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The aim of this discussion paper is to explore factors and contexts that influence how nurses might conceptualise and assign personhood for people with altered consciousness, cognition and behaviours. While a biomedical framing is founded upon a dichotomy between the body and self, such that the body can be subjected to a medical and objectifying gaze, relational theories of self, multiculturalism and technological advances for life‐sustaining interventions present new dilemmas which necessitate discussion about what constitutes personhood. The concept of personhood is dynamic and evolving: where historical constructs of rationality, agency, autonomy and a conscious mind once formed the basis for personhood, these ideas have been challenged to encompass embodied, relational, social and cultural paradigms of selfhood. Themes in this discussion include: the right to personhood, mind–body dualism versus the embodied self; personhood as consciousness, rationality and narratives of self; social relational contexts of personhood and cultural contexts of personhood. Patricia Benner's and Christine Tanner's clinical judgement model is then applied to consider the implications for nursing care that seeks to reflexively incorporate personhood. Nurse clinicians are able to move between conceptions of personhood and act to support the body, as well as presumed autonomy and relational, social and cultural personhood. In doing so, they use analytical, intuitive and narrative reasoning which prioritises autonomous constructions of self. They also incorporate relational and social contexts of the person receiving care within the possibilities of technological advances and constraints of contextual resources. [ABSTRACT FROM AUTHOR]

The article talks about the importance of people and modern citizenship in the functioning of democracy. Topics include politics and morality, political autonomy, risks in capitalistic economic system, feminism, racial discrimination, and minority protection. The concept of peopleness has been discussed.

Doi's paper has successfully spelled out several important points on amae: (1) Amae is an interpersonal process; (2) the origin of amae probably lies in the infant-mother relationship: (3) the concept of amae provides no absolute standard to classify a behavior in terms of amae;, (4) amae is best understood as a combination of patterns of behaviors; and (5) amae is g very broad concept. Implicit, but insufficiently recognized in Doi's paper, is the concept that amae is an interpersonal process of negotiation that is continuously revised throughout life. it is not just a motivational factor embedded in. an individual: underneath the surface phenomenon of amae, an amaeru-ing person usually allows the other to feel needed, valued, and respected. Operationalizing the concept of amae for international research requires that the term be defined in relation to a combination or patterns of behaviors observable in the infant/child-mother dyad. [ABSTRACT FROM AUTHOR]

Aim: To review the evidence of the existing literature on the impact of guided self‐determination across methodologies in different healthcare settings. Methods: An integrated five‐stage review. Results: Forty‐five eligible papers were included. Guided self‐determination was applied in full‐ or small‐scale, or combined with another intervention or approach in different healthcare settings handling, for example diabetes, stroke survivorship, schizophrenia, attention‐deficit hyperactivity disorder and medical disorder, gynaecological and breast cancer, endometriosis, persons with chronic pain, persons in haemodialysis and intensive care survivors. The included studies covered 12 randomised trials, 26 qualitative and seven papers of different methodology. A statistically significant effect was found in three trials. Six main themes describe the qualitative findings across papers on patients: (1) Guided self‐determination reduces disease‐related loneliness, (2) Insight enables integration of life and disease, (3) Reflection sheets—appreciated but challenging tool to prompt insights and person‐specific knowledge, (4) New person‐specific knowledge enables person‐centred support, (5) Feeling seen and believed in a new and trusted relationship and (6) Exchange of knowledge enables the development of life skills. Four themes describe the healthcare professionals' experience: (1) Change of usual practice—a decision from above, (2) A new role—unlearning previous behaviour and need for support, (3) Reflection sheets as facilitators and barriers and (4) Discovering the benefits of changing to a person‐centred approach. Conclusion: Overall, guided self‐determination proved to have a great impact on patient important outcomes and was useful and well‐accepted by the majority of patients and healthcare professionals. Albeit guided self‐determination is not a 'one size fits all' method. Continuous training and supervision of professionals are a necessary mean when implementing guided self‐determination to enhance adoption and sustainability in clinical practice. [ABSTRACT FROM AUTHOR]

In appraising human actions, an important consideration is whether they are free. If they are compelled, this may be excusatory; if controlled by someone other than the agent, this may mitigate; and if selfishly motivated, this may invalidate excuses. Moral appraisals of action by non‐philosophers do not normally consider whether it can be free under determinism. Metaphysical inquiry about action, by contrast, seems incomplete if it does not consider this. Are there two free will problems, one normative and one metaphysical? If so, they share such terms as ‘could’ and ‘could not’, and thoughtful non‐philosophers question their own normative assumptions once they understand the metaphysical problem determinism poses for the philosophy of action. This paper distinguishes metaphysical from action‐theoretic elements of the free will problem but also connects the metaphysical issues with normative questions about responsibility; it critically appraises some major metaphysical arguments concerning free action; and—to the extent possible in a single paper—it provides a positive account of free action neutral toward determinism. [ABSTRACT FROM AUTHOR]

Whilst a body of work exists that has engaged with and conceptualised transnational fields, and in particular for this paper, the transnational field of human rights, more work needs to be done to elaborate on the effects of transnational fields, at the national level. Using Bourdieu's field theory, and more recent scholarship that focuses on scalar aspects of fields, this research focuses on a human rights field at the national level in Bahrain. The paper addresses two levels/dimensions of the transnational field of human rights: the transnational level and the national level, focussing on the field's vertical autonomy. Based upon nineteen in‐depth interviews, the research retrieves the biographical trajectories of Bahraini human rights activists and activists from iNGOs with a specific remit that includes Bahrain. The paper argues that the vertical autonomy of the transnational field of human rights has demonstrable field effects at the national level, and that this has a number of implications. First, where transnational fields have greater vertical autonomy, the national level can operate with varying hierarchies, with actors adopting practices that diverge from those acting transnationally. Second, as a result of these scalar differences and the vertical autonomy of the transnational field, actors at the national level may have to adapt their practices, others can be side‐lined as a result of 'symbolic pollution.' Third, in order for local actors to engage with transnational advocacy networks, they must be the right type of actor. [ABSTRACT FROM AUTHOR]

Currently, Aboriginal children are significantly over‐represented in the out‐of‐home‐care system. Drawing on Aboriginal trauma scholarship and decolonizing methodologies, this paper situates the contemporary state removal of Aboriginal children against the backdrop of historical policies that actively sought to disrupt Aboriginal kinship and communities. The paper draws on submissions to the 2018 Australian Senate Parliamentary Inquiry into Adoption Reform from Aboriginal community controlled organizations and highlights four common themes evident throughout these submissions: (i) the role of intergenerational trauma in high rates of Aboriginal child removal; (ii) the place of children within Aboriginal culture, kinship and identity; (iii) the centrality of the principles of self‐determination and autonomy for Aboriginal communities and (iv) Aboriginal community controlled alternatives to child removal. Acknowledging the failure of both federal and state reforms to address the issues raised in these submissions, the paper reflects on the marginalization of Aboriginal voices and solutions within contemporary efforts to address the multiple crises of the child protection system and the implications for the future of Aboriginal children. [ABSTRACT FROM AUTHOR]

Background: Nurses play a crucial role in enabling older people's autonomy in residential care. However, there is a lack of synthesised knowledge about how nurses can support older people. Objective: The aim of this study was to identify and synthesise nursing support for older people's autonomy in residential care. Methods: An integrative review was carried out by searching the CINAHL, Philosopher's index, PubMed, SocINDEX, Scopus and Web of Science databases, supplemented by manual searches. The searches focused on peer‐reviewed scientific empirical research papers published in English, without date limitations. The constant comparison method was used for the analysis. Results: The review identified 24 papers, and these showed that older people's autonomy was based on dignity. Nurses protected older people's autonomy in eight different ways. They protected their right to make their own decisions, acted as advocates, respected their wishes, provided opportunities for autonomy, fostered independence, gave information to residents and relatives, provided individualised care practices and protected older people's safety. However, there were also barriers that needed to be overcome. Conclusions: Nurses used multiple, individually tailored activities to support older people's autonomy, but they also had different reasons for supporting or hindering it. Work and leadership structures are needed to ensure that older people's autonomy is driven by ethical practices. Implications for practice: The results of this review can help nurses who provide residential care for older people to recognise the different nursing activities that can be used to support older people's autonomy and to develop strategies to apply them in different daily care situations. However, further research is needed to determine how these activities can be realised in daily care and how they cover different aspects of older people's lives in residential care. [ABSTRACT FROM AUTHOR]

The study discusses a new approach to parental agency in pediatric palliative care based on an active form of caregiving. It also explores the possibility of a positive conceptualization of parental agency in its relational context. The paper begins with an illustrative case study based on a clinical situation. This is followed by an analysis of various aspects of parental agency based on empirical studies that disclose the insufficiencies of the traditional approach to parental agency. In the next step, parental agency is analyzed from a reality‐based perspective as an activity focused on relationships and the cognitive capacity of parents vis‐a‐vis their seriously ill children. The paper also considers the importance of the cultural and social contexts in which parental agency and decision‐making take place. This agency is addressed not as individualistic in form, and nor is it exercised in terms of fixed choices. Rather, the focus is on its dynamic and future‐oriented aspects. Consequently, parental agency should be comprehended not only as a form of proxy agency representing the child's best interests but also as a complex decision‐making process in which the parents learn from their child how to become good, compassionate caregivers and at the same time good parents. [ABSTRACT FROM AUTHOR]

This paper will take as its starting point the premise that developing translational bioethics is a worthwhile endeavour. I will develop an account of translational bioethics and discuss what implications this would have for the wider discipline of bioethics and argue that this would be a useful development for bioethics. The paper will conduct a form of 'translational meta‐bioethics analysis', in the words of Bærøe. I will argue that if we are serious about instituting translational bioethics, then it will need to look and be organised in a very different way from current bioethics research, this will be a radically different form of bioethics from what we currently have. In this paper I will sketch what translational bioethics might look like. My proposal here is not that translational bioethics should supplant existing ways of doing bioethics, but rather that it should be an addition to it, another subdiscipline of bioethics. [ABSTRACT FROM AUTHOR]

The task of fostering adolescents is unique, requiring skills, qualities, and information that acknowledge each young person's particular needs. This editorial summarises a range of research in this special issue covering parenting styles, transitions out of care, child sexual exploitation, and the needs of LGBTQ and separated teenagers. Three themes emerging from the papers are discussed: autonomy and control; risk, resilience, and trauma; and relationships, identity, and stigma. [ABSTRACT FROM AUTHOR]

In 2011, bioethicists turned their attention to the question of whether prisoners on death row ought to be allowed to be organ donors. The discussion began with a provocative anti‐procurement article by Arthur Caplan and prompted responses from an impressive lineup of commentators. In the 10 years since, the situation for death‐row inmates seeking to donate has hardly changed: U.S. prison authorities consistently refuse to allow death‐row procurement. We believe that it is time to revisit the issue. While Caplan's commentators rebutted his narrow contention that organ procurement would undermine the goals of deterrence and retribution, none of them attempted to make a positive, nonconsequentialist case for organ donation as a right of death‐row inmates. That is the task we take up in this paper. After sketching and briefly defending a theory of punishment, we show how denial of organ donation is inconsistent with punishment's basic logic. [ABSTRACT FROM AUTHOR]

Skepticism about ethical expertise has grown common, raising concerns that bioethicists' roles are inappropriate or depend on something other than expertise in ethics. While these roles may depend on skills other than those of expertise, overlooking the role of expertise in ethics distorts our conception of moral advising. This paper argues that motivations to reject ethical expertise often stem from concerns about elitism: either an intellectualist elitism, where some privileged elite have supposedly special access in virtue of expertise in moral theory; or an authoritarian elitism, where our reliance on experts in ethics risks violation of autonomy and democracy. The paper sketches an anti‐elitist conception of ethics expertise in bioethics as continuous with an anti‐elitist conception of ethics expertise in common moral practice, undercutting the intellectualism, and then uses this anti‐elitist conception to reject arguments that ethical expertise violates autonomy or democracy. An anti‐elitist picture of ethical expertise both renders it consistent with our general moral practice and allows us to resist skeptical concerns. [ABSTRACT FROM AUTHOR]

Protection in the region has rapidly become a favoured durable solution to refugee situations and the hallmark of all current policies. These initiatives reflect changes in humanitarian approaches that have taken place over the past decades as the focus has shifted towards the resilience of crisis‐affected communities and the need to enable their self‐reliance. Despite the strong logic that this change will bring about more dignified solutions, the approach is easily instrumentalized. This instrumentalization is particularly evident where resilience humanitarianism meets security‐migration politics. This paper focuses on the efforts of the European Union and a number of its member states to advance so‐called protection in the region. The paper reviews the characteristics of these policies, highlights a number of risks and defines some known and lesser known implications of this approach. [ABSTRACT FROM AUTHOR]

This paper addresses bioethics in the context of the coronavirus disease 2019 (COVID‐19) pandemic. The Introduction (Section 1) highlights that at the field's inception, infectiousness was not front and center. Instead, infectious disease was widely perceived as having been conquered. This made it possible for bioethicists to center values such as individual autonomy, informed consent, and a statist conception of justice. Section 2 urges shifting to values more fitting for the moment the world is in. To find these, it directs attention to the Global South, and in particular, Africa, and to the values of ubuntu, solidarity, dignity, kinship, and humility. The paper concludes (in Section 3) that 21st‐century challenges facing bioethics are increasingly global, and calls on bioethicists themselves to be more globally inclusive in their approaches. [ABSTRACT FROM AUTHOR]

This paper offers an account of why prenatal harms seem particularly objectionable. It identifies structural similarities between key cases of prenatal harm and the recently characterized "all‐or‐nothing" problem from Joe Horton. According to the account defended by the paper, a willingness to parent incurs a duty to protect the fetus from harm. This implication provides independent support for so‐called "voluntarist" or "intentionalist" accounts of parental role obligations, according to which, roughly, a mother's autonomous choice to parent a child suffices for having the obligations distinctive of parenthood toward the child. [ABSTRACT FROM AUTHOR]

Using a specific case as an example, the article argues that the Internet allows dissemination of academic ideas to the general public in ways that can sometimes pose a threat to academic freedom. Since academic freedom is a fundamental element of academia and since it benefits society at large, it is important to safeguard it. Among measures that can be taken in order to achieve this goal, the publication of anonymous research seems to be a good option. [ABSTRACT FROM AUTHOR]

It has been argued that Thomson's defense of abortion, if successful, implies that abortion is permissible only until the point of viability. After that point, if one wanted to end a pregnancy, one must do so by birthing the fetus through induction or cesarean. In this paper, I argue that Thomson's defense of abortion does, in fact, imply that abortion after the point of viability is sometimes permissible. To show this, I point out that the process of birthing a fetus makes use of the body of the pregnant person in significant ways. Indeed, the body of the pregnant person is as much a part of this process as it is a part of the process of carrying a fetus during pregnancy. Thus, just as it is sometimes morally permissible to choose to have an abortion rather than continue a pregnancy, it is sometimes morally permissible to choose to have an abortion rather than undergo an induction or cesarean. Those who support Thomson's defense of abortion, then, have reason not to support the view that induction or cesarean are the only permissible procedures for ending an unwanted pregnancy with a viable fetus. I then use this discussion to suggest that autonomy rights are more complicated than initially thought. Given the extent to which the body is involved in detaching the fetus, it is not merely that one has a right to detach a fetus, but also a right to actualize one's reasonable preferences over the method of detachment. [ABSTRACT FROM AUTHOR]

This paper presents new developments on drone‐based automated survey for the detection of individual items or fragments of material culture visible on the ground surface. Since the publication of our original proof of concept, awarded with the Journal of Archaeological Science and Society for Archaeological Sciences Emerging Investigator Award 2019, additional funding has allowed us to implement a series of improvements to the method. These aim to improve detection capabilities and the extraction of items' shapes and increase flight autonomy, control, area covered per flight and the type of environments in which the method can be applied while reducing computing needs, processing time and expertise necessary for its application. This paper provides an account of the methods followed to achieve these objectives, their preliminary results and the current development for their implementation into a free and open‐source system that can be used by the archaeological community at large. [ABSTRACT FROM AUTHOR]

The idea of commercial‐assisted suicide lives a marginal existence in the bioethical literature, despite its significant presence in popular culture. The practice of commercial‐assisted suicide (CAS) is defined as suicide assistance performed for a financial reward through a contractual agreement between a customer and a service‐provider, who does not necessarily need to be a medical professional. While CAS does indeed offer some potential solutions regarding the moral controversies surrounding physician‐assisted suicide (PAS), I defend the idea that adopting it as policy ultimately proves morally indefensible and practically inefficient. This is due to the fact that the commodification of a given good necessarily implies the creation of a market of said good; as such, what I propose in this paper is a moral and practical evaluation of a market of CAS. In order to do so, I first examine the arguments in favor of CAS as put forward by Roland Kipke, who argues that any liberal defense of PAS necessarily implies a defense of CAS. In the first section, I argue against this idea using the liberal values of autonomy and equality of opportunity. In the second section of the paper, I argue that a market of CAS would be gravely dysfunctional due to one particular characteristic of death, namely, that is not compensable ex post. I conclude by arguing that while the practice of CAS may not prove morally problematic, the inevitable market that it will create should it be legalized most certainly will. [ABSTRACT FROM AUTHOR]

An editorial is presented on presentations offered at the International Association of Bioethics' (IAB) 15th World Congress of Bioethics (WCB) hosted by the University of Pennsylvania in June 2020. Topics include expanding beyond clinical and medical ethics to encompassing public health ethics and matters of social justice; and committed to the defense of women's human rights and the eradication of violence in all interpersonal relationships.

Watchful waiting is a concept that is traditionally not associated with severe and enduring mental illness. This paper, however, boldly argues that the concept could be used as a ground‐breaking and accessible antidote to the perceived inequality experienced by black service users experiencing both mild and severe mental illnesses in England. The novel concepts proposed in this paper are not intended to be consensual, but rather uncompromising to provoke critical thinking in mental health practice. A conceptual framework for watchful waiting in mental health is suggested. [ABSTRACT FROM AUTHOR]

Introduction: Doctors hold a prima facie duty to respect the autonomy of their patients. This manifests as the patient's 'right' not to know when patients wish to remain unaware of medical information regarding their health, and poses ethical challenges for good medical practice. This paper explores how the emergence of digital health technologies might impact upon the patient's 'right' not to know. Method: The capabilities of digital health technologies are surveyed and ethical implications of their effects on the 'right' not to know are explored. Findings: Digital health technologies are increasingly collecting, processing and presenting medical data as clinically useful information, which simultaneously presents large opportunities for improved health outcomes while compounding the existing ethical challenges generated by the patient's 'right' not to know. Conclusion: These digital tools should be designed to include functionality that mitigates these ethical challenges, and allows the preservation of their user's autonomy with regard to the medical information they wish to learn and not learn about. [ABSTRACT FROM AUTHOR]

Background: Despite the significant emphasis on self‐determination in special education and the crucial role of mobile learning, there is a notable absence of path modelling studies that explore the effect of self‐determination on the usage of mobile learning by students with special needs. Objectives: This study sought to investigate the intentions of mobile learning usage among students with special needs by proposing a model rooted in the technology acceptance model, complemented by extraneous constructs from self‐determination theory (competence, autonomy and relatedness). Methods: The data of the study was obtained online from 1298 special needs university students with eight different types of disabilities. Data were analysed with descriptive statistics, confirmatory factor analysis, structural equation modelling and bootstrapping. Results and Conclusions: The proposed model explained 78.4% of ease of use, 85.2% of usefulness, and 76.5% of intention. 11 of the 12 hypotheses tested within the scope of the model were supported. All hypotheses examining the impacts of self‐determination theory constructs on ease of use, usefulness, and intention were validated (8 hypotheses), with the exception of the autonomy → intention relationship. Substantial empirical evidence has been acquired to support the role of the self‐determination theory in exploring the intention toward mobile learning among university students with special needs. Concurrently, a robust theoretical framework has been introduced to the field of special education to elucidate the acceptance and utilization of technology by university students with special needs. Lay Description: What is already known about this topic: Numerous studies have demonstrated the significance of mobile tools and mobile learning in the realm of special education.Self‐determination holds immense importance in fostering independence and social engagement by empowering individuals with special needs to gain confidence, assume control and accountability for their own choices and actions.Self‐determination theory underscores the importance of providing individuals with support for three fundamental psychological needs—autonomy, competence, and relatedness—to foster healthy development. What this paper adds: To the best of the authors' knowledge, this study stands as a unique contribution within its field due to its distinctive characteristics. The model, supported by exceptionally successful outcomes and its ability to elucidate technology acceptance constructs at remarkably high levels, offers a robust theoretical framework for enabling students with special needs to engage effectively with mobile learning in both special and inclusive educational settings.Investigating how self‐determination theory enhances the explanatory power of the technology acceptance model in special education.Illuminating the significance of basic psychological needs in the adoption of mobile learning, employing advanced statistical methods with a substantial participant base, and delivering valuable insights to advance the utilization of mobile learning in special education. Implications for practice and/or policy: Special education settings should encourage students to take initiative, make choices, and exercise autonomy, and curriculum design should include opportunities for students to make choices.Making students part of the design processes and emphasizing usability through the prioritization of customizable, user‐friendly designs should be an inherent aspect of educational technology.Educators and support staff must have training and professional development opportunities to effectively use mobile learning tools and create inclusive learning environments. [ABSTRACT FROM AUTHOR]

The context of this paper is family situations where young people are experiencing significant behavioural and emotional problems. Based on a qualitative study, it offers an empirical and theoretical contribution to the understanding of family‐related factors that promote or hinder behaviour change. Data were collected through face‐to‐face, semi‐structured group interviews with nine families (28 participants), all of them mandatory recipients of child welfare services in Croatia. Thematic analysis comprised primary coding designed to elicit information about individual family members' capacity for change and secondary coding of family‐level phenomena. The results indicated 10 phenomena that were judged to represent factors that helped or hindered change. The discussion section suggests three broad categories of capacity to change at family level (Goals and Priorities; Problem solving dynamics; and Development of role relationship). This analysis is offered as the basis for an examination of the concept of family capacity for change. [ABSTRACT FROM AUTHOR]

In recent decades, the neuroscientific community has moved from describing the neural underpinnings of mental phenomena—as characterized by experimental psychology and philosophy of mind—to attempting to redefine those mental phenomena based on neural findings. Nowadays, many are intrigued by the idea that neuroscience might provide the “missing piece” that would allow philosophers (and, to an extent, psychologists, too) to make important advances, generating new means that these disciplines lack to close knowledge gaps and answer questions like “What is Free Will?” and “Do humans have it?.” In this paper, we argue that instead of striving for neuroscience to replace philosophy in the ongoing quest to understanding human thought and behavior, more synergetic relations should be established, where neuroscience does not only inspire philosophy but also draws from it. We claim that such a collaborative coevolution, with the two disciplines nourishing and influencing each other, is key to resolving long‐lasting questions that have thus far proved impenetrable for either discipline on its own. [ABSTRACT FROM AUTHOR]

Objective: To systematically review evaluated local, community or peer‐delivered well‐being and employment interventions delivered within regional, rural and remote Australia. Design: Searches within nine databases retrieved peer‐reviewed and grey literature from an initial pool of 3186 papers published between 2012 and 2022. PRISMA guidelines were adhered to, and the Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the well‐being or employment (or both) articles. Findings: A total of 19 items met the inclusion criteria, which included two quantitative, 12 qualitative and five mixed‐methods evaluations. Intervention cohorts included Indigenous Australians, youth, older people, workers and the general community. The average methodological rating was 83%. The overall level of evidence for the interventions was low due to mostly descriptive studies. Discussion: Interventions that appeared effective in improving well‐being tended to focus on addressing social connectedness and self‐determination. Unexpected employment outcomes were evident across many of the studies, which highlighted the reciprocity between well‐being and employment. Conclusion: This review highlights promising interventions for improving well‐being by focusing on social connectedness and self‐determination. Further empirical evidence is encouraged to explore the reciprocal relationship between well‐being and employment, emphasising the significance of social connectedness and self‐determination in this context. [ABSTRACT FROM AUTHOR]

'Big Data' digital technologies are beginning to make inroads into peasant agriculture in the Global South. Of particular importance is the subset of technologies that appropriate agricultural decision‐making, here theorized as surveillance agriculture. These technological regimes aspire to not only remove decision‐making from the farmer, but eventually to replace the farmer with, for instance, 'autonomous' tractors. This paper looks ahead to ask what a technological trajectory that aspires to autonomy for the tractor may portend for autonomy for the peasant farmer. It compares surveillance agriculture to other forms of surveillance capitalism, noting that it shares a will to not only sell products and services but to manipulate behaviour but differs in that the behaviour being manipulated is professional productive behaviour. The paper surveys the vested interests of the entities behind surveillance agriculture and asks how informational relations of production may be changed between farmers and these entities. It then examines the informational relations of production among peasant farmers that may be interdicted by surveillance agriculture, especially the group‐level decision‐making dynamics that make 'individual autonomy' a misnomer. But surveillance agriculture is resolutely individualized, which raises concerns for peasant decision‐making autonomy. [ABSTRACT FROM AUTHOR]

In the debates regarding the ethics of human enhancement, proponents have found it difficult to refute the concern, voiced by certain bioconservatives, that cognitive enhancement violates the autonomy of the enhanced. However, G. Owen Schaefer, Guy Kahane and Julian Savulescu have attempted not only to avoid autonomy‐based bioconservative objections, but to argue that cognition‐enhancing biomedical interventions can actually enhance autonomy. In response, this paper has two aims: firstly, to explore the limits of their argument; secondly, and more importantly, to develop a more complete understanding of autonomy and its relation to cognitive enhancement. By drawing a distinction between the capacity for autonomy and the exercise and achievement of autonomy, and by exploring the possible effects of cognitive enhancement on both competence and authenticity conditions for autonomy, the paper identifies and explains which dimensions of autonomy can and cannot, in principle, be enhanced via direct cognitive interventions. This allows us to draw conclusions regarding the limits of cognitive enhancement as a means for enhancing autonomy. [ABSTRACT FROM AUTHOR]

The episode of Chauntecleer's dream found in Chaucer's "The Nun's Priest's Tale" is a controversial topic for Chaucer critics. Some critics argue that the downfall‐escape experience of Chauntecleer is worthy of investigation because animal figures in fables symbolize people (Finlayson, 2005, 495) and thus their rise and downfall sometimes allude to certain theological or philosophical issues such as the original Fall of Adam and Eve (Payne, 1976, 211–112). Other critics propose, on the contrary, that the episode of Chauntecleer is a "joke" and therefore should not be overestimated (Eliason, 1972, 172). These two opposing perspectives have their own rationale; nevertheless, the centrality of Chauntecleer's dream to the narrative of "The Nun's Priest's Tale" is hard to ignore. Considering the philosophical reverberations of the tale concerning the medieval concepts of destiny and free will, this paper argues that the Chauntecleer episode is not a "joke" but a philosophical exemplar that proposes the absence of any demarcating lines between destiny and free will, bearing in mind that destiny refers to the many options decreed by the deity to be available in every single situation for each individual, while free will refers to humans' freedom to decide what to say and do. The paper contends that Chauntecleer's dream shows how free will and destiny—though they are "inconsistent" forces (Boethius, 1785, 195)—mysteriously connive together to form what can be called conditional free will. [ABSTRACT FROM AUTHOR]

Supporters of opt‐in organ procurement policies typically claim that the absence of consent to postmortem transplantable organ retrieval is a normative barrier to such retrieval. On this ground, justification of opt‐out policies is demanded. The paper shows that postmortem organ retrieval is normatively different from live organ removal, and so the doctrine of informed consent does not apply to it in the way it does in other types of cases. First, seen as the instrument of protection of autonomy or the right to self‐determination, informed consent cannot be relied on in the case of dead persons; secondly, viewed as an instrument of annulment of harm or wrong to the dead (volenti non fit injuria), informed consent relies on indefensible accounts of posthumous harm or wrong. Postmortem organ retrieval in cases of absence of the decedent's consent and refusal is governed by other norms than those related to consent. Such norms include, among others, respectful treatment of human remains (such as those found in regulations of medicine, law enforcement, and research) and avoidance of inherently wrong contexts and purposes (such as killing for the purpose of organ retrieval or trade in the human body or its parts). It is concluded that the onus probandi is on the supporters of opt‐in, rather than opt‐out, policies of posthumous organ retrieval. [ABSTRACT FROM AUTHOR]

Distressed couples often become polarized and caught up in power struggles, with competing claims and perspectives. When escalated, partners may become reactive and unkind. The competitive‐individualistic worldview of the Euro‐American culture feeds polarization between partners. This article explores relational views of the self and relational ethics developed in philosophy, psychology, feminist theory, neurobiology, and couple and family therapy that counter this individualistic view. A major focus is on the ways in which partners impact each other's identity and well‐being for better or worse, and the ethical responsibility this entails. The discussion addresses couple relational ethics within the larger sociocultural context that privileges power and competition. The paper offers applications to couple relationships and couple therapy, with interventions to promote mutual responsibility, fairness, dialogue, and care—helping partners to identify their higher values and interact with greater intentionality. A case example is offered to illustrate therapeutic techniques to enhance relational ethics in couples. [ABSTRACT FROM AUTHOR]

Consensual homicide remains a crime in jurisdictions where active voluntary euthanasia has been legalized. At the same time, both jurisdictions, in which euthanasia is legal and those in which it is not, recognize that all patients (whether severely ill or not) have the right to refuse or withdraw medical treatment (including life‐saving treatment). In this paper, I focus on the tensions between these three norms (the permission of active euthanasia, the permission to reject life‐saving treatment, and the prohibition of consensual homicide), assuming a justification of euthanasia based on the right to (personal) autonomy. I argue that the best way to provide a coherent account of these norms is to claim that patients have two distinct rights: the right to autonomy and the right to bodily integrity. This solution has some relevant implications for the discussion of the legalization of active euthanasia. [ABSTRACT FROM AUTHOR]

Supporting older adults in their desire to remain in an independent living environment requires a collaborative, interprofessional approach in which the individual's medical and social needs are coordinated. This approach requires recognizing the difference in the culture of care between primary care and communitybased organizations. Identifying how the two cultures differ may be the first step to learning how to work collaboratively and effectively to meet the social and medical needs of older adults. In this paper, we describe the rationale and process for integrated primary and community-based care in a comprehensive restructuring of care for older adults as well as recommendations for implementation. [ABSTRACT FROM AUTHOR]

Five countries now permit organ donation after euthanasia, on the basis of respecting donor autonomy. Some now openly consider performing euthanasia itself via organ extraction to better preserve organ viability, albeit in violation of the dead donor rule. Proponents argue that respect for patient autonomy requires this option; the dead donor rule is inapplicable since it fulfills donors' wishes. Other ethical arguments, not addressed herein, explore issues including dying at home, impact on clinicians, and societal faith in donation enterprise, but these concerns are not insurmountable. This paper instead solely critiques proponents' oversimplified understanding of autonomy with an autonomy‐based argument against any linkage of organ donation and euthanasia, regardless of its timing. Respect for patient autonomy does not unilaterally require fulfilling patients' every wish. Moreover, the very possibility of organ donation with euthanasia limits donor autonomy qualitatively and quantitatively substantially more than by offering it. In fact, organ donation after euthanasia violates the purpose of the dead donor rule, even if not its technicalities. [ABSTRACT FROM AUTHOR]

Background: Although advance care planning (ACP) for persons with dementia (PWD) can promote patient‐centered care by aligning future healthcare with patient values, few PWD have documented ACPs for reasons incompletely understood. The objective of this paper is to characterize the perceived value of, barriers to, and successful strategies for completing ACP for PWD as reported by frontline clinicians. Methods: Qualitative study using semi‐structured interviews (August 2018–December 2019) with clinicians (physicians, nurse practitioners, nurses, social workers) at 11 US health systems. Interviews asked clinicians about their approaches to ACP with PWDs, including how ACP was initiated, what was discussed, how carepartners were involved, how decision‐making was approached, and how decision‐making capacity was assessed. Results: Of 75 participating generalist and specialty clinicians from across the United States, 61% reported conducting ACP with PWD, of whom 19% conducted ACP as early as possible with PWD. Three themes emerged: value of early ACP preserves PWD's autonomy in cases of differing PWD carepartner values, acute medical crises, and clinician paternalism; barriers to ACP with PWD including the dynamic and subjective assessment of patient decision‐making capacity, inconsistent awareness of cognitive impairment by clinicians, and the need to balance patient and family carepartner involvement; and strategies to support ACP include clarifying clinicians' roles in ACP, standardizing clinicians' approach to PWD and their carepartners, and making time for ACP and decision‐making assessments that allow PWD and carepartner involvement regardless of the patients' capacity. Conclusions: Clinicians found early ACP for PWD valuable in promoting patient‐centered care among an at‐risk population. In sharing their perspectives on conducting ACP for PWD, clinicians described challenges that are amenable to changes in training, workflow, and material support for clinician time. Clinical practices need sustainable scheduling and financial support models. [ABSTRACT FROM AUTHOR]

Background: Mobile‐assisted language learning (MALL) has long been advocated to promote students' language study outcomes. However, little is known about how using instant messaging applications (an example of MALL) affect student motivation, language anxiety, and actual achievement. Objectives: To help close this gap, we have conducted a quasi‐experimental study, in which we have used self‐determination theory to test a mediational process model, in an effort to understand the psychological mechanisms that underlie the effect of instant messaging applications on student outcomes. Methods: Two groups of Saudi undergraduate students (N = 447) were recruited to participate in the study. Participants under the experimental condition were invited to engage in language‐related tasks with their teacher outside of class through the WhatsApp application, whereas participants under the control condition received standard teaching. We applied partial least square structural equation modelling (PLS‐SEM) to test our model. Results and Conclusions: The results of the PLS‐SEM showed that the total effects of using instant messaging applications on autonomous motivation and L2 achievement were significant but that language anxiety was influenced only indirectly and negatively through language achievement. Also, the PLS‐SEM showed that our results have strong predcitive power indicating support for external validity. Implications: Our results show that instant messaging applications can be used to facilitate interest and achievement and to decrease anxiety. Furthermore, we are contributing to L2 methodological literature by using applications of PLS‐SEM in experimental designs that can help researchers and practitioners of motivational processes. Lay Description: What is already known about this topic: Using WhatsApp and more broadly instant messaging applications are conceived to be motivating in language teaching contextStudies indicate students are inclined toward using these applications in language learningResearch shows that using WhatsApp is easy to apply for language teaching purposes What this paper adds: The study examined the effect of using WhatsApp on language learners' motivation, achievement, and language anxietyA pre‐ and post‐test approach with experimental and control condition has been used to evaluate the effect more accuratelyThe study employs Self‐determination Theory as a theoretical framework for testing a motivational process modelResults show that using WhatsApp predicted the outcomes directly and indirectly Implications for practice and/or policy: WhatsApp can significantly encourage university students to better learning of the language skills especially in times where face‐to‐face communication is limitedWhatsApp is conditioned by the guidance of instructors, their ongoing formative and summative assessmentWhatsApp appears to allow students enjoy their learning process due to the opportunities for collaborative work and constant exchange of content [ABSTRACT FROM AUTHOR]

This paper offers a theoretical analysis of Self‐Determination Theory (SDT) and its claims regarding human autonomy. Self‐determination theorists have advanced a form of self‐regulated, engaged behavior (i.e., autonomy), founded upon on a consilient account of human motivation that assumes multiple, hierarchical levels of organization and causation (e.g., biological, psychological, and social). Autonomy, from this perspective, is taken to emerge from underlying biological mechanisms, but also able to exert its own causal effects in the world as a unique psychological phenomenon. We contend that in theorizing this way, self‐determination theorists have invoked a mixed discourse of mechanism and autonomy that leaves important questions unanswered, perhaps most importantly those concerning how autonomy as a kind of volition can fit coherently in the mechanistic account of world that they advocate. We then offer an alternative perspective based upon the work of various hermeneutic‐phenomenological thinkers in philosophy and psychology. This alternative perspective conceptualizes human phenomena such as autonomy and motivation in agentic terms, emphasizing meaningful participation in possibility‐laden contexts of everyday practices. [ABSTRACT FROM AUTHOR]

Research Question/Issue: This paper examines the effect of additional independent directors' attributes, beyond formal independence, on earnings management practices. Research Findings/Insights: I find that being non‐busy, having accounting expertise, and being appointed by non‐controlling shareholders are relevant directors' attributes—beyond formal independence—in their earnings management monitoring task, among the directors' attributes I have tested. Additionally, the paper shows that independent directors who possess such features simultaneously outclass all other directors—included the touted effective formally independent directors—in mitigating earnings management activities. Theoretical/Academic Implications: I respond to calls for dismantling common wisdom on board independence, investigating factors leading to better monitoring, showing that independent directors are not all‐alike. With specific reference to directors' monitoring task, when controlling for additional directors' attributes, formal independence becomes uninfluential in constraining earnings management activities. I also show that the co‐existence of attributes makes independent directors more effective relative to board mates not sharing such attributes. Practitioner/Policy Implications: Findings of this work might be useful for practitioners in attempting to design corporate governance mechanisms better able to monitor earnings management practices through independent directors and may serve as a stimulus for regulators when re‐thinking regulations on board composition and structure. [ABSTRACT FROM AUTHOR]

Aim: In this paper, we critically discuss the ethics of nurses' choice to strike during the COVID‐19 pandemic, considering legal and ethical arguments, overlaying the Ubuntu philosophy, an African ethic. Background: The recent unprecedented coronavirus disease pandemic and the increased reports on the absence of personal protective equipment in South Africa places many health workers' lives at risk. Nurses spend most of their time with patients, which exposes them to fatal risks as they work in unsafe environments. Research Methods: Exploratory literature review was conducted using Pubmed, CINAHL, Google Scholar and Science Direct) and law cases repository. Findings: Nurses thus may be justified in striking to protect their safety. State healthcare entities are obliged to ensure safety and protect the health of professionals during the pandemic. According to their Code of Practice and Pledge of Service, they are ethically obliged to put patients first, and as a result, they are legally barred from engaging in strike action. Conclusion: We conclude that there may be constitutional human rights arguments to support strike action. We also find that ethical principles alone do not provide clear direction to guide nurses in making justified and ethical decisions regarding service provision in an environment threatening to compromise their safety. [ABSTRACT FROM AUTHOR]

This paper critically analyses 'the paradox of autonomy and consent in maternity care'. It argues that maternity care has certain features that increase the need for explicit attention to, and respect for, both autonomy and rigorous informed consent processes. And, moreover, that the resulting need is considerably greater than in almost all other areas of medicine. These features are as follows: (1) maternity care involves particularly socially sensitive body parts that are regularly implicated in consent‐centred procedures, as well as in unconsented interventions, in ordinary, non‐medical life; and (2) much of maternity care (especially intervening in childbirth) is medically unique, in that it harms one patient (the mother) not primarily for the promotion of her own health but for the benefit of another (the baby). The apt comparison, within medicine, is therefore with non‐therapeutic research and transplantation medicine—both of which have elevated consent requirements characterized by very rigorous consent processes. At the same time—and this delivers the titular paradox—the importance of autonomy and consent in maternity care is at particular risk of being denied or disregarded. Jointly, these considerations make a very strong case for change: attention to and respect for autonomy and consent should be (1) core values; (2) key points of practical attention in the years ahead; and (3) central quality indicators in maternity care. [ABSTRACT FROM AUTHOR]

In recent decades, researchers have attempted to prospectively identify individuals at high risk of developing psychosis in the hope of delaying or preventing psychosis onset. These psychosis risk individuals are identified as being in an 'At‐Risk Mental State' (ARMS) through a standardised psychometric interview. However, disclosure of ARMS status has attracted criticism due to concerns about the risk–benefit ratio of disclosure to patients. Only approximately one quarter of ARMS patients develop psychosis after three years, raising concerns about the unnecessary harm associated with such 'false‐positive' results. These harms are especially pertinent when identifying psychosis risk individuals due to potential stigma and discrimination in a young clinical population. A dearth of high‐quality evidence supporting interventions for ARMS patients raises further doubts about the benefit accompanying an ARMS disclosure. Despite ongoing discussion in the bioethical literature, these concerns over the ethical justification of disclosure to ARMS patients are not directly addressed in clinical guidelines. In this paper, we aim to provide a unified disclosure strategy grounded in principle‐based analysis for ARMS clinicians. After considering the ethical values at stake in ARMS disclosure, and their normative significance, we argue that full disclosure of the ARMS label is favoured in the vast majority of clinical situations due to the strong normative significance of enhancing patients' understanding. We then compare our framework with other approaches to ARMS disclosure and outline its limitations. [ABSTRACT FROM AUTHOR]

As more jobs require employees to continually learn and adapt, empowering employees to adopt learning goals becomes a competitive advantage. Although research has identified key leadership behaviors that empower employees, the relationship between managers and empowered employees is ongoing and dynamic. Therefore, it is important to understand how key leadership behaviors interact with employees in their current state of empowerment to influence learning and performance. In this paper, we draw from self‐determination theory to argue that the way employees perceive a given leadership behavior will differ by dimension of empowerment, and these perceptions impact their intrinsic motivation to learn. Specifically, employees who are high in competence and impact will perceive the leadership behavior of goal clarity as controlling, and be less likely to set learning goals, while those who are high in autonomy and meaning will perceive the same behavior as supportive, and be more likely to set learning goals. In a time‐lagged study of 349 salespeople, we find that goal clarity acts as a boundary condition by weakening the relationship between empowerment and learning goal orientation (LGO) for those high on the competence and impact dimensions. As hypothesized, we find that the same behavior of goal clarity actually strengthens the relationship for those high on the autonomy and meaning dimensions. Further, we provide theoretical and empirical evidence that LGO mediates the relationship between empowerment and adaptive selling. [ABSTRACT FROM AUTHOR]

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This paper offers a critical perspective on the debate surrounding autonomy at work for a specific category of non‐standard workers: independent professionals. The increasing numbers now working this way as well as their spread into all sectors, industries and occupations, mean that their work arrangements can no longer be dismissed as non‐standard or atypical. Defining them by what they are not is quite simply no longer an option. Our paper examines the various components intertwined behind the taken‐for‐granted concept of autonomy. Drawing on debates from the legal through to the sociological and HR literatures, we identify three underlying dimensions to autonomy. When combined, they provide the basis for an analytical matrix that may assist policy makers, practitioners and individual workers to understand the challenges and opportunities linked to new ways of working. [ABSTRACT FROM AUTHOR]

Relations between First Nations and the Commonwealth government are in a parlous state in Australia, and the Commonwealth government's response to the Uluru Statement from the Heart has prompted much criticism from First Nations leaders. This paper examines the impact of one of the significant changes made by the Abbott government, the machinery of government change placing Indigenous Affairs into the Department of Prime Minister and Cabinet, with a Minister for Indigenous Affairs sitting in Cabinet. It considers the rationale for the move and explores the implications of the loss of a 'shadow team' function and the placement of a sensitive portfolio in the highly politicised environment of a central agency. Given that the current governance arrangements are not 'fit for purpose', the paper notes the call by First Nations organisations in the Redfern Statement for the establishment of a stand‐alone Department of Aboriginal and Torres Strait Islander Affairs, and recommends adoption of this as a partial government response to demands for First Nations self‐determination. This paper examines the impact of the machinery of government changes which placed Indigenous Affairs into the Department of Prime Minister and Cabinet in 2013, and considers the restoration of a stand‐alone Department of Aboriginal and Torres Strait Islander Affairs as a partial government response to demands for First Nations self‐determination. [ABSTRACT FROM AUTHOR]

In 2020, due to the Nightingale year and COVID‐19 crisis, nursing is in the public eye more than ever. Nurses often are being seen as compassionate helpers. The public image of nursing, however, also consists of stereotypes such as nursing being a 'doing' profession and care being a 'female' characteristic. Next to that, nursing is associated with images from the past, such as 'the lady with the lamp'. Therefore, in the public eye at least, the nursing identity seems a simple and straightforward enough construct, but nothing less is true. Looking at what a professional identity consists of, historic and social developments influence a group identity as a construct. In addition, individual, professional and contemporary societal moralities, including stereotypes, play its role. Nurses themselves reinforce stereotypes in order to fit into what is expected, even when they believe professional behaviour encompasses other features. They may do so individually as well as in a group context. But nursing actually seems to be better off when viewed upon as a diverse, autonomous profession. Moral values such as compassion motivate nurses to enter the profession. Research shows that if such values are addressed in daily practice, nursing could perhaps be saved from nurses leaving the profession because of feeling unfulfilled. Another aspect concerns the huge nursing body of knowledge. If seen as the ground on which nursing behaviour is standing, it would contribute to a different image of nursing than simplified stereotypes, which do not acknowledge the complex nature of the profession. This paper challenges the idea that the nursing identity is unchangeable and the notion that 'a nurse will always be a nurse'. By doing so, the paper contributes to a debate on the supposed 'true' nature of the nursing identity and opens a discussion on the need for it to change. [ABSTRACT FROM AUTHOR]

Autonomy arrangements short of secession have been popular among international actors as a solution to deadly self‐determination conflicts. However, the number of peace agreements incorporating autonomy, while clearly eliminating the possibility of secession, is limited in practice. According to the literature, this is because: (1) ethnic rebels are too weak militarily to extract substantial concessions from national governments; and (2) because the governmental offer of autonomy is not credible to rebels. Drawing upon the single case study of Aceh, this research examines how warring parties overcome these two obstacles and successfully settle ethnonational conflicts through autonomy. First, although ethnonational conflicts do not tend to be costly over a single year, they often last for decades, and the accumulation of this cost over years can be substantial. In light of this long‐term cost, national governments have incentives to offer substantial concessions to stop the conflict from persisting indefinitely. Second, rebels could sign the agreement if they perceive that their autonomy is internationally guaranteed in the long term. It is imperative for international policy makers to consider these points when they try to help resolve ethnonational conflicts through autonomy. Through the single case study of Aceh, this paper has investigated specific mechanisms warring parties in ethnonational conflicts could use to overcome the two obstacles for conflict resolution identified in the literature: no bargaining range, and commitment problems. [ABSTRACT FROM AUTHOR]

Community engagement is increasingly defended as an ethical requirement for biomedical research. Some forms of community engagement involve asking the consent of community leaders prior to seeking informed consent from community members. Although community consent does not replace individual consent, it could problematically restrict the autonomy of community members by precluding them from research when community leaders withhold their permission. Community consent is therefore at odds with one of the central principles of bioethics: respecting autonomy. This raises the question as to how community consent can be justified or even required. This paper aims to provide an answer to this question by arguing, based on the work of Taylor and Kymlicka, that community practices are important for the identity and autonomy of community members. When these practices are incompatible with a solitary focus on individual informed consent, they need to be protected by making these decision‐making practices (including asking permission to community authorities) part of the consent process. Since these decision‐making practices are important for the autonomy of community members, community consent with the goal of protecting these practices is not necessarily in conflict with autonomy. [ABSTRACT FROM AUTHOR]

Background: Despite strong evidence supporting the expansion of midwife‐led unit provision, as a result of optimal maternal and perinatal outcomes, cost‐effectiveness, and positive service user and staff experiences, scaling‐up has been slow. Systemic barriers associated with gender, professional, economic, cultural, and social factors continue to constrain the expansion of midwifery as a public health intervention globally. This article aimed to explore relationships and trust as key components of a well‐functioning freestanding midwifery unit (FMU). Method(s): A critical realist ethnographic study of an FMU located in East London, England, was conducted over a period of 15 months. Recruitment of the 82 participants was purposive. Data collection included participant observation and semi‐structured interviews, and data were analyzed thematically along with relevant local guidelines and documents. Results: Twelve themes emerged. Relationships and Trust were identified as a core theme. The other 11 themes were grouped into six families, three of which: Ownership, Autonomy, and Continuous Learning; Team Spirit, Interdependency, and Power Relations; and Salutogenesis will be covered in this paper. The remaining three families: Friendly Environment; Having Time and Mindfulness; and Social Capital, will be covered in a separate paper. Conclusions: A relationship‐based model of care was crucial for both the functioning of the FMU and service users' satisfaction and may offer a compelling response to high levels of stress and burnout among midwives. [ABSTRACT FROM AUTHOR]