ABSTRACTCertain restrictions on public funding for assisted reproductive technology are articulated and defended by recourse to a distinction between medical infertility and social infertility. We propose that underlying the prioritization of medical infertility is a vision of medicine whose proper role is to restore but not to improve upon nature. We go on to mark moral responses that speak of investments many continue to make in nature as properly an object of reverence and gratitude and therein a source of moral (...) guidance. We draw on the work of Ludwig Wittgenstein in arguing for the plausibility of an appeal to nature in opposition to the charge that it must contain a logical fallacy. We also invite consideration of the moral plausibility of some appeal to nature. Finally, we examine what follows in the case of ART. Should medicine respect as natural limits that should not be overcome: the need for a man and a woman in reproduction; menopause; and even declining fertility with age? We must first ask ourselves to what degree we should defer to nature in the conduct of medicine, at least in the particular if not the general case. This will involve also asking ourselves what we think is natural and in what instances and spirit might we defy nature. Divergent opinions and policies concerning who should receive ART treatment and public funding are more easily understood in view of the centrality, complexity and fundamental nature of these questions. (shrink)

Next SectionWhilst there has been considerable debate about the fit between moral theory and moral reasoning in everyday life, the way in which moral problems are defined has rarely been questioned. This paper presents a qualitative analysis of interviews conducted with 15 general practitioners (GPs) in South Australia to argue that the way in which the bioethics literature defines an ethical dilemma captures only some of the range of lay views about the nature of ethical problems. The bioethics literature has (...) defined ethical dilemmas in terms of conflict and choice between values, beliefs and options for action. While some of the views of some of the GPs in this study about the nature of their ethical dilemmas certainly accorded with this definition, other explanations of the ethical nature of their problems revolved around the publicity associated with the issues they were discussing, concern about their relationships with patients, and anxiety about threats to their integrity and reputation. The variety of views about what makes a problem a moral problem indicates that the moral domain is perhaps wider and richer than mainstream bioethics would generally allow. (shrink)

Chipman, Meagher and Barwise (2024) propose a framework to interrogate public health responsibilities for populations with limited proficiency in the predominant language. We agree with many of the...

Certain restrictions on public funding for assisted reproductive technology (ART) are articulated and defended by recourse to a distinction between medical infertility and social infertility. We propose that underlying the prioritization of medical infertility is a vision of medicine whose proper role is to restore but not to improve upon nature. We go on to mark moral responses that speak of investments many continue to make in nature as properly an object of reverence and gratitude and therein (sometimes) a source (...) of moral guidance. We draw on the work of Ludwig Wittgenstein in arguing for the plausibility of an appeal to nature in opposition to the charge that it must contain a logical fallacy. We also invite consideration of the moral plausibility of some appeal to nature. Finally, we examine what follows in the case of ART. Should medicine respect as natural limits that should not be overcome: the need for a man and a woman in reproduction; menopause; and even declining fertility with age? We must first ask ourselves to what degree we should defer to nature in the conduct of medicine, at least in the particular if not the general case. This will involve also asking ourselves what we think is natural and in what instances and spirit might we defy nature. Divergent opinions and policies concerning who should receive ART treatment and public funding are more easily understood in view of the centrality, complexity and fundamental nature of these questions. (shrink)

The link between alcohol consumption and cancer is well established, but public awareness of the risk remains low. Mandated warning labels have been suggested as a way of ensuring “informed choice” about alcohol consumption. In this article we explore various ethical issues that may arise in connection with cancer warning labels on alcoholic beverages; in particular we highlight the potentially questionable autonomy of alcohol consumption decisions and consider the implications if the autonomy of drinking behavior is substantially compromised. Our discussion (...) demonstrates the need for the various ethical issues to be considered and addressed in any decision to mandate cancer warning labels. (shrink)

Precision medicine is an emerging approach to treatment and disease prevention that relies on linkages between very large datasets of health information that is shared amongst researchers and health professionals. While studies suggest broad support for sharing precision medicine data with researchers at publicly funded institutions, there is reluctance to share health information with private industry for research and development. As the private sector is likely to play an important role in generating public benefits from precision medicine initiatives, it is (...) important to understand what the concerns are and how they might be mitigated. This study reports outcomes of a deliberative method of citizen engagement in Singapore that asked whether sharing precision medicine data with private industry would be permissible, and if so, under what circumstances. Findings from this citizens’ jury suggest sharing with industry would be permissible under certain conditions that are set out in nine recommendations. Implications of the recommendations and their underlying assumptions for policy decision makers are discussed. This study aligns with prior international studies which found conditional acceptance for data sharing with private industry, a public benefit requirement, specific reluctance to share with insurance companies and an emphasis on accountability and transparency to demonstrate trustworthiness. However, our results differ from prior studies in that opt-in consent did not dominate the deliberations as jurors were able to set it aside as an assumed prerequisite for participation in a precision medicine programme. (shrink)

Background Outbreaks of infectious disease cause serious and costly health and social problems. Two new technologies – pathogen whole genome sequencing and Big Data analytics – promise to improve our capacity to detect and control outbreaks earlier, saving lives and resources. However, routinely using these technologies to capture more detailed and specific personal information could be perceived as intrusive and a threat to privacy. Method Four community juries were convened in two demographically different Sydney municipalities and two regional cities in (...) New South Wales, Australia to elicit the views of well-informed community members on the acceptability and legitimacy of: making pathogen WGS and linked administrative data available for public health researchusing this information in concert with data linkage and machine learning to enhance communicable disease surveillance systems Fifty participants of diverse backgrounds, mixed genders and ages were recruited by random-digit-dialling and topic-blinded social-media advertising. Each jury was presented with balanced factual evidence supporting different expert perspectives on the potential benefits and costs of technologically enhanced public health research and communicable disease surveillance and given the opportunity to question experts. Results Almost all jurors supported data linkage and WGS on routinely collected patient isolates for the purposes of public health research, provided standard de-identification practices were applied. However, allowing this information to be operationalised as a syndromic surveillance system was highly contentious with three juries voting in favour, and one against by narrow margins. For those in favour, support depended on several conditions related to system oversight and security being met. Those against were concerned about loss of privacy and did not trust Australian governments to run secure and effective systems. Conclusions Participants across all four events strongly supported the introduction of data linkage and pathogenomics to public health research under current research governance structures. Combining pathogen WGS with event-based data surveillance systems, however, is likely to be controversial because of a lack of public trust, even when the potential public health benefits are clear. Any suggestion of private sector involvement or commercialisation of WGS or surveillance data was unanimously rejected. (shrink)

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

Should there be a female age limit on public funding for assisted reproductive technology (ART)? The question bears significant economic and sociopolitical implications and has been contentious in many countries. We conceptualise the question as one of justice in resource allocation, using three much-debated substantive principles of justice—the capacity to benefit, personal responsibility, and need—to structure and then explore a complex of arguments. Capacity-to-benefit arguments are not decisive: There are no clear cost-effectiveness grounds to restrict funding to those older women (...) who still bear some capacity to benefit from ART. Personal responsibility arguments are challenged by structural determinants of delayed motherhood. Nor are need arguments decisive: They can speak either for or against a female age limit, depending on the conception of need used. We demonstrate how these principles can differ not only in content but also in the relative importance they are accorded by governments. Wide variation in ART public funding policy might be better understood in this light. We conclude with some inter-country comparison. New Zealand and Swedish policies are uncommonly transparent and thus demonstrate particularly well how the arguments we explore have been put into practice. (shrink)

Introduction No consent for health and medical research is appropriate when the criteria for a waiver of consent are met, yet some ethics committees and data custodians still require informed consent. Methods A single-blind parallel-group randomised controlled trial: 1129 families of children born at a South Australian hospital were sent information explaining data linkage of childhood immunisation and hospital records for vaccine safety surveillance with 4 weeks to opt in or opt out by reply form, telephone or email. A subsequent (...) telephone interview gauged the intent of 1026 parents (91%) in relation to their actions and the sociodemographic differences between participants and non-participants in each arm. Results The participation rate was 21% (n=120/564) in the opt-in arm and 96% (n=540/565) in the opt-out arm (χ2 (1 df) = 567.7, p<0.001). Participants in the opt-in arm were more likely than non-participants to be older, married/de facto, university educated and of higher socioeconomic status. Participants in the opt-out arm were similar to non-participants, except men were more likely to opt out. Substantial proportions did not receive, understand or properly consider study invitations, and opting in or opting out behaviour was often at odds with parents' stated underlying intentions. Conclusions The opt-in approach resulted in low participation and a biased sample that would render any subsequent data linkage unfeasible, while the opt-out approach achieved high participation and a representative sample. The waiver of consent afforded under current privacy regulations for data linkage studies meeting all appropriate criteria should be granted by ethics committees, and supported by data custodians. Trial registration number Australian New Zealand Clinical Trials Registry ACTRN12610000332022. (shrink)

Background There is a growing concern about artificial intelligence (AI) applications in healthcare that can disadvantage already under-represented and marginalised groups (eg, based on gender or race). Objectives Our objectives are to canvas the range of strategies stakeholders endorse in attempting to mitigate algorithmic bias, and to consider the ethical question of responsibility for algorithmic bias. Methodology The study involves in-depth, semistructured interviews with healthcare workers, screening programme managers, consumer health representatives, regulators, data scientists and developers. Results Findings reveal considerable (...) divergent views on three key issues. First, views on whether bias is a problem in healthcare AI varied, with most participants agreeing bias is a problem (which we call the bias-critical view), a small number believing the opposite (the bias-denial view), and some arguing that the benefits of AI outweigh any harms or wrongs arising from the bias problem (the bias-apologist view). Second, there was a disagreement on the strategies to mitigate bias, and who is responsible for such strategies. Finally, there were divergent views on whether to include or exclude sociocultural identifiers (eg, race, ethnicity or gender-diverse identities) in the development of AI as a way to mitigate bias. Conclusion/significance Based on the views of participants, we set out responses that stakeholders might pursue, including greater interdisciplinary collaboration, tailored stakeholder engagement activities, empirical studies to understand algorithmic bias and strategies to modify dominant approaches in AI development such as the use of participatory methods, and increased diversity and inclusion in research teams and research participant recruitment and selection. (shrink)

Across the world, pain is under-treated in emergency departments. We canvass the literature testifying to this problem, the reasons why this problem is so important, and then some of the main hypotheses that have been advanced in explanation of the problem. We then argue for the plausibility of two new hypotheses: pain's under-treatment in the ED is due partly to an epistemic preference for signs over symptoms on the part of some practitioners, and some ED practices that themselves worsen pain (...) by increasing patients' anxiety and fear. Our argument includes the following logic. Some ED practitioners depart from formal guidance in basing their acute pain assessments on observable features rather than on patient reports of pain. This is potentially due to an epistemic preference for signs over symptoms which aims to circumvent intentional and/or unintentional misrepresentation on the part of patients. However, conducting pain assessments in line with this epistemic preference contributes to the under-treatment of pain in at least three respects, which we detail. Moreover, it may do little to help the practitioner circumvent any intentional misrepresentation on the part of the patient, as we explain. Second, we examine at least four ED practices that may be contributing to the under-treatment of pain by increasing patient anxiety and fear, which can worsen pain. These practices include failing to provide orienting information and partially objectifying patients so as to problem-solve along lines pre-established by modern medical science. We conclude by touching on some potential solutions for ED practice. (shrink)

Copyright © 2008 by International Union for Health Promotion and Education.

This paper takes a virtuist approach to medical ethics to explore, from an empirical angle, ideas about settled ways of living a good life. Qualitative research methods were used to analyse the ways in which a group of 15 general practitioners articulated notions of good doctoring and the virtues in their work. I argue that the GPs, whose talk is analysed here, defined good general practice in terms of the ideals of accessibility, comprehensiveness, and continuity. They regarded these ideals significant (...) both for the way they dealt with morally problematic situations and for how they conducted their professional lives more generally. In addition, I argue that the GPs who articulated these ideals most clearly were able to, in part, because they shared the experience of working in rural areas. This experience helped them to develop an understanding of the nature of general practice that their urban colleagues were less able to draw on. In that sense, the structural and organisational framework of general practice in rural areas provided the context for their understanding of ideals in general practice. (shrink)

(No abstract is available for this citation).

This book addresses the problem of how to make democratically-legitimate public policy on issues of contentious bioethical debate. It focuses on ethical contests about research and their legitimate resolution, while addressing questions of political legitimacy. How should states make public policy on issues where there is ethical disagreement, not only about appropriate outcomes, but even what values are at stake? What constitutes justified, democratic policy in such conflicted domains? Case studies from Canada and Australia demonstrate that two countries sharing historical (...) and institutional characteristics can reach different policy responses. This book is of interest to policymakers, bioethicists, and philosophers, and will deepen our understanding of the interactions between large-scale socio-political forces and detailed policy problems in bioethics. (shrink)

Neglected and tropical diseases, pervasive in developing countries, are important contributors to global health inequalities. They remain largely untreated due to lack of effective and affordable treatments. Resource-poor countries cannot afford to develop the public health interventions needed to control neglected diseases. In addition, neglected diseases do not represent an attractive market for pharmaceutical industry. Although a number of international commitments, stated in the Millennium Development Goals, have been made to avert the risk of communicable diseases, tropical diseases still remain (...) neglected due to delays in international assistance. This delay can be explained by the form international cooperation has generally taken, which is limited to promoting countries’ national interests, rather than social justice at a global level. This restricts the international responsibility for global inequalities in health to a humanitarian assistance. We propose an alternative view, arguing that expanding the scope of international cooperation by promoting shared health and economic value at a global level will create new opportunities for innovative, effective and affordable interventions worldwide. It will also promote neglected diseases as a global research priority. We build our argument on a proposal to replace the patenting system that currently regulates pharmaceutical research with a global fund to reward this research based on actual decreases in morbidity and mortality at a global level. We argue that this approach is beneficent because it will decrease global health inequalities and promote social justice worldwide. (shrink)

Community-based healthcare organisations manage competing, and often conflicting, priorities. These conflicts can arise from the multiple roles these organisations take up, and from the diverse range of stakeholders to whom they must be responsive. Often such conflicts may be titled conflicts of interest; however, what precisely constitutes such conflicts and what should be done about them is not always clear. Clarity about the duties owed by organisations and the roles they assume can help identify and manage some of these conflicts. (...) Taking divisions of general practice in Australia as an example, this paper sets out to distinguish two main types of conflicts of interest, so that they may be more clearly identified and more effectively managed. (shrink)

Ethik-Komitees gehören zum festen Bestandteil des Ethikmanagements und der Organisationsethik in klinischen Einrichtungen des Gesundheitswesens. Entsprechende Ethikstrukturen und die damit verbundenen Angebote stoßen hinsichtlich ihrer Wirksamkeit allerdings an ihre Grenzen. Ihre Arbeitsweisen sind häufig reaktiv und eine Verankerung in den entsprechenden Organisationsebenen fehlt. Ausgehend von diesen Limitationen der klinischen Ethikberatung hat sich die multiprofessionelle „Arbeitsgruppe Ethik“ am Universitätsklinikum Tübingen um die Konzeption und Implementierung eines neuen Ansatzes zur nachhaltigen Integration von ethischen Reflexions- und Entscheidungsprozessen auf den Stationen des UKT bemüht. (...) Mit dem Tübinger Modell der Ethikbeauftragten der Station verfolgt sie ein Pilotprojekt, das speziell geschulte Pflegekräfte aus allen Stationen des UKT als AnsprechpartnerInnen für ethische Fragen einsetzt. Damit stellen die Ethikbeauftragten eine Erweiterung zu etablierten Strukturen der Ethikberatung dar und ergänzen vorhandene Top-Down-Strategien. Der vorliegende Beitrag stellt die Zielsetzungen des Tübinger Modells dar und schildert erste Erfahrungen in der Umsetzung. Neben der Einbettung in organisationale Strukturen der Ethikberatung werden die stationsinternen und stationsübergreifenden Aufgaben der Ethikbeauftragten dargestellt. Zudem wird das Qualifikationsprogramm für Ethikbeauftragte sowie ein Train-the-Trainer-Konzept vorgestellt, welche eine vertiefende Entwicklung von pflege- und medizinethischer Kompetenzen unterstützen und Sicherheit in den stationsbezogenen Reflexions- und Entscheidungsprozessen vermitteln. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Life is GoodAnnette ChacosI live in Hervey Bay. I’m a member of several social groups. I have adult children and grandchildren, and many lovely friends. I love to write. Most importantly I love The Lord Jesus Who has been my strength, bringing me through the good times, the not so good times, and the, ‘I’m throwing in the towel’ times.I was first diagnosed with a brain tumour in 1997. (...) Prior to knowing about the tumour and for some time after its removal I had little or no memory of events. The tumour was a left Frontal Meningioma (benign). For some time afterward I was partially [End Page 189] paralyzed. Now there is only some weakness on the right side of my body. Epilepsy too became part of my life. There are different types of seizures, which are rarely, if ever, amusing.Humour is very important. If you can’t laugh at the things that happen life would be a constant tale of woe. I’m very blessed. There are so many people who are much worse off than myself.My storyIn July 1997 my husband went to see if everything was okay because I wasn’t up out of bed yet. I was lying across the bed in a disheveled state. After being cleaned up I was taken to the local hospital. The duty doctor, who hadn’t even seen me, told my son that he didn’t think there was much wrong and to take me home. My sons refused and insisted that the doctor admit me. He did.I was diagnosed with a urinary tract infection. My memories of this are scattered. I learned some time later that I had had a Tonic Clonic seizure (formerly known as “grand mal” seizures which are commonly associated with epilepsy). After I came out of hospital I saw my general practitioner (GP). She sent me for an x–ray, and then to see a Neurosurgeon. An MRI was taken and there was a large tumour in my brain.My memory of this time is poor. I do recall a friend phoning and I told her I was going into hospital to have a brain tumour removed. After fifteen years she is still saying I was so matter of fact about it. I now know that my emotions, like my memory, was at a very low ebb due to the tumour. There was no caring or worrying. If there was, in the next minute, probably second, it was forgotten.Before going into hospital my late husband said to the kids “better take a photograph of your mother in case she dies.” I was told about that comment some time later. What a comfort! Then one day the photo turned up. It was so ugly I tore it up. You’ll note I said the photo was ugly!The operation took place in Canberra hospital, at the end of August. It was to be earlier but they deferred it because an emergency came in. They were going to defer it again, by which time I was mute and non–responsive. My daughter Maria arrived from Melbourne and my daughter Katrina and her husband Kevin came from America with their 3–month–old baby. My son Libe arrived from Sydney. Marcus, my youngest, lived locally, as did my daughter Tania. On hearing the operation was to be deferred again they took action informing hospital staff they were going to the local MP and the A Current Affair television show. So l had the operation—it was much easier to put me under the scalpel than battle the bureaucracy!I have only one film from that MRI. Where the others are I don’t know. According to Dr C, the tumour was very large. But to me, what does size matter—it was no longer there. Most importantly, I survived. The ten days I was in hospital are mostly forgotten. The few people I remember are like snapshots. No one moved, or so it seemed to me.In 2006, the second tumour was removed. It was discovered by the same lovely GP, who found the first one. I was... (shrink)

Many patients were surprised or confused by their first visit to Dr. Freud's office. Lying on the famous couch, they found themselves surrounded by a plethora of objects and images they would never have associated with the business of the psychoanalytic cure. Statuettes, masks, and portraits from ancient times were arranged in showcases, on the shelves and on desks within a room whose walls were covered with depictions of mythological scenes and portraits of Freud's mentors . The patient's first impressions (...) of this peculiar display, which has been faithfully preserved by Anna Freud in their last London home at Maresfield Gardens, were frequently strong ones. One of the most articulate of Freud's patients, Hilda Doolittle, herself a lover of antiquities, did not hesitate to tell him how “overwhelmed and upset” she was to find him “surrounded by these treasures, in a museum, a temple.” During her own analysis, a variety of these “toys,” as she called them, seemed to act as replicas or “ghosts” of the figures appearing in her dreams or memories: “We are all haunted houses.”1 · 1. H. D. [Hilda Doolittle], “Advent,” Tribute to Freud , pp. 119, 146. (shrink)

Are you a Reluctant Metaphysician? A career change, an upsetting external event, a serious illness, a painful breakup, or an unravelling culture can all be invitations to enter a deeper world behind the world. You may not have chosen to go there, but you evolve thereby. This book weaves together stories and reflections to introduce teachings and practices from ancient wisdom traditions that illuminate our unique life path.The Path of a Reluctant Metaphysician speaks to the importance of a holistic spiritual (...) philosophy in our current times of the "great unraveling" of our political, economic, cultural, and ecological world. Here you will find an approach to finding your life stance in such troubled times. The metaphysical path is an "all vector approach" that incorporates both "spiritual" and "soulful" pathways, traditions of postural initiation such as Tai Chi, mythology, depth psychology, bodymind healing methods, a non-deterministic approach to astrology, and a multi-dimensional approach to the political sphereDr. Mayer transmits stories, teachings, and practices from his multifaceted career that are so captivating, they may lead you to reluctantly take time out of your busy everyday life. Be forewarned if you read this book you too may become a Reluctant Metaphysician! Kirkus Reviews says: "A meaningful contribution to the spiritual self-help library...A psychologist blends spiritual paths from the East, West, and beyond for an innovative approach to healing...an expansive tale told with humility and insight." Larry Dossey, MD says, Dr. Mayer's revelations in various metaphysical domains are a guide for anyone who desires a richer and more fulfilling experience of life. If you think life must contain more juice than you have known so far, this book is for you. (shrink)

Der Band diskutiert ausgewählte Positionen der Theoriebildung Ernesto Laclaus, die in den letzten Jahren im Kontext demokratietheoretischer Debatten zwar in politik-, kultur- und sozialwissenschaftlichen Feldern rezipiert wurde, deren Aufnahme in erziehungswissenschaftlichen Debatten aber eher als 'handverlesen' bezeichnet werden könnte. Die Rezeption beschränkt sich häufig auf spezifische Einsätze rund um die gemeinsam mit Chantal Mouffe in Hegemonie und radikale Demokratie entwickelte und an Antonio Gramsci ansetzende Hegemonietheorie. Dass Laclaus Perspektiven jedoch eine Vielzahl produktiver Anschlüsse und Irritationen für unterschiedliche pädagogische Frage- und (...) Problemstellungen beinhalten, verdeutlichen die hier versammelten Beiträge rund um transdisziplinäre Spannungsverhältnisse von Politik, Bildung und Pädagogik, von Artikulation und Repräsentation, von Ontologie und Identität oder im Kontext aktueller Sichtweisen auf Inklusion, Solidarität, Migration, pädagogische Beziehungen und Professionalität. Die Herausgebenden Dr. Steffen Wittig, Professor Dr. Ralf Mayer und Julia Sperschneider arbeiten und forschen an der Universität Kassel. (shrink)

In this paper, I identify a theoretical and political role for ‘white ignorance’, present three alternative accounts of white ignorance, and assess how well each fulfils this role. On the Willful Ignorance View, white ignorance refers to white individuals’ willful ignorance about racial injustice. On the Cognitivist View, white ignorance refers to ignorance resulting from social practices that distribute faulty cognitive resources. On the Structuralist View, white ignorance refers to ignorance that (1) results as part of a social process that (...) systematically gives rise to racial injustice, and (2) is an active player in the process. I argue that, because of its greater power and flexibility, the Structuralist View better explains the patterns of ignorance that we observe, better illuminates the connection to white racial domination, and is overall better suited to the project of ameliorating racial injustice. As such, the Structuralist View should be preferred. (shrink)

In recent decades in North American social and moral philosophy, alongside the development and discussion of widely influential theories of justice, taken as Rawls takes it as the ‘first virtue of social institutions,’ there has been a counter-movement gathering strength, one coming from some interesting sources. For some of the most outspoken of the diverse group who have in a variety of ways been challenging the assumed supremacy of justice among the moral and social virtues are members of those sections (...) of society whom one might have expected to be especially aware of the supreme importance of justice, namely blacks and women. Those who have only recently won recognition of their equal rights, who have only recently seen the correction or partial correction of long-standing racist and sexist injustices to their race and sex, are among the philosophers now suggesting that justice is only one virtue among many, and one that may need the presence of the others in order to deliver its own undenied value. Among these philosophers of the philosophical counterculture, as it were - but an increasingly large counterculture - I include Alasdair MacIntyre, Michael Stocker, Lawrence Blum, Michael Slote, Laurence Thomas, Claudia Card, Alison Jaggar, Susan Wolf and a whole group of men and women, myself included, who have been influenced by the writings of Harvard educational psychologist Carol Gilligan, whose book In a Different Voice caused a considerable stir both in the popular press and, more slowly, in the philosophical journals. (shrink)

Especially where a patient's ability to communicate is limited, the receptive use of art visually offers an entry point into contemplation and insight. Here, receptive work with visual art can help to dissolve limitations in verbal communication. In receptive art therapy, an independent therapeutic resource is attributed to the artistic work and its symbolic pictorial content, which can initiate a healing process. A form of indirect communication is stimulated, in which not only a change on the symbolic but also on (...) the emotional level takes place through the emotionally highly charged pictorial-symbolic expression in the confrontation. Different approaches and basic concepts of the method are presented. This conference volume is addressed to the patients, therapists and clinical as well as inclusive companions in these processes. With contributions by Dr. Alexandra Daszkowski, Prof. Dr. Georg Franzen, Dr. Barbara Laimböck, Prof. Andreas Mayer-Brennenstuhl, Prof. Dr. Karl-Heinz Menzen, Karolina Sarbia, Prof. Dr. Martin Schuster and Ass.-Prof. Dr. Karla Villavicencio. (shrink)

Both a morality, like Kant's, which relies on wrongdoers' guilt feelings and expectation of punishment, as enforcement for its requirements, and one which, like Hume's, relies on the feelings of shame and expectation of their fellows' contempt which will be felt by those showing lack of the moral virtues, seem to merit the charge that morality is an intrinsically cruel institution. The prospects for a gentle non-punitive morality are explored, and Hume's views found more promising, for this purpose, than Kant's.