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PubMed1993

Qualitative approaches in nursing research. Phenomenology: the method.

Anderson (1989) argued that the proper focus for phenomenological nurse researchers is working out the problems and dilemmas of doing phenomenology well, rather than pondering the possibilities of triangulated research. Among those problems are questions concerning how and when one "brackets," how the researcher's self is featured, and the issue of rigor in analysis of phenomenological data. In accord with this position, the overview of phenomenological method in this chapter reveals a need to continue development of a phenomenology that produces nursing knowledge to guide nursing practices. It has been proposed that the qualities and characteristics of the researcher-researched relationship are particularly important to reconsider. The commonalities of the various phenomenologies that are engaging nurse researchers have been emphasized; their variations serve to raise methodological questions, redirecting us to yet another look at philosophical foundations for our science. The very subject matter of phenomenology is described variously. Some phenomenologies specify that the subject matter is such experiences as being in pain, doubting treatment, hoping to be well again, recovering from illness, or preparing for discharge. However, it may also be the mode of doubting or hoping, or it may be a focus on ways that it is possible to be in the world, such as what it is like to parent a child with a chronic illness, for example. The product of phenomenological inquiry, the description of experience, is inescapably interpretive, but the extent of the interpretation is another variability among the phenomenologies. However, to the extent that the description is an effective communication of insights into human experience, its relevance is immediate and direct. As a particular qualitative approach in nursing research, phenomenology has the distinction of turning the researcher on the self, that is, on his or her own reflective and intuitive grasp of experience. The researcher's direct experience constitutes the data, whether immediate or vicarious. It also has the distinction of deliberate modification by nurses for its use in nursing. This is a fortuitous development well worth our attention as the qualitative paradigm in nursing continues to gain momentum in revolutionizing our science and our practice.

Consciousness↗
PubMed2006

Ethical principles--emergency medicine.

Neither law nor religion, bioethics absorbs and applies elements of both. Its theories, principles, and methods stem from various philosophical schools. Practitioners use case-based reasoning to apply bioethics to clinical situations, usually giving most weight to patients' autonomy and values, but also incorporating other relevant bioethical principles, including those encompassed in professional oaths and codes. Emergency clinicians must be able to recognize bioethical dilemmas, have action plans based on their readings and discussions, and have a method through which to apply ethical principles in clinical settings. This article provides an overview of ethical considerations and guidelines for emergency clinicians.

Bioethical Issues↗
PubMed2002

The philosophical background: from principles to rules and analysis.

Encounters between doctors and patients are subtle but complex forms of social interaction. Attempts to regulate aspects of the doctor-patient relationship have a long history. Initially, the production of guidance on principles and conduct was the domain of practitioners. In the 21st century, modern medical ethics still reflects some of this traditional thinking even though the responsibility for formulating ethical guidance increasingly falls to policy-makers, lawyers and theoreticians rather than doctors. Ethical concepts are also increasingly interwoven with contemporaneous concepts of patient autonomy, human rights and law. In a brief and necessarily sketchy overview of some of the key influences on European ethical development, this article traces the development of medical ethics through three broad stages: from principles to rules to providing tools for detailed moral analysis. It also discusses whether the original Hippocratic principles still find echo with modern doctors.

Bioethics↗
PubMed2005

Seeing the mind: considerations on visual metaphors of the mind in Western thought (16th-18th centuries).

Throughout the centuries, in Western culture, scientists, philosophers, and artists have been fascinated by the working of the mind. They have attempted to translate this into visual models that are able to provide tangible references to otherwise abstract concepts. These metaphors are deeply rooted in culture and their significance encompasses ideas which shape and characterize different epochs. With a consideration of visual models of the mind developed in Western thought during the 16th and 18th centuries, this article aims to provide an overview of some of the most significant metaphors developed to illustrate the working of the mind and highlight their broader cultural significance. Generally, models used to describe the brain, and consequently to conceptualize the mind, match the most recent technical achievements or important cultural developments. They illustrate the processes through which material reality and the self are perceived and represented. This article shows how these models betray broader cultural concerns and testify to the zeitgeist of an epoch.

Brain↗
PubMed1977

The biology of aging: 1976, an overview.

This article is a comprehensive overview of the biology of aging. The largely unproductive history of research on aging is presented, to lay the groundwork for a discussion of why such research is performed and what aging levels and human models are employed. The anatomic, biochemical, physiologic and behavioral measures used in such studies are delineated. Some of the most promising theories of aging (genetic, autoimmune, viral, free radical) are discussed, as are factors that could prolong the lifespan if optimally employed. Philosophic considerations are emphasized.

Aged↗
PubMed1988

Current status of AIDS. An overview of statistics, reporting, and at-risk populations.

The acquired immunodeficiency syndrome (AIDS) was first described in 1981. It is estimated that there have now been more than 250,000 cases worldwide, with more than 69,000 in the United States. Probably there are between 5 and 10 million people infected with the causative organism--the human immunodeficiency virus--globally. Current theory holds that the great majority of these infected persons will eventually develop AIDS. Education of high-risk populations, including minorities, is vital since there is no cure and no vaccine at present. Apart from the medical problems of AIDS, there are multitudes of legal, economic, social, philosophic, and theologic problems that the medical practitioner would be well advised to be aware of. AIDS is a threat to society as a whole. In view of current trends, the populations giving most concern for the future are intravenous drug abusers and heterosexually active teenagers and young adults.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[An exercise in mutual complementation between nurses and educators].

This article describes the strategy adopted by the Philippe Pinel Institute of Montreal in implementing the Callista Roy conceptual model. The institute, which specializes in forensic psychiatry, has some 300 patients. It is interesting to note that there are approximately twice as many therapists as nurses at the institute. This seemed at the outset to be a major stumbling block. The authors give an overview of the institute's mission, which is fourfold: health care, teaching, research and guardianship of the patients. The reasons for adopting the Roy model and the process followed are described. The primary challenge was to change the organization's corporate culture and health care philosophy. This was enormously time-consuming and required a great deal of mental energy and conscious effort on the part of the staff. To ensure successful implementation, the institute addressed not only the philosophical and policy dimensions of the model (the why), its technical aspect (the how), but also its logical and systematic dimension (the what). The article describes the elements of the model and its assumptions, with an emphasis on the various modes of adaptation to stimuli. It also looks at the training approach that was taken, the methods used to overcome resistance to change and the problems encountered. The clinical example will help readers better understand the implementation process. The subject is a 27-year-old woman, mother of a 10-year-old son and a four-month-old baby girl. She was confined to the institute by a court order after having drowned the infant while giving her a bath. The assessment process consisted of: data collection, analysis and determination of relevant stimuli, for example, the stimuli that could be manipulated, either to promote more adaptive behavior patterns, or to diminish negative responses. Normal daily and weekly activities are the means through which behavioral change can be achieved. The nursing care plan describes this in detail.

Adult↗
PubMedDate not supplied

Problems of the communicatively disadvantaged. An overview.

The article traces the attitude of various cultures through the centuries toward the hearing and speech handicapped. It outlines the early efforts to develop rehabilitative techniques for such handicaps, and describes a number of the pioneers in the field of education for the "deaf and dumb." The emergence of the opposing philosophies for training the hearing handicapped, the oral school and the signing school, and the influence these two had on the development of education for the deaf is described. The part played by basic research and the development of new instrumentation during the past 50 years in the solution of many of the problems of disordered communication is reviewed. Finally, the philosophic aims are described that led to the establishment of the Boys Town Institute for communicatively handicapped children.

Academies and Institutes↗
PubMed1998

Workshop overview: scientific and regulatory challenges for the reduction, refinement, and replacement of animals in toxicity testing.

Public concern for animal welfare has been expressed through legislative control of animal use for experimental purposes since the first legislation was introduced in 1876 in the United Kingdom. Legislative control of animal use has been introduced in virtually every developed country, with major initiatives in Europe (1986) and the United States (1966 and 1985). Advances in scientific thinking resulted in the development of the concept of the three Rs--refinement, reduction, and replacement--by Russell and Burch in 1959. The field has expanded substantially since, with specialist scientific journals dedicated to alternatives, World Congresses organized to discuss the scientific and philosophical issues, and European and U.S. validation organizations being launched. Current scientific attention is focused on validation of alternative methods. The underlying scientific principles of chemical toxicity are complicated and insufficiently understood for alternative methods for all toxicity endpoints of importance in protecting human health to be available. Important lessons have been learned about how to validate methods, including the need to have prediction models available before the validation is undertaken, the need to understand the variability of the animal-based data which is to be used as the validation standard, and the need to have well-managed validation programs. Future progress will depend on the development of novel methods, which can now be validated through international collaborative efforts.

Animal Testing Alternatives↗
PubMed2006

Women's stories of birth: a suitable form of research evidence?

In the past one to two decades, midwifery care has taken a new direction, which encompasses a valuing of women's birth experiences. This move has been contingent upon, and congruent with the adoption of 'woman centred' care and a renewed emphasis on normal birth. In line with these developments, women's stories and anecdotes of birth and midwives stories of experience increasingly form the basis of presentations at midwifery conferences and forums. Overall, this philosophical realignment, which commenced in Australia in the early 1990s, has been applauded by many midwives in terms of a greater valuing of the wishes and experiences of childbearing women and as being consistent with a greater promotion of normal birth. Nonetheless, it also gives rise to several questions, regarding the suitability of this form of research evidence. In a bid to answer some of those questions, this paper aims to evaluate the use of stories and anecdotal evidence within midwifery. First, an overview is presented of the way in which stories of pregnancy and birth appear in the literature. Secondly, the value of stories as evidence is critiqued and, finally, the ratio of story based publications, compared to traditional research methodologies, is reviewed. This review aims to address an area poorly attended in the literature and asks specifically: Are women's birth stories a suitable form of research evidence in midwifery?

Anecdotes as Topic↗
PubMed2006

The ethics of Foucault and Ricoeur: an underrepresented discussion in nursing.

Paul Ricoeur and Michel Foucault enjoy a privileged status in nursing academia as two thinkers who influence both nursing research and philosophical explorations of nursing practice. Most nurse authors, however, focus only on the earlier works of these two philosophers and, for example, base qualitative research methodologies on Foucault's genealogy and Ricoeur's hermeneutics. In their later years, both these writers talk more explicitly about being an ethical self. Ideas from their earlier writing is evident in their writing on ethics and both writers could not discuss ethics without also exploring their ideas of the self and the other. I suggest that some of their thoughts on ethics connect with or complement each other quite well. I will first give an overview of Foucault's ethics, self and the other, and then do the same with Ricoeur's thought. In the third part of the paper I will describe how Foucault and Ricoeur complement each other, and conclude the paper by briefly suggesting how these writers influence my own practice as a nurse educator.

Ethics, Nursing↗
PubMed1989

Medical ethics education: coming of age.

Medical ethics education is instruction that endeavors to teach the examination of the role of values in the doctor's relationship with patients, colleagues, and society. It is one front of a broad curricular effort to develop physicians' values, social perspectives, and interpersonal skills for the practice of medicine. The authors define medical ethics education as more clinically centered than human values education and more inclusive of philosophical, social, and legal issues than is interpersonal skills training. The authors review the history of the emergence of medical ethics education over the last 20 years, examine the areas of consensus that have emerged concerning the general objectives and premises for designing medical ethics programs, and describe teaching objectives and methods, course content, and program evaluation used in such programs on both preclinical and clinical levels. The four interrelated requirements for successful institutionalization of medical ethics education programs are defined and discussed, and the paper ends with an overview of the uncertain future of medical ethics education, an accepted but still not fully mature part of physician training in the United States. An extensive reference list accompanies the article.

Bioethical Issues↗
PubMed2001

What did we learn about national organizational collaboration at the advisory committee level?

This article provides an overview of the typical roles and tasks of advisory groups in general, followed by a discussion of the roles and tasks the Interdisciplinary Generalist Curriculum (IGC) Project Advisory Committee was asked to assume and how these were fulfilled. It analyzes the lessons learned about advisory committees as a result of the IGC Project experience. Key elements of success in fulfilling advisory committee obligations include well-defined expectations, periodic evaluations, and clear communication between project leadership and the members of the advisory committee. In the spirit of lessons learned from the IGC Project, this critique identifies several philosophical and logistic issues that might be considered in the design and implementation of future projects, such as the need to choose committed, high-energy advisory committee members who are willing to perform many complex, time-consuming tasks.

Curriculum↗
PubMed2005

Conceptualizing the world: lessons from history.

Throughout history, philosophers, scientists, and other scholars have named and organized the salient elements of the world. These efforts have led to conceptualizations that differ widely in both content and form. This paper argues that all conceptualizations are biased, both because they depend on the purposes for which they have been created, and because they are closely tied to the world view of their designers. This bias needs to be recognized, and its consequences need to be addressed if the conceptualizations are to be used for purposes other than those for which they were designed. The paper begins with a brief overview of the disciplines that have been concerned with conceptualizing particular domains. This is followed by a non-exhaustive, illustrative, historical perspective, and the paper concludes with the interesting case study of biological taxonomy.

Computational Biology↗
PubMed1999

[Al-Biruni--a universal scientist].

Al-Biruni's was of Persian descent. He was born in Horesmiya and had studied mathematics, history and medicine. Acquiring knowledge from these sciences, he wrote an outstanding work on chronology of several nations and devoted it to Ziyarit ruler Kabus. He made a chronological overview of calendars from many nations, including Persians, Greeks, Egyptians, Jews, Melkitian and Nestorian Christians, Sabeyaans as well as the old Arabs. Data presented in the work, according to the later authors, were taken from very reliable sources. He was contemporary of Ibn-Sina, and thanks to their friendship, they have discussed very much miscellaneous topics. He belonged to the group of scholars, taken by Gaznevian Soultan Mahmud to a long journey to India. Afterwards Al-Biruni wrote and published detailed work "Description of India"--a work on cultural history of India. Due to excellent abilities of Al-Biruni as a philosopher and scholar, there are still significant and reliable notes about buddhistic philosophy, structure of castes and Brahmans' life style. In this Al-Biruni's masterpiece, there are many comparative analysis of Suffism and certain Indian philosophical methods. Al-Biruni's most important work is "Pharmacopoeia"--"Kitab al-saydala", which brilliantly describes all medicaments. This work has been published in many languages. He also wrote few works on astronomy and astrology. In those works he has explained some astrological events through scientific approach in a such peculiar way that nobody has ever explained before. He was also interested in sciences like geology, mineralology, geography, mathematics, psychology and many others.

Arabia↗
PubMed2005

An early work [1910-1913] in Biological Psychology by pioneer psychiatrist, criminologist and philosopher José Ingenieros, M.D. (1877-1925) of Buenos Aires.

One of the earliest recorded works in Biological Psychology was published in 1910 by Argentine psychiatrist José Ingenieros (1877-1925), Professor of Experimental Psychology at the Faculty of Philosophy and Letters of the University of Buenos Aires. Ingenieros, a multifaceted personality and prolific author and educator famous for his lapidary aphorisms, has been considered a 'luminary' for generations. Trained as a physician, he was the first scientist to establish a comprehensive psychological system in Latin America. His long list of publications includes more than 300 titles generally divided in two periods: studies in mental pathology and criminology (1897-1908) and studies in philosophy, psychology and sociology (1908-1925). His works were never made particularly available to English-speaking audiences, despite the fact that certain of his books are still best-sellers in the Spanish-speaking world. We present an overview of Ingenieros' life and work, and a detailed account of his profoundly interesting work Principios de Psicología Biológica, in which he analyzes the development, evolution and social context of mental functions. We also provide an English translation of the Introduction contributed by Nobel laureate Wilhelm Ostwald (1853-1932) to the 1922 German edition of the work, pertinent to the energetic principles Ingenieros used and the study of Psychology as a natural science. It is a hope, 80 years after Ingenieros' parting, to bibliographically resurrect this champion of reason, who, until now, has not been given his due placement in the international psychological and biomedical literature.

Argentina↗
PubMed1999

The expert witness: defending the profession or prosecuting your peers.

The use of CRNAs as expert witnesses in court cases is well-established. The CRNA who acts as a legal consultant or an expert witness is not retained merely to pontificate in the courtroom based on their considerable experience and expertise. The CRNA will undertake many roles in the process of assisting the attorney including those of (1) record reviewer and data analyst, (2) researcher and retriever, (3) synthesizer, and (4) teacher. Beyond these roles is the philosophical premise that the person best suited to evaluate the competence of a nurse anesthetist is another nurse anesthetist. Poor practitioners who are a danger to the public ought to be held accountable for their failings, whereas excellent practitioners who are mistakenly accused of negligence ought to be defended. Although challenging and time consuming, the role of the legal consultant and expert witness is rewarding in both financial and personal satisfaction terms. The role and functions of the CRNA who takes on the challenges of appearing as an expert witness or legal consultant is explored. The fine points of medical malpractice is not discussed, except as a cursory overview. The goal is to provide the practicing CRNA with the basic tools needed for these roles.

Certification↗
PubMed1990

Neuropsychological systems deficits and the isomorphism of control.

The papers that follow are based on a symposium presented at the Twelfth European Conference of the International Neuropsychological Society held in Antwerp, Belgium between 5-8th July 1989. The symposium, using closed head injury as a vehicle, attempted to overview approaches to the study of systems function and dysfunction. Rather than concentrate on skill and subtest deficit, the papers addressed diffuse, systemic, subcortical effects and disruption of lower integration centers. They addressed the utility of neural network models to develop theory to explain deficits in behavioral integrating systems; the role of systems approaches in better understanding the overlapping clinical subsets of migraine and seizure disorders; the provision of visual examples of lateralized systemic changes associated with closed head injury through infrared thermology and the presentation of an application of biomathematical systems modeling with potent applications for diagnosis and rehabilitation. Finally the papers were discussed in terms of the clinical and philosophical issues.

Brain↗