Some health care organizations allow physicians to withhold cardiopulmonary resuscitation from a patient, despite patient or surrogate requests that it be provided, when they believe it will be more harmful than beneficial. Such cases usually involve patients with terminal diagnoses whose medical teams argue that aggressive treatments are medically inappropriate or likely to be harmful. Although there is state-to-state variability and a considerable judicial gray area about the conditions and mechanisms for refusals to perform CPR, medical teams typically follow a (...) set of clearly defined procedures for these decisions. The procedures are based on the principle of nonmaleficence and typically include consultation with hospital ethics committees, reflecting the guidelines of relevant professional associations. Ethical debates about when CPR can and should be limited tend to rely more on discussions of theory, principles, and case studies than systematic empirical study of the situations in which such limitations are applied. Sociologists of bioethics call for empirical study, arguing that what ethicists and health professionals believe they are doing when they draft policies or invoke principles does not always mirror what is happening on the ground. In this article, we begin the task of modeling the empirical analyses sociologists call for, focusing on a cohort at Massachusetts General Hospital. We inductively analyzed ethics committee notes and medical records of nineteen patients whose surrogates did not accept the decision to withhold CPR. (shrink)

Nursing faces an uncertain future as technological developments, structural changes within health systems and rapidly evolving health needs create new and challenging possibilities. This article draws on the results of a qualitative study undertaken with a range of Queensland nurse leaders to explore their perceptions of these changes. The study re‐surfaced, and allows for a re‐examination of, four issues that have long created tension within nursing and which continue to have a negative impact on the profession as a whole. These (...) are as follows: professionalisation; preparation of graduates; myths and narratives of nursing; and leadership. We provide a metaphor that imagines all of these tensions operating in dynamic interplay. The image is that of a Newton's Cradle – a model for energy and momentum. The metaphor allows one to see the wide context of changes affecting nursing and the significance of the interconnections. If tensions within nursing maintain their own integrity through containment, understanding and development, they remain in alignment, and energy is conserved rather than wasted or misdirected. It suggests that with increased awareness and attention paid to internal challenges, and by taking a broad‐based approach to systemic improvements, nursing could become more effective, progressive and proactive in shaping its own future. (shrink)

People with mental illness are subjected to stigma and discrimination and constantly face restrictions in the exercise of their political, civil and social rights. Considering this scenario, mental health, ethics and human rights are key approaches to advance the well-being of persons with mental illnesses. The study was conducted to review the scope of the empirical literature available to answer the research question: What evidence is available regarding human rights and ethical issues regarding nursing care to persons with mental illnesses? (...) A scoping review methodology guided by Arksey and O’Malley was used. Studies were identified by conducting electronic searches on CINAHL, PubMed, SCOPUS and Hein databases. Of 312 citations, 26 articles matched the inclusion criteria. The central theme which emerged from the literature was “Ethics and Human Rights Boundaries to Mental Health Nursing practice”. Mental health nurses play a key and valuable role in ensuring that their interventions are based on ethical and human rights principles. Mental health nurses seem to have difficulty engaging with the ethical issues in mental health, and generally are dealing with acts of paternalism and with the common justification for those acts. It is important to open a debate regarding possible solutions for this ethical dilemma, with the purpose to enable nurses to function in a way that is morally acceptable to the profession, patients and members of the public. This review may serve as an instrument for healthcare professionals, especially nurses, to reflect about how to fulfil their ethical responsibilities towards persons with mental illnesses, protecting them from discrimination and safeguarding their human rights, respecting their autonomy, and as a value, keeping the individual at the centre of ethical discourse. (shrink)

This article addresses the seemingly paradoxical proliferation of coded systems designed to guarantee our safety and crises that endanger us. These two phenomena, it argues, are not opposites but rather complements; crises are not accidental to a culture focused on safety, they are its raison d'être. Mapping out the temporality of networks, it argues that crises are new media's critical difference: its exception and its norm. Although crises promise to disrupt memory – to disturb the usual programmability of our machines (...) by indexing ‘real time’ – they reinforce codes and coded logic: both codes and crises are central to the production of mythical and mystical sovereign subjects who weld together norm with reality, word with action. Codes and states of exception are complementary functions, which render information and ourselves undead. Against this fantasy and against the exhaustion that crisis as norm produces, the article ends by arguing that we need a means to exhaust exhaustion, to recover the undecidable potential of our decisions and our information through a practice of constant care. (shrink)

Department of Medical Education, Flinders University of South Australia, GPO Box 2100, Adelaide SA 5001. Tel. : +61-8-7225-1111; Fax: +61-8-8204-5675; Email: lee0359{at}flinders.edu.au ' + u + '@ ' + d + ' '/ /- ->.This paper analyses the role of communication strategies in pandemic influenza planning. Our central concern is with the extent to which nations are using communication to address issues of social justice. Issues associated with disadvantage and vulnerability to infection in the event of an influenza pandemic raise (...) distinct questions about how well less well off groups will be protected. The potential for a public health emergency of this type to exacerbate existing inequalities, making those in less well off positions worse off, makes social justice an important consideration for pandemic planners. National PI plans offer insights into the ways that nations may use communication to address issues of disadvantage, thereby providing a way of examining how communication strategies are presented and their potential to mitigate inequities. Our research reviewed 12 national PI plans and assessed the extent to which nations are using communication to assist and limit possible harms to less well off groups. We outline in this paper some important issues and considerations associated with social justice and flu planning, in particular if and how plans are addressing inequalities. CiteULike Connotea Del.icio.us What's this? (shrink)

I argue for a Wittgensteinian reading of Judith Butler's performative conception of identity in light of Marilyn Frye's analysis of lesbian as nonexistent and Butler's analysis of abject. I suggest that the attempt to articulate a performative lesbian identity must take seriously the contexts within which abjection is vital to maintaining gender, exposing the intimate link between context and the formulation of intention, and shedding light on possible lesbian identities irreducible to abjection.

The behavioral sciences have come under attack for writings and speech that affront sensitivities. At such times, academic freedom and tenure are invoked to forestall efforts to censure and terminate jobs. We review the history and controversy surrounding academic freedom and tenure, and explore their meaning across different fields, at different institutions, and at different ranks. In a multifactoral experimental survey, 1,004 randomly selected faculty members from top-ranked institutions were asked how colleagues would typically respond when confronted with dilemmas concerning (...) teaching, research, and wrong-doing. Full professors were perceived as being more likely to insist on having the academic freedom to teach unpopular courses, research controversial topics, and whistle-blow wrong-doing than were lower-ranked professors (even associate professors with tenure). Everyone thought that others were more likely to exercise academic freedom than they themselves were, and that promotion to full professor was a better predictor of who would exercise academic freedom than was the awarding of tenure. Few differences emerged related either to gender or type of institution, and behavioral scientists' beliefs were similar to scholars from other fields. In addition, no support was found for glib celebrations of tenure's sanctification of broadly defined academic freedoms. These findings challenge the assumption that tenure can be justified on the basis of fostering academic freedom, suggesting the need for a re-examination of the philosophical foundation and practical implications of tenure in today's academy. (Published Online February 8 2007) Key Words: academia; academic freedom; ethical issues; faculty beliefs; professoriate; promotion; scientific misconduct; tenure; whistle-blowing. (shrink)

While Sarah Hoagland's conception of a lesbian ethic offers a promising route toward articulating an ethics of resistance, her notion of self in community does not provide a conception of "subject" capable of both embracing political action as fundamental to personal life and explicitly recognizing cultural, ethnic, and sexual multiplicity as central to ethical decision-making. Such a notion can be found, however, in the remarks of later Wittgenstein concerning the "language games" of describing.

The aim of the following paper is, firstly, to provide the reader with a brief exposition of the critical response offered by some current french feminists of the largely American, compensatory approach to feminist historiography. Secondly, I wish to show why the french feminist alternative itself provides an inadequate methodology for the resolution of the problems that it raises in its critique. Lastly, I shall suggest that the Wittgensteinian concept of ‘family resemblance’ contains the seeds of a plausible alternative to (...) either the compensatory or the french structuralist approach to feminist historiography. The upshot of this latter claim is that the historical subject may be most fruitfully conceived genealogically, that is, as the dynamic product of an inexhaustible complex of historical and contextual resemblances constructed on the behalf of a specific interpretational task. (shrink)

Much recent feminist theory tacitly subscribes to some version of what cognitive and evolutionary scientists are successfully undermining as untenably Cartesian, namely, the view that moral agency is achieved through the transcendence of physical causality guaranteed by self-consciousness. Appealing to Wittgenstein's insights concerning self-reference, I argue that abandoning Cartesian dualism implies abandoning neither subject nor moral agency but rather opens up nonandrocentric possibilities unavailable to the traditional model of mind.

Tolerance is generally regarded as an unqualified achievement of the modern West. Emerging in early modern Europe to defuse violent religious conflict and reduce persecution, tolerance today is hailed as a key to decreasing conflict across a wide range of other dividing lines-- cultural, racial, ethnic, and sexual. But, as political theorist Wendy Brown argues in Regulating Aversion, tolerance also has dark and troubling undercurrents. Dislike, disapproval, and regulation lurk at the heart of tolerance. To tolerate is not to (...) affirm but to conditionally allow what is unwanted or deviant. And, although presented as an alternative to violence, tolerance can play a part in justifying violence--dramatically so in the war in Iraq and the War on Terror. Wielded, especially since 9/11, as a way of distinguishing a civilized West from a barbaric Islam, tolerance is paradoxically underwriting Western imperialism. Brown's analysis of the history and contemporary life of tolerance reveals it in a startlingly unfamiliar guise. Heavy with norms and consolidating the dominance of the powerful, tolerance sustains the abjection of the tolerated and equates the intolerant with the barbaric. Examining the operation of tolerance in contexts as different as the War on Terror, campaigns for gay rights, and the Los Angeles Museum of Tolerance, Brown traces the operation of tolerance in contemporary struggles over identity, citizenship, and civilization. (shrink)

Lloyd (2009) contends that climate models are confirmed by various instances of fit between their output and observational data. The present paper argues that what these instances of fit might confirm are not climate models themselves, but rather hypotheses about the adequacy of climate models for particular purposes. This required shift in thinking—from confirming climate models to confirming their adequacy-for-purpose—may sound trivial, but it is shown to complicate the evaluation of climate models considerably, both in principle and in practice.

'Is politics gendered? Wendy Brown things so, and argues for this point with elegance, imagination and pungent phrases. Brown's book is challenging, provocative and...original; it does force us to question the degree to which gender controls our politics.'-THE REVIEW OF POLITICS.

Autoethnographers have grappled with how to represent others in the stories they tell. However, very few have written about the need to protect themselves in the process of doing autoethnographic writing. In this paper, I explore the ethical challenges faced when writing about a potentially-ongoing disorder, such as anorexia, when the research process triggers previously disengaged unhealthy thinking or behaviors for those involved. In the story-writing process, I felt a strong pull to go back into anorexia, as I immersed myself (...) in my research on this topic. The compulsion to publish became intertwined with the compulsion of my anorexia, illustrated by the need to control both and present a certain "face" as a researcher. Using a meta-autoethnographic format, I walk the reader through the choices I made in an attempt to protect myself as a researcher in the process of publishing an autoethnography about anorexia. I also explain the lessons I learned, which can be applied to persons doing autoethnographies on topics that may affect their own personal well-being. This paper reveals the importance of writing through our pain in an ethical fashion and that the ethics of doing autoethnography is not just about protecting those implicated in our stories, but also ourselves. (shrink)

Wendy Donner contends here that recent commentators on John Stuart Mill's thought have focused on his notions of right and obligation and have not paid as much attention to his notion of the good. Mill, she maintains, rejects the quantitative hedonism of Bentham's philosophy in favor of an expanded qualitative version. In this book she provides an account of his complex views of the good and the ways in which these views unify his moral and political thought.

In Sleeping with Extra-Terrestrials , Wendy Kaminer argues that we are a society intoxicated by the irrational: religion, spirituality, and popular therapies threaten to replace rational thought with supernaturalism and impassioned but unexamined personal testimony. Ranging from our fascination with angels, aliens, and near- death experiences to the rise of junk science, the recovery movement, and the digital culture, Kaminer points out the amusing and ominous effects of our deference to spiritual authorities and resistance to critical thinking. She questions (...) conventional wisdom about the association of religious belief with virtue, identifying the sectarianism of efforts to establish religion in the public square. With both wit and empathy, Kaminer takes on what many people hold sacred. Kaminer is an eloquent and incisive critic and rationalist living in a superstitious, evangelical age. In Sleeping with Extra-Terrestrials she challenges us to exercise skepticism, reason, and irreverence and to appreciate the pleasures of free inquiry. (shrink)

DIVA reader aimed at revitalizing left legal and political critique./div.

An uncertainty report describes the extent of an agent’s uncertainty about some matter. We identify two basic requirements for uncertainty reports, which we call faithfulness and completeness. We then discuss two pitfalls of uncertainty assessment that often result in reports that fail to meet these requirements. The first involves adopting a one-size-fits-all approach to the representation of uncertainty, while the second involves failing to take account of the risk of surprises. In connection with the latter, we respond to the objection (...) that it is impossible to account for the risk of genuine surprises. After outlining some steps that both scientists and the bodies who commission uncertainty assessments can take to help avoid these pitfalls, we explain why striving for faithfulness and completeness is important. (shrink)

While the economic and environmental dimensions of the triple bottom line have been covered extensively by management theory and practice, the social dimension remains largely underrepresented. The resource-based view of the firm and the natural resource-based view of the firm are revisited to lay the theoretical foundation for exploring how the social dimension might be addressed. Social capabilities are then explored by looking at the social entrepreneurship literature and illustrative cases with the purpose of elaborating RBV toward a social resource-based (...) view of the firm. Three illustrative cases, which represent social businesses located in catastrophe-ridden Haiti, show how capabilities are used to overcome challenging constraints. The goal for the social entrepreneur is to employ the appropriate capabilities to ensure economic success, a positive environmental impact, and social benefits that leave the local community in a better position than without the business. Just as NRBV is a previous elaboration of RBV, so can SRBV be an elaborated theoretical foundation for future research. The components of a theory are systematically addressed by extending the range of variables, extending the domain, and offering propositions on variable relationships and outcome predictions. By highlighting the social capabilities of social entrepreneurs, this research illuminates the micro-foundations of corporate social responsibility, emphasizing the value of individual level analyses. (shrink)

Increasingly there are calls for climate services to be “co-produced” with users, taking into account not only the basic information needs of users but also their value systems and decision contexts. What does this mean in practice? One way that user values can be incorporated into climate services is in the management of inductive risk. This involves understanding which errors in climate service products would have particularly negative consequences from the users’ perspective (e.g., underestimating rather than overestimating the change in (...) an impact variable) and then prioritizing the avoidance of those errors. This essay shows how inductive risk could be managed in climate services in ways that serve user values and argues that there are both ethical and practical reasons in favor of doing so. (shrink)

The error in Kingsley's attack on special relativity is shown to arise from his failure to actually use the Lorentz transformation. He has instead applied a fallacious symmetry argument to justify the use of time dilation in a situation for which this special case formula is not valid.

The Court of Appeals of New York held, in Council of the City of New York u. Giuliani, slip op. 02634, 1999 WL 179257, that New York City may not privatize a public city hospital without state statutory authorization. The court found invalid a sublease of a municipal hospital operated by a public benefit corporation to a private, for-profit entity. The court reasoned that the controlling statute prescribed the operation of a municipal hospital as a government function that must be (...) fulfilled by the public benefit corporation as long as it exists, and nothing short of legislative action could put an end to the corporation's existence.In 1969, the New York State legislature enacted the Health and Hospitals Corporation Act, establishing the New York City Health and Hospitals Corporation as an attempt to improve the New York City public health system. Thirty years later, on a renewed perception that the public health system was once again lacking, the city administration approved a sublease of Coney Island Hospital from HHC to PHS New York, Inc., a private, for-profit entity. (shrink)

The Supreme Court ended its last term by making unconstitutional a choice Brown v. Board of Education once required - the voluntary, and race conscious, pursuit of integration - to little public outcry. As a society, we continue to find comfort in segregation. This Article argues that this acceptance is wrong, both educationally and constitutionally. It does so through the lens of teacher segregation, a topic all but ignored in the current literature. The first step of this argument is demonstrating, (...) by an original empirical study, the segregation of teachers, thereby proving a more profound school segregation than is generally recognized. The second step establishes, through an extensive review of the existing social science literature, that the typical minority student benefits from integration because it ensures a fundamental resource - experienced teachers. Lastly, the inherent inequality of segregation should have constitutional implications. While the Rehnquist Court utilized an interest balancing approach to the Equal Protection clause and recognized the constitutional harms of segregation, the Roberts Court has begun to minimize the Equal Protection to concern only capitalizing individual treatment and has erred in creating a "constitutional chill" toward the value of integration. (shrink)

First published in 1982. Routledge is an imprint of Taylor & Francis, an informa company.

Surveying a wide range of cultural controversies, from the Mapplethorpe affair to Salman Rushdie's death sentence, from canon-revision in the academy to the scandals that have surrounded Anthony Blunt, Martin Heidegger, and Paul de Man, Wendy Steiner shows that the fear and outrage they inspired are the result of dangerous misunderstanding about the relationship between art and life. "Stimulating. . . . A splendid rebuttal of those on the left and right who think that the pleasures induced by art (...) are trivial or dangerous. . . . One of the most powerful defenses of the potentiality of art."--Andrew Delbanco, New York Times Book Review "A concise and . . . readable account of recent contretemps that have galvanized the debate over the role and purposes of art. . . . [Steiner] writes passionately about what she believes in."--Michiko Kakutani, New York Times "This is one of the few works of cultural criticism that is actually intelligible to the nonspecialist reader. . . . Steiner's perspective is fresh and her perceptions invariably shrewd, far-ranging, and reasonable. A welcome association of sense and sensibility."-- Kirkus Reviews, starred review "Steiner has succeeded so well in [the] task she has undertaken. The Scandal of Pleasure is itself characterized by many of the qualities Steiner demans of art, among them, complexity, tolerance and the pleasures of unfettered thought."--Eleanor Heartly, Art in America "Steiner . . . provides the best and clearest short presentation of each of [the] debates."--Alexander Nehamas, Boston Book Review "Steiner has done a fine job as a historian/reporter and as a writer of sophisticated, very clear, cultural criticism. Her reportage alone would be enough to make this a distinguished book."--Mark Edmundson, Lingua Franca. (shrink)

Computer simulation modeling is an important part of contemporary scientific practice but has not yet received much attention from philosophers. The present project helps to fill this lacuna in the philosophical literature by addressing three questions that arise in the context of computer simulation of Earth's climate. Computer simulation experimentation commonly is viewed as a suspect methodology, in contrast to the trusted mainstay of material experimentation. Are the results of computer simulation experiments somehow deeply problematic in ways that the results (...) of material experiments are not? I argue against categorical skepticism toward the results of computer simulation experiments by revealing important parallels in the epistemologies of material and computer simulation experimentation. It has often been remarked that simple computer simulation models---but not complex ones---contribute substantially to our understanding of the atmosphere and climate system. Is this view of the relative contributions of simple and complex models tenable? I show that both simple and complex climate models can promote scientific understanding and argue that the apparent contribution of simple models depends upon whether a causal or deductive account of scientific understanding is adopted. When two incompatible scientific theories are under consideration, they typically are viewed as competitors, and we seek evidence that refutes at least one of the theories. In the study of climate change, however, logically incompatible computer simulation models are accepted as complementary resources for investigating future climate. How can we make sense of this use of incompatible models? I show that a collection of incompatible climate models persists in part because of difficulties faced in evaluating and comparing climate models. I then discuss the rationale for using these incompatible models together and argue that this climate model pluralism has both competitive and integrative components. (shrink)

_John Stuart Mill_ investigates the central elements of the 19th century philosopher’s most profound and influential works, from _On Liberty_ to _Utilitarianism_ and _The Subjection of Women_. Through close analysis of his primary works, it reveals the very heart of the thinker’s ideas, and examines them in the context of utilitarianism, liberalism and the British empiricism prevalent in Mill’s day. • Presents an analysis of the full range of Mill’s primary writings, getting to the core of the philosopher’s ideas. • (...) Examines the central elements of Mill’s writings in easily accessible prose • Places Mill’s work and thought within the larger cultural and social context of 19th century Britain • Illustrates the continued relevance of Mill’s philosophy to today’s reader. (shrink)

Why do some national movements use violent protest and others nonviolent protest? Wendy Pearlman shows that much of the answer lies inside movements themselves. Nonviolent protest requires coordination and restraint, which only a cohesive movement can provide. When, by contrast, a movement is fragmented, factional competition generates new incentives for violence and authority structures are too weak to constrain escalation. Pearlman reveals these patterns across one hundred years in the Palestinian national movement, with comparisons to South Africa and Northern (...) Ireland. To those who ask why there is no Palestinian Gandhi, Pearlman demonstrates that nonviolence is not simply a matter of leadership. Nor is violence attributable only to religion, emotions or stark instrumentality. Instead, a movement's organizational structure mediates the strategies that it employs. By taking readers on a journey from civil disobedience to suicide bombings, this book offers fresh insight into the dynamics of conflict and mobilization. (shrink)