Client Participation in Moral Case Deliberation: A Precarious Relational Balance

Moral case deliberation (MCD) is a form of clinical ethics support in which the ethicist as facilitator aims at supporting professionals with a structured moral inquiry into their moral issues from practice. Cases often affect clients, however, their inclusion in MCD is not common. Client participation often raises questions concerning conditions for equal collaboration and good dialogue. Despite these questions, there is little empirical research regarding client participation in clinical ethics support in general and in MCD in particular. This article aims at describing the experiences and processes of two MCD groups with client participation in a mental healthcare institution. A responsive evaluation was conducted examining stakeholders’ issues concerning client participation. Findings demonstrate that participation initially creates uneasiness. As routine builds up and client participants meet certain criteria, both clients and professionals start thinking beyond ‘us-them’ distinctions, and become more equal partners in dialogue. Still, sentiments of distrust and feelings of not being safe may reoccur. Client participation in MCD thus requires continuous reflection and alertness on relational dynamics and the quality of and conditions for dialogue. Participation puts the essentials of MCD (i.e., dialogue) to the test. Yet, the methodology and features of MCD offer an appropriate platform to introduce client participation in healthcare institutions

Definitive fossil evidence for the extant avian radiation in the Cretaceous

Long-standing controversy 1-9 surrounds the question of whether living bird lineages emerged after non-avian dinosaur extinction at the Cretaceous/Tertiary (K/T) boundary1,6 or whether these lineages coexisted with other dinosaurs and passed through this mass extinction event2-5,7-9. Inferences from biogeography4,8 and molecular sequence data2,3,5,9 (but see ref. 10) project major avian lineages deep into the Cretaceous period, implying their 'mass survival' 3 at the K/T boundary. By contrast, it has been argued that the fossil record refutes this hypothesis, placing a 'big bang' of avian radiation only after the end of the Cretaceous1,6. However, other fossil data-fragmentary bones referred to extant bird lineages11-13-have been considered inconclusive1,6,14. These data have never been subjected to phylogenetic analysis. Here we identify a rare, partial skeleton from the Maastrichtian of Antarctica15 as the first Cretaceous fossil definitively placed within the extant bird radiation. Several phylogenetic analyses supported by independent histological data indicate that a new species, Vegavis iaai, is apart of Anseriformes (waterfowl) and is most closely related to Anatidae, which includes true ducks. A minimum of five divergences within Aves before the K/T boundary are inferred from the placement of Vegavis; at least duck, chicken and ratite bird relatives were coextant with non-avian dinosaurs.Fil: Clarke, Julia A.. North Carolina State University; Estados Unidos. North Carolina Museum of Natural Sciences; Estados UnidosFil: Tambussi, Claudia Patricia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Museo de la La Plata; ArgentinaFil: Noriega, Jorge Ignacio. Provincia de Entre Ríos. Centro de Investigaciones Científicas y Transferencia de Tecnología a la Producción. Universidad Autónoma de Entre Ríos. Centro de Investigaciones Científicas y Transferencia de Tecnología a la Producción. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Centro de Investigaciones Científicas y Transferencia de Tecnología a la Producción; ArgentinaFil: Erickson, Gregory M.. Florida State University; Estados Unidos. American Museum of Natural History; Estados Unidos. Field Museum of National History; Estados UnidosFil: Ketcham, Richard A.. University of Texas at Austin; Estados Unido