El fin de esta investigación teórica es analizar y explicar la contribución de las relaciones públicas en el diálogo intercultural dentro de las organizaciones sociales. Para ello, se recurrió a investigar los conflictos sociales ocurridos durante el año 2020; así como a describir de qué manera la utilización de las herramientas comunicativas, en particular la del diálogo intercultural, puede fomentar la comprensión y empatía frente a las diferentes problemáticas sociales. La gestión comunicativa que debe llevar a cabo un profesional de (...) relaciones públicas mediante una comunicación eficaz ha de tener como fin la comprensión mutua entre gobierno y ciudadanos, enfatizando la participación activa de la comunidad y el valor que representa el debate continuo entre los ciudadanos y sus instituciones. Para los profesionales de relaciones públicas constituye un desafío llevar a cabo una comunicación intercultural con el propósito de resolver los graves problemas de diálogo y falta de entendimiento, reconociendo así la importancia de mantener una comunicación organizacional estratégica, en donde los mensajes sean bidireccionales, generando de ese modo una mayor interacción y, sobre todo, la resolución de los conflictos sociales. (shrink)

Although health and disease occupy opposite ends of a spectrum, distinguishing between them can be difficult. This is the “line-drawing” problem. The papers in this special issue engage with this challenge of delineating the boundaries of disease. The authors explore different views as to where the boundary between disease and nondisease lies, and related questions, such as how we can identify, or decide, what counts as a disease and what does not; the nature of the boundary between the two categories; (...) and what sorts of considerations could justify the location of that boundary. In exploring these questions, the papers draw on detailed clinical examples, provide theoretical critiques of existing approaches to disease definition, and offer new ways to conceptualize key features in debates about disease, including harm and biological dysfunction. (shrink)

Theoretical debates about the nature of grief and bereavement draw attention to the sensitivity of carrying out research with bereaved people, the possible threats that this may pose and the ethical considerations required to ameliorate potentially damaging outcomes. The authors of this article present a framework for ethical decision-making that has been successfully developed in the context of research with bereaved families. The discussion focuses on application and evaluation of the framework during research with family members who were approached about (...) the donation of a deceased relative’s organs and/or tissues for transplantation. Practical strategies of relevance to the processes of participant recruitment, the interview encounter and follow-up care in the post-interview period are identified and discussed. Concerns about the possible impact of bereavement research are balanced with the views of family members who gave credence to the therapeutic and cathartic benefits of participating in sensitive, death-related research. (shrink)

Sign languages provide direct evidence for the relation between human languages and the body that engenders them. We discuss the use of the hands to create symbols and the role of the body in sign language verb systems, especially in two quite recently developed sign languages, Israeli Sign Language and Al-Sayyid Bedouin Sign Language.

According to Buddhist philosophies, recognizing the self as impermanent, changing, and interdependent is at the root of virtue. With this realization, desires shift away from inward self-cherishing and toward outward self-transcending. This altruistic outlook underlies virtuous action and flourishing. Our primary research question asks: 1) to what extent do people experience self-transcending and self-cherishing desires in everyday life, and 2) to what extent do these different desires predict behaviors and body physiology that underlie virtue and well-being. As highlighted by the (...) SMV project, one challenge involves measuring both intention and action. To overcome this challenge, we propose a multi­methodological study that will integrate first­person experiences of desires, second­person reports from close others, and third­person laboratory measures of prosocial behavior and body physiology that underlie virtue and flourishing in the context of social relationships. We will use an “experience sampling” method delivered via a smartphone app to capture psychological desires in daily life. In the laboratory, we will examine if desires in daily life are related to prosocial behavior and physiological synchrony during face-to-face social interactions with a romantic partner. Theoretically, we anticipate that integration of Buddhist philosophy into Western psychology research will encourage more emphasis on the deep psychological desires that appear to continually drive behavior. Empirically, we predict that frequent self-transcending desires in daily life will be related to prosocial behavior and physiological synchrony during interactions with romantic partners. Going forward, this project will provide the foundation for future work examining how the moral self can be shaped through contemplative practice in everyday life. (shrink)

In the paper “An archeology of corruption in medicine”, Miles Little, Wendy Lipworth, and Ian Kerridge present an account of corruption and describe its prevalent forms in medicine. In presenting an individual-focused account of corruption found within “social entities”, Little et al. argue that these entities are corruptible by nature and that certain individuals are prone to take advantage of the corruptibility of social entities to pursue their own ends. The authors state that this is not preventable, so the (...) way to remedy corruption is via management and, where necessary, punishment. This commentary will briefly lay out the key features and functions of corruption as presented by Little et al., before providing a critical discussion that will focus on whether corruptibility is a necessary feature of social entities. I will propose that it is not a necessary feature, though it may frequently arise where individualistic values are unchecked. Corruption can be prevented within social entities by enhancing structures that direct toward virtue and which promote and reward cooperation instead of competition. (shrink)

Lloyd (2009) contends that climate models are confirmed by various instances of fit between their output and observational data. The present paper argues that what these instances of fit might confirm are not climate models themselves, but rather hypotheses about the adequacy of climate models for particular purposes. This required shift in thinking—from confirming climate models to confirming their adequacy-for-purpose—may sound trivial, but it is shown to complicate the evaluation of climate models considerably, both in principle and in practice.

It is increasingly recognised that evidence generated using “real-world data” is crucial for assessing the safety and effectiveness of health-related interventions. This, however, raises a number of issues, including those related to the quality of RWD, and of the scientific methods used to generate evidence from it, and the potential for those gathering and using RWD be driven by commercial, political, professional or personal self-interest. This article is an application of the framework presented in this issue of ABR. Please refer (...) to that article for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end to demonstrate how those generating or using RWD can make use of values when deliberating about ethical issues. (shrink)

First published in 1982. Routledge is an imprint of Taylor & Francis, an informa company.

Unable to answer the call of our patients: mental health nurses’ experience of moral distress When health practitioners’ moral choices and actions are thwarted by constraints, they may respond with feelings of moral distress. In a Canadian hermeneutic phenomenological study, physicians, nurses, psychologists and non‐professional aides were asked to identify care situations that they found morally distressing, and to elaborate on how moral concerns regarding the care of patients were raised and resolved. In this paper, we describe the experience of (...) moral distress related by nurses working in mental healthcare settings who believed that lack of resources (such as time and staff) leads to dispiritedness, lack of respect, and absence of recognition (for both patients and staff) which severely diminished their ability to provide quality care. The metaphors of flashlight and hammer are used to elaborate nurses’ possible responses to intolerable situations. (shrink)

Wendy Donner contends here that recent commentators on John Stuart Mill's thought have focused on his notions of right and obligation and have not paid as much attention to his notion of the good. Mill, she maintains, rejects the quantitative hedonism of Bentham's philosophy in favor of an expanded qualitative version. In this book she provides an account of his complex views of the good and the ways in which these views unify his moral and political thought.

Madness, Language, Literature (2019) brings together a series of unpublished works on literature that belong to Michel Foucault’s first stage of production. This article focuses on those works that express a concept of madness as social partition or outside, and also on those that elucidate the concept of the ‘extralinguistic’ of literature. The combined reading of these texts sheds light on a concept of the extralinguistic outside of literature that enables Foucault to overcome a concept of ontological outside and, therefore, (...) using literature, think on this discourse’s historical possibilities of resistance. As a result of this new reading, I analyse some fundamental aspects of this early Foucault. First, his development of a politics of literary form in the 1960s. Second, I propose that Foucault’s studies on literature in the 1960s were a kind of laboratory in which he was already raising some questions concerning his political history of truth. And, lastly, I examine the capacity of literature to make visible a part of reality that remains hidden (the excluded), the processes by which literature creates (language’s mechanism of self-representation), the possible forms of subjectivation that the fiction of every episteme allows (what Foucault calls verisimilitude), and the formulation of novel forms of being (that he later developed as aesthetics of existence). (shrink)

Resumen: Este artículo consiste en un comentario del ensayo Ser justo con Freud: La historia de la locura en la era del psicoanálisis de Derrida con el objeto de rastrear lo que no puede ser reapropiado por la presuposición del marco del debate entre Derrida y Foucault. Al analizar la pregunta “¿quién anuncia el no-recurso?”, exploraré la forma en que la escritura de Derrida es afectada por la necesidad e imposibilidad de no reprimir la sinrazón. Argumentaré que Derrida compulsivamente escribe (...) los efectos de dicha resistencia a no reprimir la sinrazón a través de la repetición de la búsqueda Foucaultiana de un más allá de la razón. Esta “compulsión de repetición’ no solamente reabre una y otra vez el debate, sino que desencadena el retorno de la sinrazón en la forma de un desarreglo de los principios de identidad y tiempo lineal, desestabilizando todo forma de autoría sobre la historia de la locura en general y cada una de sus críticas. Este artículo se aproxima a los intercambios entre Derrida y Foucault deconstruyendo la premisa de la posibilidad de un debate sobre la historia de la locura. (shrink)

Background: The pharmaceutical industry has been responsible for major medical advances, but the industry has also been heavily criticized. Such criticisms, and associated regulatory responses, are no doubt often warranted, but do not provide a framework for those who wish to reason systematically about the moral dimensions of drug development. We set out to develop such a framework using Beauchamp and Childress's “four principles” as organizing categories. Methods: We conducted a qualitative interview study of people working in the “medical affairs” (...) departments of pharmaceutical companies to determine: (1) whether our data could meaningfully be organized under the headings of “autonomy,” “beneficence,” “nonmaleficence,” and “justice”; (2) how principles might be expressed in this particular commercial setting; and (3) if these principles are expressed, whether and how competing principles are balanced. We then critiqued these findings using existing normative theory. Results: Our interviews demonstrated that three of Beauchamp and Childress's four principles were salient to our participants: beneficence, nonmaleficence, and justice. Within each of these principles, participants had two broad ethical orientations: an altruistic public focus (“other-ness”) and a commitment to their companies (“firm-ness”). Our participants also demonstrated efforts to balance these principles and highlighted the importance of phronesis (or practical wisdom) in balancing and enacting principles. Notably, however, our participants did not spontaneously emphasize the importance of autonomy. Conclusions: It is possible to use qualitative empirical research, together with normative analysis, to derive a framework for pharmaceutical ethics. We suggest that our framework would be useful for those who wish to reason ethically within, or in collaboration with, the pharmaceutical industry. (shrink)

Once a term used primarily by moral philosophers, “moral distress” is increasingly used by health professionals to name experiences of frustration and failure in fulfilling moral obligations inherent to their fiduciary relationship with the public. Although such challenges have always been present, as has discord regarding the right thing to do in particular situations, there is a radical change in the degree and intensity of moral distress being expressed. Has the plight of professionals in healthcare practice changed? “Plight” encompasses not (...) only the act of pledging, but that of predicament and peril. The author claims that health professionals are increasingly put in peril by healthcare reform that undermines their efficacy and jeopardizes ethical engagement with those in their care. The re-engineering of healthcare to give precedence to corporate and commercial values and strategies of commodification, service rationing, streamlining, and measuring of “efficiency,” is literally demoralizing health professionals. Healthcare practice needs to be grounded in a capacity for compassion and empathy, as is evident in standards of practice and codes of ethics, and in the understanding of what it means to be a professional. Such grounding allows for humane response to the availability of unprecedented advances in biotechnological treatments, for genuine dialogue and the raising of difficult, necessary ethical questions, and for the mutual support of health professionals themselves. If healthcare environments are not understood as moral communities but rather as simulated marketplaces, then health professionals’ moral agency is diminished and their vulnerability to moral distress is exacerbated. Research in moral distress and relational ethics is used to support this claim. (shrink)

The moral distress of psychologists working in psychiatric and mental health care settings was explored in an interdisciplinary, hermeneutic phenomenological study situated at the University of Alberta, Canada. Moral distress is the state experienced when moral choices and actions are thwarted by constraints. Psychologists described specific incidents in which they felt their integrity had been compromised by such factors as institutional and interinstitutional demands, team conflicts, and interdisciplinary disputes. They described dealing with the resulting moral distress by such means as (...) silence, taking a stance, acting secretively, sustaining themselves through work with clients, seeking support from colleagues, and exiting. Recognizing moral distress can lead to a significant shift in the way we perceive moral choices and understand the moral context of practice. (shrink)

Wendy Brown's work commands widespread attention and respect, and there has been considerable interest as to how it would develop after "States of Injury." This book will not disappoint.

This article explores some of the roles of computer simulation in measurement. A model-based view of measurement is adopted and three types of measurement—direct, derived, and complex—are distinguished. It is argued that while computer simulations on their own are not measurement processes, in principle they can be embedded in direct, derived, and complex measurement practices in such a way that simulation results constitute measurement outcomes. Atmospheric data assimilation is then considered as a case study. This practice, which involves combining information (...) from conventional observations and simulation-based forecasts, is characterized as a complex measuring practice that is still under development. The case study reveals challenges that are likely to resurface in other measuring practices that embed computer simulation. It is also noted that some practices that embed simulation are difficult to classify; they suggest a fuzzy boundary between measurement and non-measurement. 1 Introduction2 A Contemporary View of Measurement3 Three Types of Measurement4 Can Computer Simulations Measure Real-World Target Systems?5 Case Study: Atmospheric Data Assimilation5.1 Why data assimilation?5.2 A complex measuring practice under development5.3 Epistemic iteration6 The Boundaries of Measurement7 Epistemology, Not Terminology. (shrink)

Current practices of identifying and treating small indolent thyroid cancers constitute an important but in some ways unusual form of overdiagnosis. Overdiagnosis refers to diagnoses that generally harm rather than benefit patients, primarily because the diagnosed condition is not a harmful form of disease. Patients who are overdiagnosed with thyroid cancer are harmed by the psycho-social impact of a cancer diagnosis, as well as treatment interventions such partial or total thyroidectomy, lifelong thyroid replacement hormone, monitoring, surgical complications and other side (...) effects. These harms seem to outweigh any putative benefit of knowing about a cancer that would not have caused problems if left undiscovered. In addition to harms to patients, thyroid cancer overdiagnosis leads to significant opportunity costs at a societal level, due to costs of diagnosis and treatment. Unlike many other overdiagnosed cancers, accurate risk stratification is possible with thyroid cancer. At the individual patient level, use of this risk information might support informed choice and/or shared decision-making, as mandated by clinical ethics frameworks. And this approach might, to some extent, help to reduce rates of diagnosis and intervention. In practice, however, it is unlikely to stem the rising incidence and associated harms and costs of overdiagnosed thyroid cancer, especially in situations where health professionals have conflicts of interest. We argue in this article that thyroid cancer overdiagnosis may be usefully understood as a public health problem, and that some public health approaches will be readily justifiable and are more likely to be effective in minimising its harms. (shrink)

'Is politics gendered? Wendy Brown things so, and argues for this point with elegance, imagination and pungent phrases. Brown's book is challenging, provocative and...original; it does force us to question the degree to which gender controls our politics.'-THE REVIEW OF POLITICS.

In the biomedical field, calls for the generation of new regulations or for the amendment of existing regulations often follow the emergence of apparently new research practices (such as embryonic stem cell research), clinical practices (such as facial transplantation) and entities (such as Avian Influenza/’Bird Flu’). Calls for regulatory responses also arise as a result of controversies which bring to light longstanding practices, such as the call for increased regulation of human tissue collections that followed the discovery of unauthorised post-mortem (...) organ retention. Whilst it seems obvious that new regulations should only be generated if existing regulations are inadequate (a practice referred to in this paper as ‘regulatory syncretism’), this does not always occur in practice. This paper examines the conceptual steps involved in generating regulatory responses to emerging phenomena. Two decision points are identified. First, a stance is taken as to whether the emerging phenomenon raises unique ethical or legal issues (exceptionalism versus non-exceptionalism). Second, the decision is made as to whether new regulation should be generated only for truly unique phenomena (syncretism versus asyncretism). It is argued here that it is important to make a careful assessment of novelty, followed by a reflective and deliberate choice of regulatory syncretism or asyncretism, since each type of regulatory response has advantages which need to be harnessed and disadvantages which need to be managed—something that can only occur if regulators are attentive to the choices they are making. (shrink)

Increasingly there are calls for climate services to be “co-produced” with users, taking into account not only the basic information needs of users but also their value systems and decision contexts. What does this mean in practice? One way that user values can be incorporated into climate services is in the management of inductive risk. This involves understanding which errors in climate service products would have particularly negative consequences from the users’ perspective (e.g., underestimating rather than overestimating the change in (...) an impact variable) and then prioritizing the avoidance of those errors. This essay shows how inductive risk could be managed in climate services in ways that serve user values and argues that there are both ethical and practical reasons in favor of doing so. (shrink)

Allan Franklin has identified a number of strategies that scientists use to build confidence in experimental results. This paper shows that Franklin's strategies have direct analogues in the context of computer simulation and then suggests that one of his strategies—the so-called 'Sherlock Holmes' strategy—deserves a privileged place within the epistemologies of experiment and simulation. In particular, it is argued that while the successful application of even several of Franklin's other strategies (or their analogues in simulation) may not be sufficient for (...) justified belief in results, the successful application of a slightly elaborated version of the Sherlock Holmes strategy is sufficient. (shrink)

According to an adequacy-for-purpose view, models should be assessed with respect to their adequacy or fitness for particular purposes. Such a view has been advocated by scientists and philosophers...

The Trafficking Victims’ Protection Act of 2000 has been presented as an important tool in combatingthe exploitation and abuse of undocumented workers, especially those forced into prostitution. Through a close reading of the legislation and the debates surrounding its passage, this article argues that the law makes strategic use of anxieties over sexuality, gender, and immigration to further curtail migration. The law does so through the use of misleading statistics creating a moral panic around “sexual slavery,” through the creation of (...) a gendered distinction between “innocent victims” and “guilty migrants,” and through the demand that aid to victims be tied to their willingness to assist in the prosecution of traffickers. As a result, the legislation is less a departure from, than of a piece with, other recent antisex and antiimmigrant policies. (shrink)

Recent calls for retraction of a large body of Chinese transplant research and of Dr Jiankui He’s gene editing research has led to renewed interest in the question of publication, retraction and use of unethical biomedical research. In Part 1 of this paper, we briefly review the now well-established consequentialist and deontological arguments for and against the use of unethical research. We argue that, while there are potentially compelling justifications for use under some circumstances, these justifications fail when unethical practices (...) are ongoing—as in the case of research involving transplantations in which organs have been procured unethically from executed prisoners. Use of such research displays a lack of respect and concern for the victims and undermines efforts to deter unethical practices. Such use also creates moral taint and renders those who use the research complicit in continuing harm. In Part 2, we distinguish three dimensions of ‘non-use’ of unethical research: non-use of published unethical research, non-publication, and retraction and argue that all three types of non-use should be upheld in the case of Chinese transplant research. Publishers have responsibilities to not publish contemporary unethical biomedical research, and where this has occurred, to retract publications. Failure to retract the papers implicitly condones the research, while uptake of the research through citations rewards researchers and ongoing circulation of the data in the literature facilitates subsequent use by researchers, policymakers and clinicians. (shrink)