Nursing ethics in end-of-life care is often framed in reference to dramatic moral dilemmas and resulting moral distress that nurses experience in practice. While important, this framing obscures the moral significance of nurses’ everyday practice. The purpose of this study was to explore nurses’ moral experiences of palliative and end-of-life care, including situations that are enriching. The research question was: What are the moral experiences of nurses engaged in ethically meaningful situations in end-of-life care? Semi-structured interviews were conducted with five nurses from across Canada who practice in settings where palliative and/or end-of-life care are an important part of their role. Informed by interpretive description and a theoretical scaffold about nurses’ moral practice, a descriptive and thematic analysis of the data was performed. The participants described ethical challenges relating to patient autonomy, futility, prognostication, and navigating requests for medical assistance in dying. Experiences that were ethically enriching involved situations where the nurse, patient, and family worked together to create a peaceful and dignified death. Taken together, the participants’ narratives revealed them as morally engaged in their everyday practice, where such moral engagement is both reflective and relational. This study expands understanding about how nurses’ stories of end-of-life care reveal their capacity for moral sensitivity. This study also contributes to the articulation of a theoretical lens for examining the moral dimensions of nursing work. By explicating the relational dimensions of ethically meaningful experiences, including relationships with wider structures that facilitate and constrain the possibility for ethical action, this theoretical lens can support researchers to think creatively about palliative and end-of-life nursing from an explicitly ethical perspective.

This PhD by published work consists of: • two single authored articles in refereed journals; • four jointly authored articles in refereed journals; • one jointly authored editorial; • one jointly authored book, including four single authored chapters; They were published in the period 2003-2013. Philip Gilligan submitted the jointly written publications as part of his submission for the award of Degree of Doctor of Philosophy by Published Work in 2013. This thesis identifies substantive findings, theoretical insights, new questions and practice/policy implications arising from the published work. The body of work has and continues to stimulate debate about the need to recognise and appreciate the significance and relevance of religion and related belief in the lives of people accessing health and social care services in the UK. It outlines the general relevance and impact of religion and related belief and explores questions and research concerned with the extent to which social work takes these matters into account in its practices, polices and professional training. It prompts practitioners to reflect on their own and others’ religious beliefs by providing a framework of nine related principles to assist them in their professional practice. One key finding is the need for service providers and policy makers to develop new services that are more responsive to the diverse needs of people living in the UK today by recognising and adopting some of the diverse helping strategies employed and imported by different communities. / The full text of the published articles submitted with this PhD thesis are not available in full text in Bradford Scholars due to copyright restrictions.

No description available.

In this thesis, I propose an argument against the possibility of moral dilemmas, which I construe as situations in which moral wrongdoing is inescapable. The first chapter addresses some terminological matters and attempts to sort out the main issues of contention between proponents and opponents of moral dilemmas. The second chapter lays out my argument, which I dub the "Argument from Action-Guidingness," against proponents of moral dilemmas. Negative moral judgments of the sort "X is wrong" typically carry with them the implication that X ought not to be done. If judgments of wrongness always have this action-guiding force, then moral dilemmas, which say that all courses of action available to the agent are morally wrong, threaten morality with incoherence. To avoid this problem, proponents of dilemmas will be forced to abandon the action-guiding implications of negative moral judgments when dilemmas arise. But this move is not without its own difficulties, which I elucidate. The final chapter identifies flaws in two prominent arguments in favor of dilemmas: the argument from moral distress and the argument from incommensurable values. The latter half of the chapter examines Sayre-McCord's "fairness argument" against dilemmas, and contrasts it with the argument from action-guidingness. / Master of Arts

<p>This paper discusses difficulties and Failures with being a Neutral and objective scientist when writing about a subject which he or she is dedicated too.The purpose with this paper is to study the knowledge process, in other words, is some knowledge harder to see due to the scientist dedication to the subject or is some knowledge constructed due to the scientist dedication to the subject studied, and the process of intermediating, in other words, how to validate the results. Subject which is discussions are scientist objectivity, sociologist dilemmas, and different roles of scientists. The paper also deals with the importance of different perspectives and how ours choice of perspective influences ours research. Ethical state of conditions in interview situations and how we can reflect and criticise our own part and attitudes as an interviewer are also discussed in this paper.</p>

This paper discusses difficulties and Failures with being a Neutral and objective scientist when writing about a subject which he or she is dedicated too.The purpose with this paper is to study the knowledge process, in other words, is some knowledge harder to see due to the scientist dedication to the subject or is some knowledge constructed due to the scientist dedication to the subject studied, and the process of intermediating, in other words, how to validate the results. Subject which is discussions are scientist objectivity, sociologist dilemmas, and different roles of scientists. The paper also deals with the importance of different perspectives and how ours choice of perspective influences ours research. Ethical state of conditions in interview situations and how we can reflect and criticise our own part and attitudes as an interviewer are also discussed in this paper.

<p>Informationsteknologin (IT) fortsätter att utvecklas snabbt. Det ger möjlighet för företag och organisationer att kostnadseffektivisera sina processer och hitta alternativa lösningar som ökar konkurrenskraften. Den höga utvecklingstakten och de stora kostnader som är inbegripna skapar samtidigt en genuin beslutsosäkerhet vid investering i IT. Företagare ställs inför en rad dilemman: var, när och hur ska investeringar göras? I de situationer där utfallen av ett beslut är oklara eller motstridiga befinner sig beslutsfattaren i ett dilemma. Syftet med denna studie är att beskriva och analysera beslutsdilemman som beslutsfattare har vid dessa IT-investeringar.</p><p>Studien bygger på beslutsteori, där referensramen bestäms av såväl den rationella skolans mycket bestämda beslutskedja som av mer socialkonstruktivistiska beslutsmodeller. Beslutsperspektiven varierar med kontexten och intressenterna. Företaget är en koalition mellan olika aktörer, alla med sitt perspektiv på företagets beteende i den specifika branschen.</p><p>Empirin utgörs av två myndigheter (fallstudier), Skatteverket respektive Premiepensionsmyndigheten (PPM). Genom intervjuer, studier av arkivmaterial samt deltagande observation har jag samlat information om två beslutsprocesser: PPM:s val mellan att köpa ett färdigt IT-system och att utveckla ett eget samt Skatteverkets val mellan ett proprietärt IT-verktyg och ett baserat på öppen källkod.</p><p>Analysen av det empiriska materialet har resulterat i en typologi med tre typer av beslutsdilemman vid IT-investeringar. Den första typen av dilemman är de beslutspunkter som uppstår i samband med investeringar. Jag kallar dessa för (a) dilemmapunkter. Den andra typen av dilemman beror av att resultat och konsekvenser ofta är svårbestämda. Det leder till en hög beslutsosäkerhet och jag benämner därför det (b) konsekvensdilemman. Beslutsdilemmat kan också betyda att man ställs inför flera beslutsalternativ med både förväntat önskat och möjliga, oönskade resultat. Det ställer beslutsfattaren inför valet att balansera mellan alternativen. Jag kallar dessa för (c) balansaktsdilemman.</p> / <p>Summary: The rapid progress of Information Technology (IT) continues. IT can make processes more cost-effective and be a tool when identifying alternative solutions to increase competitiveness. However, the rapid pace of development and the high costs attached, creates a genuine uncertainty when it comes to IT-investments. Eventually, the organization will be confronted with dilemmas such when decisions or their outcomes are unclear or contradictory, you have a dilemma.</p><p>The purpose of this study is to describe and analyze balance acts (dilemmas) of IT-investments. The base of study is decision theory, from the traditional rational way of reasoning to more socially constructed models. The perspective varies with the contexts and actors. The company is a coalition of actors, all with a different perspective on a specific part of the business.</p><p>The empirical data consist of two public authorities (case-studies), Swedish Tax Authority and Premium Pension Authority (PPM). I have collected data by conducting interviews, taking part of archived material and being an observant participator. PPM’s dilemma is whether to buy or to develop a system and Swedish Tax Authority’s dilemma is whether to use open source or a proprietary development tool.</p><p>The analysis of the empiric material have resulted in a typology of dilemmas in conjunction with IT-investments. The typology consists of:</p><p>(a) dilemma points - events where the dilemmas originate.</p><p>(b) dilemma consequences – dilemmas that are hard to discern and thus associated with a great deal of risk.</p><p>(c) balancing acts dilemmas - the decision maker must balance between multiple choices in order to reach a satisfying outcome. Each choice has its pros and cons.</p>

Informationsteknologin (IT) fortsätter att utvecklas snabbt. Det ger möjlighet för företag och organisationer att kostnadseffektivisera sina processer och hitta alternativa lösningar som ökar konkurrenskraften. Den höga utvecklingstakten och de stora kostnader som är inbegripna skapar samtidigt en genuin beslutsosäkerhet vid investering i IT. Företagare ställs inför en rad dilemman: var, när och hur ska investeringar göras? I de situationer där utfallen av ett beslut är oklara eller motstridiga befinner sig beslutsfattaren i ett dilemma. Syftet med denna studie är att beskriva och analysera beslutsdilemman som beslutsfattare har vid dessa IT-investeringar. Studien bygger på beslutsteori, där referensramen bestäms av såväl den rationella skolans mycket bestämda beslutskedja som av mer socialkonstruktivistiska beslutsmodeller. Beslutsperspektiven varierar med kontexten och intressenterna. Företaget är en koalition mellan olika aktörer, alla med sitt perspektiv på företagets beteende i den specifika branschen. Empirin utgörs av två myndigheter (fallstudier), Skatteverket respektive Premiepensionsmyndigheten (PPM). Genom intervjuer, studier av arkivmaterial samt deltagande observation har jag samlat information om två beslutsprocesser: PPM:s val mellan att köpa ett färdigt IT-system och att utveckla ett eget samt Skatteverkets val mellan ett proprietärt IT-verktyg och ett baserat på öppen källkod. Analysen av det empiriska materialet har resulterat i en typologi med tre typer av beslutsdilemman vid IT-investeringar. Den första typen av dilemman är de beslutspunkter som uppstår i samband med investeringar. Jag kallar dessa för (a) dilemmapunkter. Den andra typen av dilemman beror av att resultat och konsekvenser ofta är svårbestämda. Det leder till en hög beslutsosäkerhet och jag benämner därför det (b) konsekvensdilemman. Beslutsdilemmat kan också betyda att man ställs inför flera beslutsalternativ med både förväntat önskat och möjliga, oönskade resultat. Det ställer beslutsfattaren inför valet att balansera mellan alternativen. Jag kallar dessa för (c) balansaktsdilemman. / Summary: The rapid progress of Information Technology (IT) continues. IT can make processes more cost-effective and be a tool when identifying alternative solutions to increase competitiveness. However, the rapid pace of development and the high costs attached, creates a genuine uncertainty when it comes to IT-investments. Eventually, the organization will be confronted with dilemmas such when decisions or their outcomes are unclear or contradictory, you have a dilemma. The purpose of this study is to describe and analyze balance acts (dilemmas) of IT-investments. The base of study is decision theory, from the traditional rational way of reasoning to more socially constructed models. The perspective varies with the contexts and actors. The company is a coalition of actors, all with a different perspective on a specific part of the business. The empirical data consist of two public authorities (case-studies), Swedish Tax Authority and Premium Pension Authority (PPM). I have collected data by conducting interviews, taking part of archived material and being an observant participator. PPM’s dilemma is whether to buy or to develop a system and Swedish Tax Authority’s dilemma is whether to use open source or a proprietary development tool. The analysis of the empiric material have resulted in a typology of dilemmas in conjunction with IT-investments. The typology consists of: (a) dilemma points - events where the dilemmas originate. (b) dilemma consequences – dilemmas that are hard to discern and thus associated with a great deal of risk. (c) balancing acts dilemmas - the decision maker must balance between multiple choices in order to reach a satisfying outcome. Each choice has its pros and cons.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The central scope in this doctoral thesis refers to the comparative analysis of dilemmas in moral and legal cases in order to sustain that, genuinely moral dilemmas and genuinely legal dilemmas do not exist. Moreover, those examples which frequently are used and referred to in literature or are part of distinct systems of rules, or are mental creations which serve to evaluate or analyze a system of rules, or yet are false dilemmas (pseudo dilemmas) and, therefore, are perfectly solvable. Thus, we analyze, in Law, the arguments that lead to the classification and ruling of legal cases (in easy, difficult and tragic) and compared them with the arguments involved in moral dilemmas. We assessed whether these cases are real or just ideal, that is, if moral and legal dilemmas indeed exist. We have performed a historical overview on the influence of the main paradigm related to the theme, namely, Legal Positivism and we have presented logical problems (coherence and completeness) of the legal ruling, especially the emergence of gaps. As we have approached the theme of gaps from the vagueness of legal terms and presented the classification and solution of legal cases from Dworkin, Hart, Atienza and MacCormick. Within moral scope, we present a historical overview of the traditional view of moral problems, the interdependence between Moral and Law, we investigate the existence of moral dilemmas of soluble and insoluble type, we expose the problem of decidability of moral cases and present a taxonomy and solution to moral issues in easy, difficult and tragic (dilemmas). Eventually, we developed a comparative table with the four components of moral and legal decisions: on the deliberator, on the object of deliberation, on the decision-making process, and on the result of the deliberation. Forthwith, we describe each of the criteria related to the deliberation components in order to present points of approximation, the differences and connections that may exist among themselves. / O tema central dessa tese de doutorado refere-se à análise comparativa dos dilemas em casos morais e em casos jurídicos com o objetivo de sustentar que dilemas genuinamente morais e dilemas genuinamente jurídicos não existem. Além disso, aqueles exemplos que frequentemente são utilizados e referidos na literatura ou fazem parte de distintos sistemas de normas, ou são criações mentais que servem para avaliar ou analisar um sistema de normas, ou, ainda, são falsos dilemas (pseudo-dilemas) e, portanto, são perfeitamente solucionáveis. Desse modo, analisamos, no Direito, os argumentos que conduzem à classificação e decisão de casos jurídicos (em fáceis, difíceis e trágicos) e os comparamos aos argumentos relacionados aos dilemas morais. No âmbito jurídico, realizamos um apanhado histórico da influência do principal paradigma relacionado ao tema, a saber, o Positivismo Jurídico; apresentamos os problemas lógicos (coerência e completude) da decisão jurídica, em especial o surgimento das lacunas; abordamos o tema das lacunas a partir da vaguidade dos termos jurídicos e apresentamos a classificação e solução de casos jurídicos a partir de Dworkin, Hart, Atienza e MacCormick. No âmbito da moral, apresentamos um apanhado histórico da visão tradicional de problemas morais, a interdependência entre Moral e Direito, investigamos a existência de dilemas morais do tipo solúvel e insolúvel, expomos o problema da decidibilidade de casos morais e apresentamos uma taxonomia e solução de casos morais em fáceis, difíceis e trágicos (dilemas). Por fim, elaboramos um quadro comparativo com quatro componentes das deliberações moral e jurídica: quanto ao deliberador, ao objeto de deliberação, ao processo de deliberação, e ao resultado da deliberação. Em seguida, descrevemos cada um dos critérios relacionados aos componentes da deliberação a fim de apresentar os pontos de aproximação, as diferenças, e conexões que podem existir entre os mesmos.

Master of Landscape Architecture / Landscape Architecture/Regional and Community Planning / Howard D. Hahn / Landscape architecture’s scope of knowledge and professional practice is continuously broadening. Formalized certification and certification standards do not exist to date; as a result, limiting the depth of knowledge in landscape architects. Beyond competency in core skills like natural systems, site planning and design, and visualization graphics, the general knowledge base of most landscape architects spans a variety of disciplines. This ability to “see the bigger picture” offers certain strengths when “placemaking”, interacting with allied professionals, and leading project teams; yet there are limited opportunities for landscape architects to formally develop a depth of expertise. An extensive literature search identified forty-one knowledge domains that exist in landscape architecture. This report identifies fourteen domains that landscape architects need in current and future work supported with identified core skills and knowledge in the profession. This report seeks to update the Council of Landscape Architecture Registration Board’s (CLARB) identification of knowledge domains by layering skills and knowledge found in sixty current job postings, literature search, and structured interviews. In addition, this report identifies future trends in the profession and marketplace and future dilemmas landscape architects must address in the next twenty years. Content analysis of certification programs offered to landscape architecture students at accredited schools was conducted. A certification precedent study was conducted to understand the range of certification standards that exist in order to propose a standardized certification program. Thirteen themes are identified in the structured interviews that are incorporated into themes of this report. Overall, professionals feel that landscape architecture’s strength as a generalist profession makes the profession unique from its allied professions. However, some professionals acknowledge that as a landscape architect progresses in his or her career, they tend toward areas of specialization. This report suggests that certifications be offered to graduate students and professionals, explains specialization in the profession, and identifies areas landscape architects need to increase their skills and knowledge in, to stay relevant.