Most healthcare providers work from ethical principles based on a Western model of practice that may not adhere to the cultural values intrinsic to Indigenous peoples. Breaking bad news is an important topic of ethical concern in health research. While much has been documented on BBN globally, the ethical implications of receiving bad news, from an Indigenous patient perspective in particular, is an area that requires further inquiry. This article discusses the experiences of Māori lung cancer patients and their families, (...) in order to investigate the ethical implications of receiving bad news. Data collection occurred through 23 semistructured interviews and nine focus groups with Māori lung cancer patients and their families in four districts in the Midland Region of New Zealand: Waikato, Bay of Plenty, Lakes and Tairāwhiti. The findings of this study were categorised into two key themes: communication and context. Avenues for best practice include understanding the centrality of the HCP–patient relationship and family ties in the healthcare journey, and providing patients with the full range of viable treatment options including hope, clear advice and guidance when the situation calls for it. Overall, the findings of this study hold implications for providing culturally safe and humanistic cancer care when BBN to Māori and Indigenous patients. (shrink)

This paper takes as its starting point a debate between Harry Frankfurt and J. David Velleman. Frankfurt argues that we need to resolve ambivalence since it necessarily threatens autonomy. Velleman challenges this claim, arguing that a desire to resolve ambivalence threatens autonomy when it prompts repression. I argue that the relationship between ambivalence and autonomy is more ambiguous than either theorist tends to acknowledge. In doing so, I recommend three features relevant for assessing whether or not ambivalence threatens autonomy.

We use a transmission chain method to establish how context and category salience influence the formation of novel stereotypes through cumulative cultural evolution. We created novel alien targets by combining features from three category dimensions—color, movement, and shape—thereby creating social targets that were individually unique but that also shared category membership with other aliens (e.g., two aliens might be the same color and shape but move differently). At the start of the transmission chains each alien was randomly assigned attributes that (...) described it (e.g., arrogant, caring, confident). Participants were given training on the alien‐attribute assignments and were then tested on their memory for these. The alien‐attribute assignments participants produced during test were used as the training materials for the next participant in the transmission chain. As information was repeatedly transmitted an increasingly simplified, learnable stereotype‐like structure emerged for targets who shared the same color, such that by the end of the chains targets who shared the same color were more likely to share the same attributes (a reanalysis of data from Martin et al., which we term Experiment 1). The apparent bias toward the formation of novel stereotypes around the color category dimension was also found for objects (Experiment 2). However, when the category dimension of color was made less salient, it no longer dominated the formation of novel stereotypes (Experiment 3). The current findings suggest that context and category salience influence category dimension salience, which in turn influences the cumulative cultural evolution of information. (shrink)

This book forms part of the multi-disciplinary Studies in Ethics Series from Liverpool Hope University. It explores the slipperiness of ethics as a concept and demonstrates the multiplicity of intellectual inquiry within contemporary Film Studies. At first glance, â ~ethicsâ (TM) is not necessarily a subject conventionally associated with film. Film is often regarded as a form of â ~lowbrowâ (TM) popular culture, either offering bland entertainment or deliberately setting out to shock â " or, more cynically, generate box office (...) revenue â " through gratuitous inclusion of sex and violence. Certainly, there have always been a minority of films based on the stereotypically â ~ethicalâ (TM) subject of religion, but these have often generated the most controversy, from the studio system decree that it was blasphemous to represent the corporeal body of Christ to the furore surrounding Martin Scorseseâ (TM)s The Last Temptation of Christ (1988). This book shows that from the silent era to the present day, film has been inherently concerned with ethical issues. In this light, the definition of ethics that informs the volume and is taken as the starting point of each of the chapters is the notion of personal or institutional motivation; most usually because a character or industry figure makes a decision or choice based on their own moral â " or ethical â " code. Once this is defined, the ethical dimension to films is immediately evident. This book takes as its central theme the difficulty of decisions refracted through personal ethical codes, and thus recognises that what counts as ethics, or morality, is always subjective. Some of the chapters explore films which take conventionally â ~goodâ (TM) ethical standpoints, others investigate why â ~badâ (TM) decisions were made; at least one explores the celebration of practices invoking popular disgust, but all the contributions study ethical decisions within film that represent the strongly felt convictions of those involved and, moreover, address aspects of filmmaking which force the spectator to be an active and reciprocal participant in the creation of meaning, thus implicitly acknowledging that ethics are subjective and in perpetual flux rather than fixed, objective truths. (shrink)

Martha Nussbaum subscribes to the view that our identity is an evaluative question determined by our common, deeply held beliefs about what is worthwhile in human life. In so doing, she asserts that for an account of ethics to have “philosophical power” it needs to be grounded in an account of human nature that is both evaluative and internal. I focus on Nussbaum's claim that personal identity has to include the necessary features of practical rationality and sociability. Although Nussbaum puts (...) forward self-validating arguments to prove that we cannot – on pain of pragmatic in consistency – dispute that practical rationality and sociability are necessary features of human life, it is my claim that her account is flawed. The nature of the relationship between ethics and human nature is the broader context to such debates. This paper raises questions regarding on the one hand, whether it is possible to found ethics in human nature and, on the other, what we are to make of accounts that turn on the assumption that identity is ethical, not meta physical. S. Afr. J. Philos. Vol.24(2) 2005: 87-96. (shrink)

What does world peace mean? Peace is more than the absence and prevention of war, whether international or civil, yet most of our ways of conceptualizing and measuring peace amount to just that definition. In this essay, as part of the roundtable “World Peace (And How We Can Achieve It),” I argue that any vision of world peace must grapple not only with war but with the continuums of violence and peace emphasized by feminists: running from the home and community (...) to the public spaces of international relations. Breaking free of the constraints of the last century's intellectual boundaries, I suggest that war and peace are not a dichotomy but rather are intimately related. Yet the dearth of feminist perspectives in global debates prevents us from seeing how violence and harm are exacerbated in households and through the global economy under conditions of both “war” and “peace.” To understand the possibilities for world peace, we must understand these varieties of violence and harm that threaten peace. And to sustain peace we must address the harmful gendered identities, ideologies, and social dynamics that support violence in every society. A narrow understanding of peace as merely the absence of organized violence does not engender the kind of nuanced and rich understanding of human history and human relations needed to bring an end to the structural and physical violence that remains pervasive worldwide. (shrink)

Feminist Geneaologies, Colonial Legacies, Democratic Futures provides a feminist anaylsis of the questions of sexual and gender politics, economic and cultural marginality, and anti-racist and anti-colonial practices both in the "West" and in the "Third World." This collection, edited by Jacqui Alexander and Chandra Talpade Mohanty, charts the underlying theoretical perspectives and organization practices of the different varieties of feminism that take on questions of colonialism, imperialism, and the repressive rule of colonial, post-colonial and advanced capitalist nation-states. It provides a (...) comparative, relational, historically grounded conception of feminist praxis that differs markedly from the liberal pluralist, multicultural understanding that sheapes some of the dominant version of Euro-American feminism. As a whole, the collection poses a unique challenge to the naturalization of gender based in the experiences, histories and practices of Euro-American women. (shrink)

This article looks at the discourses of love through an analysis of the ‘stratification of intimacy’ within lesbian families. I suggest that traditional discourses of love effectively reify our emotions into socially prescribed categories, where ‘mature love’ is conflated with sex and desire. The love that mothers feel for their child is set apart, ‘instinctive’, wholly separate to adult love. However this ‘stratification of intimacy’ obscures the lived experiences and feelings of many parents. In this article the author argues that (...) whom we love is culturally constituted: it is unnecessarily quantified whereby monogamy is read as the sign of true love. I illustrate how lesbian mothers’ location on the social margins enables them to construct new ‘patterns of love’ within their ‘families of choice’ in ways that challenge these traditional discourses of love. This theoretical analysis is based upon ‘patterned variations’ drawn from qualitative research with 20 lesbian families with children living within the Yorkshire region in the UK. (shrink)

Background: When adolescent boys experience close, secure relationships with their parents and peers, the implications are potentially far reaching, including lower levels of mental health problems in adolescence and young adulthood. Here we use rare prospective intergenerational data to extend our understanding of the impact of adolescent attachments on subsequent postpartum mental health problems in early fatherhood.Methods: At age 17–18 years, we used an abbreviated Inventory of Parent and Peer Attachment to assess trust, communication, and alienation reported by 270 male (...) participants in their relationships with mothers, fathers, and peers. More than a decade later, we assessed the adult males, now fathers, at 12 months postpartum for symptoms of depression, anxiety, and stress. Logistic regression was used to examine the extent to which attachment dimensions predicted paternal postpartum mental health, adjusting for potential confounding, and with assessment for interactions between parent and peer attachments.Results: Trust in mothers and peers, and good communication with fathers during adolescence, were associated with 5 to 7 percentage point reductions in postpartum mental health symptoms in early fatherhood. Weak evidence of parent-peer interactions suggested secure attachments with either parent or peer may compensate for an insecure attachment with the other.Conclusions: Our results suggest that fostering trust and communication in relationships that adolescent boys have with parents and peers may have substantial effects on rates of paternal postpartum mental health problems. The protective benefits may be preventative in intergenerational cycles of risk for mental health problems. (shrink)

With reference to examples of violence during Apartheid, I argue that the socio-political contexts in which violence occurs significantly shape agents ideas about and responses to violence. As such, philosophers can only make sense of why perpetrators and bystanders alike may have judged violent acts morally justifiable or failed to challenge instances of violence against the backdrop of the particular characteristics of the socio-political context in which it occurs.

The three of us (be)come together, yes on Zoom calls and in Google docs, and in a way that re-imagines the sitting together at a well-worn kitchen table to animate our current shared preoccupations. The table has seen many conversations before us, so it’s well-worn by feminist scholars who were also troubled, yearning, and adamant about leaving their marks. We have come to, become at, this type of table for centuries, sitting together preparing food, folding laundry, and washing up, all (...) while also reckoning that our stories matter and can make a difference. In a context that is both practical and intellectual – centring fat liberation in public health nutrition – how do we remain good scholarly support to one another in and through challenging times? Times of dissent. Times of tedium. This chapter reveals the stories we need most now as we grapple with our places in the neoliberal university and public health pedagogy, specifically as a critique of policies that we read as non-liberatory. We grapple with how our complicity within these spaces might be considered from a place of mutual support and a shared commitment to unlearning and unsettling colonial ways of knowing, especially as we contemplate the problematics of public health imperatives regarding “intuitive eating” and health behaviour change. And we ask what this means for scholarship that is accountable to liberation, that is, personal survival and collective healing and learning. (shrink)

Epistemic injustice is a harm done to a person in their capacity as an epistemic subject by undermining her capacity to engage in epistemic practices such as giving knowledge to others or making sense of one’s experiences. It has been argued that those who suffer from medical conditions are more vulnerable to epistemic injustice than the healthy. This paper claims that people with mental disorders are even more vulnerable to epistemic injustice than those with somatic illnesses. Two kinds of contributory (...) factors for epistemic injustice in psychiatric patients are outlined: global and specific. Some suggestions are made to counteract the effects of these contributory factors, for instance we suggest that physicians should participate in groups where the subjective experience of patients is explored, and learn to become more aware of their own unconscious prejudices towards psychiatric patients. (shrink)

The gut protozoan parasite, Giardia duodenalis, is the best characterized example of the most ancient eukaryotes, which are anaerobic and appear to be primitively amitochondrial. Apart from its obvious medical importance, Giardia is fascinating in its own right. Its prokaryotic-like anaerobic metabolism renders it selectively sensitive to some bacterial drugs, especially the nitroimidazoles, which are activated to form toxic radicals. Other features, including an enzyme that reduces oxygen directly to water, cysteine as the keeper of redox balance, a plasmid, and (...) toxin-like genes are also distinctly prokaryotic-like. But, unlike prokaryotes, Giardia has a sophisticated, highly developed cytoskeleton, bounded nuclei, linear chromosomes capped with telomeric repeats, and telomere positional regulation of gene expression. BioEssays 20:256–263, 1998.© 1998 John Wiley & Sons, Inc. (shrink)

An essay review of Havi Carel, 'Phenomenology of Illness' (OUP 2015).

This study provides evidence of the significant life experiences , which influence advocates for nonhuman animals to develop sensitivity toward animals. Thirty-nine humane educators participated in an online survey. Findings indicate that having a relationship with a companion animal in adulthood is the most important life experience, followed by having a childhood experience with an animal, being exposed to a positive role model in childhood, and reading about animals and animal issues. The study did not find age and gender related (...) differences in life experiences. This paper compares the results from this study to two previous studies. The first study examined the SLEs of animal advocate leaders through analysis of autobiographies, biographies, oral histories, and written interviews. The second study examined the SLEs of animal rescuers through an open-ended survey. This paper discusses similarities and differences among these three groups. (shrink)

Abstract:Lucian's Fatherland Encomium is thought to have been delivered at Samosata, Lucian's hometown. Although he never mentions "Samosata" in this speech, he repeatedly toys with the "name of the fatherland" as the speech's theme. But what is the name of his native city? The Greeks called it "Samosata" but this is clearly a transliteration. I consider the Aramaic, Persian, and Armenian versions of the name, and notice that the Aramaic "Shemshat" has a number of resonances in Lucian's speech, not least (...) the set theme of the speech itself "the name of (shem) the fatherland.". (shrink)

In this paper we defend the notion of narrative identity against Galen Strawson's recent critique. With reference to Elyn Saks's memoir of her schizophrenia, we question the coherence ofStrawsons conception of the Episodic self and show why the capacity for narrative integration is important for a flourishing life. We aho argue that Scú put pressure on narrative theories that specify unduly restncúve constraints on self-constituting narratives, and chrify the need to distinguish identity from autonomy.

Abstract Havi Carel has recently argued that one can be ill and happy. An ill person can ?positively respond? to illness by cultivating ?adaptability? and ?creativity?. I propose that Carel's claim can be augmented by connecting it with virtue ethics. The positive responses which Carel describes are best understood as the cultivation of virtues, and this adds a significant moral aspect to coping with illness. I then defend this claim against two sets of objections and conclude that interpreting Carel's phenomenology (...) of illness within a virtue-ethical framework enriches our understanding of how illness can be edifying. (shrink)

L’Association nationale des réseaux de personnel handicapé (NADSN) est un super-réseau qui relie et représente les réseaux de personnel handicapé dans les organisations à travers le Royaume-Uni. Le NADSN a été très préoccupé par le développement de la politique nationale jusqu’à ce jour et par le fait de sortir de la phase de verrouillage COVID-19, car la politique nationale est restée silencieuse en ce qui concerne le personnel handicapé, si ce n'est en présentant un point de vue étroit et médicalisé. (...) Nous avons structuré ce document dans le cadre d’un modèle social du handicap et des sentiments exprimés dans la Convention des Nations unies relative aux droits des personnes handicapées (CDPH) en examinant les problèmes actuels et en formulant nos douze recommandations. Ce document présente les observations du NADSN sur les expériences vécues par les personnes handicapées au cours de la conférence COVID-19. Il décrit ensuite la COVID-19 et l’évolution du lieu de travail. Il aborde ensuite une discussion générale sur les pratiques et les politiques de sécurité au travail, à mesure que nous sortons de l’isolement et au-delà. (shrink)

It is my contention that the law has its origins and derives its authority from moral precepts; and this morality is not dead, but is a live spirituality and ultimately depends on connection with the divine. In the spirit of the law, what is mercy and the admonition to love one's fellow humans as oneself and its application in the new millennium? If this view is accepted it has profound implications for the way law is practised. The implications for the (...) role of customary law in the legal decision-making process and the recognition of indigenous rights generally are affected. (shrink)

‘The co-production of meaning’ is a popular, widely-used, but under-defined concept. To better understand the co-production of meaning, we shall attempt to develop an account of co-production through phenomenological psychopathology. Through Hans Georg Gadamer’s remarks on ‘the hermeneutic problem of psychiatry’, we distinguish kinds of contingent and intrinsic obstacles to 'co-production'. In calling attention to these obstacles, we problematise the concept of ‘co-production’ in public mental health, revealing it to be more complex than originally thought. We conclude that new developments (...) in phenomenological psychopathology can be used to overcome some of the limitations of ‘co-production’. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Disability Embodied: Narrative Exploration of the Lives of Two Brothers Living with Traumatic Brain InjuryDouglas E. KiddAny discussion of personal experiences with disability, inevitably lead me to recall the experiences of my brother, Richard Kidd. An examination of our journeys clearly illustrates the term disability. More so, our stories reveal the outcome of severe physical impairment dictates the limits of personal agency and autonomy. Perhaps an obvious conclusion, (...) but exploration of our experience is useful as we provide living testimony to eventualities that could similarly occur to others. In order to provide context for discussion of our disabilities, I will briefly recall how we acquired our traumatic brain injuries (TBI), as well as how our brain injuries are expressed. The article will demonstrate that due to the severity of the brain damage he acquired, Richard is entirely subject to the whim of the society he encounters, and thus disabled. The article will also discuss how the disabling attitudes I have encountered sought to diminish my humanity.Richard KiddRichard’s descent into impairment began in the early evening hours of December 31, 1987. As a pedestrian, Richard attempted to cross a street in Indianapolis, when a car without using headlights, slammed into him. In addition, the driver fled the scene of the accident. After stabilizing from the initial trauma—multiple compound fractures to both legs and severe brain injury—Richard spent approximately ten months in coma. After emerging from coma, Richard underwent months of therapy. Albeit with consistent direction from others, therapy enhanced Richard’s ability to hold a cup and use a spoon. These were significant victories for Richard and signaled the beginning of his recovery. However, within two years of his accident, monies ended for rehabilitation and Richard entered into custodial care at his first nursing facility. As time passed, his daily interactions with poorly supervised, unskilled, and underpaid nursing facility employees with little time to work with Richard meant it was more cost efficient for staff to simply spoon–feed Richard. Consequently, Richard lost the ability to participate in an aspect of his self–care. Richard’s humanity took years to gradually erode, but due to the severity of his impairments, he became viewed by those he encountered as an object of treatment, or reservoir of pain and pity, rather than an individual worthy of respect. Accordingly, [End Page 199] Richard became viewed as other. Thus began Richard’s descent into disability.A complete lack of dental care for decades provides a good example of Richard’s treatment as other. Richard’s experience also demonstrates that desensitized members of the medical, dental, and long–term care professions sometimes precipitate grave circumstances. The combination of an inattention to his needs and his limited ability to participate with his self–care meant that Richard typically went without dental treatment. His quality of life diminished further when aides at a nursing facility dropped him. During the fall, Richard’s face smashed into the floor and several teeth were shattered. More than a decade passed before Richard finally received follow–up dental treatment—that day nearly cost him his life. Due to prolonged neglect, all of Richard’s teeth required extraction. I do not question the dental surgeon’s assessment of Richard’s teeth. I am certain that all of his teeth needed to be removed; but Richard’s sedentary lifestyle meant that he had limited ability to cope with the trauma associated with having 24 teeth removed in one session. I feel certain the dental surgeon assumed Richard was like most other patients and could handle the stress associated with the procedures. However, Richard could not cope with trauma and blood loss the extractions produced. What is worse than the dental surgeon’s assessment of Richard’s ability to withstand surgery is the post–op personnel decision to discharge him to home, shortly after surgery. The nursing facility was ill–equipped to cope with the extent of the blood loss that ensued and soon Richard began to aspirate on his own blood. Accordingly, Richard was sent to the hospital where he proceeded to slip into coma. Richard remained in a coma for approximately four days and in hospital... (shrink)

The virtue of trust is often spoken of as central to the work of dietitians working in nutrition counseling, especially in the context of disordered eating/eating disorders nutrition therapy. Indeed, dietitians are purported to be the most trusted source of information on nutrition and food by professional associations such as Dietitians of Canada. Here trust is explored through educational, relational, and virtue theory in order to elucidate trusts meaning and relevance to dietitians work and interactions with each other, including the (...) general public. If dietitians are to continue to be trusted during times of skepticism in expert knowledge, reflexivity, active contestation, and moral testing in the context of our socio-political milieu need be employed so that we as a profession may respond to clients in respectful, authentic, meaningful ways; practices worthy of our trust. (shrink)

What sorts of epistemic virtues are required for effective mathematical practice? Should these be virtues of individual or collective agents? What sorts of corresponding epistemic vices might interfere with mathematical practice? How do these virtues and vices of mathematics relate to the virtue-theoretic terminology used by philosophers? We engage in these foundational questions, and explore how the richness of mathematical practices is enhanced by thinking in terms of virtues and vices, and how the philosophical picture is challenged by the complexity (...) of the case of mathematics. For example, within different social and interpersonal conditions, a trait often classified as a vice might be epistemically productive and vice versa. We illustrate that this occurs in mathematics by discussing Gerovitch’s historical study of the aggressive adversarialism of the Gelfand seminar in post-war Moscow. From this we conclude that virtue epistemologies of mathematics should avoid pre-emptive judgments about the sorts of epistemic character traits that ought to be promoted and criticised. (shrink)

An essay review of Léna Soler, Emiliano Trizio, and Andrew Pickering (eds.), Science As It Could Have Been: Discussing the Contingency/Inevitability Problem (Pittsburgh: Pittsburgh University Press).

This paper is a critique of ‘integrative medicine’ as an ideal of medical progress on the grounds that it fails to realise the cognitive value of alternative medicine. After a brief account of the cognitive value of alternative medicine, I outline the form of ‘integrative medicine’ defended by the late Stephen Straus, former director of the US National Centre for Complementary and Alternative Medicine. Straus’ account is then considered in the light of Zuzana Parusnikova’s recent criticism of ‘integrative medicine’ and (...) her distinction between ‘cognitive’ and ‘opportunistic’ engagement with alternative medicine. Parusnikova warns that the medical establishment is guilty of ‘dogmatism’ and proposes that one can usefully invoke Karl Popper’s ‘critical rationalism’ as an antidote. Using the example of Straus, I argue that an appeal to Popper is insufficient, on the grounds that ‘integrative medicine’ can class as a form of cognitively-productive, critical engagement. I suggest that Parusnikova’s appeal to Popper should be augmented with Paul Feyerabend’s emphasis upon the role of ‘radical alternatives’ in maximising criticism. ‘Integrative medicine’ fails to maximise criticism because it ‘translates’ alternative medicine into the theories and terminology of allopathic medicine and so erodes its capacity to provide cognitively-valuable ‘radical alternatives’. These claims are then illustrated with a discussion of ‘traditional’ and ‘medical’ acupuncture. I conclude that ‘integrative medicine’ fails to exploit the cognitive value of alternative medicine and so should be rejected as an ideal of medical progress. (shrink)

I provide an account of the political and philosophical thought of Oswald Spengler.