In this article we consider some of the implications of the UK Human Rights Act 1998 for nurses in practice. The Act has implications for all aspects of social life in Britain, particularly for health care. We provide an introduction to the discourse of rights in health care and discuss some aspects of four articles from the Act. The reciprocal relationship between rights and obligations prompted us to consider also the relationship between guidelines in the United Kingdom Central Council’s Code (...) of professional conduct and the requirements of the Human Rights Act 1998. We conclude with the recommendation that the new legislation should be welcomed for its potential to support good practice and to urge critical and reflective practice rather than as yet another burdensome bureaucratic imposition. (shrink)

Background Supporting physicians in Intensive Care Units s as they face dying patients at unprecedented levels due to the COVID-19 pandemic is critical. Amidst a dearth of such data and guided by evidence that nurses in ICUs experience personal, professional and existential issues in similar conditions, a systematic scoping review is proposed to evaluate prevailing accounts of physicians facing dying patients in ICUs through the lens of Personhood. Such data would enhance understanding and guide the provision of better support for (...) ICU physicians. Methods An SSR adopts the Systematic Evidenced Based Approach to map prevailing accounts of caring for dying patients in ICUs. To enhance the transparency and reproducibility of this process, concurrent and independent use of tabulated summaries, thematic analysis and directed content analysis is adopted. Results Eight thousand three hundred fifty-eight abstracts were reviewed from four databases, 474 full-text articles were evaluated, 58 articles were included, and the Split Approach revealed six categories/themes centered around the Innate, Individual, Relational and Societal Rings of Personhood, conflicts in providing end of life care and coping mechanisms employed. Conclusion This SSR suggests that caring for dying patients in ICU impacts how physicians view their personhood. To resolve conflicts within individual concepts of personhood, physicians use prioritization, reframing and rely on accessible, personalized support from colleagues to steer coping strategies. An adapted form of the Ring Theory of Personhood is proposed to direct timely personalized, appropriate and holistic support. (shrink)

In spite of vast global improvements in living standards, health, and well-being, the persistence of absolute poverty and its attendant maladies remains an unsettling fact of life for billions around the world and constitutes the primary cause for the failure of developing states to improve the health of their peoples. While economic development in developing countries is necessary to provide for underlying determinants of health – most prominently, poverty reduction and the building of comprehensive primary health systems – inequalities in (...) power within the international economic order and the spread of neoliberal development policy limit the ability of developing states to develop economically and realize public goods for health. With neoliberal development policies impacting entire societies, the collective right to development, as compared with an individual rights-based approach to development, offers a framework by which to restructure this system to realize social determinants of health. The right to development, working through a vector of rights, can address social determinants of health, obligating states and the international community to support public health systems while reducing inequities in health through poverty-reducing economic growth. At an international level, where the ability of states to develop economically and to realize public goods through public health systems is constrained by international financial institutions, the implementation of the right to development enables a restructuring of international institutions and foreign-aid programs, allowing states to enter development debates with a right to cooperation from other states, not simply a cry for charity. (shrink)

How does microbiota research impact our understanding of biological individuality? We summarize the interdisciplinary summer school on "Microbiota, Symbiosis and Individuality: Conceptual and Philosophical Issues" (July 2019), which was supported by a European Research Council starting grant project "Immunity, DEvelopment, and the Microbiota" (IDEM). The summer school centered around interdisciplinary group work on four facets of microbiota research: holobionts, individuality, causation, and human health. The conceptual discussion of cutting-edge empirical research provided new insights into microbiota and highlights the value of (...) incorporating into meetings experts from other disciplines, such as philosophy and history of science. (shrink)

Digital mental health can be understood as the in situ quantification of an individual’s data from personal devices to measure human behavior in both health and disease (Huckvale, Venkatesh and Chr...

In confronting the insalubrious ramifications of globalization, human rights scholars and activists have argued for greater national and international responsibility pursuant to the human right to health. Codified seminally in Article 12 of the International Covenant on Economic, Social and Cultural Rights, the right to health proclaims that states bear an obligation to realize the “highest attainable standard” of health for all. However, in pressing for the highest attainable standard for each individual, the right to health has been ineffective in (...) compelling states to address burgeoning inequalities in underlying determinants of health, focusing on individual medical treatments at the expense of public health systems. This article contends that the paradigm of individual health, focused on a right to individual medical care, is incapable of responding to health inequities in a globalized world and thereby hampers efforts to operationalize health rights through public health systems. While the right to health has evolved in international discourse over time, this evolution of the individual right to health cannot address the harmful societal ramifications of economic globalization. Rather than relying solely upon an individual right to medical care, envisioning a collective right to public health – a right applied at the societal level to address underlying determinants of health – would alleviate many of the injurious health inequities of globalization. (shrink)

Mason and McCall Smith's classic textbook discusses the relationship of medical practice and ethics with the operation of the law. The subjects covered include natural and assisted reproduction, the impact of modern genetics on medicine, medical confidentiality, consent to medical treatment, the use of resources and problems surrounding death in the new medical era. It is of significance to anyone with an interest in the ethical and legal practice of medicine.

_Appearing in English for the first time, Schelling’s 1842 lectures develop the idea that many philosophical concepts are born of religious-mythological notions._.

Models of global governance abound: expert governance, networked governance, algorithmic governance, and old-fashioned juridico-political governance vie for explanatory power. This article takes up style as a way of analysing configurations of governance that do not readily fit a particular model of governance. Style is particularly revealing when it comes to deliberately unspecified or over-specified, genre-busting, and bet-hedging ways of imagining governance. The UN’s use of the phrase ‘convening power’ is a case in point. This article looks at how the UN (...) has styled itself as a convening power in the area of counter-terrorism governance. A visual analysis of promotional materials for the UN’s Counter-Terrorism Week suggests that the UN’s self-styling as a convening power is shaped by anxieties as well as aspirations. (shrink)

In stark opposition to this anti-aesthetic project, Isobel Armstrong evolves a new poetics, forging an alternative aesthetic discourse by remaking its ...

The Mental Capacity Act (2005) was designed to protect and empower patients with impaired capacity. Despite an estimated 40% of medical inpatients lacking capacity, it is unclear how many patients undergo capacity assessments and treatment under the Act. We audited the number of capacity assessments on the general medical wards of an English-teaching hospital. A total of 95 sets of case notes were reviewed: the mean age was 78.6 years, 57 were female. The most common presenting complaints were feeling ‘unwell’ (...) (n = 25) and confusion (n = 24). In all, 52 patients had conditions, such as delirium (n = 26) and dementia (n = 15), which often impair capacity. Capacity was assessed in seven (7.4%) patients, all of whom disagreed with the medical team about their treatment. The number of documented assessments fell short of the estimated rate of incapacity, suggesting that some means of improving capacity assessment in busy medical environments is required. (shrink)

This paper takes James David Forbes’ Encyclopaedia Britannica entry, Dissertation Sixth, as a lens to examine physics as a cognitive, practical, and social enterprise. Forbes wrote this survey of eighteenth- and nineteenth-century mathematical and physical sciences between 1852 and 1856, when British “physics” was at a pivotal point in its history, situated between a field identified by its mathematical methods – originating in France – and a discipline identified by its university laboratory institutions. Contemporary encyclopedias provided a nexus for publishers, (...) the book trade, readers, and men of science in the formation of physics as a field. Forbes was both a witness, whose account of the progress of physics or natural philosophy can be explored at face value, and an agent, who exploited the opportunity offered by the Encyclopaedia Britannica in the mid nineteenth century to enroll the broadly educated public and scientific collective, illuminating the connection between the definition of physics and its forms of social practice. Forbes used the terms “physics” and “natural philosophy” interchangeably. He portrayed the field as progressed by the natural genius of great men who curated it within an associational culture that engendered true intellectual spirit. Although this societal mechanism was becoming ineffective, Forbes did not see university institutions as the way forward. Instead, running counter to his friend William Whewell, he advocated inclusion of the mechanical arts (engineering), and a strictly limited role for mathematics. He revealed tensions when the widely accepted discovery-based historiography conflicted with intellectual and moral worth, reflecting a nineteenth-century concern with spirit that cuts across twentieth-century questions about discipline and field. (shrink)

The majority of biomedical and biological research relies on a few molecular biology techniques. Here we show that eight key molecular biology techniques would not exist without basic biological research.We also find that the scientific reward system does not sufficiently value basic biological research into molecular mechanisms.

What does the unofficial artist see from the public seats of a courtroom? I have drawn occasionally in the UK Supreme Court, with the court’s permission. I have also drawn proceedings in other courts, such as nude appearances of the Naked Rambler, but these sketches have to be from memory: despite calls for greater transparency, it is still illegal to draw in any UK court below the UK Supreme Court. Official court artists seek to draw a newsworthy moment to please (...) their paymasters—news outlets, or lawyers who like a flattering image. I can please myself and pick out private human moments or elements of coded theatre. I write as a non-lawyer, representing the view of the lay person. What are the public, lawyers, parties and judges doing? How do performance nerves affect people? What can a drawing say? I take a practical rather than a theoretical look: I literally get my hands dirty. (shrink)

Alice Dunbar-Nelson is mostly remembered as a poet, activist, and ex-wife of Paul Laurence Dunbar. Her volume The Goodness of St. Rocque and Other Stories (1899) has been largely overshadowed as a result. Yet, the collection contains a portfolio of heroines analogous and contemporaneous to the famed New Woman figure of the fin de siècle. In this article, I consider Dunbar-Nelson’s heroines in light of their New Woman-esque agency and autonomy as they find remedies and power in objects and materials (...) steeped in New Orleans’s cultural heritage. Ceded neither social nor political self-governance nor domestic comfort, this article reads these transcendental, metaphysical objects as sources of self-care. With close analysis of “The Goodness of St. Rocque,” “Tony’s Wife,” and “Little Miss Sophie,” I argue that Dunbar-Nelson’s protagonists exert influence over their lives, specifically in the negotiation of romantic relationships, through voodoo charms, Catholic candles, tarot cards, sewing machines, and knitting needles. Covering courtship, break-ups, and unhappy marriages, I demonstrate the ways in which these empowering spiritual objects respond to health concerns, including malnutrition and domestic violence, in turn, situating them as alternatives to patriarchal and historically racist medical institutions. Valorizing the cultural milieu of New Orleans and the customs of the Caribbean and European heritage, and thereby conveying Dunbar-Nelson’s resistance to white and male supremacist ideologies in late-nineteenth-century Southern America, the article ultimately assesses the parallels with (predominantly white) New Woman fiction, through shared themes of fraught heterosexual dynamics and women’s declining health. (shrink)

In 1847, Johanne Luise Heiberg, a thirty-year old Danish actress and friend of Søren Kierkegaard, performed the role of Juliet in Shakespeare’s Romeo and Juliet in the Copenhagen theatre. She had played Juliet once before, aged 16, and it was this first performance which helped to launch her prestigious career. The 1847 performance prompted Kierkegaard to write an article for the newspaper Fædrelandet , called 'The Crisis and a Crisis in the Life of an Actress' under the name of Inter (...) et Inter. Its publication contradicted Kierkegaard’s resolve to cease his literary authorship and to write directly under his own name as a religious author. This essay shows what was at stake for Kierkegaard in publishing 'The Crisis and a Crisis in the Life of an Actress' and its pivotal status for him both as a writer and a Christian. Both ‘crises’ of the title refer to a metamorphosis as a return to ‘the beginning’ effected through a series of elliptical characters: the actress, Juliet, Inter et Inter, Kierkegaard himself and the reader. Kierkegaard’s commentary on Frau Heiberg’s performance of Juliet brings together categories of repetition and anxiety in order to understand how “the metamorphosis of the actress” is effected as a return to the 'beginning', mirroring Kierkegaard's own transition from 'literary' to 'religious' writer and ultimately reflecting back on the reader’s own condition as existing individual. (shrink)

A clinical scenario is described where an anaesthetist is concerned about the seemingly high risk/benefit ratio relating to laparoscopic versus standard inguinal hernia operations. Some options for further action by the anaesthetist are introduced. The remainder of the paper explores the question of who can legitimately assess the acceptability of risk/benefit ratios, and defends the use of practice guidelines at the expense of so called clinical freedom. It is argued that respect for persons is not breached by limiting the treatment (...) options offered to patients to those therapies which have a ‘reasonable’ risk/benefit ratio. This ‘reasonableness’ is context dependent, and should be properly decided by those with expertise in the field. (shrink)

A clinical scenario is described where an anaesthetist is concerned about the seemingly high risk/benefit ratio relating to laparoscopic versus standard inguinal hernia operations. Some options for further action by the anaesthetist are introduced. The remainder of the paper explores the question of who can legitimately assess the acceptability of risk/benefit ratios, and defends the use of practice guidelines at the expense of so called clinical freedom. It is argued that respect for persons is not breached by limiting the treatment (...) options offered to patients to those therapies which have a ‘reasonable’ risk/benefit ratio. This ‘reasonableness’ is context dependent, and should be properly decided by those with expertise in the field. (shrink)

The Hypothesis of Extended Cognition (HEC)—that many cognitive processes are carried out by a hybrid coalition of neural, bodily and environmental factors—entails that the intentional states that are reasons for action might best be ascribed to wider entities of which individual persons are only parts. I look at different kinds of extended cognition and agency, exploring their consequences for concerns about the moral agency and personal responsibility of such extended entities. Can extended entities be moral agents and bear responsibility for (...) actions, in addition to or in place of the individuals typically held responsible? What does it mean to be autonomous when one’s cognition is influenced and supported by a milieu of environmental factors? To answer these questions, I explore strong parallels between HEC’s critique of individualism in cognition, and feminist critiques of individualist accounts of self, agency, and autonomy. This relational and social conception of autonomous agency, as scaffolded and supported (or undermined and impaired) by a milieu of social, relational, and normative factors, has important lessons for HEC. Drawing together these two visions of distributed and decentralized aspects of personhood highlights how cognition, action, and responsibility are inextricably linked. It also encourages a reconceptualization of all cognition and all concerns about responsibility for actions, not simply as sometimes extended around individuals, but as fundamentally communal, social, and normative, with individual cognition and individual moral responsibility being derivative special cases, not the paradigm examples. Individuals are merely one of many possible loci of cognition, action, and responsibility. (shrink)

In this paper I discuss various hard cases that an account of moral ignorance should be able to deal with: ancient slave holders, Susan Wolf’s JoJo, psychopaths such as Robert Harris, and finally, moral outliers. All these agents are ignorant, but it is not at all clear that they are blameless on account of their ignorance. I argue that the discussion of this issue in recent literature has missed the complexities of these cases by focusing on the question of epistemic (...) fault. It is not clear that all blameworthy morally ignorant agents have committed an epistemic fault. There are other important issues that pull us in various directions: moral capacity, bad will, and formative circumstances. I argue that bad will is what is crucial, and moral ignorance itself can be a form of bad will. I argue that we should distinguish between two sorts of bad will, and correspondingly, two sorts of blameworthiness. Ordinary blameworthiness, requires moral knowledge, and is based on akratic action. The other kind of blameworthiness, objective blameworthiness, applies when the agent is morally ignorant, and when this indicates bad will. Objective blameworthiness can be undermined by unfortunate formative circumstances. (shrink)

What’s the difference between those psychological posits that are ‘me” and those that are not? Distinguishing between these psychological kinds is important in many domains, but an account of what the distinction consists in is challenging. I argue for Psychological Constructionism: those psychological posits that correspond to the kinds within folk psychology are personal, and those that don’t, aren’t. I suggest that only constructionism can answer a fundamental challenge in characterizing the personal level – the plurality problem. The things that (...) plausibly qualify as personal are motley. Other attempts at accounting for the personal level either cannot accommodate this plurality, or cannot explain what unifies the personal. Given arguments others have given for a pluralistic conception of folk psychology, constructionism explains and predicts this plurality in a systematic and unified way, thereby solving the plurality problem. (shrink)

Social workers form part of many healthcare teams. This role can involve in-depth conversations with clients and home visits. These encounters can reveal sensitive information, not all of which may be accessible to other members of the healthcare team. Most modern healthcare systems employ shared care records, which are populated by, and accessible to, multiple members of the healthcare team. Shared care records are valued for their capacity to enhance inter-professional communication and improve patient care. But this very capacity may (...) increase an underlying tension between privacy and efficient, effective care. Ethical tensions can arise for health social workers between comprehensive documentation and protecting client privacy by limiting access to privileged information obtained in the context of a social work encounter. This qualitative empirical ethics study investigated health social workers' experiences of tensions between client privacy and maintaining complete records, and how they thought the tension should be resolved. Participant testimony informed a pragmatist approach to identify principles governing recording of sensitive information in shared care records. Three principles were identified: necessity, accuracy, and neutrality. Participants' reports of moral concerns about recording indicate that ethical tensions can occur. The identified principles offer a starting point for managing such tensions. (shrink)

This paper explores Dewey's landmark book Democracy and Education1 and the insights it holds for 21st-century education. Regarding the term "21st-century education," Alfie Kohn aptly notes that "we can take whatever objectives of teaching strategies we happen to favor and, merely by attaching a label that designates a future time period, endow them and ourselves with an aura of novelty and significance."2 The intention of this paper is to re-appropriate this term from two groups that tend to employ it. The (...) first of these is the standardization movement, which includes proponents of high-stakes testing and the concomitant narrowing of curricula. The second group is advocates for digital ubiquity in K–12 classrooms... (shrink)

In these remarks on Feldman's recent book, Pleasure and the Good Life, I concentrate on Feldman's account of pleasure as attitudinal. I argue that an account of pleasure according to which pleasure need not have any feel is implausible. I suggest that Feldman could avoid this problem but retain the advantages of his attitudinal hedonism by giving an account of the attitude such that the attitude has a feel.

Despite contemporary moral philosophers' renewed attention to the moral significance of emotions, the attitudinal repertoire with which they equip the mature moral agent remains stunted. One attitude moral philosophers neglect (if not disown) is contempt. While acknowledging the nastiness of contempt, I here correct the neglect by providing an account of the moral psychology of contempt. In the process, I defend the moral propriety of certain tokens of properly person-focused contempt against some prominent objections -- among them, objections stemming from (...) Kantian worries that contempt is incompatible with the respect we owe to persons as such. (shrink)

I support much of Maiese and Hanna’s (M&H) account of the ways social institutions “mindshape” people’s cognition (values, meanings, affective framings, and habits of bodily comportment), and of the ways neoliberal individualism can be resisted and progressive social change can be enacted. But the overall approach can be augmented, I argue, if M&H would embrace an enactivist account of socially distributed and collective cognition, and action, in which cognitive systems include but are not limited to individuals. Complementing M&H’s focus on (...) top-down “repressive” forms of power, with also “ideological” forms of power that are distributed throughout social communities and their discursive practices, symbolic resources, and shared meanings would enable M&H to see not just top-down mindshaping by institutions, but also peer-to-peer mindshaping between members of distributed normative social practices. This analysis also entails that diverse institutions are often composed of many differing communities and practices, such that institutions are not wholly destructive and deforming nor wholly constructive and enabling. It also augments their largely top-down account of social change with the kinds of social change enacted through peer-to-peer interactions between members of different communities, whose iterated interactions over time embody competition (differing distributions of repressive and ideological power) between different normative communities with different practices, especially through heterodox communities of resistance, offering liberatory and “enabling” social practices as alternatives to dominant orthodox “deforming” social practices. (shrink)

When we look around us, some things look “alive,” others do not. What is it to “look alive”—to perceive animacy? Empirical work supports the view that animacy is genuinely perceptual. We should construe perception of animacy as perception of agents and behavior. This proposal explains how static and dynamic animacy cues relate, and explains how animacy perception relates to social cognition more broadly. Animacy perception draws attention to objects that are apt to be well‐understood folk psychologically, enabling us to marshal (...) our folk psychological resources efficiently. (shrink)

This lecture argues that new optical experiences created by the lens and what we now call the virtual image were the foundation alike of ‘high’ science, associated at this historical moment with the telescope, and popular spectacle. They precipitated and renewed an enquiry into the nature and status of the image as the technologies of the phantasmagoria, the kaleidoscope and the diorama penetrated deep into the poets' worlds and words. The projected image, without a correspondence in reality, was a troubling (...) aspect of this modern technology, provoking new understandings of materiality and immateriality. Colour, reflection and refraction became central concerns as a corollary of the debate. Some poets assimilated this imagery into their work, albeit skeptically. Others violently resisted it. The lecture looks closely at image-making in poetic language, and argues that there were both ontological and political stakes in this enquiry. (shrink)

Disputes between separated couples over whether frozen embryos can be used in an attempt to create a child create a moral dilemma for public policy. When a couple create embryos intending to parent any resulting children, New Zealand’s current policy requires the consent of both people at every stage of the ART process. New Zealand’s Advisory Committee on Assisted Reproductive Technology has proposed a policy change that would give ex-partners involved in an embryo dispute twelve months to come to an (...) agreement before the embryos are destroyed. New Zealand’s current policy and the proposed policy both favour the person who wishes to avoid procreation. Two alternative policy approaches that do not favour procreative avoidance are considered. Using pre-fertilisation contracts to determine the decision reached in embryo disputes allows the couple’s wishes at the time the embryos are created to determine what happens to the embryos if they separate. However, pre-fertilisation contracts are agreements about healthcare and personal relationships, and changing circumstances can make enforcing such agreements unjust. Finally, it is argued that New Zealand’s Family Court system should be used to reach decisions that balance the interests of those involved in the dispute. (shrink)

This paper introduces some of the debates in the field of critical thinking by highlighting differences among thinkers such as Siegel, Ennis, Paul, McPeck, and Martin, and poses some questions that arise from these debates. Does rationality transcend particular cultures, or are there different kinds of thinking, different styles of reasoning? What is the relationship between critical thinking and learning? In what ways does the moral domain overlap with these largely epistemic and pedagogical issues? The paper concludes by showing how (...) Peters, Evers, Chan and Yan, Ryan and Louie, Luntley, Lam, Doddington, and Kwak, respond to these questions. (shrink)