We are reminded of relevant stories, tales, or symbols from long-term memory when facing a novel problem our daily lives. Visual cues are 1 tool known to facilitate reminding. In 2 experiments, Chinese students, who had experienced a folk tale many years ago during childhood, were asked to solve an analogous problem. We tested the hypothesis that a visual cue can help bridge the gap between a novel problem and a source analogy experienced in the distant past. Different types of (...) cues proved to have distinct influences on components of analogical problem solving. This research suggests that analogical representational features of a story or problem can be stored in long-term memory and can be activated by visual cues. The implications of these findings for theories that point to perceptual or grounded, rather than decontextualized structures in knowledge representation are discussed. (shrink)

Purpose The purpose of this paper is clearly illustrate this convergence and the prescriptive recommendations that such documents entail. There is a significant amount of research into the ethical consequences of artificial intelligence. This is reflected by many outputs across academia, policy and the media. Many of these outputs aim to provide guidance to particular stakeholder groups. It has recently been shown that there is a large degree of convergence in terms of the principles upon which these guidance documents are (...) based. Despite this convergence, it is not always clear how these principles are to be translated into practice. Design/methodology/approach In this paper, the authors move beyond the high-level ethical principles that are common across the AI ethics guidance literature and provide a description of the normative content that is covered by these principles. The outcome is a comprehensive compilation of normative requirements arising from existing guidance documents. This is not only required for a deeper theoretical understanding of AI ethics discussions but also for the creation of practical and implementable guidance for developers and users of AI. Findings In this paper, the authors therefore provide a detailed explanation of the normative implications of existing AI ethics guidelines but directed towards developers and organisational users of AI. The authors believe that the paper provides the most comprehensive account of ethical requirements in AI currently available, which is of interest not only to the research and policy communities engaged in the topic but also to the user communities that require guidance when developing or deploying AI systems. Originality/value The authors believe that they have managed to compile the most comprehensive document collecting existing guidance which can guide practical action but will hopefully also support the consolidation of the guidelines landscape. The authors’ findings should also be of academic interest and inspire philosophical research on the consistency and justification of the various normative statements that can be found in the literature. (shrink)

In this article I will introduce and outline the concept of resistance as it relates to health and healthcare. Starting with a number of examples of action, I will then turn to the broader literature to discuss some conventional definitions and related concepts, outlining debates, controversies and limitations related to conceptualizing resistance. I conceptualize resistance broadly, as any act, performed by any individual (or collective) acting as or explicitly identifying as a healthcare professional, that is a response to power, most (...) often in opposition to contentious, harmful or unjust rules, practices, policies or structures. Practically this could account for any public action, marches, sit‐ins and civil disobedience, but also forms of ‘everyday resistance’, such as working slowly, feigning sickness, or even providing care for marginalized groups that would otherwise not have access. Such action could go unrecognized by those in power and perhaps more contentiously, those resisting needn’t even recognize their actions as resistance. I will then apply this conceptualization to explain action that has been undertaken by healthcare professionals, identifying its key features. I will briefly discuss future directions for inquiry that appear particularly pressing. These including ongoing conceptual development, identifying the functions of resistance in health and healthcare along with what makes it distinct from healthcare as usual and other forms of resistance and finally, the range of normative questions resistance raises. (shrink)

While strike action has been common since the industrial revolution, it often invokes a passionate and polarising response, from the strikers themselves, from employers, governments and the general public. Support or lack thereof from health workers and the general public is an important consideration in the justification of strike action. This systematic review sought to examine the impact of strike action on patient and clinician attitudes, specifically to explore (1) patient and health worker support for strike action and (2) the (...) predictors for supporting strike action and the reasons given for engaging in strike action. A systematic scoping review was employed to identify all relevant literature, followed by a textual narrative synthesis. A total of 34 studies met inclusion criteria. Support for strike action was largely context‐dependent. A range of factors impact support for strike action; broader cultural and structural factors, such as unionisation and general acceptance of strike action; systemic factors, such as the nature of the healthcare system, including infrastructure and work conditions; the strike itself and a range of individual factors, the most notable of which was being a student or in an early career stage. There were also some surprising results, for example, during doctors strike, nurses were provided with the opportunity to expand their role, which led to greater professional autonomy and job satisfaction. (shrink)

Theists are, according to Lovering, in an “unenviable position.” Lovering . Noting that debates on evil and God’s existence depend conceptually upon claims about what God would or would not do, he lays out three frameworks within which such claims could operate, all of which raise significant problems for theism. While his contention that these arguments depend on such claims is correct, the dire consequences for theism do not follow. After briefly discussing his three alternatives, I will argue that while (...) some of his supporting arguments are successful, his overall conclusion is not. Although both Broad Skeptical Theism and Broad Epistemic Theism are untenable, the latter has more resources than he suggests for dealing with the evidential argument from evil. More significantly, Narrow Skeptical Theism need not be ad hoc as Lovering contends, but is a position which we ought to accept provided it is not itself used as a pseudo-theodicy. The upshot of these observations is that theistic arguments may reasonably be grounded in considerations about what God would do. (shrink)

Strike action in healthcare has been a common global phenomenon. As such action is designed to be disruptive, it creates substantial ethical tension, the most cited of which relates to patient harm, that is, a strike may not only disrupt an employer, but it could also have serious implications for the delivery of care. This article systematically reviewed the literature on strike action in healthcare with the aim of providing an overview of the major justifications for strike action, identifying relative (...) strengths and shortcomings of this literature and providing direction for future discussions, and theoretical and empirical research. Three major themes emerged related to (1) the relationship between healthcare workers, patients and society; (2) the consequences of strike action; and (3) the conduct of strike action. Those who argue against strike action generally cite the harms of such action, particularly as it relates to patients. Many also argue that healthcare workers, because of their skills and position in society, have a special obligation to their patients and society more generally. Those who see this action as not only permissible but also, in some cases, necessary have advanced several points in response, arguing that healthcare workers do not necessarily have any special obligation to their patients or society, and even if so, this obligation is not absolute. Overwhelmingly, when talking about the potential risks of strike action, authors have focused on patient welfare and the impact that a strike could have. Several directions for future work are identified, including greater explorations into how structural and systemic issues impact strike action, the need for greater consideration about the contextual factors that influence the risks and characteristics of strike action and finally the need to tie this literature to existing empirical evidence. (shrink)

Resistance is a concept understudied in the context of health and healthcare. This is in part because visible forms of social protest are sometimes understood as incongruent with professional identity, leading healthcare workers to separate their visible actions from their working life. Resistance takes many forms, however, and focusing exclusively on the visible means more subtle forms of everyday resistance are likely to be missed. The overarching aim of this study was to explore how resistance was enacted within the workplace (...) amongst a sample of twelve healthcare workers, based in the United Kingdom; exploring the forms that such action took and how this intersected with health and healthcare. In depth-interviews were conducted and results were analysed utilizing Lilja’s framework ( 2022 ). Our findings suggest that resistance took a number of forms, from more direct confrontational acts, to those which sought to avoid power or which sought to create alternative or prefigurative practices or norms. These findings speak to the complexities, ambiguities, and contradictions of resistance, as carried out by healthcare workers in the workplace. While many acts had clear political motives, with issues like climate change in mind for example, participants also described how the act of providing care itself could be an act of resistance. While saying something about our participants, this also said something about the healthcare systems in which they worked. These findings also raise a range of normative issues. Perhaps needless to say, there appears to be substantial scope to expand and interrogate our findings and apply the idea of resistance to health and healthcare. (shrink)

We generalize ordinary register machines on natural numbers to machines whose registers contain arbitrary ordinals. Ordinal register machines are able to compute a recursive bounded truth predicate on the ordinals. The class of sets of ordinals which can be read off the truth predicate satisfies a natural theory SO. SO is the theory of the sets of ordinals in a model of the Zermelo-Fraenkel axioms ZFC. This allows the following characterization of computable sets: a set of ordinals is ordinal register (...) computable if and only if it is an element of Gödel’s constructible universe L. (shrink)

Resistance involves a range of actions such as disobedience, insubordination, misbehaviour, agitation, advocacy, subversion, and opposition. Action that occurs both publicly, privately, and day-to-day in the delivery of care, in discourse and knowledge. In this article I will demonstrate how resistance plays an important role in shaping health and well-being, for better and worse. To show how it can be largely productive and protective, I will argue that resistance intersects with health in at least two ways. First, it acts as (...) an important counterbalance to power; undermining harmful policies, disobeying unfair instructions, challenging rights abuses, confronting those who would otherwise turn a blind eye and even holding ourselves to account when simply accepting the status quo. Second, and beyond being oppositional, resistance is a constructive, productive force, that is fundamental to imagining alternatives; new and better futures and perhaps most fundamentally resistance is cause for hope that we are not resigned to the status quo. While there are numerous examples of how resistance has been employed in service of health and well-being, resistance is not always rational or productive, it can also harm health. I will briefly explore this point. Finally, I will offer some reflections on the intersections of power and health and why this makes resistance both distinct and important when it comes to how it shapes health and well-being. (shrink)

Political action has a long history in the health workforce. There are multiple historical examples, from civil disobedience to marches and even sabotage that can be attributed to health workers. Such actions remain a feature of the healthcare community to this day; their status with professional and regulatory bodies is far less clear, however. This has created uncertainty for those undertaking such action, particularly those who are engaged in what could be termed ‘contentious’ forms of action. This study explored how (...) advocacy and activism were presented in nursing and medical codes of ethics, comparing disciplinary and temporo‐spatial differences to understand how such action may be promoted or constrained by codes. The data for this study comes from 217 codes of ethics. Because of the size of the corpus and to facilitate analysis, natural language processing was utilised, which allowed for an automated exploration of the data and for comparisons to be drawn between groups. This was complemented by a manual search and contextualisation of the data. While there were noticeable differences between medical and nursing codes, overall, advocacy, activism and even politics were rarely discussed explicitly in most codes. When such action was spoken about, this was often vague and imprecise with codes speaking of ‘political action’ and ‘advocacy’ in general terms. While some codes were far more forthright in what they meant about advocacy or broader political action (i.e., Nursing codes in Denmark, Norway, Canada) more forceful language that spoke in specific terms or in terms of oppositional or specific actions (e.g., civil disobedience or marches) was almost completely avoided. These results are discussed in relation to the broader literature on codes and the normative questions they raise, namely whether such action should be included in codes of ethics at all. (shrink)

In this article, I will argue that the delivery of healthcare could be an act of resistance, that is, day‐to‐day, routine and perhaps mundane acts, undertaken in the course of the delivery of health services, which for many could also be considered otherwise routine care. I first consider how resistance has been conceptualised. How we understand resistance will determine if we believe healthcare could be conceptualised this way. I will show how resistance has been applied to day‐to‐day struggles elsewhere and (...) argue that it can clearly encompass open, collective dissent and more subtle, day‐to‐day action that does not necessarily make clear political demands. I go on to introduce some examples, where the delivery of health services could be conceptualised as resistance. While I advocate for a broad understanding of resistance, clearly not every act could be considered resistance; I will consider some points of tension and contention in utilising resistance to describe the delivery of health services, in particular discussing the issue of intent and opposition as they relate to resistance. Finally, while I hope that I make a convincing case, one final issue remains, namely, why turn to resistance at all, when many of the examples that I provide could be labelled using concepts that are more widely utilised. I will offer some general reflections on this point, speaking to the benefits and potential of resistance. (shrink)

Healthcare organisations are hierarchical; almost all are organised around the ranking of individuals by authority or status, whether this be based on profession, expertise, gender or ethnicity. Hierarchy is important for several reasons; it shapes the delivery of care, what is prioritised and who receives care. It also has an impact on healthcare workers and how they work and communicate together in organisations. The purpose of this scoping review is to explore the qualitative evidence related to hierarchy in healthcare organisations (...) defined broadly, to address gaps in macro‐level healthcare organisational research, specifically focusing on the (1) impact of hierarchy for healthcare workers and (2) how hierarchy is negotiated, sustained and challenged in healthcare organisations. After a search and screening, 32 papers were included in this review. The findings of this review detail the wide‐reaching impacts that hierarchy has on healthcare delivery and health workers. The majority of studies spoke to hierarchy's impact on speaking up, that is, how it shaped communication between staff with differential status: not only what was said, but how it had an impact on what was acceptable to say, by whom and at what time. Hierarchy was also noted to have substantial personal costs, impacting on the well‐being of those in less powerful positions. These findings also provide insight into the complex ways in which hierarchy was negotiated, challenged and reproduced. Studies not only detailed the way in which hierarchy was navigated day to day but also spoke to the reasons as to why hierarchy is often entrenched and difficult to shift. A number of studies spoke to the impact that hierarchy had in sustaining gender and ethnic inequalities, maintaining historically discriminatory practices. Importantly, hierarchy should not be reduced to differences between or within the professions in localised contexts but should be considered at a broad organisational level. (shrink)

Healthcare strikes have been a remarkably common and varied phenomenon. Strikes have taken a number of forms, lasting from days to months, involving a range of different staff and impacting a range of healthcare systems, structured and resourced vastly differently. While there has been much debate about strike action, this appears to have done little to resolve the often polarising debate that surrounds such action. Building on the existing normative literature and a recent synthesis of the empirical literature, this paper (...) will present a deliberative framework to assess the justifiability of strike action. I will first review the empirical literature that explores the impact of strike action, on patient outcomes and healthcare delivery. I will then discuss the debates that have occurred in this area, including an existing deliberative framework proposed by Selemogo (2014). I will argue that this framework is overly restrictive in that it could lead us to find otherwise justified strike action, unjust. I will then propose a framework that remedies these shortcomings. The framework outlines two broad conditions that should be met if strike action is to be justified. It then goes on to outline two deliberative, interrelated questions that should be used to assess whether strike action meets these conditions. For the purposes of this framework, healthcare strike action is justified when 1) it makes demands or raises grievances about some form of injustice, unfairness or threat to health and when 2) the risks in striking are proportionate to its demands or grievances. These two conditions should be considered in light of two further questions, namely, the 3) social and political context of the strike and 4) the characteristics of the strike. I will offer some further reflections on the application of this framework and its shortcomings. (shrink)

Background Non-violent resistance which has involved healthcare workers has been instrumental in securing a number of health-related gains and a force in opposing threats to health. Despite this, we know little about healthcare workers who have engaged in acts of non-violent resistance. Research aim Amongst a sample of healthcare workers who had engaged in acts of resistance this study sought to explore their understanding of non-violent resistance and how or whether they felt healthcare workers made a distinct contribution to such (...) action. Research design Cross-sectional survey Participants and research context Healthcare workers (doctors, nurses, academics and others) from the UK and Europe who had engaged in acts of non-violent resistance. Ethical considerations Ethical approval for this study was granted by the University of Greenwich Human Research Ethics Committee (UREC/20.5.6.11). Findings/results Most participants spoke about the nature of non-violent resistance, its oppositional, didactic and symbolic functions and the role of violence or harm. While most people understood non-violent resistance as a public, oppositional and collective act, many identified more subtle everyday acts in the workplace that undermined policy or procedures they saw as harmful. When asked about distinctions in non-violent resistance carried out by healthcare workers, most participants referred to their standing in society, noting that healthcare works were a trusted and authoritative source. Some identified an ethical imperative to act while others identified the risks that came with such action, noting their accountability and responsibility they had to patients. About a quarter of participants felt that such action was no different to others carrying out non-violent resistance or dependent on the issue or nature of the action. Conclusions These findings speak to the complex and multifaceted nature of non-violent resistance. Additionally our findings suggest healthcare workers have a distinct role to play in leading and supporting non-violent actions. (shrink)

Civility is a nice idea. While we find common ground with the aspirations of a civility-based professional culture in healthcare and acknowledge the potential impacts of incivility on staff and patients, we should be careful in dismissing it entirely, as McCullough et al 1 do. As we will argue below, appeals to civility, when understood alongside power, could serve to stifle and mask legitimate dissent, limiting genuine criticism and progress. Crucially, we contend that incivility itself may serve instrumental and communicative (...) purposes that draw attention to injustice or inequity. Our aim is not to defend every act of incivility but to caution calls for its prevention. By focusing on intentional acts of incivility and by emphasising the political, we hope to show that ‘being polite is not the same as being a good citizen’2 and the absence of tension is not the same as the presence of justice (King, 1963).3 We go on to discuss the implications of this approach to addressing ‘uncivil’ behaviour, arguing that incivility is a by-product of institutions that dismiss genuine grievances and maintain inequitable conditions. When we …. (shrink)

The article makes two substantive contributions to the existing literature on the ethics of international assistance and global justice. First, it builds what we take to be a widely held set of propositions about international assistance into a consistent view, and articulates a strong case against its desirability. Second, it sketches a more attractive alternative. To do so the article uses Sen’s idea of agent-oriented development as a starting point while at the same time providing a generalization of Sen’s account (...) and a justificatory framework that does not rely on the capability approach. (shrink)

Writers of very different persuasions have relied on arguments about self-ownership; in recent years, it is libertarians who have rested their political theory on self-ownership, but Grotian authoritarianism rested on similar foundations, and, even though it matters a good deal that Hegel did not adopt a full-blown theory of self-ownership, so did Hegel's liberal-conservatism. Whether the high tide of the idea has passed it is hard to say. One testimony to its popularity was the fact that G. A. Cohen for (...) a time thought that the doctrine of self-ownership was so powerful that an egalitarian like himself had to come to terms with it; but he has since changed his mind. I have tackled the topic of self-ownership glancingly elsewhere, but have not hitherto tried to pull together the observations I have made in passing on those occasions. The view I have taken for granted and here defend is that self-ownership is not an illuminating notion—except in contexts that are unattractive to anyone of libertarian tastes. (shrink)

Translation of the death scene from Phaedo by Plato.

Australian immigration detention has received persistent criticism since its introduction almost 25 years ago. With the recent introduction of offshore processing, these criticisms have intensified. Riots, violence, self-harm, abuse and devastating mental health outcomes are all now well documented, along with a number of deaths. Clinicians have played a central role working in these environments, faced with the overarching issue of delivering healthcare while facilitating an abusive and harmful system. Since the re-introduction of offshore processing a number of authors have (...) begun to discuss the possibility of a boycott. While taking such action may lead to change, further discussion is needed, not only in relation to the impact of a boycott, but whether it is possible for clinicians to engage with this system in more productive, ethical ways. This article utilises a framework proposed by Lepora and Goodin that provides a structured approach to examine complicity and seeks to explore how clinicians have engaged with Australian immigration detention and ultimately whether they should continue to do so. (shrink)

Australian immigration detention has been called state sanctioned abuse, cruel and degrading and likened to torture. Clinicians have long worked both within the system providing healthcare and outside of it advocating for broader social and political change. It has now been over 25 years and little, if anything, has changed. The government has continued to consolidate power to enforce these policies and has continued to attempt to silence dissent. It was in this context that a boycott was raised as a (...) possible course of action. Despite discussions among the healthcare community about the merits of such action, a number of questions have been overlooked. In this article, I will examine whether a boycott is both ethical and feasible. Taking into account the costs and benefits of current engagement and the potential impact of a boycott, more specifically the potential it has to further harm those detained, I conclude that under current circumstance a boycott cannot be justified. This however does not mean that a boycott should be dismissed completely or that the status quo should be accepted. I discuss potential ways forward for those seeking change. (shrink)

Bioethical consensus promotes a shared decision making model, which requires healthcare professionals to partner their knowledge with that of their patients—who, at a minimum, contribute their valu...

Background Ethical climate refers to the shared perception of ethical norms and sets the scope for what is ethical and acceptable behaviour within teams. Aim This paper sought to explore perceptions of ethical climate amongst healthcare workers as measured by the Ethical Climate Questionnaire (ECQ), the Hospital Ethical Climate Survey (HECS) and the Ethics Environment Questionnaire (EEQ). Methods A systematic review and meta-analysis was utilised. PSYCINFO, CINAHL, WEB OF SCIENCE, MEDLINE and EMBASE were searched, and papers were included if they (...) sampled healthcare workers and used the ECQ, HECS or EEQ. Ethical consideration Ethical approval was not required. Results The search returned 1020 results. After screening, 61 papers were included ( n = 43 HECS, n = 15 ECQ, n = 3 EEQ). The overall sample size was over 17,000. The pooled mean score for the HECS was 3.60. Mean scores of individual studies ranged from 2.97 to 4.5. For the HECS studies, meta-regression was carried out. No relationship was found between the country of the studies, the study setting (ICU v non-ICU settings) or the mean years of experience that the sample had. For the ECQ, sub-scales had mean scores ranging from 3.41 (instrumental) to 4.34 (law) and were all observed to have significant and substantial heterogeneity. Three studies utilised the EEQ so further analysis was not carried out. Conclusions The above results provide insight into the variability of scores as measured by the HECS, ECQ and EEQ. To some extent, this variability is not surprising with studies carried out across 21 countries and in a range of healthcare systems. Results also suggest that it may be that more local and context specific factors are more important when it comes to predicting ethical climate. (shrink)

Although Australia has comparatively few individuals seeking asylum, it has had a mandatory detention policy in place since 1992. This policy has been maintained by successive governments despite the overwhelmingly negative impact mandatory detention has on mental health. For mental health professionals working in this environment, a number of moral, ethical, and human rights issues are raised. These issues are discussed here, with a focus on dual loyalty conflicts and drawing on personal experience, the bioethics and human rights literature, and (...) recent parliamentary inquiries. For those who continue to work in this environment, future directions are also discussed. (shrink)

In this paper, I will argue that a number of well-known health interventions or initiatives could be considered anarchist, or at the very least are consistent with anarchist thinking and principles. In doing this I have two aims: First, anarchism is a misunderstood term—by way of example, I hope to first sketch out what anarchist solutions in health and healthcare could look like; second, I hope to show how anarchist thought could stand as a means to improve the health of (...) many, remedying health inequalities acting as a buffer for the many harms that threaten health and well-being. On this second point, I will argue that there are a number of theoretical and instrumental reasons why greater engagement with anarchism and anarchist thinking is needed, along with how this could contribute to health and in addressing broader injustices that create and perpetuate poor health. (shrink)

This chapter provides an overview of the philosophy of Adam Smith by examining the place of history and the role of impartiality in his philosophy. A brief introduction to Smith and his writings is followed by discussions of impartiality and Smith’s engagement with the philosophical role of history and the historian. The section that follows focuses on Smith’s discussion of rights as providing a connection between his moral theory and history via the role of the impartial spectator. The chapter concludes (...) with a brief description of Smith’s history of moral systems. Throughout the chapter tries to show unified philosophical commitments in Smith’s range of writings. (shrink)

Australian immigration detention has been called state sanctioned abuse and a crime against humanity. The Australian healthcare community has been closely involved with these policies, calling for their reform and working within detention centres to provide healthcare. As well as having a devastating impact on health, immigration detention changes the scope and nature of healthcare, with its delivery described as a Sisyphean task. In this article I will explore the guidance that is available to clinicians who work within detention centres (...) and argue that codes, guidelines and positions statements provide little help in relation to ethical decision making. First I will outline guidance that can be found in codes of ethics and position statements, focusing on particularly relevant principles, such as advocacy, clinical independence and the clinicians’ relationship to human rights. I will then highlight the disparity between this guidance and the delivery of healthcare within detention by drawing on the testimony of clinicians who formerly worked in these environments. While this disparity should be cause for alarm and at a minimum call into question how codes and positions statements are being used, there are more fundamental reasons why codes and position statements fail to provide guidance in these circumstances. I will outline a more general criticism of codes of ethics and use this to suggest a way forward, including looking beyond codes and position statements to guide action within Australian immigration detention. (shrink)

Discourses of ‘internationalisation’ of the curriculum of Western universities often describe the philosophies and paradigms of ‘Western’ and ‘Eastern’ scholarship in binary terms, such as ‘deep/surface’, ‘adversarial/harmonious’, and ‘independent/dependent’. In practice, such dichotomies can be misleading. They do not take account of the complexities and diversity of philosophies of education within and between their educational systems. The respective perceived virtues of each system are often extolled uncritically or appropriated for contemporary economic, political or social agendas. Critical thinking, deep learning, lifelong (...) and lifewide learning are heralded as the outcomes of Western education but these concepts are often under‐theorised or lack agreed meanings. Equally fuzzy concepts such as ‘Asian values’ or ‘Confucian education’ are eulogised as keys to successful teaching and learning when Asia prospers economically. They are also used to explain perceived undesirable behaviour such as plagiarism and uncritical thinking when Asian economies do not do so well. We argue that in general, educationists should be aware of the differences and complexities within cultures before they examine and compare between cultures. This paper uses the Confucian‐Western dichotomy as a case study to show how attributing particular unanalysed concepts to whole systems of cultural practice leads to misunderstandings and bad teaching practice. (shrink)

In February 2016 a twelve-month-old asylum seeker, who came to be know as Baby Asha, was transferred from Nauru and hospitalized in Brisbane. This case came to public attention after Doctors refused to discharge Asha as she would have been returned to detention on Nauru. What in other circumstances would have been considered routine clinical care, quickly turned into an act of civil disobedience. This paper will discuss the ethical aspects of this case, along with its implications for clinicians and (...) the broader healthcare community. (shrink)

For several decades, renewed interest in the connection between perception and knowledge has sustained a robust debate over external world skepticism. Recently, however, a growing consensus claims the skeptical challenge has been substantially met, and that realism in some robust form has emerged a clear victor. I invite us to rethink this consensus in a two-part response. The first forges a temporary alliance with skepticism against prominent forms of contemporary realism. That these fail to rebuff ews bolsters Barry Stroud’s call (...) for a new paradigm of objectivity. In the second part I sketch such a paradigm based upon a transactional interpretation of John Dewey’s pragmatism, and indicate its resilience to skeptical attacks. (shrink)

Body integrity identity disorder is a very rare condition in which people experience long-standing anguish because there is a mismatch between their bodies and their internal image of how their bodies should be. Most typically, these people are deeply distressed by the presence of what they openly acknowledge as a perfectly normal leg. Some with the condition request that their limb be amputated. 1 We and others have argued that such requests should be acceded to in carefully selected patients.1–4 Consistent (...) with this view, a group at the University of Sydney is developing a programme to better understand and treat BIID and to offer amputation if appropriate. In a recent paper, Patrone argues that such amputations should be prohibited.5 He suggests that authors supporting amputation in BIID depend on analogies with more familiar conditions and then claim that the ‘the desires, choices and requests of BIID patients should be held to exactly the same standards and treated with exactly the same respect as the desires, choices and requests of any more conventional patient’.5 He believes that these analogies are invalid and that therefore the arguments for amputation are invalid.Patrone concentrates a great deal upon whether a decision to have a particular medical intervention is to be regarded as ‘rational’. Unfortunately, he makes no attempt to define what he …. (shrink)

Is there an intimate connection between nationalism and war? Does the right to national self-determination invariably lead to bellicose relations with others? These have been central concerns in the literature on nationalism and war. They have also been concerns of political thinkers/activists who have worried about these connections and have sought to fashion a conception of national identity free of its warlike proclivities. This essay explores the link of war, nationalism, and national self-determination with reference to the founding of the (...) state of Israel. And it reflects on the views of Martin Buber whose writings on Zionism constantly engaged these questions in searching for a peace-oriented nationalism. (shrink)

The purpose of this study is to deconstruct the language used in President Trump’s Facebook posts while on the campaign trail, and the subsequent comments which reiterate and reify this rhetoric, to understand how Syrian refugees are labeled as a dangerous population unworthy of asylum. By utilizing the theoretical groundwork of Foucault, Agamben, and Mbembe, this qualitative content analysis will explore how Syrian refugees, as depicted by Facebook comments, represent a “disposable population.” We conclude that by reducing Syrian refugees to (...) a sub-human status and representing them as the dangerous and unworthy other, both President Trump who initiated this rhetoric, and those who responded in a way which legitimized his views, effectively labeled Syrian refugees as a dangerous population unworthy of asylum within the USA. (shrink)

Is there ever any reason for a doctor to lie to a patient? In this paper, we critically review the literature on lying to patients and challenge the common notion that while lying is unacceptable, a related entity--'benevolent deception' is defensible. Further, we outline a rare circumstance when treating psychotic patients where lying to the patient is justified. This circumstance is illustrated by a clinical vignette.

Although he did not invent the term, Jürgen Habermas has popularised “constitutional patriotism” as a form of political unity that avoids excessive nationalism. This paper attempts to examine the link between emotivism and normativity that has otherwise been excluded from Habermas’s notion of constitutional patriotism. Beyond Habermas, political theory as a whole has not yet taken emotivism as a serious component of normativity. Rather than developing it in isolation, this paper attempts to reconcile emotivism with cognitive-normative practices found within rational (...) deliberation. Reconciling the two not only provides a better normative steering component for judging good from bad practices, but also depicts contemporary political practices more accurately. In sum, constitutional patriotism’s normativity must be sourced from a complex integration of emotion and cognition, or put another way, from the interplay between citizens’ moral sentiments and rational judgements. (shrink)

Can conscious awareness be ascertained from physiological responses alone? We evaluate a novel learning-based procedure permitting detection of conscious awareness without reliance on language comprehension or behavioural responses. The method exploits a situation whereby only consciously detected violations of an expectation alter skin conductance responses . Thirty participants listened to sequences of piano notes that, without their being told, predicted a pleasant fanfare or an aversive noise according to an abstract rule. Stimuli were presented without distraction , or while distracted (...) by a visual task to remove awareness of the rule . A test phase included occasional violations of the rule. Only participants attending the sounds reported awareness of violations and only they showed significantly greater SCR for noise occurring in violation, vs. accordance, with the rule. Our results establish theoretically significant dissociations between conscious and unconscious processing and furnish new opportunities for clinical assessment of residual consciousness in patient populations. (shrink)

Standard representative democracy is criticised on democratic grounds and the case is made for an alternative system of democratic governance. The paper discusses ways in which representative democracy falls short of the democratic ideal of self-governance. Referendum and initiative are examined as mechanisms that further self-governance, but are argued not to go far enough. Direct democracy is considered as an alternative to representative democracy, but the case is made that even on democratic grounds direct democracy is unnecessarily demanding. It is (...) argued that this is also the case with regard to Budge’s proposal for direct democratic governance, which retains a place for representation and for political parties. Real-time democracy is defended as a superior alternative. In real-time democracy, a voter’s vote is attached to an elected representative’s weighed parliamentary vote. The voter, however, is able to withdraw that vote and vote independently of her representative in parliamentary votes. (shrink)

The separation of ownership and control is said to have exploded the atom of property in the modern corporation. This article suggests that if the atom ever did split, it may have recently been “fu...

Excerpt: …I here tackle three topics: first, the lowly place of happiness among the goals of political action in the great tradition of political thought; second, the novelty of the idea of happiness is the proper aim or public policy; and last, the importance of the distinction between what was aptly described by T.H. Green as "hindering hindrances to the good life" and the promotion of happiness by political action. As that might suggest, I shall say some unkind things about (...) the paternalism implicit in some recent emphasis on happiness as an object of state action. (shrink)