Researching stigma as an outsider: considerations for qualitative outsider research

In this article, we discuss a number of important considerations that we have encountered in the process of researching health stigma topics as “outsiders”: researchers (personally) unfamiliar with the experience or topic under study. In particular, we discuss the importance of the following: a reflective stance, challenging negative representations, flexible and sensitive recruitment strategies, validating experiences of stigma, and participant control and power. We see these points as particularly important in the context of researching stigma as outsiders, where our privilege may contribute to unhelpful, narrow, de-politicized or overly simplistic representations of particular “groups” or experiences. We share these considerations in hope of assisting other researchers to reflect on, and articulate, how they negotiate their positionings within their research and the ways in which they shape and construct the research agenda and, by implication, the people or topics under examination.     

A Pilot Evaluation of Portfolios for Quality Attestation of Clinical Ethics Consultants

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step on the pathway to an eventual certification process for clinical ethics consultants.     

An Ethical Exploration of Barriers to Research on Controlled Drugs

We examine the ethical, social, and regulatory barriers that may hinder research on therapeutic potential of certain controversial controlled substances like marijuana, heroin, or ketamine. Hazards for individuals and society and potential adverse effects on communities may be good reasons for limiting access and justify careful monitoring of these substances. Overly strict regulations, fear of legal consequences, stigma associated with abuse and populations using illicit drugs, and lack of funding may, however, limit research on their considerable therapeutic potential. We review the surprisingly sparse literature and address the particular ethical concerns pertinent to research with illicit and addictive substances, such as undue inducement, informed consent, therapeutic misconception, and risk to participants, researchers, and institutions. We consider the perspectives of key research stakeholders and explore whether they may be infected with bias. We conclude by proposing an empirical research agenda to provide an evidentiary basis for ethical reasoning.     

Ethics Consultation Quality Assessment Tool: A Novel Method for Assessing the Quality of Ethics Case Consultations Based on Written Records

Although ethics consultation is offered as a clinical service in most hospitals in the United States, few valid and practical tools are available to evaluate, ensure, and improve ethics consultation quality. The quality of ethics consultation is important because poor quality ethics consultation can result in ethically inappropriate outcomes for patients, other stakeholders, or the health care system. To promote accountability for the quality of ethics consultation, we developed the Ethics Consultation Quality Assessment Tool (ECQAT). ECQAT enables raters to assess the quality of ethics consultations based on the written record. Through rigorous development and preliminary testing, we identified key elements of a quality ethics consultation (ethics question, consultation-specific information, ethical analysis, and conclusions and/or recommendations), established scoring criteria, developed training guidelines, and designed a holistic assessment process. This article describes the development of the ECQAT, the resulting product, and recommended future testing and potential uses for the tool.     

A Postcolonial Framework for Justification and Eco‐Justice

This work proposes a relationship between eco‐justice and justification by grace rooted in a phenomenological approach. The reality of structural sin experienced by persons living in economic poverty on the African continent is interpreted through the lens of Lutheran catechetical ethics. Lives of repentance will lead to incarnational interventions striving for concrete social transformation.     

The refugee’s flight: homelessness,hospitality, and care of the self

This paper argues that the contemporary international refugee regime is grounded in a paradigm of ‘homesickness’, which puts the refugee in an inferior position of the supplicant, whose subjectivity is framed by the regime of fixed belonging. In order to address this situation, we need to challenge the ontological primacy of homesickness and embrace ‘homelessness’, which offers the possibility of rethinking the positions of both refugees and non-refugees in ethical terms. While the responsibility of the non-refugees lies in cultivating an ethos of hospitality, the refugee can take hold of her subjectivity through the practice of care of the self. This paper first examines Nietzsche’s thought on homelessness and compares it with Foucault’s reading of the role of anakhōrēsis in the Hellenistic practice of care of the self. It then suggests how, by building on the project of universal hospitality, we can interpret the figure of the refugee through the prism of an ethic of freedom, anchored in a positive break with the city. From this perspective, the refugee regains her ethico-political agency by cultivating the relationship with her own living self, which offers new avenues for resistance against the dominant paradigm of ‘homesickness’ that governs her subjectivity today.     

Trust and Involvement as Higher-Order Factors of General Attitudes Towards Politics. Testing a Structural Model Across 26 Democracies

Interindividual differences in how people think and feel about politics have been investigated for decades. However, the great number of attitudinal concepts that has been developed to describe these differences is likely to distract from their conceptual overlap and dimensional structure. In addition, not much is known about the cross-cultural invariance of their interrelation. We propose that attitudes towards politics can be structured by two broad higher-order factors, a factor of general political involvement and a factor of general political trust. In two studies (N₁ = 767; N₂ = 29,018), including representative samples from 26 democracies, we first conduct several confirmatory factor analyses (CFA) to show that the higher-order model is a well-fitting and parsimonious alternative to a baseline model without higher-order factors in most samples. Second, we present evidence from multigroup CFA that the overall patterns of factor loadings are the same across all 26 countries. We interpret this structural equivalence across different democracies as support for the assumption that general political involvement and general political trust reflect basic orientations towards politics that are based on (1) demands of democratic political systems and (2) universal principles in human trait structure.     

The ethical dimension of analytical psychology

The centrality of the ethical dimension in Carl Gustav Jung's analytical psychology is demonstrated through careful reference to fundamental moments in the Jungian text. Tracking Jung's statements about the primacy of the ‘moral function’ (or ‘moral factor’) in the cure of neurosis as well as in the process of individuation, the ethical nature of the psychotherapeutic praxis proposed by Jung is highlighted. This allows us to see the ethical aspect of psychological conflicts, and thus to understand better why individuation can be seen as a ‘moral achievement’. Finally, the intelligible ethical structure of Jungian psychotherapeutic praxis is exposed.     

In Politics We Trust…or Not? Trusting and Distrusting Demonstrators Compared

This article sheds light on the debate regarding political trust and protest activity. The debate boils down to the question whether trust in politics is positively or negatively related to protest activity. We exploit a dataset encompassing data on about 9,000 demonstrators spread over seven European countries. These demonstrators' trust in their parliaments varies widely, ranging from trustworthy capable, to corrupt incapable. We examine the diverging sociodemographic profiles and motivational dynamics that turn distrusting and trusting citizens into demonstrators. We hypothesize and show that distrusting demonstrators turn their back to institutionalized politics; for them, demonstrating substitutes the party politics they distrust. For trusting demonstrators, demonstrating supplements party politics. Trusting and distrusting demonstrators also differ considerably in terms of motivation. Distrusting demonstrators are stronger motivated to demonstrate than trusting demonstrators. Moreover, while political cynicism amplifies the motivation of distrusting demonstrators, it suppresses the motivation of trusting demonstrators. We conclude that the question to be answered is not so much whether people who engage in protest activity trust or distrust their political elites, but rather who the trusting and distrusting protesters are and why they protest.