This presentation is designed to stimulate philosophers' interest in the Allied Health Professions, as areas of inquiry appropriate to philosophical reflection and particularly rewarding to those with a major focus on value and its experience. With their careful attention to the ways in which value is present in human experience, their second-order principles for designating priority relations among conflicting values, their ability to transfer the results of sustained inquiry into issues of responsibility and decision making from one context (...) to another, philosophers should find the study of the Allied Health Professions rewarding and fulfilling. But with the longstanding commitment to education and the new commitment to applied ethics and values represented by the emergence of institutes and centers devoted to value inquiry in the many professions, philosophers will find these fields increasingly receptive to measured overtures to integrate the humanistic concerns of philosophy into the Allied Health Science curriculum. Attention to the nature and theory of the activities of the Allied Health Professions may also serve to limit the hegemony of medicine in bioethics courses and texts, and thus better enable teachers of bioethics to assist pre-professional students in understanding their chosen professions as embodying the values about which axiology and ethics theorize. (shrink)

Social justice is consistently upheld as a central value within the nursing profession, yet there are persistent inconsistencies in how this construct is conceptualized, further compounded by a lack of empirical inquiry into how nurses enact social justice in everyday practice. In the current context in which structural inequities are perpetuated throughout the health care system, and the emergency department in particular, it is crucial to understand how nurses understand and enact social justice as a disciplinary commitment. This research (...) examines how nurses' talk and institutional texts discursively construct social justice within the institutional context of the emergency department, and how such discourses shape the enactment of social justice within nursing practice. Guided by Iris Marion Young's theorizing of distributive and systemic social justice paradigms, this Foucauldian discourse analysis draws on emergency department nurses' talk (N = 25 interviews) and institutional documents (N = 27) as key texts that visibilize dominant and excluded discourses of social justice within the institutional context of the emergency department, and implications for how social justice is enacted through nursing practices. This analysis identified one overarching discursive pattern, in which social justice was discursively constructed through a hegemonic distributive paradigm, yet also resisted through nurses' conceptualization and enactment of a systemic social justice paradigm that facilitated their recognition and remediation of inequities. This central discursive pattern is explored through three exemplars of nurses' enactment of social justice as resistance: triage, harm reduction, and care planning. Findings from this analysis demonstrate that while a hegemonic distributive paradigm has dominated conceptualizations of social justice within nursing, a re‐construction of social justice through a systemic paradigm may guide nurses in enacting practices that remediate inequities in health and health care. (shrink)

Inpatient mental health nursing operates with an overarching goal to support people living with mental health challenges by managing risk of harm to self and others, decreasing symptoms, and promoting capacity to live outside of hospital settings. Yet, dominant, harmful stereotypes persist, constructing patients as less than, in need of saving, and lacking self‐control and agency. These dominant assumptions are deeply entrenched in racist, patriarchal, and Othering beliefs and continue to perpetuate and (re)produce inequities, specifically for people with (...) multiple intersecting identities relating to race, class, gender, and culture. This paper explores the relevance of postcolonial feminism, particularly Gayatri Spivak's concept of Subaltern—conceptualized as groups of people who are denied access to power and therefore continue to be systematically oppressed and marginalized—in illuminating the problematic and dominant assumptions about people living with mental health challenges as lacking agency and requiring representation. Through an understanding of Subalternity, this paper aims to decenter and deconstruct dominant colonial, patriarchal narratives in mental health nursing, and ultimately calls for mental health nursing to fundamentally reconsider prevailing assumptions of patients as needing representation and lacking agency. (shrink)

Standardization has emerged as the dominant principle guiding the organization and provision of healthcare, with standards resultantly shaping how nurses conceptualize and deliver patient care. Standardization has been critiqued as homogenizing diverse patient experiences and diminishing nurses’ skills and critical thinking; however, there has been limited examination of the philosophical implications of standardization for nursing knowledge and practice. In this manuscript, I draw on Foucault's philosophy of order and categorization to inform an analysis of the consequences of healthcare standardization for (...) the profession of nursing. I utilize three exemplars to illustrate the impact of the primacy of standardized thinking and practices on nurses, patients and families: pain assessments using the 0‐10 pain scale; patient triage emergency departments through the Canadian Triage and Acuity Scale; and determination of cause of death within the context of the current opioid crisis. Through each exemplar, I demonstrate that standardization reductively constrains nursing knowledge and the health and healthcare experiences of patients and populations. I argue that the centrality of standardization must be re‐envisioned to embrace the complexity of health and more effectively and meaningfully frame nursing knowledge and practice within healthcare systems. (shrink)

Patient-centred communication is widely regarded as a best practice in contemporary medical care, both in terms of maximising health outcomes and respecting persons. However, not all patients communicate in ways that are easily understood by clinicians and other healthcare professionals. This is especially so for patients with non-speaking intellectual disabilities. We argue that assumptions about intellectual disability—including those in diagnostic criteria, providers’ implicit attitudes and master narratives of disability—negatively affect communicative approaches towards intellectually disabled patients.Non-speakingintellectually disabled patients may also (...) be taken to lack decision-making capacity and resultingly, may be given very little role in determining their care. But, given evidence of the heterogeneous communicative practices available to non-speaking patients, efforts should be made to extend patient-centred communication to them. We offer four suggestions for doing so: (1) treating those with non-speaking intellectual disabilities as potential communicators; (2) lengthening appointment times to develop relationships necessary for communication; (3) disentangling capacity from communication in concept and in practice; and (4) recognising the bidirectional connection between supported decision-making and patient-centred communication. (shrink)

Due to the prevalence, severity, and costs associated with autism spectrum disorders, it has become a public health issue. In response, state governments have adopted ASD-specific private insurance mandates requiring coverage of ASD screening, diagnosis, and treatment. Despite rapid uptake of these laws, differences exist in the type and levels of coverage, especially for allied health services including occupational therapy. We piloted a structured legal research methodology to code ASD insurance mandates that impact allied health (...) service provisions. State private insurance mandates were obtained from WestlawNext. A coding methodology was piloted on 14 states and included variables for age and service limits, treatments covered, and medical necessity. Coding methods were feasible and highly reliable among raters. Ten of 12 states had a coverage mandate, many with specific provisions for allied health providers. A full analysis of all 50 states is warranted to identify provisions affecting allied health providers serving individuals with ASD. (shrink)

Female Genital Mutilation (FGM) is a universal issue which affects girls in Africa, the Middle East, Asia and South America, and immigrant communities in Western Europe, North America, Australia and New Zealand. FGM is a cultural practice in approximately 29 countries in Africa, affecting over 140 million girls. FGM is practiced as a rite of passage, where girls are initiated into womanhood. This practice is promoted as a means for incorporation, thus ascribing personhood, and belonging for girls to their communities. (...) African scholars hold conflicting positions about FGM, with some arguing that it is essential for relational fullness and harmony. While others believe FGM is unjustified because of the health and social risks associated with the practice. We argue, applying sustainable social harmony and Gyekye's views on cultural revitalization, that FGM is morally unjustified and should be prohibited. We believe the claims that FGM fosters harmony, a value of Ubuntu, are fallacious, and this perceived harmony is pretentious and unsustainable. We claim that FGM is inauthentic, unjust and steeped in patriarchal underpinnings that are unsustainable, thus it is a disharmonious practice. Cultural practices that are disharmonious should be refined and pruned and must be dynamic and responsive to current realities. (shrink)

Social justice is widely advanced as a central nursing value, and yet conceptual understandings of social justice remain inconsistent and vague. Further, despite persistently articulated commitments to upholding social justice, the profession of nursing has been implicated in perpetuating inequities in health and health care. In this context, it is essential to establish both conceptual clarity and tangible guidance for nurses in enacting practices to advance social justice—particularly through regulatory, education and accreditation documents that shape the nursing profession. (...) This Foucauldian discourse analysis examines how social justice is discursively positioned within nursing professional documents in Canada, and illustrates that social justice was largely discursively excluded from these texts. Where social justice discourses were invoked, we identified that four central discursive patterns obscured and de‐centred this nursing value: (i) Vague language undermined professional commitments to social justice; (ii) Constructions of knowledge and awareness de‐emphasized practice; (iii) Individualism discourses minimized institutional/professional responsibility; and (iv) Aspirational language obscured present action. Extending from this analysis, we contend that the nursing profession must re‐examine how social justice is understood and articulated, and call for a re‐conceptualization of social justice grounded in nursing practice toward remediating inequities in health and health care. (shrink)

Ethics education is recognized as an integral component of health professionals’ education and has been occurring in various guises in the curricula of health professional training in many countries since at least the 1970s. However, there are a number of different aims and approaches adopted by individual educators, programs, and, importantly, different health professions that may be characterized according to strands or trends in ethics education.

Medicine and its allied health sciences have for too long been peripherally involved in work on human rights. Fifty years ago, the door to greater involvement was opened by Article 25 of the Universal Declaration of Human Rights, which underlined social and economic rights: “Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing, and medical care and necessary social services, and the right (...) to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”. (shrink)

The New Charter for Health Care Workers is a revision and updating of the earlier 1994 edition, also produced by the Pontifical Council for Health Care Workers. The work is divided into three major sections: "Procreating," "Living," and "Dying," each of which lays out authoritative teachings in medical ethics grounded in the traditional resources of the Church.

This unique textbook utilizes an integrated, case-based approach to explore how the domains of bioethics, public health and the social sciences impact individual patients and populations. It provides a structured framework suitable for both educators (including course directors and others engaged in curricular design) and for medical and health professions students to use in classroom settings across a range of clinical areas and allied health professions and for independent study. The textbook opens with an introduction, describing (...) the intersection of ethics and public health in clinical practice and the six key themes that inform the book's core learning objectives, followed by a guide to using the book. It then presents 22 case studies that address a broad spectrum of patient populations, clinical settings, and disease pathologies. Each pair of cases shares a core concept in bioethics or public health, from community perspectives and end-of-life care to medical mistakes and stigma and marginalization. They engage learners in rigorous clinical and ethical reasoning by prompting readers to make choices based on available information and then providing additional information to challenge assumptions, simulating clinical decision-making. In addition to providing a unique, detailed clinical scenario, each case is presented in a consistent format, which includes learning objectives, questions and responses for self-directed learning, questions and responses for group discussion, references, and suggested further reading. All cases integrate the six themes of patient- and family-centered care; evidence-based practice; structural competency; biases in decision-making; cultural humility and awareness of the culture of medicine; and justice, social responsibility and advocacy. The final section discusses some challenges to evaluating courses and learning encounters that adopt the cases and includes a model framework for learner assessment. (shrink)

Intra- and intergroup conflict are likely to have been recurrent features of human evolutionary history; however, little research has investigated the factors that affect men’s combat alliance decisions. The current study investigated whether features of previous one-on-one combat with an opponent affect men’s interest in allying with that opponent for future group combat. Fifty-eight undergraduate men recruited from a psychology department subject pool participated in a one-on-one laboratory fight simulation. We manipulated fight outcome, perceived fighter health asymmetry, and the (...) presence of a witness over six sets of five rounds of fighting. Following each set, we asked men how interested they would be in allying with their opponent for future group combat. We found that men were more interested in allying with their opponent for future group combat if their opponent won the fight or if a witness was present, but perceived fighter-health asymmetry did not affect men’s decision to ally with their opponent. Exploratory analyses revealed a two-way interaction between fight outcome and the presence of a witness, such that winners without a witness present expressed less interest in allying with their opponent for future group combat. Our findings suggest that men attend to the benefits of allying with a man who has demonstrated relatively superior fighting ability. Alliance with a previous opponent for group combat may vary with the relationship value of the opponent and the utility of demonstrating cooperativeness to third-party observers. These findings inform our understanding of coalition formation. (shrink)

Background Nurses experience moral distress when they cannot do what they believe is right or when they must do what they believe is wrong. Given the limited mechanisms for managing ethical issues for nurses in Japan, an Online Ethics Consultation on mental health (OEC) was established open to anyone seeking anonymous consultation on mental health practice. Research objective To report the establishment of the Online Ethics Consultation and describe and evaluate its effectiveness. Ethical considerations The research was conducted (...) in accordance with the Declaration of Helsinki. Research design This evaluation describes the outcomes of 5 years of operation of the Online Ethics Consultation on mental health in Japan Participants The Online Ethics Consultation received 12 emails requesting consultation. Consultees included mental health nurses, psychiatrists, and service users. Findings The most common questions directed to the service were about seclusion and physical restraint. Response time from receipt of email to sending a reply was between 1 and 14 days. Despite the disappointing number of consultations, feedback has been positive. Discussion The Online Ethics Consultation was established to assist morally sensitive nurses in resolving their ethical problems through provision of unbiased and encouraging advice. Mental health care in Japan has been less than ideal: long-term social hospitalization, seclusion, and restraint are common practices that often lead to moral distress in nurses and the questions received reflected this. The head of the Online Ethics Consultation sent a supportive, facilitative response summarizing the opinions of several consultants. Conclusion This study provides key information for the establishment of an online ethics resource the adoption of which has the potential to improve the experience of nurses, allied health and clients of mental health services. This paper has implications for services concerned with improving patient care, managing nurses’ moral distress, building ethics into decision-making. (shrink)

Moral distress has been identified as an occupational hazard for clinicians caring for vulnerable populations. The aim of this systematic review was (i) to summarize the literature reporting on prevalence of, and factors related to, moral distress among nurses within acute mental health settings, and (ii) to examine the efficacy of interventions designed to address moral distress among nurses within this clinical setting. A comprehensive literature search was conducted in October 2022 utilizing Nursing & Allied Health, Embase, (...) CINAHL, PsychInfo, and PubMed databases to identify eligible studies published in English from January 2000 to October 2022. Ten studies met inclusion criteria. Four quantitative studies assessed moral distress among nurses in acute mental health settings and examined relationships between moral distress and other psychological and work-related variables. Six qualitative studies explored the phenomenon of moral distress as experienced by nurses working in acute mental health settings. The quantitative studies assessed moral distress using the Moral Distress Scale for Psychiatric Nurses (MDS-P) or the Work-Related Moral Stress Questionnaire. These studies identified relationships between moral distress and emotional exhaustion, depersonalization, cynicism, poorer job satisfaction, less sense of coherence, poorer moral climate, and less experience of moral support. Qualitative studies revealed factors associated with moral distress, including lack of action, poor conduct by colleagues, time pressures, professional, policy and legal implications, aggression, and patient safety. No interventions targeting moral distress among nurses in acute mental health settings were identified. Overall, this review identified that moral distress is prevalent among nurses working in acute mental health settings and is associated with poorer outcomes for nurses, patients, and organizations. Research is urgently needed to develop and test evidence-based interventions to address moral distress among mental health nurses and to evaluate individual and system-level intervention effects on nurses, clinical care, and patient outcomes. (shrink)

Within the context of structural theories this paper examines what health professionals say about their clinical service structures. We firstly trace various conceptual perspectives on clinical service structures, discussing multiple theoretical axes. These theories question whether clinical service structures represent either superficial or more profound changes in hospitals. We secondly explore which view is supported though a content analysis of the free text responses of 111 health professionals (44 doctors, 45 nurses and 22 allied health practitioners) (...) about their clinical service structures in a questionnaire survey in two large hospitals that had implemented clinical service structures three years previously. Commentaries unfavourable toward clinical service structures were made by 47.7% of staff, favourable by 24.3%, mixed (both favourable and unfavourable) by 17.1% and non-evaluative statements were made by 10.8%. The most frequent criticisms were inefficient organisation of change (27%), poor management (24.3%), lack of cooperation between staff (15.9%) and failure to empower health practitioners (13.5%). All professions made more negative than positive evaluations of their clinical service structures but the ratio was highest for doctors and lowest for allied health. Ranking of nurses' and allied health staffs' specific evaluations were similar but both differed significantly from doctors.' Unfavourable or negative comments predominated, and change appears more superficial and less profound than advocates of structural contributions hope. Four types of belief systems about clinical service structures are apparent. Some study participants are disposed toward the status quo; others toward restructuring; yet others are team oriented; and a final group is tribally oriented. The implication of this paper for managers is that more work is needed if clinical service structures are to realise the promise of more multi-disciplinarity and less fragmentation across professional groups. For scholars, the implication is that marrying different theoretical frames with empirical data can serve to produce fresh perspectives and perhaps new insights. (shrink)

As web instruction becomes more and more prevalent at universities across the country, instructors of ethics are being encouraged to develop online courses to meet the needs of a diverse array of students. Web instruction is often viewed as a cost-saving technique, where large numbers of students can be reached by distance education in an effort to conserve classroom and instructor resources. In practice, however, the reverse is often true: online courses require more of faculty time and effort than do (...) many traditional classes. Based on personal experience teaching an online course in health care ethics for students in the Allied Health Professions, it is evident that there are both benefits and challenges in teaching online courses, particularly in ethics. Examples of benefits are (1) the asynchronous nature of web instruction allows students to progress through the course at their own pace and at times that are convenient given their clinical responsibilities; (2) web courses allow for a standardization of content and quality of instruction over a diversity of programs; and (3) examples can be tailored to the differing experiences of students in the course. Some challenges to teaching online ethics courses include (1) the fact that online instruction benefits visual learners and disadvantages those lacking good reading comprehension or strong writing skills; (2) developing meaningful student-student and student-instructor interaction; and (3) teaching ethics involves teaching a process rather than a product. Allowing students to apply their knowledge to real-world cases in their disciplines and encouraging them to share experiences from clinical practice is an effective way to meet several of these challenges. Building an online community is another good way to increase the interaction of students and their engagement with the material. (shrink)

This essay argues that pre-health humanities programs should focus on intensive research practice for baccalaureate students and provides three guiding principles for implementing it. Although the interdisciplinary nature of health humanities permits baccalaureate students to use research methods from the natural sciences, social sciences, and humanities, pre-health humanities coursework tends to force students to adopt only one of many disciplinary identities. Alternatively, an intensive research approach invites students to critically select and combine methods from multiple disciplines to (...) ask and answer questions about health problems more innovatively. Using the authors’ experiences with implementing health humanities baccalaureate research initiatives at The University of North Carolina at Chapel Hill, the authors contend that pre-health humanities programs should teach and study multiple disciplinary research methods and their values; examine how health humanities research might transfer across disciplines; and focus on mentoring opportunities for funding, presenting, and publishing research. These recommendations have the potential to create unprecedented research experiences for baccalaureate students as they prepare to enter careers within and beyond the allied health professions. (shrink)

Feminized care work occupations have traditionally paid lower wages compared to non–care work occupations when controlling for human capital. However, when men enter feminized occupations, they often experience a “glass escalator,” leading to higher wages and career mobility as compared to their female counterparts. In this study, we examine whether men experience a “wage penalty” for performing care work in today’s economy, or whether the glass escalator helps to mitigate the devaluation of care work occupations. Using data from the Survey (...) of Income and Program Participation for the years 1996-2011, we examine the career patterns of low- and middle-skill men in health care occupations. We found that men in occupations that provide the most hands-on direct care did experience lower earnings compared to men in other occupations after controlling for demographic characteristics. However, men in more technical allied health occupations did not have significantly lower earnings, suggesting that these occupations may be part of the glass escalator for men in the health care sector. Minority men were significantly more likely than white men to be in direct care occupations, but not in frontline allied health occupations. Male direct care workers were less likely to transition to unemployment compared to men in other occupations. (shrink)

As health care systems have been recast as innovation assets, commercial aims are increasingly prominent within states’ health and medical research policies. Despite this, the reformulation of notions of social and of scientific value and of long-standing relations between science and the state that is occurring in research policies remains comparatively unexamined. Addressing this lacuna, this article investigates the articulation of ‘actually existing neoliberalism' in research policy by examining a major Australian research policy and funding instrument, the Medical (...) Research Future Fund. We identify the MRFF and allied initiatives as a site of state activism: reallocating resources from primary and preventive health care to commercially-oriented biomedical research; privileging commercial objectives in research and casting health as a “flow on effect”; reorganising the publicly funded production of health and medical knowledge; and arrogating for political actors a newly prominent role in research grant assessment and funding allocation. We conclude that rather than the state’s assumption of a more activist role in medical research and innovation straightforwardly serving a ‘public good’, it is a driver of neoliberalisation that erodes commitments to redistributive justice in health care and significantly reconfigures science-state relations in research policy. (shrink)

Mental health care providers increasingly confront challenges posed by the introduction of new neurotechnology into the clinic, but little is known about the impact of such capabilities on practice patterns and relationships with patients. To address this important gap, we sought providers’ perspectives on the potential clinical translation of functional neuroimaging for prediction and diagnosis of mental illness. We conducted 32 semi-structured telephone interviews with mental health care providers representing psychiatry, psychology, family medicine, and allied mental (...) class='Hi'>health. Our results suggest that mental health providers have begun to re-conceptualize mental illness with a neuroscience gaze. They report an epistemic commitment to the value of a brain scan to provide a meaningful explanation of mental illness for their clients. If functional neuroimaging continues along its projected trajectory to translation, providers will ultimately have to negotiate its role in mental health. Their perspectives, therefore, enrich bioethical discourse surrounding neurotechnology and inform the translational pathway. (shrink)

This chapter contains sections titled: Trends in Ethics Teaching in the Health Professions Theoretical Questions Underlying Curriculum Content Ethical Knowledge or Ethical Behavior? The Hidden Curriculum Conclusion References.

The practice of the Western medicine often identifies the symptom with the disease itself, but a current of thought and medical practice considers it as the important message of an organic imbalance. In fact, in standard therapies symptoms are usually suppressed, thus interrupting a normal physiological process and risking severe reactions due to the organic imbalance. Dr. Hahnemann, the father of homeopathy, founded his diagnostic and therapeutic model on the interpretation of the symptoms and maintained that symptoms are an expression (...) of altered physiology. The same concept is to be found in Dr. Reckeweg's “reactivity” and homotoxicology; he believed that diseases are the expression of the struggle of the body against toxins. Reckeweg's contribution was particularly important in considering the inflammation process as a biologic process through which the body restores its health. Also PNEI proposes a model where the symptom is interpreted as information and as the res... (shrink)

There is more to modern health than new scientific discoveries, the development of new technologies, or emerging or re‐emerging diseases. World events and experiences, such as the AIDS epidemic and the humanitarian emergencies in Bosnia and Rwanda, have made this evident by creating new relationships among medicine, public health, ethics, and human rights. Each domain has seeped into the other, making allies of public health and human rights, pressing the need for an ethics of public health, (...) and revealing the rights‐related responsibilities of physicians and other health care workers. (shrink)

Is positive thinking really so healthy that, as Martin Seligman (2000) and Mihaly Csikszentmihalyi passionately thus argued, "we believe that a psychology of positive human functioning will arise, which achieves a scientific understanding and effective interventions to build thriving individuals, families, and communities"? This optimistic view on positive thinking for health can be contrasted with an opposing view by Barbara Ehrenreich (2009), who "extensively critiqued 'positive psychology'" and showed "how obsessive positive thinking impedes productive action, causes delusional assessments of (...) situations, and people are then blamed for not visualising hard enough and thus 'attracting' failure even in situations when 'masses of lives were lost'." (WK 2013; R Byrne 2006) Contrary to these opposing views (and other ones as will be discussed in the book), health care (in relation to mental health and physical health in the context of mind and body) are neither possible (or impossible) nor desirable (or undesirable) to the extent that the respective ideologues (on different sides) would like us to believe. Surely, this questioning of the opposing views on health care does not suggest that the study of health care is worthless, or that those fields (related to health care) like medicine, chiropractic, health system, dentistry, health info tech, nursing, psychiatrics, clinical psychology, occupational therapy, pharmacy, allied health, and so on are unimportant. Needless to say, neither of these extreme views is reasonable. Instead, this book offers an alternative (better) way to understand the future of health care, especially in the dialectic relationships between mental health and physical health in the context of mind and body -- while learning from different approaches in the literature but without favouring any one of them (nor integrating them, since they are not necessarily compatible with each other). More specifically, this book offers a new theory (that is, the interconnected theory of health care) to go beyond the existing approaches in a novel way and is organised in four chapters. (shrink)

Bayes’ rule shows how one might rationally change one’s beliefs in the light of evidence. It is the foundation of a statistical method called Bayesianism. In health care research, Bayesianism has its advocates but the dominant statistical method is frequentism. There are at least two important philosophical differences between these methods. First, Bayesianism takes a subjectivist view of probability (i.e. that probability scores are statements of subjective belief, not objective fact) whilst frequentism takes an objectivist view. Second, Bayesianism is (...) explicitly inductive (i.e. it shows how we may induce views about the world based on partial data from it) whereas frequentism is at least compatible with non-inductive views of scientific method, particularly the critical realism of Popper. Popper and others detail significant problems with induction. Frequentism’s apparent ability to avoid these, plus its ability to give a seemingly more scientific and objective take on probability, lies behind its philosophical appeal to health care researchers. However, there are also significant problems with frequentism, particularly its inability to assign probability scores to single events. Popper thus proposed an alternative objectivist view of probability, called propensity theory, which he allies to a theory of corroboration; but this too has significant problems, in particular, it may not successfully avoid induction. If this is so then Bayesianism might be philosophically the strongest of the statistical approaches. The article sets out a number of its philosophical and methodological attractions. Finally, it outlines a way in which critical realism and Bayesianism might work together. (shrink)

The predominant use of junk food in our societies is continuously held responsible for the obese body physiques and overweight among the kids and adolescents. The current supportive environments where organic foods are limited, and new processed foods have been brought to the market with more variant tastes and acceptability for the kids and adolescents that have diverged their eating patterns. It has significantly contributed to the health issues and growth discrepancies of the users. However, the awareness of the (...) food contents is an important milestone for understanding the risks associated with the usage of junk foods. A quantitative approach has been used in this study to measure the effect of perceived severity, vulnerability and fear on the junk food eating behaviors and ultimately on the obesity. The moderating role of product knowledge hiding has also been measured on the relationship of junk food eating and obesity. Structural equation modeling is used using the software Smart-PLS for measuring the hypothesis with a sample size of 228 selected through purposive sampling. The sample consisted of kids and adolescents who were reached on purpose for data collection. The current study has explored the role of perceived severity, vulnerability and the fear of using junk foods which have been found as a negative effect on junk food eating behavior which is positively associated with obesity among the kids and adolescents. The result of study shows that perceived threat has a negative effect on the junk food eating behavior of the adolescents. However, the positive relationship of junk food eating behavior with obesity can be decreased if the information about the products is not hidden. This study will be useful for making the consumers aware of the product knowledge hiding of the junk food usage. Moreover, it will help the users in creating understanding of risks allied with the use of junk food which may be addressed in order to avoid obesity issues in the kids and adolescents globally. (shrink)

In modern mental health care, ‘recovery’ does not necessarily mean the same thing for clinicians, service users, and survivor groups. This divergence is especially stark where self-injury is concerned. For clinicians, recovery often refers to cessation of self-injury; for those with lived experience, self-harm may be a temporary or long-term method of navigating trauma and distress. This article explores how the survivor-led model, which regards self-injury as an understandable reaction to distress, poverty, abuse, and discrimination emerged from second-wave feminism, (...) the survivor movement, and the growth of grassroots mental health groups in the 1980s. We focus on Bristol Crisis Service for Women (BCSW), a peer-led listening service for women who self-injure, founded in 1986. We begin with the history of BCSW and how experiences of their founders and users caused them to advocate for a different model of self-injury. We then situate BCSW’s approach to self-harm and recovery within the frame of women’s mental health activism. Finally, we explore how BCSW and its allies criticised existing psychiatric paradigms of self-harm, showing how the individualised medical model was rooted in gendered stereotypes that failed to recognise the real-world concerns of many women. We argue that it remains important to see self-harm not as an individual health concern, but in relation to the structural and practical issues affecting users and survivors. Within BCSW, a peer-led service, experience of self-injury became not a deficit but a useful asset in supporting other women, indicating that recovery itself could be both collective and non-linear. (shrink)

This is the third volume of a three-volume set on The Innate Mind. The extent to which cognitive structures, processes, and contents are innate is one of the central questions concerning the nature of the mind, with important implications for debates throughout the human sciences. By bringing together the top nativist scholars in philosophy, psychology, and allied disciplines these volumes provide a comprehensive assessment of nativist thought and a definitive reference point for future nativist inquiry. The Innate Mind: Volume (...) 3: Foundations and the Future, concerns a variety of foundational issues, as well as questions about the direction of future nativist research. It addresses such questions as: What is innateness? Is it a confused notion? What is at stake in debates between nativists and empiricists? What is the relationship between genes and innateness? How do innate structures and learned information interact to produce adult forms of cognition, e.g. about number, and how does such learning take place? What innate abilities underlie the creative aspect of language use, and of creative cognition generally? What are the innate foundations of human motivation, and of human moral cognition? In the course of their discussions, many of the contributors pose the question : Where next for nativist research? Together, these three volumes provide the most intensive and richly cross-disciplinary investigation of nativism ever undertaken. They point the way toward a synthesis of nativist work that promises to provide a powerful picture of our minds and their place in the natural order. (shrink)

This article argues that universities have duties to negotiate contracts with the pharmaceutical industry that are favourable to the world’s poor, and to do more research into diseases which disproportionately strike the global poor. It is argued that these duties are related to human rights (in particular to a human right to health) and that they are therefore very weighty. Furthermore, these duties are in line with some of the most important things that Universities Allied for Essential Medicines (...) (UAEM), a worldwide group of students and academics, wants universities to do. A number of objections are discussed, among other things to do with safeguarding pharmaceutical innovation, and it is argued that the aforementioned duties should, as UAEM also advocates, often be combined with efforts on the part of universities to work towards more long-term, large-scale institutional arrangements to ensure access to and availability of essential medicines for the global poor. -/- . (shrink)

Bengt Brülde in his article ``The Goals of Medicine. Towards a Unified Theory'' has proposed a normative theory of the goals of medicine within which the concept of quality of life plays a crucial role. In Brülde's analysis, however, the very concept of medicine is deliberately left quite vague and it is therefore difficult to see how the goals of medicine are related to the goals of closely allied enterprises such as health promotion and social welfare. In this (...) reply I therefore propose an analysis of these related conceptual areas. I do this mainly in two respects. Following the nomenclature in a previously published article I propose a systematic conceptual framework for all varieties of health enhancement and distinguish different notions of medicine within this framework. A consequence of this analysis is, for instance, that the means and also the immediate goals of medicine in its broadest sense are more diversified than the means and immediate goals of medicine in its narrowest sense. From this position I expand the topic further by comparing medicine and health enhancement with social welfare and try to trace the basic features between – as well as the common properties of – these different enterprises. (shrink)

Indigenous nurse scholars across nations colonised by Europeans articulate the need for accomplices (as opposed to mere performative allies) to work alongside them and support their ongoing struggle for health equity and respect and to prioritise and promote culturally safe healthcare. Although cultural safety is now being mandated in nursing codes of practice as a strategy to address racism in healthcare, it is important that white nurse educators have a comprehensive understanding about cultural safety and the pedagogical skills needed (...) to teach it to undergraduate nurses. We open this article with stories of our journeys as two white nurses in becoming accomplices and working alongside Indigenous Peoples, as patients and colleagues. Our lived experience of the inertia of healthcare and education organisations to address systemic and institutional resistance to the practice of cultural safety underpins the intention of this article. We understand that delivering this challenging and complex topic effectively and respectfully is best achieved when Indigenous and white educators work together at the cultural interface. Doing so requires commitment from white nurses and power holders within universities and healthcare institutions. A decolonising approach to nurse education at individual and institutional levels is fundamental to support and grow the work that needs to be done to reduce health inequity and increase cultural safety. White nurse accomplices can play an important role in teaching future nurses the importance of critical reflection and aiming to reduce power imbalances and racism within healthcare environments. Reducing power imbalances in healthcare environments and decolonising nursing practice is the strength of a cultural safety framework. (shrink)

During World War II, the Allies created the United Nations and its associated international institutions to stabilize the post-war world. The Allies envisioned a coordinated world in which human rights for all were respected, economic and social progress for all promoted, and global warfare prevented. This was a phenomenally fantastic vision that seemed unattainable in the wake of the most devastating global war in history.Today, the world is witnessing some of the fruits of these mid-20th century events and aspirations, especially (...) since the collapse of Communism in 1989. Economic integration and free trade has become much more prevalent as exemplified by astounding developments such as the European Union. And there is a greater appreciation of human rights, including the international human right to health. This article examines the evolution of trade policy and the impact of free trade policies on the health care sectors of the three countries of North America and the realization of the human right to health in North America. (shrink)

Indian Philosophy is a term that refers to schools of philosophical thought that originated in the Indian subcontinent. Over the ages there has been continuity in enlarge this filed of philosophical enquiry, which as lead to a wide range of scriptures and systems of philosophy. The Yoga School, which was founded by Patanjali, was closely allied with Samkhya, and accepts its epistemology and metaphysics it was introduced by Patañjali in the 2nd century BC. The Practice of Yoga as a (...) discipline had been done since ancient times. However, since its alliance with the Samkhya, it tried to develop a specific philosophy of its own, which would be in harmony with the Samkhya Philosophy. Though the popular understanding of Yoga equates it with just the asanas, there are eight steps prescribed for its practice, which emphasize internal and external cleansing, self - discipline physical fitness, and meditation, which result in alertness and mental strength. Yoga as a term used for a system of abstract meditation or mental abstraction. Someone who practices yoga or follows the yoga philosophy with a high level of commitment is called a yogi or yogini. Virtually everyone can see physical benefits from yoga, and its practice can also give psychological benefits, such as stress reduction and a sense of well- being, and spiritual benefits, such as a feeling of connectedness with God or Spirit, or a feeling of transcendence. Mental stress is an important part of our life. It is the biggest challenge to live a life without stress and to continue with the peace of mind. In this paper it is an attempt to made the discuss yoga philosophy in present day intellectual world as well its application to maintain human well-being. (shrink)

There is a curious asymmetry in cases where the use of religious language involves a breakdown in communication and leads to a seemingly intractable dispute. Why does the use of religious language in such cases almost always arise on the side of patients and their families, rather than on the side of clinicians or others who work in healthcare settings? I suggest that the intractable disputes arise when patients and their families use religious language to frame their problem and the (...) possibilities of solution. Unlike clinicians, they are not bilingual and thus lack the capacity to understand and negotiate differences in terms that are responsive to those who work in healthcare settings. After considering a representative case, I explore whether an ethics consultant or chaplain can function as a translator and suggest that, at best, such efforts at mediation depend on contingent aspects of a case and will only be partially successful. To appreciate limits on the role for bilingual translators, I consider a futility dispute where a parent using religious language demands that everything be done for a permanently unconscious child. I challenge the traditional interpretation that says the parent values “mere duration of biological life irrespective of quality.” From a religious perspective, human life is never “merely biological.” This effort to slot the dispute into standard philosophical schemas misses what is crucial in the dispute. I suggest that a better interpretation views the dispute at a meta-level as one about whether withholding and withdrawing care is morally distinguishable from killing. Curiously, this interpretation makes the advocate of futile care into an ally of those “quality of life” advocates who also challenge this distinction. The crux of their dispute now rests on the normative ethics of killing. While I think my interpretation comes much closer to the views of many who demand ‘futile care,’ I suggest that it still falls short because of the way it reconstructs the religious concerns in nonreligious terms. I close by considering an analogy between the language of suffering and the language of faith, suggesting that both require a much richer understanding of the narratives that orient the lives of patients and their families. (shrink)

The article addresses issues at the nexus of physician industrial action, moral agency, and responsibility. There are situations in which we find ourselves best placed to offer aid to those who may be in vulnerable positions, a behavior that is consistent with our everyday moral intuitions. In both our interpersonal relationships and social life, we make frequent judgments about whether to praise or blame someone for their actions when we determine that they should have acted to help a vulnerable person. (...) While the average person is unlikely to confront these kinds of situations often, those in the medical professions, physicians especially, may confront these and similar situations regularly. Therefore, when physicians withhold their services for whatever reason in support of industrial action, it raises issues of moral responsibility to patients who may be in a vulnerable position. Using theories of moral responsibility, vulnerability, and ethics, this paper explores the moral implications of physician industrial action. We explore issues of vulnerability of patients, as well as the moral responsibility and moral agency of doctors to patients. Determining when a person is vulnerable, and when an individual becomes a moral agent, worthy of praise or blame for an act or non-action, is at the core of the framework. Notwithstanding the right of physicians to act in their self-interest, we argue that vulnerability leads to moral obligations, that physicians are moral agents, and the imperatives of their obligations to patients clear, even if limited by certain conditions. We suggest that both doctors and governments have a collective responsibility to prevent harm to patients and present the theoretical and practical implications of the paper. (shrink)

This article analyzes the contribution Christian ethics might be able to make to the ethical debate on policy and caregiving in health and social care in the United Kingdom. The article deals particularly with the concepts of solidarity and subsidiarity which are essential in Christian social ethics and health care ethics, and which may be relevant for the ethical debate on health and social caregiving in the United Kingdom. An important argument in the article is that utilitarian (...) and market-driven policies in the National Health Service (NHS) and the social care system have marginalized the position of the elderly and have seriously impoverished the quality of care for the elderly. The neglect of the elderly and other vulnerable groups is also the result of widespread consumerist attitudes among patients and of libertarian models of noninterference which are affirmed by a public ethos of self-sufficiency and counter-dependency. Those who need care dare not make their need known to others and ask for help, while simultaneously those who could help are so intimidated by the public affirmation of privacy and negative rights that they do not dare to offer help except if this is explicitly demanded. This distant and standoffish attitude is in an important way responsible for the fact that the voice of those in need is altogether lost to the public forum. Christian ethics puts much emphasis on responsibility and solidarity with the needy other but is not able to have much impact on the delivery of care in a secularized society and health care system like the NHS. Nonetheless, Christianity still has a powerful and respected voice, by speaking up for those who cannot speak for themselves, such as the elderly and the handicapped. Christians can find allies in the ethics of care and other relational approaches in health care ethics in order to combat libertarianism, consumerism, and utilitarianism. (shrink)