Moral imagination is a central component of moral agency and person‐centred care. Becoming moral agents who can sustain attention on patients and their families through their illness and suffering involves imagining the other, what moral possibilities are available, what choices to make, and how one wants to be. This relationship between moral agency, moral imagination, and personhood can be effaced by a focus on task‐driven technical rationality within the multifaceted challenges of contemporary healthcare. Similarly, facilitating students' moral agency can also (...) be obscured by the task‐driven technical rationality of teaching. The development of moral agency requires deliberate attention across the trajectory of nursing education. To prepare nursing students for one practice challenge, workplace violence, we developed a multimodal education intervention which included a simulated learning experience (SLE). To enhance the realism and consistency of the educational experience, 11 nursing students were trained as simulated participants (SP). As part of a larger study to examine knowledge acquisition and practice confidence of learners who completed the SLE, we explored the experience of being the SP through interviews and a focus group with the SP students. The SP described how their multiple performances contributed to imagining the situation ‘on both sides’ prompting empathy, a reconsideration of their moral agency, and the potential to prevent violence in the workplace beyond technical rational techniques, such as verbal de‐escalation scripts. The empirical findings from the SP prompted a philosophical exploration into moral imagination. We summarise the multimodal educational intervention and relevant findings, and then, using Johnson's conception of moral imagination and relevant nursing literature, we discuss the significance of the SP embodied experiences and their professional formation. We suggest that SLEs offer a unique avenue to create pedagogical spaces which promote moral imagination, thereby teaching for moral agency and person‐centred care. (shrink)

Brussen, Kerri Anne This paper is a brief history of suicide, euthanasia, and physician assisted suicide in the United States of America which aims to provide an understanding of the continued and persistent effort in the USA to legalise physician assisted suicide. Oregon and Washington State Dying with Dignity Laws are reviewed as examples of legalised physician assisted suicide.

Brussen, Kerri Anne Children born through gamete donation can be genetically linked to one or neither parent. This article examines the practice of gamete donation, seeking to establish if there is cause for concern.

Brussen, Kerri Anne In 2002, euthanasia became legal in the Netherlands. Since then, the Groningen Protocol has been endorsed, allowing infanticide for disabled babies. More recently, a citizen's initiative is being prepared to propose to the Dutch government that people should be allowed to legally terminate their life if they consider it completed. The slippery slope in the Netherlands appears to be well lubricated.

Brussen, Kerri Anne This article begins with a fictionalised account of a teenage party to celebrate a sporting club's end of season achievements. It then looks at some of the potential outcomes of the behaviours displayed and the longer term consequences.

Brussen, Kerri Anne Adolescence and young adulthood are a time of change. It is also a time where there is an increased chance of being diagnosed with a mental illness. Professor Patrick McGorry has driven the agenda to transform the approach to youth mental health. This article is a review of the recommendations of McGorry and others within the mental health field on how best to care for our youth with a mental illness. We also briefly look at some of (...) the services offered by a Catholic agency. (shrink)

Brussen, Kerri Anne In February 2009, the National Health and Medical Research Council (NHMRC) issued revised guidelines to help reduce the health risks from alcohol consumption. This report summarises these guidelines. Above all, it discusses the change of thought in these guidelines based on a greater understanding of the need to reduce both the immediate as well as the lifetime risks of alcohol consumption.

Brussen, Kerri Anne Sex Cells, written by Rene Almeling, describes the commercial market that has emerged in the United States for human eggs and sperm. Almeling examines how agendas that are economically, biologically and culturally driven have lead to distinctly different practices within egg agencies and sperm banks. Further, she observes how these practices subsequently shape an individual's perception of the commodification of human gametes.

Brussen, Kerri Anne The selection of the sex of an unborn child brings to mind many thoughts: playing God, gender discrimination, imbalance in the male:female gender ratio, and a slippery slope that could lead to designer babies. Sex selection also raises the question of reproduction autonomy. These and other issues are explored in this article.

Brussen, Kerri Anne This article briefly examines the history and genetics of Down syndrome. Contemporary prenatal testing practices are described as is the effect of testing on the birth prevalence of children with Down syndrome. The analysis of a series of articles on families with a child with Down syndrome provides a touching insight into these families. It demonstrates that each person - including those with Down syndrome - make a unique and valuable contribution to their family and the world.

Brussen, Kerri Anne A patent provides the exclusive legal right to a person or company to regulate the distribution, manufacture or use of their invention. This paper examines some of the issues surrounding Gene Patents. Although there is a drive to abolish Gene Patents, we argue that refined and clearly defined regulation would continue to support medical research, avoid exploitation, and be of benefit to public health.

Brussen, Kerri Anne On 29 November 2012, one of the Standing Committees of the Commonwealth House of Representatives released a report on the prevention, diagnosis and management of Fetal Alcohol Spectrum Disorders in Australia. This article explores the findings and recommendations of this report. The Commonwealth parliamentary committee noted that FASD is a serious health issue in Australia. It therefore called for a National Plan of Action, education for health professionals, and public awareness campaigns to encourage women not to drink (...) when pregnant or when planning a pregnancy. Other recommendations included better management of FASD within education, disability services, and the criminal justice system. (shrink)

Brussen, Kerri Anne Ethically compromised vaccines are vaccines where the virus used in the manufacture of the vaccine has been cultured in a cell line developed from tissue grown from an aborted foetus. In Australia, an ethically compromised vaccine is the only vaccine available for Chicken pox (varicella), shingles (zoster), Hepatitis A, and Rubella (which is part of the MMR - measles, mumps, rubella - vaccine). The poliovirus vaccine component of Quadracel, available in Western Australia, is ethically compromised. However, the (...) poliovirus component of Infanrix-IPV is not ethically compromised and is used in all other Australian States and Territories. The rabies vaccine, Rabipur, is not ethically compromised and is the preferred option to Merieux Inactivated Rabies Vaccine (MIRV) which is an ethically compromised vaccine. This article lists the ethically compromised vaccines available in the various Australian States and Territories, and explains why they are ethically compromised. It also explains when and why vaccination should still be accepted even when the only available vaccine is ethically compromised. (shrink)

Brussen, Kerri Anne The National Health and Medical Research Council released a new set of dietary guidelines on 18 February 2013, to help ensure that Australians continue to make healthy food choices based on the best available scientific evidence. Unlike the 2003 guidelines which were based on nutrients, these guidelines are based on food and food groups. The guidelines encourage the consumption of a varied diet and physical exercise. They also encourage the limiting of energy-dense nutrient-poor food. By making these (...) food choices, we can help to reduce our risk of diet-related disease. (shrink)

Using 16 in-depth interviews drawn from a larger sample of Black/white biracial individuals, this article explores how gender shapes the microlevel process of racial identity construction. Skin color stratification within the Black community, combined with a low rate of marriageable men and high rates of interracial marriages among the most educated and affluent Black men, has created a social context that differentiates the interactional experiences of biracial men and women. The findings highlight the need for more complex theoretical conceptualizations of (...) how gender shapes the way that women negotiate their racial identities in post-Civil Rights America. (shrink)

It is often overlooked that, in addition to the integrity of protein‐coding sequences (PCSs), human health is crucially linked to the normal expression of genes by cis‐regulatory sequences (CRSs). These CRSs often lie at some considerable distance from the PCSs whose expression they control and often within other genes. The resulting gene interdigitation can make long‐range CRS identification and characterisation difficult. We propose that the need to conserve long‐range CRSs in cis with their target PCSs through evolution, in combination with (...) gene interdigitation and co‐regulation of many genes by individual CRSs, has contributed to the persistence of conserved synteny blocks between diverse species. We further hypothesise that examination of the varying extents of synteny blocks between multiple species in combination with phylogenetic footprinting to find CRSs might provide important clues to the existence of crucial functional CRS–PCS linkages. Identifying CRS–PCS linkages crucial to human health will lead to a better understanding of how their disruption by CRS mutation or chromosome translocation might contribute to many distressing human diseases. BioEssays 26:1217–1224, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

Occupying a space in-between conventional scholarship and imaginative storytelling, The University in Crumbs: A Register of Things Seen and Heard is an experimental work that dramatizes the everyday life of the academy.

Contexte : Dans les systèmes de santé universitaires complexes, les projets d’amélioration de la qualité (AQ) destinés à améliorer les soins et l’apprentissage prolifèrent, mais il existe des différences considérables quant à la manière dont ces projets sont supervisés sur le plan éthique, voire même s’ils le sont. À la suite d’un volume élevé de projets soumis à l’un de nos comités d’éthique de la recherche (CER), mais considérés comme n’étant pas de la recherche et donc non éligibles à un (...) examen, des questions ont commencé à se poser au sein de notre organisation sur la manière dont les dimensions éthiques des projets d’AQ pourraient être évaluées et sur les approbations institutionnelles qui pourraient être nécessaires pour garantir la conformité avec les normes émergentes. Méthodes : Une enquête environnementale à méthodes mixtes a conduit à une analyse quantitative rétrospective des projets d’AQ de notre organisation, associée à des consultations qualitatives approfondies avec le personnel, les médecins et les apprenants de l’ensemble de notre réseau de santé. Les exemptions de CER ont été analysées à l’aide de diagrammes d’exécution afin d’évaluer les volumes de base des projets d’AQ, et des analyses thématiques ont été menées sur les notes de terrain de 133 consultations avec les parties prenantes. Résultats : Au cours d’une période de 34 mois, 117 lettres d’exemption du CER ont été émises pour des projets d’AQ. Les consultations ont mis en évidence la nécessité d’un processus d’évaluation éthique clairement défini pour les projets d’AQ, de structures de gouvernance appropriées et de possibilités d’identifier et d’atténuer les risques. Les personnes interrogées ont également évoqué l’impératif éthique de mener des initiatives d’AQ. Le présent document explique comment ces thèmes ont contribué à l’élaboration et à la mise en place de notre comité d’examen de l’amélioration de la qualité (CEAQ). Conclusion : Depuis 2020, plus de 840 projets ont été examinés par notre CEAQ, dans le but d’atténuer les risques pour les patients, le personnel et les équipes de projet d’AQ dans l’ensemble de l’UHN. (shrink)

There couldn't be a more appropriate method for illustrating the dynamics of psychoanalysis than the vehicle of story. In this book, Kerry L. Malawista, Anne J. Adelman, and Catherine L. Anderson share amusing, poignant, and sometimes difficult stories from their personal and professional lives, inviting readers to explore the complex underpinnings of the psychoanalytic profession and its esoteric theories. Through their narratives, these practicing analysts show how to incorporate psychodynamic concepts and identify common truths at the root of shared (...) experience. Their approach demystifies dense material and the emotional consequences of deep clinical work. The book covers psychodynamic theory, the development of ideas, various techniques, the challenges of treatment, and the experiences of trauma and loss. Each section begins with a brief memoir by one of the authors and leads into a discussion of related concepts. Overall the text follows a developmental trajectory, opening with stories from early childhood and concluding with present encounters. The result is a unique approach enabling the absorption of psychodynamic concepts as they unfold across the life span. (shrink)

McGovern, Kevin; Brussen, Kerri Anne Some vaccines are produced using cell lines which were originally developed from tissue from an aborted foetus. Vaccines are ethically compromised by this connection to abortion. within the Catholic Church, the Pontifical Academy for Life has called for research and development of alternative vaccines which are ethically acceptable. Until alternative vaccines are developed, it has also accepted the use even of these ethically compromised vaccines in order to protect children, pregnant women and the population as (...) a whole from the risk of contracting serious disease. This article explores all these issues from an Australian perspective. (shrink)

Dispositional compatibilists argue that a proper understanding of our abilities vindicates both compatibilism and the principle of Alternate Possibilities (the claim that the ability to do otherwise is required for freedom and moral responsibility). In this paper, I argue that this is mistaken. Both analyses of dispositions and abilities should distinguish between local and global dispositions or abilities. Once this distinction is in place, we see that neither thesis is established by an analysis of abilities.

Considerations upon the nature of properties and laws have led some philosophers to claim that the correct epistemic attitude with regards to the intrinsic properties of particulars is scepticism. I examine one particularly clear version of this line of argument, and contend that a serious form of scepticism is not established. However, I argue that the theories of properties and laws underlying the argument have unwanted metaphysical implications. These provide a stronger reason to jettison the analyses. I end by sketching (...) an alternative view that avoids these difficulties. -/- . (shrink)

Theories of perception have traditionally dismissed the sense of smell as a notoriously variable and highly subjective sense, mainly because it does not easily fit into accounts of perception based on visual experience. So far, philosophical questions about the objects of olfactory perception have started by considering the nature of olfactory experience. However, there is no philosophically neutral or agreed conception of olfactory experience: it all depends on what one thinks odors are. We examine the existing philosophical methodology for addressing (...) our sense of smell: on the one hand appeals to phenomenology that focus on the experiential dimensions of odor perception and on the other approaches that look at odor sources and their material dimensions. We show that neither strategy provides enough information to account for the human sense of smell and argue that the inclusion of the missing dimension of biology, with its concern for the function (or functions) of olfaction, provides the means to develop a satisfactory and empirically informed philosophy of smell. (shrink)

Fair competition law and public health law talk past each other when discussing pharmaceutical pricing and distribution. The former cannot agree on the relevant definition of consumer welfare. The latter does not fully comprehend the highly complex but inherently collective nature of pharmaceutical drug acquisition in the United States. This essay proposes to inject public health discourse into this debate to enrich it, focus it, and render it more accessible to those who must live by its outcome.

Although moral distress is now a well-recognized phenomenon among all of the healthcare professions, few evidence-based strategies have been published to address it. In morally distressing situations, the “presenting problem” may be a particular patient situation, but most often signals a deeper unit- or system-centered issue. This article describes one institution’s ongoing effort to address moral distress in its providers. We discuss the development and evaluation of the Moral Distress Consultation Service, an interprofessional, unit/system-oriented approach to addressing and ameliorating moral (...) distress. (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.

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)