Bibliography: leaves 336-344 / 344 leaves ; 31 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, 1985

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S’entendre annoncer, lors d’une consultation médicale, que la mort est proche, n’est pas sans effet subjectif. Effroi et traumatisme : violence faite à cette illusion d’immortalité protectrice qui soutient le sujet dans sa quotidienneté, ouverture faite sur le gouffre de la déréliction. La clinique que l’on rencontre dans une unité de soins palliatifs met en évidence les effets subjectifs, trop souvent délétères, d’une telle annonce. C’est à partir de celle-ci que se déploie cette interrogation concernant le sujet et ce qu’il parvient à faire –ou non– de cette annonce. Nous serons alors amenés à rendre compte de ce que la mort réelle, annoncée du lieu de l’Autre, a cet effet de produire une néantisation de la fonction symbolique qu’il supporte, en ce que son manque vient subitement à manquer. La clinique propre aux soins palliatifs montre alors les incidences subjectives d’une telle vacillation et les possibles recours du sujet dans ses tentatives pour pallier au défaut del’Autre. / Agree announce during a medical consultation, that death is near, is not without subjective effect. Fear and trauma: violence against the illusion of immortality, which supports the protective subject his everyday life, opening made on the gulf of abandonment. The clinic encountered in a palliative care unit highlights the subjective effects, often deleterious, suchan announcement. It is from this that unfolds this question on the subject and he manages to do-or not-of this announcement. We will then be brought to account for what the actual death, announced the place of the Other, this has to produce an annihilation of the symbolic function that it supports, in that its lack is suddenly missing. The clinic-specific palliative care then shows the implications of such a subjective vacillation and the possible use of the subject inhis attempts to overcome the lack of the Other.

Bakgrund: Enligt World Health Organisations världshälsorapport bidrar alkohol till mer än 9% av sjukdomsorsakerna i Europa och vållar 1,8 miljoner dödsfall årligen i hela världen. Alkohol har alltid varit och är än idag ett av världens största samhälls- och sjukvårdsproblem. I Sverige är det mer än sex tusen personer som dör i alkoholrelaterade sjukdomar per år, vilket motsvarar lika många dödsfall som i tobaksrelaterade sjukdomar. Alkoholproblematiken tas därför upp i litteraturstudien. Syfte: Att beskriva vilka förebyggande åtgärder en sjuksköterska kan erbjuda personer för att de ska undvika att missbruka alkohol. Metod: Arbetet är en allmän litteraturstudie baserat på kvalitativa och kvantitativa artiklar. Resultat: Okunskap och dålig utbildning skapade en osäkerhet hos sjuksköterskan, vilket kunde resultera i att de inte vågade ingripa när de mötte personer som hade ett alkoholmissbruk. Tidigt ingripande hade enligt studier en viktig uppgift då det visade sig att en tidig intervention oftast förhindrade ett skadligt intag av alkohol i framtiden. Det viktigaste och kanske tuffaste steget för en sjuksköterska var att våga uppmärksamma skadligt alkoholintag hos en patient och att det helst skulle vara en rutin i sjuksköterskans arbete. / Background: According to the World Health Organization more than 9% of the disease-causes in Europe are caused by alcohol and more than 1.8 million people in the world die annually because of high alcohol consumption. Alcohol has always been and will always be regarded as a problem for the society and health. Only in Sweden more than six thousand people die annually in alcohol-related diseases, putting it on the same level as tobacco-related death-causes. The problems with alcohol are therefore discussed in this exam. Aim: To describe what preventive actions a nurse can offer to persons that may develop an abuse for alcohol. Methodology: This work is a general literature review in Swedish based on qualitative and quantitative articles from various databases. Results: Ignorance and the lack of education caused insecurity for the nurse resulting in fewer or no interventions for persons with alcohol-abuse problems. Early intervention has according to studies exposed its importance often preventing an unhealthy consumption of alcohol in the future. One of the most important and toughest steps for a nurse is to dare pointing out the high alcohol-consumption for a person and turning that practice into a routine.

Bakgrund: Trycksår är ett välkänt begrepp i vården och är vanligt förekommande runtom i världen. Trycksår visar sig vara smärtsamma och påfrestande för personen som är drabbad och att leva med ett trycksår kan utvecklas till ett lidande för personen. Syfte: Att utifrån Erikssons lidandebegrepp beskriva personers erfarenheter i samband med trycksår. Metod: En litteraturöversikt där kvalitativa artiklar analyserades deduktivt. Sökningarna resulterade i totalt åtta artiklar som analyserades utifrån Erikssons lidandebegrepp; sjukdomslidande, vårdlidande och livsslidande. Resultat: Sjukdomslidande visade att smärta i samband med trycksår var representerat för flera personer.  Även skam och genans på grund av trycksåret och dess odör beskrevs. I kategorin vårdlidande beskrevs nonchalans samt brister i kommunikation och information vilket resulterade i kritik mot sjukvård och vårdpersonal. Livslidandet yttrade sig i livsförändringar och bidrog till en social isolering. Slutsats: Personers lidande till följd av deras trycksår visade sig vara komplext men också vanligt förekommande. Därför är det viktigt att vårdpersonal har strategier för att identifiera lidande och då med hjälp av Erikssons lidandeteori. När vårdpersonalen vet vilket lidande personer upplever kan åtgärderna riktas specifikt och individanpassas. Vid exempelvis outhärdlig smärta bör då fokus ligga på att få smärtan hanterbar för personen. / Background: Pressure ulcer is a well-known concept worldwide in the care environment. Pressure ulcers are painful and stressful and it can create a suffering for the person living with it. Purpose: To describe the suffering a person is experiencing when having a pressure ulcer based on Eriksson’s suffering concept. Method: A qualitative literature review with a deductive analysis. Eight articles where found which were analyzed by Eriksson’s suffering concept; suffering in sickness, suffering in care and suffering which affect life. Result: Suffering in sickness showed that pain, shame and embarrassment was common reported.  Suffering in care resulted in reported critic against healthcare and caregivers because of lack of communication and information. Suffering which affect life created a change of life and social isolation. Conclusion: The persons’ experiences of suffering, as a result of pressure ulcers, are complex and hard to define but also common to see. Caregivers therefore needs to create strategies to identify the suffering with directions from Eriksson´s suffering concept. When the caregiver knows which suffering the person experiencing arrangements can be specific directed and individualized. For example, when someone experiencing unbearable pain, focus should be to get the pain manageable for the person.

John Rawls was a political philosopher who proposed a theory centered around the idea of justice as fairness. His primary concern was social justice, so more specifically, he proposed a basic structure for society that ensures major social institutions like the government fairly distribute fundamental rights and duties and optimally divide advantages brought about by social cooperation. His theory is based on the idea that the correct principles to use for the basic structure of society are those that free and rational people would agree to in attempt to advance their own self-interest from a fair and equal starting position. Rawls proposes three principles that he believes people would agree to in this situation and describes what a society based on these principles would look like. Throughout this paper, I will attempt to explain Rawls’s “Theory of Justice” and defend various aspect of the theory against common objections.

Democratic theorists have influentially argued that inclusive deliberation, where citizens voice their concerns and exchange justifications, is crucial to democracy. However, this deliberative ideal has come under sustained attack for being excessively utopian. As a result, to make this ideal more relevant and action-guiding, the present thesis investigates what norms should govern deliberation in political settings marked by severe social divisions. After motivating this project (Chapter 1), I defend the following account of deliberation. Although the requirement that deliberators appeal to shared reasons is morally attractive, even the weakest variant of this norm risks excluding too many considerations from the public deliberation of divided societies. To offset these exclusionary tendencies, I argue that public deliberation should give a greater role to emotionally-charged forms of speech, such as narrative (Chapter 2). Now, this last suggestion might seem overly inclusive, by opening the door for intensely angry narratives and for narratives expressing degrading or disrespectful views. In response to this 'overinclusiveness' concern, I argue 1) that degrading or disrespectful public speech is best countered through state-backed counterspeech, rather than through coercive legal norms that forcibly eliminate it from public discourse (Chapter 3) and 2) that narratives expressing anger in fact have a crucial epistemic role to play in divided societies, by enhancing our understanding of persisting injustices (Chapter 4). The final two chapters address a pressing worry: that the deliberative norms I advance demand too much of actual citizens. One might think that if citizens distrust each other and are highly ignorant about politics, they will be unable to deliberate fruitfully. But these problems are not decisive against my account. Chapter 5 investigates how the kind of public dialogue I defend offers important resources for rebuilding trust and goodwill in divided societies. As for political ignorance, Chapter 6 demonstrates that it is equally problematic for other political systems, democratic and non-democratic. Since this ignorance threatens all accounts, the solution is not to abandon inclusive deliberation, but rather to tackle political ignorance itself.

My central aim in the dissertation is to defend an account of the epistemic condition of moral responsibility that distinguishes culpable ignorance from non-culpable ignorance. The view that I defend is that ignorance is culpable just when an agent flouts or ignores moral reasons that underlie her epistemic norms or obligations. This view is a quality-of-will theory of moral responsibility that emphasizes the agent’s reasons-responsiveness. It holds that only relevant epistemic obligations are those that require acts of investigation or reflection. In the dissertation, I examine extant theories of culpable ignorance and suggest that they all fall short in some important respect. Then, I propose and defend an account in which epistemic norms play a leading role. I analyze the nature of epistemic norms and their normativity, and I argue that agents who ignore or flout actional investigative norms and then act on subsequent false beliefs are connected to the wrongness of their action in a way that establishes their blameworthiness. I also argue that epistemic norms that require agents to hold certain beliefs or make certain inferences are not relevant to culpable ignorance. Finally, I explore the implications of my view for certain interesting cases of moral ignorance. I discuss ignorance that results from an agent’s social or historical circumstances, ignorance that stems from pure moral deference, and ignorance that is explained by epistemic difficulty of getting certain moral facts right. There are two striking outcomes of my research. The first is that reflection on the epistemic condition shows that one cannot think deeply about moral responsibility without also engaging issues in epistemology relating to the nature and normativity of belief, and issues in normative ethics relating to what our moral obligations actually are. The second striking outcome is that bringing these rather disparate topics together, as I attempted to do, reveals that much of our ignorance is actually non-culpable, and that many of our beliefs about the blameworthiness of ignorant agents are unwarranted.

The paper will describe one of David Miller’s arguments for limiting immigration by concluding that immigration is a threat to a successful democratic welfare state. There is a threat to a democratic welfare state when there is lack of trust in a heterogeneous society. Immigration contributes to heterogeneity. The paper will present flaws in Miller’s argument, which include the unacknowledged concepts of ignorance and fear that can lead to mistrust in cultural heterogeneous communities. I will then consider Miller’s response to the critiques. Lastly, I will mention some proposals for increasing trust and addressing the real issues in a multicultural society.