This article draws on an empirical investigation of how Australia’s cervical screening program came to be the way it is. The study was carried out using grounded theory methodology and primarily uses interviews with experts involved in establishing, updating or administering the program. We found strong differences in experts’ normative evaluations of the program and beliefs about optimal ways of achieving the same basic outcome: a reduction in morbidity and mortality caused by invasive cervical cancer. Our analysis demonstrates how variations (...) in values and preferences associated with key concepts underpinning public health such as benefit, harm and burden led to different perspectives on the purpose of an organized cervical screening program. These variations were largely driven by different bases of professional experience. Differently conceived purposes in turn led to conflict over how the program should be operationalized. Following Frith’s model of empirical bioethics, the results of the study both draw on and inform the existing public health and screening ethics literature. (shrink)

Surgical innovation promises improvements in healthcare, but it also raises ethical issues including risks of harm to patients, conflicts of interest and increased injustice in access to health care. In this article, we focus on risks of injustice, and use a case study of robotic prostatectomy to identify features of surgical innovation that risk introducing or exacerbating injustices. Interpreting justice as encompassing matters of both efficiency and equity, we first examine questions relating to government decisions about whether to publicly fund (...) access to innovative treatments. Here the case of robotic prostatectomy exemplifies the difficulty of accommodating healthcare priorities such as improving the health of marginalized groups. It also illustrates challenges with estimating the likely long-term costs and benefits of a new intervention, the difficulty of comparing outcomes of an innovative treatment to those of established treatments, and the further complexity associated with patient and surgeon preferences. Once the decision has been made to fund a new procedure, separate issues of justice arise at the level of providing care to individual patients. Here, the case of robotic prostatectomy exemplifies how features of surgical innovation, such as surgeon learning curves and the need for an adequate volume of cases at a treatment centre, can exacerbate injustices associated with treatment cost and the logistics of travelling for treatment. Drawing on our analysis, we conclude by making a number of recommendations for the just introduction of surgical innovations. (shrink)

There are increasing concerns that research regulatory requirements exceed those required to manage risks, particularly for low- and negligible-risk research projects. In particular, inconsistent documentation requirements across research sites can delay the conduct of multi-site projects. For a one-year, negligible-risk project examining biobank operations conducted at three separate Australian institutions, we found that the researcher time required to meet regulatory requirements was eight times greater than that required for the approved research activity. In total, 76 business days were required to (...) obtain the necessary approvals, and site-specific processes required twice as long as primary Human Research Ethics Committee and Research Governance Office processes. We describe the impact of this administrative load on the conduct of a one-year, externally-... (shrink)

BackgroundCervical cancer disproportionately burdens disadvantaged women. Organised cervical screening aims to make cancer prevention available to all women in a population, yet screening uptake and cancer incidence and mortality are strongly correlated with socioeconomic status. Reaching underscreened populations is a stated priority in many screening programs, usually with an emphasis on something like ‘equity’. Equity is a poorly defined and understood concept. We aimed to explain experts’ perspectives on how cervical screening programs might justifiably respond to ‘the underscreened’.MethodsThis paper reports (...) on a grounded theory study of cervical screening experts involved in program organisation. Participants were 23 experts from several countries and a range of backgrounds: gynecology; epidemiology; public health; pathology; general practice; policy making. Data were gathered via semi-structured interview and concepts developed through transcript coding and memo writing.ResultsMost experts expressed an intuitive commitment to reducing systematic differences in screening participation or cancer outcomes. They took three different implicit positions, however, on what made organised programs justifiable with respect to underscreened populations. These were: 1) accepting that population screening is likely to miss certain disenfranchised groups for practical and cultural reasons, and focusing on maximising mainstream reach; 2) identifying and removing barriers to screening; and 3) providing parallel tailored screening services that attended to different cultural needs. Positions tended to fall along country of practice lines.ConclusionsExperts emphasised the provision of opportunity for underscreened populations to take up screening. A focus on opportunity appeared to rely on tacit premises not supported by evidence: that provision of meaningful opportunity leads to increased uptake, and that increased uptake of an initial screening test by disadvantaged populations would decrease cervical cancer incidence and mortality. There was little attention to anything other than the point of testing, or the difficulties disadvantaged women can have in accessing follow up care. The different approaches to ‘improving equity’ taken by participants are differently justified, and differently justifiable, but none attend directly to the broader conditions of disadvantage. (shrink)

Background Outbreaks of infectious disease cause serious and costly health and social problems. Two new technologies – pathogen whole genome sequencing and Big Data analytics – promise to improve our capacity to detect and control outbreaks earlier, saving lives and resources. However, routinely using these technologies to capture more detailed and specific personal information could be perceived as intrusive and a threat to privacy. Method Four community juries were convened in two demographically different Sydney municipalities and two regional cities in (...) New South Wales, Australia to elicit the views of well-informed community members on the acceptability and legitimacy of: making pathogen WGS and linked administrative data available for public health researchusing this information in concert with data linkage and machine learning to enhance communicable disease surveillance systems Fifty participants of diverse backgrounds, mixed genders and ages were recruited by random-digit-dialling and topic-blinded social-media advertising. Each jury was presented with balanced factual evidence supporting different expert perspectives on the potential benefits and costs of technologically enhanced public health research and communicable disease surveillance and given the opportunity to question experts. Results Almost all jurors supported data linkage and WGS on routinely collected patient isolates for the purposes of public health research, provided standard de-identification practices were applied. However, allowing this information to be operationalised as a syndromic surveillance system was highly contentious with three juries voting in favour, and one against by narrow margins. For those in favour, support depended on several conditions related to system oversight and security being met. Those against were concerned about loss of privacy and did not trust Australian governments to run secure and effective systems. Conclusions Participants across all four events strongly supported the introduction of data linkage and pathogenomics to public health research under current research governance structures. Combining pathogen WGS with event-based data surveillance systems, however, is likely to be controversial because of a lack of public trust, even when the potential public health benefits are clear. Any suggestion of private sector involvement or commercialisation of WGS or surveillance data was unanimously rejected. (shrink)

This article reports initial findings from a research project that focused on the impact of the reaccreditation process and its outcomes on teacher educators in four institutions in England where Qualified Teacher Status accreditation was removed, despite leading successful programmes as detailed in Ofsted inspections and National Student Survey data. Whilst the outcomes of the reaccreditation process were mentioned in the mainstream press, the impact of this policy on teacher educators had only been reported anecdotally. This research fills a research (...) gap to document impact on teacher educator identity and provides an evidence base to inform teacher education policy debates. Data were gathered through focus groups using a triad collaborative enquiry approach, based on the lesson study model, where researchers took on different roles: clarifier, observer, and questioner. This method formed part of a constructed focus group and built on a process of semi-structured and unstructured creative tasks. Initial findings identified the shifting context university educators perceived in relation to policy constraints, including a greater top-down, centralisation that negated the opportunity for teacher educators to provide a contextualised, evidence informed approach to teacher preparation. This contributed to the impact of the reaccreditation process on teacher educators’ professional identity, self-efficacy and agency. (shrink)

“In When Your Life Is On Fire Erik Kolbell listens, provokes, and most of all, shares with us the enduring lessons and insights of life and faith as realized by a diverse population of thoughtful people. It’s a town hall of the soul.” -- Tom Brokaw If your life was on fire, what would be the one thing you save? Psychotherapist and former pastor Erik Kolbell asks that question of 13 remarkable and unique individuals, and the answers may surprise you. (...) Provided by celebrities such as Jane Pauley and Alan Alda, artists such as Regina Carter and Tao Porchon Lynch, and ordinary people put into extraordinary situations like Don Lange and Brenda Berkman, these reflections will help all of us consider what it is that we value most in life. His goal, Kolbell says, is not to examine the worth of each of these things. “What matters is that for all of the sham and artifice that can make cynics of us all, there are things, solid things, that compel us onward.”. (shrink)

Women in Rock, Women in Romanticism is the first book-length work to explore the interrelationships between contemporary female musicians and eighteenth- and nineteenth-century art, music, and literature by women and men. The music and videos of contemporary musicians including Erykah Badu, Beyoncé, The Carters, Hélène Cixous, Missy Elliot, the Indigo Girls, Janet Jackson, Janis Joplin (and Big Brother and the Holding Company), Natalie Merchant, Joni Mitchell, Janelle Monáe, Alanis Morrisette, Siouxsie Sioux, Patti Smith, St. Vincent (Annie Clark), and Alice Walker (...) are explored through the lenses of pastoral and Afropresentism, Gothic, female Gothic, and the literature of William Blake, Beethoven, Arthur Schopenhauer, Samuel Taylor Coleridge, Charlotte Dacre, Ralph Waldo Emerson, E.T.A. Hoffmann, Ann Radcliffe, William Shakespeare, Mary Shelley, her husband Percy Shelley, Henry David Thoreau, Horace Walpole, Jane Williams, Mary Wollstonecraft, and William Wordsworth to explore how each sheds light on the other, and how women have appropriated, responded to, and been inspired by the work of authors from previous centuries. (shrink)

As a new trend in aesthetics appearing concurrently in the West and the East in the last ten years, the aesthetics of everyday life points to a growing diversification among existing methodologies for pursuing aesthetics, alongside the shift from art-based aesthetics. The cultural diversity manifest in global aesthetics offers common ground for the collaborative efforts of aesthetics in both the West and the East. Given the rapidly growing interest and its potential for attracting new audiences extending beyond the more narrowly (...) focused traditions of twentieth-century analytic and environmental aesthetics, it stands to command its own share of attention in the future of aesthetic studies. The aesthetics of everyday life has become a stream of thought with a global ambition. This interest has led to numerous systematic and in-depth works on this topic, some of which were conducted by the authors represented in this volume. A salient feature of this book is that it not only represents the recent developments of the aesthetics of everyday life in the West, but also highlights the interaction between scholars in the West and the East on this topic. Thus, the project is a contribution toward mutual progress in the collaboration between Western and Eastern aesthetics. What distinguishes this book from other anthologies and monographs on this topic is that it reconstructs the aesthetics of everyday life through cultural dialogue between the West and the East, with a view to building a new form of aesthetics of everyday life, as seen from a global perspective. At present, the aesthetics of everyday life as a newly emergent approach to aesthetics may encounter skepticism among aestheticians accustomed to the rigors of analytic philosophers who prefer to discuss aesthetics at the level of abstract concepts and argument, and who tolerate the particulars of experience mainly as illustrations. But, there is no reason to abandon the pursuit of the aesthetics of everyday life in the face of such objections. On the contrary, there are many benefits to gain in bringing aesthetics to bear on a wider sphere of human life, made possible through efforts to show the relevance of aesthetics to a broader range of human actions. (shrink)

Contents: LEGAL THEORY 1. Reflections on law in context / William Twining -- 2. Are omissions less culpable? / Tony Honore -- 3. Scandinavian legal realism in the law of contract / Jan Hellner -- 4. Statutes and contracts as founts of formal reasoning / Robert S. Summers -- 5. Conceptions of public policy / John Bell LEGAL HISTORY 6. Aftermath / Paul D. Carrington -- 7. The role of the judiciary: lessons from the end of empire / Robert Stevens (...) -- 8. The Origins of futures trading in the Liverpool Cotton Market COMMON LAW 9.payment undertakings / Roy Goode -- 10. Pre-contractual duties of disclosure / S.M. Waddams -- 11. Three problems with the new product liability / Jane Stapleton -- 12. Evaluating the goals of personal injury law: some empirical evidence / Donald Harris -- 13. Negligence and economic loss / John Dwyer -- 14. Libel and constitutional free speech / John Fleming -- 15. The basis of tortious liability / Peter Cane. (shrink)

The continued predominance of SL‐logic and deductive paradigms in the research on conditional‐based reasoning by experimental psychologists is examined and criticized. After recounting the history and influence of the model, I note the emergence of trends in epistemology and other areas of theory that might provide a springboard for the critique of the model, and I argue that a new approach to examining reasoning with conditionals ought to be developed. I conclude that a superior approach would model such reasoning with (...) sociolinguistic, inductive, and neurophysiological parameters, and that it would not involve any comparison of subjects’ reasoning with the standard deductive rules of logic. (shrink)

This article argues for an understanding of the scream at the nexus of a pre-verbal, imperceptible and inaudible operation. The work of Jean-François Lyotard describes a figure that breaks with figurative, illustrative and narrative forms, and takes up an operative function. In aesthetic terms, this operative figure – the figure of the matrix of desire – is what Lyotard describes as “seeing” rather than “vision”. That is, a child-like look that does not recognise the world by which it might master (...) it, but which desires to surpass limited existence, to lose oneself and to desire everything incompossibly. “Seeing”, in other words, is an opening of the self to the world in the original sense of aisthesis. Such an opening describes a masochistic jouissance inasmuch as this is an eroticism that has no mastery in dialectical terms or in verbal expression. This article will examine the screaming, howling, whooping and wailing of characters in Marco Ferreri's La Grande Bouffe (1973) to understand the appearance of masochistic jouissance in cinema. (shrink)

by Jane E, McArthur vi, pp. 1-142. Special issue of the journal Argumentation in Context : Vol. 1, No. 1. Amsterdam: John Benjamins. Available ISBN 9789027242525, € 80.00, US$ 120.00.

Although feminist philosophers have been critical of the gendered norms contained within the history of philosophy, they have not extended this critical analysis to norms concerning disability. In the history of Western philosophy, disability has often functioned as a metaphor for something that has gone awry. This trope, according to which disability is something that has gone wrong, is amply criticized within Disability Studies, though not within the tradition of philosophy itself or even within feminist philosophy. In this paper, I (...) use one instance of this disability metaphor, contained within a passage from Georg Wilhelm Friedrich Hegel’s Philosophy of Right, in order to show that paying attention to disability and disability theory can enable identification of ableist assumptions within the tradition of philosophy and can also open up new interpretations of canonical texts. On my reading, whereas Hegel’s expressed views of disability are dismissive, his logic and its treatment of contingency offer up useful ways to situate and re-evaluate disability as part of the concept of humanity. Disability can in fact be useful to Hegel, especially in the context of his valorization of experiences of disruption and disorientation. Broadening our understanding of the possible ways that the philosophical tradition has conceived human beings allows us to better draw on its theoretical resources. (shrink)

The hero might do something that he or she may regret later, but since the action is so boldly and decisively undertaken, we can’t help but be impressed. We may even find ourselves awed by the magnificence of an action that is ethically abhorrent.