Trailblazing marine biologist, visionary conservationist, deep ecology philosopher, Edward F. Ricketts has reached legendary status in the California mythos. A true polymath and a thinker ahead of his time, Ricketts was a scientist who worked in passionate collaboration with many of his friends—artists, writers, and influential intellectual figures—including, perhaps most famously, John Steinbeck, who once said that Ricketts's mind “had no horizons.” This unprecedented collection, featuring previously unpublished pieces as well as others available for the first time in their original (...) form, reflects the wide scope of Ricketts’s scientific, philosophical, and literary interests during the years he lived and worked on Cannery Row in Monterey, California. These writings, which together illuminate the evolution of Ricketts’s unique, holistic approach to science, include “Verbatim transcription of notes on the Gulf of California trip,” the basic manuscript for Steinbeck’s and Ricketts’s _Log from the Sea of Cortez;_ the essays “The Philosophy of Breaking Through” and “A Spiritual Morphology of Poetry;” several shorter pieces on topics including collecting invertebrates and the impact of modernization on Mexican village life; and more. An engaging critical biography and a number of rare photographs offer a new and richly detailed view of Ricketts’s life. (shrink)

In the mid 1980s it was apparent that the need for organ donors exceeded those willing to donate. Some University of Pittsburgh Medical Center (UPMC) physicians initiated discussion of possible new organ donor categories including individuals pronounced dead by traditional cardiac criteria. However, they reached no conclusion and dropped the discussion. In the late 1980s and the early 1990s, four cases arose in which dying patients or their families requested organ donation following the elective removal of mechanical ventilation. Controversy surrounding (...) these cases precipitated open discussion of the use of organ donors pronounced dead on the basis of cardiac criteria. Prolonged deliberations by many committees in the absence of precedent ultimately resulted in what is, to our knowledge, the country's first policy for organ donation following elective removal of life support. The policy is intricate and conservative. Care was taken to include as many interested parties as possible in an effort to achieve representative and broad based support. This paper describes the development of the UPMC policy on non-heart-beating organ donation. (shrink)

Health systems research is widely identified as an indispensable means to achieve the goal of health equity between and within countries. Numerous health systems research consortia comprised of institutions from high-income countries and low and middle-income countries are currently undertaking programs of research in LMICs. These partnerships differ from collaborations that carry out single projects in the multiplicity of their goals, scope of their activities, and nature of their management. Recent conceptual work has explored what features might be necessary for (...) health systems research consortia and their research programs to promote health equity. Identified features include selecting research priorities that focus on improving access to high-quality health services and/or financial protection for disadvantaged populations in LMICs and conducting research capacity strengthening that promotes the independent conduct of health systems research in LMICs. Yet, there has been no attempt to investigate whether existing consortia have such characteristics. This paper describes the results of a survey undertaken with health systems research consortia leaders worldwide to assess how consistent current practice is with the proposed ethical guidance. The findings suggest that consortia may be fairly well organised to promote health equity, but have scope for improvement, particularly in terms of achieving inclusive priority-setting. (shrink)

Here I consider the possible role of the temporal updating system in the development of the temporal reasoning system. Using evidence from children's acquisition of time words, I argue that abstract temporal concepts are not built from primitive representations of time. Instead, I propose that language and cultural learning provide the primary sources of the temporal reasoning system.

When successful solid organ transplantation was initiated almost 40 years ago, its current success rate was not anticipated. But continuous efforts were undertaken to overcome the two major obstacles to success: injury caused by interrupting nutrient supply to the organ and rejection of the implanted organ by normal host defense mechanisms. Solutions have resulted from technologic medical advances, but also from using organs from different sources. Each potential solution has raised ethical concerns and has variably resulted in societal acclaim, censure, (...) and apathy. Transplant surgery is now well accepted, and the list of transplant candidates has grown far quicker than the availability of organs. More than 30,000 patients were awaiting organs for transplantation at the end of March 1993. While most organs came from donors declared dead by brain criteria, the increasing shortage of donated organs has prompted a reexamination of prior restrictions of donor groups. Recently, organ procurement from donors with cardiac death has been reintroduced in the United States. This practice had been mostly abandoned by the U.S. and some, though not all, other countries. Transplantation has been more successful using organs procured from heart-beating, "brain dead" cadavers than organs from non-heart-beating cadavers. However, recent advances have led to success rates with organs from non-heart-beating donors that may portend large increases in organ donation and procurement from this source. (shrink)

Individual experience is subjective: We can describe experiences, but we cannot share them directly. Thus, many investigators favour threshold measures of experience , while suprathreshold methods are met with scepticism. We believe that suprathreshold measures are useful, as they reveal group differences in sensation that cannot be observed with thresholds. These differences, however, are distorted when scales are used incorrectly. Of particular interest, oral sensory intensity predicts long-term health outcomes ; these findings are validated by robust differences in oral anatomy, (...) suggesting that valid suprathreshold comparisons convey accurate and meaningful differences in experience. (shrink)

Biological evolution allegedly requires a genealogical conception of species (i.e., that species are descent-based "historical entities" rather than similarity-based "natural kinds"). After considering David Hull's arguments for this view, this paper opts instead for individuating species primarily via genetic similarities, but in a way which avoids charges of "Essentialism". It is suggested that a genealogical conception of species actually derives from a biological version of Behaviorism plus an interrelated pair of confusions regarding evolution and identity. Current taxonomic method may favor (...) the genealogical conception, but evolutionary theory-- as well as genetics and molecular biology--count against it. (shrink)

International travel for medical care, or medical tourism, creates ethical and safety concerns for patients. Guidelines could be developed and distributed to help address these concerns, but they may at the same time appear to endorse this practice.

This paper focuses on smallholder agriculture and livelihoods in north-central Tanzania. It traces changes in agricultural production and asset ownership in one community over a 28 year period. Over this period, national development policies and agriculture programs have moved from socialism to neo-liberal approaches. Using a combination of qualitative and quantitative methods, we explore how farmers have responded to these shifts in the wider political-economic context and how these responses have shaped their livelihoods and ideas about farming and wealth. This (...) case study clearly debunks the idea that rural farmers are slow to respond to “modern” farming methods or that smallholder farming is stagnant and cannot reduce poverty. While changes overall are very positive in this rural community, challenges remain as land sizes are small and markets often unreliable. This research cautions against a shift in emphasis to large-scale farming as a strategy for national development. It suggests instead that increased investment in supporting smallholder farming is critical for addressing poverty and rural well-being. (shrink)

This essay demonstrates how the early Enlightenment salonnière madame de Lambert advanced a novel feminist intellectual synthesis favoring women's taste and cognition, which hybridized Cartesian and honnête thought. Disputing recent interpretations of Enlightenment salonnières that emphasize the constraints of honnêteté on their thought, and those that see Lambert's feminism as misguided in emphasizing gendered sensibility, I analyze Lambert's approach as best serving her needs as an aristocratic woman within elite salon society, and show through contextualized analysis how she deployed honnêteté (...) towards feminist ends. Additionally, the analysis of Malebranche's, Poulain de la Barre's, and Lambert's arguments about the female mind's gendered embodiment illustrates that misrepresenting Cartesianism as necessarily liberatory for women, by reducing it to a rigid substance dualism, erases from view its more complex implications for gender politics in the late seventeenth and early eighteenth centuries, especially in the honnête environment of the salons. (shrink)

In this paper I develop a systemic discrimination approach to defining a narrowly construed category of ‘hate speech’, as speech that harms to a sufficient degree to warrant government regulation. This is important due to the lack of definitional clarity, and the extraordinarily wide usage, of the term. This article extends current literature on how hate speech can harm by identifying under what circumstances speakers have the capacity to harm, and under what circumstances targets are vulnerable to harm. It also (...) shows how the capacity to harm can be mobile and involve the construction of new targets. Finally, it bridges the gap between conceptual understandings of hate speech and policy designed to regulate it. (shrink)

In the preceding commentary, Campbell and Weber raise two valid and important issues concerning non-heart-beating organ donation (NHBOD). First, because the procedure links withdrawal of life support and the potential for subsequent organ donation, the desire for organs may create a situation in which care of the dying individual has relatively less importance and the dying may receive suboptimal care. Second, even if concerns about care of the dying were dealt with adequately, there will not be enough non-heart-beating donors to (...) significantly decrease the organ shortage that exists, making the procedure not worth the risk. We agree that attention to the important details of caring for the dying are, and must be, the primary concern of all health care workers caring for those individuals. Ensuring the patients' comfort, dignity, and autonomy, and providing for family and social support are the mainstays of this care. All policies for NHBOD should clearly support and mandate these concepts. Regarding the second concern, we agree that NHBOD is currently rare; however, evidence is increasing that this type of donation has great potential. Continued growth of the practice in this country will depend largely on public acceptance, which we believe will be directly influenced by whether the public perceives that care of the dying is not compromised by this procedure. (shrink)

"Plato texts, a retrieve": p. [108]-174.

Medical tourism is a practice, whereby individuals travel across national borders with the intention of receiving medical care. Medical tourists are motivated to travel abroad by a number of factors, including the affordability of care abroad, access to treatments not available at home, and wait times for care at home. In this article, we share the findings of interviews conducted with 32 Canadian medical tourists with the aim of developing a better understanding of medical tourism, the ethical issues it raises (...) for public health within Canada and other source countries for medical tourists, and to identify research gaps and policy responses to this practice. While patient and academic perspectives overlap in several regards, we suggest areas in which academic consideration of the ethical issues raised by medical tourism can be informed by patient perspectives. (shrink)

Students in an undergraduate legal and ethical issues course continually told the authors that they did not have time to study for the course because they were busy studying for their clinical courses. Faculty became concerned that students were failing to realize the value of legal and ethical concepts as applicable to clinical practice. This led the authors to implement a transformational learning experience in which students applied legal and ethical course content in a high-fidelity human simulation (HFHS) scenario. A (...) preliminary evaluation compared the new HFHS experience with in-person and online student groups using the same case. Based on both student and faculty perceptions, the HFHS was identified as the best of the three approaches for providing a transformational learning experience regarding legal and ethical content. (shrink)

Background: Medical tourism involves patients travelling internationally to receive medical services. This practice raises a range of ethical issues, including potential harms to the patient's home and destination country and risks to the patient's own health. Medical tourists often engage the services of a facilitator who may book travel and accommodation and link the patient with a hospital abroad. Facilitators have the potential to exacerbate or mitigate the ethical concerns associated with medical tourism, but their roles are poorly understood. -/- (...) Methods: 12 facilitators were interviewed from 10 Canadian medical tourism companies. -/- Results: Three themes were identified: facilitators' roles towards the patient, health system and medical tourism industry. Facilitators' roles towards the patient were typically described in terms of advocacy and the provision of information, but limited by facilitators' legal liability. Facilitators felt they played a positive role in the lives of their patients and the Canadian health system and served as catalysts for reform, although they noted an adversarial relationship with some Canadian physicians. Many facilitators described personally visiting medical tourism sites and forming personal relationships with surgeons abroad, but noted the need for greater regulation of their industry. -/- Conclusion: Facilitators play a substantial and evolving role in the practice of medical tourism and may be entering a period of professionalisation. Because of the key role of facilitators in determining the effects of medical tourism on patients and public health, this paper recommends a planned conversation between medical tourism stakeholders to define and shape facilitators' roles. (shrink)

Medical tourism is the practice of traveling across international borders with the intention of accessing medical care, paid for out-of-pocket. This practice has implications for preferential access to medical care for Canadians both through inbound and outbound medical tourism. In this paper, we identify four patterns of medical tourism with implications for preferential access to care by Canadians: Inbound medical tourism to Canada’s public hospitals; Inbound medical tourism to a First Nations reserve; Canadian patients opting to go abroad for medical (...) tourism; and Canadian patients traveling abroad with a Canadian surgeon. These patterns of medical tourism affect preferential access to health care by Canadians by circumventing domestic regulation of care, creating jurisdictional tensions over the provision of health care, and undermining solidarity with the Canadian health system. (shrink)

In this article, I identify a distinctive form of injustice—ontic injustice—in which an individual is wronged by the very fact of being socially constructed as a member of a certain social kind. To be a member of a certain social kind is, at least in part, to be subject to certain social constraints and enablements, and these constraints and enablements can be wrongful to the individual who is subjected to them, in the sense that they inflict a moral injury. The (...) concept of ontic injustice is valuable in three main ways: it draws our attention to the role played by social kinds in enacting wrongful constraints and enablements; it clarifies our options for developing accounts of the ontology of particular social kinds, such as gender kinds; and, along with the related concept of ‘ontic oppression’, it helps us to understand and respond to oppression. (shrink)

This article discusses the relationship between the origins of the concept of post-normal science, its potential as a heuristic and the phenomenon of complex science entailed policy problems in late industrial societies. Drawing on arguments presented in the early works of Funtowicz and Ravetz, it is proposed that there is a fundamentally empirical character to the post-normal science call for democratizing expertise, which serves as an antidote to late industrial poisoning of the fairy tale ideal of a clean divide between (...) science and politics. Post-normal science extended-peer-review methodology is interpreted as a response to a crisis in the governance of science. Rather than viewing extended-peer-review processes as products of the post-normal science discourse, here the post-normal science discourse is understood to provide a heuristic lens through which existing complex science/society collaborations and conflicts can be better understood. Two different post-normal science situations—management of mega-contamination in Bitterfeld, Germany, and eviction of the Parakuiyo Maasai from the eastern wetlands of the Usangu plains of Tanzania—are presented and the implications of their de facto extended-peer-review structures are discussed, to illustrate this heuristic potential. (shrink)

BackgroundMedical tourism, the practice of persons intentionally travelling across international boundaries to access medical care, has drawn increasing attention from researchers, particularly in relation to potential ethical concerns of this practice. Researchers have expressed concern for potential negative impacts to individual safety, public health within both countries of origin for medical tourists and destination countries, and global health equity. However, these ethical concerns are not discussed within the sources of information commonly provided to medical tourists, and as such, medical tourists (...) may not be aware of these concerns when engaging in medical tourism. This paper describes the methodology utilized to develop an information sheet intended to be disseminated to Canadian medical tourists to encourage contemplation and further public discussion of the ethical concerns in medical tourism.MethodsThe methodology for developing the information sheet drew on an iterative process to consider stakeholder feedback on the content and use of the information sheet as it might inform prospective medical tourists’ decision making. This methodology includes a literature review as well as formative research with Canadian public health professionals and former medical tourists.ResultsThe final information sheet underwent numerous revisions throughout the formative research process according to feedback from medical tourism stakeholders. These revisions focused primarily on making the information sheet concise with points that encourage individuals considering travelling for medical tourism to do further research regarding their safety both within the destination country, while travelling, and once returning to Canada, and the potential impacts of their trip on third parties. This methodology may be replicated for the development of information sheets intending to communicate ethical concerns of other practices to providers or consumers of a certain service. (shrink)

The dividing walls of hostility -- The roots of othering -- The forms of othering -- The violent consequences of othering -- Voices of the moral imperative -- And the walls come tumbling down.

“It was the best of times. It was the worst of times.” Charles Dickens easily could have been describing our time and the dilemma in which victims of nonmalignant chronic pain find themselves.I am a forty-six-year-old registered nurse who specializes in oncology care and education. I am also a patient who suffers from chronic nonmalignant pain, and this malady has been the most frightening, the most humiliating, and the most difficult ordeal of my life.The morning of February 1983 severed my (...) life into “before” and “after,” as clearly as if it has been cut by a sharp knife. The “before” included my career as an oncology nurse, a college nursing professor, and a writer; but that was abruptly ended by the catastrophic rupture of a deep cerebral aneurysm. Surgery saved my life, but something unforeseen occurred during the procedure; and so, in the “after,” I have had to live with a serious seizure disorder and memory loss. (shrink)

This essay argues that Malebranche originated the model of sensitive taste in French thought, several decades before Du Bos. It examines the highly gendered, negative physiological model of taste and of the female mind which Malebranche developed within the Cartesian framework and as a witness to Parisian salon society in which women’s taste had great cultural influence, and strongly questions the common assumption that Cartesian substance dualism necessarily contained feminist potential. The essay argues for Malebranche’s great influence in this regard, (...) connecting him to later Enlightenment critics of women’s taste such as Rousseau, and to Vitalist physicians like Le Camus. -/- All rights reserved. Except for brief quotations used for purposes of scholarly citation, none of this work may be reproduced in any form by any means without written permission from the publisher. For information address the University of Pennsylvania Press, 3905 Spruce Street, Philadelphia, Pennsylvania 19104-4112. (shrink)

Medical tourists, persons that travel across international borders with the intention to access non-emergency medical care, may not be adequately informed of safety and ethical concerns related to the practice of medical tourism. Researchers indicate that the sources of information frequently used by medical tourists during their decision-making process may be biased and/or lack comprehensive information regarding individual safety and treatment outcomes, as well as potential impacts of the medical tourism industry on third parties. This paper explores the feedback from (...) former Canadian medical tourists regarding the use of an information sheet to address this knowledge gap and raise awareness of the safety and ethical concerns related to medical tourism. (shrink)

This article discusses the conditions of research in international and European contexts, in particular European elite politics and politicians, arguing that the researcher is a central agent and research instrument in this process. The article suggests that the researcher finds herself renegotiating parts of her socially assigned identity in relation to European national and international structures and discusses the ways in which the gendered ‘self’ remains the centre of a research project above other identity componentseven in such conditions that might (...) appear to be gender neutral. The article examines the micro-politics of research from the level of archive research to elite interviewing. (shrink)

The way society is organised means that we all get made into members of various types of people, such as judges, wives, or women. These ‘human social kinds’ may be brought into being by oppressive social arrangements, and people may suffer oppression in virtue of being made into a member of a certain human social kind. This book argues that we should pay attention to the ways in which the very fact of being made into a member of a certain (...) human social kind can be oppressive in and of itself. For example, someone who becomes a wife under circumstances where husbands have unjust powers over their wives has suffered a wrong, even if her husband never in fact exercises these powers. The book argues that social movements against racial and gendered oppression, including efforts to advance trans liberation, must get to grips with this phenomenon, and it supplies the conceptual tools needed to do so. The first tool is an analysis of this general form of wrong, termed ‘ontic injustice’. The second tool is an account of ‘ontic oppression’, a particular kind of ontic injustice in which the wrong amounts to a form of oppression, in the sense of being structural and pervasive. The third tool is a pluralist account of race and gender kinds, according to which there is no single social kind that corresponds to a gender category such as ‘woman’, but, rather, there are various different social kinds, each of which is explanatory for different purposes. (shrink)

Despite an abundance of theoretical literature on virtue ethics in nursing and health care, very little research has been carried out to support or refute the claims made. One such claim is that ethical nursing is what happens when a good nurse does the right thing. The purpose of this descriptive, qualitative study was therefore to examine nurses’ perceptions of what it means to be a good nurse and to do the right thing. Fifty-three nurses responded to two open-ended questions: (...) (1) a good nurse is one who...; and (2) how does a nurse go about doing the right thing? Three hundred and thirty-one data units were analysed using qualitative content analysis. Seven categories emerged: personal characteristics, professional characteristics, patient centredness, advocacy, competence, critical thinking and patient care. Participants viewed ethical nursing as a complex endeavour in which a variety of decision-making frameworks are used. Consistent with virtue ethics, high value was placed on both intuitive and analytical personal attributes that nurses bring into nursing by virtue of the persons they are. Further investigation is needed to determine just who the ‘good nurse’ is, and the nursing practice and education implications associated with this concept. (shrink)

Artificial intelligence and robotics have increasingly been adopted in agri-food systems—from milking robots to self-driving tractors. New projects extend these technologies in an effort to automate skilled work that has previously been considered dependent on human expertise due to its complexity. In this paper, we draw on qualitative research carried out with farm managers on apple orchards and winegrape vineyards in Aotearoa New Zealand. We investigate how agricultural managers’ perceptions of future agricultural automation relates to their approach to expertise, or (...) the degree to which they think specialised skills and knowledge are required to perform agricultural work on their orchards and vineyards. Our research generates two insights: the perceived potential for work to be automated is related to the degree to which it is seen to require technical or embodied expertise, with technical expertise being more automatable; and, while embodied expertise is perceived to be more difficult to automate, it is sometimes attributed more exclusively to those in positions of power, such that embodied expertise can be highly valued while the majority of embodied work is viewed as non-expert and thus automatable. Our analysis illustrates that a robot can be an expert when expertise is technical. It also shows variability in the conceptualization of skilled or unskilled work, and that those conceptualizations can set the stage for the future effects of new technologies. This generates new insights into the conditions under which automation might reproduce existing inequalities in agriculture, and also raises new questions about responsibility in the context of automation. (shrink)

The international migration of health workers, including long-term care workers for aging populations, contributes to a shortage of these workers in many parts of the world. In the Anglophone Caribbean, LCW shortages and the migration of nurses to take on LCW positions abroad threaten the health of local populations and widen global inequities in health. Many responses have been proposed to address the international migration of health workers generally, including making it more difficult for these workers to emigrate and increasing (...) and improving local employment opportunities. In this article, we suggest an additional means of ethically reducing health worker migration, targeting the Anglophone Caribbean specifically. Countries in this region can take advantage of their warmer climate and well-trained work force to encourage aging populations in the global north to emigrate temporarily or permanently through international retirement migration. As a result, countries in the Anglophone Caribbean can not only decrease the international migration of trained health workers through the provision of well-paying, local jobs, but potentially reverse this flow by drawing on the international diaspora of their workers. International retirement migration, if carefully managed, can reduce global inequities in health while treating both retirees and LCWs ethically. (shrink)