In this wide-ranging interview Andrew Sayer discusses how he became a realist and then the development of his work over the subsequent decades. He comments on his postdisciplinary approach, his early work on economy and its influences, how he came to write Method in Social Science and the transition in Realism and Social Science to normative critical social science and moral economy. The interview concludes with discussion of his three most recent books and the themes that connect them, not (...) least the ongoing problem of a ‘diabolical double crisis’ of capitalism: extreme inequality and climate change. (shrink)

Advance refusals of life-sustaining treatment involve three potentially conflicting interests: those of the patient; those of the doctor; and those of the law. The state's interest in protecting life can clash with the patient's right to self determination which, in turn, can conflict with the doctor's desire to act in the patient's best interests. Against this background, we present the case of a patient who was treated (arguably) contrary to his advance refusal but in accordance with English law.

The concept of alienation: Hegelian themes in modern social thought -- Creative activity and alienation in Hegel and Marx -- The concept of labour -- The individual and society -- Freedom and the "realm of necessity" -- Alienation as a critical concept -- Private property and communism -- The division of labour and its overcoming -- Marx's concept of communism.

The paper assesses the aims and arguments of critical social science and the reconstructions of it provided by critical realist philosophy. It argues that attempts to derive normative conclusions on the basis of explanatory critiques of social phenomena are flawed in several important respects. Accounts of critical social science standardly underestimate the problems of justifying critical standpoints and finding alternative social forms which generate fewer problems than those they replace, and hence lead to net improvement. By arguing that value positions (...) can be derived from explanatory critiques, the philosophical reconstructions make light of the normative issues raised by proposals for social change. They also ignore the question of the feasibility of alternative systems and the prevalence of structures which generate both good and bad effects. While the reconstructions succeed in defending critiques centering on straightforward cases of false beliefs or the frustration of universal human needs, in others, where culturally-specific needs and issues of social responsibilities are involved, they fail to recognise the need to address prior normative questions. It is therefore argued that the aims and claims of critical social science need to be moderated and its dependence on normative discourse properly acknowledged. (shrink)

Andrew Sayer undertakes a fundamental critique of social science's difficulties in acknowledging that people's relation to the world is one of concern. As sentient beings, capable of flourishing and suffering, and particularly vulnerable to how others treat us, our view of the world is substantially evaluative. Yet modernist ways of thinking encourage the common but extraordinary belief that values are beyond reason, and merely subjective or matters of convention, with little or nothing to do with the kind of beings (...) people are, the quality of their social relations, their material circumstances or well-being. The author shows how social theory and philosophy need to change to reflect the complexity of everyday ethical concerns and the importance people attach to dignity. He argues for a robustly critical social science that explains and evaluates social life from the standpoint of human flourishing. (shrink)

Research ethics committees are charged with providing an opinion on whether research proposals are ethical. These committees are overseen by a central office that acts for the Department of Health and hence the State. An advisory group has recently reported back to the Department of Health, recommending that it should deal with inconsistency in the decisions made by different RECs. This article questions the desirability and feasibility of questing for consistent ethical decisions.

The dominant focus of thinking about economic justice is overwhelmingly distributive, that is, concerned with what people get in terms of resources and opportunities. It views work mainly negatively, as a burden or cost, or else is neutral about it, rather than seeing it as a source of meaning and fulfilment—a good in its own right. However, what we do in life has at least as much, if not more, influence on whom we become, as does what we get . (...) Thus we have good reason also to be concerned with what Paul Gomberg has termed contributive justice , that is, justice as regards what people are expected and able to contribute in terms of work. Complex, interesting work allows workers not only to develop and exercise their capacities, and gain the satisfaction from achieving the internal goods of a practice, but to gain the external goods of recognition and esteem. As Gomberg’s analysis of the concept of contributive justice in relation to equality of opportunity shows, as long as the more satisfying kinds of work are concentrated into a subset of jobs, rather than shared out among all jobs, then many workers will be denied the chance to have meaningful work and the recognition that goes with it. In this paper I examine the contributive justice argument, suggest how it can be further strengthened, arguing, inter alia, that ignoring contributive injustice tends to support legitimations of distributive inequality. (shrink)

Traditionally clinicians have determined their patients' resuscitation status without consultation. This has been condemned as morally indefensible in cases where not for resuscitation (NFR) orders are based on quality of life considerations and when the patient's true wishes are not known. Such instances would encompass most resuscitation decisions in elderly patients. Having previously involved patients in CPR decision-making, we chose formally to explore the reasons behind the choices made. Although the patients were not upset, and readily decided at the time (...) of initial consultation, on later analysing the decision-making we found poor understanding of the procedure, poor recall of information given and in some cases evidence of harm. This may be attributed to impaired decision-making capacity of elderly hospitalised patients as previously shown, or to the discomfort precipitated by having to contemplate the apparent immediacy of cardiac arrest by these patients. We propose that subscribing to autonomy as a general principle needs to be balanced against particular cases where distress may be caused by, or result in, diminished competence and limited autonomy. (shrink)

`Being sensitive' in nursing was explored using Schwartz-Barcott and Kim's hybrid model of concept development, producing a tentative definition of the concept. Three phases were employed: theoretical, empirical/fieldwork and analytical. An exploration of the literature identified where the common idea of `being sensitive' as a nurse was embedded and demonstrated that a theoretical development of this fundamental aspect of nursing was absent. The empirical phase was conducted using semistructured interviews with nine expert palliative care and cancer nurses. This method was (...) particularly useful for the exploration of this concept because of its firm grounding in practical example. A definition of what the concept `being sensitive' means in nursing, and subsequent clarification of `being insensitive', have been posed from the research process undertaken. The essential nature of this concept being integral to nursing practice is emphasized. Potential implications for the development of nursing practice through teaching of this concept were identified. (shrink)

For the past decade, the government has been ruthlessly pursuing free market policies. It has introduced market forces into many walks of life previously protected from them; and it has vigorously promoted the values of the `enterprise culture'. The economic and social consequences of these policies have been dramatic and profound. On the one hand, there has been a radical economic `restructuring': a ruthless sweeping away of much that was old and inefficient, and a considerable streamlining and modernizing of the (...) economy. In the process, however, the lives of countless individuals have been disrupted. Communities, and even whole regions, have been devastated. Millions have been thrown out of work, or forced into new and often uncongenial occupations. (shrink)

At a time when many professional philosophers in the English speaking world have all but given up the attempt to think critically and in large scale terms about the modern world, MacIntyre's work is defiantly untimely, and greatly welcome for that. It is remarkably wide ranging, comprehensive and thought provoking. He has been described as a `revolutionary Aristotelian', but this indicates only part of the picture. His work draws on ideas not only from Marx and Aristotle, but also from analytical (...) philosophy, philosophy of science and Thomist sources; and it combines these all together to construct a critical response to the modern condition. It has generated important debates among thinkers in all these areas. (shrink)

Marx conceives of labor as form-giving activity. This is criticized for presupposing a "productivist" model of labor which regards work that creates a material product — craft or industrial work — as the paradigm for all work (Habermas, Benton, Arendt). Many traditional kinds of work do not seem to fit this picture, and new "immaterial" forms of labor (computer work, service work, etc.) have developed in postindus trial society which, it is argued, necessitate a fundamental revision of Marx's approach (Hardt (...) and Negri). Marx's theory, however, must be understood in the context of Hegel's philosophy. In that light, the view that Marx has a "productivist" model of labor is mistaken. The concept of "immaterial" labor is unsound, and Marx's ideas continue to provide an illuminating framework for understanding work in modern society. (shrink)

For Marx, work is the fundamental and central activity in human life and, potentially at least, a ful lling and liberating activity. Although this view is implicit throughout Marx’s work, there is little explicit explanation or defence of it. The fullest treatment is in the account of ‘estranged labour’ [entfremdete Arbeit] in the Economic and Philosophical Manuscripts;1 but, even there, Marx does not set out his philosophical assumptions at length. For an understanding of these, one must turn to Hegel. Marx (...) is quite explicit about his debt to Hegel in this respect. (shrink)

Hiding behind the anodyne title of this book is a work of large scope and considerable interest for the Hegelian reader. Its main purpose is to vindicate a dialectical interpretation of Marxism in the context of recent analytical Marxism. The book falls into two parts. The first contains a detailed account of the dialectical philosophy implicit in Marx's work, and of its background in the philosophies of Kant and Hegel. The second shows how this account of Marx's approach can be (...) used to resolve some of the major issues in Marxist philosophy and to illuminate some of the central topics in Marxist social, political and economic thought. (shrink)

The appearance of this Korean translation of Reality and Reason gives me the opportunity to clarify the purpose of the book and to indicate some of the areas in which my views have developed and altered in the years since it was first written. My primary aim in the book is to explain and defend the realist and materialist view that there is an objective material world of which we can have knowledge. My argument, I have now come to realise, (...) takes a Kantian `transcendental' form. I do not prove these propositions from any more fundamental or indubitable premises, for there are none. Rather, starting from the assumptions that there is a material world and that knowledge of it is possible, I try to show how such knowledge is possible Β what are its necessary conditions Β and what this entails about the nature of subject and object, appearance and reality, and the relations between them. Althusser and Ruben adopt a similar approach, I now see, and I regret my polemic against them on this topic (pp. 9-14). A great deal of traditional epistemology starts from the Cartesian assumption that we have immediate and indubitable knowledge of the contents of subjective consciousness, of appearances; whereas objective reality is something beyond and separate, and related to appearances only contingently. Once a dualistic gulf is created in this way between subject and object, knowledge of the objective world by the subject becomes inexplicable and impossible. The possibility of such knowledge obliges us to reject dualism and assume instead the unity of subject and object, appearance and reality. Reality must not be regarded as a mere `thing-initself' beyond or behind appearances, it is revealed in and through appearances. And appearances are not purely subjective: they are not mere appearances, but always and necessarily the appearances of some aspect of objective reality which is disclosed in and through them.. (shrink)

The paper by Szasz is about mental illness and its meaning, and like Procrustes, who altered hapless travellers to fit his bed, Szasz changes the meanings of words and concepts to suit his themes.1 Refuting the existence of “mental illness”, he suggests that the term functions in an apotropaic sense. He submits that in this sense it is used to avert danger, protect society, and hence justify preventive detention of “dangerous” people.But his arguments misrepresent the precise meaning of the term (...) “apotropaic”, which is an adjective, defined in Webster’s, Chambers and the New Shorter Oxford dictionaries as averting or turning aside evil. It is possible that amulets and incantations ward off evil, in the same way as garlic repels vampires, but evil and danger are different concepts. Yet Szasz talks of using phrases like ‘“dangerousness to self and others’ as apotropaics to ward off dangers we fear”, and the word “evil” does not appear in his paper.I will argue that “dangerousness to self and others” and “psychiatric treatment” have a prosaic rather than an apotropaic function.The word “danger” is familiar rather than arcane, and includes many risks. A predatory paedophile is usually both dangerous and evil, but many dangerous people are not evil. For example, a child who plays with a box of matches is dangerous, as is a demented person who drives a car, or a schizophrenic who, acting on delusional beliefs, arms herself with a knife and roams the streets believing she is an avenging angel.Suppose …. (shrink)

Objectives—To study the value of taking an ethics history as a means of assessing patients' preferences for decision making and for their relatives' involvement.Design—Questionnaire administered by six junior doctors to 56 mentally competent patients, admitted into general and geriatric medical beds.Setting—A large district general hospital in the United Kingdom.Main measures—To establish whether patients were adequately informed about their illness and whether they minded the information being communicated to their relatives. To establish their preference regarding truthful disclosure and participation in decision (...) making with risk attached. To establish whether they wished to be involved in CPR decision making, and if not, who should make the decision. To establish whether they knew of living wills and whether they had any advance directives.Results—Twenty-four were inadequately informed of their illness.Forty-six said they would want to know were something serious to be found. Twenty-eight wanted to make their own decision if requiring risky treatment and 11 wanted family members involved. Thirty-one wanted to make a cardiopulmonary resuscitation decision and five of these decisions differed from those made by the doctors. Twenty-five preferred the doctors to decide. Eleven of the patients had heard of living wills but only one had executed such a will. Seven of the patients wished to provide advance directives. Three did not find the history taking helpful but none were discomforted.Conclusion—Taking an ethics history is a simple means of obtaining useful information about patients' preferences. (shrink)

Objectives: To compare non-treatment decision making by general practitioners and geriatricians in response to vignettes. To see whether the doctors’ decisions were informed by ethical or legal reasoning.Design: Qualitative study in which consultant geriatricians and general practitioners randomly selected from a list of local practitioners were interviewed. The doctors were asked whether patients described in five vignettes should be admitted to hospital for further care, and to give supporting reasons. They were asked with whom they would consult, who they believed (...) ought to make such decisions, and whether the relatives’ preferences would influence their decision making.Main measures: To analyse the factors influencing the doctors’ decisions not to admit otherwise terminally ill patients to hospital for life prolonging treatment.Results: Seventeen GPs and 18 geriatricians completed the interview. All vignettes produced strong concordance in decision making between both groups. Ten per cent of the doctors would provide life prolonging treatment to patients with severe brain damage. Most would admit a surgical patient regardless of age or disability. Medical reasons were largely used to explain decision making. The wishes of relatives were influential and resource considerations were not. There was variability regarding decision making responsibility.Conclusions: Little attempt was made to link decision making with ethical or legal concepts and there may have been non-recognition, or denial, of the ethical consequences of failure to admit. The process of decision making may involve deception. This may be conscious, because of the illegality of euthanasia, or unconscious , because of deepseated medical and societal reluctance to accept that intentionally withholding life prolonging treatment may equate with intentionally causing death. (shrink)

Women currently earn 77 cents for every dollar earned by men. Explanations abound for why, exactly, this wage gap exists. One of the more potent justifications attributes this pay differential to the unequal effects of marriage on the sexes: the marital asymmetry hypothesis. However, even when marital status is accounted for, a small but significant residual gap remains. This article argues that this is the result of social factors. Entrenched societal sexism causes all of us to harbor unconscious bias about (...) the capabilities and proper gender roles of women. This bias, in turn, leads us to discount work completed by females, especially in professional environments. Employers are not immune from this effect, and the undervaluation of female ability affects hiring practices, leading to the residual wage gap. (shrink)

Universities must transmit technically exploitable knowledge. That is, they must meet an industrial society's need for qualified new generations and at the same time be concerned with the expanded reproduction of education itself. In addition, universities must not only transmit technically exploitable knowledge, but also produce it. This includes both information flowing from research into the channels of industrial utilization, armament, and social welfare, and advisory knowledge that enters into strategies of administration, government, and other decision-making powers, such as private (...) enterprises. Thus, through instruction and research the university is immediately connected with functions of the economic process. (shrink)

Since 2007, capitalism has been going through its greatest crisis since the 1930s or before. In 2008, the banking system was saved from meltdown (at least for the time being) only by extensive government intervention in the USA, Britain, and a number of other countries. Stock markets all over the world plummeted. Then the crisis spread to the ‘real’ economy. A long and deep recession followed. Only now are we perhaps beginning to see what may – or may not – (...) be fragile signs of recovery. Capitalism, it is sometimes said, has been on the verge of collapse. (shrink)

Why work? Most people say that they work only as a means to earn a living. This is also implied by the hedonist account of human nature which underlies utilitarianism and classical economics. It is argued in this paper that Marx’s concept of alienation involves a more satisfactory theory of human nature which is rooted in Hegel’s philosophy. According to this, we are productive beings and work is potentially a fulfilling activity. The fact that it is not experienced as such (...) is shown to be at the basis of Marx’s critique of capitalist society. (shrink)