Biobanks that are run on an opt-in basis depend on people having the motivation to give and to trust in those who control their samples. Yet in the UK trust in the healthcare system has been in decline and there have been a number of health-related scandals that have received widespread media and public attention. Given this background, and the previous public consultations on UK Biobank, the paper explores the way people express their trust and mistrust in the area of (...) medical and genetic information through discussions in six focus groups held in different areas of Britain. The themes that emerged in the discussion were the special character of genetic data; the ease with which information spreads; the public/private divide in genetic research; the potential of genetic information to harm people; choice, consent and lack of control; and the difficulty of establishing trustworthy governing arrangements. The expert agenda of policy-makers and medical ethics does not address the broader concerns expressed by participants. It seems that public consultation and the language of openness and transparency may not be sufficient to establish trust in the governance of genetic databases. Donors will be asked to give freely without any return but the participants' perception of those using the samples is that they are motivated by success and profit rather than healthcare priorities. In this context altruism seems naive and even dangerous. In order to place their trust well people need evidence of a relationship with obligations and expectations on both sides. (shrink)

The Vitruvian Man is a metaphor for the “ideal man” by feminist posthuman philosopher Rosi Braidotti (2013) as a proxy for eurocentric humanist ideals. The first half of this paper extends Braidotti's concept by thinking about the metaphor of the “ideal nurse” (Vitruvian nurse) and how this metaphor contributes to racism, oppression, and burnout in nursing and might restrict the professionalization of nursing. The Vitruvian nurse is an idealized and perfected form of a nurse with self‐sacrificial language (re)producing self‐sacrificing expectations. (...) The second half of this paper looks at how regulatory frameworks (using the example of UK's Nursing and Midwifery Council Code of Conduct) institutionalize the conditions of possibility through collective imaginations. The domineering expectations found within the Vitruvian nurse metaphor and further codified by regulatory frameworks give rise to boredom and burnout. The paper ends by suggesting possible ways to diffract regulatory frameworks to practice with affirmative ethics and reduce feelings of self‐sacrifice and exhaustion among nurses. (shrink)

Despite the prominence of person‐centred care (PCC) in nursing, there is no general agreement on the assumptions and the meaning of PCC. We sympathize with the work of others who rethink PCC towards relational, embedded, and temporal selfhood rather than individual personhood. Our perspective addresses criticism of humanist assumptions in PCC using critical posthumanism as a diffraction from dominant values We highlight the problematic realities that might be produced in healthcare, leading to some people being more likely to be disenfranchised (...) from healthcare than others. We point to the colonial, homo‐ and transphobic, racist, ableist, and ageist consequences of humanist traditions that have influenced the development of PCC. We describe the deep rooted conditions that structurally uphold inequality and undermine nursing practice that PCC reproduces. We advocate for the self‐determination of patients and emphasize that we support the fundamental mechanisms of PCC enabling patients' choice; however, without critical introspection, these are limited to a portion of humans. Last, we present limitations of our perspective based on our white*‐cisheteropatriarchy** positionality. We point to the fact that any reimagining of models such as PCC should be carefully done by listening, following, and ceding power to people with diversity dimensions*** and the lived experience or expertise that exists from diverse perspectives. We point towards Black, queer feminism, and critical disabilities studies to contextualize our point of critique with humanism and PCC to amplify equity for all people and communities. Theory and philosophy are useful to understand restrictive factors in healthcare delivery and to inform systematic strategies to improve the quality of care so as not to perpetuate the oppression of groups of people with diversity dimensions. *We purposely capitalize Black and use lower case for white to decentre whiteness and as an intentional act of antiracism (see White Homework a podcast series by Tori W. Douglas). **Cisheteropatriarchy describes people with intersecting identities of dominant social groups; cisgender is the gender identity that aligns with the gender you were assigned at birth, hetero means heterosexual, and patriarchy refers to structural systems of power based on maleness where women are often excluded and hold less power. ***With diversity dimensions, we refer to subjective lived experience and material realities of people that exist outside the ‘dominant minorities' of white‐cisheteropatriarchy, meaning groups of people in society who historically and currently hold more power and through this, structurally dominate the norms and possibilities of living for other people. (shrink)

This article focusses upon defining those factors which may contribute to the pathogenesis of cancer. The molecular basis of tumour etiology is discussed with reference to cancer predisposing syndromes, and in particular to the human inherited disease, Bloom's sysdrome. In Bloom's syndrome, patients are predisposed to a wide variety of malignant disease. We propose a model in which overexpression of the ubiquitous c‐myc proto‐oncogene contributes to this process.

Status anxiety, the constant concern about individuals’ position on the social ladder, negatively affects social cohesion, health, and wellbeing. Given previous findings showing that status anxiety is associated with economic inequality, we aimed in this research to test this association experimentally. A cross-sectional study was run in order to discard confounding effects of the relationship between perceived economic inequality and status anxiety, and to explore the mediating role of a competitive climate. Then we predicted that people assigned to a condition (...) of high inequality would perceive more status anxiety in their social context, and they would themselves report higher status anxiety. Thus, in an experimental study PEI was manipulated. In Study 1, PEI uniquely predicted status anxiety, and perceived competitiveness mediated the relationship. In Study 2 PEI increased perceived contextual status anxiety, a specific form of perceived competitiveness based on socioeconomic status. Moreover, preliminary evidence of an indirect effect was found from PEI to personal status anxiety, through perceived contextual status anxiety. These preliminary findings provide experimental evidence for the effects of economic inequality on status anxiety and the mechanism involved. Economic inequality makes people feel that they live in a society where they are constantly concerned and competing with each other for their SES. These results could have important implications as health and wellbeing could be promoted by reducing economic inequalities and the competitive and materialistic environments of our societies. (shrink)

While animal rights have been a central topic within moral philosophy since the 1970s, it has remained virtually invisible within political philosophy. This article explores two key reasons for the difficulties in locating animals within political philosophy. First, even if animals are seen as having intrinsic moral status, they are often seen as ultimately distant others or strangers, beyond the bounds of human society. Insofar as political philosophy focuses on the governing of a shared social life, animals are seen as (...) falling outside its remit. Second, even if animals are recognized as members of society, they are seen as lacking the capacities or competences said to be essential for politics, and for membership in the demos. We challenge both assumptions. Many animals live and work alongside us, within an interspecies society, and all members of society should have the right to shape decisions about how that society is governed. An interspecies society requires interspecies politics. (shrink)

Bridging the traditionally separate domains of analytic and Continental philosophies, Pamela Sue Anderson presents for the first time, a feminist framework for studying the philosophy of religion.

I begin with the assumption that a philosophically significant tension exists today in feminist philosophy of religion between those subjects who seek to become divine and those who seek their identity in mutual recognition. My critical engagement with the ambiguous assertions of Luce Irigaray seeks to demonstrate, one the one hand, that a woman needs to recognize her own identity but, on the other hand, that each subject whether male or female must struggle in relation to the other in order (...) to maintain realism about life and death. No one can avoid the recognition that we are each given life but each of us also dies. In addition, I raise a more general, philosophical problem for analytic philosophers who attempt to read Continental philosophy of religion: how should philosophers interpret deliberately ambiguous assertions? For example, what does Irigaray mean in asserting. 'Divinity is what we need to become free, autonomous, sovereign'? To find an answer, I turn to the distinctively French readings of the Hegelian struggle for recognition which have preoccupied Continental philosophers especially since the first half of the last century. I explore the struggle for mutual recognition between womrn and men who must face the reality of life and death in order to avoid the projection of their fear of mortality onto the other sex. This includes a critical look at Irigaray's account of subjectivity and divinity. I turn to the French philosopher Michèle Le Doeuff in order to shift the focus from divinity to intersubjectivity. I conclude that taking seriously the struggle for mutual recognition between subjects forces contemporary philosophers of religion to be realist in their living and dying. With this in mind, the lesson from the Continent for philosophy of religion is that we must not stop yearning for recognition. Indeed, we must event risk our autonomy/divinity in seeking to recognize intersubjectivity. (shrink)

Cultural diversity between residents and staff is significant in aged care homes in many developed nations in the context of international migration. This diversity can be a challenge to achieving effective cross‐cultural communication. The aim of this study was to critically examine how staff and residents initiated effective cross‐cultural communication and social cohesion that enabled positive changes to occur. A critical hermeneutic analysis underpinned by Giddens’ Structuration Theory was applied to the study. Data were collected by interviews with residents or (...) their family and by focus groups with staff in four aged care homes in Australia. Findings reveal that residents and staff are capable of restructuring communication via a partnership approach. They can also work in collaboration to develop communication resources. When staff demonstrate cultural humility, they empower residents from culturally and linguistically diverse backgrounds to engage in effective communication. Findings also suggest that workforce interventions are required to improve residents’ experiences in cross‐cultural care. This study challenges aged care homes to establish policies, criteria and procedures in cross‐cultural communication. There is also the challenge to provide ongoing education and training for staff to improve their cross‐cultural communication capabilities. (shrink)

Over the past decade, teaching and learning in virtual worlds has been at the forefront of many higher education institutions around the world. The DEHub Virtual Worlds Working Group (VWWG) consisting of Australian and New Zealand higher education academics was formed in 2009. These educators are investigating the role that virtual worlds play in the future of education and actively changing the direction of their own teaching practice and curricula. 47 academics reporting on 28 Australian higher education institutions present an (...) overview of how they have changed directions through the effective use of virtual worlds for diverse teaching and learning activities such as business scenarios and virtual excursions, role-play simulations, experimentation and language development. The case studies offer insights into the ways in which institutions are continuing to change directions in their teaching to meet changing demands for innovative teaching, learning and research in virtual worlds. This paper highlights the ways in which the authors are using virtual worlds to create opportunities for rich, immersive and authentic activities that would be difficult or not possible to achieve through more traditional approaches. (shrink)

By definitively establishing that racism has broad implications for how the entire field of philosophy is practiced -- and by whom -- this powerful and ...

Moral distress is reported to be a critical force contributing to intensifying rates of anxiety, depression and burnout experienced by healthcare workers. In this paper, we examine the moral dilemmas and ensuing distress personally and collectively experienced by healthcare workers while caring for patients during the pandemic. Data are drawn from free-text responses from a cross-sectional national online survey of Australian healthcare workers about the patient care challenges they faced. Three themes were derived from qualitative content analysis that illuminated the (...) ways in which moral dilemmas and distress were relationally experienced by healthcare workers: (1) the moral ambiguity of how to care well for patients amid a rapidly changing work environment; (2) the distress of witnessing suffering shared between healthcare workers and patients; and (3) the distress of performing new forms of invisible work in the absence of institutional recognition. These findings reveal that moral distress was a strongly shared experience. Findings advance understandings of moral distress as a relational experience, collectively felt, constituted, and experienced by healthcare workers. Considering how to harness collective solidarity in effectively responding to moral distress experienced across the frontline healthcare workforce is critical. (shrink)

Background Moral distress is reported to be a critical force contributing to intensifying rates of anxiety, depression and burnout experienced by healthcare workers. In this paper, we examine the moral dilemmas and ensuing distress personally and collectively experienced by healthcare workers while caring for patients during the pandemic. Methods Data are drawn from free-text responses from a cross-sectional national online survey of Australian healthcare workers about the patient care challenges they faced. Results Three themes were derived from qualitative content analysis (...) that illuminated the ways in which moral dilemmas and distress were relationally experienced by healthcare workers: (1) the moral ambiguity of how to care well for patients amid a rapidly changing work environment; (2) the distress of witnessing suffering shared _between_ healthcare workers and patients; and (3) the distress of performing new forms of invisible work in the absence of institutional recognition. These findings reveal that moral distress was a strongly shared experience. Conclusions Findings advance understandings of moral distress as a relational experience, collectively felt, constituted, and experienced by healthcare workers. Considering how to harness collective solidarity in effectively responding to moral distress experienced across the frontline healthcare workforce is critical. (shrink)

Australia, along with other countries, has introduced New Public Management (NPM) into public sector hospitals in an effort to contain healthcare costs. NPM is associated with outsourcing of service provision, the meeting of government performance indicators, workforce flexibility and rationing of resources. This study explores the impact of rationing of staffing and other resources upon delivery of care outside of business hours. Data was collected through semistructured interviews conducted with 21 nurses working in 2 large Australian metropolitan hospitals. Participants identified (...) four strategies associated with NPM which add to workload after‐hours and impacted on the capacity to deliver nursing care. These were functional flexibility, vertical substitution of staff, meeting externally established performance indicators and outsourcing. We conclude that cost containment alongside of the meeting of performance indicators has extended work traditionally performed during business hours beyond those hours when less staffing and material resources are available. This adds to nursing workload and potentially contributes to incomplete nursing care. (shrink)

Relationships with international students can be beneficial to higher education in terms of financial and human resources. For this reason, establishing and maintaining such relationships are usually pre-eminent concerns. In this study, we extended the application of the disconfirmation expectation model by incorporating components from subjective task value to predict the loyalty of international students toward their host countries. On a sample of 410 Vietnamese students enrolled in establishments of higher education in over 15 countries across the globe, we employed (...) structural equation model to construct the conceptual model. Our empirical findings revealed that while the roles of satisfaction and disconfirmation are still important as direct and indirect antecedents of international student loyalty, its most powerful predictors are the three components of subjective task value: attainment, utility and intrinsic. These insights result in a number of implications for actors on the higher ducation scene, such as heads of institutions and policy makers. (shrink)

ABSTRACT:We focus on the core institution of the capital market and the institutional work of professional service firms that provide ratings on corporate issuers, initially in a bid to maintain this institution, which suffered when those involved relied solely on information from the issuers themselves. Through our analysis we identify a new type of decoupling—complicit decoupling. Complicit decoupling evolves over time, beginning with the creation of a new practice, here corporate ratings as a form of policing work, which emerges to (...) help to maintain a core institution. This practice is then adopted, implemented and later becomes decoupled. Exposure does not undermine the legitimacy of the practice because external actors collude in the ‘window dressing’ and, because it has become normalized, only partial repairs are enacted. It is by nature field-level institutional work, benefiting the majority of the field and inherently involves a violation of promise keeping. We conclude with implications for managers and behavioral ethics researchers. (shrink)

This book takes a fascinating look at the linguistic, psychological, and anthropological implications of Sue Savage-Rumbaugh's work with Kanzi--a bonobo who has achieved stunning cognitive and linguistic skills.

Studies of workers in health care and the care of older people disclose tensions that emerge partly from their conflicting obligations. They incur some obligations from the personal relationships they have with clients, but these can be at odds with organizational demands and resource constraints. One implication is the need for policies to recognize the importance of allowing workers some discretion in decison making. Another implication may be that sometimes care workers can meet their obligations to clients only by taking (...) collective action. (shrink)

In this paper I explore a “variation” on the “theme” of intuition in the evolution of modern metaphysics. My aim is not to criticize A. W. Moore’s account of intuition as one of two ways by which Bergson makes sense of things (the other way is analysis). Instead I will suggest the significance in extending Bergson’s metaphysics to mystical life as “the ‘very life of things’ into which intuition installs itself.” When the metaphysical drama, in The Evolution of Modern Metaphysics, (...) reaches chapter 16, “Bergson: Metaphysics as Pure Creativity,” Moore expresses astonishment that Bergson could have thought philosophers have ever agreed on aligning “analysis” in science with the impossibility of non-perspectival sense-making and “intuition” in metaphysics with the possibility of absolute (non-perspectival) knowledge. Using a method of intuition, not of analysis, as non-perspectival sense-making is the opposite of what Moore himself finds in other philosophical contributions to modern metaphysics as “a most general attempt to make sense of things.” He takes an influential example: Bernard Williams associates analysis, not intuition, with the possibility of non-perspectival sense-making and absolute knowledge. My response defends Bergsonian intuition in giving it a positive—and, why not, non-perspectival?—role in metaphysics as mystical; that is, as unique and inexpressible life. Moore describes intuition in Bergson as both the faculty and the method for the evolution of new concepts and new ways of making sense of things. I will stress that Bergsonian intuition is “an effort to place oneself into a movement, such as that of philosophy itself,” expressing “what is ‘living in philosophers’ rather than what is ‘fixed and dead in theses.’ ” This mystical life pushes out the limits set up by Kant for metaphysics (and science) by allowing intuition (with analysis) to reach for absolute, non-perspectival knowledge. (shrink)

We present, in various limits, analytical expressions for the center-of-mass wave function of a spin-1/2 atom as it is deflected by a Stern-Gerlach apparatus.

Feminist philosophy of religion as a subject of study has developed in recent years because of the identification and exposure of explicit sexism in much of the traditional philosophical thinking about religion. This struggle with a discipline shaped almost exclusively by men has led feminist philosophers to redress the problematic biases of gender, race, class and sexual orientation of the subject. Anderson and Clack bring together new and key writings on the core topics and approaches to this growing field. Each (...) essay exhibits a distinctive theoretical approach and appropriate insights from the fields of literature, theology, philosophy, gender and cultural studies. Beginning with a general introduction, part one explores important approaches to the feminist philosophy of religion, including psychoanalytic, poststructualist, postmetaphysical, and epistemological frameworks. In part two the authors survey significant topics including questions of divinity, embodiment, autonomy and spirituality, and religious practice. Supported by explanatory prefaces and an extensive bibliography which is organized thematically, Feminist Philosophy of Religion is an important resource for this new area of study. (shrink)

Pharmacological cognitive enhancements nontherapeutically improve cognitive functioning, though recent critics have challenged their use by claiming that cognitive success, aided by the use of cognitive enhancement, is less valuable than otherwise. We criticize two recent responses to this objection, due to Carter and Pritchard and Wang, and propose a different response on behalf of proponents of cognitive enhancement that is shown to be more promising.