Consent remains a crucial, yet challenging, cornerstone of clinical practice. The ethical, legal and professional understandings of this construct have evolved away from a doctor-centred act to a patient-centred process that encompasses the patient’s values, beliefs and goals. This alignment of consent with the philosophy of shared decision-making was affirmed in a recent high-profile Supreme Court ruling in England. The communication of information is central to this model of health care delivery but it can be difficult for doctors to gauge (...) the information needs of the individual patient. The aim of this paper is to describe ‘core information sets’ which are defined as a minimum set of consensus-derived information about a given procedure to be discussed with all patients. Importantly, they are intended to catalyse discussion of subjective importance to individuals. The model described in this paper applies health services research and Delphi consensus-building methods to an idea orginally proposed 30 years ago. The hypothesis is that, first, large amounts of potentially-important information are distilled down to discrete information domains. These are then, secondly, rated by key stakeholders in multiple iterations, so that core information of agreed importance can be defined. We argue that this scientific approach is key to identifying information important to all stakeholders, which may otherwise be communicated poorly or omitted from discussions entirely. Our methods apply systematic review, qualitative, survey and consensus-building techniques to define this ‘core information’. We propose that such information addresses the ‘reasonable patient’ standard for information disclosure but, more importantly, can serve as a spring board for high-value discussion of importance to the individual patient. The application of established research methods can define information of core importance to informed consent. Further work will establish how best to incorporate this model in routine practice. (shrink)

Background: Lack of compassion is claimed to result in poor and sometimes harmful nursing care. Developing strategies to encourage compassionate caring behaviours are important because there is evidence to suggest a connection between having a moral orientation such as compassion and resulting caring behaviour in practice. Objective: This study aimed to articulate a clearer understanding of compassionate caring via nurse educators’ selection and use of published texts and film. Methodology: This study employed discourse analysis. Participants and research context: A total (...) of 41 nurse educators working in universities in the United Kingdom (n = 3), Ireland (n = 1) and Canada (n = 1) completed questionnaires on the narratives that shaped their understanding of care and compassion. Findings: The desire to understand others and how to care compassionately characterised educators’ choices. Most narratives were examples of kindness and compassion. A total of 17 emphasised the importance of connecting with others as a central component of compassionate caring, 10 identified the burden of caring, 24 identified themes of abandonment and of failure to see the suffering person and 15 narratives showed a discourse of only showing compassion to those ‘deserving’ often understood as the suffering person doing enough to help themselves. Discussion: These findings are mostly consistent with work in moral philosophy emphasising the particular or context and perception or vision as well as the necessity of emotions. The narratives themselves are used by nurse educators to help explicate examples of caring and compassion (or its lack). Conclusion: To feel cared about people need to feel ‘visible’ as though they matter. Nurses need to be alert to problems that may arise if their ‘moral vision’ is influenced by ideas of desert and how much the patient is doing to help himself or herself. (shrink)

This book aims to understand why women are the targets of online hate speech and how we can stop this from occurring. -/- Why are women so frequently targeted with hate speech online and what can we do about it? Psychological explanations for the problem of woman-hating overlook important features of our social world that encourage latent feelings of hostility toward women, even despite our consciously-held ideals of equality. Louise Richardson-Self investigates the woman-hostile norms of the English-speaking internet, the (...) ‘rules’ of engagement in these social spaces, and the narratives we tell ourselves about who gets to inhabit such spaces. It examines the dominant imaginings (images, impressions, stereotypes, and ideas) of women that are shared in acts of hate speech, highlighting their ‘emotional stickiness’. But offering strategies through which we may reimagine our norms of online engagement, the stories that justify those norms, and the logic that makes sense of it all, this book shows how we can create alternative visions of what it means to take up online space as a woman and to ensure that women are seen as entitled to be there. By exploring aspects of ‘social imaginaries’ theory and applying it to the problem of hate speech against women online, this book illuminates why woman-hating has become such a prominent feature of this environment and how we can make these spaces safer for women. (shrink)

Meteorology IV.12, the final chapter of Aristotle’s “chemical” treatise, is a major text for the traditional view that Aristotle believed in universal teleology, the idea that everything in the cosmos—including the elements, earth, water, air, and fire—is what it is because of the goal or good it serves. But in the context of the rest of Meteorology IV, a different picture emerges. Meteorology IV.1–11 analyze the dispositional properties of material compounds (malleability, elasticity, etc.), examine the behavior of stuffs when heated (...) and cooled, and provide the resources to classify kinds in terms of their material composition and dispositional properties. Meteorology IV.12 places itself within that larger investigation but takes a different approach, examining those same materials from the perspective of their functions in bodies of greater complexity (e.g., the function of flesh in an organism). I argue that the teleological account of, say, the elements is limited to their function in the composition of complex kinds, such as living organisms, and that outside such a complex the elements behave as they do, not for the sake of some good they serve but “of necessity,” according to their material natures and interactions with other materials. (shrink)

Since the 1960s, the focus of African Philosophy has predominantly been Afrocentric, and with an emphasis on racial issues, as a reaction to Eurocentrism. To hold an open intercultural dialogue on African Philosophy with African and other philosophers is, therefore, not-self-evident. This article will argue that intercultural dialogues or (in case of more than two participants) ‘polylogues’ can and should become a more central point of focus in the academic study of African Philosophy. The author will center on how three (...) renowned African(a) philosophers with a focus on the Akan people of Ghana have initiated intercultural dialogues for the enhancement of human wellbeing. These are Kwasi Wiredu, Kwame Gyekye and Kwame Anthony Appiah. What these philosophers have in common is their belief that all human beings are interdependent and that an emphatic, ethic orientation to one another and mutual communication helps to live together in social harmony, which enhances the wellbeing of mankind. Discussing these African philosophers’ insights into depth will pave the way for other scholars to explore the intercultural dialogue as a weak or non-centric and non-racial focused philosophical method and to enhance understanding of its relation to African(a) Philosophy and a Global Ethics of care. Keywords: Global Ethics, African(a) Philosophy, Akan, intercultural philosophical dialogue, human wellbeing. (shrink)

This book brings together the stories of biographers, novelists, scholars, and artists as they have written about the journeys (some literal, some figurative) they have made to their subjects. Contributors include Elizabeth Wood, J.J. Wilson, Leah Glasser, Jane Lazarre, and Alice Walker.

This Article explores how managerial prerogative shapes disputes over employment classification and reveals a neglected but prominent feature in legal arguments about platform worker rights—the disputed relevance of a platform’s intellectual property rights. In classification disputes, instead of denying that it has a right to control how others perform services for it, the company often concedes its employer-like authority but offers an alternative rationale: managerial prerogative. The company argues, and judges often agree, that its labor control is not the exercise (...) of employer authority but instead reflects a prerogative of enterprise ownership, like a right to protect property and determine product lines. Thus, managerial prerogative both explains labor control and exempts that control from the statutory duties that would otherwise attach under the legal tests. Platform companies appear to have taken notice of such cases and designed their work relationships around property-based rationales. For instance, Uber uses a software “license” in which drivers agree to Uber’s authority as a condition for accessing the app. The license depicts the terms upon which drivers must affirmatively cooperate with Uber to produce transportation as simply the negative duties not to interfere with Uber’s intellectual property. The Article concludes that we must reject appeals to managerial prerogative in employment classification disputes. To assume that a property-based rationale for labor control is inconsistent with employment is to misunderstand the legal basis of employment and the purpose of statutory labor law. The appeals also rely on dubious economic assumptions and conflate property rights with agreements about the use of property. (shrink)

We share Jaswal & Akhtar's concerns about the unintended repercussions of assumed social disinterest in autism. We expand consideration of these consequences with discussion of the literature and our own work on loneliness, mental ill-health, and self-representation, which is a cornerstone to social and emotional health. Further study is needed with expansive, mixed methodologies and involvement of the autistic community.

This article reports on an empirical qualitative study on applying a Philosophy for Children (P4C) modeled science story to support the teaching of basic science process skills of classification, observation, and inference to a group of fifth-grade science students. The science story was written to model the skills for the children. From individual interviews with a focus group of 10 students, the findings show that the story modeled the understanding of classification, observation, and inference skills for the children as well (...) as encouraged reflection on the meaning of inference. The majority of the students identified with the fictional characters, particularly regarding traits such as cleverness and inquisitiveness, and with the learning context of the story. Implications for the theory and practice of P4C are discussed. (shrink)

Within recent years, we have witnessed an alarming increase in so-called school-shootings, where one or more students enter their school and purposely start shooting other students or staff. Earlier, the phenomenon was primarily American, but lately school-shootings have also been seen in Canada, Europe, and Australia. School-shootings have become an increasing problem and the phenomenon calls for more thorough investigation. In this article, we analyse the actions of teachers, more specifically the ones where teachers give their lives to save students. (...) This unselfish act is analysed in the light of Jacques Derrida’s ethical discussions around ‘the gift of death’, and is displayed as an absolute responsibility. Moreover, the sacrificial actions displayed by teachers are viewed as acts of primitive leadership, which take us back to the romanticism and heroism of leadership. Unlike the everyday management of organisations, crises call for extraordinary leadership; for sacrifice and responsibility. (shrink)

Résumé Richelieu envoie, en 1629, Louis Deshayes de Courmenin à Moscou afin de signer un traité pour la reprise du commerce français en Russie. Après Hauser (1944) et Zordanija (1960), nous tentons d’éclairer cette mission à l’aide de textes inédits. Un extrait du journal de voyage de Brisacier et d’autres documents montrent que les Français recherchent surtout les produits russes (fourrures et autres peaux, fournitures de marine, céréales). Bien que le tsar leur refuse le droit d’aller en Perse pour acheter (...) la soie brute via la Russie, la mission de Deshayes est néanmoins un succès, économique et aussi politique. (shrink)

Allan Bell calls on hermeneutics to enliven the relation between discourse analysts and the materials they study, exploring the image of the analyst ‘standing before’ a corpus, prepared to be transformed by it. The ingredient of desire must be added to the account, as well as the embodied scenario of interpretation. These elements are mobilized to situate Bell’s rereading of Babel and of empire.

Social-psychological dimensions of learning are under-researched, but they affect student achievement. Within a marketized higher education context in England, United Kingdom, this study examined whether the relation between students’ social identities as members of their discipline and academic achievement could be further understood by considering the mediating roles of approaches to learning and frequency of making course complaints. Undergraduates completed a questionnaire to assess these constructs. As expected, approaches to learning and course complaining both acted as serial mediators of the (...) link between discipline identification and academic achievement: stronger discipline identification was related to more deep approaches to learning, less complaining, and higher achievement, whereas weaker discipline identification was related to more surface approaches to learning, more complaining, and lower achievement. The findings suggest that addressing these social-psychological aspects of learning could improve students’ academic achievement. (shrink)

This article investigates differences in pragmatic abilities between children who have cochlear implants and their hearing peers. Recordings of 10-minute conversations between 10 children with cochlear implants and a hearing peer were transcribed. Conversation analysis provides insights into interactional troubles not evident in broader measures of number of turns, requests for clarification, topic initiation and so on used in earlier studies. How the children go about repair proves of particular interest; other-initiated repair that prompts the speaker to repeat the prior (...) utterance is, not surprisingly, more commonly produced by the children who have cochlear implants. The key contribution of this article, however, is to detail examples where children with cochlear implants choose not to initiate repair of an error made by their hearing friend. The discussion not only highlights the interactional cost of initiating repair, but also demonstrates that not doing repair can cause a breakdown in conversation. (shrink)

BackgroundDespite its ubiquity in academic research, the phrase ‘ethical challenge(s)’ appears to lack an agreed definition. A lack of a definition risks introducing confusion or avoidable bias. Conceptual clarity is a key component of research, both theoretical and empirical. Using a rapid review methodology, we sought to review definitions of ‘ethical challenge(s)’ and closely related terms as used in current healthcare research literature.MethodsRapid review to identify peer-reviewed reports examining ‘ethical challenge(s)’ in any context, extracting data on definitions of ‘ethical challenge(s)’ (...) in use, and synonymous use of closely related terms in the general manuscript text. Data were analysed using content analysis. Four databases (MEDLINE, Philosopher’s Index, EMBASE, CINAHL) were searched from April 2016 to April 2021.Results393 records were screened, with 72 studies eligible and included: 53 empirical studies, 17 structured reviews and 2 review protocols. 12/72 (17%) contained an explicit definition of ‘ethical challenge(s), two of which were shared, resulting in 11 unique definitions. Within these 11 definitions, four approaches were identified: definition through concepts; reference to moral conflict, moral uncertainty or difficult choices; definition by participants; and challenges linked to emotional or moral distress. Each definition contained one or more of these approaches, but none contained all four. 68/72 (94%) included studies used terms closely related to synonymously refer to ‘ethical challenge(s)’ within their manuscript text, with 32 different terms identified and between one and eight different terms mentioned per study.ConclusionsOnly 12/72 studies contained an explicit definition of ‘ethical challenge(s)’, with significant variety in scope and complexity. This variation risks confusion and biasing data analysis and results, reducing confidence in research findings. Further work on establishing acceptable definitional content is needed to inform future bioethics research. (shrink)

The four principles approach to biomedical ethics points to respect for autonomy, beneficence, non-maleficence and justice as the norms that should guide moral agents working in the biosciences, and particularly in health care. While the approach is well known, it is not without its critics. In this paper, which is primarily aimed at health professionals and students (from various disciplines) who are studying health care ethics, I consider four problems with the four principles, which respectively claim that the approach is (...) imperialist, inapplicable, inconsistent and inadequate. In keeping with the aims of the ‘five-minute focus’, the primary objective is to introduce these debates, rather than seek to resolve them. However, I will suggest that the approach does have its merits, not least for time-pressed clinicians who are keen to keep an eye on the ethical dimensions of their practices, and for students training in the health care professions, provided that they appreciate that the approach provides only a starting point for, and not the end point of, moral deliberation. (shrink)

This paper explores the contradiction of positing the existence of a God who is at once omnipotent and not omnipotent in respect of his power that arises in the thought of two African philosophers of religion, John A.I. Bewaji and Ademola Kazeem Fayemi who accept the limitation thesis that projects a limited God and deny the legitimacy of the transcendence view in Yoruba and, by extension, African thought. I demonstrate in this paper that the contradiction arises from the fact that (...) while Bewaji and Fayemi explicitly deny the legitimacy of the transcendence view in Yoruba and, by extension, African thought, they implicitly accept the view and unwittingly and illegitimately attempt to reconcile the conflicting views through the analysis of the notions of God’s creatorship, co-creatorship, and controllership. I conclude by recommending that instead of attempting to reconcile the antinomy of God’s existence in African philosophy of religion, African philosophers should acknowledge the legitimacy of the two conflicting theses constituting the antinomy and, accordingly, sustain logical consistency by strictly thinking within either the framework of limitedness or the framework of transcendence. (shrink)

Background There is growing interest in the use and incorporation of empirical data in bioethics research. Much of the recent focus has been on specific “empirical bioethics” methodologies, which attempt to integrate the empirical and the normative. Researchers in the field are, however, beginning to explore broader questions, including around acceptable standards of practice for undertaking such research. The framework: In this article, we further widen the focus to consider the overall shape of an empirical bioethics research project. We outline (...) a framework that identifies three key phases of such research, which are conveyed via a landscaping metaphor of Mapping-Framing-Shaping. First, the researcher maps the field of study, typically by undertaking literature reviews. Second, the researcher frames particular areas of the field of study, exploring these in depth, usually via qualitative research. Finally, the researcher seeks to shape the terrain by issuing recommendations that draw on the findings from the preceding phases. To qualify as empirical bioethics research, the researcher will utilise a methodology that seeks to bridge these different elements in order to arrive at normative recommendations. We illustrate the framework by citing examples of diverse projects which broadly adopt the three-phase framework. Amongst the strengths of the framework are its flexibility, since it does not prescribe any specific methods or particular bridging methodology. However, the framework might also have its limitations, not least because it appears particularly to capture projects that involve qualitative – as opposed to quantitative – research. Conclusions Despite its possible limitations, we offer the Mapping-Framing-Shaping framework in the hope that this will prove useful to those who are seeking to plan and undertake empirical bioethics research projects. (shrink)

ABSTRACT The Dutch case of Brongersma presents novel challenges to the definition and evaluation of voluntary euthanasia since it involved a doctor assisting the suicide of an individual who was (merely?) ‘tired of life’. Legal officials had called on the courts to ‘set a principled boundary’, excluding such cases from the scope of permissible voluntary euthanasia, but they arguably failed. This failure is explicable, however, since the case seems justifiable by reference to the two major principles in favour of that (...) practice, respect for autonomy and beneficence. Ultimately, it will be argued that those proponents of voluntary euthanasia who are wary of its use in such circumstances may need to draw upon ‘practical’ objections, in order to erect an otherwise arbitrary perimeter. Furthermore, it will be suggested that the issues raised by the case are not peculiarly Dutch in nature and that, therefore, there are lessons here for other jurisdictions too. (shrink)

ABSTRACT An American surgical team has announced its intention to perform the first human facial transplantation. The team has, however, invited further analysis of the ethical issues before it proceeds and in this paper we take up that challenge in seeking to frame the debate with a particular focus on the recipients of the transplant. We address seven related areas of concern and identify numerous questions that require answers or, perhaps, better answers. We start by examining the nature of the (...) procedure and its intended benefits, why the procedure is being developed, and whether or not this should be viewed as experimental. Having concluded that this is experimental in nature, we then consider the broad question, who is the patient? Here we perceive difficulties in terms of the autonomy of the recipient, the unpredictable effects of receiving the transplant, and the role and influence of society. We conclude by asking whether the question should be ‘whether or not?’ rather than ‘when?’, particularly while the risks of losing face appear to far outweigh the likelihood of gaining face. (shrink)

Agich and Siemionov are to be congratulated for their attempt to refocus the debate on facial transplantation on those with most to gain: individuals with severe facial disfigurement.1 They make a good case for the surgical benefits offered by what they term facial allograft transplantation . Moreover, they fare better than other teams in recognising that candidates for FAT might also have much to lose. The team in Louisville had little to say on this issue, writing only rather benignly of (...) the possible “loss of transplanted tissue”.2 In contrast, Agich and Siemionov squarely confront this risk and offer the most complete account to date of how the risk will be minimised and rejection dealt with. This is an important development, which can only enhance the discussions that, contrary to what these authors imply, must indeed continue.According to Agich and Siemionov, their paper also provides a counterbalance to the numerous more sceptical views being expressed in bioethical and media circles—views which are said to rely more on fiction than fact. In response, we wish to argue that, as persuasive as some of their arguments undoubtedly are, the authors will not succeed in stalling this debate for there remain numerous issues that require further attention. We start with a central component of the authors’ argument, their appeal to “clinical need”, and suggest that this is not straightforwardly identifiable. No more straightforward is their suggestion that metaphors and lessons from the creative world have no place in this debate. This seems particularly unlikely when we consider that FAT will not offer the “ideal” solution; perhaps, then, wholesale facial transplantation is or will become the ideal and a film like Face/Off can offer some insights. Finally, we query the role and influence of …. (shrink)

This article marks a decisive step towards the recovery of the French woman writer, journalist, and aviation pioneer Louise Faure-Favier, who today is virtually forgotten. The article begins by sit...

The recent ruling from England on the case of M is one of very few worldwide to consider whether life-sustaining treatment, in the form of clinically assisted nutrition and hydration, should continue to be provided to a patient in a minimally conscious state. Formally concerned with the English law pertaining to precedent autonomy (specifically advance decision-making) and the best interests of the incapacitated patient, the judgment issued in M's case implicitly engages with three different accounts of the value of human (...) life, which respectively emphasise its self-determined, intrinsic and instrumental value. The judge appeared to be most persuaded by the intrinsic value of life and he concluded that treatment ought to continue. Assessing whether his approach or conclusion were ethically appropriate involves significant substantive and evidential questions regarding where the burden of proof should lie and what standard of proof should be required when decisions are to be made about the fates of patients inhabiting ‘twilight worlds’. (shrink)

"In this highly original book, Ada Agada responds to the question of how a philosophy can be African and at the same time universally relevant by constructing an original philosophical system that is at once African and universal. Drawing on African forms of thought and conceptual schemes like ethnophilosophy, ubuntu, sage philosophy, négritude, ibuanyidanda philosophy, and ezumezu logic, the author introduces new concepts and conceptual schemes like mood and proto-panpsychism into philosophical vocabulary and weaves them into a coherent and original (...) system that promises to significantly impact contemporary African philosophy. Arguing for intercultural and comparative philosophy as a desirable mode of philosophising in a continually globalising and interconnected world, the book demonstrates the universal applicability of consolationism. This book will be of interest to scholars in the fields of African Studies, intercultural philosophy, philosophy of mind, and existentialism"--. (shrink)

This paper examines Nietzsche’s conception of what persists, or occurs, as becoming in relation to Ramose’s reconceptualization of what persists, or occurs, as be-ing becoming with a view to showing how divergence and convergence of thought in the western and African contexts can inform cross-cultural philosophizing. Nietzsche radically subverts the traditional notion of an eternal immutable being that constitutes the ground of change and replaces it with the notion of becoming. Ramose’s notion of being, which is grounded in ubuntu philosophy, (...) integrates a dynamic perspective into a process view of reality. While Nietzsche seeks to abandon the categories of being, unity, and purpose altogether, Ramose ambiguously retains them and, in fact, endorses the category of unity. I highlight the dynamics of Nietzsche’s notion of becoming and articulate the basic principles of Ramose’s idea of being as be-ing becoming and argue that both thinkers’ struggle to subvert substance-based understanding of being invites us to question the intelligibility of the binary opposition of being with becoming and to regard both concepts as indicating different ways of understanding reality. (shrink)

BackgroundAs the COVID-19 pandemic develops, healthcare professionals are looking for support with, and guidance to inform, the difficult decisions they face. In the absence of an authoritative national steer in England, professional bodies and local organisations have been developing and disseminating their own ethical guidance. Questions inevitably arise, some of which are particularly pressing during the pandemic, as events are unfolding quickly and the field is becoming crowded. My central question here is: which professional ethical guidance should the professional follow?Main (...) bodyAdopting a working definition of “professional ethical guidance”, I offer three domains for a healthcare professional to consider, and some associated questions to ask, when determining whether – in relation to any guidance document – they should “bin it or pin it”. First, the professional should consider the source of the guidance: is the issuing body authoritative or, if not, at least sufficiently influential that its guidance should be followed? Second, the professional should consider the applicability of the guidance, ascertaining whether the guidance is available and, if so, whether it is pertinent. Pertinence has various dimensions, including whether the guidance applies to this professional, this patient and/or this setting, whether it is up-to-date, and whether the guidance addresses the situation the professional is facing. Third, the professional should consider the methodology and methods by which the guidance was produced. Although the substantive quality of the guidance is important, so too are the methods by which it was produced. Here, the professional should ask whether the guidance is sufficiently inclusive – in terms of who has prepared it and who contributed to its development – and whether it was rigorously developed, and thus utilised appropriate processes, principles and evidence.ConclusionAsking and answering such questions may be challenging, particularly during a pandemic. Furthermore, guidance will not do all the work: professionals will still need to exercise their judgment in deciding what is best in the individual case, whether or not this concerns COVID-19. But such judgments can and should be informed by guidance, and hopefully these preliminary observations will provide some useful pointers for time-pressed professionals. (shrink)