The aim of this study was to explore the influences, processes and environments that shaped the practice of European nurses for indigenous New Zealand (NZ) Māori communities who were being overwhelmed by introduced infectious diseases. Historical data were accessed from multiple archival sources and analysed through the lens of colonial theory. Through their work early last century, NZ nurses actively gained professional status and territory through their work with Māori. By living and working alongside Māori, they learned to practise in (...) new ways that influenced Māori health. By developing a new role in new professional territory, nurses extended their practice to include health promotion as well as disease prevention. Māori survival from epidemics improved, and the population grew over that period. For Māori, however, Eurocentric care alleviated their immediate health problems, but the detrimental impact of the mechanisms of colonisation overall has continued to the present day. (shrink)

Theories of perception have traditionally dismissed the sense of smell as a notoriously variable and highly subjective sense, mainly because it does not easily fit into accounts of perception based on visual experience. So far, philosophical questions about the objects of olfactory perception have started by considering the nature of olfactory experience. However, there is no philosophically neutral or agreed conception of olfactory experience: it all depends on what one thinks odors are. We examine the existing philosophical methodology for addressing (...) our sense of smell: on the one hand appeals to phenomenology that focus on the experiential dimensions of odor perception and on the other approaches that look at odor sources and their material dimensions. We show that neither strategy provides enough information to account for the human sense of smell and argue that the inclusion of the missing dimension of biology, with its concern for the function (or functions) of olfaction, provides the means to develop a satisfactory and empirically informed philosophy of smell. (shrink)

What does it take for a scientific model to represent? Scientific models have received a great deal of attention in recent philosophical literature. Following Morgan and Morrison’s account of “Models as Mediators”, analysis of how models represent has changed from questioning what properties of models can be said to correlate with the world to asking how models are used to relate to an intended target-system. This turn to a practice-oriented approach of understanding models was a response to a general philosophical (...) problem that attends the empirical application of scientific representations such as models. This problem is twofold. Models, on the one hand, are often said to make false claims about the world.. (shrink)

Considerations upon the nature of properties and laws have led some philosophers to claim that the correct epistemic attitude with regards to the intrinsic properties of particulars is scepticism. I examine one particularly clear version of this line of argument, and contend that a serious form of scepticism is not established. However, I argue that the theories of properties and laws underlying the argument have unwanted metaphysical implications. These provide a stronger reason to jettison the analyses. I end by sketching (...) an alternative view that avoids these difficulties. -/- . (shrink)

AI has numerous applications and in various fields, including the military domain. The increase in the degree of autonomy in some decision-making systems leads to discussions on the possible future use of lethal autonomous weapons systems (LAWS). A central issue in these discussions is the assignment of moral responsibility for some AI-based outcomes. Several authors claim that the high autonomous capability of such systems leads to a so-called “responsibility gap.” In recent years, there has been a surge in philosophical literature (...) around the concept of responsibility gaps and different solutions have been devised to close or bridge these gaps. In order to move forward in the research around LAWS and the problem of responsibility, it is important to increase our understanding of the different perspectives and discussions in this debate. This paper attempts to do so by disentangling the various arguments and providing a critical overview. After giving a brief outline of the state of the technology of LAWS, I will review the debates over responsibility gaps using three differentiators: those who believe in the existence of responsibility gaps versus those who do not, those who hold that responsibility gaps constitute a new moral problem versus those who argue they do not, and those who claim that solutions can be successful as opposed to those who believe that it is an unsolvable problem. (shrink)

Detecting contract cheating in written submissions can be difficult beyond direct plagiarism detectable via technology. Successfully identifying potential cases of contract cheating in written work such as essays and reports is largely dependent on the experience of assessors and knowledge of student. It is further dependent on their familiarity with the patterns and clues evident in sections of body text and reference materials to identify irregularities. Consequently, some knowledge of what the patterns and clues look like is required. This paper (...) documents how to identify some of the patterns and clues observed in essay and report submissions. Effective assessment design with specific contextual requirements make irregularities easier to detect and interpret. The irregularities identified were confirmed as instances of contract cheating through conversations held with postgraduate students. An essential element of the conversations was the evidence presented for discussion. Irregularities were noted on a pro-forma specifically developed for this purpose. Patterns identified include misrepresented bibliographic data, inappropriate references, irrelevant material and generalised text that did not address the assessment question or grading criteria. The validated patterns formed the basis of identifying potential instances of contract cheating in later submissions. Timely conversations with students before the end of semester are essential to determining whether the patterns and clues link to poor knowledge of academic writing conventions or classified as contract cheating necessitating the application of appropriate penalties under institutional policies and procedures. (shrink)

Despite the fact that ethics consultations are an accepted practice in most healthcare organizations, many clinical ethicists continue to feel marginalized by their institutions. They are often not paid for their time, their programs often have no budget, and institutional leaders are frequently unaware of their activities. One consequence has been their search for concrete ways to evaluate their work in order to prove the importance of their activities to their institutions through demonstrating their efficiency and effectiveness.

BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...) objective of this review was to identify and map the outcomes reported in primary studies of CEC. The secondary objective was to provide a comprehensive overview of CEC structures, processes, and roles to enhance understanding and to inform standardization.MethodsWe searched electronic databases to identify primary studies of CEC involving patients, substitute decision-makers and/or family members, clinicians, healthcare staff and leaders. Outcomes were mapped across five conceptual domains as identified a priori based on our clinical ethics experience and preliminary literature searches and revised based on our emerging interpretation of the data. These domains included personal factors, process factors, clinical factors, quality, and resource factors. ResultsForty-eight studies were included in the review. Studies were highly heterogeneous and varied considerably regarding format and process of ethical intervention, credentials of interventionist, population of study, outcomes reported, and measures employed. In addition, few studies used validated measurement tools. The top three outcome domains that studies reported on were quality, process factors, and clinical factors. The majority of studies examined multiple outcome domains. All five outcome domains were multidimensional and included a variety of subthemes.ConclusionsThis scoping review represents the initial phase of mapping the outcomes reported in primary studies of CEC and identifying gaps in the evidence. The confirmed lack of standardization represents a hindrance to the provision of high quality intervention and CEC scientific progress. Insights gained can inform the development of a core outcome set to standardize outcome measures in CEC evaluation research and enable scientifically rigorous efficacy trials of CEC. (shrink)

Hospital ethics committees have evolved as a response to complicated legal, ethical, and social dilemmas that accompany modern medicine. In the United States, their growth has been augmented by Joint Commission for the Accreditation of Healthcare Organizations standards and the Patient Self-Determination Act. There appears to be an implicit presumption that all clinical ethics consultation practices are relatively similar. Finally, there is heightened awareness of the needs for quality standards and assessment of the outcomes of ethics consultations.

Ann Whittle offers a fresh approach to questions about whether our actions are free and whether we are morally responsible for them. She argues that the answers to these questions depend on the contexts in which we make claims about our abilities and our control over our actions.

Does the sense of smell involve the perception of odor objects? General discussion of perceptual objecthood centers on three criteria: stimulus representation; perceptual constancy; and figure-ground segregation. These criteria, derived from theories of vision, have been applied to olfaction in recent philosophical debates about psychology. An inherent problem with such framing of olfactory objecthood is that philosophers explicitly ignore the constitutive factors of the sensory systems that underpin the implementation of these criteria. The biological basis of odor coding is fundamentally (...) different from the coding principles of the visual system. This article analyzes the three measures of perceptual objecthood against the biological background of the olfactory system. It contrasts the coding principles in olfaction with the visual system to show why these criteria of objecthood fail to be instantiated in odor perception. The argument demonstrates that olfaction affords perceptual categorization without the need to form odor objects. (shrink)

We are living in a time of war on multiple fronts. This is as true metaphorically as it is geographically. In particular, we live in an age in which war has been declared against disease, and war has been declared against terror. This essay considers in tandem the costs of those wars—more precisely, the costs of those metaphors of war.

Although moral distress is now a well-recognized phenomenon among all of the healthcare professions, few evidence-based strategies have been published to address it. In morally distressing situations, the “presenting problem” may be a particular patient situation, but most often signals a deeper unit- or system-centered issue. This article describes one institution’s ongoing effort to address moral distress in its providers. We discuss the development and evaluation of the Moral Distress Consultation Service, an interprofessional, unit/system-oriented approach to addressing and ameliorating moral (...) distress. (shrink)

Relatively few articles discuss the ethical issues that accompany healthcare in rural areas. This article presents and discusses the key findings obtained from multi-method research studies conducted over a 9-year period of time in a multi-state rural area. It challenges the efficacy of current models for bioethics, shows what kinds of ethical issues develop in rural communities, and offers a framework for envisioning resources and approaches that may be more appropriate.

In this paper, I explore an alternative to the Principle of Alternate Possibilities for Moral Responsibility—the Ceteris Paribus Principle of Alternative Possibilities for Moral Responsibility. I consider motivations for this principle and answer some objections to it.

The practice of reductionism in science and philosophy includes attempts to essentialize human persons, which can lead to serious social problems. Reductionism is not necessary, as comparative philosophers and alternative-thinking scientists have shown.

Education has long been charged with the taskof forming and shaping subjectivity andidentity. However, the prevailing view ofeducation as a project of producing rationalautonomous subjects has been challenged bypostmodern and poststructuralist critiques ofsubstantial subjectivity. In a similar vein,Emmanuel Levinas inverts the traditionalconception of subjectivity, claiming that weare constituted as subjects only in respondingto the other. In other words, subjectivity isderivative of an existentially priorresponsibility to and for the other. Hisconception of ethical responsibility is thusalso a radical departure from the prevailingview (...) of what it means to be a responsible moralagent. In this paper, I use jazz improvisationas a metaphor to focus on three interrelatedaspects of ethical responsibility on Levinas'saccount: passivity, heteronomy, andinescapability. I then point toward some waysin which reframing responsibility andsubjectivity along this line might offer newpossibilities for conceiving subjectivity andmoral agency in education. (shrink)

This paper examines the three US national security strategies released by Presidents George W. Bush and Barack Obama since 9/11. These national security strategies are required presidential statements describing US plans for national security. The authors analyze Bush’s two and Obama’s one post-9/11 national security strategies and evaluate the argumentative framework of imperial righteousness in the documents. The rhetoric of American imperial righteousness contains four themes: national security, the nature of the enemy, freedom and democracy, and American morality. While there (...) are some differences between the documents, the authors argue that Bush and Obama both promoted the idea of imperial righteousness in their plans for American national security. Moreover, the four themes of imperial righteousness worked together effectively to advance America’s interests in world affairs. (shrink)

While there is an extensive subfield in sociology studying the sources, content, and consequences of collective memory, the study of future projections has been much more fragmentary. In part, this has to do with the challenge of measurement; how do you measure something that has not happened yet? In this article, I argue that future projections can be studied via their externalizations in attitudes, narratives, performance, and material forms. They are particularly evident in what I call “sites of hyperprojectivity,” that (...) is, sites of heightened, future-oriented public debate about possible futures. As a pilot project, I examine contending narratives about possible futures in the online documents of the United Nations Conference on Sustainable Development and the accompanying “People’s Summit,” held in Rio de Janeiro in June 2012. I propose a framework for studying how public interventions into debates about “sustainable futures” and the “green economy” differ on various dimensions of projectivity, including their temporal reach, attention to contingency and causality, and network mapping of future actors. I present a preliminary analysis at the level of narrative and grammar, by analyzing the use of predictive, imperative, and subjunctive verb forms in both programmatic and oppositional texts. I close with a discussion of how different genres of future projection might be put to analytical use in studying processes of interest to social scientists, such as coalition formation, institution building, political mobilization, and policy change. (shrink)

Abstract.Telling the tale about South Dakota's recent legislative ban on nearly all abortions gets messy, complicated, and dirty. There are no innocent subjects and no simple plot lines. The story reveals other stories underneath and over the top of the others. Stories counter stories, revealing who is in the know and who does the telling. To “tell the old, old story,” as the song goes, is not as simple as it may seem. Religion and medical science are caught in the (...) politics and cultural wars about abortion. (shrink)

The aim of this article is to add to the research surrounding nurses' work in hospitals. Throughout history, nurses have faced adverse working conditions, an aspect of their work that remains remarkably unchanged today. Prevailing historical ideologies and sociopolitical conditions influences the context of nurses' work in contemporary hospitals. This research revealed how ruling patriarchal power and nurses' altruistic ways normalize the conditions in hospitals as nurses' work. Moving discourses further add to the work of nurses in hospitals. For example, (...) cost containment strategies, overcapacity and short staffing have resulted in practices to accommodate these problems. While contemporary hospitals may look different, clearly, inside, little has changed since the early days; hospital issues have clearly become an ordinary part of nurses' work. This article discusses how the conditions in hospitals have become an ordinary part of nurses' work. The research in this article emphasizes how prevailing ideologies and institutional discourses make invisible and taken‐for‐granted, how this normalizing of nurses' work contributes to sustaining the hospital's power. (shrink)

The demand for science trainees to have appropriate responsible conduct of research instruction continues to increase the attention shown by federal agencies and graduate school programs to the development of effective ethics curriculums. However, it is important to consider that the main learning environment for science graduate students and post-doctoral research fellows is within a laboratory setting. Here we discuss an internal laboratory program of weekly 15-minute ethics discussions implemented and used over the last 3 years in addition to the (...) graduate school’s program of scientific integrity training. During this time, the environment and culture within our laboratory has changed to place greater emphasis on the ethical implications of our own research and the research we evaluate. We still struggle with how to accurately assess this behavioral change; although, we present preliminary survey results on the evaluation and impact of this style of curriculum for ethics instruction in our laboratory. (shrink)

This second edition of _Women, Knowledge, and Reality_ continues to exhibit the ways in which feminist philosophers enrich and challenge philosophy. Essays by twenty-five feminist philosophers, seventeen of them new to the second edition, address fundamental issues in philosophical and feminist methods, metaphysics, epistemology, and the philosophies of science, language, religion and mind/body. This second edition expands the perspectives of women of color, of postmodernism and French feminism, and focuses on the most recent controversies in feminist theory and philosophy. The (...) chapters are organized by traditional fields of philosophy, and include introductions which contrast the ideas of feminist thinkers with traditional philosophers. The collected essays illustrate both the depth and breadth of feminist critiques and the range of contemporary feminist theoretical perspectives. (shrink)

Table of Contents: Illustrations Acknowledgments Conventions Introduction 3 Ch. 1 Kinds of Natural Philosophy 14 Ch. 2 Methods of Bookishness 49 Ch. 3 Modes of Argument 82 Ch. 4 Bodin’s Philosophy of Nature 116 Ch. 5 Theatrical Metaphors 153 Ch. 6 The Reception of the Theatrum 180 Epilogue: The Legacies of the Theatrum 225 Notes 233 Bibliography 331 Index 369.

Stress in health care is affected by moral factors. When people are prevented from doing ‘good’ they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations (...) and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach’s alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: ‘internal demands’ and ‘external demands and restrictions’. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts. (shrink)

Recent UK reports have revealed extensive evidence of unethical care practices. Older and vulnerable patients in some British health services have experienced appalling and avoidable suffering. Explanations for, and solutions to, these care failures have been proposed with wide-ranging recommendations. Many of these have direct implications for clinical ethics with additional frameworks for ethical values proposed, a heightened awareness of the moral culture of organisations acknowledged and a renewed interest in the ethics component of professional education debated. In this paper, (...) I suggest that we integrate insights from the slow movement into clinical ethics practice. Distinctions are made between fast and slow healthcare practice and between fast and slow ethics. I argue that, whilst there is a place for both, slow ethics enables us to assume a more positive stance in relation to ‘crisis’, and requires that we learn from past accounts and scholarship and consider the role of clinical ethics in sustaining caring cultures. (shrink)

Examines how violence has been conceptually and rhetorically put to use in continental social theory.

This chapter argues that violence is and has always been a crucial component in the origin and maintenance of oppression. It explores how violence and the threat of violence constrain the actions of groups, harming the victims and benefiting the correlative privileged social groups. It argues that women as a group are oppressed materially through violence, and that there is a credible, psychologically effective threat of greater harm that is transmitted by the obvious material harm that they do suffer.

Objectification is a foundational concept in feminist theory, used to analyze such disparate social phenomena as sex work, representation of women's bodies, and sexual harassment. However, there has been an increasing trend among scholars of rejecting and re-evaluating the philosophical assumptions which underpin it. In this work, Cahill suggests an abandonment of the notion of objectification, on the basis of its dependence on a Kantian ideal of personhood. Such an ideal fails to recognize sufficiently the role the body plays in (...) personhood, and thus results in an implicit vilification of the body and sexuality. The problem with the phenomena associated with objectification is not that they render women objects, and therefore not-persons, but rather that they construct feminine subjectivity and sexuality as wholly derivative of masculine subjectivity and sexuality. Women, in other words, are not objectified as much as they are derivatized, turned into a mere reflection or projection of the other. Cahill argues for an ethics of materiality based upon a recognition of difference, thus working toward an ethics of sexuality that is decidedly ­and simultaneously ­incarnate and intersubjective. (shrink)

Three female physicians were interviewed as part of a comprehensive investigation into the narratives of female and male physicians and nurses, concerning their experience of being in ethically difficult care situations in the care of elderly people. The interviewees expressed great concern for the low status of care for elderly people, and the need to fight for the specialty and for the care and rights of their patients. All the interviewees’ narratives concerned problems relating to perspectives of both action ethics (...) and relational ethics. The main focus was on problems concerning the latter perspective, expressed as profound concern and respect for the individual patient. Secondary emphasis was placed on relationships with relatives and other professionals. The most common themes in an action ethics perspective were too little treatment and the lack of health services for older patients, together with overtreatment and death with dignity. These results were discussed in the light of Løgstrup’s ethics, which emphasize that human life means expressing oneself, in the expectation of being met by others. Both Ricoeur’s concept of an ethics of memory and Aristotle’s virtue ethics are presented in the discussion of too little and too much treatment. (shrink)

A few weeks ago, a rural hospital administrator phoned with a question posed by his management team. “If you were going to give us some ethics resources,” he queried, “just exactly what would they...

A decade ago, conventional wisdom in the medical establishment was that physicians treating chronic pain with opioid analgesics were at a substantial risk of being sanctioned for overprescribing by state medical regulatory boards. Dozens of articles written since have alluded to this risk as an obstacle to effective pain re1ief. In the early 1990s, a number of high profile cases in which physicians were disciplined by regulatory boards for overprescribing to patients with chronic pain were reported in the press. Although (...) the board actions in many of these cases were eventually overturned by state judiciaries, the publicity heightened practitioners’. sensitivity to the regulatory risks associated with prescribing opioids.A review of the available data on state medical board actions nationwide for the period from 1990 to 1996 reveals that the perception of regulatory risk far exceeds the reality. Indeed, relatively few of the disciplinary actions taken for overprescribing by state medical boards in any given year directly concern the treatment of chronic pain—malignant or nonmalignant—in patients. (shrink)

Since the publication of Carol Gilligan's In a different voice in 1982, there has been much discussion about masculine and feminine approaches to ethics. It has been suggested that an ethics of care, or a feminine ethics, is more appropriate for nursing practice, which contrasts with the 'traditional, masculine' ethics of medicine. It has been suggested that Nel Noddings' version of an 'ethics of care' (or feminine ethics) is an appropriate model for nursing ethics. The 'four principles' approach has become (...) a popular model for medical or health care ethics. It will be suggested in this article that, whilst Noddings presents an interesting analysis of caring and the caring relationship, this has limitations. Rather than acting as an alternative to the 'four principles' approach, the latter is necessary to provide a framework to structure thinking and decision-making in health care. Further, it will be suggested that ethical separatism (that is, one ethics for nurses and one for doctors) in health care is not a progressive step for nurses or doctors. Three recommendations are made: that we promote a health care ethics that incorporates what is valuable in a 'traditional, masculine ethics', the why (four principles approach) and an 'ethics of care', the 'how' (aspects of Noddings' work and that of Urban Walker); that we encourage nurses and doctors to participate in the 'shared learning' and discussion of ethics; and that our ethical language and concerns are common to all, not split into unhelpful dichotomies. (shrink)

This collection presents stimulating and diverse essays by scholars from several different fields; the contributors have made important contributions to the ...

My aim … is to show that the celestial machine is likened not to a kind of divine living being but rather to a clockwork. I consider the human body to be a machine … Although it may exaggerate to say that Descartes fathered the mechanization of biology, it is true that his Treatise of Man provided the first systematic development of the idea that a complete understanding of all the phenomena of life, including all abilities and behaviour of animals, (...) can be achieved by viewing living things as machines. To make this out, Decartes had to learn to think about living things in a new way. My first aim here is to identify the fundamental conceptual innovations at work in Descartes’ attempt to extend the new mechanics to include biology. My second aim is to locate the point at which Descartes’ mechanical imagination runs out. This requires study of Descartes’ scientific work on sense. (shrink)