Nursing has a gendered and religious history where ideas of duty and servitude are present and shape its professional identity. The profession also promotes idealized notions of relationships with patients and of professional autonomy both of which are, in practice, highly constrained or even impossible. This paper draws on psychoanalytic concepts in order to reconsider nursing's professional identity. It does this by presenting an analysis of data from two focus group studies involving nurses in England and Australia held between 2010 (...) and 2012. The studies gave rise to data where extremely negative talk about nursing work seemed to produce, or to be expressed with, a high degree of energy, and a particular kind of enjoyment. In our analysis, we focus on the nurses' apparent enjoyment derived from their expression of a position of powerlessness in which they describe themselves as ‘slaves’ or ‘martyrs’ in the health care system. We interpret this as jouissance and suggest that the positions of slave or martyr provide a possible response to what we argue is the impossibility of the nurse's role. We argue that a remnant of a quasi‐religious ethic within the profession makes it acceptable for nurses to talk about self‐sacrifice and powerlessness as part of their working subjectivity. We further argue that this analysis offers a new consideration of the issue of power and professional identity in nursing that goes beyond seeing nurses as simply overpowered by, or engaged in, a gendered power struggle with other professional groups. We suggest that powerlessness and victimhood hold particular attractions and advantages for nurses and are positions that are more available to nurses than to other occupational groups. This research shows how psychoanalytic theory can help produce new insights into the problems and complexity of nursing and extend existing study of the professions. (shrink)

A new model for environmental and urban sustainability living architecture that connects artifice with the natural world through the use of materials that possess some of the properties of living systems, and can therefore actively exchange energy with the ecosphere, is proposed.

Using data on the ‘career’ paths of one thousand ‘leading scientists’ from 1450 to 1900, what is conventionally called the ‘rise of modern science’ is mapped as a changing geography of scientific practice in urban networks. Four distinctive networks of scientific practice are identified. A primate network centred on Padua and central and northern Italy in the sixteenth century expands across the Alps to become a polycentric network in the seventeenth century, which in turn dissipates into a weak polycentric network (...) in the eighteenth century. The nineteenth century marks a huge change of scale as a primate network centred on Berlin and dominated by German-speaking universities. These geographies are interpreted as core-producing processes in Wallerstein’s modern world-system; the rise of modern scientific practice is central to the development of structures of knowledge that relate to, but do not mirror, material changes in the system. (shrink)

Recently, several articles in the scholarly literature on medical ethics proclaim the need for “responsible scholarship” in the debate over the proper criteria for death, in which “responsible scholarship” is defined in terms of support for current neurological criteria for death. In a recent article, James M. DuBois is concerned that academic critiques of current death criteria create unnecessary doubt about the moral acceptability of organ donation, which may affect the public’s willingness to donate. Thus he calls for a closing (...) of the debate on current death criteria and for journal editors to publish only critiques that “substantially engage and advance the debate.” We argue that such positions as DuBois’ are a threat to responsible scholarship in medical ethics, especially scholarship that opposes popular stances, because it erodes academic freedom and the necessity of debate on an issue that is literally a matter of life and death, no matter what side a person defends. (shrink)

In debates over the regulation of communication related to dual-use research, the risks that such communication creates must be weighed against against the value of scientific autonomy. The censorship of such communication seems justifiable in certain cases, given the potentially catastrophic applications of some dual-use research. This conclusion however, gives rise to another kind of danger: that regulators will use overly simplistic cost-benefit analysis to rationalize excessive regulation of scientific research. In response to this, we show how institutional design principles (...) and normative frameworks from free speech theory can be used to help extend the argument for regulating dangerous dual-use research beyond overly simplistic cost-benefit reasoning, but without reverting to an implausibly absolutist view of scientific autonomy. (shrink)

The “doctrine of the given” that Fales defends holds that there are certain experiences such that we can have justified beliefs about their “contents” that are not based on any other beliefs, and that the rest of our justified empirical beliefs rest on those “basic beliefs.” The features of experience basic beliefs are about are said to be “given.” Fales holds that some basic beliefs are infallible, having a kind of clarity that guarantees their truth to the believer. In addition, (...) some basic beliefs are fallible, typically due to failure to devote full attention to one’s experience. (shrink)

The depletion effect, a decreased capacity for self-control following previous acts of self-control, is thought to result from a lack of necessary psychological/physical resources (i.e., “ego depletion”). Kurzban et al. present an alternative explanation for depletion; but based on statistical techniques that evaluate and adjust for publication bias, we question whether depletion is a real phenomenon in need of explanation.

In this article, we raise ethical concerns about the potential misuse of open-source biology : biological research and development that progresses through an organisational model of radical openness, deskilling, and innovation. We compare this organisational structure to that of the open-source software model, and detail salient ethical implications of this model. We demonstrate that OSB, in virtue of its commitment to openness, may be resistant to governance attempts.

In recent years, there has been a heated debate about how to interpret findings that seem to show that humans rapidly and automatically calculate the visual perspectives of others. In the current study, we investigated the question of whether automatic interference effects found in the dot-perspective task (Samson, Apperly, Braithwaite, Andrews, & Bodley Scott, 2010) are the product of domain-specific perspective-taking processes or of domain-general “submentalizing” processes (Heyes, 2014). Previous attempts to address this question have done so by implementing inanimate (...) controls, such as arrows, as stimuli. The rationale for this is that submentalizing processes that respond to directionality should be engaged by such stimuli, whereas domain-specific perspective-taking mechanisms, if they exist, should not. These previous attempts have been limited, however, by the implied intentionality of the stimuli they have used (e.g. arrows), which may have invited participants to imbue them with perspectival agency. Drawing inspiration from “novel entity” paradigms from infant gaze-following research, we designed a version of the dot-perspective task that allowed us to precisely control whether a central stimulus was viewed as animate or inanimate. Across four experiments, we found no evidence that automatic “perspective-taking” effects in the dot-perspective task are modulated by beliefs about the animacy of the central stimulus. Our results also suggest that these effects may be due to the task-switching elements of the dot-perspective paradigm, rather than automatic directional orienting. Together, these results indicate that neither the perspective-taking nor the standard submentalizing interpretations of the dot-perspective task are fully correct. (shrink)

In this paper, we highlight some problems for accounts of disability and enhancement that have not been sufficiently addressed in the literature. The reason, we contend, is that contemporary debates that seek to define, characterise or explain the normative valence of disability and enhancement do not pay sufficient attention to a wide range of cases, and the transition between one state and another. In section one, we provide seven cases that might count as disability or enhancement. We explain why each (...) case might count, and on what basis, and why it is been neglected. Each case is explained as a transition in what we call capacity space. We then argue that no definition of disability or enhancement addresses all of these cases, except for strict welfarist accounts of disability that do not rely on a depiction of any particular capacity. We argue further, however, that this is a serious deficiency of welfarist conceptions of disability. We then address objections to our account. (shrink)

When the benefits of surgery do not outweigh the harms or where they do not clearly do so, surgical interventions become morally contested. Cutting to the Core examines a number of such surgeries, including infant male circumcision and cutting the genitals of female children, the separation of conjoined twins, surgical sex assignment of intersex children and the surgical re-assignment of transsexuals, limb and face transplantation, cosmetic surgery, and placebo surgery.

Horse racing has begun to enter an economic decline in many countries, notably represented by a decline in revenues in betting volumes. A number of reasons may be attributed to this: the success of...

Vaccine hesitancy is a major public health challenge, and racial disparities in the acceptance of vaccines is a particular concern. In this essay, we draw on interviews with mothers of Black male adolescents to offer insights into the reasons for the low rate of vaccination against the human papillomavirus among this group of adolescents. Based on these conversations, we argue that increasing the acceptance of HPV and other vaccines cannot be accomplished merely by providing people with more facts. Instead, we (...) must address the pervasive racial discrimination in the United States that undermines trust in social institutions, including the health care system. In the short term, it may be helpful to increase the number of clinicians of color working in the health system, but more fundamental changes are required. The U.S. must adopt and implement policies that dismantle structural racism if it hopes to produce greater trust and community‐oriented thinking on behalf of people who have been exploited for centuries. (shrink)

First published in 1975, this book provides an interpretative introduction to the political thought of Karl Marx. The approach is both historical and analytical, with emphasis placed on developments and changes in Marx's thought. The book is firmly based on a close reading of primary sources including recently discovered documents on the Communist League, the drafts of Marx's Civil War in France and the Grundrisse manuscripts.

The experience of a reward appears to enhance memory for recent prior events, adaptively making that information more available to guide future decision-making. Here, we tested whether reward enhances memory for associative item-location information and also whether the effect of reward spreads to other categorically-related but unrewarded items. Participants earned either points (Experiment 1) or money (Experiment 2) through a time-estimation reward task, during which stimuli-location pairings around a 2D-ring were shown followed by either high-value or low-value rewards. All stimuli (...) were then tested for location memory or recognition (yes/no), immediately and after a 24-hour delay. Across both experiments (combined analysis), there was a robust improvement in location memory following high-value rewards, even though evidence supporting this effect was reliable in Experiment 2 but not in Experiment 1. The memory-enhancing effect of reward was observed on both the immediate and delayed location-memory tests. Reward-enhanced memory for both directly rewarded stimuli and categorically related stimuli that were not directly rewarded. No reliable effect of reward value on yes/no recognition-memory performance was observed in either experiment. We hypothesise that reward enhances the consolidation of recent experience and conceptually related memories to make these more available for future decisions. (shrink)

Given the current context of the experience of migration on schools in England and Europe, and the competing policies and approaches to social integration in schools, there is a need to understand the connection between language development and social integration as a basis for promoting appropriate policies and practices. This volume explores the complex relationship between language, education and the social integration of newcomer migrant children in England, through an in-depth analysis of case studies from schools in the East of (...) England. The authors set this evidence against the background of policy debates in the wider international setting, including a critical discussion of assumptions underlying national narratives of mainstreaming and assimilation. In the light of an absence of national guidelines for appropriate practice in schools, the authors outline a model of inclusive pedagogy for English as an additional language and a framework of home-school communication to promote effective EAL parental engagement in schools. (shrink)

The requirement of the Association to Advance Collegiate Schools of Business to include business ethics in the curriculum has prompted business programs to teach ethics either integrated across the curriculum or in standalone classes. The question addressed here is how to engage students in thinking deeply and empathetically about ethical issues impacting corporate social responsibility. This research focused on using a thought experiment developed by John Rawls in which students examined CSR issues from the perspective of six stakeholder groups. A (...) pre-test/post-test design measured the effectiveness of an instruction module on CSR coupled with an active exercise using Rawls’ veil of ignorance and original position. Results indicate that students placed greater responsibility on the stockholders and board of directors after taking this module. The implication of the Rawlsian technique to use stakeholder empathy is discussed as a tool for engaging business ethics students. (shrink)

BackgroundMedical oaths and ethical codes play a crucial role in guiding physicians through their professional responsibilities. This study extends prior research on ethical codes created by students at the Medical School for International Health (MSIH) by analysing codes from the years 2007 to 2022.ObjectiveThe objective of this study is to evaluate changes in the ethical principles emphasised by MSIH students over time and to compare these with previous cohorts.MethodsEthical codes from MSIH classes (2007–2022) were analysed using the framework developed by (...) Baker. This framework categorises oaths into four sections: preamble, covenant, code of duties to patients and peroration. The focus was primarily on the code of duties to patients. Quantitative analysis was used to assess the prevalence of specific ethical principles.ResultsThe study found an increased emphasis on principles such as ‘respect for patients’ and ‘cultural competence/sensitivity’, while traditional values like ‘benevolence’ and ‘honesty’ were mentioned less frequently. New themes, including ‘patient autonomy’ and ‘cultural competence’, emerged, reflecting a shift towards patient-centred care and justice, though emerging issues like artificial intelligence ethics were not addressed.ConclusionsMSIH students’ ethical codes have evolved to emphasise patient respect and cultural competence. The findings suggest a maturation in the ethical perspectives of medical students, though gaps remain in addressing contemporary challenges. Future studies should explore how ethical codes can incorporate emerging issues in healthcare. (shrink)

Despite its prominence in traditional societies and its apparent commonsense appeal, the moral tradition of Role Ethics has been largely neglected in mainstream normative theory. Role Ethics is the view that the duties and/or virtues of social life are determined largely by the social roles we incur in the communities we inhabit. This essay aims to address two of the main challenges that hinder Role Ethics from garnering more serious consideration as a legitimate normative theory, namely that it is ill-suited (...) to support a theory of right action that can enhance moral reasoning, and that it countenances certain unjust roles such as that of slave or slave-owner. Taking inspiration from contemporary social science, we argue that proponents of Role Ethics can adopt a view that reduces the apparent diversity of role obligations to four prototypical types of role duties. We propose a contemporary version of Role Ethics that coheres with human moral psychology, and which lends itself to a relatively pragmatic theory of right action that precludes the possibility of unjust roles. (shrink)

Individual athletes, coaches and sports teams seek continuously for ways to improve performance and accomplishment in elite competition. New techniques of performance analysis are a crucial part of the drive for athletic perfection. This paper discusses the ethical importance of one aspect of the future potential of performance analysis in sport, combining the field of biomedicine, sports engineering and nanotechnology in the form of ‘Nanobiosensors’. This innovative technology has the potential to revolutionise sport, enabling real time biological data to be (...) collected from athletes that can be electronically distributed. Enabling precise real time performance analysis is not without ethical problems. Arguments concerning data ownership and privacy; data confidentiality; and athlete welfare are presented alongside a discussion of the use of the Precautionary Principle in making ethical evaluations. We conclude, that although the future potential use of Nanobiosensors in sports analysis offers many potential benefits, there is also a fear that it could be abused at a sporting system level. Hence, it is essential for sporting bodies to consider the development of a robust ethically informed governance framework in advance of their proliferated use. (shrink)

Visuospatial (VS) skills, or one’s ability to mentally manipulate spatial information about objects, are critical to STEM enrollment, retention, and achievement. Low level of VS skills may deter some people from joining the STEM workforce or complicate their learning experience. While there is plenty of evidence suggesting that VS skills can be improved through training, few accessible training programs exist as of now, particularly for younger students. The current study proposes a new direction of VS training focusing on the development (...) of visuospatial self-efficacy (VSSE), or one’s confidence that they can complete specific VS tasks. The collaborative, desktop/mobile Virtual Reality game called [hidden for peer review] (available for download at [hidden for peer review]) was designed to improve VSSE in middle school students. A total of 169 students across 11 classrooms in 3 middle schools in a mid-western city in the United States participated in the intervention. The participants in the experimental condition (n=96, 6 classrooms) played the intervention game during 4 sessions over the course of 2 weeks, while the participants in the control condition (n=73, 5 classrooms) engaged in typical class activities. The results revealed that the intervention significantly increased students’ VS self-efficacy but not their VS performance or STEM performance. The implications and significance of the findings are discussed along with suggestions for further research. (shrink)

Despite iterative learning design being increasingly implemented, such approaches are often delineated by well-defined periods of design/implementation. However, second-order cybernetics, which suggests a participatory approach to learning design, involves responsively adapting learning environments to meet students’ needs, treating them as agentic participants in the classroom. In our mixed methods study, we investigate whether such a process can facilitate egalitarian participation and collaborative interactions in a technology-assisted classroom. We use the example of a graduate psychology class of 17 students and suggest (...) that adaptation of live-chat activities by a participant observer on the Reddit social media platform that supplemented the in-person lecture dynamically, using a network analysis and qualitative ethnography as a modelling facility mimicked the ongoing feedback loops of social media platforms, enabling students to use social media with a critical eye, and engage in productive collaboration. Our quantitative results present network graphs for weekly eigen centrality to understand the egalitarian nature of the network, and transitivity to understand the likelihood for collaboration between more than two agents. Our qualitative results elaborate selected Reddit posts, and weekly field notes to explain how redesigning the chat weekly helped augment lecture-based discussion with the instructor and critique of student presentations, spurring egalitarian participation through a space-place dialectic. Students also provided end-semester feedback that was analyzed using inductive coding, to design future courseware. (shrink)

It is well established that nursing practice produces considerable anxiety, and it can also give rise to envy and jealousy. While envy in nursing was identified in the literature more than 50 years ago, there remains a paucity of articles addressing either envy or jealousy for nurses. In a recent research study on current experiences of clinical practice, we analysed a fragment of nurses’ speech via Klein's theory of jealousy. The results revealed that the nurses expressed jealousy at the privilege (...) afforded to doctors. We argue that it is important to acknowledge jealousy in nursing practice because it has the potential for ‘spoiling’ effective care delivery and as such, can have detrimental ramifications in the health system. Also, jealousy may keep the nurse from fully focusing on their nursing practice in that it divides the nurse's attention and so limits the nurse's treatment of the patient. Nurses’ jealousy of doctors is a taboo topic in nursing, and yet it warrants serious consideration due to the potential deleterious consequences that can arise when this dynamic is present. (shrink)

State militaries have strong interests in developing enhanced warfighters: taking otherwise healthy service personnel (soldiers, marines, pilots, etc.) and pushing their biological, physiological, and cognitive capacities beyond their individual statistical or baseline norm. However, the ethical and regulatory challenges of justifying research into these kinds of interventions to demonstrate the efficacy and safety of enhancements in the military has not been well explored. In this paper, we offer, in the context of the US Common Rule and Institutional Review Board framework, (...) potential justifications for justifying research into enhancing warfighters on the grounds of (1) individual and group risk reduction, (2) protection of third parties such as civilians, and (3) military effectiveness. (shrink)

It is well established, following Menzies' work, that nursing practice produces considerable anxiety. Like Menzies, we bring a psychoanalytic perspective to a theorization of anxiety in nursing and do so in order to consider nursing practice in the light of psychoanalytic theory, although from a Lacanian perspective. We also draw on Bataille's notion of ‘surplus’. These concepts provide the theoretical framework for a study investigating how some clinical nurses are able to remain in clinical practice rather than leave the profession (...) or seek work at a distance from the bedside. We conducted focus groups and present here an analysis of two fragments of nurses' speech. We found the nurses responded from one of two positions. In the first position, the nurses focus on doctors, complain about the surplus afforded them, and call for it to be eliminated. In this way, the nursing group is similar to other groups, considered by Bataille, who also attempt to get rid of a surplus. However, in the second position, the nurses stay with the surplus, tolerating it as they nurse the patient. This latter position is one where the nurse practises with a focus on the patient rather than being distracted by their dispute over the doctor's privilege. The importance of this paper is in its illustration of two distinct positions from which the nurse can practise: one that is not optimal because the nurse is distracted and the other that is more focused on practice, and thus the nurse is in a position to provide the best care possible to patients. (shrink)

Highly portable and accessible MRI technology will allow researchers to conduct field-based MRI research in community settings. Previous guidance for researchers working with fixed MRI does not address the novel ethical, legal, and societal issues (ELSI) of portable MRI (pMRI). Our interdisciplinary Working Group (WG) previously identified 15 core ELSI challenges associated with pMRI research and recommended solutions. In this article, we distill those detailed recommendations into a Portable MRI Research ELSI Checklist that offers practical operational guidance for researchers contemplating (...) using this technology. (shrink)

Many adoptees face a number of challenges relating to separation from biological parents during the adoption process, including issues concerning identity, intimacy, attachment, and trust, as well as language and other cultural challenges. One common health challenge faced by adoptees involves lack of access to genetic-relative family health history. Lack of GRFHx represents a disadvantage due to a reduced capacity to identify diseases and recommend appropriate screening for conditions for which the adopted person may be at increased risk. In this (...) article, we draw out common features of traditionally understood “health disparities” in order to identify analogous features in the context of adoptees’ lack of GRFHx. (shrink)

To think about how to anchor abstract symbols to objects in the world is to become part of a tradition in philosophy with a long history, and an especially rich recent past. It is to ask, with Wittgenstein, “What makes my thought about him, a thought about him?” and thus it is to wonder not just about the nature of referring expressions or singular terms, but about the nature of referring beings. With this in mind I hereby endeavor—briefly, incompletely, but (...) hopefully still usefully—to introduce what in my judgment is the single best philosophical starting-point for those interested in understanding the referential connections between symbols and the world, and the cognitive, epistemic, and linguistic capacities which support them: The Varieties of Reference by Gareth Evans.1 It is worthwhile first of all to note, as the title indicates, that it is the varieties of reference that are of interest. It is Evans’ contention that no single theory can account for our various use of singular terms; although the different kinds of reference share certain features, and rely on related cognitive, linguistic and epistemic capacities, it appears that, rather than being a class defined by necessary and sufficient criteria for membership, they form a family of abilities, united, like a thread, by its overlapping fibers. Evans does not defend this claim so much as display it in his account. Much of the underlying variety in reference can be brought out by considering the guiding principle of the work as a whole, which Evans.. (shrink)

We discuss our surgical philosophy concerning the subtle interplay between the size of the surgical margin taken and the resultant morbidity from ablative oncological. procedures, which is ever more evident in the treatment of head and neck malignancy. The extent of tissue resection is determined by the "trade off" between cancer control and the perioperative, functional and aesthetic morbidity and mortality of the surgery. We also discuss our dilemmas concerning recent minimally invasive endoscopic microsurgical. techniques for the trans-oral laser removal. (...) or co-ablation of aero-digestive tract tumours, which result in a minimal. surgical margin of oncological clearance. By a process of inductive argument as to the nature of the surgical margin, we consider whether the risks of taking a lesser margin with adjuvant therapy is justified by the attendant gain in reduced surgical morbidity and the possible costs in tumour control. (c) 2006 Elsevier Ltd. All rights reserved. (shrink)