IT WAS an outlandish, ethically questionable experiment, but this was the 1960s after all. Psychiatrist Robert Heath of Tulane University in New Orleans hoped to cure his patients' depression, intractable pain, schizophrenia, suicidal feelings, addiction, and even homosexuality - which in those days was considered a psychiatric disorder - by drowning them out with pleasure, induced by an electrode implanted deep in their brains.

Global ignorance about Africa continues to sustain inappropriate global interventions to resolve public health crises, often with disastrous consequences. To explain why this continues to happen, I marshal two theorems that predict basic statistical properties, called ‘the doctrinal paradox’ and ‘the discursive dilemma’, which underlie scientific consensus formation and evidence-based decision making on a global scale. These mathematical results illuminate the epistemic and material injustices committed by the protocols of medical research conducted at the highest level of global knowledge production (...) in the service of international humanitarian aid for Africans. These social choice theorems reveal that a global scientific consensus projecting claims and proposing policies about Africa’s disease burden is likely to yield a low degree of reliability, in that the probability of its accuracy is less than chance. The solution to this anomaly is to remove from the global scientific agenda the statistically unrealisable demand of satisfying too many multinational corporate and foreign governments’ priorities as equally entitled to benefit from the knowledge produced to improve Africa’s public health sector. Instead, foreign funding targeted to support medical science and policy in Africa should be directed by those specialists in situ who are most familiar with their own national health challenges and potential solutions, rather than relying upon foreign decision makers to interpret Africa’s emergency public health care needs. Keywords Doctrinal paradox, discursive dilemma, scientific consensus, epistemic trust, global health ethics, group agency. (shrink)

Our contribution in this paper is to highlight the ethical implications of workforce engagement strategies in an age of austerity. Hard or instrumentalist approaches to workforce engagement create the potential for situations where engaged employees are expected to work ever longer and harder with negative outcomes for their well-being. Our study explores these issues in an investigation of the enactment of an engagement strategy within a UK Health charity, where managers and workers face paradoxical demands to raise service quality and (...) cut costs. We integrate insights from engagement, paradox, and ethic of care literatures, to explore these paradoxical demands—illustrating ways in which engagement experiences become infused with tensions when the workforce faces competing requirements to do ‘more with less’ resources. We argue that those targeted by these paradoxical engagement strategies need to be supported and cared for, embedded in an ethic of care that provides explicit workplace resources for helping workers and managers cope with and work through corresponding tensions. Our study points to the critical importance of support from senior and frontline managers for open communications and dialogue practices. (shrink)

This article documents the increasing participation of poor women in social movements in Latin America, focusing on movements centered around human rights and collective consumption issues, such as the cost of living or the provision of public services. It analyzes the factors that have contributed to the increased participation of poor Latin American women in social movements and why they have chosen the state rather than the workplace as the principal arena of confrontation. Although these movements are undertaken in defense (...) of women's traditional domestic role, collective action appears to be contributing to a greater consciousness of gender subordination among Latin American women and to their greater legitimacy in the public sphere. (shrink)

In turning to photography the paper explores ways of conveying historical truth. It seems that contemporary art places itself at the very limit of representation in an attempt to remain faithful to historical eventuality. In fact, one is reminded of the type of historical occurrence which can be grasped only through ‘as-if presentations’, to remember the Kantian term. ‘Fiction’, therefore, is no longer opposed to ‘truth’, but becomes its conductor and ally.

As we know, Merleau-Ponty was struggling with a dynamic shift in his thinking at the premature end of his life. In those last notes he raises the question of how to elaborate a phenomenology of “’the other world’, as the limit of a phenomenology of the imaginary and the ‘hidden’”—a phenomenology that would open onto an invisible life, community, other and culture (VI, Jan. 1960). In her essay on “Eye and Mind”, “To Paint the Invisible”, Luce Irigaray shows why Merleau-Ponty (...) was not yet ready to address this question, why he was not yet ready to engage the limits of his vision posed by the presence of an other. Against Merleau-Ponty’s assertion that the artist has no other task than to bring to appearance the world in the way he corporeally encounters it employing no “other technique than what his eyes and hands discover in seeing and painting”, Irigaray argues that the painter as phenomenologist then appropriates what is other to his vision without reflecting upon a limit to vision, as well as the limit provided by the invisible of an other, an other world. This is not to say that there are no intertwinings with this other, for there are other metabolisms with which we engage the world. Moreover, the sharing of vision with an other can alter the ways I see, challenging cultural complicity, rather than providing evidence that we share the same world. Irigaray is of course not the first to challenge a phenomenological approach to art and to vision—and here I turn specifically to Gilles Deleuze—who is critical of the phenomenological tendency to take on a world given to us by others. His artist, Francis Bacon, focuses on the sensation, which remains unmediated by narration or the feelings of others. Finally, the artworks of abstract expressionist artist Joan Mitchell are considered in the ways that they open up a different time-space; they suggest an other world with which we intertwine without appropriation. Her works, I argue, defy reduction to essences, but also do not rely merely on sensation—for this reason they point in the direction of how to think phenomenology anew. For I do think Merleau-Ponty would be open to these conversations, to these other worlds and other visions. (shrink)

This chapter is a study on Luce Irigaray’s engagement with Martin Heidegger’s approach to language. Although language is central to both thinkers, rather than privileging language in terms of the poëtic event of being, the arising of something out of itself, Irigaray reveals how language is privileged in terms of its promise of dialogue between two who are different. This difference provides for a limit to what can be known or recognized, as well as for a creative potentiality that is (...) directed towards the future. (shrink)

Lehar argues that a simple Neuron Doctrine cannot explain perceptual phenomena such as size constancy but he fails to discuss existing, more complex neurological models. Size models that rely purely on scaling for distance are sparse, but several models are also concerned with other aspects of size perception such as geometrical illusions, relative size, adaptation, perceptual learning, and size discrimination.

The essay analyses the hermeneutics of civilizational dialogue and identifies four basic principles, or requirements: recognition of the equality of the “lifeworlds;” awareness of the “dialectics” of cultural self-comprehension; acknowledgement of formal “metanorms” such as the principle of mutuality; and transcending the circle of “civilizational self-affirmation.” On the basis of these criteria, the essay investigates how politics will have to be reshaped – domestically, regionally and globally – to enable a genuine dialogue of cultures and civilizations that can also serve (...) as a cornerstone of peaceful coexistence among states. Addressing today’s multicultural reality and its impact on the traditional nation-state, the essay underlines the importance of intercultural openness and “civilizational curiosity” – instead of “civilizational nostalgia” – and suggests a redefinition of “co-existence” in the sense of active mutual engagement. The paper further undertakes a critical assessment of the role of “dialogue” as a fashionable decorum of international politics and questions the instrumentalization of the civilizational paradigm in the context of international politics. (shrink)

: This paper interprets Descartes's use of the Scholastic doctrine of divine concurrence in light of contemporaneous sources, and argues against two prevailing occasionalist interpretations. On the first occasionalist reading God's concurrence or cooperation with natural causes is always mediate (i.e., concurrence reduces to God's continual recreation of substances). The second reading restricts God's immediate concurrence to his co-action with minds. This paper shows that Descartes's metaphysical commitments do not necessitate either form of occasionalism, and that he is more plausibly (...) and charitably read as appropriating elements of Scholastic views on concurrence to bridge the gap between his metaphysics and physics. (shrink)

Although there has been significant academic interest in the complex relationship between gender and migration, the relevant literature often focuses on women as victims of trafficking, sexism and racism in the host and sending societies. This article discusses instead the question of gender and migration as an open field of contestation within which transitory and incomplete identities are performed. Based on a series of focus group discussions with Albanian women working in the domestic sector in Athens, the article documents the (...) emergence of a discourse of `becoming masculine' while performing typically `feminine tasks'. Drawing from Judith Butler's theoretical challenge to subject formation, the analysis traces the development of gender relations within discourse. While Albanian women are doubly disadvantaged in the mind—body relationship, they gradually come to perform roles that redefine the space of domesticity where the limits between men/women, private/public and migrants/nationals lie. (shrink)

Why might alternative taxonomies be needed in contemporary life, and how might the notion of categorisation or anti-categorisation be thought speculatively? This essay considers some of the ways that life and matter have been historically divided and segmented and asks how this might be rendered mobile, offering new divisions and definitions for those who exist outside hegemonic segments or scales.

This paper argues that the position on free will which is defended in ‘Freedom: An Impossible Reality’ is not, as Tallis claims, a compatibilist view, but actually a version of libertarianism. While endorsing many aspects of that libertarian view itself, the paper raises questions about how one of the central arguments for Tallis’s view is supposed to work, and queries whether it really follows from the fact that we need to stand apart from nature in a certain sense, in order (...) to develop the kind of abstract knowledge that is constituted by the body of scientific law, that our own actions are not mere manifestations of what Tallis calls the ‘habits of nature’. It is also suggested that while a strong case can be made for many varieties of human exceptionalism, Tallis’s view of animal behaviour may be too simple and that there are examples of animal agency which cannot be explained merely by the associative learning which appears to be the highest grade of animal cognition that Tallis countenances. (shrink)

Problems with clinical research that create conflicts between doctors' therapeutic and research obligations may be fueled by a rigid view of science as determiner of truth, a heavy reliance on statistics, and certain features of randomized clinical trials. I suggest some creative, feminist approaches to such research and explore ways to provide choice for patients and to use values in directing both therapy and science - to enhance the effectiveness of each.

Many criminal offenders come from disadvantaged backgrounds, which punishment entrenches. Criminal culpability explains some disadvantageous treatment in state-offender interactions; yet offenders remain people, and ‘some mother’s child’, in Eva Kittay’s terms. Offending behaviour neither erases needs, nor fully excuses our responsibility for offenders’ needs. Caring is demanded in principle, recognising the offender’s personhood. Supporting offenders may amplify welfare resources: equipping offenders to provide self-care; to meet caring responsibilities; and enabling offenders’ contribution to shared social life, by providing support and furthering (...) the choices of others seeking to engage with them. The desistance paradigm (viewing desistance from offending as a process, following from an offender’s active choice in the context of stabilising social structures and personal circumstances), implies that a supportive environment may facilitate reduced recidivism. While decisions about criminal culpability need justice, we may use state resources most effectively by also including care ethics in our thinking about punishment. (shrink)

A ‘good enough’ nurse: supporting patients in a fertility unitIn this paper, I discuss the findings of an ethnographic study of a fertility unit. I suggest that caring as ‘emotional awareness’ and ‘non‐caring’ as ‘emotional distance’ may be forms of nursing akin to Fabricius’s (1991) arguments around the ‘good enough’ nurse. This paper critiques caring theories and contributes to the debates over the nature of caring in nursing. I discuss the implications raised for nurses if patients want a practical approach (...) to caring and do not expect an emotionally intimate relationship from nurses. (shrink)

This paper defends the Limited Use View of our duties to save. The Limited Use View holds that the duty to save is a duty to treat oneself, and perhaps one’s resources, as a means for preventing harm to others. But the duty to treat oneself as a means for the sake of others is limited. One need not treat oneself as a means when doing so is either very costly, or conflicts with one’s more stringent duties to others. This (...) provides an agent-neutral account of the duty to save. When the cost of saving passes a certain threshold, one is permitted to fail to save, and it is impermissible for others to force one to save, if doing so will force one to incur an equal or greater cost. I argue that the Limited Use View is to be preferred to agent-relative accounts of the duty to save, which hold that the limit on our duty to save is grounded in an agent-relative prerogative to weight our own interests (and those of special others) more heavily than other people’s interests. (shrink)

Distinguished feminist philosophers consider the future of their field and chart its political and ethical course in this forward-looking volume. Engaging with themes such as the historical trajectory of feminist phenomenology, ways of perceiving and making sense of the contemporary world, and the feminist body in health and ethics, these essays affirm the base of the discipline as well as open new theoretical spaces for work that bridges bioethics, social identity, physical ability, and the very nature and boundaries of the (...) female body. Entanglements with thinkers such as Heidegger, Merleau-Ponty, Beauvoir, and Arendt are evident and reveal new directions for productive philosophical work. Grounded in the richness of the feminist philosophical tradition, this work represents a significant opening to the possible futures of feminist phenomenological research. (shrink)

Human beings have to ask how faith is possible, in this mixed world of trouble and joy. A safe universe with no scope for adversity would be a mechanical toy, not a creation. A glorious universe will be a place where troubles have eventually been overcome. Christians believe in one God, who is three Persons. God the heavenly Father took the risk of making a real world, full of living people capable of happiness. Jesus Christ, God the Son, came as (...) a human being to take responsibility for creation. He suffered and died; and he rose from death to vindicate the whole enterprise and show that creation can and will be made good. People are not left to work out their own faith but are invited to belong to the church, in order to keep in touch with God the Spirit. They are to behave as God's children, not by rule-bound conformity but by grateful response to the glory of God the Holy Trinity. (shrink)

Frank Balfour was regarded by his colleagues as one of the greatest biologists of his day and Charles Darwin’s successor, yet the young aristocrat died in a climbing accident before his thirty-first birthday. Reactions to his death reveal much about the image of science and scientists in late-Victorian Britain. In this paper I examine the development of the Cambridge school of animal morphology, headed by Balfour, and the interdependence of his research reputation and his charisma. Contemporaries praised his gentlemanly qualities, (...) making his aristocratic background a part of his scientific character. Yet his reputation for good judgement and his abilities as a leader were severely tested when it began to emerge that the accident that killed Balfour and his guide might have been prevented. Nonetheless, the image of Balfour that emerges from his obituaries is that of a noble hero and outstanding scientist, who lived on in the memories of all who knew him. (shrink)

abstractPosthumanism can be understood as a position that de-prioritizes or rescinds the privilege of the human in some way – frequently by attempting to think humanity as one element of a wider ecology of interdependent forces. This paper argues that one can be on the side of the human without neglecting the assemblages of which we are all a part – by conceiving of humanity as a site of nascent potential for sapience + care – an alienated understanding of a (...) complex world combined with the will to engage in the reparative processes of tending to it. (shrink)

In this article, Hannah Arendt's concept of action will be used to problematize current transformations of the health care sector and examine some responses by ethicists in light of those transformations. The sphere of human interaction that should typify health care work is identified as an action of unpredictable praxis in contrast to controllable procedures and techniques which increasingly take place in the health care sector.

In order to open new possibilities for bioethics, I argue that we need to rethink our concept of nature. The established cognitive framework determines in advance how new technologies will become visible. Indeed, in this dualistic approach of metaphysics, nature is posited as limitless, as material endowed with force which causes us to lose the sense of nature as arising out of itself, of having limits, an end. In contrast, drawing upon the example of the gender assignment and construction of (...) intersexed infants, I want to suggest for bioethics an understanding of nature that arises not from our scientific explorations, but rather from attending to our situated perceptual encounters with the world which underlie such experimentation; these encounters are too easily overlooked, and yet they are crucial for opening up new ways of thinking. (shrink)

The US Supreme Court’s abortion decisions over the past forty years have helped to shape cultural beliefs and practices concerning heterosexual relationships, marriage, and parenting. This is true both in the practical and in the legal senses. Practically speaking, definitively separating sex from childbearing, as only abortion can do (given how often contraception fails), inevitably changes the meaning of sex, and therefore of heterosexual relationships. Legally speaking, the Court’s influence was mediated significantly by its decision to locate the right of (...) abortion in an area of constitutional law—substantive due process—which claims to contain only those rights that are indispensable to our national understanding of freedom, both at the level of the individual and respecting our overarching democratic order. In particular, over the course of forty years of abortion opinions, the Court’s reflections on a claimed link between abortion and freedom have led it to conclusions broadly reflected in modern American beliefs and practices insofar as sex, marriage, and parenting are concerned. These include, inter alia, a suspicion of motherhood on the grounds of its risks and harms, the dispensable roles and violent characters of men, the great importance of adults’ wishes, and the importance of sexual expression for individual identity, divorced from consequences for partners or children. (shrink)

This paper develops previous work on theories of embodiment by drawing on empirical data from a study into the experiences of infertile women in the UK. I suggest experiences of embodiment shape the preferences of infertile women for a female nurse as chaperone during intimate medical procedures. I explore the impact of this role on the understandings and meanings of nursing in a highly gendered field of practice. I present data from an ethnographic study of infertile women who chose to (...) attend a British infertility clinic for investigation and fertility treatment cycles. Data were collected over 2 years using participant observation and semistructured interviews with 15 women and 20 members of staff in a British fertility unit. Data analysis was completed using a modified thematic analysis following Boyle and McEvoy. I discuss women's experiences of intimacy and bodily care and how these experiences might be understood by exploring the phenomenological concept of embodiment. I argue that women benefit from having a female nurse as chaperone because of their expectations of gender, nursing and caring. Women's expectations reinforce both notions of gendered caring and the gendered role of nursing. These data challenge notions of patriarchal professionalism prevalent in nursing, which seek to move away from the gendered role of the nurse (which traditionally included a chaperone role) towards a model of professional development based on a mind–body split. I suggest that these data offer a way of understanding the female embodied subject in the field of gendered caring, which is potentially transgressive because they suggest ways in which both mind and body can be integrated through the role of the female chaperone. (shrink)

There has been considerable recent debate about prostitution in Europe that reflects concerns about health, employment and human rights. Legal changes are being introduced in many countries. We focus on two examples in order to discuss the likely implications. A new law in The Netherlands is normalizing aspects of the sex industry through decriminalizing both workers and businesses. In Sweden, on the other hand, prostitution is considered to be a social problem, and a new law criminalizes the purchasers of sexual (...) services in an attempt to reduce demand. Both reforms appear to have had their desired effect at one level; in The Netherlands, health and safety regulations will be introduced as in any other job, and EU sex workers gain full social, legal and employment rights; in Sweden there was initially a tenfold decrease in the numbers of women working visibly on the streets, and some workers have left the industry. However, in both countries, the new legislation has also driven some sex work underground. Many sex workers are excluded by the Dutch system and move underground to become effectively invisible to the authorities. In Sweden sex workers and their clients also become less visible in order that the latter can avoid sanction. Social and economic changes, such as increased migration and the growing use of the Internet will also render the sex industry less visible both to state regulation and to health care workers. The major problems of prostitution for the workers remain exploitation, stigma, abuse and criminalization. These are not unique to the industry, and can only be tackled effectively by the self-organization of sex workers into unions and rights groups, along with full decriminalization. An alternative vision is promised through self-organization and anti-racist actions by sex workers in Germany; normalization and workers’ rights are tackled alongside training programmes for those seeking alternatives. Policy makers throughout Europe would do well to look at their experience and not simply at the clash of legal reforms. (shrink)