Contexte : Dans les systèmes de santé universitaires complexes, les projets d’amélioration de la qualité (AQ) destinés à améliorer les soins et l’apprentissage prolifèrent, mais il existe des différences considérables quant à la manière dont ces projets sont supervisés sur le plan éthique, voire même s’ils le sont. À la suite d’un volume élevé de projets soumis à l’un de nos comités d’éthique de la recherche (CER), mais considérés comme n’étant pas de la recherche et donc non éligibles à un (...) examen, des questions ont commencé à se poser au sein de notre organisation sur la manière dont les dimensions éthiques des projets d’AQ pourraient être évaluées et sur les approbations institutionnelles qui pourraient être nécessaires pour garantir la conformité avec les normes émergentes. Méthodes : Une enquête environnementale à méthodes mixtes a conduit à une analyse quantitative rétrospective des projets d’AQ de notre organisation, associée à des consultations qualitatives approfondies avec le personnel, les médecins et les apprenants de l’ensemble de notre réseau de santé. Les exemptions de CER ont été analysées à l’aide de diagrammes d’exécution afin d’évaluer les volumes de base des projets d’AQ, et des analyses thématiques ont été menées sur les notes de terrain de 133 consultations avec les parties prenantes. Résultats : Au cours d’une période de 34 mois, 117 lettres d’exemption du CER ont été émises pour des projets d’AQ. Les consultations ont mis en évidence la nécessité d’un processus d’évaluation éthique clairement défini pour les projets d’AQ, de structures de gouvernance appropriées et de possibilités d’identifier et d’atténuer les risques. Les personnes interrogées ont également évoqué l’impératif éthique de mener des initiatives d’AQ. Le présent document explique comment ces thèmes ont contribué à l’élaboration et à la mise en place de notre comité d’examen de l’amélioration de la qualité (CEAQ). Conclusion : Depuis 2020, plus de 840 projets ont été examinés par notre CEAQ, dans le but d’atténuer les risques pour les patients, le personnel et les équipes de projet d’AQ dans l’ensemble de l’UHN. (shrink)

The influence of historiography on aspects of political thought in France, Italy and Germany. In recent years the overlap between political thought and historiography has changed the boundaries of intellectual history. Donald Kelley, the longtime editor of The Journal of the History of Ideas has played a leading part in this process. These essays by his friends and former students follow in his footsteps. The collection is divided into three parts: France, England [six essays], and Italy and Germany [four essays]. (...) Anthony Grafton and John Salmon provide an introduction, and the volume concludes with a bibliography of Donald Kelley's many works. Historians and Ideologues is designed for those with an interest in the contribution of historiography to political thought, and will be a timely addition to the growing reaction against the postmodern scepticism in historiographical research in this field. Contributors include Ann Blair, Julian Franklin, Kathleen Parrow, David Harris Sacks, Sarah Hanley, Daniel Woolf, Gordon Schochet, Joseph Levine, John Pocock, Perez Zagorin, William Connell, Donald Phillip Verene, and Michael Carhart. Anthony Grafton is a Professor in the Department of History at Princeton University. John Salmon is the Marjorie Walter Goodheart Emeritus Professor of History at Bryn Mawr College. (shrink)

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)

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.

Philosophical discussion about the reality of sensory perceptions has been hijacked by two tendencies. First, talk about perception has been largely centered on vision. Second, the realism question is traditionally approached by attaching objects or material structures to matching contents of sensory perceptions. These tendencies have resulted in an argumentative impasse between realists and anti-realists, discussing the reliability of means by which the supposed causal information transfer from object to perceiver takes place. Concerning the nature of sensory experiences and their (...) capacity to provide access to reality, this article challenges the standard categories through which most arguments in this debate have been framed to date. Drawing on the underexplored case of olfaction, I first show how the details of the perception process determine the modalities of sensory experiences. I specifically examine the role of measurement and analyze its influence on the characterization of perceptions in olfaction. My aim is to argue for an understanding of perception through a process view, rather than one pertaining to objects and properties of objects. (shrink)

It is argued that dignity can be considered both subjectively, taking into account individual differences and idiosyncrasies, and objectively, as the foundation of human rights. Dignity can and should also be explored as both an other-regarding and a self-regarding value: respect for the dignity of others and respect for one’s own personal and professional dignity. These two values appear to be inextricably linked. Aristotle’s doctrine of the mean enables nurses to reflect on the appropriate degree of respect for the dignity (...) of others and of respect for themselves. To develop an understanding of the rationale for and the significance and implications of dignity in health care practice, a view of human nature is proposed that implies vulnerability and fallibility, and that urges that an ethic of aspiration is embraced. Anonymized vignettes are included to illustrate points about the everyday nature of dignity. (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)

In this article I will revisit the question of what I term the continuum of heteronormative sexual interactions, that is, the idea that purportedly ethically acceptable heterosexual interactions are conceptually, ethically, and politically associated with instances of sexual violence. Spurred by recent work by psychologist Nicola , I conclude that some of my earlier critiques of Catharine MacKinnon's theoretical linkages between sexual violence and normative heterosex are wanting. In addition, neither MacKinnon's theory nor my critique of it seem up to (...) the task of providing an ethical account of the examples of “unjust sex” that Gavey has described. I come to the conclusion that an ethical analysis of sexual interactions requires a focus on sexual desire, but that desire cannot take on the by now heavily criticized role of consent. Rather than looking for the presence or absence of sexual desire prior to sexual encounters as a kind of ethical certification of them, we ought instead to focus on the efficacy of that sexual desire, that is, its ability (or lack thereof) to shape an encounter in substantial and meaningful ways. (shrink)

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)

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.

The notion of virtue in general, and courage in particular, has had a hard time integrating itself into the everyday lexicon of bioethics. Following the lead of enlightenment moral philosophy, which concentrates on the theory of right action as opposed to the ancient Greeks' emphasis on the development of good character, bioethics, with some notable exceptions, has tended to relegate consideration of the virtues to the sidelines of moral argument. Recently, however, there have been calls for the necessity of “moral (...) courage” in the context of clinical ethics. As nurses, physicians, and other health care professionals confront a variety of moral contexts in which the virtue of courage is invoked to "do the right thing," stand up for patients' rights, and uphold the ethical standards of their professions, they are increasingly reminded of their moral duty to exhibit courage in the face of institutional obstacles to the proper care of their patients. For example, a nurse's hesitation to approach a physician to request increased sedation for an agitated patient out of fear of retaliation is represented in one article as a lack of courage.In this paper we offer a critical assessment of such invocations of courage. While we find courage to be an indispensable virtue in some challenging contexts, in other settings we find invocations of courage to be both an unfortunate endorsement of an oppressive status quo that can divert attention from the real problems and an undesirable and potentially destructive strategy within health care institutions whose goal is medically excellent and morally good clinical practice. As we shall argue, a call to virtuousness is not always virtuous. (shrink)

What if depression, in the Americas at least, could be traced to histories of colonialism, genocide, slavery, exclusion, and everyday segregation and isolation that haunt all of our lives, rather than to biochemical imbalances? This article seeks alternatives to the medical model found in most depression memoirs by considering how the epistemological and methodological struggles faced by a scholar of the African diaspora confronted by the absent archive of slavery are relevant to discussions of political depression. Combining scholarly investigation and (...) personal memoir, Saidiya Hartman’s Lose Your Mother exemplifies feminism’s affective turn not only by bringing personal narrative into scholarship, but by seeking reparation for the past in the affective dynamics of cultural memory rather than in legal reform or state recognition. Stubbornly refusing to find solace in an African past before slavery, though, Hartman provides a model of emotional reparation in which feelings of loss and alienation persist. Her work suggests the relevance of political depression to both the ordinary life of racism and to what gets called clinical depression. (shrink)

The history of note?taking has only begun to be written. On the one hand, the basic functions of selecting, summarizing, storing and sorting information garnered from reading, listening, observing and thinking can be identified in most literate contexts in some form or other. On the other hand, Renaissance humanists emphasized with unprecedented success the virtues of stockpiling notes on large scales and for the long term, thanks to the availability of paper and a new abundance of books, but also to (...) their ability to transmit their own keen motivation to avoid any future loss of learning. We continue to share many early modern ideals for insuring the collection and retrievability of information and have built on early modern practices that facilitate the accumulation and the organization of information, including collaborative work and the use of rearrangeable slips. (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)

Background: Intensive care unit nurses are providing care to COVID-19 patients in a stressful environment. Understanding intensive care unit nurses’ sources of distress is important when planning interventions to support them. Purpose: To describe Canadian intensive care unit nurse experiences providing care to COVID-19 patients during the second wave of the pandemic. Design: Qualitative descriptive component within a larger mixed-methods study. Participants and research context: Participants were invited to write down their experiences of a critical incident, which distressed them when (...) providing nursing care. Thematic analysis was used to analyze the data. Ethical considerations: The study was approved by the ethics committee at the researchers’ university in eastern Canada. Results: A total of 111 critical incidents were written by 108 nurses. Four themes were found: (1) managing the pandemic, (2) witness to families’ grief, (3) our safety, and (4) futility of care. Many nurses’ stories also focused on the organizational preparedness of their institutions and concerns over their own safety. Discussion: Nurses experienced moral distress in relation to family and patient issues. Situations related to insufficient institutional support, patient, and family traumas, as well as safety issues have left nurses deeply distressed. Conclusion: Identifying situations that distress intensive care unit nurses can lead to targeted interventions mitigating their negative consequences by providing a safe work environment and improving nurses’ well-being. (shrink)

Background: The foundation of all nursing practice is respect for human rights, ethical value and human dignity. In perioperative practice, challenging situations appear quickly and operating theatre nurses must be able to make different ethical judgements. Sometimes they must choose against their own professional principles, and this creates ethical conflicts in themselves. Objectives: This study describes operating theatre nurses’ experiences of ethical value conflicts in perioperative practice. Research design: Qualitative design, narratives from 15 operating theatre nurses and hermeneutic text interpretation. (...) Ethical consideration: The study followed ethical principles in accordance with the Helsinki Declaration and approval was granted by the local university ethics committee. Findings: The result showed that value conflicts arose in perioperative practice when operating theatre nurses were prevented from being present in the perioperative nursing process, because of current habits in perioperative practice. The patient’s care became uncaring when health professionals did not see and listen to each other and when collaboration in the surgical team was not available for the patient’s best. This occurred when operating theatre nurses’ competence was not taken seriously and was ignored in patient care. Conclusion: Value conflicts arose when operating theatre nurses experienced that continuity of patient care was lacking. They experienced compassion with the patient but still had the will and ability to be there and take responsibility for the patient. This led to feelings of despair, powerlessness and of having a bad conscience which could lead to dissatisfaction, and even resignations. (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)

Respect is much referred to in professional codes, in health policy documents and in everyday conversation. What respect means and what it requires in everyday contemporary nursing practice is less than clear. Prescriptions in professional codes are insufficient, given the complexity and ambiguity of everyday nursing practice. This article explores the meaning and requirements of respect in relation to nursing practice. Fundamentally, respect is concerned with value: where ethical value or worth is present, respect is indicated. Raz has argued that (...) the two ways of encountering value are to respect and to engage with it. The former requires acknowledgement and preservation. Respect in nursing practice necessarily requires also engagement. Respect is an active value and can be conceptualized within the context of virtue ethics as a hybrid virtue having both intellectual and ethical components. Examples from the literature are provided to illustrate situations where the respectful nurse requires these components or capabilities. (shrink)

This article discusses explanatory theories of normative concepts and argues for a set of criteria of adequacy by which such theories may be evaluated. The criteria offered fall into four categories: ontological, theoretical, pragmatic, and moral. After defending the criteria and discussing their relative weighting, this article uses them to prune the set of available explanatory theories of oppression. Functionalist theories, including Hegelian recognition theory and Foucauldian social theory, are rejected, as are psychoanalytic theory and social dominance theory. Finally, the (...) article defends structural rational choice theory as the most promising methodology for explaining oppression. Key Words: oppression • explanation • rational choice theory. (shrink)

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.

In 2012, chief nursing officers (CNO) in England published a policy on compassion in response to serious criticisms of patients’ care. Because their objective is fundamentally to shape nursing, this study argues, following Popper, that the policy should be analysed. An appraisal tool, developed from Popper, Gadamer, Jauss and Thiselton, is the framework for this analysis. The CNO policy document identified six values and behaviours, termed ‘6Cs’, required by all nurses, midwives and care staff. The document contains no data, references (...) or acknowledgements, but is similar to the 6Cs defined by the Canadian nursing nun, Sister M. Simone Roach, in her theory of caring published 30 years earlier. Roach considered caring and the components of it, including compassion, to be moral virtues, an inner motivation to care. This study suggests that without explicit reference to Roach's ideas, and her underlying theoretical base, the CNO requirement has the effect of turning virtues into commodities and a form of external control, described by Ritzer as a McDonaldized dehumanization. This study, which has international relevance beyond England and the UK, suggests that the CNO revise their policy by acknowledging Roach's 6Cs and openly discuss the implications of her work for their policy. (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)

Literature on caring for those with advanced Parkinsonian dementia often urges caregivers to refrain from arguing with, or contesting, their hallucinatory landscape. The clinical advice tends to be to go with the flow and “play along.” It is the above prescription that I aim to trouble here, on phenomenological grounds. With reference to Maurice Merleau-Ponty’s idea of the perceptual faith, I explore that idea that caregiving often requires the relaxation or expansion of the perceptual faith, not for the purposes of (...) “playing along” so much as being-with. At the intersection of the ethics of care and phenomenology, and in reference to my experience caregiving for my mother, this paper explores the ethics of caregiving for those with dementia. (shrink)

In this first part, Matthew Lipman offers the reader a glimpse at the thought processes that resulted in Philosophy for Children and, in so doing, ...

At the UN, important projects laying down transnational corporations' (TNCs) human rights responsibilities have been launched without ever clarifying the relevant theoretical foundations. One of the consequences is that the human rights principles in projects like the 2000 UN Global Compact and the 2003 Norms on the Responsibilities of Transnational Corporations and Other Business Enterprises with Regard to Human Rights can be understood in different ways, which should not cause surprise given that their authors come from diverse backgrounds, including economics (...) and public policy. An examination of these projects and the views of their authors reveals that, although they are superficially linked to international human rights law, they go well beyond it and attempt to deal with corporate social responsibility issues in ways that elude neat classification as fitting neatly in either legal or non-legal categories. Too little attention has been paid to how in the course of developing these projects the legal and ethical dimensions have become entwined and how lines have gotten blurred. Meanwhile, there has been recognition that these UN projects have emerged simply as ad hoc responses to practical concerns about the sustainability of globalization. The lack of any foundational theory or normative framework should be addressed; it is time to bring together specialists from different fields concerned with the human rights responsibilities of corporations to see if it is possible to define a coherent overarching theory for these UN projects. (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.

Male-dominated and sex segregated elite professional and amateur sport1 in North America constitutes a "sport nexus" (Burstyn, 1999; Heywood & Dworkin, 2003) that combines economic and cultural influence to reinforce and perpetuate gender injustice. The sport nexus is an androcentric sex-segregated commercially powerful set of institutions that is highly visible and at the same time almost completely taken for granted to the extent that its anti-democratic impetus goes virtually unnoticed. The sport nexus’s hegemonic role in defining sporting norms (Coakley & (...) Donnelly, 2004) means that its role in shaping lower level amateur and recreational sporting institutions and cultures is highly significant. Fraser (2007) defines gender justice, and hence democracy, in terms of "participatory parity," that is, material and cultural equality for women. The sport nexus itself is characterized by highly gendered occupational segregation (Coventry, 2004). It further contributes to gender injustice, homophobia and transphobia by promoting the ideology of the two sex system (Fausto-Sterling, 2000) and gendering citizenship as fundamentally male (Burstyn, 1999). Feminist strategies for sport reformation attempt to reduce or eradicate the role of the sport nexus in legitimating and perpetuating gender injustice. In this article I consider the potential of these strategies and conclude with a set of recommendations for transforming organized sport at both elite and recreational levels. (shrink)

This collection challenges the traditional divide between the investigation of ethics is a private concern and politics as a public, group concern.

Agrifood scholars commonly adopt “a matter of fact way of speaking” to talk about the extent of neoliberal rollout in the food sector and the viability of “alternatives” to capitalist food initiatives. Over the past few decades this matter of fact stance has resulted in heated debate in agrifood scholarship on two distinct battlegrounds namely, the corporate food regime and the alternative food regime. In this paper I identify some of the limitations of speaking in a matter of fact way (...) and of focusing on capitalist and neoliberal economies as the yardstick by which to assess all food economy initiatives. Using stories of bananas in Australia and the Philippines I advocate for a new mode of critical inquiry in food scholarship that focuses on matters of concern. Following Bruno Latour I use the term critical inquiry to refer to research methods and thinking practices that multiply possible ways of being and acting in the world. The new mode of critical inquiry I propose centers on enacting three broad research matters of concern. These are gathering and assembling economic diversity human actancy and nonhuman actancy. I argue that through becoming critical minds in the Latourian sense researchers can play a key role in enacting economic food futures in the Anthropocene. (shrink)

This paper investigates an aspect of the question of whether capitalism can be defended as a morally legitimate economic system by asking whether capitalism serves progressive, feminist ends of freedom and gender equality. I argue that although capitalism is subject to critique for increasing economic inequality, it can be seen to decrease gender inequality, particularly in traditional societies. Capitalism brings technological and social innovations that are good for women, and disrupts traditions that subordinate women in materially beneficial and socially progressive (...) ways. Capitalism upholds the ideology of individual rights and the ideal of mutual advantage. By institutionalizing mutual advantage through the logic of voluntary exchange, progressive capitalism promotes the idea that no one is to be expected to sacrifice their interests with no expectation of benefit. Thus capitalism opposes the traditional, sexist ideal of womanly self-sacrifice. (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.

Clinical research is increasingly conducted in settings that include private physicians’ offices, clinics, community hospitals, local institutes, and independent research centers. The migration of such research into this new, non–academic environment has brought new cadres of researchers into the clinical research enterprise and also broadened the pool of potential research participants. Regulatory approaches for protecting human subjects who participate in research have also evolved. Some institutions retain their own Institutional Review Boards (IRBs), but Independent IRBs, community hospital IRBs and community–based (...) IRBs also fulfill oversight responsibilities. This article sheds light on this evolving world by discussing the findings gleaned from two studies: a study of the decision making processes used by members who serve on different kinds of IRBs and a study of the decision making processes employed by research participants. The article then discusses how the key findings may inform proposed revisions to the Common Rule. (shrink)

The title question becomes a rabbit-hole through which we tumble in search of an answer, encountering everyone from Herodotus to Humphrey Bogart along the way. Is History Fiction? is an invaluable guide on how to weld creative thinking and sound research into meaningful history, and how to understand the different arguments that have abounded throughout time regarding the nature of history. More than a book of theory about theory, this innovative work is an asset to the undergraduate classroom and the (...) research seminar alike. Is History Fiction? will be a welcome aid for teaching historical writing and examining an age-old question. Is History Fiction? is a must-read for undergraduate and graduate students and scholars from the humanities and social sciences, or anyone grappling with the enduring issues that have shaped the theory and practice of recording history. (shrink)

Perfumes embody a chemical record of style and technology. Blurring the boundary between what counts as natural and artificial in both a material and a perceptual sense, perfumery presents us with a domain of multiple disciplinary identities relevant to social studies: art, craft, and techno‐science. Despite its profound impact as a cultural practice, perfume has seldom featured in historical scholarship. The reason for this neglect is its inherently qualitative dimension: perfume cannot be understood via codified representation but requires direct acquaintance (...) with its sensory and material basis. The historical study of perfumery thus necessitates an experimental approach that comes not without challenge. This article looks at contemporary recreations of old perfumes to identify the difficulties involved in the experimental recreation of fragrances as sensory and performative artifacts. We highlight the need for a reconceptualization of methodology for inconcrete objects of study as part of the broader interest in experimental approaches to the humanities. (shrink)

The notion of representation figures centrally both in Descartes’ scientific theorizing about sense in humans and in his conceptual speculations about the nature of human cognition.Descartes’ philosophical innovation in the Dioptrics is the claim that sensing in humans is a kind of representing rather than a kind of resembling. This provides the cornerstone for his attack on traditional theories of sense, and it underwrites his own position that sensing is a kind of thinking, ascribable to the rational soul rather than (...) to any Aristotelean sensitive soul. (shrink)

Feminist analysis of cultural mythology surrounding organ donation offers a critical perspective on current U.S. transplant policy. My argument is three-pronged. First, I argue that organ donation is appropriately understood as a sacrifice. Structurally, donation accords both to general and to specifically Christian archetypes of sacrifice. The characterization of donation as sacrifice resonates in the cultural psyche even though it is absent in public rhetoric. Second, I characterize widespread feminist concerns about the over-glorification of sacrifice. These concerns provide a helpful (...) framework for considering whether the sacrifice of organ donation is over-glorified in our culture. Third, I consider several specific aspects of organ recruitment and organ allocation. Each demonstrates an over-glorification of sacrifice that leads to a dangerous "routinization" of sacrifice. None of these excesses are addressable without due attention to the symbolic import of organ donation and transplantation. I close by suggesting lessons my analysis offers to Christian churches who support donation, to the discourse of bioethics, and to the general public. (shrink)