Doctor and patient meet in a circle of feelings determined by suffering. Sensitivity to the suffering is an axis determining the nature of the doctor and patient relationship. The patient's experience of an illness is individual, private, and very often difficult to describe. But the possibility to understand the suffering of another person comes from the fact that suffering is a universal feeling. We propose to enter the world of patient's experience by writing a letter to a doctor, which would (...) reflect their experiences and expectations towards him. This was the task required for 120 students of the second year of medicine and dentistry education. (shrink)

We are printing in its entirety the discussion document which sets out a code of professional conduct for nurses published by the Royal College of Nursing in November 1976 together with commentaries by the Assistant Secretary of the British Medical Association, a professor of nursing studies, student nurses and a lawyer. The image of the nurse is still that of one of Florence Nightingale's young ladies or of a member of a religious order who is wholly dedicated to caring for (...) the sick. Today, as this document and the comments upon it show, 'dedication' is still part of the motive which leads a man or woman to become a nurse but in addition, and this is where the public may be ignorant or choose to be ignorant, nursing offers a career where intellectual achievement and the satisfaction of a demanding job bring their proper financial reward and place in the professional community. We are grateful to the Royal College of Nursing for permission to publish this document. (shrink)

Descriptions of body imagery and body parts are evident in expressions of Old Testament texts. Although there is no single term for ‘body’ in the Hebrew mind, the concept of ‘body’ functions in its different parts. As part of anthropomorphic descriptions of God and expressions attached to humankind, body parts have special significance, contributing to the theological dimension of texts. The poems in the Psalter are no exception. Several body parts are mentioned in Psalm 38, an individual lament song. In (...) addition to God’s hand (v. 3) and an allusion to his voice (v. 16), several body parts describe the psalmist’s condition. These include ‘flesh’ (bāšār, 3, 8), bones (‘ætsæm, 3), head (rôsh, 5), loins (kæsæl, 8), heart (lēb, 9, 11), eyes (‘yn, 11), mouth (pæh, 14, 15), and feet (rægæl, 17). In addition, allusions to the ear (14, 15) and injured body (wounds, 6) form part of the psalmist’s lamenting experience.Contribution: This presentation touches on the general meaning of these body imagery in the Old Testament and their specific function and meaning in the text of Psalm 38. A textual analysis will portray their theological significance. (shrink)

This survey set out to explore occupational health professionals' courses of action with respect to privacy in a situation of dual loyalty between employees and employers. A postal questionnaire was sent to randomly selected potential respondents. The overall response rate was 64%: 140 nurses and 94 physicians returned the questionnaire. Eight imaginary cases involving an ethical dilemma of privacy were presented to the respondents. Six different courses of action were constructed within the set alternatives proposed. The study indicated that privacy (...) as an absolute value is not in the interest of either employees or employers. It also showed that, where dual loyalty is concerned, the most valid course of action in dealing with sensitive subjects such as drug and work community problems, sexual harassment and sick leave is to rely on tripartite co-operation. If they maintain their professional independence and impartiality, health professionals are well placed to succeed in this challenging task; if not, there are bound to be severe violations of privacy. (shrink)

Adverbial modification is probably one of the least understood areas of linguistics. The essays in this volume all address the problem of how to give an analysis of adverbial modifiers within truth-conditional semantics. Chapters I-VI provide analyses of particular modifiers within a possible worlds framework, and were written between 1974 and 1981. Original publication details of these chapters may be found on p. vi. Of these, all but Chapter I make essential use of the idea that the time reference involved (...) in tensed sentences should be a time interval rather than a single instant. The final chapter (Chapter VII) was written especially for this volume and investigates the question of how the 'situation semantics' recently devised by Jon Barwise and John Perry, as a rival to possible-worlds semantics, might deal with adverbs. In addition I have included an appendix to Chapter III and an introduction which links all the chapters together. (shrink)

In this paper, I offer a view beyond that which would narrowly reduce the role of parents in medical decision making to acting as custodians of the best interests of children and toward an account of family authority and family autonomy. As a fundamental social unit, the good of the family is usually appreciated, at least in part, in terms of its ability successfully to instantiate its core moral and cultural understandings as well as to pass on such commitments to (...) future generations. The putative rights of children to expression, information, freedom of thought, conscience, religion, and to freedom of association with others are, in this essay, assessed from the perspective of those conditions necessary for the family to function as a moral community. In so doing, I respond to the move to liberate children from parental authority and to effect the transformation of the family as implied by the United Nations’ "Convention on the Rights of the Child" and the pediatric bioethics it supports. (shrink)

Divided-mind approaches to the conflict involved in self-control are pervasive. According to an influential version of the divided-mind approach, self-control conflict is a dispute between affective reactions and “cold” cognitive processes. I argue that divided-mind approaches are based on problematic bipartite architectural assumptions. Thus views that understand self-control as “control _of_ the self” might be better suited to account for self-control. I subsequently aim to expand on this kind of view. I suggest that self-control conflict involves a rivalry between narrative (...) self-models aimed at reducing error, analogous to model rivalry in binocular rivalry paradigms. This approach straightforwardly accounts for the sense of conflict that is characteristic of self-control within a unified-mind approach, and among its other explanatory advantages, it directly aligns with current views that account for addiction in terms of maladaptive self-representational processes. (shrink)

We use Marya Schechtman’s Narrative Self-Constitution View to support the widespread idea that food can contribute to the construction and expression of our identities and be used to understand others. What foods we consume can be one such way to construct our identities as food itself can have different values: ethically sourced, healthy, culturally significant, etc. However, the ability to constitute one’s own identity in this way depends on the ability to autonomously choose what we consume. We argue that most (...) consumers have much less control over their own consumption habits than is typically assumed (indeed, much of the literature on food and identity relies on the assumption) and thus consumers have diminished autonomy with respect to identity-constitution. We focus on the effects of three such autonomy compromising practices: food impositions, which are social pressures on food choice; manipulative marketing; and impediments to access. Together these practices diminish second-order endorsement of food-related values, generate false beliefs about what one is eating, and create social, economic, or physical barriers which limit access to desired foods. There are, however, spaces where consumers are fighting back against cultural norms and agribusiness and changing their own relationship(s) with consumption, thereby exercising increased autonomy over their food and their identity. (shrink)

In Roper v. Simmons (2005) the United States Supreme Court announced a paradigm shift in jurisprudence. Drawing specifically on mounting scientific evidence that adolescents are qualitatively different from adults in their decision-making capacities, the Supreme Court recognized that adolescents are not adults in all but age. The Court concluded that the overwhelming weight of the psychological and neurophysiological data regarding brain maturation supports the conclusion that adolescents are qualitatively different types of agents than adult persons. The Supreme Court further solidified (...) its position regarding adolescents as less than fully mature and responsible decisionmakers in Graham v. Florida (2010) and Miller v. Alabama (2012). In each case, the Court concluded that the scientific evidence does not support the conclusion that children under 18 years of age possess adult capacities for personal agency, rationality, and mature choice. This study explores the implications of the Supreme Court decisions in Roper v. Simmons, Graham v. Florida, and Miller v. Alabama for the “mature minor” standard for medical decision making. It argues that the Supreme Court’s holdings in Roper, Graham, and Miller require no less than a radical reassessment of how healthcare institutions, courts of law, and public policy are obliged to regard minors as medical decisionmakers. The “mature minor” standard for medical decision making must be abandoned. (shrink)

Following the lead of Annette Baier, this essay argues that trust relations provide the ethical substance of everyday living. When A trusts B, A unreflectively allows B to approach sufficiently close so as to be able to harm A. In order for this to be possible, A practically presupposes that B perceives A as a person and will hence act accordingly. Trust relations are relations of mutual recognition in which we acknowledge our mutual standing and vulnerability with respect to one (...) another. A robust account of trust assumes: first, trust relations are primary and practical, and while monitored by reason, they are not rationally constituted; second, trust can sustain its practical primacy over moral reason because it is developmentally prior to reason; and third, trust relations can be the bearers of our worth and vulnerability because they are the developmental products of first love. (shrink)

In this paper, we examine how organizations’ impression management evolves in response to rising stakeholder pressures regarding organizations’ corporate responsibility initiatives. We conducted a comparative case study analysis over a period of 13 years for two organizations—Exxon and BP—that took extreme initial stances on climate change. We found that as stakeholder pressures rose, their IM tactics unfolded in four phases: advocating the initial stance, sensegiving to clarify the initial stance, image repairing, and adjusting the stance. Taken together, our analysis of (...) IM over these four phases provides three key insights about the evolution of IM in the face of rising pressures. First, when faced with stakeholder pressures, it seems that organizations do not immediately resort to conforming but tend to give in gradually when pressures increase and start to come from relatively powerful stakeholders. Second, evolution of IM seems to be characterized by path dependence, i.e., even as organizations’ positions evolve, they continue to show their conviction in their initial positions and try to convey that their subsequent positions flow logically from the previous ones. Finally, IM involves navigation between symbolism and substance, and companies tend to strive toward harmonizing their symbolic and substantive actions as stakeholder pressure increases. (shrink)

John Locke claimed that: ‘We never finding, nor conceiving it possible, that two things of the same kind should exist in the same place at the same time, we rightly conclude that, whatever exists anywhere at any time excludes all of the same kind, and is there itself alone’. He argued that, otherwise, ‘The notions and names of identity and diversity would be in vain, and there could be no such distinctions of substances or anything else one from another’. More (...) recently Professor D. Wiggins has made a similar claim for similar reasons. I shall maintain that, even if we accept the general outline of the essentialist account of identity given by Wiggins in his book, the claim that two things of the same kind cannot be in the same place at the same time should be rejected, until better reasons are forthcoming. (shrink)

In a number of publications A.N. Prior considered the use of what he called ‘metric tense logic’. This is a tense logic in which the past and future operators P and F have an index representing a temporal distance, so that Pnα means that α was true n -much ago, and Fn α means that α will be true n -much hence. The paper investigates the use of metric predicate tense logic in formalising phenomena ormally treated by such devices as (...) multiple indexing or quantification over times. (shrink)

Criticisms of the ethical justification of antidoping legislation are not uncommon in the literatures of medical ethics, sports ethics and sports medicine. Critics of antidoping point to inconsistencies of principle in the application of legislation and the unjustifiability of ethical postures enshrined in the World Anti-Doping Code, a new version of which came into effect in January 2009. This article explores the arguments concerning the apparent legal peculiarities of antidoping legislation and their ethically salient features in terms of: notions of (...) culpability, liability and guilt; aspects of potential duplication of punishments and the limitations of athlete privacy in antidoping practice and policy. It is noted that tensions still exist between legal and ethical principles and norms that require further critical attention. (shrink)

In “Imposing Risks,” Judith Thomson gives a case in which, by turning on her stove, she accidentally causes her neighbor’s death. She claims that both the following are true: (1) she ought not to have caused her neighbor’s death; (2) it was permissible for her to turn her stove on. In this paper it is argued that it cannot be that both (1) and (2) are true, that (2) is true, and that therefore (1) is false. How this is so (...) is explained, and the implications of this position regarding the relation between rights and duties is explored. (shrink)