in abstract terms but the plays relate ethical issues to individuals (...) and individual actions in specific situations that connect either directly or figuratively to practical situations engineers find themselves in. The paper describes how the resources have or could be used in an educational programme. (shrink)

Volume 19, Issue 11, November 2019, Page 71-73.

The capacity to collect and analyse data is growing exponentially. Referred to as ‘Big Data’, this scientific, social and technological trend has helped create destabilising amounts of information, which can challenge accepted social and ethical norms. Big Data remains a fuzzy idea, emerging across social, scientific, and business contexts sometimes seemingly related only by the gigantic size of the datasets being considered. As is often the case with the cutting edge of scientific and technological progress, understanding of the ethical implications (...) of Big Data lags behind. In order to bridge such a gap, this article systematically and comprehensively analyses academic literature concerning the ethical implications of Big Data, providing a watershed for future ethical investigations and regulations. Particular attention is paid to biomedical Big Data due to the inherent sensitivity of medical information. By means of a meta-analysis of the literature, a thematic narrative is provided to guide ethicists, data scientists, regulators and other stakeholders through what is already known or hypothesised about the ethical risks of this emerging and innovative phenomenon. Five key areas of concern are identified: informed consent, privacy, ownership, epistemology and objectivity, and ‘Big Data Divides’ created between those who have or lack the necessary resources to analyse increasingly large datasets. Critical gaps in the treatment of these themes are identified with suggestions for future research. Six additional areas of concern are then suggested which, although related have not yet attracted extensive debate in the existing literature. It is argued that they will require much closer scrutiny in the immediate future: the dangers of ignoring group-level ethical harms; the importance of epistemology in assessing the ethics of Big Data; the changing nature of fiduciary relationships that become increasingly data saturated; the need to distinguish between ‘academic’ and ‘commercial’ Big Data practices in terms of potential harm to data subjects; future problems with ownership of intellectual property generated from analysis of aggregated datasets; and the difficulty of providing meaningful access rights to individual data subjects that lack necessary resources. Considered together, these eleven themes provide a thorough critical framework to guide ethical assessment and governance of emerging Big Data practices. (shrink)

The internet of things is increasingly spreading into the domain of medical and social care. Internet-enabled devices for monitoring and managing the health and well-being of users outside of traditional medical institutions have rapidly become common tools to support healthcare. Health-related internet of things (H-IoT) technologies increasingly play a key role in health management, for purposes including disease prevention, real-time tele-monitoring of patient’s functions, testing of treatments, fitness and well-being monitoring, medication dispensation, and health research data collection. H-IoT promises many (...) benefits for health and healthcare. However, it also raises a host of ethical problems stemming from the inherent risks of Internet enabled devices, the sensitivity of health-related data, and their impact on the delivery of healthcare. This paper maps the main ethical problems that have been identified by the relevant literature and identifies key themes in the on-going debate on ethical problems concerning H-IoT. (shrink)

Arguing that the fruitful approach to a reworking of the social depends upon forging an alliance between sociological theory and feminist theory, the paper analyses strands in sociological thinking which are responsible for renewed interest in the ‘social’. The first perspective, as developed by Touraine, Urry, Bauman and Castells, formulates a new agenda for ‘sociology beyond the social’ and emphasizes the limitations of the concept of ‘the social as society’. The second orientation, represented here by Richard Sennett, tracks the shifting (...) relationships between public and private. The third strand, illustrated by the recent work of Robert Putnam, focuses on the notion of social capital. A comparison between these perspectives introduces my argument that we should search for a new balance not only between local and global, and private and public, but also between formality and informality as only such an approach has the potential to capture the complexity of and the interdependence between conditions responsible for the production of demands for trust and ways of generating trust. The paper argues that how actors strike the optimal balance between formality and informality in interactions depends on the specific characteristics of different realms of interaction. Therefore, in conclusion, I describe three styles of interaction: civility, sociability and intimacy, which represent the essential basis for an enhanced quality of social and personal life. (shrink)

Journal of Philosophy of Education, EarlyView.

The understanding of science by members of the public has been of increasing concern to social scientists. This article argues that such understanding, or the ostensible lack of it, is structured by discourses that address science both as an abstract entity or principle and as an activity directed at specific phenomena or problems. Drawing upon a wide range of interviews about various sources of ionizing radiation, it is suggested that understanding is tied to questions of social identity that encompass relations (...) of differentiation from and identification with science and the institutions in which it is embedded. (shrink)

This article presents results from a qualitative empirical investigation of how Danish oncology physicians and Danish molecular biologists experience the principle of respect for autonomy in their daily work.

Volume 19, Issue 12, December 2019, Page 44-45.

In this paper, we present how a dialectical perspective on phenomenological psychopathology, called Dialectical Phenomenology (DPh), can contribute to current needs of psychiatric diagnosis. We propose a three-stage diagnostic methodology: first- and second-person stages, and synthetic hermeneutics stage. The first two stages are divided into a pre-dialectical and a dialectical phase. The diagnostic process progresses in a trajectory of increasing complexity, in which knowledge obtained at one level is dialectically absorbed and intertwined into the next levels. Throughout the article, we (...) offer some examples of each step. In overall, the method starts off from the patient's own narrative, proceeds to two stages of phenomenological reduction designed to guarantee the scientific validity of the object, and concludes with a hermeneutical narrative synthesis that is dialectically composed of the patient's and psychopathologist's shared narratives. At the end of this process, the initial first-person narrative is transformed into a specific scientific object, a full dialectical phenomenological psychiatric diagnosis. This form of diagnosis constitutes a comprehensive alternative for an integral assessment of the complexities of human psychological alteration, bringing together both the interpretation of the suffering person and the scientific categories of psychiatry. (shrink)

ABSTRACTIn recent work, Maeve Cooke has criticised Jürgen Habermas’s post-metaphysical model in order to motivate an alternative “post-secular” conception of the state, which involves the replacement of the “institutional translation proviso” with the “nonauthoritarian reasoning requirement”. I provide a qualified defence of the Habermasian model by arguing that it does not lead to the kind of negative consequences regarding legitimacy and solidarity Cooke attributes to it. This, in turn, means that Cooke’s proposal for the secular foundation of political authority on (...) a post-secular basis is insufficiently motivated. In the process, I argue that the point of departure for the debate about religion in the public sphere shared by both Habermas and Cooke – the picture of the “total” religious citizen – should be rejected because it presupposes an overly simplistic view of religions and religious identities. (shrink)

It is widely held that reflexivity is the defining feature of selfhood: the ability of the self to stand in a certain relation to itself. The question of how exactly to theorize this self-relation, however, has been the source of ongoing debate. In recent years, Kantian and post-Kantian approaches such as Christine Korsgaard’s constitutivism and Richard Moran’s commitment view, have attempted to establish the priority of the agential over the epistemic self-relation, thereby re-orientating the debate away from metaphysics and epistemology (...) towards ethics and moral psychology. Despite the important progress they make towards a de-alienated and reified understanding of the self-relation, however, I argue that the Kantian paradigm is ultimately inadequate because its methodological individualism makes it incapable of accounting for the irreducibly social dimension of the self-relation and, therefore, of successfully making the transition from ethics to social and political philosophy. In other words, an adequate ontology of the self-relation is possible only as a social ontology. In order to motivate this thesis, I appeal to two examples that expose the “social deficit” of the Kantian approach: Frantz Fanon’s phenomenology of race/racism in “The Lived Experience of the Black” and the phenomenon of cultural collapse in Jonathan Lear’s Radical Hope. I then go on to provide a sketch of an alternative approach based on the notion of “self-appropriation”, distinguishing it from Rahel Jaeggi’s use of the term in her recent critique of alienation, in the process. (shrink)

In discussions of the conservation of culturally significant architecture, awareness about issues of temporality and its theoretical import has been approached from varied, partial, perspectives. These perspectives have usually focused on accounts of temporality that focus on the past and the present—and more rarely the future—without considering either the complete spectrum of human temporality or its ontological bases. This article addresses this shortcoming with a phenomenology of conservation grounded on the fundamental attitudes of cultivation and care. After a phenomenological and (...) existentialist analysis of Cesare Brandi’s thought—focusing on his paradigmatic Theory of Restoration—his attitude comes forth as a limited instance of the modern conservation attitude that is concerned exclusively with architecture as art. This attitude results in a limited temporal intentionality. Following Ingarden and Ricoeur, the existential approach here applied to the deduced dimensions of the space and time of Dasein—in Heidegger’s terms—outlines the grounding of conservation on an existential interpretation of the more fundamental notions of cultivation and care. This interpretation suggests a solution for the modern impasse with an existential account of both the artistic grounding of architecture and its characterization as the place that temporally accompanies Dasein. Architecture thus emerges as a manifold being, constituting existentially the space for the authentic human being, whose temporal consciousness compels it to cultivate and care about that space, thus enriching the possible approaches to conservation as a collective endeavor. (shrink)

In spite of the growing public awareness of those who would identify as transgender, very little has changed in attitudes that would accord such people full approbation. The author takes the reader on a 40‐year journey of discovery that has led her to an abiding interest in and dedication to the issues faced by people who do not fit within the gender binary of Western society. As well as describing a personal experience with someone who identifies as transsexual, the author (...) relates two troubling experiences from her nursing career. Included in the discussion are linguistics, sexuality, and vocabulary. A personal epistemology is explored that incorporates unknowing, intuition, and embodiment, and the difference this view can make to the care of those who identify as gender‐diverse. (shrink)

The current dominant approach on the assessment of critical thinking takes as a starting point a conception of criticality that does not commit to any substantive view or context of meaning concerning what issues are relevant to be critical about in society or in life. Nevertheless, as a detailed examination of the identification of assumptions shows, when going from the theory of critical thinking to the praxis of producing and evaluating arguments, the critical person will inevitably make such commitments from (...) particular perspectives, using particular contexts of meaning. But then she may fail to take notice of relevant ones and may end up using her critical powers in a mercenary way. It is then proposed, in the context of assessment of critical thinking, to choose and use some privileged contexts of meaning, while making them available for critical scrutiny and allowing for the possibility that new ones be brought up by those being assessed. (shrink)

Theologians and philosophers remain rather indecisive about the notion of desecularisation. I suggest that desecularisation should be considered relevant insofar as it interacts with other notions belonging to contemporary thought, namely: radical secularisation, desacralisation, deconstruction, and dis-enclosure. I argue that desecularisation can be understood as belonging to the same movement as the one marked by deconstruction and dis-enclosure. Staging this interaction will yield the following: the necessity of secularising secularisation itself, the importance of differentiating between secularisation and desacralisation, the rightful (...) belonging of desecularisation to the events of deconstruction and dis-enclosure at the “end” of metaphysics, and the need to rewind the ideological abuse of secularisation. (shrink)

The philosophical orientation of Gadamerian hermeneutic phenomenology is explored in this paper. Gadamer offers a hermeneutics of the humanities that differs significantly from models of the human sciences historically rooted in scientific methodologies. In particular, Gadamer proposes that understanding is first a mode of being before it is a mode of knowing; what this effectively offers is an alternative to the traditional way of understanding in the human sciences. This paper details why the work of hermeneutics is not to develop (...) a procedure for understanding, but to clarify the conditions of understanding. In this explication, the author examines the hermeneutic experience and, in the process, relates it to both the practical and the historical horizons of the lifeworld of health professionals, particularly nurses. Indo-Pacific Journal of Phenomenology<, Volume 7, Edition 2 September 2007. (shrink)

This is a response to two reviews of our book "Science Unfettered: A Philosophical Study of Sociohistorical Ontology." We clarify the relationship between the ontological and the ontic, the key phrases: 'being-in-the-world,' the 'facticity' of human existence. We show where the sources of reviewers misunderstandings lie.

The present article addresses the question of whether, and to what extent, critical thinking should make attunement to current social and political landscapes central to its practice. I begin by outlining what I consider to be the basic positions in the debate about the political contextualisation of critical thinking, which are referred to as the crypto-Enlightenment and the critical pedagogical models. I argue, on the basis of various strands of research, that there is a prima facie case to be made (...) in favour of the critical pedagogical position that favours forefronting the social and political context of critical thinking and thinking in general. I then draw attention, however, to problems of coherence and justification in the critical pedagogical position, before turning, finally, to an alternative grounding of critical thinking that takes seriously the historical and social contextualisation of thinking without the coherence problems of critical pedagogy. My conclusion is that while the critical pedagogical model is right to point to the fatal incompleteness of Enlightenment-style critical thinking due to its failure to properly acknowledge the norm-saturated nature of historical consciousness, critical pedagogy itself fails to offer a coherent alternative to the problem of integrating value and rationality in a more full-blown grounding of critical thinking. I suggest that a hermeneutical model that integrates the rational, axiological and historical moments in consciousness provides a more satisfying foundation for understanding the trajectory and purpose of critical thinking. (shrink)

Health-related quality of life measures aim to assess patients’ subjective experience in order to gauge an increasingly wide variety of health care issues such as patient needs; satisfaction; side effects; quality of care; disease progression and cost effectiveness. Their popularity is undoubtedly due to a larger initiative to provide patient-centered care. The use of patient perspectives to guide health care improvements and spending is rooted in the idea that we must respect patients as self-determining agents. In this paper I look (...) at the two main orientations to quality of life measurement: standardized and individualized measures. I argue that while these measures are attempts to provide for patient self-determination, they both fail to do so. In their place I suggest a new approach which overcomes their respective difficulties: a dialogic approach. (shrink)

This paper explores the dominant rational approach to informed consent and challenges the appropriateness of this approach to ethical decision‐making with people with dementia. In dementia care a dominant assumption exists that people are not autonomous because of their inability to make decisions and exercise freedom of choice. The rational understanding of autonomy being the capacity to exercise freedom of choice means that health and social care professionals feel justified in making decisions on behalf of the person with dementia. If (...) a person cannot consent to an intervention then a proxy is used to make the decision. This paper argues that such an approach reinforces the mind‐body dualism that dominates health and social care discourse. Whilst acknowledging the place of proxy decision‐making, it is argued that there is a need to hear the voice of the person with dementia that goes beyond rational understandings of what is heard and that does not reinforce separation of the mind and body. An understanding of the person through their ‘narrative identity’ is proposed and illustrated through a case example. Drawing on the philosophy of Ricoeur it is argued that an individual's narrative identity can be developed and used to underpin informed consent decisions. Using a case example it is argued that paying attention to an individual's narrative identity provides a way of respecting the autonomy of the individual with dementia in a way that is consistent with their overall life plan. (shrink)

If you do not wish to construe philosophical discourse as simply a discourse of cognition, a theoretical discourse; if you think it is also a practical, ethical discourse: how should you write? How should you frame the ethos, the authority of your discourse? This article re‐presents an extended preface I wrote and rewrote obsessively over a period of nearly two years in an effort to forge a voice and mode of address adequate to my sense of philosophical discourse as a (...) practical discourse, whilst also being accountable to the generic requirements of a PhD. As the textual record of this struggle, the value of this text must remain primarily in its capacity to evoke or provoke similar generic memories or ambitions in the reader. (shrink)