Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal. We provide a systematic description and analysis of the different roles the family can play, and actions the family can take, in the organ procurement process across different jurisdictions and consent systems. First, families can inform or update healthcare professionals about a person’s donation wishes. Second, families (...) can authorize organ procurement in the absence of deceased’s preferences and the default is not to remove organs, and oppose donation where there is no evidence of preference but the default is to presume consent; in both cases, the decision could be based on their own wishes or what they think the deceased would have wanted. Finally, families can overrule the known wishes of the deceased, which can mean preventing donation, or permitting donation when the deceased refused it. We propose a schema of 4 levels on which to map these possible family roles: no role, witness, surrogate, and full decisional authority. We conclude by mapping different jurisdictions onto this schema to provide a more comprehensive understanding of the consent system for organ donation and some important nuances about the role of families. This classificatory model aims to account for the majority of the world’s consent systems. It provides conceptual and methodological guidance that can be useful to researchers, professionals, and policymakers involved in organ procurement. (shrink)

Science is based onfacts—facts that are systematically gathered by a community of enquirers through detailed observation and experiment. In the twentieth century, however, philosophers of science claimed that the facts that scientists “gather” in this way are shaped by the theories scientists accept, and this seemed to threaten the authority of science. Call this theold worries about science.By contrast, what seemed not to threaten that authority were other factors that shaped the facts that scientists gather—for example, the mere questions scientists (...) pursue. Call this theold nonworries about science.What I suggest is that the old nonworries are turning out to be far more worrisome than the old worries, and I use recent goings-on such as the “Death of Evidence” protests in Canada, the “replication crisis,” and the ongoing feminist critiques of science to illustrate my case. All this raises interesting new questions for philosophers of science to tackle. (shrink)

Philosophers exploring the ethical implications of closeness, or ‘given intersubjectivity’, favor an essential human predicament over an essential sexual dualism to explain their positions on responsibility for and response to the Other. This article proposes a feminist ethical ontology that rejects an essentialist base, turning instead to semiotics as a tool for describing the condition of human agency in a context of oppression. The discussion attends to the problems of downplaying the importance of difference and of blurring the distinction between (...) necessary and accidental actions and occurrences. In challenging the contention that response to the Other is beyond the realm of choice and will, this article considers the ethical implications in how this givenness substantiates inequality and gendered embodiment. The effects of hierarchical ontological dualism should not be ignored or misconstrued in an effort to isolate the definitive nature of human response. (shrink)

In this article, we discuss how we used institutional ethnography (Institutional ethnography as practice, Rowman & Littlefield, Lanham, MD and 2006) to map out powerful ruling relations that organize nurses’ wound care work. In recent years, the growing number of people living with wounds that heal slowly or not at all has presented substantial challenges for those managing the demands on Canada's publicly insured health‐care system. In efforts to address this burden, Canadian health‐care administrators and policy‐makers rely on scientific evidence (...) about how wounds heal and what treatments are most effective. Advanced wound care exemplifies the growing authorization of particular forms of evidence that change the ways in which nurses come to know about and conduct their work. The focus of this paper's nursing inquiry is a critique of registered nurses’ wound work as it arises within the established uptake of scientific evidence. (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)

Despite their regional, ethnic, and linguistic differences, the recent social and political upheavals of the Middle East have shared one basic concern. From the 2009 Green Movement in Iran to the 2011 Tunisian revolts which ignited the Arab Uprisings, and from the first Muslim Brotherhood government in Egypt in 2012 to the protests in Turkey’s Taksim Square in 2013, a central issue has been how to establish a democratic state with a modern constitution while adhering to many shari’a rules and (...) regulations. This debate is not a new one in the Middle East and, as this article will demonstrate, it has been a central theme of Iranian politics ever since the Constitutional Revolution of 1906. At the time of that first Iranian revolution, Iran was ruled by two sets of laws, shari’a religious law and ‘urf customary law. Shi’i clerics, with their elaborate institutional hierarchy, controlled shari’a law, which was considered the more important law of the land, whereas the monarch and local rulers were nominal guardians of ‘urf laws. Soon the novel discourses of the Constitutional Revolution would create a paradigm shift in Iranian society.1 Constitutionalist clerics had assumed that a new political order reformed ‘urf rulings, leaving shari’a laws more or less intact. They were stunned by the realization that a constitutional order revamped both legal systems and overturned sacrosanct social and religious hierarchies. Many clerics resisted these reforms. The result was a bifurcated set of laws that institutionalized clerical authority, while also placing limits on clerics in legislative and judicial branches of the government. (shrink)

This article explores the ethical dilemmas of doing a feminist ethnography of gender and Holocaust memory. In response to the conflicts the author experienced as both a participant/jewish woman and an observer/feminist ethnographer, she engaged in a critical examination of her research methods and goals that led to an exploration into the complex moral issues that inform research on women and genocide specifically and feminist ethnographies of violence more generally. Drawing on her fieldwork at Holocaust sites in Eastern Europe, she (...) identified three sources of methodological tension that developed during the research process: Role conflicts in the research setting, gender selectivity in studies of ethnic and racial violence, and the sexual objectification of women in academic discourse on violence and genocide. Each of these ethical tensions is examined from the standpoint of research on gender and the Holocaust. (shrink)

When thinking about the harms of drug addiction, there is a tendency to focus on the harms of drug consumption. But not all harms associated with drug addiction are caused by drug consumption. There is at least another dimension of harm worth considering: what I call the linguistic harm of drug addiction. Starting with an analysis of ‘drug addict’ as it appears in the media, I argue that ‘drug addict’ is inconsistently applied to people with drug addiction and that this (...) inconsistency reveals two important features of the term. First, being called a ‘drug addict’ is worse than being described as ‘having a drug problem’. Second, being called a drug addict exacerbates the challenges experienced by people with drug addiction. Referencing the ‘addict’ narrative, I detail how calling someone a drug addict can add to the marginalization of people with drug addiction and argue that to eliminate the linguistic harm of drug addiction, we ought to reduce it first. Using the analysis of ‘drug addict’ from the first half of the paper, I propose a novel harm reduction strategy that benefits people with drug addiction but calls on people who do not use drugs. (shrink)

This article discusses teaching survivors of violence in an introductory women's studies course and addresses the pedagogical question of whether we are able to promote individual agency and empowerment effectively and, if so, how might we best go about it. Survivors spoke out in their journals and in the classroom about their experiences, shared feelings about empowerment, and assessed the ways and extent to which the course helped them to heal. I found that survivors benefited from being able to talk (...) about their experiences and from being encouraged to place their personal experiences in a broader political context, but that a crucial component was the affirmation, validation, and solidarity they felt with each other in the classroom. (shrink)

Organ transplantation saves lives, yet thousands die through lack of organs. What lies behind our failure to donate? Janet Radcliffe Richards casts a sharp critical eye on the moral arguments, forcing us to confront the logic and implications of our own position. A book for everyone concerned with clear thinking on moral issues.

Philippe Descola has become one of the most important anthropologists working today, and _Beyond Nature and Culture_ has been a major influence in European intellectual life since its French publication in 2005. Here, finally, it is brought to English-language readers. At its heart is a question central to both anthropology and philosophy: what is the relationship between nature and culture? Culture—as a collective human making, of art, language, and so forth—is often seen as essentially different from nature, which is portrayed (...) as a collective of the nonhuman world, of plants, animals, geology, and natural forces. Descola shows this essential difference to be, however, not only a specifically Western notion, but also a very recent one. Drawing on ethnographic examples from around the world and theoretical understandings from cognitive science, structural analysis, and phenomenology, he formulates a sophisticated new framework, the “four ontologies”— animism, totemism, naturalism, and analogism—to account for all the ways we relate ourselves to nature. By thinking beyond nature and culture as a simple dichotomy, Descola offers nothing short of a fundamental reformulation by which anthropologists and philosophers can see the world afresh. (shrink)

The present study of Fichte's Wissenschaftslehre nova methodo is composed of two parts. The longer first part is a chapter by chapter interpretative explication of the text of the Wissenschaftslehre nova methodo, while the second part further develops certain key themes of this interpretation. Feeling, which plays a central role in the Wissenschaftslehre nova methodo's account of objective experience, is the special focus of this study. There are various types of feeling incorporated into the deductions of the Wissenschaftslehre nova methodo, (...) the most important of which for the purposes of this project is a feeling of self, which is here interpreted as a feeling of spontaneity or an immediate consciousness of doing . In attempting to explain how our representations come for us to possess reality or to refer to "actual things," Fichte also makes use of feelings of striving, limitation, intellectual compulsion, and a feeling of "ought," as well as other types of feeling. Fichte's use of a feeling of "ought" in his account of theoretical consciousness reflects his interest in the interdependency of the theoretical and the practical, which is a hallmark of his particular style of transcendental philosophy, focused as it is upon the freely acting I. ;Fichte's transcendental account of experience is also a genetic account of consciousness, which is here interpreted as an explanation of the origin of reflective consciousness. Another significant element of the present study is a reconstructed theory of Body as the essence of the actually willing subject for whom alone represented objects can possess reality. Finally, there is a focus in this study upon transcendental philosophy as such, including an investigation into the relations between the transcendental philosopher, the transcendental subject, and the empirical subject, as well as an examination of the distinctive method of transcendental philosophy. As a result of the latter, a theory of the double method of Fichte's transcendental philosophy is proposed as a synthesis of reason and observation. There are also occasional comparisons of Fichte's Wissenschaftslehre nova methodo, with Kant's Critique of Pure Reason. (shrink)

Not only can the influence of Gottlob Frege be found in contemporary work in logic, the philosophy of mathematics, and the philosophy of language, but his projects—and the very terminology he employed in pursuing those projects—are still current in contemporary philosophy. This is undoubtedly why it seems so reasonable to assume that we can read Frege' s writings as if he were one of us, speaking to our philosophical concerns in our language. In Joan Weiner's view, however, Frege's words (...) can be accurately interpreted only if we set that assumption aside. Weiner here offers a challenging new approach to the philosophy of this central figure in analytic philosophy. Weiner finds in Frege's corpus, from Begriffsschrift on, a unified project of remarkable ambition to which each of the writings in that corpus makes a distinct contribution—a project whose motivation she brings to life through a careful reading of his Foundations of Arithmetic. The Frege that Weiner brings into clear view is very different from the familiar figure. Far from having originated one of the standard positions on the nature of reference, Frege turns out not to have had positive doctrines on anything like what contemporary philosophers mean by "reference." Far from having served as a standard-bearer for those who take the realists' side of contemporary disputes with anti-realists, Frege turns out to have had no stake in either side of the controversy. Through Weiner's lens, Frege emerges as a thinker who has principled reasons for challenging the very assumptions and motivations that animate philosophers to dispute these doctrines. This lucidly written and accessible book will generate controversy among all readers with an interest in epistemology, philosophy of language, history of philosophy, and the philosophy of mathematics. (shrink)

The knowledge account of assertion holds that it is improper to assert that p unless the speaker knows that p. This paper argues against the knowledge account of assertion; there is no general norm that the speaker must know what she asserts. I argue that there are cases in which it can be entirely proper to assert something that you do not know. In addition, it is possible to explain the cases that motivate the knowledge account by postulating a general (...) norm that assertions would be true, combined with conversational norms that govern all speech acts. A theory on which proper assertions must be true explains the data better than a theory on which proper assertions must be known to be true. (shrink)

I defend the acceptance principle for testimony (APT), that hearers are justified in accepting testimony unless they have positive evidence against its reliability, against Elizabeth Fricker's local reductionist view. Local reductionism, the doctrine that hearers need evidence that a particular piece of testimony is reliable if they are to be justified in believing it, must on pain of scepticism be complemented by a principle that grants default justification to some testimony; I argue that (APT) is the principle required. I consider (...) two alternative weaker principles as complements to local reductionism; one yields counter-intuitive results unless we accept (APT) as well, while the other is too weak to enable local reductionism to avoid scepticism. (shrink)

BackgroundIn childhood cancer care, healthcare professionals must deal with several difficult moral situations in clinical practice. Previous studies show that morally difficult challenges are related to decisions on treatment limitations, infringing on the child's integrity and growing autonomy, and interprofessional conflicts. Research also shows that healthcare professionals have expressed a need for clinical ethics support to help them deal with morally difficult situations. Moral case deliberations (MCDs) are one example of ethics support. The aim of this study was to describe (...) the MCD-related outcomes that healthcare professionals in childhood cancer care considered important, before MCDs were implemented, in order to facilitate the implementation of MCDs in childhood cancer care in Sweden.MethodsThis study is based on qualitative data. Healthcare professionals, mostly representing registered nurses, nursing assistants and physicians, working at childhood cancer care centres in Sweden, were invited to respond to the translated and content validated European MCD Outcomes Instrument, before participating in regular MCDs. Answers to the main open-ended question, included in the questionnaire, was analysed according to systematic text condensation.ResultsData was collected from 161 responses from the healthcare professionals. The responses included healthcare professionals’ perceptions of which MCD-related outcomes they found important for handling moral challenges. Three different themes of important outcomes from the analysis of the data are presented as follows:Interprofessional well-being in team interactionson a team level;Professional comfort when dealing with moral challengeson a personal level; andImproved quality of care for the child and the familyon a care level.ConclusionsHealthcare professionals in childhood cancer care considered it important that ethics support could enhance the well-being of interprofessional teams, support healthcare professionals on an individual level and improve quality of care. The results of this study can be used in current and future training for MCD-facilitators. When knowing the context specific important MCD-outcomes, the sessions could be adapted. Managers in childhood cancer care would benefit from knowing about the specific important outcomes for their target group because they could then create relevant working conditions for clinical ethics support. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.4 (2003) 369-372 [Access article in PDF] Unity of Agency and Volition:Some Personal Reflections Stephen Weiner The issues of unity of agency, self-as-narrative, and more generally, volition are highly personal to me. Indeed, I would say I have frequently been obsessed with them. I am 52 years old, and date the onset of my psychiatric symptoms—my long-term misery—very specifically: 11:00 pm Pacific Standard Time, (...) August 28, 1965. At almost precisely that time, I started obsessing that I was homosexual and, in fact, turning into a girl. Within days, derealization followed: for instance, the houses in my neighborhood seemed one-dimensional—they seemed as though they were painted, as though I could stick my hand or an object through them. Colors seemed less bright as well—but I hardly had words for all this at the time: it was an overwhelmingly preverbal feeling, but I found some words for it.I was also depressed, and knew I was depressed—that is, I was worried, had trouble sleeping, and had suicidal thoughts and feelings. Within weeks, I asked my parents if I could see a psychiatrist, and I did. I remember asking my psychiatrist if he ever thought about the possibility that everything might be an illusion, and he quoted the refrain from "Row, Row, Row Your Boat": "merrily, merrily, merrily, merrily, life is but a dream." But just asking him produced a chilling feeling that he did not exist and, largely for this reason, I did not mention unreality feelings again to therapists for another 20 years.So, like Dr. Wells' patient Edward, described by James Phillips (2003), I was in trouble; like Edward, I was starting to construct a narrative. I started feeling that I had "to tell my story" at about this time—before then, I had not felt a need to do that. That may be partly because young children take life for granted (at least, I did), and it may be partly because suffering, by its very nature, demands explanation; both reasons were probably operating—certainly, both my parents told me years later that I had seemed emotionally distressed as a child, and my mother told they would have given me Ritalin if it had been available. So, to other people (my parents and my teachers) I was mentally ill in some sense, and I have some pretty clear memories of what I now recognize as depression, especially in the second and third grades; but I did not think of myself as sick and I did not think of myself as suffering—and I did not experience the duality (at least) of selves that I started to experience almost immediately in August 1965.Phillips further points out that the "future Edward" could look back in his narrative, at a later age, and reconstruct his history either as someone with a continuing mental illness, or as someone who had attained a secure, healthy adulthood and saw his experience as adolescent pain in the service of ultimate adult health and integration. I see my story, I am sorry to report, as [End Page 369] one of unremitting basic pain but with the positive dimension that I was able to go on, obtain a good education, work a good deal in my adult life, and father a child. But my narrative—and am I not, as a highly verbal person, almost constrained to think of my life as a narrative?—has been one, as Phillips (following Kleinman) realizes, of suffering. It is, above all else, an illness narrative. I find the approach of J. Melvin Woody (2003)—of privileging performing and performing arts and spatial metaphors over story—less relevant and true to myself, although I see no reason to argue with Mary's preference for such forms. It may be that the temporal discontinuities she has experienced predispose her to see herself in such terms—may, in fact, necessitate doing so. I am not exactly sure why, but it probably has to do with acting, with trying on and performing one role... (shrink)