Unruly Practices brings together a series of widely discussed essays in feminism and social theory. Read together, they constitute a sustained critical encounter with leading European and American approaches to social theory. In addition, Nancy Fraser develops a new and original socialist-feminist critical theory that overcomes many of the limitations of current alternatives. First, in a series of critical essays, she deploys philosophical and literary techniques to assess the work of Michael Foucault, the French deconstructionists, Richard Rorty, and Jürgen (...) Habermas. Then, in a group of constructive essays, she incorporates their respective strengths in a new critical theory of late-capitalist political culture. Fraser breaks new ground methodologically by integrating the previously divergent insights of poststructuralism, critical social theory, feminist theory, and pragmatism. Thematically, she deals with varied forms of dominance and subordination in modern, industrial, late-capitalist societies. These themes are integrated in an original theory of 'the politics of need interpretation.' This concept becomes the linchpin of the socialist-feminist critical theory. (shrink)

Nancy Fraser’s powerful new book documents the “movements of feminism” and the shifts in the feminist imaginary since the 1970s. Fraser follows the history of feminism from the ferment of the New Left, during which “Second Wave” feminism emerged as a struggle for women’s liberation alongside other social movements, to its emersion in identity politics following the decline of its initial utopian energies. Alongside this detailed history, Fraser recognizes the need for a reinvigorated feminist radicalism to respond to the (...) crisis in neoliberalism. She argues for a feminism that could join other egalitarian movements in struggles aimed at subjecting capitalism to democratic control, while retrieving the core utopian insights of feminism’s earlier phases. (shrink)

Advance directives have been lauded by scholars and supported by professional organizations, Congress, and the United States Supreme Court. Despite this encouragement, only a small number of capable patients execute living wills or appoint health care agents. When patients do empower proxies, doctors may be uncertain about the scope of their duties and obligations to these persons who, in theory, stand in the shoes of the patient. This article argues for a conscious focus on the ethical duties, emotional supports, and (...) guidance owed by physicians to health care agents. (shrink)

Background: Ethics consultation is the traditional way of resolving challenging ethical questions raised about patient care in the United States. Little research has been published on the resolution process used during ethics consultations and on how this experience affects healthcare professionals who participate in them. Objectives: The purpose of this qualitative research was to uncover the basic process that occurs in consultation services through study of the perceptions of healthcare professionals. Design and Method: The researchers in this study used a (...) constructivist grounded theory approach that represents how one group of professionals experienced ethics consultations in their hospital in the United States. Results: The results were sufficient to develop an initial theory that has been named after the core concept: Moving It Along. Three process stages emerged from data interpretation: moral questioning, seeing the big picture, and coming together. It is hoped that this initial work stimulates additional research in describing and understanding the complex social process that occurs for healthcare professionals as they address the difficult moral issues that arise in clinical practice. (shrink)

Building computational models of engineered exemplars, or prototypes, is a common practice in the bioengineering sciences. Computational models in this domain are often built in a patchwork fashion, drawing on data and bits of theory from many different domains, and in tandem with actual physical models, as the key objective is to engineer these prototypes of natural phenomena. Interestingly, such patchy model building, often combined with visualizations, whose format is open to a wide range of choice, leads to the discovery (...) of new concepts and control structures. Two key questions are raised by this practice: how could discoveries arise from building external representations for which there is wide latitude in choice of the components from which they are built, and thus can be considered significantly arbitrary, and how could such discoveries allow engineering a real-world prototype system. To examine these questions, we present two case studies of discoveries that emerged from the building of such computational models in the bioengineering sciences. We then develop a process model that accounts for the discovery and transfer problems raised by both these cases, focusing on the process of building the model. Specifically, to account for the discovery problem, we propose that the process of building such models gradually leads to a close coupling between the modeler’s internal processes and the external dynamic model. To account for the transfer problem, we propose that the process of building the model leads to the creation of an enactive model that is generic, which closely enacts, and thus reveals, the way the system-level behavior of the engineered prototype emerges in time through the interaction of its parts. This enactive replication process leads to the model and the prototype forming a new class, which allows concepts and control structures developed for the computational model to be transfered to the real-world prototype. We argue that this account requires rethinking correspondence in engineering sciences as a plastic and enactive relation. A closer focus on the process of building models is required to develop a general account of this emerging approach to discovery. (shrink)

Informed consent in clinical research is widely regarded as broken, but essential nonetheless. The most recent attempt to reform it comes as part of the first revisions to the Common Rule since it became truly “common” in 1991. This change, the addition of a “key information” requirement for most consent forms, is intended to support and promote a reasoned decision-making process by potential subjects. The key information requirement is both promising and problematic. It is promising because it encourages clarity and (...) honesty about research participation, creativity in information disclosure, and mutual learning through the investigator-subject relationship. It is problematic because those goals — which have remained aspirational since the beginning — may be difficult to achieve in what has become an excessively compliance-oriented regulatory regime. (shrink)

What is commonly called Reichenbach’s “Principle of the Common Cause” is not a general criterion for a common cause, as many philosophers nowadays suppose. Examples include W. Salmon in his accounts of causal processes and Bas van Fraassen in his new book on quantum mechanics, in which he argues that the quantum world has no causal structure. This does not matter for Reichenbach’s purposes. Indeed it should not be surprising from his point of view that in different situations we need (...) different criteria or different methods for testing for the same phenomenon. The third thesis begins from a question: Where do probabilistic criteria for causality come from? (shrink)

This logic book puts critical-thinking skills into a context that you'll remember and use throughout your life.

Efforts to decrease errors in health care are directed at prevention rather than at managing a situation when a mistake has occurred. Consequently, nurses and other health care providers may not know how to respond properly and may lack sufficient support to make a healthy recovery from the mental anguish and emotional suffering that often accompany making mistakes. This article explores the conceptualization of mistakes and the ethical response to making a mistake. There are three parts to an ethical response (...) to error: disclosure, apology and amends. Honesty and humility are discussed as important virtues that facilitate coping and personal growth for the health care provider who is involved in mistakes. In conclusion, a healthy view of nursing practice and mistake making is one that prevents error but, when prevention is not possible, accepts fallibility as part of the human condition and achieves the best possible outcome for all. (shrink)

Approximately 20% of adult cancer patients are eligible to participate in a clinical trial, but only 2.5-9% do so. Accrual is even less for minority and medically underserved populations. As a result, critical life-saving treatments and quality of life services developed from research studies may not address their needs. This study questions the utility of the bioethical concern with therapeutic misconception (TM), a misconception that occurs when research subjects fail to distinguish between clinical research and ordinary treatment, and therefore attribute (...) therapeutic intent to research procedures in the safety net setting. This paper provides ethnographic insight into the ways in which research is discussed and related to standard treatment. (shrink)

Work by social constructionists over the past decade and a half has reenforced the epistemological pessimist's despair that our system of science could ever be a mirror of nature. Realists argue that the amazing success of modern science at precise prediction and control indicates just the contrary. In response, social constructionists often point out that these successes seldom apply to the world as it comes naturally, but only as it is reconstructed in the scientist's laboratory. But this does not explain (...) how scientific accounts, which are as wide of the mark as constructionists suppose in their general descriptions of the natural world, could be so effective in a limited environment, even if that environment is as benignly constructed as possible. This paper suggests that a more wholistic view of nature than modern science usually presupposes may provide an answer. (shrink)

Editorial peer reviewers play an important role in shaping the direction of knowledge growth of their discipline. Recent concern over reports of peer review misconduct has led some to advocate the establishment of a code of ethics for peer reviewers. Such a code should include guidelines for the discipline and for society at large, but it should also contain guidelines for the authors whose manuscripts are reviewed. Peer reviewers have a special obligation to show beneficence and fairness or impartiality towards (...) the authors for whom they review. The practical application of these two ethical concepts is discussed. (shrink)

How one reacts to lying depends on individual temperament, intellectual training and value commitments, freedom status,, consideration of consequences, emotional resilience an...

Autumn Fiester identifies an important element in clinical ethics consultation (CEC) that she labels, from the Greek, aporia, “state of perplexity,” evidenced in CEC as ethical ambiguity. Fiester argues that the inherent difficulties of cases so characterized render them inappropriate for voting and more amenable to mediation and the search for consensus. This commentary supports Fiester’s analysis and adds additional reasons for rejecting voting as a process for resolving disputes in CEC including: it distorts the analysis by empowering individual voters (...) preferences and biases rather than focusing on the interests and wishes of the patient and family; it offers an insufficiently sensitive model for resolving the awesome, nuanced, conflicted, and ethically complex issues surrounding life and death; it marginalizes minority opinions that may have moral validity. (shrink)

Our paper examines what is required to protect and promote effective public discussion and policy development in the current climate of divisive disagreement about many public policy questions. We use abortion as a case example precisely because it is morally fraught. We first consider the changes made by Dobbs, as well as those which led up to the Dobbs decision, accompany it, and follow from it.

Empiricism has traditionally been concerned with two questions: What is the source of our concepts and ideas? and How should claims to empirical knowledge be judged? The empiricist answer to the first question is ‘From observation or experience.’ The concern in the second question is not to ground science in pure observation or in direct experience, but rather to ensure that claims to scientific knowledge are judged against the natural phenomena themselves. Questions about nature must be settled by nature — (...) not by faith, nor metaphysics, nor mathematics, and not by convention or convenience either. From Francis Bacon to Karl Popper empiricists have wanted to police the methods of scientific enquiry. (shrink)

: The idea of an exact science unified and complete has been advocated throughout the history of thought, but the sciences continue to cover only small patches of the world we live in. We may dream that the exact sciences will some day cover everything. But I argue that the very ways we do our exact sciences when they are most successfully done seems likely to confine them within limited domains. I discuss three cases to illustrate: the use of broad-scale (...) non-experimental statistics for causal modelling across the social sciences, an economic model on skill-loss during unemployment, and the quantum theory of superconductivity. In all cases, where we can expect exact order depends on where we can fit our models. And by the nature of how models do-and should-get constructed in exact science, they fit readily onto only very special bits of the world around us. I also maintain that an ill-supported belief in the universality of our favourite exact science can lead us to adopt bad methodologies for carrying out the central aim of the sciences, namely to make the world the way it ought to be. (shrink)

One of my favorite bioethics quotes is nearing 50 years old:Let us not forget that progress is an optional goal, not an unconditional commitment, and that its tempo in particular, compulsive as it may become, has nothing sacred about it. Let us also remember that a slower progress in the conquest of disease would not threaten society, grievous as it is to those who have to deplore that their particular disease be not yet conquered, but that society would indeed be (...) threatened by the erosion of those moral values whose loss, possibly caused by too ruthless a pursuit of scientific progress, would make its most dazzling triumphs not worth having.Despite its age, this invocation seems to me increasingly relevant as time... (shrink)