State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public. However, there is noteworthy variability in the extent to which SMBs impose severe disciplinary action. In this manuscript, we present and synthesize a subset of 11 recommendations based on findings from our team’s larger consensus-building project that identified a list of 56 policies and legal provisions SMBs can use to better protect patients from egregious (...) wrongdoing by physicians. (shrink)

In this article, we will consider how the regulation of populations is not just a feature of prisons, but of all institutions and organisations that control members though hierarchies, divisions and norms. While nurses and other allied health professionals are considered to be predominantly self‐regulatory, practice is guided by a code of conduct and codes of ethics that act as rules that serve to uphold the safety of the patient, whether they are a sick person in a hospital bed or (...) an inmate in a prison. The codes of conduct espouse a number of rules that to a certain extent govern the behaviour of individual and groups of practitioners through reciprocal rewards and punishments. Supervision is one method of monitoring the effectiveness of the codes of conduct and ethics while regulating both the minimum standard of individual practice and of training organisations. It is posited that one of the possible effects of clinical supervision is to make the person effectively self‐regulatory as, an autonomous practitioner. We take the view that professional autonomy is a highly problematic concept requiring closer examination. (shrink)

Recently among analytic political philosophers there has been a considerable revival of interest in the normative evaluation of the market and of economic processes more generally. While not rejecting markets in toto , philosophers such as Elizabeth Anderson and Amartya Sen have raised questions about the proper range of the market, explored the role of normative considerations in economic decision-making and raised doubts about the view that normative constraints are never legitimately placed on economic activity. In this article I (...) experience the relevance to such explorations of the economic casuistry of the medieval schoolmen. Key Words: Just Price • medieval philosophy • usury • distributive justice • Aquinas. (shrink)

We inhabit a world in which the market is a dominant institutional form of social organization. This influence is not without its critics, and there is considerable debate amongst political philosophers and policy-makers about whether the range of the market should expand or contract and, further, about the extent to which the market should be subject to constraints and government regulation. The expansion of the market into realms hitherto unknown is the theme of a number of recent books, including Michael (...) Sandel's What Money Can't Buy and Debra Satz's Why Some Things Should Not Be for Sale, which build on earlier work by, amongst others, Elizabeth Anderson, Margaret Jane Radin, and Michael Walzer. (shrink)

This paper considers several philosophers’ efforts to explain the metaphysical orientations of historical narratives, ones which expose the lack of common ground in modes of establishing truth and documenting change. Although philosophers have been writing about history since before Plato’s time, this brief inquiry is primarily restricted to Hegel, Maritain, R. G. Collingwood, and W. H. Walsh. The relation between history and the concept of civilization reveals a major complication for establishing historical truth – the fact of multiple meanings for (...) the concept of civilization. (shrink)

Boethius composed the Consolatio Philosophiae in the sixth century AD whilst awaiting death under torture. He had been condemned on a charge of treason which he protested was manifestly unjust. Though a convinced Christian, in detailing the true end of life which is the soul's knowledge of God, he consoled himself not with Christian precepts but with the tenets of Greek philosophy. This work dominated the intellectual world of the Middle Ages; writers as diverse as Thomas Aquinas, Jean de Meun, (...) and Dante were inspired by it. In England it was rendered into Old English by Alfred the Great, into Middle English by Geoffrey Chaucer, and later Queen Elizabeth I made her own translation. The circumstances of composition, the heroic demeanour of the author, and the `Menippean' texture have combined to exercise a fascination over students of philosophy and of literature ever since. Professor Walsh has included an introduction and explanatory notes which combined with his new translation make the text accessible to general readers and scholars alike. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Editors’ NoteJames M. DuBois, Ana S. Iltis, and Heidi A. WalshFrom childhood, David Slakter had undergone tests and invasive procedures to monitor his nephritis. It was not a surprise when in 2015, doctors told him he needed a kidney transplant. The wife of a childhood friend was a close match and gave him one of her kidneys. Before his transplant, aerobic exercise was difficult; a few months after transplant, (...) Slakter could ride his bike, hike, and work out with a personal trainer. He no longer had to weigh food or gauge his potassium consumption, a concern for people with kidney failure. For Slakter, “life post-transplant has been a significant improvement.”Individuals or family members of those who have received an organ transplant from a living or deceased donor share their stories in this issue of Narrative Inquiry in Bioethics. The symposium is titled “Receiving the Gift of Life: Stories from Organ Transplant Recipients.” Organ transplantation can extend an individual’s life by decades. It can also greatly improve an individual’s quality of life, as was Slakter’s experience. At the same time, organ transplantation is expensive and stressful. Recipients can experience complications, including organ rejection, and there are few appealing alternatives.After her heart transplant, author Leilani R. Graham required four open-heart surgeries, ECMO, and an intra-aortic balloon pump. She experienced delirium, necrotizing pneumonia, and severe muscular atrophy that required her to re-learn how to walk. She struggled with weight gain, explosive mood swings, hair loss, and was terrified that her body would reject the new heart. For Graham, “[Transplant] was not the miracle [she] was hoping for.” Graham says she felt unprepared for and inadequately informed about what to expect after her transplant, which left her “battered, beaten, and bruised” with a 12-inch line from neck to navel and “bullet holes” up and down her torso from the chest tubes. When reflecting on her experience post-transplant, Graham says, “It wasn’t the physical trauma that hurt the most. It was that no one seemed surprised [by the aftereffects of transplant].” Seemingly no one, that is except Graham, who calls on transplant providers to “prioritize empathy.”The symposium editors are Jason T. Eberl and Tristan McIntosh. Three commentary articles, written by Macey Leigh Levan, Heather Lannon, and Vidya A. Fleetwood, Roslyn B. Mannon & Krista L. Lentine, offer important insights into the authors’ stories. The editors thank Mid-America Transplant, the UCSF Lung Transplant Program, Donor Connect, William L. Freeman, MD, MPH, MJIL, CIP, Janet Monk, and the individuals who gave anonymous donations to support the publication of this issue, an open-access VOICES edition of the symposium, and accompanying teaching guides.The research article in this issue, “‘A Shell of My Former Self’: Using Figurative Language to Promote Communication about Patient Suffering,” was written by Tyler Tate, Elizabeth Stein, and Robert A. Pearlman. The relief of suffering is a primary goal of medicine. However, the authors note that clinicians often miss or ignore suffering because they focus on the causes rather than the experience of suffering, or the subjective nature of suffering makes it difficult to discuss. The authors believe that “the key to communicating about suffering lies in finding [End Page vii] the right kind of words to describe the experience” and say that figurative language offers a promising approach. In their research, the authors performed qualitative analysis on 52 works of literature and identified 254 excerpts of figurative language with themes of non-physical or psychological suffering. The authors found 13 salient themes: brokenness, diminishment, disorientation, drowning, emptiness, imprisonment, battle, darkness, isolation, invisibility, lifelessness, punishment, and torture. The authors reiterate that developing a shared language of suffering could foster a therapeutic patient-clinician relationship and improve clinicians’ ability to recognize and address a patient’s experience of suffering.María Susana Ciruzzi wrote the first of two case studies included in this issue. “The Sword of King Solomon” addresses a tragic and difficult subject—how to navigate the situation posed by conjoined twins when “any decision will produce damage and suffering.” The case involves two infant male patients born at 37 weeks gestation as omphalo-ischiopagus conjoined twins... (shrink)

The dual-code proposal of number representation put forward by Cohen Kadosh & Walsh (CK&W) accounts for only a fraction of the many modes of numerical abstraction. Contrary to their proposal, robust data from human infants and nonhuman animals indicate that abstract numerical representations are psychologically primitive. Additionally, much of the behavioral and neural data cited to support CK&W's proposal is, in fact, neutral on the issue of numerical abstraction.

People evolved as part of an ecosystem, making use of the Earth’s bounty without reflection. Only when our ancestors developed the capacity for moral agency could we begin to reflect on whether we had taken in excess of our due. This outlines a ‘green libertarianism’ in which our property rights are grounded in fundamental ecological facts. It further argues that it is immune from two objections levelled at right- and left- libertarian theories of acquisition: that Robert Nozick, without justification, divided (...) people into those who were able to acquire unowned resources, and those would could not; and, that left-libertarian attempts, such as Hillel Steiner’s, to separate choice from circumstance cannot account for the fact that not only people’s decisions to have children, but even their decisions to continue living, affect people’s entitlements to use the natural world. (shrink)

Introduction: Depression, biology, aggression -- Underbelly -- The biological unconscious -- Bitter melancholy -- Chemical transference -- The bastard placebo -- The pharmakology of depression.

Technology and its interfaces with nursing care, patients and carers, and the home are many and varied. To date, healthcare services research has generally focussed on pragmatic issues such access to and the optimization of technology, while philosophical inquiry has tended to focus on the ethics of how technology makes the home more hospital like. However, the ethical implications of the ways in which technology shapes the subjectivities of patients and carers have not been explored. In order to explore this, (...) poststructural theory, in particular the work of Butler, Foucault, and Deleuze, is used to theorize the relationship between subjectivity and materiality as ethically mandated on producing rather than precluding the development of subjectivities in novel ways. This theoretical understanding is then utilized through a process of ‘plugged in’ as described by Jackson and Massie that aims to link empirical data, research, and philosophical inquiry. Through this process, it is suggested that power, which the empirical data demonstrate, is frequently exercised through medical discourses and restricts patients' and carers' ability to shape the material environment of the home as a place to live and be cared for in palliative stages of illness. Alternative discourses are suggested both from the empirical data as well as other research, which may offer patients and carers the possibility of reclaiming power over the home and their subjectivities. Finally, the dichotomy between the home and hospital, mediated via technology, is posited as being problematic. It is argued the dichotomy is false and should be moved away from in order to allow an ethical embrace of technology in palliative care. (shrink)

This chapter defends the account of metaphysical indeterminacy of Barnes and Williams against Eklund's objections.

Ethical care is beginning to be recognised as care that accounts for the views of those at the receiving end of care. However, in the context of palliative and supportive district nursing care, the patients’ and their carers’ views are seldom heard. This qualitative research study explores these views. Data were collected through semi-structured interviews with 26 patients with palliative and supportive care needs receiving district nursing care, and 13 of their carers. Participants were recruited via community nurses and hospices (...) between September 2010 and October 2011. Post-structural discourse analysis is used to examine how discourses operate on a moral level. One discourse, ‘busyness’, is argued to preclude a moral form of nursing care. The discourse of friendship is presented to contrast this. Discussion explores Gallagher’s ‘slow ethics’ and challenges the currently accepted ways of measuring to improve quality of care concluding that quality cannot be measured. (shrink)

Introducing the work of three French feminists - Julia Kristeva, Luce Irigaray and Michele L Doeuff - "Sexual Subversions" provides access to the work of these writers. In doing so this book raises some key issues of relevance to feminist research, addressing debates around the nature of feminist theory; the relationship between feminist thinking theory; the relationship between feminist thinking and male-dominated areas of knowledge; the strategies appropriate for developing non-patriarchal or woman-centered knowledges. No book on French feminists would be (...) complete without including the contributions of Kristeva and Irigaray. The inclusion of Le Doeuff's work, which brings a different perspective to bear on the question of sexual difference, provides a counterbalance to literary appropriations of French feminism by Anglo-American readerships. Kristeva, Irigaray and Le Doeuff are the focal points of this study, precisely because each highlights the differences of the others, revealing the frameworks to which the others are committed. Nevertheless, while these writers do not present a common political or theoretical position or form a school, each does address the question of women's autonomy from male definition, affirms the sexual specificity of women, seeks out a femininity women can use to question the patriarchal norms and ideals of femininity and rejects the preordained positions patriarchy allots to woman. This book is intended for students and researchers in women's studies, philosophy and feminism. (shrink)

Buddhismus: Stifter, Schulen und Systeme. Hans Wolfgang Schumann. Diederichs Gelbe Reiher 99, 2nd expanded edition. Munich 1993. 259 pp.

This webliography has several functions: for teaching faculty to consult as a tool to aid in enhancing the media ethics curricula; contribute to the scholarly exchange of ideas; and perhaps cultivate a new awareness and direction for exploring secondary and tertiary nonprint sources involving ethics and mass media.

Das Sutra von den vier Ständen. Das Aggañña Sutta im Licht seiner chinesischen Parallelen. Konrad Meisig., Otto Harrassowitz, Wiesbaden 1988. ix, 249 pp. DM 44.

Pali Buddhism. Edited by Frank J. Hoffman and Deegalle Mahinda. Curzon Press, Richmond 1996. 233 pp. £40. ISBN 0-7007-0359-4.

Pali Literature, including the Canonical Literature in Prakrit and Sanskrit of all the Hinayana Schools. K. R. Norman. Vol.VII, fasc.2, of A History of Indian Literature ed. Jan Gonda. Otto Harrassowitz, Wiesbaden 1983. X + 210pp. DM 98.

Theravada Buddhism. A Social History from Ancient Times to Modern Colombo. Richard F. Gombrich. Routledge, London 1988. x, 237 pp. Hbk £20.00, pbk £7.95.

Teachings of a Buddhist Monk. Ajahn Sumedho. Edited by Diana St Ruth. Foreword by Jack Kornfield. Sharpham North 1990. 109 pp., illustrated. £4.99.

What the Buddha Never Taught. Timothy Ward. Element Books, Shaftesbury 1990. 242 pp. £6.95.

Quality of care is a prominent discourse in modern health‐care and has previously been conceptualised in terms of ethics. In addition, the role of knowledge has been suggested as being particularly influential with regard to the nurse–patient–carer relationship. However, to date, no analyses have examined how knowledge (as an ethical concept) impinges on quality of care. Qualitative semi‐structured interviews were conducted with 26 patients with palliative and supportive care needs receiving district nursing care and thirteen of their lay carers. Poststructural (...) discourse analysis techniques were utilised to take an ethical perspective on the current way in which quality of care is assessed and produced in health‐care. It is argued that if quality of care is to be achieved, patients and carers need to be able to redistribute and redevelop the knowledge of their services in a collaborative way that goes beyond the current ways of working. Theoretical works and extant research are then used to produce tentative suggestions about how this may be achieved. (shrink)

This book is about what exceeds or resists calculation--in life and in death. Its two parts and nine chapters highlight, in their coupling of Freud and Derrida, the accidents both in and of psychoanalytic writing, and the philosophical question of what limits the openness of our horizon.

David Hume’s theory of action is well known for several provocative theses, including that passion and reason cannot be opposed over the direction of action. In Hume, Passion, and Action, the author defends an original interpretation of Hume’s views on passion, reason and motivation that is consistent with other theses in Hume’s philosophy, loyal to his texts, and historically situated. This book challenges the now orthodox interpretation of Hume on motivation, presenting an alternative that situates Hume closer to “Humeans” than (...) many recent interpreters have. Part of the strategy is to examine the thinking of the early modern intellectuals to whom Hume responds. Most of these thinkers insisted that passions lead us to pursue harmful objects unless regulated by reason; and most regarded passions as representations of good and evil, which can be false. Understanding Hume’s response to these claims requires appreciating his respective characterizations of reason and passion. The author argues that Hume’s thesis that reason is practically impotent apart from passion is about beliefs generated by reason, rather than about the capacity of reason. Furthermore, the argument makes sense of Hume’s sometimes-ridiculed description of passions as “original existences” having no reference to objects. The author also shows how Hume understood morality as intrinsically motivating, while holding that moral beliefs are not themselves motives, and why he thought of passions as self-regulating, contrary to the admonitions of the rationalists. (shrink)

Throughout most of human history women have been defined by their biological role in reproduction, seen first and foremost as gestators, which has led to the reproductive system being subjected to outside interference. The womb was perceived as dangerous and an object which husbands, doctors and the state had a legitimate interest in controlling. In this article, we consider how notions of conflict surrounding the womb have endured over time. We demonstrate how concerns seemingly generated by the invisibility of reproduction (...) and the inaccessibility of the womb have translated into similar arguments for controlling women, as technology increases the accessibility of the female body and the womb. Developments in reproductive medicine, from in vitro fertilisation (IVF) to surrogacy, have enabled women and men who would otherwise have been childless to become parents. Uterus transplants and ‘artificial wombs’ could provide additional alternatives to natural gestation. An era of ‘womb technology’ dawns. Some argue that such technology providing an alternative to ‘natural’ gestation could be a source of liberation for female persons because reproduction will no longer be something necessarily confined to the female body. ‘Womb technology’, however, also has the potential to exacerbate the labelling of the female body as a source of danger and an ‘imperfect’ site of gestation, thus replaying rudimentary and regressive arguments about controlling female behaviour. We argue that pernicious narratives about control, conflict and the womb must be addressed in the face of these technological developments. (shrink)

This article examines three divergent constructions about the salience of legal gender in lay people’s everyday lives and readiness to decertify gender. In our interviews (and survey data), generally participants minimised the importance of legal gender. The central argument in this article is that feminist socio-legal scholars applying legal consciousness studies to legal reform topics should find scrutinizing the construction of interview talk useful. We illustrate this argument by adapting and applying Ewick and Silbey’s (1998) ‘The Common Place of Law: (...) Stories from Everyday Life', ‘before’, ‘with’ and ‘against’ typology to interview talk about legal gender, and critique their cognitivist approach by offering a constructionist alternative. In our analysis, we offer a detailed discursive explication of three key legal consciousness themes. These themes offer a balanced representation of a dataset problematically ‘skewed’ towards sex-based rights feminist perspectives, namely that ‘before’ legal gender is an anti-decertification account, decertification would be risky for natal females; a ‘with’ legal gender construction is neither for nor against decertification per se, though the impact of decertification is produced in accounts as limited and unimportant; and ‘against’ legal gender is a pro-decertification classification, as not abolished legal gender is constructed as harmful to already marginalised groups. In concluding, we explore the reasoning for the lack of readiness for decertification currently, and return to the value of examining the construction of lay discourse about legal matters as talk is a form of social action. We suggest that applying discursive analysis to themes in legal consciousness studies enables a refocusing on the how rather than purely the what of divergent legal consciousnesses, and that this approach is a fruitful addition to feminist socio-legal studies. (shrink)

This article addresses the question: “What follows from the claim that we have a certain kind of strong reason against animal cruelty?” It deals with the ethics of killing animals. It finds the following common assumption highly puzzling and problematic: despite our obligations not to commit animal cruelty, there is no comparably strong reason against painlessly killing animals in the prime of life. It argues that anyone who accepts this view is committed to the moral position that either we have (...) no reasons against such killings or we have only weak reasons. (shrink)

Hearing the words of Deuteronomy, the preacher is called to make clear what it means to be God's covenant community and to live according to his will rather than the dictates of the surrounding culture.

Behind every sermon lies an understanding of the nature of the Bible; by its contribution to that understanding, biblical studies can make a crucial difference for preaching.

Understanding the form and content of the Bible's hymns allows the sermon to share their principal characteristic: praise to the honor and glory of God.

Unethical pro-organisational behaviour is an ongoing concern, prompting the need for more nuanced understanding of the workplace environment most likely to inhibit it. This study considers the role of risk climate, sometimes referred to as risk culture, as well as ethical climate, for reducing UPB. The study investigates whether four risk climate factors can, by focusing on the long-term consequences of UPB to the organisation, and providing guidance on behavioural norms, reduce UPB misconduct. Surveying employees in three financial institutions we (...) found that only one of the risk climate factors, avoidance, is consistently associated with UPB. On the other hand, a self-interested, ethical climate significantly increases UPB in all samples. In multi-climate analysis, we found that risk climate factors interacted with ethical climate to predict UPB. That is, when employees perceive that the workplace ethos is not self-interested, three factors of risk climate—avoidance, proactive and manager—significantly predict UPB. UPB is least likely when self-interest is low, avoidance risk climate is low, proactive risk climate is high and manager risk climate is high. Implications for leaders are discussed. (shrink)

This paper develops a form of realism about aesthetics that is stronger than typical versions of aesthetic realism. As I conceive of it, aesthetic realism is the view that there are some response-independent aesthetic facts. This kind of realism is unpopular in aesthetics and is often viewed as a non-starter. Against this pessimism, I argue that the prospects for this realist approach are more favorable than commonly supposed. I offer some reasons to prefer my brand of aesthetic realism to competing (...) realist and anti-realist positions. I also defend this aesthetic realism against what I call the ‘overly objective worry’ and correct misconceptions about what realism’s commitment to response-independence involves. (shrink)

A critical analysis of Diana Fuss's Essentially Speaking: Feminism, Nature, and Difference and Elizabeth Grosz's Sexual Subversions: Three French Feminists.

Not only is deception commonplace in medical encounters, according to Christopher Meyers (2021), but the clinical ethicist might have moral obligations to support and even enact deception. Descriptively Meyers is right that there are “opportunistic, self-interested and benevolent reasons” for deception through omission and commission in clinical medicine. But it is possible to retain this premise while rejecting the normative conclusion that the clinical ethicist “should sometimes be an active participant in the deception of patients and families.” One reason to (...) reject the normative conclusion is its incompatibility with providing trauma informed ethics consultation (TIEC). In the TIEC framework I developed with Uchenna Anani, we defend the integration of trauma informed care (TIC) into ethics consultation (Lanphier and Anani 2021). While ethicists narrowly attend to the question and scope of the ethics consults made to them, doing so in alignment with trauma informed principles is tantamount to providing good ethics consultation. According to Meyers, the clinical ethicist is an “advocate for the best ethical choices.” The best ethical choices are also trauma informed ones. (shrink)

Background The COVID-19 pandemic has forced rapid and widespread change to standards of patient care and nursing practice, inevitably leading to unprecedented shifts in the moral conditions of nursing work. Less is known about how these challenges have affected nurses’ capacity to meet their ethical responsibilities and what has helped to sustain their efforts to continue to care. Research objectives 1) To explore nurses’ experiences of striving to fulfill their ethical responsibilities of care during the COVID-19 pandemic and 2) to (...) explore what has fostered nurses’ capacity to fulfill these responsibilities. Research Design A generic qualitative approach was used incorporating concepts coming from fundamental features of care. Participants Twenty-four Canadian Registered Nurses from a variety of practice settings were interviewed. Ethical Considerations After receiving ethics approval, signed informed consent was obtained before participants were interviewed. Findings Four themes were identified. 1) Challenges providing good care in response to sudden changes in practice. 2) Tensions in juggling the responsibility to prevent COVID-19 infections with other competing moral responsibilities. 3) Supports to foster nurses’ capacity to meet their caring responsibilities. 4) The preservation of nurses’ moral identity through expressions of gratitude and health improvement. Discussion Infection control measures and priorities set in response to the pandemic made at distant population and organizational levels impacted nurses who continued to try to meet the ideals of care in close proximity to patients and their families. Despite the challenges that nurses encountered, the care they received themselves enabled them to continue to care for others. Nurses benefited most from the moral communities they had with their colleagues and occasionally nurse leaders, especially when they were supported in a face-to-face manner. Conclusion: Moral community can only be sustained if nurses are afforded the working conditions that make it possible for them to support each other. (shrink)

De Bie et al. posit thatthe best way to describe the person who would receive current AWT is as a “fetal neonate” or fetonate. Neonatal pertains to the fact that the subject is removed from the wom...

In their paper, ‘How to reach trustworthy decisions for caesarean sections on maternal request: a call for beneficial power’, Eide and Bærøe present maternal request caesarean sections (MRCS) as a site of conflict in obstetrics because birthing people are seeking access to a treatment ‘without any anticipated medical benefit’. While I agree with the conclusions of their paper -that there is a need to reform the approach to MRCS counselling to ensure that the structural vulnerability of pregnant people making birth (...) decisions is addressed—I disagree with the framing of MRCS as having ‘no anticipated medical benefit’. I argue that MRCS is often inappropriately presented as unduly risky,without supporting empirical evidence,and that MRCS is most often sought by birthing people on the basis of a clinical need. I argue that there needs to be open conversation and frank willingness to acknowledge the values that are currently underpinning the presentation of MRCS as ‘clinically unnecessary’; specifically there needs to be more discussion of where and why the benefits of MRCS that are recognised by individual birthing people are not recognised by clinicians. This is important to ensure access to MRCS for birthing people that need it. (shrink)