Being, Doing, and Knowing: Developing Ethical Competence in Health Care

There is a growing interest in ethical competence-building within nursing and health care practising. This tendency is accompanied by a remarkable growth of ethical guidelines. Ethical demands have also been laid down in laws. Present-day practitioners and researchers in health care are thereby left in a virtual cross-fire of various legislations, codes, and recommendations, all intended to guide behaviour. The aim of this paper was to investigate the role of ethical guidelines in the process of ethical competence-building within health care practice and medical research. A conceptual and critical philosophical analysis of some paragraphs of the Helsinki Declaration and of relevant literature was performed. Three major problems related to ethical guidelines were identified, namely, the interpretation problem (there is always a gap between the rule and the practice, which implies that ethical competence is needed for those who are to implement the guidelines); the multiplicity problem (the great number of codes, declarations, and laws might pull in different directions, which may confuse the health care providers who are to follow them); and the legalisation problem (ethics concerns may take on a legal form, where ethical reflection is replaced by a procedure of legal interpretations). Virtue ethics might be an alternative to a rule based approach. This position, however, can turn ethics into a tacit knowledge, leading to poorly reflected and inconsistent ethical decisions. Ethical competence must consist of both being (virtues) and doing (rules and principles), but also of knowing (critical reflection), and therefore a communicative based model is suggested.     

公正作为德性——亚里士多德公正德性探析

People currently regard justice as the main principle of institutions and society, while in ancient Greek people took it as the virtue of citizens. This article analyzes Aristotle’s virtue of justice in his method of virtue ethics, discussing the nature of virtue, how justice is the virtue of citizens, what kind of virtue the justice of citizens is, and the prospect of the virtue of justice against a background of institutional justice. Since virtue can be said to be a specific individual character, Aristotle also defines the virtue of justice as the character of justice, with which citizens act justly and desire to do what is just. The virtue of justice is also an individual ethical virtue, differing from others for it is at the same time a social ethic. We can call the virtue of justice a “non-individual individual ethical virtue.” It has been explained as between pure altruism and egoism, which is a wrong explanation. John Rawls regards justice as the first virtue of social institutions, challenging Aristotle’s virtue of justice, an assertion which also needs further deliberation. Translated from Zhongguo Renmin Daxue Xuebao 中国人民大学学报 (Journal of Renmin University of China), 2006, (2): 61–69     

Cultural Complexities and Scientific Development

Methodological issues in psychology consist of a key aspect for the scientific development of the discipline. In this paper I elaborate on the reasons why I partially agree with Toomela's ideas, and why I also disagree with some of his arguments. The convergence refers to the need for a radical change concerning the widespread use of methodologies that has been typical of mainstream psychology, which still flavors too positivist and pseudo-quantitative, overlooking the central relevance of theory for scientific development. The divergence resides in Toomela's insistence to oppose what he designates as "the North American" to "the German-Austrian" scientific thinking: from my perspective, the misuse of cultural categories can only lead to misguided and unconstructive dichotomies that entails a naive concept of culture, and do not contribute to scientific development. From a contemporary systemic approach, complex issues deserve more sophisticated analysis.     

Tolerance as a Primary Virtue

The commonly perceived tension between authentic moral and ethical action and action involving tolerance is held to be the illusory product of an unduly individualistic frame of thought. Moral and ethical actions are produced not by independent individuals but by participants in cultural traditions. And even the wholly routine continuation of a single homogeneous tradition must always and invariably involve mutual tolerance: participants must interact not as independent individuals but as tolerant members. Tolerance deserves recognition, accordingly, as a primary virtue, not merely compatible with authentic moral and ethical action, but required by it. An explicit rhetoric enjoining tolerance needs to be understood as performative discourse employed to change, or else to sustain, the systems of tolerances in which all cultures, whether simple or differentiated, homogeneous or diverse, unified or fragmented, invariably consist. This revised version was published online in August 2006 with corrections to the Cover Date.     

The Search for the Source of Epistemic Good

Knowledge has almost always been treated as good, better than mere true belief, but it is remarkably difficult to explain what it is about knowledge that makes it better. I call this "the value problem." I have previously argued that most forms of reliabilism cannot handle the value problem. In this article I argue that the value problem is more general than a problem for reliabilism, infecting a host of different theories, including some that are internalist. An additional problem is that not all instances of true belief seem to be good on balance, so even if a given instance of knowing p is better than merely truly believing p , not all instances of knowing will be good enough to explain why knowledge has received so much attention in the history of philosophy. The article aims to answer two questions: (1) What makes knowing p better than merely truly believing p ? The answer involves an exploration of the connection between believing and the agency of the knower. Knowing is an act in which the knower gets credit for achieving truth. (2) What makes some instances of knowing good enough to make the investigation of knowledge worthy of so much attention? The answer involves the connection between the good of believing truths of certain kinds and a good life. In the best kinds of knowing, the knower not only gets credit for getting the truth but also gets credit for getting a desirable truth. The kind of value that makes knowledge a fitting object of extensive philosophical inquiry is not independent of moral value and the wider values of a good life.     

易学中的人学思想

易学是“范围天地”、“曲成万物”,利用自然现象以求人事、关心人之学。但不无遗憾的是从来无人把易学作为人学来研究。本文认为易学即人学。人学是关心人、研究人的学问。易学从人的生命意义、生命价值的基础上探索人在自然界的形成、演化以及人性的内容等,在解释《易经》的系统中,阐述了人其所以为人的内容,从天地设位、大化流行、三材之道、性命之理、裁成辅相、弥纶天地、情见乎辞、继之者善、自强不息、人文化成等十个方面,构建了一个古老的人学系统。     

Comparing theories of consciousness: Object position,not probe modality,reliably influences experience and accuracy in object recognition tasks

People often claim seeing images completely despite performing poorly. This highlights an issue with conscious representations. We introduce an experimental manipulation aiming to disentangle two prevalent positions: Rich views posit that people virtually represent the external world with unlimited capacity; Sparse views state that representations are reconstructed from expectations and information. In two experiments using the object recognition task, we tested two probe types: Images, which should aid reconstruction more, and Words, which should aid it less. From a sparse view, one should expect that Images lead to greater accuracy and reported experience. We found no reliable differences in accuracy and reported experience across probe types; however, we observed that the object positions influenced both accuracy and reported experience, which is surprising from a Rich view as it seemingly requires assumptions of different access across the visual field. Both theoretical positions thus currently need further development to explain our results.     

Distributed learning: Educating and assessing extended cognitive systems

Extended and distributed cognition theories argue that human cognitive systems sometimes include non-biological objects. On these views, the physical supervenience base of cognitive systems is thus not the biological brain or even the embodied organism, but an organism-plus-artifacts. In this paper, we provide a novel account of the implications of these views for learning, education, and assessment. We start by conceptualizing how we learn to assemble extended cognitive systems by internalizing cultural norms and practices. Having a better grip on how extended cognitive systems are assembled, we focus on the question: If our cognition extends, how should we educate and assess such extended cognitive systems? We suggest various ways to minimize possible negative effects of extending one’s cognition and to efficiently find and organize (online) information by adopting a virtue epistemology approach. Educational and assessment implications are foregrounded, particularly in the case of Danish students’ use of the internet during exams.     

Being an Intelligent Slave of God

How did premodern Muslim thinkers talk about living authentically as a Muslim in the world? How, in their view, could selves transform themselves into ideal religious subjects or slaves of God? Which virtues, technologies of the self and intersubjective relations did they see implicated in inhabiting or attaining what I shall call ?abdī subjectivity? In this paper, I make explicit how various discursive, ethical strategies formed, informed, and transformed Muslim subjectivity in early Muslim thought by focusing on the writings of an important ninth century Muslim moral pedagogue, al‐Mu?āsibī (d. 857). This study illustrates the advantages of approaching early Muslim texts and discourses through the tools and methods made available by comparative religious ethics in order to reexamine our understanding of Muslim subject formation and the role of ethical and theological discourses in the same.     

An investigation of the theoretical content of physical activity brochures

New evidence-based physical activity (PA) guidelines and recommendations for constructing messages supplementing the guidelines have been put forth. As well, recent reviews have identified theoretical constructs that hold promise as targets for intervention: self-regulation, outcome expectancies and self-efficacy. The purpose of this study was to examine the integration of messages targeting self-regulation, self-efficacy and outcome expectancies in existing physical activity brochures. Twenty-two PA brochures from Canadian and American National Health Organizations were assessed for their use self-efficacy, self-regulatory processes and outcome expectancies. Brochures were analyzed line-by-line using a modified version of the validated Content Analysis Approach to Theory-Specified Persuasive Educational Communication (CAATSPEC; Abraham, Southby, Quandte, Krahé, & van der Sluijs, 2007). Two independent raters coded a third of the brochures (n = 7). Inter-rater reliability was acceptable for 17 of the 20 categories (rs > .79). Discrepancies in all categories were discussed and agreement was reached. The remaining brochures were coded by one of the two raters. Usage of the three key theoretical constructs accounted for only 36.43% of brochure content (20.23% self-efficacy, 10.40% outcome expectancies, 5.80% self-regulation). Brochures lacked the use of a variety of theoretical strategies, specifically goal-setting, planning and verbal persuasion and rarely highlighted the affective benefits of physical activity. In the future brochures should aim to place increased emphasis on self-regulation, self-efficacy, and affective outcome expectancies.