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Abstract: Amedeo Giorgi has published a review article devoted to Phenomenology as Qualitative Research: A Critical Analysis of Meaning Attribution. However, anyone reading this article, but unfamiliar with the book, will get a distorted view of what it is about, whom it is addressed to, what it seeks to achieve and how it goes about presenting its arguments. Not mildly distorted, in need of the odd correction here and there, but systematically misrepresented. The article is a study in misreading. Giorgi misreads the book's mise en scène; he misreads its narrative arc; he misreads individual arguments; he misreads short, simple passages; he misreads the philosophy of the science literature; he misreads his own data; he misreads the title; he misreads the blurb; he misreads the acknowledgements. In addition, there are serious failures of scholarship (ironically, he demonstrates how unacquainted he is with the relevant literature at the very moment he is accusing me of being ill‐informed). In this reply, I provide several examples of these errors, but my primary aim is to understand why Giorgi's misreading is as ubiquitous as it is. To this end, I explain his mistakes by reference to the hermetic epistemology within which he is confined. [ABSTRACT FROM AUTHOR]

Abstract: Phenomenology as Qualitative Research: A Critical Analysis of Meaning Attribution has attracted the attention of Max van Manen, who has published a highly critical review article. Anyone reading this article, but unfamiliar with the book, will get a distorted view of what it is about, whom it is addressed to, what it tries to achieve, and how it goes about presenting its arguments. Not mildly distorted, in need of the odd correction here and there, but systematically misrepresented. One problem is that van Manen appears to have an idée fixe which prevents him from recognizing that the book is not about a certain philosophical tradition (known as “phenomenology”), but about a particular type of qualitative research (also known, unfortunately and confusingly, as “phenomenology”). A second idée fixe disposes him to misread an earlier article of mine and (much more seriously) three works by Heidegger. My aim in this article is to describe these two idées fixes, and exhibit their consequences. In doing so, I will examine what van Manen has to say on four crucial topics: meaning, lived experience, empathy, and Heidegger's analysis of boredom in The Fundamental Concepts of Metaphysics. [ABSTRACT FROM AUTHOR]

Peter Kevern believes that the cognitive science of religion ( CSR) provides a justification for the idea of spiritual care in the health services. In this paper, I suggest that he is mistaken on two counts. First, CSR does not entail the conclusions Kevern wants to draw. His treatment of it consists largely of nonsequiturs. I show this by presenting an account of CSR, and then explaining why Kevern's reasons for thinking it rescues 'spirituality' discourse do not work. Second, the debate about spirituality-in-health is about classification: what shall count as a 'spiritual need' and what shall count as 'spiritual care'. It is about the politics of meaning, an exercise in persuasive definition. The function of 'spirituality' talk in health care is to change the denotation of 'spiritual', and attach its indelibly religious connotations to as many health-related concepts and practices as possible. CSR, however plausible it may be as a theory of the origins and pervasiveness of religious belief, is irrelevant to this debate. [ABSTRACT FROM AUTHOR]

This paper discusses compassion failure and compassion deficits in health care, using two major reports by Robert Francis in the UK as a point of reference. Francis enquired into events at the Mid Staffordshire Hospital between 2005 and 2009, events that unequivocally warrant the description 'appalling care'. These events prompted an intense national debate, along with proposals for significant changes in the regulation of nursing and nurse education. The circumstances are specific to the UK, but the issues are international. I suggest that social psychology provides numerous hints about the mechanisms that might have been involved at Mid Staffs and about the reasons why outsiders are blind to these mechanisms. However, there have been few references to social psychology in the post- Francis debate (the Francis Report itself makes no reference to it at all). It is an enormously valuable resource, and it has been overlooked. Drawing on the social psychology literature, I express scepticism about the idea that there was a compassion deficit among the Mid Staff nurses - the assumption that the appalling care had something to do with the character, attitudes, and values of nurses - and argue that the Francis Report's emphasis on a 'culture of compassion and caring in nurse recruitment, training and education' is misconceived. It was not a 'failure of compassion' that led to the events in Mid Staffs but an interlocking set of contextual factors that are known to affect social cognition. These factors cannot be corrected or compensated for by teaching ethics, empathy, and compassion to student nurses. [ABSTRACT FROM AUTHOR]

The article reviews the book "The Moral Psychology Handbook," edited by John Doris and the Moral Psychology Research Group.

Aim. The concept of spirituality is much discussed in the UK nursing literature, despite the fact that Britain is one of the most secular countries in the world, and steadily becoming more so. Here, I pose the following question: given this increasing secularization, what accounts for the current interest in spirituality among UK nurses? Background. The literature on spirituality in nursing has blossomed in the last 10 years, and various attempts have been made to define ‘spirituality’, ‘spiritual need’ and ‘spiritual care’. Most definitions distinguish between ‘spirituality’ and ‘religion’, acknowledging that the latter is more institutional, and theologically more restrictive, than the former; and they suggest that spirituality is universal, something which (unlike religion) all human beings share. Method. I draw on the sociology of religion – neglected, for the most part, in the nursing literature – to establish two main points. Firstly, that the UK and the USA are at opposite ends of the religion/secularity spectrum, implying that it is a mistake to assimilate USA and UK sources. Secondly, that the concept of spirituality, as currently understood, is of very recent origin, and is still ‘under construction’, having become separated from its associations with Christian piety and mysticism only since the 1980s. Conclusions. The extension of spirituality into secular domains is part of a professionalization project in nursing, a claim to jurisdiction over a newly invented sphere of work. For the time being, it remains an academic project (in the UK) as it is not one with which many clinicians identify. Relevance to clinical practice. What counts as ‘spiritual need’ or ‘spiritual care’ may not be the same in both countries, and UK clinicians are unlikely to welcome the role of surrogate chaplain, which their USA colleagues are apparently willing to embrace. [ABSTRACT FROM AUTHOR]

Psychological research has shown that cognitive illusions, of which visual illusions are just a special case, are systematic and pervasive, raising epistemological questions about how error in all forms of research can be identified and eliminated. The quantitative sciences make use of statistical techniques for this purpose, but it is not clear what the qualitative equivalent is, particularly in view of widespread scepticism about validity and objectivity. I argue that, in the light of cognitive psychology, the‘error question’ cannot be dismissed as a positivist obsession, and that the concepts of truth and objectivity are unavoidable. However, they constitute only a‘minimal realism’, which does not necessarily bring a commitment to‘absolute’ truth, certainty, correspondence, causation, reductionism, or universal laws in its wake. The assumption that it does reflects a misreading of positivism and, ironically, precipitates a‘crisis of legitimation and representation’, as described by constructivist authors. [ABSTRACT FROM AUTHOR]

PALEY J. Nursing Inquiry 2005; 12: 106–116 Phenomenology as rhetoric The literature on‘nursing phenomenology’ is driven by a range of ontological and epistemological considerations, intended to distance it from conventionally scientific approaches. However, this paper examines a series of discrepancies between phenomenological rhetoric and phenomenological practice. The rhetoric celebrates perceptions and experience; but the concluding moment of a research report almost always makes implicit claims about reality. The rhetoric insists on uniquely personal meanings; but the practice offers blank, anonymous abstractions. The rhetoric invites us to believe that knowing is subjective and involved, but at the same time it recommends a technique (bracketing) which can only represent a crude, and entirely misconceived, gesture towards objectivity. Finally, the rhetoric claims that generalisation is beside the point; but the majority of researchers generalise anyway. In quietly ignoring their own rhetoric,‘phenomenologists’ appropriate scientific prerogatives illegitimately. For their methods do not entitle them to lay claim to anything resembling‘objectivity’, or generalisability, or‘reality’, or theoretical abstraction. Like other researchers, they want to talk in generalisable terms about reality; they want to be objective, they want to do theory. But they are saddled with a philosophy that is disabling, because it says they can only talk about perceptions, and meanings, and uniqueness. [ABSTRACT FROM AUTHOR]

The idea of narrative has been widely discussed in the recent health care literature, including nursing, and has been portrayed as a resource for both clinical work and research studies. However, the use of the term‘narrative’ is inconsistent, and various assumptions are made about the nature (and functions) of narrative: narrative as a naive account of events; narrative as the source of‘subjective truth’; narrative as intrinsically fictional; and narrative as a mode of explanation. All these assumptions have left their mark on the nursing literature, and all of them (in our view) are misconceived. Here, we argue that a failure to distinguish between‘narrative’ and‘story’ is partly responsible for these misconceptions, and we offer an analysis that shows why the distinction between them is essential. In doing so, we borrow the concept of‘narrativity’ from literary criticism. Narrativity is something that a text has degrees of, and our proposal is that the elements of narrativity can be‘sorted’ roughly into a continuum, at the‘high narrativity’ end of which we find‘story’. On our account,‘story’ is an interweaving of plot and character, whose organization is designed to elicit a certain emotional response from the reader, while‘narrative’ refers to the sequence of events and the (claimed) causal connections between them. We suggest that it is important not to confuse the emotional persuasiveness of the‘story’ with the objective accuracy of the‘narrative’, and to this end we recommend what might be called‘narrative vigilance’. There is nothing intrinsically authentic, or sacrosanct, or emancipatory, or paradigmatic about narrative itself, even though the recent health care literature has had a marked tendency to romanticize it. [ABSTRACT FROM AUTHOR]

Sally Gadow's work is a sophisticated version of a familiar line of thought in nursing. She creates a chain of distinctions which is intended to differentiate cultural narratives, and particularly the ‘science narrative’, from imaginative narratives, especially poetry. Cultural narratives regulate and restrict; imaginative narratives are creative, liberating and potentially transcendent. These ideological effects are (supposedly) achieved through different structures of language. Scientific language, for example, is abstract and literal, while poetry is sensuous and metaphorical. In this paper, I argue that Gadow's way of discriminating between science and poetry fails. In the first place, the ideological valence she assigns to each of them is unwarranted. Science and poetry can both be harnessed to the project of emancipation, just as both can be incorporated in a strategy of oppression. In the second place, the claim that poetry and science are distinguished by their respective linguistic features – specifically, that one is metaphorical and the other literal – cannot be sustained. I illustrate this argument, as Gadow illustrates hers, by reference to the concept of embodiment, and consider whether Gadow is correct in thinking that poetry, not science, makes it possible for individuals (especially women) to ‘reclaim the body’. I also suggest that Gadow's brand of postmodernism echoes Romanticism, whose defining characteristic was an insistent contrast between poetry and science. This is ‘flip side’ postmodernism, which merely opposes modernist values, preferring subjectivity to objectivity, feeling to rationality, and multiple realities to truth. It is less radical, and far less interesting, than ‘remix’ postmodernism, whose objective is not to reverse the polarities, but to reconfigure the entire circuit. [ABSTRACT FROM AUTHOR]

Editorial. Focuses on the significance of 'Cartesian dualism,' by Rene Descartes in nursing. Criticism of 'Cartesianism' by nurses; Description of 'Cartesian dualism' in the nursing literature; Adoption of ontological dualism by nurses; Reasons for not criticizing physicalism by nurses; Different views of nurses and Descartes on dualism of mind and body.

Abstract The ethics of care, adopted in much of the nursing literature, is usually framed in opposition to the Kantian ethics of principle. Irrespective of whether the ethics of care is grounded in gender, as with Gilligan and Noddings, or inscribed on Heidegger's ontology, as with Benner, Kant remains the philosophical adversary, honouring reason rather than emotion, universality rather than context, and individual autonomy rather than interdependence. During the past decade, however, a great deal of Kantian scholarship – including feminist scholarship – has rendered this series of oppositions questionable, challenging the view that an ethics of care and Kant's moral law are irreconcilable. This paper therefore re-examines Kant's writings, drawing on recent scholarship, and argues both that they provide the care ethicists with everything they require, and that they offer something beyond an ethics of care, something that repairs the deficits in philosophies of caring. It concludes by suggesting that a Kantian ethics of care has significant implications for the construction of nursing knowledge. [ABSTRACT FROM AUTHOR]

Abstract The idea of meaning plays, together with the notion of caring, a pivotal role in recent nursing theory, informing its approach to philosophy, research and practice. Unlike caring, however, it has received relatively little analytical attention – a fact that is surprising in view of the scepticism about meaning that is characteristic of much contemporary philosophy and social theory. This paper reviews the philosophical literature on meaning, highlighting sceptical currents in the Wittgensteinian corpus, neo-behaviourism and poststructuralism. It also considers a similar line of thought that has emerged in social theory, questioning the explanatory value of concepts such as ‘practice’, ‘culture’, ‘norms’, ‘tacit knowledge’, and ‘tradition’. All these perspectives suggest that there is something wrong with the common-sense picture of a set of shared, implicit rules that account for our ability to understand and communicate; and they all point to an alternative picture which is naturalistic, materialist and causal, and which depicts ‘shared meaning’ as a rather mysterious quality, unable to explain the familiar regularities of verbal and nonverbal behaviour. In this picture, while the idea of meaning can be retained, it ceases to be something shared, and becomes something individual and idiosyncratic, a unique cluster of associations, concomitants, and other habits of thought. The paper closes with a brief interpretation of what the alternative implies for a research methodology in nursing. In particular, it proposes that certain well established approaches will have to be abandoned, and that qualitative strategies will have to be grounded in a rigorous scientific framework, rather than in techniques (such as phenomenology), which presuppose a misleading and inaccurate conception of what meaning is. [ABSTRACT FROM AUTHOR]

Abstract The claim that, in some nontrivial sense, nursing can be identified with caring has prompted a search for the philosophical foundations of care in the nursing literature. Although the ethics of care was initially associated with Gilligan's ‘different voice’, there has more recently been an attempt – led principally by Benner – to displace the gender perspective with a Heideggerian one, even if Kant is the figure to whom both Gilligan and Benner appear most irretrievably opposed. This paper represents the first half of a double-edged project: initially, to point out that Heidegger explicitly disowns any ethical implications for his ontological thinking, and to argue that no ethical theory (including an ethics of care) can be derived from Being and Time; and then to argue that Kant's categorical imperative is not only compatible with the ethics of care but actively entails it. In this, Heideggerian, part of the argument, I consider three attempts to wrest an ethics from Being and Time – those of Benner, Olafson and Guignon – suggesting that, for different reasons, they all fail. Benner systematically confuses the ontological with the ontic, not recognizing that care, concern and solicitude have ‘deficient’ modes as well as positive ones, and that Heidegger's ontology retrieves the possibility of an ethics-in-general without at any point implying an ethics-in-particular (whether of care or justice). Olafson does recognize this, and to that extent admits his failure, but his efforts to amplify Heidegger's thought in such a way as to generate an ethical theory involve both the importing of Kantian premises, and an appeal to some rather doubtful empirical observations. Guignon resorts to Heidegger's discussion of authenticity, and the idea that authentic Dasein ‘may choose its hero’, suggesting a morally reassuring list of heroes who might fit the bill. However, there is nothing in Heidegger's account of this choice that justifies his confidence, and I conclude by proposing that we should take Heidegger at his word when he says that ontology has ‘no result, no effect’. [ABSTRACT FROM AUTHOR]

The article presents the reply of John Paley to the comments of Barbara Pesut regarding his article "Spirituality and nursing: a reductionist approach." Paley noted that the comments of Pesut on an earlier draft that prompted significant revision. He noted that Pesut does not appreciate the cancelling of the gratuitous assertations where she implied with certainty that a spiritual realm does not exist.

Responds to a commentary on an article about nursing care. Distinction between the nursing and caring literature; Notions about caring; Misinterpretations about the concept of caring.

Peter Draper has offered a critique of concept analysis in nursing, suggesting that many concept analysis studies can be regarded as low‐grade literature reviews. Although I will argue en passant that he was right, defending Draper is not my main concern in this paper. Instead, I undertake a close reading of a single study, and identify a series of puzzles about what it says. The puzzles pertain to the distinction between concept and phenomenon; the function of definition; discriminating between the concept of interest and other concepts; how defining attributes are derived; in what sense concept analysis clarifies the concept; whether concept analysis can adjudicate current debates; the role of model cases. The point is to show how a precise and detailed interrogation of this kind sets an agenda of questions which can be asked about other examples of the same genre. The approach gives rise to concerns about the politics of reading in the current academic environment, and I refer to these concerns briefly at the end. [ABSTRACT FROM AUTHOR]

In this article author discusses about the fictionalist paradigm and defence of the methods adopted by professional qualification requirements (PQR) researchers. Topics discussed include evidence for the "naturalistic paradigm" by citing Schwartz & Ogilvy's account of "cutting‐edge" science during the 1970s; highly inaccurate comments on the history of positivism; and derivation of the characteristics of naturalistic inquiry from the"axioms."

A response by John Paley on a letter to the editor about his article "Spirituality and nursing: a reductionist approach" published in a previous issue is presented.

A letter to the editor is presented in response to the article "Nursing's Ways of Knowing and Dual Process Theories of Cognition" published in a 2007 issue.

The article presents the author's comment on the article "Meta-synthesis of caring in nursing," by D. Finfgeld-Connett. The author says that Finfgeld-Connett's paper is the most recent twist in the spiral, another indicator of the stranglehold that the knowledge- as-list-of-descriptions theory has on nursing. He comments that knowledge of caring is basically a list of things said about caring by nurses and patients usually recorded in qualitative studies, together.

The article discussed several articles published within the issue including one by Barbara Pesut on spirituality on health care and another by Margaret Mahon and Jeanne Sorrell on the quality of life for people with Alzheimer's disease.

Special issue Philosophy and palliative care Guest editor: John Paley [ABSTRACT FROM AUTHOR]

Comments on the article "Caring and uncaring encounters in nursing in an emergency department." Use of the caring concept of Halldorsdottir in emergency nursing; Difficulty in using the coding scheme in a consistent way; Requirement for a range of suitable dependent variables for different nursing context; Mathematics of the relationship between nurse and patient.

Comments on a study which focused on nursing values. Issues that affect nurses' well-being; Discussion on the working environment of nurses.

Comments on the article "Scientific Methods are the Only Credible Way Forward for Nursing Research," by Roger Watson, published in the "Journal of Advanced Nursing." Notions about qualitative research in nursing; Concept of positivism in nursing research; Methodological issues surrounding nursing research.

Presents a debate on the issue of studying a phenomenon in the field of science. Reminder on the use of words and symbols in describing a person's attitude, behavior or perception; Perception on researchers' words'; Recommendations.