O Cuidado Empático: Contribuições para a Ética e Sua Interface com a Educação Moral na Formação em Saúde

RESUMO O presente artigo apresenta alguns pontos essenciais do pensamento do filósofo Michael Slote em sua obra “The ethics of care and empathy”. Situamos a sua produção no contexto em que a ética do cuidado foi desenvolvida e problematizada, evidenciando, sobretudo, a questão de gênero que atravessa essa perspectiva ética. Assim, convocamos autores e autoras que dialogam estreitamente com as questões levantadas por Slote como interlocutores fundamentais para se pensar a empatia como componente fundamental da ética do cuidado. Em sequência, resgatamos o sentido ontológico do cuidado e da responsabilidade, correlacionando-os com a prática do cuidado em saúde. Ao final, apresentamos um caso paradigmático para um debate concreto da ética do cuidado e empatia no âmbito da educação moral, destacando sua importância no processo de formação dos profissionais de saúde no Brasil.

Competência Moral e Espiritualidade na Educação Médica: Realidade ou Desafio?

RESUMO Estudantes de Medicina iniciam a faculdade idealistas, mas muitos consideram sair indiferentes: este é o maior desafio da educação médica. Estudos ratificam uma involução da competência moral durante o curso. Outro interesse crescente no meio acadêmico é a espiritualidade. Objetivo Avaliar a relação entre competência moral e espiritualidade dos estudantes de Medicina. Métodos Estudo descritivo transversal, com 121 estudantes. A coleta foi realizada por meio do software limesurvey, contendo o TCLE e três questionários: sociodemográfico, teste de competência moral de George Lind, calculado em planilha do Excel, e escala de espiritualidade de Pinto e Pais-Ribeiro. Utilizou-se o software Stata 12.0 na análise. Resultados Ter religião está associado a maior espiritualidade. Em relação ao gênero feminino e a ter pais médicos, houve tendência de associação com espiritualidade elevada. O escore C manteve-se crescente durante o curso. Na relação entre espiritualidade e competência moral, estudantes com baixa espiritualidade apresentaram tendência a escore C maior. Conclusão Estudantes mais espiritualizados apresentam tendência a ter competência moral menor. O questionário de espiritualidade, contudo, está intrincado com dimensões religiosas, que tendem a limitar o desenvolvimento da competência moral na população estudada.

DISAGREEING OVER EVALUATIVES: PREFERENCE, NORMATIVE AND MORAL DISCOURSE

Abstract Why would we argue about taste, norms or morality when we know that these topics are relative to taste preferences, systems of norms or values to which we are committed? Yet, disagreements over these topics are common in our evaluative discourses. I will claim that the motives to discuss rely on our attitudes towards the standard held by the speakers in each domain of discourse, relating different attitudes to different motives -mainly, conviction and correction. These notions of attitudes and motives will allow me to claim that different domains of evaluative discourse have a different distribution of disagreements driven by them.

How to (dis)solve Nagel's paradox about moral luck and responsibility

Abstract In this paper I defend a solution to the moral luck problem based on what I call "a fair opportunity account of control." I focus on Thomas Nagel's claim that moral luck reveals a paradox, and argue that the apparent paradox emerges only because he assumes that attributions of responsibility require agents to have total control over their actions. I argue that a more modest understanding of what it takes for someone to be a responsible agent-i.e., being capable of doing the right thing for the right reasons-dissolves the paradox and shows that responsibility and luck aren't at odds.

A ética médica sob o viés da bioética: o exercício moral da cirurgia

O exercício profissional da medicina atual tem uma forte abordagem biológica, devido à crescente especialização da ciência médica. Com frequência, a ciência, por si só, não ajuda a enfrentar e resolver uma situação particular de um profissional médico, e este é o lugar onde as ciências humanas, sociais e, especialmente as outras disciplinas, como a Bioética, podem dar uma abordagem mais humana e socialista, ao estudar sistematicamente a conduta humana no campo das ciências da vida e da saúde, através da luz dos valores e princípios morais. Como parte deste estudo, o segmento que está limitado à análise dos conflitos éticos decorrentes da prática da medicina e da assistência ao paciente, é conhecido como Ética médica. A Ética médica, no âmbito da cirurgia, compreende a integração do paciente cirúrgico com a natureza do cirurgião, influenciada pela sua formação e pelo seu treinamento, pela sua sensibilidade em identificar o que é correto. O ético não deve estar apenas no procedimento, no ato cirúrgico propriamente dito ou no que acontece em uma sala de operação ou mesmo no exercício da cirurgia como especialidade. A ética deve estar na vida e conduta do cirurgião, de forma que todos os atos profissionais e de vida devam ser eticamente válidos.

International Students' Quality Expectations in Higher Education

The purpose of this research is to examine factors affecting international students’ service quality expectations in higher education. The aim is pursued by investigating the international students’ quality expectations and the role of price, culture and personal values in forming these expectations. The theoretical part of this research is centered on themes related to service quality, the nature of educational services, the process of forming quality expectations and the antecedents of service quality expectations. The empirical part of the research was conducted with a quantitative method and the data was collected by using a web based questionnaire. The sample consisted of 268 students who applied to international master’s degree programmes in Finland in the spring of 2012. The response rate was 24,1 %. The research results show that personal values and culture affect the international students’ quality expectations of educational services but that price is not significantly related to the quality expectations.

University Image vs. University Identity: Congruence between Expectations and Experience

The aim of this thesis was to examine congruencies between university identity and university images of prospective and current students. Therefore, factors essentially influencing on expected and experienced university images were identified. Providing an understanding on the differences in the formation of both concepts allowed the analysis of potential incongruities between a university’s identity and the perceptions its students hold. The study was conducted in July and August 2013 at Lappeenranta University of Technology by means of a web-based research survey. The sample consisted of 160 international Master’s degree students who were admitted in 2011, 2012 and 2013. Descriptive and multivariate statistical analysis methods were used to process the data. The results of the study indicated statistically significant incongruities between the case university’s identity and its students’ images. Further, the expected and experienced university images showed incongruities to each other. Deviations were additionally detected to be dependent on the students’ home regions. All in all, there is potential for an improvement of the students’ experiences resulting from a low perception of the student’s preparation for future job life.

Expectations, frames and practices of genetic counselling in different contexts of genetic testing

Genetic counselling is a process in which the counsellee receives information and support concerning a genetic disease. This study examines the genetic counselling attached to genetic testing. Since genetic information is increasing alongside new testing technologies and the situations faced at the genetic clinics will therefore be more diverse, it is essential to assess what the expectations directed at genetic counselling are. It is also important to compare how they face the current counselling practices. In this study, the expectations, frames and practices of genetic counselling in different contexts of genetic testing were examined from three different perspectives: First, international guidelines covering genetic counselling were analysed to summarise what is expected from genetic counselling and to study how genetic information is framed. Second, national experts in European countries were asked about the regulations and practices of genetic counselling in their country. Finally, ten counsellees who had visited a genetic clinic were interviewed to analyse their expectations and experiences. The counsellees’ perspective was also approached through the background review of the previous studies on counsellees’ experiences. On the basis of the study, there are basic elements that are expected to be covered in genetic counselling from all perspectives. However, the views concerning bioethics, genetic exceptionalism and psychosocial aspects vary depending on the perspective and on the individual situation. Since there are sometimes more differences than similarities between genetic tests, no universal recommendations for counselling can be applied. The practices of genetic counselling should be defined situationally, emphasising the individual needs over the genes.

Focus on the user: perception, expectations and needs

Esitys KDK-käytettävyystyöryhmän järjestämässä seminaarissa: Miten käyttäjien toiveet haastavat metatietokäytäntöjämme? / How users' expectations challenge our metadata practices? 30.9.2014.

The importance of customer's value expectations in customer acquisition

Pro gradu –tutkielman tavoitteena on tutkia asiakasarvoa ja sitä, miten asiakasarvoa voidaan käyttää hyväksi uusasiakashankinnassa. Tällä hetkellä kirjallisuudessa on pinnalla muutos tuotekeskeisyydestä asiakaskeskeiseen näkökulmaan, joka tunnistaa asiakasarvon tärkeyden bisnes suhteissa. Tämä tutkimus osallistuu kyseiseen keskusteluun muodostamalla tavan mitata asiakasarvoa, ja peilaamalla saavutettuja tuloksia uusasiakashankinta prosessiin. Empiirinen tutkimus on toteutettu kahdessa osassa: kvalitatiivisessa sekä kvantitatiivisessa. Ensimmäisessä osassa haastateltiin kahdeksaa potentiaalista asiakasta, minkä jälkeen saadut tulokset vietiin suurempaan skaalaan toteuttamalla kysely suurelle joukolle potentiaalisia asiakkaita. Lopulliset tulokset osoittavat, että asiakasarvon käyttäminen hyväksi uusasiakashankinnassa on erittäin tehokas ja käyttökelpoinen metodi. Asiakasarvoon perustuvat asiakassegmentit mahdollistavat oikeiden arvojen kommunikoinnin oikeille segmenteille. Se antaa yritykselle myös mahdollisuuden valita houkuttelevimmat asiakasryhmät ja vahvistaa asiakaskantaansa.

Determination of potential value drivers by identifying customer expectations and perceived value

The purpose of this exploratory research is to identify the potential value drivers regarding a new service offering. More specifically, the aim is to build understanding of customer expectations and perceived value of energy efficiency solutions in the building’s sector. The knowledge is then used in defining potential value drivers. The research is conducted from the customer’s perspective in a business-to-business context. The theory part of the master’s thesis focuses on discussing the antecedents of customer expectations and customer value. The theory gives implications how to determine value drivers and develop value propositions as well as conduct value assessment. The empirical part is based on the qualitative research method. The research was conducted as a single-case study, and the primary data was collected through semi-structured interviews with potential customers. The results of the research revealed that the customer expectations are connected to being able to define value drivers. In addition, the research revealed generic themes relating to the offering and customer-supplier relationship, which help in the process of identifying potential value drivers. The results were discussed in terms of product-, service-, price- and relationship-related value drivers for the new service. Based on the data analysis the dominant value drivers are elaborated in terms of identified customer benefits and customer sacrifices (costs). Finally, some implications of value proposition and value assessment to support the value delivery were given.

Mistä on hyvät tytöt tehty? Somalitytöt ja maineen merkitykset

Tutkimus käsittelee islaminuskoisten somalityttöjen hyvään ja huonoon maineeseen liittyviä uskonnollisia, kulttuurisia ja etnisiä määrittelyjä ja niiden merkityksiä heidän arjessaan. Turussa hankittu etnografinen tutkimusaineisto koostuu osallistuvaan havainnointiin perustuvasta kenttäpäiväkirja-aineistosta sekä kahdestakymmenestäviidestä 17‒35-vuotiaiden somalityttöjen ja -naisten teemahaastattelusta vuosilta 2003–2006. Tutkimuksen tehtävänä on selvittää, minkälaista somalityttöä pidetään maineeltaan hyvänä ja miten tytön maine voi mennä. Tutkimuksessa tarkastellaan yhtäältä sitä, mikä merkitys sosiaalisilla verkostoilla on tyttöjen maineen määrittelyssä. Toisaalta kysytään, mitä somalitytöt ja nuoret naiset itse ajattelevat tytön maineeseen liittyvistä odotuksista ja miten he niistä tietoisina toimivat. Lähestymistapa rakentuu uskontotieteen, antropologian, sukupuolentutkimuksen, tyttötutkimuksen, nuorisotutkimuksen ja kulttuurimaantieteen näkökulmia yhdistelemällä. Ensimmäisessä aineistontulkintaluvussa tarkastellaan tyttöyteen ja maineen rakentumiseen liittyvää ruumiillista merkityksenantoa pukeutumisen, seksuaalisuuden, tyttöjen ympärileikkausta koskevan asennemuutoksen ja seurustelun teemojen kautta. Toisessa luvussa keskitytään kaupunkitilan ja tyttöjen vapaa-ajanvieton sosiotilallisiin tulkintoihin sekä tyttöjen käytöstä kodin ulkopuolella määritteleviin ja mainetta rakentaviin puheisiin. Haastatellut arvostivat islamiin ja somaliperinteeseen liittyviä arvoja ja pitivät niitä oman käytöksensä ohjenuorina. Omanarvontunto, itsekontrolli ja vastuuntunto omista teoista liitettiin ”hyvään tyttöyteen”. Tyttöjen toimijuus ilmeni heihin kohdistuvien odotusten suuntaisena käyttäytymisenä ja näiden ihanteiden arvostamisena. Toimijuus näkyi myös tiettyjen tyttöihin ja poikiin kohdistuvien erilaisten odotusten kyseenalaistamisena ja joissakin tapauksissa vastoin odotuksia toimimisena. Turkua myös verrattiin somalityttöjen käytöksen osalta pääkaupunkiseutuun. Tässä vertailussa Turku nimettiin kulttuurisen jatkuvuuden, pääkaupunkiseutu kulttuurisen muutoksen paikaksi. Haastateltujen mukaan yhteisöllisiä tulkintoja tyttöjen käytöksestä tehtiin puheissa ja juoruissa, usein suhteessa havaintoihin suomalaistyttöjen käytöksestä. Tyttöjen arkeen nämä etniset ja moraaliset eroteot eivät kuitenkaan vaikuttaneet aina samalla tavoin, koska tulkinnat tyttärille sopivasta ja mahdollisesta käytöksestä voivat vaihdella perheiden välillä. Tutkimus tuo esille, että tytön hyvä maine on eräs perheen hyvinvointiin vaikuttavista tekijöistä. Somalityttöjen käytös on myös eräs yhteisöllinen peili, jota vasten tehdään laajempia tulkintoja somalikulttuurin ja uskonnollisten arvojen tilasta diasporassa. Liiallinen muutos tyttöjen käyttäytymisessä uhkasi yhteisöllistä jatkuvuutta ja uskonnolliskulttuuristen arvojen välittymistä seuraaville sukupolville. Laajasti ymmärrettynä ”hyvä tyttöys” ja hyvä maine oli onnistuneen kulttuurisen neuvottelun tulosta diasporassa. Se tarkoitti, että tyttö kiinnittyi somalialaiseen taustaansa ja sen välittämiin arvoihin, osallistuen samalla kuitenkin myös suomalaiseen yhteiskuntaan.