Evidence in medicine can come from more or less trustworthy sources and be produced by more or less reliable methods, and its interpretation can be disputed. As such, it can be unclear when disagreements in medicine result from different, but reasonable, interpretations of the available evidence and when they result from unreasonable refusals to consider legitimate evidence. In this article, we seek to show how assessments of the relevance and implications of evidence are typically affected by factors beyond that evidence (...) itself, such as our beliefs about the credibility of the speaker or source of the evidence. In evaluating evidence, there is thus a need for reflective awareness about why we accept or dismiss particular claims. (shrink)

OBJECTIVES: This article presents an original definition of surgical innovation and a practical tool for identifying planned innovations. These will support the responsible introduction of surgical innovations. BACKGROUND: Frameworks developed for the safer introduction of surgical innovations rely upon identifying cases of innovation; oversight cannot occur unless innovations are identified. However, there is no consensus among surgeons about which interventions they consider innovative; existing definitions are vague and impractical. METHODS: Using conceptual analysis, this article synthesizes findings from relevant literature, and (...) from qualitative research with surgeons, to develop an original definition of surgical innovation and a tool for prospectively identifying planned surgical innovations. The tool has been developed in light of feedback from health care professionals, surgeons, and policy makers. RESULTS: This definition of innovation distinguishes between variations, introduction of established interventions, and innovations in surgical techniques or use of devices. It can be applied easily and consistently, is sensitive to the key features of innovation, is prospective, and focuses on features relevant to safety and evaluation. The accompanying tool is deliberately broad so that appropriate supports may, if necessary, be provided each time that a surgeon does something "new". CONCLUSIONS: The definition presented in this article overcomes a number of practical challenges. The definition and tool will be of value in supporting responsible surgical innovation, in particular, through the prospective identification of planned innovations. (shrink)

Ethical leadership is an important construct in the literature on behavioral ethics in organizations, given its link with employee attitudes and behaviors. What remains unclear, however, is what leader characteristics are associated directly with ethical leader perceptions and indirectly with employee unethical behavior. In this paper, we use a socio-cognitive lens to integrate goal orientation theory with the literature on ethical behavior in organizations. Specifically, we propose that certain patterns of managers’ goal-oriented behavior provide signals and cues to employees about (...) their managers’ ethical leadership, which then relates to employee displays of more unethical behavior. Using a sample of 265 manager–employee dyads, our findings largely support our claims. We found that leader performance-avoid goal orientation was negatively related to perceptions of ethical leadership and positively related to employee unethical behavior. Moderated mediation tests indicated that the positive indirect effect of leader performance-avoid goal orientation on employee unethical behavior through perceptions of ethical leadership was attenuated by higher levels of leader learning goal orientation. Taken together, these findings suggest that when leaders emphasize avoiding failure while downplaying the importance of personal learning and development, employees perceive them as less ethical and are more willing to engage in ethical misconduct. We discuss implications of our findings for both theory and practice. (shrink)

This is the long-awaited publication of a set of writings by the British philosopher, historian, and archaeologist R.G. Collingwood on critical, anthropological, and cultural themes only hinted at in his previously available work. At the core are six essays on folktale and magic in which Collingwood applies the principles of his philosophy of history to problems in the long-term evolution of human society and culture. The volume opens with three substantial introductory essays by the editors, authorities in their various fields, (...) who provide their explanatory and contextual notes to guide the reader through the texts. The Philosophy of Enchantment highlights the broad range of Collingwood's intellectual engagements, their integration, and their relevance to current areas of debate in the fields of philosophy, cultural studies, social and literary history, and anthropology. (shrink)

At the beginning of the twentieth century the tropes of messianism, apocalypse and redemption, which had been so central to the West's religious formation, seemed spent forces in Germany. Nietzsche had pronounced God as dead and theology seemed to be travelling the same secular route as philosophy. But World War I changed that. This book introduces some of Germany's key thinkers in theology, philosophy, literature and social and political thought through their engagement with these previously discarded concepts. They initiated a (...) new and urgent dialogue between philosophy and theology. This imaginative and innovative collection brings together essays by established scholars on Messiamism, Redemption and Apocalypse in twentieth century German thought. Major theologians such as Barth, Buber, Bonhoeffer, Rahner, Pannenberg and Moltmann are discussed alongside leading intellectuals such as Adorno, Benjamin, Bloch, Heiddeger and Rosenzweig. Literary figures, such as Kafka and George, are also included. The interfaces imply a different way of reading theology and challenge the reader to think what the implications of immanence in a specific philosophical culture are for the theological project. Some of the essays introduce thinkers who are little known to English speaking readers. Others cast new light on more familiar figures. The collection as a whole contextualises German religious and philosophical thought on these crucial topics in very useful ways. The dialogue at work in these pages is a very important one and should be carried further. (shrink)

Women in the business school are beginning to assume characteristics that will prove both ineffective and detrimental in the workplace. This paper seeks to present a framework for understanding these changes as well as their implications. We present several testable hypotheses as well as suggestions for easing the tensions felt by women in business settings.

Jim Stone argues that one cannot combine three-dimensionalism with counterpart theory. This paper argues to the contrary.

This paper reports on the design and implementation of a multi-phase interactive process among a set of scientists, policy makers, land managers, and community representatives, so as to facilitate communication, mutual understanding, and participative decision making. This was part of the Ecosystem Services Project in Australia. The project sought to broaden public understanding about the natural ecosystems in Australia. The study reported here pertains to one of the project sites--the Goulburn Broken catchment, a highly productive agricultural watershed in the south-east (...) of Australia. The paper demonstrates how, starting from a condition of diversity of ideas and interests among the participants, systematic dialogue and mutual learning could be generated, leading to identification of options for more sustainable land management practices. The concept of "ecosystem services" was used as an integrative tool across disciplines and community perspectives. The concept of scenarios was used to encourage future-focussed thinking among the participants. The idea of "stakeholder jury" was used to promote deliberation. A process of multi-criteria evaluation was used to facilitate convergence of viewpoints, through informed trade-offs and compromises. This experience led to the development of a process for integration research, which helped in harmonising across diverse understandings and values in a transparent and structured manner. (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.

The threshold problem for knowledge is the problem of saying where the threshold for knowledge lies in various cases and explaining why it lies there rather than elsewhere. Pragmatic encroachment is the idea that the knowledge-threshold is sensitive to practical factors. The latter idea seems to help us make progress on the former problem. However, Jessica Brown has argued that appearances are deceiving in this case: the threshold problem is still a thorny one even for those who accept pragmatic encroachment. (...) This paper takes a look at Brown’s arguments and at Michael Hannon’s recent attempt to respond to them. Hannon’s response is shown to face serious difficulties and a novel alternative response to Brown is provided. The paper also takes up an issue Brown raises very briefly concerning cases in which a proposition is relevant to multiple stakes which a subject faces at a given time. It turns out that there is a good deal more to be said about how defenders of pragmatic encroachment should try to handle such cases than Brown permits. (shrink)

_Hans Kelsen and the Natural Law Tradition_ provides the first sustained examination of Hans Kelsen’s critical engagement, itself founded upon a distinctive theory of legal positivism, with the Natural Law Tradition.

This article compares and contrasts Hans Kelsen's concept of normative imputation, in the Lecture Course of 1926, with the concepts of peripheral and central imputation, in The Pure Theory of Law of 1934. In this process, a wider and more significant distinction is revealed within the development of Hans Kelsen's theory of positive law. This distinction represents a shift in Kelsen's philosophical allegiance from the Neo-Kantianism of Windelband to that of Cohen. This, in turn, reflects a broader disengagement of The (...) Pure Theory of Law from the more direct connection with a political project of a civitas maxima envisaged by the Lecture Course. (shrink)

We invoke the ideal of tolerance in response to conflict, but what does it mean to answer conflict with a call for tolerance? Is tolerance a way of resolving conflicts or a means of sustaining them? Does it transform conflicts into productive tensions, or does it perpetuate underlying power relations? To what extent does tolerance hide its involvement with power and act as a form of depoliticization? Wendy Brown and Rainer Forst debate the uses and misuses of tolerance, an (...) exchange that highlights the fundamental differences in their critical practice despite a number of political similarities. Both scholars address the normative premises, limits, and political implications of various conceptions of tolerance. Brown offers a genealogical critique of contemporary discourses on tolerance in Western liberal societies, focusing on their inherent ties to colonialism and imperialism, and Forst reconstructs an intellectual history of tolerance that attempts to redeem its political virtue in democratic societies. Brown and Forst work from different perspectives and traditions, yet they each remain wary of the subjection and abnegation embodied in toleration discourses, among other issues. The result is a dialogue rich in critical and conceptual reflections on power, justice, discourse, rationality, and identity. (shrink)

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

Whether in characterizing Catharine MacKinnon's theory of gender as itself pornographic or in identifying liberalism as unable to make good on its promises, Wendy Brown pursues a central question: how does a sense of woundedness become the basis for a sense of identity? Brown argues that efforts to outlaw hate speech and pornography powerfully legitimize the state: such apparently well-intentioned attempts harm victims further by portraying them as so helpless as to be in continuing need of governmental protection. "Whether (...) one is dealing with the state, the Mafia, parents, pimps, police, or husbands," writes Brown, "the heavy price of institutionalized protection is always a measure of dependence and agreement to abide by the protector's rules." True democracy, she insists, requires sharing power, not regulation by it; freedom, not protection.Refusing any facile identification with one political position or another, Brown applies her argument to a panoply of topics, from the basis of litigiousness in political life to the appearance on the academic Left of themes of revenge and a thwarted will to power. These and other provocations in contemporary political thought and political life provide an occasion for rethinking the value of several of the last two centuries' most compelling theoretical critiques of modern political life, including the positions of Nietzsche, Marx, Weber, and Foucault. (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.

Unable to answer the call of our patients: mental health nurses’ experience of moral distress When health practitioners’ moral choices and actions are thwarted by constraints, they may respond with feelings of moral distress. In a Canadian hermeneutic phenomenological study, physicians, nurses, psychologists and non‐professional aides were asked to identify care situations that they found morally distressing, and to elaborate on how moral concerns regarding the care of patients were raised and resolved. In this paper, we describe the experience of (...) moral distress related by nurses working in mental healthcare settings who believed that lack of resources (such as time and staff) leads to dispiritedness, lack of respect, and absence of recognition (for both patients and staff) which severely diminished their ability to provide quality care. The metaphors of flashlight and hammer are used to elaborate nurses’ possible responses to intolerable situations. (shrink)

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

This paper considers the problem that arises when the number of patients who need a resource exceeds the supply. An initial decision-making model is proposed that uses two essential criteria, medical prognosis and the priority of life-threatening situations. The model is then subjected to the criticism that it is grotesque to ignore questions relating to the value of, for example, a productive mother over against an aged recluse, and to treat them as having equal rights to access. It is argued (...) that this criticism need not be an expression of prejudice but may reflect a defendable view in which utilitarian considerations enter into the selection process provided that certain fundamental, or 'deontological' rights are observed for all. In the light of the discussion the model is modified in order to contain both a non-utilitarian feature that stresses the intrinsic importance of all persons, and a utilitarian feature that can allow one, in certain circumstances, to take consequences into account, especially those that follow from the 'irreplaceability' of some people. (shrink)

G Langford; Education, Journal of Philosophy of Education, Volume 2, Issue 1, 30 May 2006, Pages 31–41, https://doi.org/10.1111/j.1467-9752.1968.tb00442.x.

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)

Glenn Langford; Education and Values, Journal of Philosophy of Education, Volume 22, Issue 2, 30 May 2006, Pages 283, https://doi.org/10.1111/j.1467-9752.1988.t.

Glenn Langford; Education is of the Whole Man, Journal of Philosophy of Education, Volume 13, Issue 1, 30 May 2006, Pages 65–72, https://doi.org/10.1111/j.1467-.

It is increasingly recognised that evidence generated using “real-world data” is crucial for assessing the safety and effectiveness of health-related interventions. This, however, raises a number of issues, including those related to the quality of RWD, and of the scientific methods used to generate evidence from it, and the potential for those gathering and using RWD be driven by commercial, political, professional or personal self-interest. This article is an application of the framework presented in this issue of ABR. Please refer (...) to that article for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end to demonstrate how those generating or using RWD can make use of values when deliberating about ethical issues. (shrink)

Wendy Brown's work commands widespread attention and respect, and there has been considerable interest as to how it would develop after "States of Injury." This book will not disappoint.

CHAPTER ONE Education and teaching INTRODUCTION This book is about education and teaching and the way they are related when teaching is thought of as a ...

The moral distress of psychologists working in psychiatric and mental health care settings was explored in an interdisciplinary, hermeneutic phenomenological study situated at the University of Alberta, Canada. Moral distress is the state experienced when moral choices and actions are thwarted by constraints. Psychologists described specific incidents in which they felt their integrity had been compromised by such factors as institutional and interinstitutional demands, team conflicts, and interdisciplinary disputes. They described dealing with the resulting moral distress by such means as (...) silence, taking a stance, acting secretively, sustaining themselves through work with clients, seeking support from colleagues, and exiting. Recognizing moral distress can lead to a significant shift in the way we perceive moral choices and understand the moral context of practice. (shrink)