Au cours de l’été 2014, le cas d’un patient conscient, dépendant d'un respirateur, ayant demandé un arrêt de traitement vital et exprimé le souhait de faire don de ses organes a secoué la communauté québécoise du don d’organes et de la transplantation. Ce fut le début d’une réflexion importante quant à l’acceptabilité du don d’organes chez des personnes conscientes et aptes ayant choisi de mettre fin à un traitement vital. Cette réflexion était d’autant plus pertinente que le gouvernement québécois préparait sa Loi concernant les soins de fin de vie qui allait rendre légale l’aide médicale à mourir (AMM). Puisqu’il était cliniquement possible pour certains patients de faire un don d’organes suite à une AMM, il était probable que la légalisation de cette pratique augmente le nombre de patients conscients désirant donner leurs organes alors qu’ils auraient choisi de mourir. La littérature sur les enjeux éthiques soulevés par ce type de dons d’organes était alors quasi inexistante et, au moment de débuter le projet de recherche, des lignes directrices de pratique n’existaient pas au Québec et au Canada. Il devenait donc impératif de mieux identifier les enjeux éthiques et de les analyser afin de contribuer à l’encadrement de ces nouvelles pratiques. Il n’y avait également aucune étude décrivant les perspectives des professionnels de la santé face à de tels dons. Les objectifs de ce projet de thèse étaient i) d’identifier les enjeux éthiques soulevés par le don d’organes chez un patient conscient et apte demandant un retrait de thérapie de maintien des fonctions vitales ou une AMM; ii) d’analyser ces enjeux à l’aide de théories éthiques; iii) de connaître et comprendre les perspectives des professionnels de la santé sur les enjeux soulevés par le don d’organes dans ces contextes particuliers; iv) finalement, de mettre en relation les perspectives des professionnels et les politiques qui ont été adoptées au Québec depuis sa mise en route. Nous avons donc mené une étude exploratoire qualitative par le biais d’entretiens avec des professionnels du don d’organes susceptibles d’être impliqués à un moment ou un autre dans le processus du don d’organes par un patient apte ayant demandé un retrait de thérapie de maintien des fonctions vitales ou une AMM. Notre échantillon comprenait médecins et infirmiers des soins intensifs, de la salle d’opération ou impliqués en don d’organes dans deux centres hospitaliers montréalais très actifs au niveau du don d’organes (CHUM et l’Hôpital Sacré-Cœur) et à Transplant Québec. Nous avons identifié les enjeux éthiques à l’aide d’une revue de littérature et par l’analyse des perspectives des professionnels. Les principaux enjeux éthiques sont liés au respect de l’autonomie des patients, à l’information à fournir ou non aux donneurs potentiels, à l’objection de conscience par les professionnels, à la possibilité pour les receveurs de refuser ou non les organes provenant de l’AMM, à l’acceptabilité du don d’organes suite à une AMM confidentielle, à la règle du donneur décédé́, à la possibilité de diriger un don d’organe vers un receveur désigné par le donneur et à l’acceptabilité de choisir l’AMM pour rendre possible le don d’organes. Nous avons d’abord analysé ces enjeux éthiques à l’aide du modèle de l’équilibre réflexif large de Norman Daniels et nous avons ensuite intégré à notre analyse les perspectives des participants sur les différents enjeux selon le modèle de l’équilibre réflexif- normatif empirique. À la lumière de nos résultats, nous pouvons conclure que : i) le don d’organes pour les patients aptes demandant une AMM ou un retrait de thérapies de maintien des fonctions vitales était, de manière générale, éthiquement acceptable dans le contexte légal en vigueur au moment de notre recherche; ii) les patients demandant l’AMM et souffrant d’une maladie compatible avec le don d’organes devaient être informés de la possibilité qui s’offre à eux de faire un don d’organes; iii) les objections de conscience devraient être respectées dans la mesure où elles ne compromettent pas l’accès aux soins des patients; iv) la possibilité de refuser des organes provenant de l’AMM devrait être offerte aux receveurs lors de leur inscription sur la liste d’attente et v) un patient désirant faire don de ses organes suite à une AMM qu’il désire garder confidentielle devrait être informé de toutes les implications liées au contexte particulier du prélèvement et consentir à un bris de la confidentialité afin de minimiser les risques de nuire au don d’organes. Certaines de ces conclusions sont contraires aux politiques en vigueur. Notre étude a contribué à mieux cerner les enjeux éthiques soulevés par le don d’organes dans ces nouveaux contextes. De plus, nous identifions les enjeux pour lesquels une réflexion plus poussée , et possiblement une révision des lignes directrices, s’imposent. Plusieurs questions demeurent et de nouvelles questions surgissent alors que des modifications aux critères d’admissibilité à l’AMM sont entrevues à court ou à moyen terme (AMM en dehors de la fin de vie, en cas de maladie mentale ou pour les patients inaptes ayant fait une demande anticipée). / In the summer of 2014, the case of a conscious patient, respirator dependent, who requested a withdrawal of life-sustaining therapy and expressed the wish to donate his organs shook the Quebec organ donation and transplantation community. It was the beginning of an important reflection on the acceptability of organ donation in conscious and competent people who have chosen to stop vital treatment. This reflection was timely as the Quebec government was preparing its End-of-Life Care Act, which would make medical assistance in dying (MAID) legal. Since it was clinically possible for some patients to donate organs following MAID, it was likely that the legalization of this practice would increase the number of conscious patients wishing to donate their organs when they would have chosen to die. The literature on the ethical issues raised by this type of organ donation was then almost non-existent and, at the time the research project began, practice guidelines did not exist in Quebec and Canada. It therefore became imperative to identify these ethical issues and to analyze them in order to contribute to the guidance of these new practices. There was also no study describing the perspectives of health professionals regarding such donations. The objectives of this doctoral project were (i) to identify the ethical issues raised by organ donation in a conscious and competent patient requesting withdrawal of life sustaining therapy or MAID; (ii) to analyze these issues using ethical theories; (iii) to obtain and understand the perspectives of health professionals on the issues raised by organ donation in these particular contexts; (iv) finally, to compare the perspectives of professionals to the policies that have been adopted in Quebec since its inception. We therefore conducted a qualitative exploratory study through interviews with organ donation professionals likely to be involved in the organ donation process by a conscious patient who has requested withdrawal of life-sustaining therapy or MAID. Our sample included physicians and nurses in intensive care, operating room or involved in organ donation in two Montreal hospital centers that are very active in organ donation (CHUM and Hôpital Sacré-Cœur) and at Transplant Québec. We identified ethical issues through a literature review and by analyzing the perspectives of professionals. The main ethical issues are related to respect for patient autonomy, information to be provided to potential donors, conscientious objection by professionals, the possibility for recipients to refuse organs procured after MAID, the acceptability of organ donation following a confidential MAID, the dead donor rule, the acceptability of directing an organ to a specific recipient designated by the donor and the acceptability of choosing MAID in order to make organ donation possible. We first analyzed these ethical issues using Norman Daniels' wide reflexive equilibrium model and then incorporated participants' perspectives on the various issues using the normative empirical - reflexive equilibrium model into our analysis. Based on our results, we can conclude that : (i) organ donation for competent patients requesting MAID or withdrawal of life-sustaining therapies was generally ethically acceptable within the legal context in effect at the time of our research; (ii) patients requesting MAID and suffering from a disease compatible with organ donation should be informed of the possibility of organ donation; and (iii) conscientious objections should be respected as long as they do not compromise patients' access to care; iv) recipients should be offered the opportunity to refuse organs procured after MAID when they are placed on the waiting list; and v) a patient who wishes to donate his or her organs following MAID that he or she wishes to keep confidential should be informed of all the implications related to the specific context of the procurement and should consent to a breach of confidentiality in order to minimize the risk of undermining public trust in organ donation. Some of these conclusions are contrary to current policies. Our study has contributed to a better understanding of the ethical issues raised by organ donation in these new contexts. In addition, we identify issues that require further reflection and possibly a revision of the guidelines in place. Many questions remain and new ones arise as changes to the MAID eligibility criteria are foreseen (MAID outside of the end-of-life context, in cases of mental illness or by advanced request).

Child protection is one of the most demanding fields of social protection and requires comprehensive solutions which have a major impact on the lives of children and their families. It also includes the agenda of parental conflicts and related child custody proceedings. The thesis deals with the practice of child protection social workers at the municipal authorities with extended powers in the Czech Republic in solving parental disputes. The theoretical part introduces legal, educational and competence framework of child protection and sets it into the context of specific aspects and pitfalls associated with the profession and approach of child protection social workers to solving parental conflicts. It also provides recommendations on how to solve parental conflicts followed by a case study of child protection department at the Prague 8 Municipality District Authority. It identifies attributes of best practice that contribute to the best interests of the child, including participation of families, multidisciplinary cooperation, transparency of processes and neutrality, professionalism and reflexivity of child protection social workers. The empirical part focuses on the understanding of working conditions and attitudes of child protection social workers at the municipal authorities with extended...

Begreppet psykologisk trygghet har visat sig vara en faktor som påverkar om personal trivs och stannar på arbetsplatsen. Begreppet innebär hur tryggt det upplevs att visa sig sårbar i en grupp och vad det får för konsekvenser. Forskning om poliskultur har visat att den karaktäriseras av tradition och rigida normer, vilket påverkar beteenden i gruppen. Den aktuella studien syftade till att undersöka hur nyblivna poliser upplever psykologisk trygghet i sin arbetsgrupp, samt hur de beskriver normer i förhållande till detta. Åtta deltagare intervjuades med en semistrukturerad intervjuguide baserad på Edmondsons teori om psykologisk trygghet samt forskning på poliskultur. Datat analyserades med reflexiv tematisk analys. Majoriteten av deltagarna upplevde att humor var ett framträdande sätt att hantera svåra upplevelser, men det fanns även behov av annat typ av stöd. De flesta deltagare upplevde att det var viktigt att visa sårbar för att lära sig yrket, samt att det påverkade relationerna i arbetsgruppen positivt, men flera upplevde det även som skrämmande och skamfyllt. Deltagarnas beskrivningar av arbetsgruppens normer, och deras förhållande till dem, verkade påverka upplevelsen av psykologisk trygghet. Normbrytande beteende sanktionerades, vilket avskräckte från framtida normbrytande. Resultaten stärker teorierna om att psykologisk trygghet är förenat med lärandebeteende och att poliskulturen är traditionsbunden. Psykologisk trygghet kan vara en bidragande faktor till att få poliser att trivas och stanna inom yrket. / Psychological safety has been shown to affect employees’ job satisfaction and turnover intention. The term “psychological safety” means how safe one feels in showing vulnerability in a group and the consequences it might bring. Research has shown that police culture is characterized by traditionality and rigid norms, which affects group behaviour. The present study aimed to examine how new police officers’ experience psychological safety within their work group. Eight police officers were interviewed with a semistructured interview guide based on Edmondson’s theory of psychological safety and literature on police culture. The data were analysed using reflexive thematic analysis. Most participants found humour to be a pronounced coping strategy for negative experiences, but there was a need for alternative ways of coping. Most participants found showing vulnerability to be essential for learning the police role, and that these behaviours had a positive effect on relationships within the work group, even though several found showing vulnerability frightening and shameful. The participants’ descriptions of the norms within the work group, and how well you fit into them, affected their experience of psychological safety. Breaking norms in the group was often followed by sanctions, which disencouraged similar future behaviour. The findings in this study support existing research on the link between psychological safety and learning behaviour and on police culture being governed by traditions. Psychological safety could be a contributing factor to keeping police officers satisfied so that they might stay within their line of work.

Der vorliegende Beitrag stellt die Konzeption und Erprobung eines Lehrkonzeptes für die Reflexionsarbeit in pädagogischen Handlungsfeldern vor. Um den Erfolg des Seminars und das Erreichen der Lernziele zu gewährleisten, wurden die Studierenden zu einer größtenteils interaktiven Erarbeitung des Lernstoffes sowie zur Aufarbeitung eigener Denk- und Handlungsmuster motiviert und angeleitet. Neben der Entwicklung einer reflexiven Haltung war das Ziel zudem, den Teilnehmenden ein Bewusstsein für die Chancen und „Risiken“ der Selbst- und Fremdreflexion in der pädagogischen Praxis zu vermitteln.

Child protection is one of the most demanding fields of social protection and requires comprehensive solutions which have a major impact on the lives of children and their families. It also includes the agenda of parental conflicts and related child custody proceedings. This thesis focuses on the practice of Czech social workers operating in the field of child protection at the municipal authorities with extended powers and on their approaches used to resolve parental disputes. The theoretical part is based on the conceptualization of practice from the perspective of a dynamic model of practice by Karen Healy, which builds on the interaction of several contexts, i.e. institutional contexts, formal professional base of social work, service users and their communities and framework for practice, and surveys them with regard to the agenda of parental disputes in detail. The empirical part aims to identify the variability of approaches used by Czech social workers operating in the field of child protection to resolve parental disputes. The research combines both qualitative and quantitative methodology and identifies a typology of defensive practice, reflexive practice, and intuitive practice. Individual types differ in the attitudes the child protection social workers express towards recognized...

The work deals with the phenomenon of so called watchdog organizations. The increasing number and influence of these organizations indicates a creation of new social movement. The authoress defines them as a type of public benefit nongovernmental organizations focused on the controlling of the public sphere or advocating and asserting a "public interest" in relation to the democratization of society. The authoress target is to understand this type of action, so she asks herself the question: Which frameworks are used by watchdog activists for the interpretation of their acting? At first there is briefly presented the concept of watchdog in the context of wider reflections of contemporary society, mainly in the context of reflexive modernity, monitory and participatory democracy and information society. Secondly there is introduced Goffman's framework analysis and the related conceptualization of framework of social movements by Benford and Snow. The authoress highlights a definition of frames as the principles of selection, emphasis and presentation about what happens, and what matters. In the next part of this work, there are presented the methodology and results of the qualitative research based on semi-structured interviews with watchdog activists. The research is settled in the area of...

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There has been little research conducted in general that explores the impact of sexualized violence on lesbian, gay, bisexual, trans, and queer (LGBTQ) youth. There is even more limited qualitative research, and almost none of it from a therapeutic perspective. This led me to engage with the fictionalized stories of LGBTQ youth characters who have survived sexualized violence to learn how these stories might inform the work of helping professionals. This thesis provides a reflexive thematic analysis of three novels written by queer authors. Through the lens of response-based therapy, intersectional feminism, and queer theory, it considers the ways in which the characters are impacted by their experiences with sexualized violence and their responses to it. Findings indicate that the characters were affected by childhood sexual abuse at a time in their lives when their sexual identities were on the cusp of being formed. Their experiences with sexualized violence impacted the ways that the characters learned to live with contradictions; experienced ambivalence in the relationships with the adults who caused them harm; and engaged in small acts of resistance against the impact of sexualized violence in their lives to create futures in which they could thrive. The characters’ experiences with casual sex and sex work are shown as an act of resistance against violence. This research aims to queer the discourses on LGBTQ youth who have experienced sexualized violence, expose the small acts of resistance that they perform against the impacts of sexualized violence, and transform the ways that child and youth care workers, therapists, social workers, and other helpers understand the resilience and experiences of LGBTQ survivors. / Graduate

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The pervasive threat of disinformation poses a challenge to societal stability and security. By investigating articles produced by three Iranian state-owned media outlets through the method of reflexive thematic analysis, this thesis presents four themes which are perceived to produce harmful narratives against Sweden in the context of the Quran crisis: (i) Swedish police as a supporter of Quran burning, (ii) Swedish government as allowing and supporting Quran burnings, (iii) Sweden as controlled by the US/Israel, (iiii) Swedish democracy as flawed. By applying the lens of social identity theory to these identified themes, the thesis investigates the production and dissemination of narratives produced by Iranian state media, elucidating the detrimental impact on Swedish security. By focusing on the creation of narratives, this thesis contributes to existing research on disinformation and the connection between narratives and disinformation. It also contributes to the growing need for literature regarding Iranian disinformation which has not yet been studied in-depth. The findings show, among other things, that the Swedish Government and police (outgroup) are perceived as enemies who constitute a threat to the survival of the Muslim community (ingroup). Swedish authorities are framed as hostile toward Iran, and the implication from Iranian leaders to act through a collective response regarding the desecration of the Quran. Further, the thesis suggests that there is a need to study the actors producing harmful narratives regarding Sweden and to study the Swedish identity within the disinformation phenomenon to gain better resilience against disinformation.