Clinical research is increasingly conducted in settings that include private physicians’ offices, clinics, community hospitals, local institutes, and independent research centers. The migration of such research into this new, non–academic environment has brought new cadres of researchers into the clinical research enterprise and also broadened the pool of potential research participants. Regulatory approaches for protecting human subjects who participate in research have also evolved. Some institutions retain their own Institutional Review Boards (IRBs), but Independent IRBs, community hospital IRBs and community–based (...) IRBs also fulfill oversight responsibilities. This article sheds light on this evolving world by discussing the findings gleaned from two studies: a study of the decision making processes used by members who serve on different kinds of IRBs and a study of the decision making processes employed by research participants. The article then discusses how the key findings may inform proposed revisions to the Common Rule. (shrink)

Prompted by the ever-increasing cesarean rate, this paper considers the interpretive disjunct between two significant strands of feminist analysis that have arisen in the last four decades as a consequence of the phenomenon of medicalized birth. In contrast to the dominant paradigm of bioethical “Principalism,” both modes of analysis, understood as “the critique of industrialized labor” and “the critique of idealized labor,” are attentive to the way in which social discourses inform bioethical deliberation and practice, but significantly diverge in the (...) nature of their accounts. The “industrialization critique” understands the culture of medical intervention to be impelled by an “obstetric desire” to appropriate women's reproductive potency, whereas the “idealization critique” relates new mothers’ “low childbirth satisfaction” to a pernicious normative ideal propagated by the natural childbirth movement. This paper will explore the anatomy of both critiques and interrogate their fidelity to the phenomenological insight of the body as chiasm between material and ideal. I will argue that while the insights of the idealization critique are well grounded, we must exercise caution about the critique's tendency to reductively understand the embodied experience of labor as entirely discursively produced, a gesture that risks re-performing the dematerialization of women often effected through obstetric intervention itself. (shrink)

In her recent paper ‘The Epistemology of Propaganda’ Rachel McKinnon discusses what she refers to as ‘TERF propaganda’. We take issue with three points in her paper. The first is her rejection of the claim that ‘TERF’ is a misogynistic slur. The second is the examples she presents as commitments of so-called ‘TERFs’, in order to establish that radical (and gender critical) feminists rely on a flawed ideology. The third is her claim that standpoint epistemology can be used to establish (...) that such feminists are wrong to worry about a threat of male violence in relation to trans women. In Section 1 we argue that ‘TERF’ is not a merely descriptive term; that to the extent that McKinnon offers considerations in support of the claim that ‘TERF’ is not a slur, these considerations fail; and that ‘TERF’ is a slur according to several prominent accounts in the contemporary literature. In Section 2, we argue that McKinnon misrepresents the position of gender critical feminists, and in doing so fails to establish the claim that the ideology behind these positions is flawed. In Section 3 we argue that McKinnon’s criticism of Stanley fails, and one implication of this is that those she characterizes as ‘positively privileged’ cannot rely on the standpoint-relative knowledge of those she characterizes as ‘negatively privileged’. We also emphasize in this section McKinnon’s failure to understand and account for multiple axes of oppression, of which the cis/trans axis is only one. (shrink)

One of the most basic understandings of nursing is that a nurse is a caregiver for a patient who helps to prevent illness, treat health conditions, and manage the physical needs of patients. Nursing is often presented as a caring profession, which provides patient care driven by ideals of empathy, compassion and kindness. These ideals of care have further been foregrounded through the development and implementation of stress on patient centred care (PCC) and/or person‐centred practice (PCP). Although the idealisation of (...) nursing as a caring profession is common, and one certainly seen as integral by nurses and written into the heart of regulatory documentation, we contend that the actual delivery of care is being undercut by the very regulatory climate that strives to professionalise care. As we outline, with specific reference to the context of Australian Nursing, this transformation delivers a commodified, even McDonaldized, model of patient management rather than care. It seems that even with its explicit stress on PCC and PCP, Australian Nursing cannot live up to its own care ideals. Having outlined this problem, the paper then demonstrates the ways in which PCC is thwarted at the coal face of nursing practice and that there must be an institutionalised change to be able to provide genuine patient‐centred care. (shrink)

There has long been acceptance within healthcare that one of the roles that nurses fulfil is to do with patient advocacy. This has historically been positioned as part of the philosophical and inhe...

Customarily patient advocacy is argued to be an essential part of nursing, and this is reinforced in contemporary nursing codes of conduct, as well as codes of ethics and competency standards governing practice. However, the role of the nurse as an advocate is not clearly understood. Autonomy is a key concept in understanding advocacy, but traditional views of individual autonomy can be argued as being outdated and misguided in nursing. Instead, the feminist perspective of relational autonomy is arguably more relevant (...) within the context of advocacy and nurses’ work in clinical healthcare settings. This article serves to highlight and problematise some of the assumptions and influences around the perceived role of the nurse as an advocate for patients in contemporary Western healthcare systems by focusing on key assumptions concerning autonomy inherent in the role of the advocate. (shrink)

A democracy is more than a form of government; it is primarily a mode of associated living, of conjoint communicated experience.in this short excerpt, John Dewey expresses the pragmatist conviction—first stated by Jane Addams in Democracy and Social Ethics—that a society must cultivate dispositions of curiosity and understanding between its diversely situated members in order to sustain a robust and genuine democracy. It is by our habitual exposure to the experiences of our fellow citizens that we can imagine and (...) understand each other’s diverse situations, struggles, and needs. In enabling such imagination and understanding, we create the possibility of fairly incorporating these diverse perspectives into... (shrink)

A symposium was held at the Centre for Research in the Arts, Social Sciences and Humanities at the University of Cambridge on June 12th 2019, ‘Rethinking Repetition in a Digital Age’, at which Geoff Stead, a leading mobile tech designer, was a keynote speaker. The focus of the Cambridge UK event was on how the potentials of digital technologies—whose harms have received widespread attention—could be redirected for the social good. For Stead, this is precisely what Babbel are doing in their (...) approach to commercial digital language learning. Stead spoke to the idea of reversing our personal relationships to mechanical affordances, and finding empowerment in understanding their designed logics. The transcript of the interview below, made in October 2021, revisits some of the main points he raised at that event. (shrink)

We are social primates, for whom language-mediated co-operative thinking (‘co-cognition’) is a central element of our shared life. Psychological concepts may be illuminated by appreciating their role in enriching and improving such co-cognition — a role which is importantly different from that of enabling detailed prediction and control of thoughts and behaviour. This account of the nature of psychological concepts (‘co-cognitivism’) has social anti-individualism about thought content as a natural corollary. The combination of co-cognitivism and anti-individualism further suggests that, in (...) addition to the familiar first person authority with which we ascribe thoughts to ourselves, there may also be something deserving the name ‘second person authority’. (shrink)

This paper examines potential ethical and legal issues arising during the research, develop- ment and clinical use of a proposed strategy in personalized medicine (PM): using human induced pluripotent stem cell (iPSC)-derived tissue cultures as predictive models of individ- ual patients to inform treatment decisions. We focus on epilepsy treatment as a likely early application of this strategy, for which early-stage stage research is underway. In relation to the research process, we examine issues associated with biological samples; data; health; vulnerable (...) populations; neural organoids; and what level of accuracy justifies using the iPSC-derived neural tissue system. In relation to clinical use, we examine potential uses in pre-natal screening, and effects on clinical decision-making. Although our focus is providing recommendations for researchers developing work in this area, we identify the novel issue of deciding on an acceptable accuracy level for the system. We also emphasize an issue thus far neglected in the ethics of PM: PM tends to represent treatment decisions as though they should be directed solely by biomedical information, but this in itself could be detri- mental to best personalizing treatment decisions in the clinic. (shrink)

Indexicality is a feature of predicates and predicate components (verbs, adjectives, adverbs and the like) as well as of referring expressions. With classic referring indexicals such as 'I' or 'that' a distinctive rule takes us from token and context to some item present in the content which is the semantic correlate of the token. Predicates and predicate components may function in an analogous fashion. For example 'thus' is an indexical adverb which latches onto some manner of performance present in its (...) context. 'John sang thus', said while indicating someone singing discordantly, claims that John sang discordantly. The phenomenon of predicatival indexicality is widespread in English and is expressed in a variety of idioms. Indexical predication plays important epistemological and psychological roles and the notion may have other interesting philosophical applications. (shrink)

This chapter examines the relationship between Soren Kierkegaard and Martin Heidegger. It explains that Heidegger mentioned Kierkegaard in much of his work from the early 1920s until his latest writings, but did not clarify the relationship between his own thought and Kierkegaard's. The chapter analyses Kierkegaard's distinctive contribution to philosophy and evaluates how this was taken up by Heidegger in his writings, particularly in Being and Time. It also evaluates the extent to which contemporary interpretation of Kierkegaard was influenced by (...) Heidegger's philosophy. (shrink)

This paper is based on case-study research in four English secondary schools. It explores the pressure placed on English and mathematics departments because of their results being reported in annual performance tables. It examines how English and maths departments enact policies of achievement, the additional power and extra resources the pressure to achieve brings and the possibility of resistance.

Racially restrictive marriage laws lay at the intersection of state claims of domestic sovereignty and federal obligations to protect the constitutional rights of citizens. In 1948, California overturned its antimiscegenation law, citing, in addition to the Fourteenth Amendment, the United Nations Charter. This decision sparked a contentious discussion about the relationship of human rights norms to racial conventions in the United States, and triggered a debate about the peril of international law that resulted in an effort to amend the Constitution (...) and limit the treaty-making powers of the president. Both the constitutional and the international logics of individual human rights threatened local custom and energized political opposition. American stigmatization of international human rights norms and treaties was rooted directly in the civil rights struggles in the United States and reflected the potential of international organizations to assault domestic racial conventions at their foundations. (shrink)

I ask whether figure-ground structure can be realized in touch, and, if so, how. Drawing on the taxonomy of touch sketched in Katz's 1925 The World of Touch, I argue that the form of touch that is relevant to such consideration is a species of immersed touch. I consider whether we can feel the space we are immersed in and, more specifically, the empty space against which the surfaces of objects, as I shall urge, “stand out.” Harnessing M. G. F. (...) Martin's account of bodily awareness and touch, I defend a positive thesis, pace Graham Nerlich on whose The Shape of Space I otherwise rely, both to defend the supposition that empty space can in principle be felt and to argue that touching empty space is not a mere species of absence perception. Along the way, I defuse a causal worry that might be thought to arise in the case of touching empty space. (shrink)

Nursing education holds a history framed in white supremacy and whiteness. Efforts to employ antiracist strategies have been hindered, largely due to an inability for faculty to acknowledge and hold accountability for racialized harms that occur within nursing educational structures. A nurse–midwifery program in the Pacific Northwest United States uncovered harm that impacted students and identified a need to respond and hold accountability. Guided by the framework of Transformative Justice, a truth and reconciliation process was implemented as a first step (...) to better address racism within nursing and nurse–midwifery education. This paper describes the process to support other institutions in their work to address harms within nursing education. (shrink)

References to strength of mind, a character trait implying “the prevalence of the calm passions above the violent”, occur in a number of important discussions of motivation in the Treatise and the Enquiry concerning the Principles of Morals. Nevertheless, Hume says surprisingly little about what strength of mind is, or how it is achieved. This paper argues that Hume’s theory of the passions can provide an interesting and defensible account of strength of mind. The paper concludes with a brief comparison (...) of Humean strength of mind with autonomy. (shrink)

This ambitious literary history traces the American novel from its emergence in the late eighteenth century to its diverse incarnations in the multi-ethnic, multi-media culture of the present day. In a set of original essays by renowned scholars from all over the world, the volume extends important critical debates and frames new ones. Offering new views of American classics, it also breaks new ground to show the role of popular genres - such as science fiction and mystery novels - in (...) the creation of the literary tradition. One of the original features of this book is the dialogue between the essays, highlighting cross-currents between authors and their works as well as across historical periods. While offering a narrative of the development of the genre, the History reflects the multiple methodologies that have informed readings of the American novel and will change the way scholars and readers think about American literary history. (shrink)

In this article we explore the ways in which the notion of the imagination might be mobilized to support researchers to develop transgressive research imaginations and communities with the capacities to think, 'be' and 'become' differently in a world of research increasingly governed by rampant reductionist rationality. To assist us we draw from the evocative views of imagination developed by Cornelius Castoriadis, the imagination's most radical exponent. In this article his ideas about knowledge and its links to the imagination will (...) be deployed as we discuss the following questions: What does the notion of the imagination mean in the everyday world of university research? Is all research an act of the imagination? What might it mean to globalize the research imagination? We will also illustrate the ways in which the imagination is mobilized in (globalizing) research practice. (shrink)

_Elite Schools in Globalizing Circumstances_ foregrounds the richly theoretical and empirically-based work of an international cast of scholars seeking to break out of the confines of the methodological nationalism that now governs so much of contemporary scholarship on schooling. Based on a 5-year extended global ethnography of elite schools in nine different countries—countries defined by colonial pasts linked to England—the contributors make a powerful case for the rethinking of elite schools and elite class formation theory in light of contemporary processes (...) of globalization and transnational change. Prestigious, high-status schools have long been seen as critical institutional vehicles directly contributing to the societal processes of elite selection and reproduction. This book asserts that much has changed and that these schools can no longer rest on their past laurels and accomplishments. Instead they must re-cast their heritages and tradition in order to navigate the new globally competitive educational field enabling them to succeed in a world in which the globalization of educational markets, the global ambitions and imaginations of school youth, and the emergence of new powerful players peddling entrepreneurial models of curriculum and education, have placed contemporary schooling under tremendous pressure. This insightful and though-provoking volume provides a well-researched perspective on the nature of contemporary schooling in the globalizing era. This book was originally published as a special issue of _Globalisation, Societies and Education. _. (shrink)

Changes in government policy over the last two decades have seen the traditional goals of criminal justice, namely prosecution and punishment, being replaced by an emphasis on prevention, fear reduction, security and harm reduction. During this time domestic abuse has gained a place on the political agenda, which has resulted in legislative initiatives in the form of civil protection orders across the U.K. which primarily focus on prevention but have also more recently begun to rely on the traditional criminal justice (...) responses should they fail to prevent further abuse. Drawing on international evaluations and a recent study conducted in Scotland (the Scottish study), the article examines whether legislation in the form of civil protection orders has the effect of curtailing the actions of abusers and if not, what occurs when the traditional criminal justice response comes into play. The strengths of civil protection orders and some explanations for the weaknesses of these orders are considered alongside the question of whether there is any value in women continuing to engage with the law in response to domestic abuse. (shrink)

Although dualism has the advantage of being intuitively plausible, it is not compatible with a 21st-century (scientific) world view. Jaak Panksepp and Antonio Damasio are contemporary writers who reject dualism, and whose views take the form of “biological naturalism”. I first discuss how their views compare in five specific respects; and then I look more closely at how the different emphases of the views affect their ability to account for the evolutionary advantages of consciousness, specifically. Both authors agree that “consciousness” (...) provides creatures with a survival advantage in terms of their ability to produce novel and/or flexible responses, their ability to plan ahead, and their motivation to promote their own survival – but the exact means by which they think these advantages are conferred, in each of these respects, differ. One might say that, whereas Damasio thinks the main evolutionary advantages of “consciousness” (the “higher reaches” of which are unique to humans) have to do with enabling creatures to work out what to do to promote their well-being, Panksepp thinks the main advantage of “consciousness” is that being “conscious” of affective feelings urgently motivates creatures to take action when their well-being is threatened. Considering that “working out what do” is only possible for a small selection of cognitively sophisticated organisms, I argue that Panksepp’s account is more plausible than Damasio’s account. (shrink)