This article explores emerging ethical questions that result from knowledge development in a complex, technological age. Nursing practice is at a critical ideological and ethical precipice where decision-making is enhanced and burdened by new ways of knowing that include artificial intelligence, algorithms, Big Data, genetics and genomics, neuroscience, and technological innovation. On the positive side is the new understanding provided by large data sets; the quick and efficient reduction of data into useable pieces; the replacement of redundant human tasks by (...) machines, error reduction, pattern recognition, and so forth. However, these innovations require skepticism and critique from a profession whose mission is to care for and protect patients. The promise of technology and the new biological sciences to radically and positively transform healthcare may seem compelling when couched in terms of safety, efficiency, and effectiveness but their role in the provision of ethical nursing care remains uncertain. Given the profound moral and clinical implications of how today’s knowledge is developed and utilized, it is time to reconsider the relationship between ethics and knowledge development in this new uncharted area. (shrink)

We live in a society that promotes the universal process of producing knowledge and truth making as fundamental social process. Such promotion of universality seems to subjugate others forms of knowing rendering them invisible, unintelligible, and ineligible and subsequently outside the community of knowing. This has material and symbolic consequences in terms of how research informs policy and subsequent victimization of those who live, and experience subjugation meted by Western truth making universalism. In the words of Foucault, this book is (...) an insurrection of subterranean and clandestine knowledges in ways that provide not just an alternative process of knowledge production but affirms local knowledge as necessary in production of a just society. The book looks at research as a social justice and transformational process that should speak of people's ways of live without necessarily streamlining them into numbers. The book is a critically reflexive project in terms of returning processes of knowledge production to the local space rather than imagining them as entirely centred in the structure. To imagine this book as reflexive exercise is to break boundaries of knowledges in ways that come to imagine how local performs global in very complicated and complex ways. This book is a resurrection of local knowledges steeped in creative and imaginative reflexive methodologies that come to reorient how we come to know what we know, the values and realities that mark what we know and the how of knowledge production. It centres subjugated voices and knowledges as fundamental in production of knowledge. Contributors include: Katie Bannon, Elizabeth Charles, Khulood Agha Khan, Dionisio Nyaga, Fritz Pino, and Rose Ann Torres. (shrink)

In this paper I attempt to trace some entanglements of an event documented in my PhD research, which contests dominant modes of enquiry. This research takes place with a group of Grade 2 learners in a government school in Cape Town, South Africa. It is experimental research which resists the human subject as the most important aspect of research, the only one with agency or intentionality. In particular, the analysis focuses on the process of the making of the circle, and (...) how integral it is in contributing to building the Community of Enquiry, the pedagogy of Philosophy with Children. A critical posthuman analysis is offered which engages with the material-discursive entanglements of the making of the circle. Also, how this making of a circle can be a democratising practice, by including in the concept of democracy, the more-than-human. The analysis also focuses on the placing of the chairs by the children, as a deliberate pedagogical practice, and how this works to disrupt the adult /child binary. There is a move beyond the linguistic turn by paying attention to not only the discursive in the transcriptions but also the intra-actions in between human and more-than-human, the circle, the chairs and the materiality of place. (shrink)

This article considers two of the methodological steps in a Community of Philosophical Enquiry: developing the questions and voting on the questions. Both of these practices are enacted by the 8-9 year old children who are the participants in a philosophical enquiry, which I facilitated at a government primary school in South Africa. Matthews (1994) reminds us that children as philosophical thinkers/doers have been left out of the dominant narratives about children and childhood. A question that guides this research is (...) where is the place for philosophical questions (developed by children) and the kind of philosophical thinking/drawing/creating/being for child (and adults) in schools? How do we make space for such questioning–so that the richness of these pedagogical encounters can really matter and make a difference to the teaching and learning taking place? Gandorfer in an interview with Barad (2021), suggests that critical thought “is to encounter what is unrecognizable and imperceptible, yet sensible and constructive of sense without separating it from the physical world” (p. 20). I would agree and apply this to the critical thoughts of child. This thinking is not located in the child, in their mind and does not emerge only through the thoughts, child verbalises. A critical posthumanism theory/practice analysis ensures that as researcher, I do not stand outside of the research peering in at a distance. Similarly the children, the questions, the voting and the enquiries are not separate from the world, they are all already entangled with the world. When the children are voting on the questions, this performs as a pedagogy of interruption (Michaud, 2020). As the facilitator, I do not know which question will receive the largest number of votes for the philosophical enquiry. This makes possible an emergent curriculum in its be(com)ing. Toby Rollo’s (2016) formulations about child as political agent and not just moral agent and the implications for more democratic and just schooling are theorised in this paper through the act of the children voting on the questions. I argue that children are not just excluded from participating in decisions about what and even how they are learning at school but from most pedagogical practices in classrooms and schools. I show how the children creating the questions and voting on the questions can be democratic practices with political and moral implications in a community of philosophical enquiry. (shrink)

This study examines the discourse representation of migrant voices in two Spanish broadsheets and two freesheets through the analysis of quoted utterances. Data analyzed were gathered within the framework of a year-long EU research pilot project aimed at developing a cost-effective methodology to comparatively analyze print media content from six EU member states. Within the paradigm of CDA and drawing on Appraisal Theory, we analyzed the writer’s use of different types of reported speech, the corresponding reporting verbs, the endorsement of (...) the reported voices, and the attitudes and emotions that these denote. Results show some significant differences in the way immigrants’ voices are reported in Spanish broadsheets and freesheets. While the stories from the broadsheets depict voices of human suffering, freesheets articles show a different immigrant voice: one which is confident, successful, and well-adapted to the host environment. (shrink)

The purpose of this article is to describe the development of a model of moral distress in military nursing. The model evolved through an analysis of the moral distress and military nursing literature, and the analysis of interview data obtained from US Army Nurse Corps officers (n = 13). Stories of moral distress (n = 10) given by the interview participants identified the process of the moral distress experience among military nurses and the dimensions of the military nursing moral distress (...) phenomenon. Models of both the process of military nursing moral distress and the phenomenon itself are proposed. Recommendations are made for the use of the military nursing moral distress models in future research studies and in interventions to ameliorate the experience of moral distress in crisis military deployments. (shrink)

There has been an ongoing appeal in the bioethics literature for a broader understanding and conceptual clarity of the phenomenon of moral distress. Several authors argue that greater conceptual cl...

In September 2008, 10 years after the untimely death of Pere Alberch (1954–1998), the 20th Altenberg Workshop in Theoretical Biology gathered a group of Pere’s students, col- laborators, and colleagues (Figure 1) to celebrate his contribu- tions to the origins of EvoDevo. Hosted by the Konrad Lorenz Institute for Evolution and Cognition Research (KLI) outside Vienna, the group met for two days of discussion. The meeting was organized in tandem with a congress held in May 2008 at the Cavanilles Institute (...) for Biodiversity and Evolutionary Biology (ICBiBE) in Valencia, Spain. The talks at the KLI were equal parts: nostalgic remembrance, excitement over new ways of thinking about old problems, and an unrepressed vitriol against the resurgence of reductionist thinking in EvoDevo. Here we highlight some of the key aspects of Pere’s life and work that informed and infused the talks. (shrink)

Chromosome ends have been implicated in the meiotic processes of the nematode Caenorhabditis elegans. Cytological observations have shown that chromosome ends attach to the nuclear membrane and adopt kinetochore functions. In this organism, centromeric activity is highly regulated, switching from multiple spindle attachments all along the chromosome during mitotic division to a single attachment during meiosis. C. elegans chromosomes are functionally monocentric during meiosis. Earlier genetic studies demonstrated that the terminal regions of the chromosomes are not equivalent in their meiotic (...) potentials. There are asymmetries in the abilities of the ends to recombine when duplicated or deleted. In addition, mutations in single genes have been identified that mimic the meiotic effects of a terminal truncation of the X chromosome. The recent cloning and characterization of the C. elegans telomeres has provided a starting point for the study of chromosomal elements mediating the meiotic process. (shrink)

In this paper, we give a flavour of how, against the odds, Reggio-Emilia-inspired pedagogical documentation can work in reconceptualizing environmental education, reconfiguring child subjectivity and provoking an ontological shift from autopoiesis to sympoiesis in teacher education. Working posthuman(e)ly and transdisciplinarily across three foundation phase teacher education courses at a university in South Africa, we situate our teaching within current environmental precarities. We show how we stirred up trouble in and outside our university classroom and provoked our students to “make kin” (...) with children, each other, other animals, and the more-than-human, but also to stay with the trouble, that is, to learn to be truly present in colonized spaces. (shrink)

Significant advances have recently been made in our understanding of the mechanisms of activation of proteins that require processing. Often this involves endoproteolytic cleavage of precursor forms at basic residues, and is carried out by a group of serine endoproteinases, termed the proprotein convertases. In mammals, seven different convertases have been identified to date. These act in both the regulated secretory pathway for the processing of prohormones and proneuropeptides and in the constitutive secretory pathway, in which a variety of proproteins (...) are activated endoproteolytically. The recently completed sequence of the nematode Caenorhabditis elegans genome affords a unique opportunity to examine the entire proprotein convertase family in a multicellular organism. Here we review the nature of the family, emphasising the structural features, characteristic of the four nematode genes, that supply all of the necessary functions unique to this group of serine endoproteinases. Studies of the C. elegans genes not only provide important information about the evaluation of this gene family but should help to illuminate the roles of these proteins in mammalian systems. BioEssays 22:545–553, 2000. © 2000 John Wiley & Sons, Inc. (shrink)

The SARS-CoV-2 (COVID-19) pandemic continues to expose underlying inequities in healthcare for black, indigenous and Latinx communities in the USA. The gaps in equitable care for communities of colour transcend the diagnosis, treatment and vaccinations related to COVID-19. We are experiencing a continued gap across racial and socioeconomic lines for those who suffer prolonged effects of COVID-19, also known as ‘Long COVID-19’. What we know about the treatment for Long COVID-19 so far is that it is complex, requires a multidisciplinary (...) approach and there is still much research needed to fully understand the effects. In this paper, we discuss pragmatic considerations for including affected communities, relevant stakeholders, and leaders from communities of colour in the planning and implementation of Long COVID-19 research. (shrink)

BackgroundThere has been media coverage surrounding the dangers of heavy drinking and benefits of moderation, with TV and radio presenter, Adrian Chiles, documenting his experience of moderating alcohol consumption in an online article for the Guardian. By analysing the comments in response to Chiles’ article, this study aimed to explore posters’ attitudes or beliefs toward moderating alcohol and posters’ experiences of moderating or abstaining from alcohol.MethodA secondary qualitative analysis of online comments in response to an article about moderating alcohol consumption. (...) Main outcome measures: Comments in response to a United Kingdom online news article about moderating alcohol consumption were extracted and inductive thematic analysis was used.ResultsFor aim one, two themes were developed; “general attitudes toward drinking” and “general attitudes toward reducing consumption”. These themes reflect negative perceptions of alcohol and issues around changing attitudes. For aim two, three themes were developed: “moderation vs. abstention”, “reflection on past drinking behaviours”, and “current drinking behaviours”. These themes represent posters’ experiences and implications changing their drinking habits.ConclusionOur analysis provides a novel insight into perceptions and experiences of moderating or abstaining from alcohol. Alcohol is embedded within United Kingdom culture, creating difficulties for those who choose to moderate or abstain from alcohol. Our analysis highlights the need for public health to focus on shifting the current drinking culture, through clearer drinking guidelines and a wider availability of alcohol-free alternatives. (shrink)

This book updates and adds to the classic Social Movements of the Sixties and Seventies, showing how social movement theory has grown and changed.

Editor's suggested further reading in BioEssays Epigenetics meets mathematics: Towards a quantitative understanding of chromatin biology Abstract.

The Covid-19 pandemic creates an unprecedented threatening situation worldwide with an urgent need for critical reflection and new knowledge production, but also a need for imminent action despite prevailing knowledge gaps and multilevel uncertainty. With regard to the role of research ethics in these pandemic times some argue in favor of exceptionalism, others, including the authors of this paper, emphasize the urgent need to remain committed to core ethical principles and fundamental human rights obligations all reflected in research regulations and (...) guidelines carefully crafted over time. In this paper we disentangle some of the arguments put forward in the ongoing debate about Covid-19 human challenge studies (CHIs) and the concomitant role of health-related research ethics in pandemic times. We suggest it might be helpful to think through a lens differentiating between risk, strict uncertainty and ignorance. We provide some examples of lessons learned by harm done in the name of research in the past and discuss the relevance of this legacy in the current situation. (shrink)

Checklists have been used to improve quality in many industries, including healthcare. The use of checklists, however, has not been extensively evaluated in clinical ethics consultation. This article seeks to fill this gap by exploring the efficacy of using a checklist in ethics consultation, as tested by an empirical investigation of the use of the checklist at a large academic medical system (Cleveland Clinic). The specific aims of this project are as follows: (1) to improve the quality of ethics consultations (...) by providing reminders to ethics consultants about process steps that are important for most patient-centered ethics consultations, (2) to create consistency in the ethics consultation process across the medical system, and (3) to establish an effective educational tool for trainers and trainees in clinical ethics consultation. The checklist was developed after a thorough literature review and an iterative process of revising and testing by a group of experienced ethics consultants. To pilot test the checklist, it was distributed to 46 ethics consultants. After a six-month pilot period in which ethics professionals used the checklist during their clinical activities, a survey was distributed to all of those who used the checklist. The 10-item survey examined consultants’ perceptions regarding the three aims listed above. Of the 25 survey respondents, 11 self-reported as experts in ethics consultation, nine perceived themselves to have mid-level expertise, and five self-reported as novices. The majority (68 percent) of all respondents, regardless of expertise, believed that the checklist could be a “helpful” or “very helpful” tool in the consultation process generally. Novices were more likely than experts to believe that the checklist would be useful in conducting consultations. The limitations of this study include: reduced generalizability given that this project was conducted at one medical system, utilized a small sample size, and used self-reported quality outcome measures. Despite these limitations, to the authors’ knowledge this is the first investigatation of the use of a checklist systematically to improve quality in ethics consultation. Importantly, our findings shed light on ways this checklist can be used to improve ethics consultation, including its use as an educational tool. The authors hope to test the checklist with consultants in other healthcare systems to explore its usefulness in different healthcare environments. (shrink)

Background During the COVID-19 pandemic, virtual visiting technologies were rapidly integrated into the care offered by intensive care units (ICUs) in the UK and across the globe. Today, these technologies offer a necessary adjunct to in-person visits for those with ICU access limited by geography, work/caregiving commitments, or frailty. However, few empirical studies explore the ethical issues associated with virtual visiting. This study aimed to explore the anticipated or unanticipated ethical issues raised by using virtual visiting in the ICU, such (...) that healthcare professionals can be informed about how to carry out virtual visits ethically, safely and productively. Methods We used a descriptive exploratory qualitative research approach recruiting a convenience sample of newly-graduated junior doctors facilitating ICU virtual visits in a tertiary academic centre. Eight newly graduated junior doctors, seven female and one male, aged 23–27, participated in semi-structured interviews. We analysed transcripts using an inductive coding approach. Results Five overarching themes emerged. Two of the themes namely, ‘fulfilling a moral instinct to connect families’ and ‘promoting autonomy’, arose from participants’ descriptions of how virtual visits aligned with healthcare standards and practices they considered ethical. Three further themes, ‘preserving dignity and privacy’, ‘managing emotional distress’, and ‘providing equitable access’ to virtual visiting technologies, highlight how virtual visits might exacerbate ethical issues related to family communications. Conclusion Virtual visiting may potentially both ameliorate and exacerbate aspects of ethical healthcare delivery for ICU patients and family members. ICU team members should consider unique ethical considerations related to using virtual visiting. We recommend virtual communications skills training for staff and advocate for the use of easily accessible educational resources for families who wish to visit critically unwell patients remotely. (shrink)

Following the introduction of do-not-resuscitate orders in the 1970s, there was widespread misinterpretation of the term among healthcare professionals. In this brief report, we present findings from a survey of healthcare professionals. Our aim was to examine current understanding of the term do-not-attempt-resuscitate, decision-making surrounding DNAR and awareness of current guidelines. The survey was distributed to doctors and nurses in a university teaching hospital and affiliated primary care physicians in Dublin via email and by hard copy at educational meetings from (...) July to December 2014. A total of 519 completed the survey. The response rate in the hospital doctors group was 35.5%, 19.8% in the nurses group but 68.8% in the specialist nurses group and 40% in the primary care physician group.Alarmingly, our results demonstrate that 26.8% of staff nurses and 30% of primary care physicians surveyed believed that a patient with a DNAR order could not receive any/at least one of a list of simple treatments including antibiotics, physiotherapy, intravenous fluids, pain relief, oxygen, nasogastric feeding or airway suctioning, which were higher percentages compared to the other hospital doctors and experienced nurses groups with statistically significant differences. Furthermore, a higher percentage of staff nurses and primary care physicians believed that a patient with a DNAR order could not be referred to hospital from home/a nursing home, when compared with other healthcare groups. Our findings highlight continued misunderstanding and over-interpretation of DNAR orders. Further collaboration and information is required for meaningful Advance Care Plans. (shrink)

The early coronavirus disease 2019 (COVID‐19) outbreak inflicted vulnerability on individuals and societies on a completely different scale than we have seen previously. The pandemic developed rapidly from 1 day to the next, and both society and individuals were put to the test. Older people's experiences of the early outbreak were no exception. Using an abductive analytical approach, the study explores the individual experiences of vulnerability as described by older people hospitalised with COVID–19 in the early outbreak. In these older (...) people, we found that the societal context and the individual experiences of vulnerability were inextricable linked. The study demonstrates that despite significant individual stress, informants displayed an interesting ability to also view their situation to reorient their perspective. The experience of vulnerability is both conditional and individual, which imposes a degree of unpredictability that neither they nor others were able to negotiate. The article discusses the phenomenon of unpredictability in light of a modern society with regard to how individuals and society may encounter unexpected events in the future where the potential to reorient will be vital. (shrink)

As national and state health care policy -making becomes contentious and complex, there is a need for a forum to debate and explore public concerns and values in health care, give voice to local citizens, to facilitate consensus among various stakeholders, and provide feedback and direction to health care institutions and policy makers. This paper explores the role that regional health care ethics committees can play and provides two contrasting examples of Networks involved in facilitation of public input into and (...) the development of health care policies and adoption of state-wide practices. (shrink)

The article explores the rich and varied experiences of a collective writing project, unfolding through an anecdote involving Charlie, a young boy who creatively disrupted conventional photography methods. This incident, during an evening promenade by the sea in Ericeira (Portugal), epitomizes the project's embrace of playfulness and exploration of diverse perspectives–materialized through Charlie's playful insistence on experimenting with different angles. The event embodied the group’s approach to writing, leading to a collective inquiry into the interplay of ages, angles, and other (...) themes like waves, threads, shadows, and liminal spaces. The project, driven by the Between Ages Collective, began with informal gatherings in Plymouth, UK, and expanded into a year-long online reading group. Participants, spanning different generations and academic stages, shared various materials, including films, picture books, and scholarly texts, which inspired individual contributions. Influenced by the Collective's collaborative spirit, these contributions explore the concept of 'between ages' – a metaphorical and literal space of transition and fluidity. Contributors were invited to craft pieces that delve into the 'between ages' theme, often exploring serendipitous moments that transform interactions and experiences. The writing tries to capture a sense of openness and curiosity, embracing the uncertainties and ambiguities inherent in the process. The works do not strictly adhere to conventional academic or narrative forms but rather emerge from the collective's shared experiences, including cooking, eating, swimming and walking together. The article suggests that these writings are not meant to be definitive or conclusive but are explorations that invite readers to engage with the mundane and profound textures of everyday life. The stories and themes explored are marked by their diversity in style, rhythm, and imagery, ranging from reflections on the philosophy of shadows to the profound implications of intergenerational and interspecies relationships. The Collective’s work is presented as an ongoing experiment in thinking and writing together, with each piece offering unique insights into the fluid and often blurred boundaries between different states of being. This openness to the in-between spaces brings into question the notion of fixed identities and experiences, inviting a more nuanced understanding of the relational dynamics that shape existence. The article allows the readers to delve into these narratives and engage with the myriad ways they resonate with broader themes of being, storying, and connecting. (shrink)

We here introduce the Zygon Symposium on “Just How Special Are Humans?” This collection is based on a symposium at Harvard University in 2020 that brought together world leaders on the study of human nature from science, theology, and philosophy. They shared their research and perceptive insights on this key topic of great contemporary interest from quite different disciplines and viewpoints. The present Symposium contains articles further developed from the presentations, as well as two additional contributions from experts specializing in (...) theological ethics and philosophy of religion. (shrink)