It is reasonable to consider and trust that information taken from us about our medical health and history will be protected by rules on confidentiality and consent. Apart from very rare cases, perhaps of major public interest or for public health reasons, this information will not be shared with others without our consent. However, both a number of reforms in National Health Service patient data management policy (now enshrined in legislation) and developments in the general law on privacy challenge this (...) traditional view of our control and choice over our medical information, as this article will show. In doing so, it analyses the question as to whether in spite of the rhetoric do any of us now really have choice over the access to and use of our medical data? In reality, our choices are limited and in any relationship of trust and shared decision making this ought to be transparent. (shrink)

The aim of this study was to obtain an increased understanding of the experiences of elderly people in geriatric care, with special reference to integrity. Data were collected through qualitative interviews with elderly people and, in order to obtain a description of caregivers’ integrity-promoting or non-promoting behaviours, participant observations and qualitative interviews with nursing students were undertaken. Earlier studies on the integrity of elderly people mainly concentrated on their personal and territorial space, so Kihlgren and Thorsén opened up the possibility (...) of considering the concept of integrity from a broader view by recognizing its relationship to the larger framework of the self-concept. Based on this, findings in the present study indicate that elderly people’s integrity relating to their corporal self were the least violated. On the other hand, their psycological, information and cultural selves were the most exposed. The study also identified a further dimension (i.e. one relating to social self), which should be included in the concept of integrity because respecting elderly people’s social self reduces their feelings of loneliness, isolation and seclusion. In summary, the results indicate that the concept of integrity is complex and has several dimensions. (shrink)

Neither the English courts nor the National Health Service (NHS) have been immune to the modern mantra of patient choice. This article examines whether beneath the rhetoric any form of real choice is endorsed either in law or in NHS policy. I explore the case law on ‘consent’, look at choice within the NHS and highlight the dilemmas that a mismatch of language and practice poses for clinicians. Given the variance in interpretation and lack of consistency for the individual patient (...) I argue for a semantic change that obviates the use of ‘choice’, focussing instead on the options for treatment that are available and accessible, with due acknowledgement of individual patient preferences, without raising unfettered and false expectations. (shrink)

Future mobility planning to cope with ongoing environmental challenges such as air pollution has to be anchored in the work of every public authority worldwide. One recent trend that could support public authorities to meet the European Union’s sustainability targets is the creation and sharing of transport and mobility “big” data between public authorities via tools such as crowdsourcing. While the benefits of the use of big data to increase public authorities’ efficiency and effectivity and their citizens’ lives is well (...) understood, examples from the public sector that highlight public authorities’ engagement in such sharing activities is still missing. To date relevant literature has highlighted issues around the capacity of public authorities that hinder shared activities. In this paper we want to raise distrust as a key reason for lack of engagement. Based on comprehensive data collected over the period of 4 years via several workshops and semi-structured interviews with seven public authorities in Europe, we are able to demonstrate that a major obstacle for not providing and sharing data via crowdsourcing for mutual benefit lies primarily in the hands of the public authority’s servants of the middle and high-level management. Our results show firstly, that distrust may emerge toward different referents such as the community, particular individuals, or the technology itself and thus, managerial implications have to be very specific to overcome distrust. Secondly, we show how distrust may spread from one referent to another through negative reciprocity and which, if unchecked may lead to an all-encompassing state that affects the whole sharing economy framework and inhibits potential benefits. (shrink)

This article reveals a 91-year-old cognitively intact man’s lived experiences of being cared for in a geriatric context in which the majority of the patients were cognitively impaired. A narrative patient story was analysed phenomenologically. The findings indicate that this patient’s basic needs for ethical care were not met. The staff did not see him as a unique individual with his own preferences, resources and abilities to master his life. In order to survive this lack of ethical care, he played (...) the role of an ‘old cognitively impaired man’, which provided him with at least the understanding and attention the cognitively impaired patients received from the staff. The findings also indicate that ethical care is independent of whether or not older cognitively intact and impaired patients stay or live in the same unit, but it is more dependent on a caregiver’s ability to respect and confirm each and every patient for who he or she is and would like to be. (shrink)

Background: To place a dependent with severe dementia in a nursing home is a painful and difficult decision to make. In collectivistic oriented societies or families, children tend to be socialised to care for ageing parents and to experience guilt and shame if they violate this principle. Leaving the care to professional caregivers does not conform with the cultural expectations of many ethnic groups and becomes a sign of the family’s moral failure. Research design: Qualitative design with individual in-depth interviews (...) with nurses, family members and dementia care coordinators in Norway, Montenegro, Serbia and South Africa. Braun and Clarke’s six analytic phases were used. Ethical considerations: The project was approved by the Regional Committee for Research, South-Eastern Norway; the Norwegian Centre for Research Data; the Ethics Committee; University of Limpopo, MEDUNSA Campus, South Africa; and by the local heads of the respective nursing homes or home care services. Interviewees were informed orally and in writing and signed an informed consent form. Findings: Healthcare professionals tend to be contacted only when the situation becomes unmanageable. Interviewees talked about feelings of obligation, shame and stigma in their societies regarding dementia, particularly in connection with institutionalisation of family members. Many lacked support during the decision-making process and were in a squeeze between their own needs and the patients’ need of professional care, and the feeling of duty and worry about being stigmatised by their surroundings. This conflict may be a source of pre-decision regret. Conclusion: Family caregivers need help to understand the behaviours of persons with dementia and how to access the formal and informal services available. Thus, they may provide effective support to patients and family carers alike. Supportive interventions for caregivers need to be tailored to meet the individual needs of both the caregiver and the persons with dementia. (shrink)

Aquaculture is the fastest growing animal producing sector in the world and is expected to play an important role in global food supply. Along with this growth, concerns have been raised about the environmental effects of escapees and pollution, fish welfare, and consumer health as well as the use of marine resources for producing fish feed. In this paper we present some of the major challenges salmon farming is facing today. We discuss issues of relevance to how to ensure sustainability, (...) by focusing on animal production systems, breeding approaches, sources for feed ingredients, and genetic engineering strategies. Other crucial issues such as animal welfare, environmental quality, and ethics are elaborated with regard to relevance for the sustainability of aquaculture. Additionally, we comment on socio-economic distributive implications by intellectual property rights (IPR) strategies on access to genetic material and traceability. To improve sustainability of salmon farming we suggest that there is a need for new approaches to guide research, for identification of ethical issues, and for engaging stakeholders in resolving these challenges. (shrink)

Obstetric ultrasound has become a significant tool in obstetric practice, however, it has been argued that its increasing use may have adverse implications for women’s reproductive freedom. This study aimed to explore Australian obstetricians’ experiences and views of the use of obstetric ultrasound both in relation to clinical management of complicated pregnancy, and in situations where maternal and fetal health interests conflict.

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)

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

The essence of religion was once widely thought to be a unique form of experience that could not be explained in neurological, psychological, or sociological terms. In recent decades scholars have questioned the privileging of the idea of religious experience in the study of religion, an approach that effectively isolated the study of religion from the social and natural sciences. Religious Experience Reconsidered lays out a framework for research into religious phenomena that reclaims experience as a central concept while bridging (...) the divide between religious studies and the sciences. Ann Taves shifts the focus from "religious experience," conceived as a fixed and stable thing, to an examination of the processes by which people attribute meaning to their experiences. She proposes a new approach that unites the study of religion with fields as diverse as neuroscience, anthropology, sociology, and psychology to better understand how these processes are incorporated into the broader cultural formations we think of as religious or spiritual. Taves addresses a series of key questions: how can we set up studies without obscuring contestations over meaning and value? What is the relationship between experience and consciousness? How can research into consciousness help us access and interpret the experiences of others? Why do people individually or collectively explain their experiences in religious terms? How can we set up studies that allow us to compare experiences across times and cultures? Religious Experience Reconsidered demonstrates how methods from the sciences can be combined with those from the humanities to advance a naturalistic understanding of the experiences that people deem religious. (shrink)

The carer of the person with dementia is enjoined to maintain respect, and to reinforce this a bill of rights has been established . Of course, talk of rights does not guarantee respectful behaviour. In this paper it is argued that the discovery that the sufferer continues to be a person, with a unique lifeworld, can assist the carer to conform willingly to the demand that they act respectfully.The current research project makes central the idiographic description of the individual case.

The implementation of skills labs in Danish nursing education can, in itself, be viewed as a complexity. The students are expected to eventually carry out their work in a situated hospital practice, but they learn their professional skills in a different space altogether, detached and removed from the hospitals and practising on plastic dummies. Despite the apparent artificiality of the skills lab, this article will show that it is possible to analyse some of the fundamental aspects of care in nursing (...) by ethnographically following this phenomenon of simulation‐based training. These particular aspects of care are not explicated in the curriculum or textbooks; however, they surfaced once this crooked approach to studying care in a simulated practice was applied. The article start from the assertion that detached engagements are not recognized within the field of nursing education as an equal component to attachments. Yet empirical cases from the skills lab and hospitals illustrate how students sometimes felt emotionally attached to plastic dummies and how experienced nurses sometimes practised a degree of detachment in relation to human patients. Detached engagements will therefore be presented as part of care practices of nurses – rendering the ability to detach in engagement with patients a professional skill that students also need to learn. In the analysis to follow, attached and detached engagements are located on an equal plane by integrating both into the same conceptual framework, rather than imposing a priori notions about their dialectic relation. The analysis shows that it is the particular intertwinement of attachment and detachment that gives care its fundamental meaning. In conclusion, the need for a conceptual shift from a strong emphasis on attached engagement to a more balanced analytical approach to care work, as involving both attached and detached engagement within Danish nursing education, is advocated. (shrink)

We combine research on business groups with the socioemotional wealth approach from family firm research to examine how family control of business group firms affects voluntary disclosure of environmental performance information. Theorizing that disclosing environmental performance information weakens the owning family’s control over its business group firm, but also generates reputational benefits, we expect family ownership and disclosure propensities to relate in a U-shaped way and, further, that this U-shape is accentuated for business group firms with a family CEO. Analysis (...) of longitudinal data on disclosure decisions of South Korean business group firms supports our theory and suggests that the effect of family control on environmental performance disclosure is neither good nor bad; instead, it depends on both the level of family ownership and whether a family CEO is in place. The finding that disclosure propensities are greatest when family control of business group firms is most extensive is provocative: it suggests that the very element that often is seen to encourage inefficiencies and fraud in business groups—family ownership combined with family leadership—can also be leveraged to foster responsible behaviors. (shrink)

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

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

William James's The Varieties of Religious Experience is one of the world's most popular attempts to meld science and religion. Academic reviews of the book were mixed in Europe and America, however, and prominent contemporaries, unsure whether it was science or theology, struggled to interpret it. James's reliance on an inherently ambiguous understanding of the subconscious as a means of bridging between religion and science accounts for some of the interpretive difficulties, but it does not explain why his overarching question (...) was so obscure, why psychopathology and unusual experiences figured so prominently, or why he gave us so many examples and so little argument. To understand these persistent puzzles we need to do more than acknowledge James's indebtedness to Frederic Myers's conception of the subconscious. We need to read VRE in the context of the transatlantic network of experimental psychologists and psychical researchers who provided the primary intellectual inspiration for the book. Doing so not only locates and clarifies the underlying question that animated the work but also illuminates the structural and rhetorical similarities between VRE and Myers's Human Personality and Its Survival of Bodily Death. In contrast to the individual case studies of hysterics, mediums, and mystics produced by others in this network, both Myers and James adopted a natural-history approach in which they arranged examples of automatisms to produce a rhetorical effect, thus invoking science in order to evoke a religious response. Where Myers organized his examples to make a case for human survival of death, James organized his to make a case for the involvement of higher powers in the transformation of the self. Read in this way, VRE marks a dramatic shift from a religious preoccupation with life after death to a religious preoccupation with this-worldly self-transformation. (shrink)

Feminist theory has produced a robust literature on embodiment that explores phenomena such as maternity, mobility, ability, and aging. However, the field has produced surprisingly few analyses of the bodily phenomenon of voice; references to voice in the context of critical theory are almost entirely metaphorical in nature, a relegation that obscures the philosophical relevance of voice as embodied phenomenon. Using insights garnered from the fields of sound studies and musicology, I argue that contemporary feminist theory should address the social, (...) political, and ethical meanings of the bodily, material phenomenon of vocality. Specifically, I argue that vocality is better understood as intervocality, that it is an existentially significant aspect of identity, and that it is implicated in systematic inequality and social relations in meaningful ways. I critique Adriana Cavarero’s approach to vocal justice, demonstrating that it does not sufficiently take up the challenges of intervocality. The article concludes with some preliminary remarks regarding a conceptualization of vocal justice. (shrink)

Methane emissions from sheep and cattle production have gained increasing profile in the context of climate change. Policy and scientific research communities have suggested a number of technological approaches to mitigate these emissions. This paper uses the concept of co-production as an analytical framework to understand farmers’ evaluation of a 'good animal’. It examines how technology and sheep and beef cattle are co-produced in the context of concerns about the climate change impact of methane. Drawing on 42 semi-structured interviews, this (...) paper demonstrates that methane emissions are viewed as a natural and integral part of sheep and beef cattle by farmers, rather than as a pollutant. Sheep and beef cattle farmers in the UK are found to be an extremely heterogeneous group that need to be understood in their specific social, environmental and consumer contexts. Some are more amenable to appropriating methane reducing measures than others, but largely because animals are already co-constructed from the natural and the technical for reasons of increased production efficiency. (shrink)

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

This essay investigates the development of seeing as an affective, political and potentially transformative practice across the course of John Kinsella’s poetic career. It analyses how seeing becomes a means for Kinsella to apprehend the relationship between self and environment and to consider how local-scale is tied to broader-scale change. At the same time, it traces Kinsella’s concern at the ways in which Western theories of vision shape and reinforce structures of power, particularly in terms of gendered and colonial violence. (...) Moving through and then past ekphrastic debates, I argue that Kinsella considers how poetry and art might, in their own ways, ethically engage with both the human and more-than-human and actively navigate and reflect upon states of connection. (shrink)

With the introduction of general management and then of planned markets into the National Health Service (NHS), health care in the UK has gone through a massive amount of change. The effect on those working for the NHS has been ‘challenging’ and often confusing. This paper aims to clarify what is happening by taking an ideological perspective: what ideologies exist, how they are changing and the strategies being used to ensure their survival. Ideologies are basically about power. The relationship between (...) market, managerial and professional ideologies is analysed using charters, codes of conduct and other associated documents. A tentative conclusion is reached that professional ideologies are able to adjust to the overriding market/consumerist ideology. However, the managerial ideology is having difficulty in gaining any real ground against the professional ideology and is having to move strategically by using audit, not just of finance, but also of clinical judgement, to gain power. (shrink)

Representational drift is a phenomenon of increasing interest in the cognitive and neural sciences. While investigations are ongoing for other sensory cortices, recent research has demonstrated the pervasiveness in which it occurs in the piriform cortex for olfaction. This gradual weakening and shifting of stimulus-responsive cells has critical implications for sensory stimulus–response models and perceptual decision-making. While representational drift may complicate traditional sensory processing models, it could be seen as an advantage in olfaction, as animals live in environments with constantly (...) changing and unpredictable chemical information. Non-topographical encoding in the olfactory system may aid in contextualizing reactions to promiscuous odor stimuli, facilitating adaptive animal behavior and survival. This article suggests that traditional models of stimulus–(neural) response mapping in olfaction may need to be reevaluated and instead motivates the use of dynamical systems theory as a methodology and conceptual framework. (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)