Self-injury is a perilous and increasingly common behavior that is particularly prevalent among youth. Nonetheless, there is a deep-rooted public stigma towards people who self-injure. Consequently, people who engage in self-injury are reluctant to seek professional help or disclose their experiences to others. This article aims to combat stigma and promote help-seeking behavior by debunking the common myths surrounding self-injury in the Malaysian context. Specifically, this article aims to serve as an eye-opener for Malaysian counselors and other mental health professionals (...) to improve their multicultural knowledge, skills, and attitudes when working with those who self-injure. (shrink)

Background: Improved techniques and life sustaining technology in the neonatal intensive care unit have resulted in an increased probability of survival for extremely premature babies. The by-product of the aggressive treatment is iatrogenic pain, and this infliction of pain can be a cause of suffering and distress for both baby and nurse. Research question: The research sought to explore the caregiving dilemmas of neonatal nurses when caring for extremely premature babies. This article aims to explore the issues arising for neonatal (...) nurses when they inflict iatrogenic pain on the most vulnerable of human beings – babies ≤24 weeks gestation. Participants: Data were collected via a questionnaire to Australian neonatal nurses and semi-structured interviews with 24 neonatal nurses in New South Wales, Australia. Ethical consideration: Ethical processes and procedures set out by the ethics committee have been adhered to by the researchers. Findings: A qualitative approach was used to analyse the data. The theme ‘inflicting pain’ comprised three sub-themes: ‘when caring and torture are the same thing’, ‘why are we doing this!’ and ‘comfort for baby and nurse’. The results show that the neonatal nurses were passionate about the need for appropriate pain relief for extremely premature babies. Conclusion: The neonatal nurses experienced a profound sense of distress manifested as existential suffering when they inflicted pain on extremely premature babies. Inflicting pain rather than relieving it can leave the nurses questioning their role as compassionate healthcare professionals. (shrink)

Background: Nurses and midwives have a professional obligation to promote health and prevent disease, and therefore they have an essential role to play in vaccination. Despite this, some nurses and midwives have been found to take an anti-vaccination stance and promulgate misinformation about vaccines, often using Facebook as a platform to do so. Research question: This article reports on one component and dataset from a larger study – ‘the positives, perils and pitfalls of Facebook for nurses’. It explores the specific (...) issue of nurses and midwives who take an anti-vaccination stance, deemed to be unprofessional by crossing professional boundaries and by providing medical information on Facebook that is not within their scope of practice. Participants: Data were collected via an online worldwide survey from nurse and midwife participants, distributed and ‘snowballed’ through relevant nursing and midwifery groups on Facebook. In total, 1644 Registered Nurses and Midwives, and Enrolled Nurses worldwide attempted the online survey. There were 1100 (66.9%) completed surveys and 54 partially (33.1%) completed surveys. Semi-structured interviews were also conducted online using Skype® with 17 participants in Australia. Ethical considerations: Ethical processes and procedures have been adhered to relating to privacy, confidentiality and anonymity of the participants. Findings/results: A mixed-methods approach was used, including descriptive and content analysis of the quantitative survey data and thematic analysis of the qualitative interview data. The main theme ‘blurred boundaries’ was generated, which comprised three sub-themes: ‘follow the science, ‘abuse of power and erosion of trust’ and ‘the moral and ethical responsibility to safeguard public health’. The results offer an important and unique understanding of how nurses and midwives interpret the conduct of fellow health professionals as unprofessional and crossing the professional boundary if they used Facebook to promulgate anti-vaccination messages and/or give medical advice online. Conclusion: There are many positives and negatives for nurses and midwives associated with using Facebook for personal and professional communication, which is in keeping with the results of the larger study from which this article is taken. Professional behaviour is a key theme in the larger research as is the ethical construct of ‘every act has a consequence’; however, in this article, the theme ‘blurred boundaries’ offers an overall understanding of how nurses and midwives interpret the behaviour of their colleagues who espouse anti-vaccination sentiment and/or give medical advice online that is outside their scope of practice and education. (shrink)

Improved life sustaining technology in the neonatal intensive care unit (NICU) has resulted in an increased probability of survival in extremely premature babies. Miracle baby stories in the popular press are a regular occurrence and these reports are often the first source from which the general public learn about extremely premature babies. The research from which this paper is drawn sought to explore the care‐giving and ethical dilemmas of neonatal nurses when caring for extremely premature babies 24 weeks gestation and (...) less. This current paper aims to outline the views of neonatal nurses on miracle baby stories in the media. Data were collected via a questionnaire to 760 Australian neonatal nurses with 414 returned, representing a response rate of 54.4%. Narrative was collected from semi‐structured interviews with 24 experienced neonatal nurses in NSW, Australia. A qualitative approach utilising thematic analysis was utilised to analyse the data. The theme the myth of the miracle baby is seen as generating myths and unrealistic expectations on the part of vulnerable families and the public. Neonatal nurses, as the primary caregivers for tiny babies and their families, viewed popular media publications with suspicion, believing published reports to be incomplete, inaccurate and biased towards the positive. (shrink)

Background: The ability to save the life of an extremely premature baby has increased substantially over the last decade. This survival, however, can be associated with unfavourable outcomes for both baby and family. Questions are now being asked about quality of life for survivors of extreme prematurity. Quality of life is rightly deemed to be an important consideration in high technology neonatal care; yet, it is notoriously difficult to determine or predict. How does one define and operationalise what is considered (...) to be in the best interest of a surviving extremely premature baby, especially when the full extent of the outcomes might not be known for several years? Research question: The research investigates the caregiving dilemmas often faced by neonatal nurses when caring for extremely premature babies. This article explores the issues arising for neonatal nurses when they considered the philosophical and ethical questions about quality of life in babies ≤24 weeks gestation. Participants: Data were collected via a questionnaire to Australian neonatal nurses and semi-structured interviews with 24 neonatal nurses in New South Wales, Australia. Ethical considerations: Ethical processes and procedures have been adhered to by the researchers. Findings: A qualitative approach was used to analyse the data. The theme ‘difficult choices’ was generated which comprised three sub-themes: ‘damaged through survival’, ‘the importance of the brain’ and ‘families are important’. The results show that neonatal nurses believed that quality of life was an important consideration; yet they experienced significant inner conflict and uncertainty when asked to define or suggest specific elements of quality of life, or to suggest how it might be determined. It was even more difficult for the nurses to say when an extremely premature baby’s life possessed quality. Their previous clinical and personal experiences led the nurses to believe that the quality of the family’s life was important, and possibly more so than the quality of life of the surviving baby. This finding contrasts markedly with much of the existing literature in this field. Conclusion: Quality of life for extremely premature babies was an important consideration for neonatal nurses; however, they experienced difficulty deciding how to operationalise such considerations in their everyday clinical practice. (shrink)

This article explores the contributions that five different approaches to discourse analysis can make to interpreting and understanding the same piece of data. Conversation analysis, interactional sociolinguistics, politeness theory, critical discourse analysis, and discursive psychology are the approaches chosen for comparison. The data is a nine-minute audio recording of a spontaneous workplace interaction. The analyses are compared, and the theoretical and methodological implications of the different approaches are discussed.

Background: Complex and expensive treatment options have increased the frequency and emphasis of ethical decision-making in healthcare. In order to meet these challenges effectively, we need to identify how nurses contribute the resolution of these dilemmas. Aims: To identify the values, beliefs and contextual influences that inform decision-making. To identify the contribution made by nurses in achieving the resolution of ethical dilemmas in practice. Design: An interpretive exploratory study was undertaken, 11 registered acute care nurses working in a district general (...) hospital in England were interviewed, using semi-structured interviews. In-depth content analysis of the data was undertaken via NVivo coding and thematic identification. Participants and context: Participants were interviewed about their contribution to the resolution of ethical dilemmas within the context of working in an acute hospital ward. Participants were recruited from all settings working with patients of any age and any diagnosis. Ethical considerations: Ethical approval was obtained from the local National Research Ethics Committee. Findings: Four major themes emerged: ‘best for the patient’, ‘accountability’, ‘collaboration and conflict’ and ‘concern for others’. Moral distress was also evident in the literature and findings, with moral dissonance recognised and articulated by more experienced nurses. The relatively small, single-site sample may not account for the effects of organisational culture on the results; the findings suggested that professional relationships were key to resolving ethical dilemmas. Discussion: Nurses use their moral reasoning based on their beliefs and values when faced with ethical dilemmas. Subsequent actions are mediated though ethical decision-making frames of reference including deontology, consequentialism, the ethics of care and virtue ethics. Nurses use these in contributing to the resolution of these dilemmas. Nurses require the skills to develop and maintain professional relationships for addressing ethical dilemmas and to engage with political and organisational macro- and micro-decision-making. Conclusion: Nurses’ professional relationships are central to nurses’ contributions to the resolution of ethical dilemmas. (shrink)

Background: Evolving technology and scientific advancement have increased the chances of survival of the extremely premature baby; however, such survival can be associated with some severe long-term morbidities. Research question: The research investigates the caregiving and ethical dilemmas faced by neonatal nurses when caring for extremely premature babies (defined as ≤24 weeks’ gestation). This article explores the issues arising for neonatal nurses when they considered the philosophical question of ‘what if it was me and my baby’, or what they believed (...) they would do in the hypothetical situation of going into premature labour and delivering an extremely premature baby. Participants: Data were collected via a questionnaire to Australian neonatal nurses and semi-structured interviews with 24 neonatal nurses in New South Wales, Australia. Ethical considerations: Relevant ethical approvals have been obtained by the researchers. Findings: A qualitative approach was used to analyse the data. The theme ‘imagined futures’ was generated which comprised three sub-themes: ‘choice is important’, ‘not subjecting their own baby to treatment’ and ‘nurses and outcome predictions’. The results offer an important and unique understanding into the perceptions of nursing staff who care for extremely premature babies and their family, see them go home and witness their evolving outcomes. The results show that previous clinical and personal experiences led the nurses in the study to choose to have the belief that if in a similar situation, they would choose not to have their own baby resuscitated and subjected to the very treatment that they provide to other babies. Conclusion: The theme ‘imagined futures’ offers an overall understanding of how neonatal nurses imagine what the life of the extremely premature baby and his or her family will be like after discharge from neonatal intensive care. The nurses’ past experience has led them to believe that they would not want this life for themselves and their baby, if they were to deliver at 24 weeks’ gestation or less. (shrink)

Collaborative learning has become increasingly prevalent throughout all disciplines in higher education, but these types of situations may prove challenging for quiet students who may prefer m...

BackgroundLiterature on issues relating to comprehension during the process of obtaining informed consent (IC) has largely focused on the challenges potential participants can face in understanding the IC documents, and the strategies used to enhance comprehension of those documents. In this review, we set out to describe the factors that have an impact on comprehension and the strategies used to enhance the IC process in sub-Saharan African countries.MethodsFrom November 2021 to January 2022, we conducted a literature search using a PRISMA (...) tool. We searched electronic databases (PubMed, EMBASE, EBSCOHOST) to identify relevant peer reviewed studies. We then reviewed the references of these articles to find additional literature that might have been missed through the initial search. We were particularly interested in full text articles in English that focused on the IC process in SSA published between 2006 and 2020. We included systematic reviews, and studies from Western and Asian countries that included data about SSA. We excluded articles that focused on medical interventions and studies that did not require IC.ResultsOut of the 50 studies included most were multi-country (n = 13) followed by single country studies in South Africa (n = 12); Kenya, Tanzania, Uganda (n = 5) each; Gambia, Ghana and Nigeria (n = 2)each ; and one each for Botswana, Malawi, Mali, Mozambique. We identified three areas of focus: (1) socio-cultural factors affecting IC; (2) gaps in the ethical and legal frameworks guiding the IC process; and (3) strategies used to improve participants’ understanding of IC.ConclusionOur review showed wide recognition that the process of achieving IC in SSA is inherently challenging, and there are limitations in the strategies aimed at improving comprehension in IC. We suggest that there is a need for greater flexibility and negotiation with communities to ensure that the approach to IC is suited to the diverse socio-cultural contexts. We propose moving beyond the literal translations and technical language to understanding IC comprehension from the participants’ perspectives and the researchers’ views, while examining contextual factors that impact the IC process. (shrink)

Bioethics, Volume 36, Issue 5, Page 576-586, June 2022.

We used Discursive Psychology to study the claims and arguments which occur when ‘the child’s best interests’ is produced as a resource in family mediation settings. Analysis draws on data from three pairs of separated or separating parents attempting to resolve child contact or residency disputes through mediation. Our analysis focuses on the tendency of claims to the abstract notion of the child’s best interests to exacerbate conflict, especially as parents drew on conflicting research in this area. Changing expectations of (...) fathering could be observed in the men’s argumentative positioning, and this was taken up in different ways by ex-partners and by mediators. Participants aligned themselves with mediators’ statements by picking up details of mediators’ language, hampering mediators’ attempted neutrality. The problematic nature of acknowledging the intensity of emotions in this process was also highlighted. (shrink)

Amid increasing demands from students and the public, universities have recently reinvigorated their efforts to increase the number of faculty from underrepresented populations. Although a myriad of piecemeal programs targeting individual recruitment and development have been piloted at several institutions, overall growth in faculty diversity remains almost negligible and highly localized. To bring about genuine change, we hypothesize a consortia approach that links individuals to hiring opportunities within a state university system might be more effective. Here we present a case (...) study describing the progress of the NSF-funded Alliances for Graduate Education and the Professoriate PROMISE Academy Alliance, a consortium within the University System of Maryland collaborating to develop, implement, self-study, evaluate, and disseminate a unique postdoc-to-faculty conversion model in the biomedical sciences. The initiative centers on diversifying faculty across five institutions in the USM, including teaching-focused institutions, comprehensive universities, research institutions, and professional schools. Components of this approach include enhanced recruiting and hiring practices to attract outstanding postdoctoral scholars from underrepresented backgrounds, multi-institutional networking and professional development, and facilitated processes to transition postdocs into tenure-track positions at their postdoctoral institution or another institution in the state system. This model is distinct from more deficit-based approaches because it goes beyond focusing on building the individual’s skills to enter the professoriate. This program restructures the traditionally short-term nature of postdoctoral employment and incorporates a pathway to a tenure-track professorship at the same institution or within the same statewide system where the postdoc is trained. This multi-institutional model leverages collaboration and distinct institutional strengths to create cross-institutional support, advocacy, and policy. Importantly, it uses a decentralized financial structure that makes this approach distinctly replicable. Recognizing the immediate need for more collaborative approaches to diversify faculty and a lack of literature about such approaches, this case study describes the development of, and potential benefits of, a state university system, as well as the qualitative lessons learned from self-study, internal evaluation, external evaluation, and NSF site visits. The AGEP PROMISE Academy can serve as a model for replication at other university systems hoping to diversify their faculty. (shrink)

Table of Contents I. WHO ARE THE SCIENTISTS? Historically. Women in the Origins of Modern Science, Londa Schiebinger. Women of Third World Descent in the Sciences, Sandra Harding. Recently. Women in Science: Half In Half Out, Vivian Gornick.”How Can a Little Girl Like You Teach a Great Big Class of Men?’ the Chairman Said, and Other Adventures of a Woman in Science, Naomi Weisstein. The Anomaly of a Woman in Physics, Evelyn Fox Keller. Currently. Women Join the Ranks of Science (...) but Remain Invisible at the Top, Natalie Angier. Creeping Toward Inclusivity in Science, Phyllis Goldberg. II. WHAT KIND OF ENTERPRISE IS SCIENCE? Science’s Aims, Methods, and Norms of Behavior. Patriarchy, Scientists, and Nuclear Warriors, Brian Easlea. Culturally Inclusive Chemistry, Catherine Hurt Middlecamp. A World of Difference, Evelyn Fox Keller. Interviewing Women: A Contradiction in Terms, Ann Oakley. Science’s Subject Matter. Have Only Men Evolved?, Ruth Hubbard. Empathy, Polyandry, and the Myth of the Coy Female, Sarah Blaffer Hrdy. The Importance of Feminist Critique for Contemporary Cell Biology, The Biology and Gender Study Group. The Engendering of Archaeology: Refiguring Feminist Science Studies, Alison Wylie. Still Seeking Transformation: Feminist Challenges to Psychology, Sue Wilkinson. Science’s Social Effects. Androcentric Bias in Clinical Research, Sue Rosser. Man-Made Medicine and Women’s Health, Nancy Krieger and Elizabeth Fee. The New Procreative Technologies, Ruth Hubbard. A Question of Genius: Are Men Really Smarter Than Women?, Anne Fausto-Sterling. III. WHAT KIND OF ENTERPRISE OUGHT SCIENCE TO BE? Feminist Empiricism. Subjects, Power, and Knowledge: Description and Prescription in Feminist Philosophies of Science, Helen Longino. Epistemological Communities, Lynn Hankinson Nelson. Feminist Standpoint Theory. ”Strong Objectivity’: A Response to the New Objectivity Question, Sandra Harding. Introduction to Tomorrow’s Tomorrow: The Black Woman, Joyce Ladner. Feminist Postmodernism. Situated Knowledges: The Science Question in Feminism and the Privilege of Partial Perspective, Donna Haraway. Though This Be Method, Yet There Is Madness in It: Paranoia and Liberal Epistemology, Naomi Scheman. (shrink)

Introduction : kith, kin, and family / Sally Haslanger and Charlotte Witt Adoption and its progeny : rethinking family law, gender, and sexual difference / Drucilla Cornell Open adoption is not for everyone / Anita L. Allen Methods of adoption : eliminating genetic privilege / Jacqueline Stevens Several steps behind : gay and lesbian adoption / Sarah Tobias A child of one’s own : property, progeny, and adoption / Janet Farrell Smith Family resemblances : adoption, personal identity, and genetic (...) essentialism / Charlotte Witt Being adopted and being a philosopher : exploring identity and the "desire to know" differently / Kimberly Leighton Real othering : the metaphysics of maternity in children’s literature / Shelley Park Accidents and contingencies of love / Songsuk Hahn ; comments by Harry Frankfurt Abuse and neglect, foster drift, and the adoption alternative / Elizabeth Bartholet Feminism, race, and adoption policy / Dorothy Roberts Racial randomization / Hawley Fogg-Davis You Mixed?: racial identity without racial biology / Sally Haslanger. (shrink)

It is no accident that white privilege designed to be both be invisible and weightless to white people. Alison Bailey’s “On White Privilege and Anesthesia: Why Does Peggy McIntosh’s Knapsack Feel Weightless?” extends a weighty invitation white readers to complete the unpacking task McIntosh (1988) began when she compared white privilege to an “invisible and weightless knapsack.” McIntosh focuses primarily making white privilege visible to white people. Bailey’s project continues the conversation by extending a ‘weighty invitation’ to white readers to (...) explore why the metaphorical knapsack, despite the weight of its contents, feels weightless. Here’s the short answer. The knapsack only feels weightless because white people have become anesthetized us to our own brokenness. We are more comfortable considering what white privilege does for us than what it does to us. People of color feel the weight of whiteness every day. The weighty invitation invites white readers to become sensitive to our own insensitivity. To do this Bailey (1) explores white resistance to unpacking the weight; (2) people of color’s testimonies to the daily impact of the weight on their bodies; and (3) how the anesthesia of white privilege distorts our humanity. The article concludes with a McIntosh style list of that the anesthesia of privilege distorts white people’s humanity. (shrink)

Michel Foucault’s _History of Sexuality_ has been one of the most influential books of the last two decades. It has had an enormous impact on cultural studies and work across many disciplines on gender, sexuality, and the body. Bringing a new set of questions to this key work, Ann Laura Stoler examines volume one of _History of Sexuality_ in an unexplored light. She asks why there has been such a muted engagement with this work among students of colonialism for whom (...) issues of sexuality and power are so essential. Why is the colonial context absent from Foucault’s history of a European sexual discourse that for him defined the bourgeois self? In _Race and the Education of Desire, _Stoler challenges Foucault’s tunnel vision of the West and his marginalization of empire. She also argues that this first volume of _History of Sexuality_ contains a suggestive if not studied treatment of race. Drawing on Foucault’s little-known 1976 College de France lectures, Stoler addresses his treatment of the relationship between biopower, bourgeois sexuality, and what he identified as “racisms of the state.” In this critical and historically grounded analysis based on cultural theory and her own extensive research in Dutch and French colonial archives, Stoler suggests how Foucault’s insights have in the past constrained—and in the future may help shape—the ways we trace the genealogies of race. _Race and the Education of Desire_ will revise current notions of the connections between European and colonial historiography and between the European bourgeois order and the colonial treatment of sexuality. Arguing that a history of European nineteenth-century sexuality must also be a history of race, it will change the way we think about Foucault. (shrink)

ABSTRACT In this paper, I shall explore the relationship between the control required for action and the control required for moral responsibility. I shall argue that there is an incongruity between Frankfurt’s account of guidance control presented in his theory of action and his commitment to the claim that alternative possibilities are not required for moral responsibility. This inconsistency centres around the role of abilities to do otherwise in our analyses of action and moral responsibility. After outlining the problem for (...) Frankfurt, I shall then motivate one way of resolving this tension. This solution provides a unified role for abilities to do otherwise in our analyses of control. (shrink)

Philosophical discussion about the reality of sensory perceptions has been hijacked by two tendencies. First, talk about perception has been largely centered on vision. Second, the realism question is traditionally approached by attaching objects or material structures to matching contents of sensory perceptions. These tendencies have resulted in an argumentative impasse between realists and anti-realists, discussing the reliability of means by which the supposed causal information transfer from object to perceiver takes place. Concerning the nature of sensory experiences and their (...) capacity to provide access to reality, this article challenges the standard categories through which most arguments in this debate have been framed to date. Drawing on the underexplored case of olfaction, I first show how the details of the perception process determine the modalities of sensory experiences. I specifically examine the role of measurement and analyze its influence on the characterization of perceptions in olfaction. My aim is to argue for an understanding of perception through a process view, rather than one pertaining to objects and properties of objects. (shrink)

Displaying her intellectual and literary abilities from a young age, 'Mrs Taylor of Ongar' enjoyed writing all her life. She had eleven children, of whom six survived to adulthood. Her published works began with advice books for her own daughters, produced when increasing deafness made ordinary conversation difficult for her. This book, published in 1818, follows her earlier works for young women with a guide to conduct and 'reciprocal duties' within the family. Stern warnings and cautionary tales are given to (...) show the importance of duty to and respect for parents by children, but the parental duties of care in rearing and especially in education are emphasised. Early discipline, lovingly applied, is seen as the key to successful parenting, and its absence is deemed disastrous. Like Ann Taylor's Practical Hints to Young Females, the book offers fascinating insights into the middle-class ideal of domestic happiness. (shrink)

I argue that a gendered division of labor is often the result of choices by women that count as fully voluntary because they are an expression of preferences and commitments that reflect women's understanding of their own good. Since liberalism has a commitment to respecting fully voluntary choices, it has a commitment to respecting these gendered choices. I suggest that justified political action may require that we fail to respect some people's considered choices.

While there is an extensive subfield in sociology studying the sources, content, and consequences of collective memory, the study of future projections has been much more fragmentary. In part, this has to do with the challenge of measurement; how do you measure something that has not happened yet? In this article, I argue that future projections can be studied via their externalizations in attitudes, narratives, performance, and material forms. They are particularly evident in what I call “sites of hyperprojectivity,” that (...) is, sites of heightened, future-oriented public debate about possible futures. As a pilot project, I examine contending narratives about possible futures in the online documents of the United Nations Conference on Sustainable Development and the accompanying “People’s Summit,” held in Rio de Janeiro in June 2012. I propose a framework for studying how public interventions into debates about “sustainable futures” and the “green economy” differ on various dimensions of projectivity, including their temporal reach, attention to contingency and causality, and network mapping of future actors. I present a preliminary analysis at the level of narrative and grammar, by analyzing the use of predictive, imperative, and subjunctive verb forms in both programmatic and oppositional texts. I close with a discussion of how different genres of future projection might be put to analytical use in studying processes of interest to social scientists, such as coalition formation, institution building, political mobilization, and policy change. (shrink)

Drawing inspiration from Susan Sontag’s notion of ‘rhetorical ownership’—applied not only to illness but also to the body more generally—this essay argues that philosophy, like medicine, has privileged a metaphorics of war and violence in its own discourses on embodiment. Drawing inspiration from Barbara Christian’s seminal essay ‘The Race for Theory,’ as well as literary theorist Eve Sedgwick’s account of what she calls ‘paranoid’ forms of inquiry in her book Touching Feeling, this essay explores the status of violence as an (...) especially resonant trope in discourses on materiality. One worry is that the omnipresence of violent metaphors in contemporary philosophy of the body may be narrowing the space for the elaboration of nonviolent understanding of corporeality that would imagine the body otherwise than as a battlefield or a site of violence. (shrink)