Search

The paper contributes to the debate of the Swedish welfare state by re‐examining the view of freedom underlying the design of this welfare model. The point of departure is two interpretations by Bo Rothstein and Henrik Berggren and Lars Trägårdh, which both describe advancement of individual autonomy as the ultimate point of the model. The paper argues that these readings are overly liberal in the sense that they exaggerate the importance of individualism and autonomy. The view of freedom that shaped the Swedish welfare state was not liberal, and individual autonomy was not the overriding goal for the founders of the model. Instead, the view is best described as quasi‐republican and nondomination based. It was mostly a result of semi‐Marxist ideas about capitalist power and exploitation that lingered on in the ideology of the Swedish social democratic party, the SAP, in the 1930s and 1940s. During the first decades of the 1900s, the SAP gradually revised these ideas in a domination‐based direction. It was the outcome of this process that more than anything else gave the impetus to the design of the Swedish welfare state. [ABSTRACT FROM AUTHOR]

Increased demand on rail, due to climate initiatives and passenger numbers, places significant pressure on existing railway operations; specifically on capacity, operational flexibility, and network robustness. These pressures are exacerbated by constraints, which prevent the construction of new track and infrastructure. This results in the need to use existing infrastructure and operating processes. One proposed solution is digitalization, which results in autonomous rail, where automated and connected intelligent transport systems facilitate smart traffic management. However, this generates the challenge of integrating autonomous trains and their associated technologies with existing infrastructure and operations. To understand this issue from an enterprise level, this paper has applied Brian Wilson's Soft Systems Methodology (a variation of Checkland's methodology) to the problem situation. This methodology explores and investigates the existing rail system in Great Britain (UK less Northern Ireland) and its stakeholders. The paper aims to propose a solution into how to transform the legacy system into one which incorporates autonomous operations and ultimately becomes fully autonomous. It culminates in a series of models that are relevant to those with a legitimate interest in the system. The models identify the activities required to analyze whether autonomy is worthwhile and if it is, how to successfully integrate it with legacy operations. Additionally, the models provide the basis for which a formal stakeholder analysis can take place. [ABSTRACT FROM AUTHOR]

This paper contributes to debates on autonomous geographies by foregrounding and analysing democratic praxis in two grassroots agrifood collectives to interrogate the ways in which it constitutes a vehicle for postcapitalist transformation. We focus on the negotiation and (re)distribution of power (Case Study 1) and the politicisation of ambiguous human–more‐than‐human entanglements (Case Study 2) and find that the dynamics and frictions these collectives experience can be understood as diverse processes of becoming‐interdependent. Becoming‐interdependent refers to a collective recognition of existing and emerging relationships and dependencies (amongst human people as well as between humans and more‐than‐human actors) and efforts to continuously navigate these. Based on these insights, we discuss tensions between capitalist–postcapitalist realities and making–unmaking in grassroots collectives. We conclude by conceptualising becoming‐interdependent as a deliberate response to the separations and abstractions inscribed in capitalism and by connecting it to debates on strategies for postcapitalist transformation. [ABSTRACT FROM AUTHOR]

Copyright of Ethos (00912131) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

We comment on Dr. Terman's considerations on the moral justification of ceasing assisted feeding and hydration for people with advanced dementia. The core idea of his paper is that an advance directive can solve future dilemmas regarding assisted feeding. We submit that this static instrument is unfit for the complex and dynamic nature of assessing how to deal with refusals to eat, in particular for people with dementia. It overvalues the past in relation to the present situation and leaves no room for the possibility of changing wishes. Moreover, the perspectives of professional caregivers and families are not addressed because the focus is entirely on individual autonomy in early dementia. Multiple perspectives should be considered in interpreting directives and the actual situation in light of the patient's view of life in order to realistically account for what is morally justifiable in care in advanced dementia. [ABSTRACT FROM AUTHOR]

Introduction Objectives Conclusions Efforts to develop reversible male contraceptives analogous to female oral contraceptives are underway and may be introduced in the next decade. The advent of novel male contraceptives provides an opportunity for an ethical reformulation of the contraceptive paradigm given the relational, rather than individual, nature of sexual relationships, and family planning. For individuals in any sexual relationship that could result in pregnancy, issues of reproductive autonomy, freedom, equality in reproductive decision‐making and risks—both of side effects and of unintended pregnancies—are significant. Historically, however, women have been attributed the greatest responsibilities simultaneously with the most restrictions on their freedom of choice and access to reproductive care.In this paper, we extend our prior “shared risk” model of male contraception to one of “shared risk and responsibility” to ethically inform this discourse.This updated framework more fully captures the complexity of this novel technology and may be of use to regulatory and legal agencies grappling with an intervention that poses medical risks to the member of the relationship who does not face risks of becoming pregnant. [ABSTRACT FROM AUTHOR]

Evidence suggests that one reason doctors provide certain interventions in assisted reproductive technologies (ART) is because of patient demand. This is particularly the case when it comes to unproven interventions such as 'add‐ons' to in vitro fertilisation (IVF) cycles, or providing IVF cycles that are highly unlikely to succeed. Doctors tend to accede to demands for such interventions because patients are willing to do and pay 'whatever it takes' to have a baby. However, there is uncertainty as to what moral weight should be placed on patient‐led demands in ART, including whether it is acceptable for such demands to be invoked as a justification for intervention. We address this issue in this paper. We start by elucidating what we mean by 'patient‐led demand' and synthesise some of the evidence for this phenomenon. We then argue that a doctor's professional role morality (PRM) yields special responsibilities, particularly in commercialised healthcare settings such as ART, because of the nature of professions as social institutions that are distinct from markets. We argue on this basis that, while there may be reasons (consistent with PRM) for doctors to accede to patient demand, this is not always the case. There is often a gap in justification between acceding to patient‐led demands and providing contested interventions, particularly in commercial settings. As a result, acceding to demand in such settings needs a strong justification to be consistent with PRM. [ABSTRACT FROM AUTHOR]

This paper offers a historical analysis of organizational identity development at a particular Dutch university, the Vrije Universiteit (VU) Amsterdam. Our analysis contributes to the discussion on what factors contribute to organizational identity maintenance and evolution. Whereas the literature suggests a rather straightforward development, with national and institutional governance arrangements offering more institutional autonomy and providing significant scope for identity development and profiling, this case study shows that these relationships between identity, governance, and autonomy are not that obvious. In this particular case, the opposite happened. Despite more autonomy, VU Amsterdam was not able to maintain its historically distinctive identity, nor was it able to replace this with a new, unambiguous identity. External factors (demographics) and internal dynamics (leadership strategies) explain the anomalies. [ABSTRACT FROM AUTHOR]

Introduction: Engaging adolescents with chronic pain in physical activities is challenging. Motivational interviewing (MI) combined with activity promotion may encourage teens to make behavioural changes. This research aimed to assess the feasibility and acceptability of our MI‐based physical activity promotion programme, the M3 training. Methods: In our exploratory study with 35 adolescent–parent dyads, we evaluated the feasibility by enrolment, drop‐out and retention rates. Acceptability of the M3 training was examined by adherence rates and participation experiences through open‐ended questions. We also assessed changes in pain self‐efficacy and readiness to change after the M3 training intervention. Results: The M3 training was feasible with an adequate enrolment (77.8%) and retention (85.7%) rate. Both teens and parents found the M3 training acceptable and considered exercise and physical activity the most helpful elements of the programme (36% and 37%, respectively). While self‐efficacy remained unchanged, we identified a significant increase in the readiness to change for adolescents and parents. Conclusion: M3 training improved physical activity engagement while prioritising adolescents' autonomy. Furthermore, it appears to be a clinically relevant approach and could result in a positive shift in readiness to change within a shorter timeframe. Patient or Public Contribution: The preliminary version of the M3 training was reviewed and commented upon by the public (adolescents and adults). Adolescents who participated in this study were designing their own movement programme, considering their lived experiences. Participants' feedback was used to create the online version of the M3 training (which will be published elsewhere). [ABSTRACT FROM AUTHOR]