Evidence shows that changes in the architecture, design, and decor of health care facilities can improve patient care and in the long run reduce expenses. These essays detail the state of the research, look inside two hospitals that put some of these innovations into practice, and consider how design fits into the moral mission ofhealth care.

This commentary identifies a range of flaws and contradictions in Parker’s critical realist position and his critique of relativism. In particular we highlight: (1) a range of basic errors in formulating the nature of relativism; (2) contradictions in the understanding and use of rhetoric; (3) problematic recruitment of the oppressed to support his argument; (4) tensions arising from the distinction between working in and against psychology. We conclude that critical realism is used to avoid doing empirical work, on the (...) one hand, and to avoid scholarly interdisciplinary engagement, on the other. (shrink)

This paper comments on some of the different senses of the notion of discourse in the various relevant literatures and then overviews the basic features of a coherent discourse analytic programme in Psychology. Parker's approach is criticised for (a) its tendency to reify discourses as objects; (b) its undeveloped notion of analytic practice; (c) its vulnerability to common sense assumptions. It ends by exploring the virtues of 'interpretative repertoires' over 'discourses' as an analytic/theoretical notion.

An introduction to Derrida's contribution to literary studies, comprising much of Derrida's work on writers such as Shakespeare, Mallarme, Joyce and Kafka, with an introductory essay on deconstruction.

Julian Savulescu argues for two principles of reproductive ethics: reproductive autonomy and procreative beneficence, where the principle of procreative beneficence is conceptualised in terms of a duty to have the child, of the possible children that could be had, who will have the best opportunity of the best life. Were it to be accepted, this principle would have significant implications for the ethics of reproductive choice and, in particular, for the use of prenatal testing and other reproductive technologies for the (...) avoidance of disability, and for enhancement. In this paper, it is argued that this principle should be rejected, and it is concluded that while potential parents do have important obligations in relation to the foreseeable lives of their future children, these obligations are not best captured in terms of a duty to have the child with the best opportunity of the best life. (shrink)

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)

Clinical geneticists are increasingly confronted with ethical tensions between their responsibilities to individual patients and to other family members. This paper considers the ethical implications of a “familial” conception of the clinical genetics role. It argues that dogmatic adherence to either the familial or to the individualistic conception of clinical genetics has the potential to lead to significant harms and to fail to take important obligations seriously.Geneticists are likely to continue to be required to make moral judgments in the resolution (...) of such tensions and may find it useful to have access to ethics training and support. (shrink)

Unlike some other reproductions of classic texts (1) We have not used OCR(Optical Character Recognition), as this leads to bad quality books with introduced typos. (2) In books where there are images such as portraits, maps, sketches etc We have endeavoured to keep the quality of these images, so they represent accurately the original artefact. Although occasionally there may be certain imperfections with these old texts, we feel they deserve to be made available for future generations to enjoy.

Default positions, predetermined starting points that aid in complex decision-making, are common in clinical medicine. In this article, we identify and critically examine common default positions in clinical ethics practice. Whether default positions ought to be held is an important normative question, but here we are primarily interested in the descriptive, rather than normative, properties of default positions. We argue that default positions in clinical ethics function to protect and promote important values in medicine—respect for persons, utility, and justice. Further, (...) default positions in clinical ethics may also guard against harm. Where default positions exist, there are epistemic burdens to overturn them. The person wishing to reject the default position, rather than the person endorsing it, bears this burden. The person who bears the burden of meeting the epistemic requirements must provide evidence proportional to the degree of harm the default position protects against. Default positions that protect against significant harm impose significant epistemic requirements to overturn. This asymmetry not only makes medical decision-making more economical but also serves to promote and protect certain values. The identification and analysis of common and recognizable default positions can help to identify other default positions and the conditions under which their associated epistemic requirements are met. The article concludes with considerations of potential problems with the use of default positions in clinical ethics. (shrink)

To increasing numbers of people, sustainability is the key challenge of the twenty-first century. In the many fields where it is a goal, persistent problems obstruct the efforts of those trying to make a difference. The task of this book is to provide an overview of the current state of philosophy in the context of what philosophy is, could be or should be – in relation to sustainability and the human future on Earth. The book is conceived as a contribution (...) to the UN Decade of Education for Sustainable Development, helping to link work on philosophy and sustainability. Critiquing Sustainability, Changing Philosophy focusses on the importance of philosophical work to the formation and effectiveness of global civil society and social movements for sustainability in the context of the Anthropocene age of the Earth. It takes a transdisciplinary systems approach that challenges philosophy and concludes by proposing a greatly enhanced role for philosophy in contributing to global public reason for sustainability. This book will be of interest to philosophers, sustainability practitioners and thinkers, policy makers and all those engaged in the global movement for sustainability. (shrink)

There is a need for all industries, including healthcare, to reduce their greenhouse gas emissions. In anaesthetic practice, this not only requires a reduction in resource use and waste, but also a shift away from inhaled anaesthetic gases and towards alternatives with a lower carbon footprint. As inhalational anaesthesia produces greenhouse gas emissions at the point of use, achieving sustainable anaesthetic practice involves individual practitioner behaviour change. However, changing the practice of healthcare professionals raises potential ethical issues. The purpose of (...) this paper is twofold. First, we discuss what moral duties anaesthetic practitioners have when it comes to practices that impact the environment. We argue that behaviour change among practitioners to align with certain moral responsibilities must be supplemented with an account of institutional duties to support this. In other words, we argue that institutions and those in power have second-order responsibilities to ensure that practitioners can fulfil their first-order responsibilities to practice more sustainably. The second goal of the paper is to consider not just the nature of second-order responsibilities but the content. We assess four different ways that second-order responsibilities might be fulfilled within healthcare systems: removing certain anaesthetic agents, seeking consensus, education and methods from behavioural economics. We argue that, while each of these are a necessary part of the picture, some interventions like nudges have considerable advantages. (shrink)

Yugoslavia-to Slovenia -- Enlightenment-with Hegel -- Psychoanalysis-from Lacan -- Politics-repeating Marx -- Culture-acting out.

Is it possible for postmodernism to offer viable, coherent accounts of ethics? Or are our social and intellectual worlds too fragmented for any broad consensus about the moral life? These issues have emerged as some of the most contentious in literary and philosophical studies. In Renegotiating Ethics in Literature, Philosophy, and Theory a distinguished international gathering of philosophers and literary scholars address the reconceptualisations involved in this 'turn towards ethics'. An important feature of this has been a renewed interest in (...) the literary text as a focus for the exploration of ethical issues. Exponents of this trend include Charles Taylor, Bernard Williams, Iris Murdoch, Cora Diamond, Richard Rorty and Martha Nussbaum, the latter a contributor and a key figure in this volume. This book assesses the significance of this development for ethical and literary theory and attempts to articulate an alternative postmodern account of ethics which does not rely on earlier appeals to universal truths. (shrink)

Should those who work on ethics welcome or resist moves to open access publishing? This paper analyses arguments in favour and against the increasing requirement for open access publishing and considers their implications for bioethics research. In the context of biomedical science, major funders are increasingly mandating open access as a condition of funding and such moves are also common in other disciplines. Whilst there has been some debate about the implications of open-access for the social sciences and humanities, there (...) has been little if any discussion about the implications of open access for ethics. This is surprising given both the central role of public reason and critique in ethics and the fact that many of the arguments made for and against open access have been couched in moral terms. In what follows I argue that those who work in ethics have a strong interest in supporting moves towards more open publishing approaches which have the potential both to inform and promote richer and more diverse forms of public deliberation and to be enriched by them. The importance of public deliberation in practical and applied ethics suggests that ethicists have a particular interest in the promotion of diverse and experimental forms of publication and debate and in supporting new, more creative and more participatory approaches to publication. (shrink)

An Anonymous DeathThe comet, a white haired traveller, hauls its tail behind, thereby hangs its tale. Its particulate history swings away into black time as it skirts you.A million times a million fissions, fires in Andromeda, a surge of ice across a steppe, the moon’s impacted skin. Events escape their birth and move out at the roar of light, hurtling endlessly nowhere and everywhere colliding stray worlds, spinning and groping.At night through cat’s eye domes watchmen on the world’s clearest ranges (...) trap the begetting of suns or discern an ancient death when intercepted at the glass when Diplodocus started the journey into strata or when a hairy thing tottered erect and stretched out tool-seeking fingers. The watchers in the domes live half in a past older than the sun.I tended a white haired man and cry out for a lens to map him. His deeds curve short of my time sputting out in a brown river carrying a wiry oarsman in a sepia photograph. The deeds of friends are buried in a beach wir. (shrink)

The recently published BMA Guidelines on Withholding and Withdrawing Medical Treatment encourage a balance between deriving maximal benefit from medical treatment, and achieving as natural a death as possible in the circumstances. I argue that the concepts of burdensomeness, natural death and medicalised death are of greater fundamental importance than that of intention, and do not help constitute a moral distinction between withdrawal of treatment and active assistance to die. Nor should they continue to ground the corresponding legal distinction. In (...) the situations of both treatment withdrawal and active assistance to die, disease causation, human agency and moral responsibility are related in the same way. In both situations, we can intend that a person die for the right reasons, based on a concern for natural death.However, the law is reluctant to impose positive obligations on people, in contrast to the protection of negative rights. For example, the Northern Territory’s Rights of the Terminally Ill Act (1996) provided for assisted death as a lawful exception to an otherwise unlawful act, rather than as an enforceable right like the right to refuse unwanted medical treatment. Nevertheless, that the enforceability of a positive right to assisted death is difficult to conceive, is itself the product of a particular historical/moral/religious frame of reference currently under deconstruction. Genuine natural death statutes would consolidate the important principles supported here, and could apply uniform safeguards to all death-hastening decisions. (shrink)

Candidate evaluation for breast implantation presents a more important obstacle to the fulfillment of the normative requirements of informed consent than do the social roles of women or cultural norms governing female beauty. I argue that women's decisions to receive breast implants may indeed be informed, competently made, and substantially voluntary, but that the cultural construction of beauty may undermine women's autonomy by influencing the evaluation of surgical candidates and risk disclosure during informed consent.

The Second Sex offers a philosophy of bodies that hinges on the crucial concepts of ambiguity and singularity. I revisit two widely influential essays on the status of “the body” in The Second Sex, those of Moira Gatens and Catriona Mackenzie. However, both of these readings mistakenly present Beauvoir as accepting lived experiences of politically overdetermined immanence, rather than exploring them as stifled modes of transcendence. Several years later, Moira Gatens took a very helpful “second look” at the status of (...) bodies and biology in Beauvoir. I contrast this with Judith Butler's reading of The Second Sex as a project engaged in the denaturalization of gender. My chapter charts a middle way between Gatens’ second essay and Butler's reading: I argue that The Second Sex does “denaturalize” gender, but it does so precisely to bring attention to the powers and plurality of bodies. Singularity as multiplicitous lived bodily variance, according to Beauvoir, will “always exist” regardless of the static and idealizing categories of some approaches to biology. (shrink)

The current revival of interest in Bradley has included a long-neglected aspect of his thought, namely his philosophy of history. There has been a new edition of The Presuppositions of Critical History with an introduction by Stock, a new essay by Rubinoff, and a recent number of Bradley Studies largely devoted to The Presuppositions of Critical History. All of these essays and articles related Bradley’s work to Collingwood’s, which has been the subject of an even bigger revival. Holdcroft made the (...) point that, though The Presuppositions often contains “embryonic versions of positions he developed in greater detail later”, he did not return to the subject of history ; this is, of course, true of his major works, and history ceased to be a major interest for him. However, on one occasion he was drawn back into the field. The occasion was one of the spats that he had with Bertrand Russell, who had taken over from Pragmatism as Bradley’s main concern, if three articles in Mind in 1909 and 1910 and new pieces prepared for publication in 1914 are anything to go by. These were reprinted or published for the first time as part of Essays on Truth and Reality. One of the new pieces, published as Chapter XIV, was entitled “What is the real Julius Caesar?”. He was responding to an article in Proceedings of the Aristotelian Society, xi, “Knowledge by Acquaintance and Knowledge by Description.”. (shrink)

This special issue is a follow-up on a previous issue in this journal on self-management in psychiatry and psychosomatic medicine. It is the concluding chapter of a research project that sought to unpack and develop the implications of an understanding of self-management in psychiatry and psychosomatic medicine as “management of the self.”Over the last, 20 years, self-management has gained a central place in treatment programs across various medical disciplines. It positions patients as “expert-clients,” who share knowledge, responsibilities and expertise with (...) health professionals, and it actively involves them in the management of their own care (Crawford, Lee, May, & Active Self-Care... (shrink)

This Medical Humanities Special Issue critiques and reflects on narrative practices around medical, psychiatric and trauma care. This introductory article explores the affordances of patient experience narratives and scenarios to illuminate lives interrupted by medical and psychological crises while raising questions about the medical ethics, epistemological frameworks and potential pathologising of diagnosing complex conditions. It discusses the problematics and ethics of ‘re-presenting’ trauma in art, photography, film or music and the potential for theatre to raise difficult issues in and beyond (...) medical training. (shrink)

The European Biomedical Ethics Practitioner Education Project (EBEPE), funded by the BIOMED programme of the European Commission, is a five-nation partnership to produce open learning materials for healthcare ethics education. Papers and case studies from a series of twelve conferences throughout the European Union, reflecting the ‘burning issues’ in the participants' healthcare systems, have been collected by a team based at Imperial College, London, where they are now being edited into a series of seven activity-based workbooks for individual or group (...) study. These draft workbooks are now being read by a network of critical readers across Europe, whose comments will be incorporated into the final versions of the workbooks. The result will be the first European-wide and Europe-centred resource for teaching students, practitioners, and members of ethics committees. Topics covered include: • Resource allocation and rationing • The rights of children and young people • Long-term care of the elderly • Mental health and mental illness • Autonomy and patient choice • Decisions at the end of life • A study guide to using the workbooks The collaborative nature of the project has highlighted differentiated national approaches in medical ethics. Against the British and Dutch rights-orientated approach have emerged two other alternative models: the Nordic preference for administrative resolution of entitlement disputes, and the southern European emphasis on deontological codes. A genuinely European reconstruction of autonomy and rights, using hermeneutic, feminist and narrative approaches to counterbalance individualistic models, is emerging across the workbooks. The programme has also uncovered national differences in how ethics should be taught, with the workbooks' style being an experiential approach. Thus the EBEPE project is developing new models in both substantive and pedagogic senses, about both what should be taught and how it should be presented. (shrink)

This article explores how insights and new knowledge were incorporated about narrative inquiry methodology, poverty, and deficit ways of thinking through a journey of mentorship. The experiences of a graduate student, as she journeys through the roles of a research assistant and graduate researcher, all the while being part of a positive mentorship experience, are relayed. The article describes the journey of an evolving researcher who becomes wakeful through the narrative inquiry methodology while engaged as a research assistant as well (...) as a graduate student alongside her supervisor. (shrink)

In this thoughtful and literate study, Schwehn argues that Max Weber and several of his contemporaries led higher education astray by stressing research--the making and transmitting of knowledge--at the expense of shaping moral character. Schwehn sees an urgent need for a change in orientation and calls for a "spiritually grounded education in and for thoughtfulness." The reforms he endorses would replace individualistic behavior, the "doing my own work" syndrome derived from the Enlightenment, with a communitarian ethic grounded in Judeo-Christian spirituality. (...) Schwehn critiques philosophies of higher education he considers misguided, from Weber and Henry Adams to Derek Bok, Allan Bloom, and William G. Perry Jr. He draws out valid insights, always showing the theological underpinnings of the so-called secular thinkers. He emphasizes the importance of community, drawing on both the secular communitarian theory of Richard Rorty and that of the Christian theorist Parker Palmer. Finally, he outlines his own prescription for a classroom-centered spiritual community of scholars. Schwehn's study will interest all those concerned with higher education in America today: faculty, students, parents, alumni, administrators, trustees, and foundation officers. (shrink)

In der musikalischen Methode der kollektiven Improvisation kommt eine Spielauffassung zum Ausdruck, deren demokratisch-emanzipatorische Grundeinstellung Vergleiche mit dem von Jürgen Habermas formulierten Konzept der idealen Sprechsituation nahe legt. Diese Vermutung wird im Rahmen einer einleitenden Annäherung an die kollektive Improvisation als von Interaktivität und Synchronizität geprägtes Beziehungsgeschehen näher ausgeführt. Nach einer Diskussion des improvisatorischen Handelns in der Musik in Bezug auf theoretische, historische und psychologische Aspekte werden die verschiedenen, aus dem Free Jazz der 1960er Jahre hervorgegangenen Entwicklungsstufen der freien bzw. (...) kollektiven Improvisation dargestellt. Im Anschluss daran wird die Kollektiv-Improvisation unter Bezugnahme auf das Konzept der idealen Sprechsituation diskutiert und im interkulturellen Kontext verortet, wobei die von Musikern wie Derek Bailey geforderte Sublimierung idiomatischer, kulturell geprägter Ausdrucksformen durch die individuelle Entwicklung einer charakteristischen Klangsprache am Instrument als egalisierend für die tendenziell asymmetrisch geprägten Dialogformen dieser Situation erläutert wird. Inklusive Interviews mit Evan Parker, Alexander von Schlippenbach und Joe Fonda. (shrink)

However distorted and dysfunctional, gangs satisfy the hunger for honor among adolescents. Churches that take ministry with youth seriously will seek to enable them to express their need for honor, group belonging, and hope in life-affirming ways.