In a recent paper in this journal, Kosso ([2000]) discussed the observational status of continuous symmetries of physics. While we are in broad agreement with his approach, we disagree with his analysis. In the discussion of the status of gauge symmetry, a set of examples offered by 't Hooft ([1980]) has influenced several philosophers, including Kosso; in all cases the interpretation of the examples is mistaken. In this paper, we present our preferred approach to the empirical significance of symmetries, re-analysing (...) the cases of gauge symmetry and general covariance. Direct and indirect empirical significance Global and local continuous symmetries Gauge symmetry 3.1 Local gauge symmetry 3.1.1 Discussion of the first claim 3.1.2 Discussion of the second claim 3.2 Global gauge symmetry Space-time symmetries Direct and indirect empirical significance again Conclusion. (shrink)

Analysis of Emmy Noether's 1918 theorems provides an illuminating method for testing the consequences of coordinate generality, and for exploring what else must be added to this requirement in order to give general covariance its far-reaching physical significance. The discussion takes us through Noether's first and second theorems, and then a third related theorem due originally to F. Klein. Contact will also be made with the contributions of, principally, J.L. Anderson, A. Trautman, P.A.M. Dirac, R. Torretti and the father of (...) the whole business, A. Einstein. (shrink)

Working women in the Caribbean and Latin America are more active in the labor market than their counterparts in most other regions of the world. Yet, they remain much less economically mobile than working men. Using research from a long-term study in Martinique, this article offers a new view of the cross-class construction of women's economic immobility. Research results suggest that irrespective of a woman's socioeconomic status, household structure, education, skills, or freedom from domestic chores, the organization of her work (...) is patterned in ways that preclude economic growth. When women try to “get ahead,” they invest more of their own time; men, by contrast, put others to work. I argue that these and other gender-based patterns of work organization and network management express a hidden but enduring legacy of a patriarchal value system. (shrink)

Initial writings and moral distress research focused on nursing, however, it soon became clear that others in healthcare also experienced moral distress. The narratives discussed in this commentary show this variation not only in the authors’ multiplicity of disciplines (psychologists, nurses, an ethicist, and physicians), but also in their workplace environments (prisons, hospitals, and homecare) and their roles, from students to well accomplished professionals. In other words no one is immune. By looking through the lens of time the author shows (...) that the experience of moral distress is not isolated in time, but in fact continues to be lived over time. Other important themes drawn out here are: isolation, powerlessness, failure, regret, undermined potential and the way feelings are experienced. It is also noted that despite the pain and angst, there is a sense of gratitude in these stories. They touch our own woundedness, remind us of our own resiliency and give us hope for the redemptive power of the experience and reflection. (shrink)

The Cambridge Quarterly has a history of presenting multidisciplinary perspectives in bioethics, welcoming a lively dialogue between clinicians, philosophers, theologians, social scientists, lawyers, and others on a range of bioethics concerns. This special issue of the journal focuses explicitly on contributions from anthropologists to the field.

This reflection draws upon two recent ‘moments’ in British sexuality politics—a series of Parliamentary debates on Global LGBT rights and Brighton Pride’s campaign to ‘Highlight Global LGBT Communities’. It contrasts these two moments in order to demonstrate how, at a time when LGBT rights have ostensibly been ‘won’ in the UK, there is an increasing tendency to shift focus to the persecution of SOGI minorities elsewhere in the world. This shift in focus sets up a binary of here versus there (...) that is politically persuasive but ultimately limited and limiting. By reflecting on the way that this growing trend of creating sexual politics elsewhere occurs in two very different locations in British politics and activism, we seek to begin a conversation about the relational affects of placing sexual politics ‘elsewhere’. (shrink)

An eighteen‐year‐old with sickle cell disease was admitted to the pediatric hematology service at his local children's hospital for management of an acute pain crisis, one of many such admissions. He had a good relationship with his primary hematologist and primary nurse, but with other health care providers, there was evident friction. Sometimes, he was simply rude, rolling over and pretending to sleep in response to questions about his symptoms. When frustrated or convinced that his pain was not being addressed (...) appropriately, he was prone to yelling and cursing at his nurses. After members of the health care team complained, their supervisor decided to transfer the patient to an adult general medicine service. Reasons cited for the transition included the stressful work environment created by the patient's actions, his refusal to follow directives from staff (although he was generally adherent to treatment), and the hypothetical harm to other young patients who might witness his behavior. Was this a just outcome? Is it ever permissible to deny access to pediatric care to a patient whose best interests would be served by it? Can access be withheld for “bad” behavior, and can transfer of care be wielded as a punishment? (shrink)

The shortage of organs for transplantation by its nature prompts ethical dilemmas. For example, although there is an imperative to save human life and reduce suffering by maximising the supply of vital organs, there is an equally important obligation to ensure that the process by which we increase the supply respects the rights of all stakeholders. In a relatively unexamined practice in the USA, organs are procured from unrepresented decedents without their express consent. Unrepresented decedents have no known healthcare wishes (...) or advance care planning document; they also lack a surrogate. The Revised Uniform Anatomical Gift Act (RUAGA) of 2006 sends a mixed message about the procurement of organs from this patient population and there are hospitals that authorise donation. In addition, in adopting the RUAGA, some states included provisions that clearly allow organ procurement from unrepresented decedents. An important unanswered question is whether this practice meets the canons of ethical permissibility. The current Brief Report presents two principled approaches to the topic as a way of highlighting some of the complexities involved. Concluding remarks offer suggestions for future research and discussion. (shrink)

This research project investigated the extent to which nurses engage in two important kinds of ethical behaviours: ethical activism (where they try to make hospitals more receptive to nurses’ participation in ethics deliberations) and ethical assertiveness (where they participate in ethics deliberations even when not formally invited). This research probed not only the extent to which nurses engage in these ethical behaviours but also whether this is influenced by professional, training and organizational factors. A random sample of 165 nurses from (...) three major hospitals in Los Angeles provided the data. Regression analyses indicate that both ethical activism and ethical assertiveness are strongly influenced by nurses’ perceptions of the receptivity of hospitals to their inclusion in ethics deliberations. In addition, nurses’ education in ethics is a significant predictor of ethical activism. The findings have important implications for the content of nurses’ ethics training as well as for expanding the boundaries of nurses’ participation in ethics deliberations. The authors define ethics deliberations as specific meetings of a number of people to discuss an ethical issue, such as one regarding the care of a patient. (shrink)

This manuscript proposes a proactive framework for preventing or mitigating disruptive ethical conflicts that often result from delayed or avoided conversations about the ethics of care. Four components of the framework are explained and illustrated with evidenced-based actions. Clinical implications of adopting a prevention-based, system-wide ethics framework are discussed. While some aspects of ethically-difficult situations are unique, system patterns allow some issues to occur repeatedly—often with lingering effects such as healthcare providers’ disengagement and moral distress (McAndrew et al. Journal of (...) Trauma Nursing 18(4):221–230, 2011), compromised inter-professional relationships (Rosenstein and O’Daniel American Journal of Nursing, 105(1):54–64, 2005), weakened ethical climates (Pauly et al. HEC Forum 24:1–11, 2012), and patient safety concerns (Cimiotti et al. American Journal of Infection Control 40:486–490, 2012). This work offers healthcare providers and clinical ethicists a framework for developing a comprehensive set of proactive, ethics-specific, and evidence-based strategies for mitigating ethical conflicts. Furthermore, the framework aims to encourage innovative research and novel ways of collaborating to reduce such conflicts and the moral distress that often results. (shrink)

Experiential education produces numerous benefits to students in terms of higher order thinking skills such as the ability to evaluate, analyze, and synthesizeinformation , engagement , and work-readiness . Partnering with community organizations provides a means to create experiential education opportunities for students. In this symposium, we discussed three examples of experiential education to promote learning around themes of sustainability, providing a brief outline of the activities, the intended outcomes, and the lessons learned from our experiences. We concluded with a (...) meditation on the importance of working with community partners and managing expectations so that students, the community, and the institutions gain the best possible outcomes when creating town-gown partnerships for sustainability education. (shrink)

The Ancrene Wisse, a guide for female recluses written in the West Midlands in the early thirteenth century, and the closely related religious works of the `Katherine Group', offer a vivid insight into the religious life of the time, and their rich and varied prose style blends Latin and native English stylistic traditions with remarkable skill and assurance. The difficulty of their language, however, has made them largely inaccessible except to experts in Middle English, and this edition is designed (...) to introduce them to a wider audience, including undergraduates with limited experience of Middle English and specialists in other disciplines, particularly history, theology, and women's studies. It provides a representative selection in new and readable critical texts, with a general introduction, notes, a select glossary, and interleaved translations. (shrink)

Agriculture is a serious contributor to pollution and other environmental harms, making it an important site of action for the development of environmentally friendly products and practices. However, farmer adoption of such options is varied and dependent on a wide range of factors including the visual appeal of sustainable farming. Recent studies have shown that negative aesthetics related to more environmentally friendly ways of farming can delay or prevent adoption of such practices. Drawing on the concepts of good farming, cultural (...) capital, and the aesthetics of waste, this paper aims to assess the status of biodegradable plastic mulch in relation to a range of alternative and conventional specialty crop growers’ aesthetic perceptions. BDM has the potential to significantly reduce non-biodegradable polyethylene mulch waste, thus addressing serious environmental and human health concerns. However, the aesthetics of BDM may present a challenge. BDM looks identical to PE plastic, and its degradation throughout the season results in scraps in the soil. To investigate aesthetics as a possible barrier to BDM adoption, we conducted five photo-elicitation focus groups with specialty crop growers in Washington State. Results indicate that alternative growers are slightly more adverse to the aesthetics of BDM, especially because of its ‘plastic’ appearance. Conventional growers had higher rates of BDM adoption, even though they felt a strong aesthetic aversion to the messy nature of BDM degradation. Confidence in the product, particularly as a result of education and experience, was believed to be the key to overcoming this negative aesthetic. Study participants offered a variety of ways to enhance the acceptability of BDM, such as making the mulch brown instead of black. These findings have wider implications for the acceptance and adoption of practices that, although environmentally friendly, have an unattractive visual element. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Living with Blindness and Fibromyalgia while Occupying AgingKatherine SchneiderI’m blind from birth and in middle age developed fibromyalgia. I’ve retired from a thirty year career as a clinical psychologist and am working on my third book tentatively titled “Occupying Aging: Delights, Disabilities and Daily Life.” My relationship with medical professionals includes gratitude (without good care I would not be alive) and also frustration for assumptions often made about my (...) abilities. I write from the perspectives of an impatient patient, woman living in the United States, former provider of mental health services, person with both invisible and visible disabilities, and boomer moving into the world of the aged. My stories are mine of course, but when I swap medical stories with blind friends, similar happenings abound.When my mom fell down the stairs at a friend’s house, five months pregnant with me, she was told to go to bed for the next four months to save the pregnancy. Thus began the impact of health care professionals on me. I was born a month premature and spent my first month in an incubator. In 1949 it wasn’t known that the enriched oxygen atmosphere in an incubator would cause blindness. At least one lawsuit was filed against physicians and a hospital by a person blinded in this way. A large out–of–court settlement was received. The way I look at it, the health care community did the best they knew and without enough oxygen, I would have died.Early in my life, my parents took me to several ophthalmologists to see what could be done for my vision. Family folklore has it that I could smell a hospital as we entered and would begin howling. These early traumatic experiences may have led to my current healthy lifestyle so I don’t have to go to doctors much now. By about age five, it was clear that nothing could be done about my vision. For the next twenty years my forays into the health care system were for tonsillitis, sprains, and the usual childhood ills.In my early twenties, I developed acute glaucoma in one eye—caused, I’m convinced, by birth control pills. In seeking treatment for this condition, I encountered the first truly insensitive physician I’d met, who said, “Your eyes aren’t doing you any good; let’s take them out.” I was horrified! They were my eyes. I was attached to them, psychologically as well as physically. It turned out that a simple operation relieved the pressure and allowed me to keep my eyes. True, they are not the best looking big brown eyes around, but they did come with the package.Life with blindness seemed quite straightforward until my early forties, when I developed extreme fatigue and pain all over. I was worried. I knew a blind woman who had developed multiple sclerosis and I admired her, but I did not want to walk in her brave footsteps. Then a college student came to see me with the same symptoms and said that she had recently been diagnosed with fibromyalgia. I am often very empathetic with people’s concerns, but this time she complimented me by saying, “You’re great! You seem to know just how I feel.” I sagely counseled her about portioning out her energy carefully, prioritizing, using short cuts, and taking elevators when possible. Being an adult [End Page 216] student used to overachieving, she did not like what I was saying, but said she’d try to follow my advice because she could no longer do it all.What finally broke through my own denial was the day coiling up a hose and dragging it to the basement for the winter took me an hour. It left me totally exhausted and I figured that even being middle aged couldn’t account for feeling that awful.After a thorough physical and plenty of blood work to rule out Lyme disease and multiple sclerosis, I was diagnosed with fibromyalgia and placed on low doses of antidepressants to help me sleep through the night. The medication worked and I began to feel like myself again. My battle to accept that... (shrink)

This narrative symposium illuminates the problem of clinician moral distress. NIB editorial staff and narrative symposium editors, Cynda Rushton, PhD, RN, FAAN and Renee Boss, MD, MHS, developed a call for stories, which was sent to several list serves and posted on Narrative Inquiry in Bioethics’ website. The request for personal stories from inter–professional healthcare providers asked them to: identify specific clinical situations that give rise to moral distress; discuss the sources of this distress; reflect on how they experienced moral (...) distress—physically, psychologically, socially, or spiritually; assess how they managed their situations; and offer suggestions for avoiding future problems of a similar nature. Twelve stories are found in the print version of the journal and an additional eight supplemental stories are published online only through Project MUSE. The clinicians describe a wide range of experiences with patients, other clinicians, and their own professional and personal identities. Embedded in each of the narratives are deeply felt emotions that accompany their experiences of moral distress. Katherine Brown-Saltzman (a nurse), Alisa Carse (a philosopher), Zhanna Bagdasarov and Shane Connelly (industrial–organizational psychologists), and Nancy Berlinger (a bioethicist) provided commentaries. (shrink)

The creation of the latest version of psychiatry's 'bible' has been surrounded by a great deal of controversy. The latest revision, the DSM-5, contains several controversial diagnoses that have been the subject of much debate. One of the central criticisms of DSM-5 is that it pathologizes some behaviors that were previously considered simply problematic, or variations of normal behavior—for example, fidgetiness, noisiness, abundance of energy, shyness, anxiety, and bereavement. Diagnoses such as Binge Eating Disorder, Disruptive Mood Dysregulation Disorder...

This pioneering anthology of Middle English prologues and other excerpts from texts written between 1280 and 1520 is one of the largest collections of vernacular literary theory from the Middle Ages yet published and the first to focus attention on English literary theory before the sixteenth century. It edits, introduces, and glosses some sixty excerpts, all of which reflect on the problems and opportunities associated with writing in the "mother tongue" during a period of revolutionary change for the English language. (...) The excerpts fall into three groups, illustrating the strategies used by medieval writers to establish their cultural authority, the ways they constructed audiences and readerships, and the models they offered for the process of reading. Taken together, the excerpts show how vernacular texts reflected and contributed to the formation of class, gender, professional, and national identity. They open windows onto late medieval debates on women's and popular literacy, on the use of the vernacular for religious instruction or Bible translation, on the complex metaphorical associations contained within the idea of the vernacular, and on the cultural and political role of the "courtly" writing associated with Chaucer and his successors. Besides the excerpts, the book contains five essays that propose new definitions of medieval literary theory, discuss the politics of Middle English writing, the relation of medieval book production to notions of authorship, and the status of the prologue as a genre, and compare the role of the medieval vernacular to that of postcolonial literatures. The book includes a substantial glossary that constitutes the first mapping of the language and terms of Middle English literary theory. _The Idea of the Vernacular_ will be an invaluable asset not only to Middle English survey courses but to courses in English literary and cultural history and courses on the history of literary theory. (shrink)

Structural Injustice has become a hugely important concept in the field of political theory with the work of Iris Marion Young central to debates on what it is, what motivates it and how it should be addressed. In this article, I focus on a particular thread in Young’s account of structural injustice which I argue is all too often overlooked - the untraceability of structural injustice. This is not only a constant theme in Young’s account of structural injustice, it is, (...) in fact, a defining feature. By ‘untraceable’, Young means that structural injustice is distinct from other sorts of injustices for which there is a traceable agent at fault – these sorts of faut-based injustices fall under what Young calls the ‘liability model of injustice’. For the purposes of exploring the concept of structural injustice, I follow the logic of the claim that structural injustice is untraceable to see where it takes us in conversation with Young’s critics. I conclude that Young’s account is not only defensible with some clarification and development but vital politically. That said, I also find Young’s account of political responsibility for structural injustice wanting and accordingly I propose a way of understanding what I see as a dynamic transition from structural to fault-based injustices which I argue Young’s more ‘static’ account fails to accommodate. This is important, I suggest, for thinking about the ways in which responsibility for different forms of injustice operate and change. _Contemporary Political Theory_ (2023). https://doi.org/10.1057/s41296-023-00634-4. (shrink)

Canada is one of the few countries in the world—China is another—that has decriminalized abortion. In Canada, there are no legislative or judicial restrictions whatsoever on abortion: When, where, and under what circumstances abortions can be performed are all unregulated. In sharp contrast, abortion is generally illegal in South American and predominantly Catholic countries, as well as in African and Muslim countries. And the countries that do allow legal abortions, including most in Europe along with America, Australia, and Russia, typically (...) permit it only up to a certain time or make it subject to circumstances such as risk to the woman. In what follows we will first explain how Canada came to decriminalize abortion and then go on to assess that position from an ethical point of view. (shrink)

SALMON A, BROWNE AJ, and PEDERSON A. Nursing Inquiry 2010; 17: 336–345 ‘Now we call it research’: participatory health research involving marginalized women who use drugsIn this paper, we discuss and analyse the strategies employed and challenges encountered when conducting a recent feminist participatory action research study with highly marginalized women who were illicit drug users in an inner city area of Vancouver, Canada. Through an analysis of the political economy of participatory praxis within current neoliberal contexts, we focus (...) on three main areas: (i) reconceptualizing the pragmatics of participation; (ii) the microeconomic implications of participatory research, including ethical issues in payment for research participation; and (iii) the value and limits of using research as a tool for activism and empowerment. We conclude with a brief discussion of what we see to be some of the most salient social justice implications arising from feminist and participatory approaches to health research within neoliberal political spaces. (shrink)

Oxford University ENGLISH FACULTY LIBRARY Manor Road Oxford OX1 3UQ Opening Hours: Monday to Friday: 9.30 am to 7 pm in Full Term. (9.30 am to 1 pm, ...

Residents in long-term care facilities and rehab hospitals sometimes ask healthcare professionals to help them do things that HCPs judge to be on balance harmful. A person with respiratory problems may ask for a cigarette, a diabetic for alcohol, a dysphagiac for food or fluids by mouth, a person at risk for falling for her walker, and so on. These requests raise two kinds of problems. The first pits residents against HCPs. Should HCPs ever help residents do what they consider (...) harmful? The second pits HCPs against HCPs. If HCPs disagree among themselves—some thinking that the resident should receive the assistance, others thinking not—what should be done? (shrink)

It is a rare patient who always does everything healthcare providers advise. Sometimes no harm comes from this; sometimes good does. But occasionally, great harm comes from not listening, as when it results in patients returning time and again for costly and invasive treatments of, say, infections, valve replacements, pressure ulcers, and so forth. No class of patients arouses more anger and resentment in healthcare providers, who often put out a call to invoke some version of the three strikes rule (...) and refuse care. And if the patients are also unemployed substance abusers who live in a local park, impolite or dangerous to staff, disruptive to other patients, and have intimidating visitors, the call to say “No” is louder. Can care ever be refused? If so, when? These are the questions we take up in this article. The answers we provide were developed as part of a Paraplegics and Quadriplegics with Pressure Ulcers Project carried out at Vancouver Hospital and Health Sciences Centre. Following an established usage, we refer to patients who exhibit a cluster of the above characteristics, the dominant one of which is a reluctance to heed medical advice, as “noncompliant patients.” This term is offensive to some, but the politically correct lexicon does not provide any alternative which is as short and clear or substantially different. We use the term as a convenient way of referring to a familiar class of patients and without any imputation of blame. (shrink)

ABSTRACTThe political is changing its shape. Ideologies are no longer stable, but instead build hybrid combinations. Populism is getting popular. In addition, there are new forms of political exper...

Baseball rules prohibit pitchers from intentionally throwing at batters. When a pitcher does so, however, it is common practice for a pitcher on the opposing team to retaliate by throwing at the first player of the offending team to bat the next inning, and for umpires to ignore the rule forbidding that. I argue that player retaliation in the form of one for one is a better response to the initial violation than any other that is available, one for one (...) can be justified as payback and for anticipated good consequences, and everyone who becomes a professional baseball player has consented to the practice. From these claims, I conclude that one for one is in the best interest of baseball, it is best if umpires follow common practice and wink at the rule forbidding it, and players cannot complain if they are told to throw at batters in certain circumstances, or are thrown at in just those circumstances. (shrink)

The Ebola epidemic that broke out inWest Africa West AfricaAfrica towards the end of 2013 had been brought under reasonable control by 2015. The epidemic had severely affected three countries. This case study is about a phase I/II clinical trial Phase I/II clinical trial of a candidate Ebola virus vaccine in 2015 in a sub-Saharan AfricanSub-Saharan Africa country which had not registered any cases of the Ebola virus disease. The study was designed as a randomized double-blinded trialRandomized double blinded trial. (...) It was sponsored and funded by one of the biggest Northern multinational pharmaceutical companiesPharmaceutical companies. The protocol received ethics clearance from the relevantNational Ethics Committee national ethics committeeEthics committee. The study was coordinated and managed at the local branch of a big Northern diagnostic laboratoryDiagnostic laboratory and a laboratory of a local regional hospital. The overall study was a multi-countryMulti-country, multi-siteMulti-site trial aimed at recruiting a total of 3,000 research participantsResearch participants across four or five sub-Saharan African countries. For this country, the recruitmentRecruitment sites were two big cities, each aiming to recruit 200 participants: adults at the first site and childrenChildren at the second. The target sampleSample size was almost achieved at the first site but, before the study commenced at the second site, some members of raised the alarm that the governmentGovernment was carelessly risking the health, safetySafety and lives of citizens in the cause of an unproven vaccine that could precipitate a public health disaster. The trial was immediately suspended. A commentary on this case, and on the importance of trustTrust, is provided by Katharine Browne and Doris Schroeder at the end of this chapter. It highlights differences between this case and a phase I Ebola vaccine trial in CanadaCanada in 2014. (shrink)

Metacognitive knowledge of one's own cognitive states is not as useful as is often thought. Differences between cognitive states often come down to differences in their intentional contents. For that reason, differences in behaviour are often explained by differences just in contents of first-order states. Uncertainty need not be a metacognitive condition. First-order interpretations of the target experiments are available.

There are two kinds of useful traits: adaptations, and all the others. Exaptations are just all the others. Exaptations are not for anything. Because there is such diversity in all the others, exaptation is not an explanatory concept. Its only real use is to block adaptationist excesses.

ArgumentSeveral recent works in sociology examine the manufacture of public identities through the notion of celebrity. This paper explores the imagery of Charles Darwin as a nineteenth-century scientific celebrity by comparing the public character deliberately manufactured by Darwin and his friends with images constructed by the public as represented here by caricatures in humorous magazines of the era. It is argued that Darwin’s outward persona drew on a subtle tension between public and private. The boundaries between public and private were (...) blurred by the ritual of Darwin “showing” himself in the flesh, either at home to visitors or, more rarely, on public occasions. The reputation for privacy and illness that he built up added materially to this public face. By contrast, caricatures tended to depict him as an ape. These apish representations played a significant role in associating Darwin, rather than any other thinker, with the notion of evolution, and in creating an alternative public persona over which he had no direct control. (shrink)