Narrative ethics taps into an inherent human need to tell our own stories centred on our own moral values and to have those stories heard and acknowledged. However, not everyone’s words are afforded equal power. The use of narrative ethics in bioethical decision-making is problematized by a disparity in whose stories are told, whose stories are heard, and whose stories are believed. Here, I conduct an analysis of narrative ethics through a critical theory lens to show how entrenched patterns of (...) narrative neglect in medicine are harming not only our capacity to make use of narrative ethics but also our capacity to deliver effective healthcare. To illustrate this point, I use three examples where the patient’s gender affects how their stories unfold: autism, weight, and pain management. From these, I argue that the use of narrative ethics without the application of a critical theory lens risks the exacerbation of what Miranda Fricker refers to as “testimonial injustice,” the prima facie harm experienced by individuals whose credibility is undermined by others’ prejudices. Finally, I suggest that narrative ethics can be a powerful tool for mitigating oppressive practices in medicine if we couple it with critical analysis that enables us to understand the power dynamics at play in storytelling. (shrink)

Objective To study how doctors care for their patients, both medically and as fellow humans, through observing their conduct in patient–doctor encounters. Design Qualitative study in which 101 videotaped consultations were observed and analysed using a Grounded Theory approach, generating explanatory categories through a hermeneutical analysis of the taped consultations. Setting A 500-bed general teaching hospital in Norway. Participants 71 doctors working in clinical non-psychiatric departments and their patients. Results The doctors were concerned about their patients' health and how their (...) medical knowledge could be of service. This medical focus often over-rode other important aspects of the consultations, especially existential elements. The doctors actively directed the focus away from their patients' existential concerns onto medical facts and rarely addressed the personal aspects of a patient's condition, treating them in a biomechanical manner. At the same time, however, the doctors attended to their patients with courteousness, displaying a polite and friendly attitude and emphasising the relationship between them. Conclusions The study suggests that the main failing of patient–doctor encounters is not a lack of courteous manners, but the moral offence patients experience when existential concerns are ignored. Improving doctors' social and communication skills cannot resolve this moral problem, which appears to be intrinsically bound to modern medical practice. Acknowledging this moral offence would, however, be the first step towards minimising the effects thereof. (shrink)

This paper raises the questions: 'What do we expect from nursing ethics?' and 'Is the literature of nursing ethics any different from that of medical ethics?' It is suggested that rather than develop nursing ethics as a separate field writers in nursing ethics should take a lead in making the patient the central focus of health care ethics. The case is made for empirical work in health care ethics and it is suggested that a good way of setting about this (...) is to ask practising nurses about the real ethical problems they encounter. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Dogs and MonstersObservations on the Evacuation of Afghanistan and the Intersection of Human Rights and the AnthropoceneK. M. Ferebee (bio)On August 28, 2021, former Royal Marine and charity worker Pen Farthing was evacuated from Afghanistan with almost two hundred dogs and cats that his Kabul animal charity, Nowzad Dogs, had rescued. The role of the British government in this evacuation remains hotly contested: At the time, the British Ministry (...) of Defence tweeted (Fig. 1) that Farthing's escape had been assisted by the British military, but Farthing later disputed this claim and argued that his rescue was not the result of high-level intervention in the British government. In January 2022 controversy erupted around the emergence of documents suggesting that Prime Minister Boris Johnson had lied to Parliament about the personal role that he played in just such an intervention. Notably, Nowzad's Afghan staff members were not evacuated alongside Farthing and the animals, though they would eventually escape to Pakistan. Following Farthing's escape, the British government failed to evacuate hundreds of British citizens and residents (Merriman and Ghouri), as well as many more Afghans who had worked on behalf of British forces. The Nowzad Dogs evacuation became a site of symbolic struggle over Britain's respect (or lack thereof) for human rights. "What a story to tell the world: Britain values dogs more than Afghan people," the headline of an opinion piece in the Guardian (Hinsliff) read.The story of Nowzad Dogs is interesting to me not only as a tale of human-nonhuman relations, but also because I was, at the time it occurred, volunteering within the Afghan aid community to assist relatives of a friend, British Afghans who had been visiting Kabul when the government [End Page 52] collapsed. The family repeatedly asked for assistance from the British Foreign, Commonwealth and Development Office—assistance that never appeared. Ultimately, due to the generosity of donors and the coordination of a volunteer team, the family was able to flee to Pakistan, where they boarded a commercial flight to London. This case was a particularly stark and powerful illustration of the negotiations of rights and value that took place during and following the evacuation. It seemed nonsensical, in August 2021, to suppose that British citizens, including British children (the family I worked with included a six- and an eleven-year-old who were British citizens), would be abandoned while Afghan dogs had their rights prioritized. As I hope to demonstrate here, however, such an incident becomes comprehensible and even logical when it is understood as part of a specifically Anthropocene manifestation of subjectivity.Upendra Baxi suggests that 1948's Universal Declaration of Human Rights (UDHR) marks a broad shift from the era of "modern" (42) human rights (which began with the American and French Revolutions) to the era of "contemporary" (42) human rights. His periodization links these eras in human rights to shifts in the ideology of capitalism and empire. The "modern" era of human rights, he writes, "signals a whole variety of ideological 'justifications' for colonization and world domination" and "provides a register of major development in industrial capitalism" (42), while the "contemporary" era of human rights "is based on the premise of radical self-determination" (46). Such a periodization also brings human rights into close alignment with the Anthropocene, which is rooted in the capitalist-colonial Enlightenment and Industrial Revolution, yet often dated most concretely to the circa-1950 shift that some (such as J. R. McNeill and Peter Engelke) label the "Great Acceleration." Indeed, one could reasonably appropriate Baxi's terms and speak of "modern" and "contemporary" Anthropocenes mapped identically onto the global timeline.I propose to use the 2021 Afghan evacuation as a site from which to explore how human rights and the Anthropocene have together coproduced certain forms of subjectivity that are essential for the continued smooth functioning of world-ecological capitalism. These new forms of subjectivity are necessary to sustain the important fiction of individual [End Page 53] agency and value and conceal the ways in which the Anthropocene moment renders this fiction meaningless. Ultimately, I paint a picture of an Anthropocene without any human agency at all. I want... (shrink)

The literature on Leonardo da Vinci is so extensive that a bibliography alone would make many volumes. Most of what has been written about him, however, are studies in history, art criticism, biography, or natural science. The number of writings on his esthetics and philosophy of culture are considerably fewer. And there are very few Marxist studies on these questions. This is particularly true of works devoted specifically to Leonardo alone.

For much of human history the idea of a right to life has not seemed self-evident. The credibility of the idea appears to depend on a particular kind of intuition concerning the nature of the world. In this paper, the kind of intuition involved is related to the idea of a covenant, illustrated by that of marriage. The paper concludes by suggesting that talk about responsibilities may be more fruitful than talk about rights.

In Nicolaus Cusanus on Faith and the Intellect: A Case Study in 15th-Century Fides-Ratio Controversy, K.M. Ziebart presents an account of the Cusan epistemology as a fascinating late-medieval attempt to definitively harmonize faith and reason.

Investigation into the reality of time can be pursued within the ontological domain or it can also span human thought and natural language. I propose to approach time by correlating three domains of inquiry: metaphysical time, the human concept of time, and temporal reference in natural language, entertaining the possibility of what I call a ‘horizontal reduction’ and ‘vertical reduction’. I present a view of temporalityL/E as epistemic modality, drawing on evidence from the L domain and its correlates in the (...) E and M domains. On this view, the human concept of time is a complex, ‘molecular’ concept and can be broken down into primitive concepts that are modal in nature, featuring as degrees of epistemic commitment to representations of states of affairs. I present evidence from tensed and tenseless languages and point out its compatibility with the view of real time as metaphysical modality. (shrink)

Philosophy of history; the idea of the not-being and the history, by K. M. Jamil.--Philosophy of history, by Khwaja Ashkar Husain.--Philosophy of history, by A. H. Kamali.--Philosophy of history, by B. H. Siddiqi.--Philosophy of history: explanation in history, by Kazi A. Kadir.

In his reply to my previous article Professor Tatum has added some interesting material to the discussion and has made some points which invite further examination. He rightly stresses that the statement in the added first line, that the dead man had been flamen Dialis, would have conflicted with the hopes expressed in the original epitaph if we think these hopes referred to success in war and politics. This objection would be equally relevant if the Publius of the epitaph were (...) the grandson proposed by Sumner or any other young Scipio who, though robust enough for a public career, died prematurely. (shrink)

This commentary focuses on two moral values implied by the case study but not specified in the working party's conclusions, namely equitable treatment of the most vulnerable and the value of political government.

The authors report and comment on student reactions to a clinical example of moral choice in the microallocation of scarce resources. Four patients require dialysis simultaneously, but only one kidney machine is available. What moral, as opposed to clinical, criteria are available to determine who should have priority?

Abortion is forbidden under normal circumstances by nearly all the major world religions. Traditionally, abortion was not deemed permissible by Muslim scholars. Shiite scholars considered it forbidden after implantation of the fertilised ovum. However, Sunni scholars have held various opinions on the matter, but all agreed that after 4 months gestation abortion was not permitted. In addition, classical Islamic scholarship had only considered threats to maternal health as a reason for therapeutic abortion. Recently, scholars have begun to consider the effect (...) of severe fetal deformities on the mother, the families and society. This has led some scholars to reconsider the prohibition on abortion in limited circumstances. This article reviews the Islamic basis for the prohibition of abortion and the reasons for its justification. Contemporary rulings from leading Shiite scholars and from the Sunni school of thought are presented and reviewed. The status of abortion in Muslim countries is reviewed, with special emphasis on the therapeutic abortion law passed by the Iranian Parliament in 2003. This law approved therapeutic abortion before 16 weeks of gestation under limited circumstances, including medical conditions related to fetal and maternal health. Recent measures in Iran provide an opportunity for the Muslim scholars in other countries to review their traditional stance on abortion. (shrink)

If George Eliot is a determinist, how can she justify judging her characters on moral grounds? The most influential discussion of her determinism concludes that she believed one overcomes its depressing effects by understanding it. But this view is contradicted by her assertion that free will is a “practical” necessity, even a necessary fiction. Kantian moral theory is strongly present in her work as is shown by her use of Kantian terms, but it is grounded nonmetaphysically. Rationality and the will (...) are essential if one is to feel free to choose. Her concept of whole self in relation to moral choice has links with Bergsonian theory. (shrink)

An Institute of Medical Ethics working party argues that an ethically desirable relationship of mutual empowerment between patient and clinician is more likely to be achieved if patients understand the ground rules of medical confidentiality. It identifies and illustrates ambiguities in the General Medical Council's guidance on AIDS and confidentiality, and relates this to the practice of different doctors and specialties. Matters might be clarified, it suggests, by identifying moral factors which tend to recur in medical decisions about maintaining or (...) breaching confidentiality. The working party argues that two such factors are particularly important: the patient's need to exercise informed choice and the doctor's primary responsibility to his or her own patients. (shrink)

Most commentators apply the phrase ‘vitans onus…iugi’ not only to the heifer but to Attis himself. When they ask what iugum Attis is avoiding, the immediate context provides no obvious answer. They are therefore compelled to interpret the iugum either in the light of a much earlier passage or in the light of a much later one. Neither procedure is satisfactory. On the other hand, at least one editor has proposed that the phrase ‘vitans onus…iugi’ does not apply to Attis (...) himself but to the heifer alone. The comparison between Attis and the heifer then lies only in their frenzied speed; the yoke-avoiding action is external to the comparison and merely heightens the picture of the charging heifer. The obvious difficulty with this view is that the concept of a yoke, and more generally of avoiding servitude, plays an important role relevant to Attis later on in the poem. From line 50 onwards Attis sees himself as an erifuga anxious to escape from slavery to Cybele. And the account of Cybele's lion, sent to round him up, twice refers to the notion of freeing from a yoke . Both these traditional approaches concentrate on the literal meaning of the phrase vitans onus…iugi: they assume that the yoke itself is important and that it either does or does not make sense when applied to Attis. But if we focus instead upon the action which the whole phrase vitans onus…iugi suggests, then the description of the heifer has an apt application to Attis within its own immediate context. (shrink)