There is increasing emphasis on the need for collaboration between practice and academic leaders in health care research. However, many problems can arise owing to differences between academic and clinical goals and timelines. In order for research to move forward it is important to name and address these issues early in a project. In this article we use an example of a participatory action research study of ethical practice in nursing to highlight some of the issues that are not frequently (...) discussed and we identify the impact of things not-named. Further, we offer our insights to others who wish to be partners in research between academic and practice settings. These findings have wide implications for ameliorating misunderstandings that may develop between nurse leaders in light of collaborative research, as well as for participatory action research. (shrink)

We invite systematic consideration of the metaphors of cycles and circulation as a long-term theme in the history of the life and environmental sciences and medicine. Ubiquitous in ancient religious and philosophical traditions, especially in representing the seasons and the motions of celestial bodies, circles once symbolized perfection. Over the centuries cyclic images in western medicine, natural philosophy, natural history and eventually biology gained independence from cosmology and theology and came to depend less on strictly circular forms. As potent ‘canonical (...) icons’, cycles also interacted with representations of linear and irreversible change, including arrows, arcs, scales, series and trees, as in theories of the Earth and of evolution. In modern times life cycles and reproductive cycles have often been held to characterize life, in some cases especially female life, while human efforts selectively to foster and disrupt these cycles have harnessed their productivity in medicine and agriculture. But strong cyclic metaphors have continued to link physiology and climatology, medicine and economics, and biology and manufacturing, notably through the relations between land, food and population. From the grand nineteenth-century transformations of matter to systems ecology, the circulation of molecules through organic and inorganic compartments has posed the problem of maintaining identity in the face of flux and highlights the seductive ability of cyclic schemes to imply closure where no original state was in fact restored. More concerted attention to cycles and circulation will enrich analyses of the power of metaphors to naturalize understandings of life and their shaping by practical interests and political imaginations. (shrink)

Table of Contents I. WHO ARE THE SCIENTISTS? Historically. Women in the Origins of Modern Science, Londa Schiebinger. Women of Third World Descent in the Sciences, Sandra Harding. Recently. Women in Science: Half In Half Out, Vivian Gornick.”How Can a Little Girl Like You Teach a Great Big Class of Men?’ the Chairman Said, and Other Adventures of a Woman in Science, Naomi Weisstein. The Anomaly of a Woman in Physics, Evelyn Fox Keller. Currently. Women Join the Ranks of Science (...) but Remain Invisible at the Top, Natalie Angier. Creeping Toward Inclusivity in Science, Phyllis Goldberg. II. WHAT KIND OF ENTERPRISE IS SCIENCE? Science’s Aims, Methods, and Norms of Behavior. Patriarchy, Scientists, and Nuclear Warriors, Brian Easlea. Culturally Inclusive Chemistry, Catherine Hurt Middlecamp. A World of Difference, Evelyn Fox Keller. Interviewing Women: A Contradiction in Terms, Ann Oakley. Science’s Subject Matter. Have Only Men Evolved?, Ruth Hubbard. Empathy, Polyandry, and the Myth of the Coy Female, Sarah Blaffer Hrdy. The Importance of Feminist Critique for Contemporary Cell Biology, The Biology and Gender Study Group. The Engendering of Archaeology: Refiguring Feminist Science Studies, Alison Wylie. Still Seeking Transformation: Feminist Challenges to Psychology, Sue Wilkinson. Science’s Social Effects. Androcentric Bias in Clinical Research, Sue Rosser. Man-Made Medicine and Women’s Health, Nancy Krieger and Elizabeth Fee. The New Procreative Technologies, Ruth Hubbard. A Question of Genius: Are Men Really Smarter Than Women?, Anne Fausto-Sterling. III. WHAT KIND OF ENTERPRISE OUGHT SCIENCE TO BE? Feminist Empiricism. Subjects, Power, and Knowledge: Description and Prescription in Feminist Philosophies of Science, Helen Longino. Epistemological Communities, Lynn Hankinson Nelson. Feminist Standpoint Theory. ”Strong Objectivity’: A Response to the New Objectivity Question, Sandra Harding. Introduction to Tomorrow’s Tomorrow: The Black Woman, Joyce Ladner. Feminist Postmodernism. Situated Knowledges: The Science Question in Feminism and the Privilege of Partial Perspective, Donna Haraway. Though This Be Method, Yet There Is Madness in It: Paranoia and Liberal Epistemology, Naomi Scheman. (shrink)

Polygamy, forced marriage, female genital mutilation, punishing women for being raped, differential access for men and women to health care and education, unequal rights of ownership, assembly, and political participation, unequal vulnerability to violence. These practices and conditions are standard in some parts of the world. Do demands for multiculturalism — and certain minority group rights in particular — make them more likely to continue and to spread to liberal democracies? Are there fundamental conflicts between our commitment to gender equity (...) and our increasing desire to respect the customs of minority cultures or religions? In this book, the eminent feminist Susan Moller Okin and fifteen of the world’s leading thinkers about feminism and multiculturalism explore these unsettling questions in a provocative, passionate, and illuminating debate. Okin opens by arguing that some group rights can, in fact, endanger women. She points, for example, to the French government’s giving thousands of male immigrants special permission to bring multiple wives into the country, despite French laws against polygamy and the wives’ own bitter opposition to the practice. Okin argues that if we agree that women should not be disadvantaged because of their sex, we should not accept group rights that permit oppressive practices on the grounds that they are fundamental to minority cultures whose existence may otherwise be threatened. In reply, some respondents reject Okin’s position outright, contending that her views are rooted in a moral universalism that is blind to cultural difference. Others quarrel with Okin’s focus on gender, or argue that we should be careful about which group rights we permit, but not reject the category of group rights altogether. Okin concludes with a rebuttal, clarifying, adjusting, and extending her original position. These incisive and accessible essays — expanded from their original publication in Boston Review and including four new contributions — are indispensable reading for anyone interested in one of the most contentious social and political issues today. The diverse contributors, in addition to Okin, are Azizah al-Hibri, Abdullahi An-Na’im, Homi Bhabha, Sander Gilman, Janet Halley, Bonnie Honig, Will Kymlicka, Martha Nussbaum, Bhikhu Parekh, Katha Pollitt, Robert Post, Joseph Raz, Saskia Sassen, Cass Sunstein, and Yael Tamir. (shrink)

Background: The concept of moral distress has been the subject of nursing research for the past 30 years. Recently, there has been a call to move from developing an understanding of the concept to developing interventions to help ameliorate the experience. At the same time, the use of the term moral distress has been critiqued for a lack of clarity about the concepts that underpin the experience. Discussion: Some researchers suggest that a closer examination of how socio-political structures influence healthcare (...) delivery will move moral distress from being seen as located in the individual to an experience that is also located in broader healthcare structures. Informed by new thinking in relational ethics, we draw on research findings from neuroscience and attachment literature to examine the reciprocal relationship between structures and agents and frame the experience of moral distress. Conclusion: We posit moral distress as a form of relational trauma and subsequently point to the need to better understand how nurses as moral agents are influenced by—and influence—the complex socio-political structures they inhabit. In so doing, we identify this reciprocity as a framework for interventions. (shrink)

If people sometimes participate in research because of altruism—because they want to help in the search for treatments—should we revise our views about what kinds of experiments are ethical? If participants act out of altruism, we might let them accept greater risks than we would if they are motivated only by a desire for personal gain. But how can we know when participants are genuinely altruistic?

We have conducted a retrospective study of deaths on a paediatric medical intensive care unit over a two-year period and reviewed similar series from outside the UK. There were 89 deaths out of 651 admission (13.7% mortality). In almost two-thirds of the cases death occurred with a decision to limit medical treatment or withdraw mechanical ventilation, implying that additional or further therapy was considered futile. We highlight this as a crucially important issue in the practice of intensive care. More comprehensive (...) studies are needed to help clinicians derive consensus on what constitutes a futile intervention, and therefore when such an intervention should be withheld. This will help families and society better understand the limitations of intensive care. (shrink)

Scholars have proposed a number of courses and programs intended to improve the ethical behavior of scientists in an attempt to maintain the integrity of the scientific enterprise. In the present study, we conducted a quantitative meta-analysis based on 26 previous ethics program evaluation efforts, and the results showed that the overall effectiveness of ethics instruction was modest. The effects of ethics instruction, however, were related to a number of instructional program factors, such as course content and delivery methods, in (...) addition to factors of the evaluation study itself, such as the field of investigator and criterion measure utilized. An examination of the characteristics contributing to the relative effectiveness of instructional programs revealed that more successful programs were conducted as seminars separate from the standard curricula rather than being embedded in existing courses. Furthermore, more successful programs were case based and interactive, and they allowed participants to learn and practice the application of real-world ethical decision-making skills. The implications of these findings for future course development and evaluation are discussed. (shrink)

“The Role of the Individual in Evolution” is a prescient yet neglected 1941 work by the 20th century’s most important paleontologist, George Gaylord Simpson. In a curious intermingling of explanation and critique, Simpson engages questions that would become increasingly fundamental in modern biological theory and philosophy. Did individuality, adaptation, and evolutionary causation reside at more than one level: the cell, the organism, the genetically coherent reproductive group, the social group, or some combination thereof? What was an individual, anyway? In this (...) introduction, we highlight two points in a wider historical context. First, recognizing the political context of Simpson’s writing profoundly deepens our understanding of the development of his science as the Modern Evolutionary Synthesis infused biology. Second, this story illuminates the emergence of debates around what would eventually come to be called multilevel selection theory. The organism-centered concept of biological individuality defended by Simpson is situated in relation to the then-emerging Synthesis, in which he was a renowned player, and also in relation to the views he opposed: the “metaphysical” ideas of paleontologists such as Henry Fairfield Osborn, who claimed that some evolutionary trends derived from potentialities already implanted in the germplasm; and the organicist ideas of Ralph W. Gerard and the Chicago School of ecologists, which he derided as all too congenial to totalitarianism. We find parallels between the ways that Simpson thought then about human individuality under totalitarianism and the way he thought about individuality in evolution; not that any causal relationship linked the two, but that commonalities of hierarchical structure exist between single entities and groups in both instances. We then trace the subsequent development of Simpson’s political and philosophical takes on the role of the individual in evolution through the 1960s and lightly sketch out the later fate of the organicist ideas of the Chicago School. Simpson’s paper, originally published in the Journal of the Washington Academy of Sciences, is available as supplementary material in the online version of this article, as part of the "Classics in Biological Theory" collection. (shrink)

Background: Nurses and midwives have a professional obligation to promote health and prevent disease, and therefore they have an essential role to play in vaccination. Despite this, some nurses and midwives have been found to take an anti-vaccination stance and promulgate misinformation about vaccines, often using Facebook as a platform to do so. Research question: This article reports on one component and dataset from a larger study – ‘the positives, perils and pitfalls of Facebook for nurses’. It explores the specific (...) issue of nurses and midwives who take an anti-vaccination stance, deemed to be unprofessional by crossing professional boundaries and by providing medical information on Facebook that is not within their scope of practice. Participants: Data were collected via an online worldwide survey from nurse and midwife participants, distributed and ‘snowballed’ through relevant nursing and midwifery groups on Facebook. In total, 1644 Registered Nurses and Midwives, and Enrolled Nurses worldwide attempted the online survey. There were 1100 (66.9%) completed surveys and 54 partially (33.1%) completed surveys. Semi-structured interviews were also conducted online using Skype® with 17 participants in Australia. Ethical considerations: Ethical processes and procedures have been adhered to relating to privacy, confidentiality and anonymity of the participants. Findings/results: A mixed-methods approach was used, including descriptive and content analysis of the quantitative survey data and thematic analysis of the qualitative interview data. The main theme ‘blurred boundaries’ was generated, which comprised three sub-themes: ‘follow the science, ‘abuse of power and erosion of trust’ and ‘the moral and ethical responsibility to safeguard public health’. The results offer an important and unique understanding of how nurses and midwives interpret the conduct of fellow health professionals as unprofessional and crossing the professional boundary if they used Facebook to promulgate anti-vaccination messages and/or give medical advice online. Conclusion: There are many positives and negatives for nurses and midwives associated with using Facebook for personal and professional communication, which is in keeping with the results of the larger study from which this article is taken. Professional behaviour is a key theme in the larger research as is the ethical construct of ‘every act has a consequence’; however, in this article, the theme ‘blurred boundaries’ offers an overall understanding of how nurses and midwives interpret the behaviour of their colleagues who espouse anti-vaccination sentiment and/or give medical advice online that is outside their scope of practice and education. (shrink)

First published in 1902, William James's Varieties of Religious Experience is considered a classic in religious studies and the psychology of religion. But how has James's classic study weathered decades of development in psychology and behavioral sciences?

This volume reaches beyond the controversy surrounding the teaching and learning of evolution in the United States, specifically in regard to the culture, politics, and beliefs found in the Southeast. The editors argue that despite a deep history of conflict in the region surrounding evolution, there is a wealth of evolution research taking place—from biodiversity in species to cultural evolution and human development. In fact, scientists, educators, and researchers from around the United States have found their niche in the South, (...) where biodiversity is high, culture runs deep, and the pace is just a little bit slower. (shrink)

Drawing from literature in the social studies of science, this paper historicizes two pivotal concepts in science literacy: the definition of life and the assumption of objectivity. In this paper we suggest that an understanding of the historical, discursive production of scientific knowledge affects the meaning of scientific literacy in at least three ways. First, a discursive study of scientific knowledge has the epistemological consequence of avoiding the selective perception that occurs when facts are abstracted from the historical conditions of (...) their emergence. Second, a discursive approach to scientific knowledge can also be an example of science‐as‐exploration. Third, literacy and discourse studies contribute insights that alter assumptions about pedagogical appropriateness in science education. The paper concludes by suggesting that when science literacy includes the historical production of scientific knowledge, it can thereby extend the possibilities for what can be thought, studied and imagined in the name of science education. (shrink)

Within the popular consciousness, Emma Goldman has become something of an icon, a symbol for rebellion and women’s rights. But there has been surprisingly little substantive analysis of her influence on social, political, and feminist theory. In _Feminist Interpretations of Emma Goldman,_ Weiss and Kensinger present essays that resist a simplistic understanding of Goldman and instead attempt to examine her thinking in its proper social, historical, and philosophical context. Only by considering the sources, influences, and specific significance of Goldman’s ideas (...) can her proper place in feminist theory be truly understood. In addition to the editors, the contributors are Martha A. Ackelsberg, Kathryn Pyne Addelson, Lynne M. Adrian, Berenice A. Carroll, Voltairine de Cleyre, Janet E. Day, Candace Falk, Kathy E. Ferguson, Marsha Aileen Hewitt, Lori Jo Marso, Jonathan McKenzie, Alix Kates Shulman, Craig Stalbaum, Jason Wehling, and Alice Wexler. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:217 HUME'S IDEAS ABOUT NECESSARY CONNECTION 1. Introduction Hume asks, "What is our idea of necessity, when we say that two objects are necessarily connected together"? He later says that he has answered this question, but it is difficult to see what his answer is, or even to see precisely what the question was. Currently there are two main ways of understanding Hume's views about our idea of necessary (...) connection. These interpretations divide on the question whether Hume allows that we can speak meaningfully of an objective and necessary connection between two events. The one interpretation, which I will call epistemological, says that Hume does allow meaning to that phrase. On this view, justification is the only topic of Hume's negative message about necessary connection. We can mean what we say when we talk about necessary connection, but we cannot justify what we (meaningfully) say. That, according to this interpretation, is the negative outcome toward which Hume aims his investigation of the origin of our idea of necessary connection. He isn't denying we have that very idea; he is denying that its origin allows us to justify applying it to anything. The other interpretation, which I will call psychological, says that Hume does not allow meaning to the phrase, "an objective and necessary connection between two events." According to this interpretation, once we see the origin of our idea of necessary connection, we realize that we cannot mean by "necessary connection" what we thought we meant. Those words allow us to speak only of a certain 218 feeling in our minds, not of an objective feature of the world. Of course, the psychological interpretation partly resembles the epistemological one: it, too, denies that we can justify saying objective necessary connections exist. But on the psychological interpretation this follows a fortiori from the central negative claim, a claim which itself concerns meaning, not justification. In what follows, I will present these two interpretations more carefully and critically, and then I will advance my own. I think Hume was trying to express a view very different in kind from either of the two I've just mentioned. I think we can get a good idea of the kind of view Hume had by looking at Newton's treatment of gravitational force. Roughly, Newton thought that while there certainly are gravitational forces in objects, we can say nothing about them except that they are whatever it is that accounts for a specific set of observable regularities. Hume's views about necessary connection, or causal power, are roughly parallel. He does not doubt that we may speak meaningfully of objective necessary connections — rE we mean just some unknown quality in objects that underlies the constant conjunction of their sensible qualities. Inevitably we try to mean something more than this, but any such attempt is doomed to failure. Showing that we cannot mean something more is the point of investigating the origin of the "idea." I will be arguing that with this interpretation we can handle the sets of texts and problems that undercut the prevailing two interpretations, and reconcile those sets of texts with one another, despite their apparent inconsistency. This interpretation also has the advantage of attributing to Hume a view closely connected with a 219 distinctively eighteenth-century way of setting up these problems. Finally, I think the interpretation brings out nicely an instructive and central failing of Hume's views about necessary connection. 2. The Epistemological View Although there are hints of this kind of interpretation in other books, it is really articulated and defended only in Barry Stroud's book, 2 Hume. In what follows here, I mean to be sketching out and commenting on that interpretation. Hume wants to find out what our idea of necessary connection is. He conducts his investigation according to the dictum, "as we have no idea, that is not deriv'd from an impression, we must find some impression, that gives rise to this idea of necessity, if we assert we have really such an idea." (T 155) He argues, of course, that among our experiences of causes and effects, there are no impressions of necessary connection. Our experiences of... (shrink)

Critically exploring medical thought in a cultural milieu with no discernible influence from the European Enlightenment, _Being Human_ reveals an otherwise unnoticed intersection of early modern sensibilities and religious values in traditional Tibetan medicine. It further studies the adaptation of Buddhist concepts and values to medical concerns and suggests important dimensions of Buddhism's role in the development of Asian and global civilization. Through its unique focus and sophisticated reading of source materials,_ Being Human_ adds a crucial chapter in the larger (...) historiography of science and religion. The book opens with the bold achievements in Tibetan medical illustration, commentary, and institution building during the period of the Fifth Dalai Lama and his regent, Desi Sangye Gyatso, then looks back to the work of earlier thinkers, tracing a strategically astute dialectic between scriptural and empirical authority on questions of history and the nature of human anatomy. It follows key differences between medicine and Buddhism in attitudes toward gender and sex and the moral character of the physician, who had to serve both the patient's and the practitioner's well-being. _Being Human_ ultimately finds that Tibetan medical scholars absorbed ethical and epistemological categories from Buddhism yet shied away from ideal systems and absolutes, instead embracing the imperfectability of the human condition. (shrink)

This paper suggests that the appearance of circularity in descartes' arguments is due to a lack of precision in his statements of them, Rather than to any flaw in his reasoning. The clear and distinct perceptions presupposed in the demonstrations of the existence of God are not the same as those whose reliability depends upon the existence of god. He is presupposing the reliability only of those clear and distinct perceptions which are known through the light of nature and have (...) metaphysical certainty in that they cannot be imagined false even on the demon hypothesis. And the only clear and distinct perceptions whose reliability he is demonstrating are those which are not known through the light of nature with metaphysical certainty but are subject to metaphysical doubt on the demon hypothesis, Even though they have moral or psychological certainty. (shrink)

One of the lessons we ought to have learned from the history of philosophy and science is that it is rarely, if ever, useful in dealing with challenges from a new movement or in distinguishing one’s position from a different school of thought, to “draw a line in the sand” and claim that everything on this side is legitimate and that everything on that side is not, and can therefore be dismissed without serious consideration or discussion. On some analyses, Plato (...) sought to dismiss all of natural science in this way, by claiming that since it dealt with change it can yield at best belief, not knowledge. The logical positivists, building on the work of Hume, tried to use the analytic/synthetic distinction and various forms of verificationism to dismiss as nonsense everything but science, logic, mathematics, and the philosophy of science. Neither of these moves succeeded in banishing what was placed on that side of the line to intellectual never-never land. More recently, critics of creationism have dismissed the views they are attacking as “not science at all” and therefore of neither concern nor interest to the scientific communities. These maneuvers tend to be unsuccessful not just because they rely on distinctions which cannot, in the end, be sustained—or can be drawn and maintained only after all the hard work which they are frequently claimed to make unnecessary has been done—but because they refuse to deal with the specific evidence and arguments advanced by the challengers, bad as those might be. (shrink)

This article critically analyzes the principle of beneficence and the principle of nonmaleficence in clinical medical ethics. It resists some recent skepticism about the principle of nonmaleficence, and then seeks to explain its role in medicine. The article proposes that the two principles are informed by different accounts of what is in the patient’s best interests. The principle of beneficence is tied to the patient’s best overall interests, whereas the principle of nonmaleficence is tied to the patient’s best medical interests (...) only. The article argues that the principle of nonmaleficence takes priority over the principle of beneficence in that it filters the treatment options that are appropriately subject to the principle of beneficence. Understanding how both principles can play an important role in medical practice, and how they relate when they come into conflict, can help clinicians to avoid certain mistakes in thinking about their duties to their patients. (shrink)