Machine generated contents note: Preface; Introduction Angus Dawson; Part I. Concepts: 1. Resetting the parameters: public health as the foundation for public health ethics Angus Dawson; 2. Health, disease and the goal of public health Bengt Brülde; 3. Selective reproduction, eugenics and public health Stephen Wilkinson; 4. Risk and precaution Stephen John; Part II. Issues: 5. Smoking, health and ethics Richard Ashcroft; 6. Infectious disease control Marcel Verweij; 7. Population screening Ainsley Newson; 8. Vaccination ethics Angus Dawson; (...) 9. Environment, ethics and public health: the climate change dilemma Anthony Kessel and Carolyn Stephens; 10. Public health research ethics: is non-exploitation the new principle for population-based research ethics? John McMillan; 11. Equity and population health: toward a broader bioethics agenda Norman Daniels; 12. Health inequities James Wilson; Index. (shrink)

Because health care professions exist to provide a good for society, ethical questions are inherently part of them. Such professions and their members can be assessed based on how effective they are in developing knowledge and enacting practices that further the health and well‐being of individuals and society. The complexity of contemporary health care environments makes it important to prepare clinicians who can anticipate, recognize, and address problems that arise in practice or that prevent a profession from fulfilling its service (...) goals and obligations. Different health care professions have evolved distinct perspectives about appropriate goals for, and the purposes of, their clinicians, even when the goal of improving health and well‐being for society is shared across professions. While medicine and nursing goals are shared in principle, they differ in the particulars. Given the centrality to nursing of ethical questions, the profession has a collective responsibility to help clinicians at all levels of practice become ethically savvy and to reinforce their moral agency as needed. Both knowledge of nursing ethics and knowledge of the interdisciplinary field of bioethics are critical to nursing work. (shrink)

Establishes that being in partnership with Nature is our birthright, explores the roots of our separation, and demonstrates that we are designed to communicate with Nature. Offers six principles of co-creative partnership with Nature that serve as a map for guiding us back to our rightful place as a part of Nature. Explains that plants can guide us in living according to our true essential nature and details the steps of creating and facilitating a plant initiation with common plants.

Issues surrounding the inclusion of transgender and intersex athletes in the women’s category in sport have spurred vigorous, and sometimes vicious, debate. The loudest voices on one edge of the de...

This paper examines the extent to which parents have absorbed New Right ideas about education and acted accordingly. What emerges is that their commitment to the rhetoric of school choice is strong. However, concepts such as the market and competition are viewed less favourably. An important theme here is the avoidance by parents of any collective agenda in discussing education policy, a factor that may thwart those who attempt to predict their responses to government policy for schools.

Raanan Gillon is a noted defender of the four principles approach to healthcare ethics. His general position has always been that these principles are to be considered to be both universal and prima facie in nature. In recent work, however, he has made two claims that seem to present difficulties for this view. His first claim is that one of these four principles, respect for autonomy, has a special position in relation to the others: he holds that it is first (...) among equals. We argue that this claim makes little sense if the principles are to retain their prima facie nature. His second claim is that cultural variation can play an independent normative role in the construction of our moral judgments. This, he argues, enables us to occupy a middle ground between what he sees as the twin pitfalls of moral relativism and moral imperialism. We argue that there is no such middle ground, and while Gillon ultimately seems committed to relativism, it is some form of moral imperialism that will provide the only satisfactory construal of the four principles as prima facie universal moral principles. (shrink)

The debate about the moral status of the embryo has gained new impetus because of the advances in reproductive technology that have made early human embryo experimentation a possibility, and because of the public concern that this arouses. Several philosophical arguments claiming that fertilisation is the event that accords moral status to the embryo were initially formulated in the context of the abortion debate. Were they formulated with sufficient precision to account for the scientific facts as we now understand them? (...) Or do these arguments need modification? Aspects of three arguments for moral status being acquired at fertilisation are examined in relation to current scientific knowledge, highlighting the reasons why such arguments, at present, seem to provide an inadequate basis for the determination of moral status. (shrink)

Recent policy in relation to clinical research proposals in the UK has distinguished between two types of review: scientific and ethical. This distinction has been formally enshrined in the recent changes to research ethics committee structure and operating procedures, introduced as the UK response to the EU Directive on clinical trials. Recent reviews and recommendations have confirmed the place of the distinction and the separate review processes. However, serious reservations can be mounted about the science/ethics distinction and the policy of (...) separate review that has been built upon it. We argue here that, first, the science/ethics distinction is incoherent, and, second, that RECs should not only be permitted to consider a study’s science, but that they have anobligation do so. (shrink)

This article provides an English translation of a historic discussion on the foundations of mathematics, during which Kurt GÖdel first announced his incompleteness theorem to the mathematical world. The text of the discussion is preceded by brief background remarks and commentary.

Advances in life-sustaining medical technology as applied to neonatal cases frequently present ethical concerns with a strong emotional component. Neonates delivered in the gestation period of approximately 23held hostagemoral distress” regarding aggressive courses of treatment for some patients. Some of this distress results from a feeling of powerlessness regarding treatment decisions, coupled with a high intensity of hands-on contact with the patients and family. Lack of authority coupled with high responsibility may itself be a recipe for a different kind of (...) futility. (shrink)

From ancient times to the present, the discovery and presentation of new proofs of previously established theorems has been a salient feature of mathematical practice. Why? What purposes are served by such endeavors? And how do mathematicians judge whether two proofs of the same theorem are essentially different? Consideration of such questions illuminates the roles that proofs play in the validation and communication of mathematical knowledge and raises issues that have yet to be resolved by mathematical logicians. The Appendix, in (...) which several proofs of the Fundamental Theorem of Arithmetic are compared, provides a miniature case study. (shrink)

Though regarded today as one of the most important results in logic, the compactness theorem was largely ignored until nearly two decades after its discovery. This paper describes the vicissitudes of its evolution and transformation during the period 1930-1970, with special attention to the roles of Kurt Gödel, A. I. Maltsev, Leon Henkin, Abraham Robinson, and Alfred Tarski.

Are there worthwhile values and ideals which flourish in the procedures of the state but wither in the transactions of the market? Are there equitable and fulfilling social relationships which are nurtured in the economic sphere but crumble in the political world? There is clearly some truth in the claim that at least in certain circumstances market systems inculcate in people not only ‘honesty and diligence, but also sensitivity to the needs and preferences of others’ . On the other hand, (...) it is difficult to deny the appeal of a tradition of thought which attaches moral superiority to the non-market ideals and values epitomised in the gift relationship. Titmuss , for example, objected to treating blood as a commodity in part because it undermined the sense of fraternity or community which a system of voluntary blood donors enhanced. A contemporary statement of this position holds that gift values differ from commodity values in being ‘tokens of love, admiration, respect, honor, and so forth, and consequently lose their value when they are provided for merely self-interested reasons’. (shrink)

We question the role given to depiction in Clark and Fischer's account of interaction with social robots. Specifically, we argue that positing a unique cognitive process for handling depiction is evolutionarily implausible and empirically redundant because the phenomena it is intended to explain are not limited to depictive contexts and are better explained by reference to more general cognitive processes.

The thesis of this article is that engagement and suffering are essential aspects of responsible caregiving. The sense of medical responsibility engendered by engaged caregiving is referred to herein as clinical phronesis, i.e. practical wisdom in health care, or, simply, practical health care wisdom. The idea of clinical phronesis calls to mind a relational or communicative sense of medical responsibility which can best be understood as a kind of virtue ethics, yet one that is informed by the exigencies of moral (...) discourse and dialogue, as well as by the technical rigors of formal reasoning. The ideal of clinical phronesis is not (necessarily) contrary to the more common understandings of medical responsibility as either beneficence or patient autonomy — except, of course, when these notions are taken in their disengaged form (reflecting the malaise of modern medicine). Clinical phronesis, which gives rise to a deeper, broader, and richer, yet also to a more complex, sense than these other notions connote, holds the promise both of expanding, correcting, and perhaps completing what it currently means to be a fully responsible health care provider. In engaged caregiving, providers appropriately suffer with the patient, that is, they suffer the exigencies of the patient's affliction (though not his or her actual loss) by consenting to its inescapability. In disengaged caregiving — that ruse Katz has described as the silent world of doctor and patient — provides may deny or refuse any given connection with the patient, especially the inevitability of the patient's affliction and suffering (and, by parody of reasoning, the inevitability of their own. When, however, responsibility is construed qualitatively as an evaluative feature of medical rationality, rather than quantitatively as a form of calculative reasoning only, responsibility can be viewed more broadly as not only a matter of science and will, but of language and communication as well — in particular, as the task of responsibly narrating and interpreting the patient's story of illness. In summary, the question is not whether phronesis can save the life of medical ethics — only responsible humans can do that! Instead, the question should be whether phronesis, as an ethical requirement of health care delivery, can prevent the death of medical ethics. (shrink)

For qualitative researchers seeking the perspectives of people with unusual characteristics or circumstances, compliance with expectations about participant anonymity can be difficult, if not impossible. In the age of internet communications and emerging research methodologies, traditional strategies require ongoing re-examination to ensure cohesion between a project’s ethical framework and its research practice. This paper reflects on the approach to informed consent used in a study with parent carers whose children had high-level support needs. A two-step process of written consent was (...) developed in response to concerns about the possible re-identification of these parents as a result of their highly individual circumstances. This approach acknowledged the potential for identification, and maximised participants’ agency in choosing the level of risk that they were comfortable to accommodate. The paper discusses the researcher’s and participants’ responses to the adapted consent process and recommends that researchers and ethics review committees remain open to the development of collaborative and innovative approaches that are also culturally and contextually relevant, to enable people to contribute perspectives that might otherwise be silenced by the very ethical frameworks that purport to protect their interests. (shrink)

This paper discusses a study examining how mentors in nurse education make professional judgments about the clinical competence of their pre‐registration nursing students. Interviews were undertaken with nine UK students and 15 mentors, using critical incidents in practice settings as a focus. The study was undertaken for the English National Practice‐Based Professional Learning Centre for Excellence in Teaching and Learning. This paper reports on the conversation analytic thread of the work. The mentor role with pre‐registration nursing students is not only (...) supportive but involves formal assessment. Central to the relationship is communication. In professional education, communication is seen as a skill to be applied and assessed in practice settings but is also the medium mentors and mentees use to talk about the relationship. Analysis of excerpts of conversation in the interviews shows that episodes of communication are used as topics of conversation to establish professional identity. It also reveals that judgments about the extent of professional capacity of both students and mentors are grounded in everyday behaviours (for example, enthusiasm, indifference and confidence) as well as professional competence. In addition to focusing on clinical issues, mentors can and do use mundane communication as a resource for judgments about competence. (shrink)

In recent years there has been an increasing critique of the philosophically based reasoning in bioethics which is known as principlism. This article seeks to make a postmodern contribution to this emerging debate by using notions of power and discourse to highlight the limits and superficiality of this , rationalistic mode of reflection. The focus of the discussion will be on the principle of autonomy. Recent doctoral research on a hospice organization (Karuna Hospice Service) will be used to contextualize the (...) debate to end-of life ethical dilemmas. The conclusion will be reached that the discursive richness of this organization's notion of autonomy or choice, which incorporates a holistic respect for the individual and the active creation of alternatives, can provide important insights to our understanding of autonomy in bioethics. The concern is raised that if autonomy is reified as a principle outside of the context of discourse, it may only complement the hegemonic power of biomedicine. (shrink)

In September of 2002, without fanfare, Ivor Grattan-Guinness retired from the faculty of Middlesex University. His scholarly activity, however, has continued unabated, his time now no longer fetter...

Nurses’ bodywork: is there a body of work? The work that many nurses do involves the use of their own body as one of the tools of their occupation. Being a nurse, in many cases, means controlled, purposeful use of her or his own body oriented to the patient. This paper discusses some of the ways in which nurses’ bodies and the work that those bodies do are represented in professional and academic research accounts and made relevant in literature. Using (...) instances of bodies and bodily activity mentioned in a variety of literature, the paper discusses three categories of accounts of nursing bodywork: those which are problematised and where the nurse's body is seen as a topic for investigation, and those which are unproblematised either explicitly discussing bodily activity (for example, touch) or implicitly dealing with bodywork (for example, taking blood pressure). Four ways in which nurses’ bodies are made relevant in accounts are proposed: relational, corporate, instrumental and human.The paper discusses the prominence (or not) nurses’ bodies are given in professional and academic accounts, as a contribution to preliminary work of generating a topic for investigation and concludes with some suggestions as to how this investigative project might be taken forward, focusing primarily on an examination of methodic practices, or how bodywork is brought off and executed as a skilled but taken‐for‐granted activity. (shrink)

The pipeline framework for identifying ethical issues in machine learning healthcare applications outlined by Char et al. is a very useful starting point for the systematic consideration...

The Report of the Ad Hoc Adivisory Group on the Operation of NHS Research Ethics Committees has resulted in a strange mixture of the timid, the revolutionary, and the bizarre.The Report of the Ad Hoc Advisory Group on the Operation of NHS Research Ethics Committees is a curious document.1 The remit of the review was focused on the workings and effectiveness of NHS research ethics committees and the multicentre committees ). The Group was primarily set up in response to a (...) series of complaints from medical researchers about the new research governance regime in the UK as a result of the Clinical Trials Directive2 and the Governance Arrangements for NHS Research Ethics Committees.3 The opportunity was also taken to consider the role of research ethics committees in a wider context, and take account of recent developments in relation to the ethics review of social care research,4 student projects,5 as well as recent legislation such as the Human Tissue Act,6 and the Mental Capacity Act.7 However, the resulting report is a strange mixture of the timid, the revolutionary, and the bizarre.A good example of the report’s timidity is its reluctance to propose fundamental change to the process of review or seriously limit the type of research that requires REC review. To its credit AHAG does suggest that some research ‘especially surveys and many studies on NHS staff, could normally be conducted safely without a requirement for REC review’ .1 This is, of course, to be welcomed. However, the report ultimately seems dismissive of the general complaint from researchers that the current process is inappropriately uniform. For example, in section 3.2, it is argued that the ‘common perception that the NHS REC system is dominated …. (shrink)

Two contrasting theories-actor-network theory and nondecision making-are separately applied to the same case study, namely, technologies for automatically identifying road vehicles. By this process, the strengths and weaknesses of each approach are highlighted: The actor-network approach is useful for understanding local processes but lacks tools for easily illuminating patterns across countries; by contrast, the concept of nondecision making is useful for explaining the general lack of implementation of technology for automatic vehicle identification but not for explaining variations between developments in (...) different countries. This study highlights the importance of attempting to compare theories by using the same case study. (shrink)

There is a growing trend in Australia to require lawyers to certify reasonable prospects of success for the cases they bring and defend. New South Wales has led the way with the Legal Profession Act 2004 (NSW) Pt 3.2 Division 10 requiring legal practitioners to certify reasonable prospects of success in all claims for damages. The requirement places a significant onus on lawyers to make a judgment about the merits of a case before it is begun, yet the common law (...) has long provided mechanisms to ensure that cases without prospects of success do not go to trial. This article considers Australian legislative provisions requiring lawyers to certify reasonable prospects of success of cases. It examines the application of the NSW legislation by the courts highlighting the difficulties of interpretation of what constitute 'reasonable prospects of success' and the application of the legislation in the context of the dynamic litigation process. It is argued that these legislated obligations on lawyers will have a detrimental effect on access to justice by denying parties, in particular plaintiffs, the opportunity to have their cases properly and fully determined in the courts. This article examines common law mechanisms for dissuading cases without prospects and argues that the general law is an effective system for ensuring that cases without prospects of success are not maintained. The Australian experience is instructive for consideration of optimal reform packages for the administration of justice and to evaluate the role of any litigation lawyer within the judicial and court process. (shrink)

Roller derby, once known for scripted theatricality that made it more like a stage play than a sport, has reinvented itself as a legitimate athletic endeavour. Since its rebirth as the Women's Flat Track Derby Association in the early 2000s, it has experienced exponential growth, from 30 flat track derby leagues in 2005 to more than 450 leagues in 2010. This translates to more than 15,000 skaters worldwide. Roller derby provides a unique case of a women's sport that is not (...) derived from, or a diminutive version of, a men's sport, proudly stating as its philosophy a commitment to be?by the skaters, for the skaters?. This do-it-yourself aspect opens the way for examination of what a sport wholly created by women looks like and how that differs from sports created by men. The WFTDA claims that roller derby is empowering and revolutionary, yet some critics have claimed that the skaters reinforce rather than dismantle gender stereotypes. Using tools from previous gender critiques, I analyse several aspects of roller derby for their emancipatory potential and conclude that, while not completely unproblematic, the sport can function as a force for reshaping ideas about women, femininity, and sport. (shrink)

It is now common in health care for a diverse range of professions and disciplines to work together in regular and close contact. Thus, there are now calls in the literature for research that documents insights on the ethical dimension of multidisciplinary relationships. Recent Australian research has responded to this call by examining how a multidisciplinary team of health professionals define and operationalize the notion of ethics in an acute ward hospital setting. This article provides findings from the research study (...) that indicate that, although there is a shared conceptualization of ethics as "patient-centered care", there can be times of conflict and tension in determining what is best for the patient. The discussion begins to build an understanding of how a multidisciplinary mix of health professionals responds to ethical conflict and tension. The authors' hope and expectation is that, by keeping the research focus on what health professionals in a multidisciplinary team (MDT) actually do, rather than exclusively on how they philosophically think about ethical dilemmas, the insights can be translated into practical strategies that can be utilized to strengthen the process of ethical decision making within the health care system. (shrink)

Plato famously characterized philosophy as practice for dying and death; contemporary philosophers in bioethics have produced a vast literature on the quest for a good death. Yet there is a relativ...

As initially envisioned, Gödel's Collected Works were to include transcriptions of material from his mathematical workbooks. In the end that material, as well as some other manuscript items from Gödel's Nachlass, had to be left out. This note describes some of the unpublished items in the Nachlass that are likely to attract the notice of scholars and surveys the extent of shorthand transcription efforts undertaken hitherto. Some examples of sources outside Gödel's Nachlass that may be of interest to Gödel scholars (...) are also indicated. (shrink)