This article draws on data from a qualitative research study undertaken in an old UK university with the main aim of investigating the issue of the gender dimension of academic careers. It examines the idea of an individualistic academic career that demands self-promotion, which is still used as a measure of achievement by those in senior positions. However, there is a basic contradiction. While this idea is upheld, men simultaneously gain by an in-built patriarchal support system. They do not have (...) to make a conscious effort to be helped by it, thereby perpetuating the cultural hegemony of individualism. Women are not admitted to this support system, and if they are seen as needing or wanting to set up their own system, this is viewed as a weakness. The answer appears to be for women to strategically harness feminist ways of working in a collaborative and supportive way. (shrink)

In this multi-disciplinary collection, we ask the question, 'What did, and do, Quakers think about good and evil?' There are no simple or straightforwardly uniform answers to this, but in this collection, we draw together contributions that for the first time look at historical and contemporary Quakerdom's approach to the ethical and theological problem of evil and good. Within Quakerism can be found Liberal, Conservative, and Evangelical forms. This book uncovers the complex development of metaethical thought by a religious group (...) that has evolved with an unusual degree of diversity. In doing so, it also points beyond the boundaries of the Religious Society of Friends to engage with the spectrum of thinking in the wider religious world. (shrink)

This article explores what might constitute the good-enough reader of Maggie Nelson's The Argonauts. Prompted by Nelson's use of D.W. Winnicott's theory of the good-enough mother whose insufficiencies generate the infant's capacity to tolerate ordinary frustration and move beyond both idealizations and denigrations, I argue that the good-enough reader here would be the one who resists the temptation to idealize both the book and its author. This argument is presented as an attempt to open up some spaces for the discussion (...) of ambivalent responses to this book, beyond the rather deferential fandom that has characterized the psychic life of its reception. (shrink)

abstract In this paper we question the basis on which judgements are made about the ‘quality’ of the lives of people whose embodied experience is anomalous, specifically in cases of impairments. In moral and political philosophy it is often assumed that, suitably informed, we can overcome epistemic gaps through the exercise of moral imagination: ‘putting ourselves in the place of others’, we can share their points of view. Drawing on phenomenology and theories of embodied cognition, and on empirical studies, we (...) suggest that there are barriers to imagining oneself differently situated, or imagining being another person, arising in part from the way imagination is constrained by embodied experience. We argue that the role of imagination in moral engagement with others is to expand the scope of our sympathies rather than to enable us to put ourselves in the other's place. We argue for explicit acknowledgement that our assessments of others’ QOL are likely to be shaped by the specifics of our own embodiment, and by the assumptions we make as a consequence about what is necessary for a good quality of life. (shrink)

Anesthesia research has focused on showing learning in the absence of awareness for good practical reasons. Crucially, continued learning during otherwise clinically adequate anesthesia may affect patients’ well-being on recovery. Theoretically, preserved perceptual priming during anesthesia offers a useful starting point for consciousness research by determining the limits of memory function during minimal consciousness. The big question for consciousness research is not to demonstrate absolutely unconscious processing, but rather to map out the cognitive and neurobiological processes that enable conscious experience (...) itself. (shrink)

Background: Use of patients’ medical data for secondary purposes such as health research, audit, and service planning is well established in the UK. However, the governance environment, as well as public understanding about this work, have lagged behind. We aimed to systematically review the literature on UK and Irish public views of patient data used in research, critically analysing such views though an established biomedical ethics framework, to draw out potential strategies for future good practice guidance and inform ethical and (...) privacy debates. Methods: We searched three databases using terms such as patient, public, opinion, and electronic health records. Empirical studies were eligible for inclusion if they surveyed healthcare users, patients or the public in UK and Ireland and examined attitudes, opinions or beliefs about the use of patient data for medical research. Results were synthesised into broad themes using a framework analysis. Results: Out of 13,492 papers and reports screened, 20 papers or reports were eligible. While there was a widespread willingness to share patient data for research for the common good, this very rarely led to unqualified support. The public expressed two generalised concerns about the potential risks to their privacy. The first of these concerns related to a party’s competence in keeping data secure, while the second was associated with the motivation a party might have to use the data. Conclusions: The public evaluates trustworthiness of research organisations by assessing their competence in data-handling and motivation for accessing the data. Public attitudes around data-sharing exemplified several principles which are also widely accepted in biomedical ethics. This provides a framework for understanding public attitudes, which should be considered in the development in any guidance for regulators and data custodians. We propose four salient questions which decision makers should address when evaluating proposals for the secondary use of data. (shrink)

Research that has been sponsored by pharmaceutical, medical device and biotechnology companies is often presented at scientific and medical conferences. However, practices vary between organizations and it can be difficult to follow both individual conference requirements and good publication practice guidelines. Until now, no specific guidelines or recommendations have been available to describe best practice for conference presentations.This document was developed by a working group of publication professionals and uploaded to PeerJ Preprints for consultation prior to publication; an additional 67 (...) medical societies, medical conference sites and conference companies were also asked to comment. The resulting recommendations aim to complement current good publication practice and authorship guidelines, outline the general principles of best practice for conference presentations and provide recommendations around authorship, contributorship, financial transparency, prior publication and copyright, to conference organizers, authors and industry professionals.While the authors of this document recognize that individual conference guidelines should be respected, they urge organizers to consider authorship criteria and data transparency when designing submission sites and setting parameters around word/character count and content for abstracts. It is also important to recognize that conference presentations have different limitations to full journal publications, for example, in the case of limited audiences that necessitate refocused abstracts, or where lead authors do not speak the local language, and these have been acknowledged accordingly. The authors also recognize the need for further clarity regarding copyright of previously published abstracts and have made recommendations to assist with best practice.By following Good Practice for Conference Abstracts and Presentations: GPCAP recommendations, industry professionals, authors and conference organizers will improve consistency, transparency and integrity of publications submitted to conferences worldwide. (shrink)

BackgroundECMO is a particularly scarce resource during the COVID-19 pandemic. Its allocation involves ethical considerations that may be different to usual times. There is limited pre-pandemic literature on the ethical factors that ECMO physicians consider during ECMO allocation. During the pandemic, there has been relatively little professional guidance specifically relating to ethics and ECMO allocation; although there has been active ethical debate about allocation of other critical care resources. We report the results of a small international exploratory survey of ECMO (...) clinicians’ views on different patient factors in ECMO decision-making prior to and during the COVID-19 pandemic. We then outline current ethical decision procedures and recommendations for rationing life-sustaining treatment during the COVID-19 pandemic, and examine the extent to which current guidelines for ECMO allocation (and reported practice) adhere to these ethical guidelines and recommendations.MethodsAn online survey was performed with responses recorded between mid May and mid August 2020. Participants (n = 48) were sourced from the ECMOCard study group—an international group of experts (n = 120) taking part in a prospective international study of ECMO and intensive care for patients during the COVID-19 pandemic. The survey compared the extent to which certain ethical factors involved in ECMO resource allocation were considered prior to and during the pandemic.ResultsWhen initiating ECMO during the pandemic, compared to usual times, participants reported giving more ethical weight to the benefit of ECMO to other patients not yet admitted as opposed to those already receiving ECMO, (p < 0.001). If a full unit were referred a good candidate for ECMO, participants were more likely during the pandemic to consider discontinuing ECMO from a current patient with low chance of survival (53% during pandemic vs. 33% prior p = 0.002). If the clinical team recommends that ECMO should cease, but family do not agree, the majority of participants indicated that they would continue treatment, both in usual circumstances (67%) and during the pandemic (56%).ConclusionsWe found differences during the COVID-19 pandemic in prioritisation of several ethical factors in the context of ECMO allocation. The ethical principles prioritised by survey participants were largely consistent with ECMO allocation guidelines, current ethical decision procedures and recommendations for allocation of life-sustaining treatment during the COVID-19 pandemic. (shrink)

Empirical evidence on the Fundamentals of Care framework and its relevance to practice is increasing. However, there is a need to understand the evidence in practice and determine how best to evaluate caring activities. This exploratory study aimed to understand current nursing practice with the Fundamentals of Care framework, how nurses understand the framework, and what is essential to patients receiving care. The objectives were (1) to observe nurses in practice and record nurse–patient interactions against the Fundamentals of Care framework (...) dimensions, (2) to probe the nurse's understanding of the framework, (3) to explore what is important to patients when receiving care from nurses, (4) to explore the nurse's and patient's understanding of culture and spirituality, and (5) to identify the barriers and facilitators to delivering integrated care. The study identified four key findings: (1) nurse–patient interactions centred around completing tasks and the physical aspects of care, (2) there are crucial gaps in nurses' ability to connect with their patients and establish a good nurse–patient relationship, (3) integrated fundamental care was not evident in the behaviours and narratives of the nurses, and (4) the context in which care is delivered significantly impacts how nurses work particularly the challenges of using technology and electronic records. Healthcare organisations and nursing leaders need to consider the implications of nurses prioritising the organisation's efficiency‐driven requirements over establishing a therapeutic relationship and integrating the patient's care needs. More work is required to support nurses in delivering integrated fundamental care. (shrink)

Atmospheres are affective, sensory realms, where mood is palpable. Memory landscapes intensify affectivity, amplifying emotion. The senses, especially smell and taste, trigger and heighten memory. There is therefore a potent intersection between landscape, atmospheres, memory, and the senses. These connections present the compelling prospect that atmospheres could be designed, with the intention of enhancing memory landscapes through sensory means. This paper is written from the perspective of landscape architecture, a discipline which designs and shapes landscapes. Landscape architects work within the (...) spatially and temporally fluid context of the landscape, and aligned with this is the prospect of generating and tuning atmospheres. Past traumatic events, losses of people and places, float in atmospheres of melancholy. Two projects are explored here to probe the possibilities of intentionally invoking atmospheres, exploring how the landscape could be sensorially tonalised. The memorial landscape of Pike River where 29 men died in a mine explosion, and Laura Daly’s augmented reality artwork, The Storm Cone, offer insights into the possibilities of atmospheric design. (shrink)

The work of a bioethicist carries distinctive responsibilities. Alongside those of any worker, there are responsibilities associated with giving guidance to practitioners, policy makers and the public. In addition, bioethicists are professionally exposed to and required to identify situations of moral trouble, and as a result may find themselves choosing to work as advocates or activists, with responsibilities that are distinct from those generally acknowledged within academia. The requirement for bioethics to make normative judgements entails taking a stance, which means (...) there cannot be a sharp line between ‘academic’ or ‘objective’ bioethics, and advocacy/activism, but a continuum of bioethicists’ engagement and an associated continuum of responsibilities. (shrink)

Susan has been profoundly deaf since childhood. She is a hearing aid wearer, and likes to use the induction loops built into some public spaces, such as theaters and cinemas, to help cut down the background noise that can make hearing speech very difficult. But this depends on the building having an induction loop fitted and properly maintained. Like many other induction loop users, Susan frequently finds that the advertised loop system is either working poorly or not working at all. (...) Almost as often, she then has the experience of making a complaint about it only to have the problem denied. If she persists, she is often then met... (shrink)

Foreign language anxiety has been identified as a crucial affective factor in language learning. Similar to the situation in language classes, university students in interpretation classes are required to perform in a foreign language when their language skills are inadequate. Investigations are needed to determine the specific impact of FLA on interpretation learning. This study investigated the effects of the specific interpretation classroom FLA on interpretation learning and dependency distance as an indicator of learners’ cognitive load. The participants were 49 (...) undergraduate and graduate students enrolled in English–Chinese interpretation classes at a university in Hong Kong. The results showed a significant negative correlation between ICFLA levels and consecutive interpretation achievement scores. ICFLA was also negatively correlated with DD in consecutive interpretations. Four factors underlying ICFLA were identified. The findings of this study would provide useful insights for researchers and educators to understand the nature and effect of FLA in different settings. (shrink)

Efforts to combat the COVID-19 crisis brought mountains of legislation and guidance to coerce or encourage people to stay at home and reduce the spread of the virus. During peak lockdown in the United Kingdom regulations defined when people could or could not leave their homes. Meanwhile guidance on social distancing advised people to stay within ‘households’. This paper explores the legislation under lockdowns in the UK from March to October 2020 and the implications for women’s gendered caring roles. The (...) regulations and guidance assumed that households were separate units and ignored the interdependencies which exist between households and between individuals and wider society. The continuing focus in the lockdown regulations has been on households as autonomous, safe, adequate and secure. This overlooks the interdependency of human life, gendered aspects of caring and the inequalities of housing and living conditions, highlighted by feminist scholarship. (shrink)

This book reconceives disability as a set of social relations and practices, as experienced embodiment, and as an emancipatory movement, as well as a biomedical phenomenon. The author brings new attention to complex ethical questions surrounding disability, looking at not only the biomedical understanding of impairment, but also its cultural representations and social organization.

This paper is based on linked qualitative studies of the donation of human embryos to stem cell research carried out in the United Kingdom, Switzerland, and China. All three studies used semi-structured interview protocols to allow an in-depth examination of donors’ and non-donors’ rationales for their donation decisions, with the aim of gaining information on contextual and other factors that play a role in donor decisions and identifying how these relate to factors that are more usually included in evaluations made (...) by theoretical ethics. Our findings have implications for one factor that has previously been suggested as being of ethical concern: the role of gratitude. Our empirical work shows no evidence that interpersonal gratitude is an important factor, but it does support the existence of a solidarity-based desire to “give something back” to medical research. Thus, we use empirical data to expand and refine the conceptual basis of bioethically theorizing the IVF–stem cell interface. (shrink)

Argument schemes are abstractions substantiating the inferential connection between premise(s) and conclusion in argumentative communication. Identifying such conventional patterns of reasoning is essential to the interpretation and evaluation of argumentation. Whether studying argumentation from a theory-driven or data-driven perspective, insight into the actual use of argumentation in communicative practice is essential. Large and reliably annotated corpora of argumentative discourse to quantitatively provide such insight are few and far between. This is all the more true for argument scheme corpora, which tend (...) to suffer from a combination of limited size, poor validation, and the use of ad hoc restricted typologies. In the current paper, we describe the annotation of schemes on the basis of two distinct classifications: Walton’s taxonomy of argument schemes, and Wagemans’ Periodic Table of Arguments. We describe the annotation procedure for each, and the quantitative characteristics of the resulting annotated text corpora. In doing so, we extend the annotation of the preexisting US2016 corpus of televised election debates, resulting in, to the best of our knowledge, the two largest consistently annotated corpora of schemes in argumentative dialogue publicly available. Based on evaluation in terms of inter-annotator agreement, we propose further improvements to the guidelines for annotating schemes: the argument scheme key, and the Argument Type Identification Procedure. (shrink)

Pandemics such as COVID-19 place everyone at risk, but certain kinds of risk are differentially severe for groups already made vulnerable by pre-existing forms of social injustice and discrimination. For people with disability, persisting and ubiquitous disablism is played out in a variety of ways in clinical and public health contexts. This paper examines the impact of disablism on pandemic triage guidance for allocation of critical care. It identifies three underlying disablist assumptions about disability and health status, quality of life, (...) and social utility, that unjustly and potentially catastrophically disadvantage people with disability in COVID-19 and other global health emergencies. (shrink)

This chapter examines the ways in which disabled people are subject to epistemic injustice. It starts by introducing how social epistemology models the creation of shared knowledge and then uses feminist epistemology to highlight the role of social and political power in producing epistemic privilege, exclusion, and oppression. The well-known concepts of testimonial and hermeneutic epistemic injustice are discussed in relation to disability, showing how these forms of injustice are frequently experienced within the lives of disabled people. In particular, disabled (...) experience has features that distinguish it from the experiences of sexism and racism most commonly used as illustrations of epistemic injustice. The chapter ends by arguing that the potential for epistemic injustice poses unprecedented risks for disabled people in the current context, which could be minimized by recognizing that ignorance about disabled lives is not inevitable, but something that can and should be challenged. (shrink)

Mitochondrial replacement techniques are intended to avoid the transmission of mitochondrial diseases from mother to child. MRT represent a potentially powerful new biomedical technology with ethical, policy, economic and social implications. Among other ethical questions raised are concerns about the possible effects on the identity of children born from MRT, their families, and the providers or donors of mitochondria. It has been suggested that MRT can influence identity directly, through altering the genetic makeup and physical characteristics of the child, or (...) indirectly through changing the child's experience of disease, and by generating novel intrafamilial relationships that shape the sense of self. In this article I consider the plausibility and ethical implications of these proposed identity effects, but I focus instead on a third way in which identity may be affected, through the mediating influence of the wider social world on MRT effects on identity. By taking a narrative approach, and examining the nature and availability of identity narratives, I conclude that while neither direct genetic nor indirect experiential effects can be excluded, social responses to MRT are more likely to have a significant and potentially damaging influence on the generation of MRT children's narratives of identity. This conclusion carries some implications for the collective moral responsibility we hold to ensure that MRT, if implemented, are practised in ethically justifiable ways. (shrink)

The pandemic years have taught bioethicists a lot about the experience of working on an issue at the same time as being directly affected by it. Under normal circumstances, if we can remember what those were, we are very often thinking and writing about a situation of moral difficulty that we know, and can only know, as outsiders. We...

La maladie de l'ame... la belle expression platonicienne n'a de cesse d'etre d'actualite. Non seulement elle est prompte a revenir d'epoque en epoque, mais elle semble particulierement friande de la notre. Que cette maladie designe une vague tristesse, un taedium vitae, ou, plus grave, une depression, elle implique tout a la fois la souffrance morale et la souffrance physique. L'ame et le corps sont divises mais se retrouvent dans la douleur si bien que la maladie de l'ame vient de ce (...) que nous avons un corps. De ce constat paradoxal Jackie Pigeaud tire une histoire, celle du triomphe du dualisme, du fardeau de l'ame et du corps contraints a etre separes et ensemble a perpetuite. Cette histoire trouve son origine dans le monde grec, et plus exactement dans sa philosophie. La division entre maladies de l'ame et autres maladies, c'est-a-dire maladies du corps, appartient a la philosophie. La medecine aurait ete bien soulagee de cette partition. Est-ce a dire qu'elle n'entendait pas etre philosophique? Sans doute: Hippocrate en offre un bon exemple. L'accord, tacite, est le suivant: l'ame appartient au philosophe et le corps au medecin. Ciceron s'occupe des passions et Galien suspend son jugement des qu'il approche la psyche. Chacun y trouve son compte mais les consequences sont importantes: la partition du champ des maladies, la place du malade dans la societe, les traitements a apporter, notamment a la folie, dependent de ce dualisme initial. Si le legs de la medecine greco-romaine est riche, il est aussi fort lourd et trouve des developpements tout au long de l'histoire de la medecine, jusqu'a la constitution au XVIIIe siecle de la psychiatrie. D'une ecriture et d'une pensee personnelles et profondes, ce livre est un essai sur l'histoire de la pensee medicale, depuis l'Antiquite jusqu'a nos jours. La Maladie de l'ame a ete un succes des sa parution, et ce succes n'a pas ete dementi depuis. L'ouvrage n'etait malheureusement plus disponible: les livres ont leur destin commentait l'auteur. Avec cette edition revue et augmentee, accompagnee d'une preface nouvelle, le livre connait enfin le sort qu'il merite.Jackie Pigeaud est professeur emerite de litterature latine a l'Universite de Nantes et membre de l'Institut universitaire de France. On lui doit egalement, aux Belles Lettres, Folie et cures de la folie chez les medecins de l'Antiquite greco-romaine. La manie. (shrink)

Philosophically grounded, methodologically sound, and theoretically rigorous, this paradigm-challenging collection ponders the most dynamic areas of feminist inquiry into bioethical thought and practice and sketches future directions for this rapidly growing field.

"First edition published 2009"--T.p. verso.

The last half of the twentieth century saw an explosion in our understanding of genetics and molecular biology; the questions now are in what form that genetic understanding will be put to use; and how and by whom it will be controlled. It's about science and spirituality, and how the two are connected.

In this paper I consider one effect that disablism has on social interactions between nondisabled and disabled people: the “hidden labor” carried out by disabled people to manage or manipulate the presentation of their impairment to others, and their own and others’ emotional responses, in order to achieve their goals. Although such management may be understood as actively enhancing the disabled person’s autonomous agency, I argue that the cost of this labor to the disabled person and the fact that it (...) must be hidden from the nondisabled partner in order to be effective, create an ethical problem. Such interactions confer a form of autonomy through a connection that is fundamentally distorted by asymmetries of power, knowledge, risk, and is therefore ethically undesirable. (shrink)

Bioethics traditionally focuses on establishing moral limits between different types of acts. However, boundaries are established by communities and individuals who differ in the constraints shaping their moral world. Phase boundaries, the sites of transition between two physical phases such as a liquid and a gas, provide a metaphor for ‘drawing a line’ in bioethics discourse. Phase boundaries occur where the physical constraints allow both phases to coexist in stable equilibrium. This relationship can also be considered in reverse, using the (...) known position of the phase boundary to disclose the physical constraints. By analogy, instead of trying to locate the ‘correct’ moral boundary, the alternative perspective of ‘reverse ethics’ works from a commonly accepted boundary to examine the constraints of the moral world that are being used to establish it. Genetic interventions into the human body provide interesting examples of boundary establishment. In gene therapy, focusing on boundaries has resulted in a model of moral permissibility that ignores some alternative standpoints and increases the potential for conflict between them. Reverse ethics examines such conflicts in terms of the nature of the moral worlds that have come into contact with each other, taking seriously the diversity of factors governing the location of a boundary, in ways that might help shift some entrenched lines of conflict. (shrink)

J.-M. Pigeaud, « Du rythme dans le corps. Quelques notes sur l'interprétation du pouls par le médecin Hérophile. » In : Bulletin del'Association Guillaume Budé, n° 3, octobre 1978, pp. 258-267. La littérature sur le pouls a été très abondante ; elle est maintenant réservée à l'archéologie de la médecine ; les philologues et les historiens de la philosophie auraient intérêt à la consulter. Nous voudrions réfléchir quelque peu à la définition du pouls par Hérophile. Ce médecin fut sans doute (...) le premier à mesurer - Médecine – Nouvel article. (shrink)

The Donchin and Holmes Emerging Scholar Prize was established in 2016 on the occasion of the twentieth anniversary of the founding of the International Network on Feminist Approaches to Bioethics. The name of the prize honors the two cofounders of FAB, Anne Donchin and Helen Bequaert Holmes. Anne was Professor Emerita of Philosophy at Indiana University at the time of her death in 2014, and she had recruited Becky Holmes, a biologist and independent women’s studies scholar, to help set up (...) the first international network of feminists writing and researching in areas related to bioethics.Both Anne and Becky were strongly committed to what now tends to be called “building capacity”: a rather ugly description... (shrink)

Kim Q. Hall, Feminist disability studies, Bloomington: Indiana University Press, 2011, reviewed by Jackie Leach Scully.

This paper reports on a method for the development of grade descriptors for an international Economics A-level syllabus. The syllabus assessment provided the opportunity to explore how different examination paper structures (compulsory short answer written questions and longer essay type questions) and different mark schemes affected this relatively new method for developing grade descriptors. Quantitative analyses of candidates' marks on each question on the November 1999 examination were carried out to identify the grade (A to E) at which candidates 'mastered' (...) the question. Qualitative differences between answers to the question from candidates achieving different grades were identified by expert judges using Kelly's Repertory Grid. These qualitative data were edited to form grade descriptors which were used in the process of grading economics examinations taken in summer 2000, and their usefulness was evaluated. The effects of the question choice and type on the development process are discussed. (shrink)