The study discusses a new approach to parental agency in pediatric palliative care based on an active form of caregiving. It also explores the possibility of a positive conceptualization of parental agency in its relational context. The paper begins with an illustrative case study based on a clinical situation. This is followed by an analysis of various aspects of parental agency based on empirical studies that disclose the insufficiencies of the traditional approach to (...) class='Hi'>parental agency. In the next step, parental agency is analyzed from a reality‐based perspective as an activity focused on relationships and the cognitive capacity of parents vis‐a‐vis their seriously ill children. The paper also considers the importance of the cultural and social contexts in which parental agency and decision‐making take place. This agency is addressed not as individualistic in form, and nor is it exercised in terms of fixed choices. Rather, the focus is on its dynamic and future‐oriented aspects. Consequently, parental agency should be comprehended not only as a form of proxy agency representing the child's best interests but also as a complex decision‐making process in which the parents learn from their child how to become good, compassionate caregivers and at the same time good parents. (shrink)

Worldwide, many impoverished parents migrate, leaving their children behind. As a result children are deprived of continuity in care and, sometimes, suffer from other forms of emotional and developmental harms. I explain why coercive responses to care drain are illegitimate and likely to be inefficient. Poor parents have a moral right to migrate without their children and restricting their migration would violate the human right to freedom of movement and create a new form of gender injustice. I propose and defend (...) an institutional solution. Taxes levied on the remittances sent by temporary migrants ought to be used to provide migrants' children with psychological counselling in order to mitigate the harm resulted from discontinuity in care. (shrink)

The worldwide COVID-19 pandemic has shed more light on the difficulty of making health care decisions integrating scientific knowledge and values associated to life and death issues, human suffering, quality of life, economic losses, liberty of movement, etc. But the difficulties related to health care decisions and the use of innovative drugs or technologies are not new, and many countries have created agencies that have the mandate to evaluate new technologies in health care. Health Technological Assessment (HTA) reports’ aim is (...) to guide the decision makers in these difficult matters. There are two ethical components in HTA. The first is the report’s presentation of an ethical evaluation of the technology. The second is the value-ladenness of the HTA decision-making process itself. When implicit value judgments are not elicited, the justification of the final decision cannot be transparent. The present paper aims to identify and elicit the implicit value-judgments related to each step of the HTA process. This research is grounded on an applied ethics decision-making paradigm based on the role of value judgments in the decision-making process. The first part discusses two different approaches to values and value judgments in HTA. In the second part, citations mentioning value judgments extracted from a systematic review on the integration of ethics into HTA were categorized to elicit the value judgments and their criteria for each different HTA decision-making steps. The results show that there are 18 decision-making steps in the HTA process where 23 implicit value-judgments can be recognized. The range of these value judgments encompasses the whole HTA process: from the initial request, the presenting of the principal issues, to the final report’s dissemination. Since stakeholders need to understand which value judgments the conclusion of a report relies on, eliciting the implicit value judgments in the HTA decision-making process should yield more transparency. (shrink)

Nous voulons mieux comprendre les lois circonscrivant le rôle social de l’Évaluation des technologies en santé (ETS) et les raisons empêchant l’inclusion de l’éthique en ETS. Nous avons ciblé un débat qui est au coeur du rôle perçu du droit réglementaire dans le développement de technologies en santé : l’opposition entre les enjeux environnementaux, sécuritaires et sanitaires (EHSI) et les enjeux éthiques, légaux et sociaux (ELSI), issus de la gouvernance technologique. La collecte de données est basée sur une revue de (...) la littérature issue de travaux antérieurs, et sur une analyse de cas où trois agences d’ETS ont été sélectionnées en utilisant différentes catégories d’obligation légale selon leur degré de force contraignante. La revue de littérature a révélé cinq thèmes relatifs au rôle social de l’ETS et une distinction entre le rôle/utilisation du droit dur et du droit souple dans le droit réglementaire, permettant ainsi de comprendre comment les agences ont utilisé le droit pour intégrer (ou non) l’éthique en ETS. Les deux approches ont démontré que le débat, EHSI/ELSI observé initialement dans la gouvernance et l’évaluation de technologies est reproduit en ETS. La principale tendance confirmée par ces analyses est la présence d’un pacte entre la science et le droit réglementaire. La demande sociale d’intégrer les ELSI, particulièrement l’évaluation éthique en ETS, n’est pas prise en compte par le droit réglementaire traditionnel régissant l’ETS et doit plutôt être considérée par le droit souple. Les difficultés d’intégration de l’éthique en ETS démontrent la nécessité de repenser la gouvernance juridique de l’ETS. (shrink)

Discusses concepts of agency and free will from the perspective of clinical practice and feminism. Following a definition of agency that locates it in a relational context , the problematized nature of subjective experience is explored from both a feminist and a psychoanalytic perspective. These considerations set the stage for examining the contradictions and dilemmas of clinical practice devoted to individual change and improving lives as well as political values and ideology devoted to social change, suggesting the history (...) of incest in Western culture and practice as an example. The need to act/practice despite uncertainty is acknowledged, relating the position of the practitioner to the responsibilities of being a parent. 2012 APA, all rights reserved). (shrink)

Philosophical defenses of parents’ rights typically appeal to the interests of parents, the interests of children, or some combination of these. Here I propose that at least in the case of biological, non-adoptive parents, these rights have a different normative basis: namely, these rights should be accorded to biological parents because of the compensatory duties such parents owe their children by virtue of having brought them into existence. Inspried by Seana Shiffrin, I argue that procreation inevitably encumbers the wills of (...) children in otherwise morally objectionable ways. Such subjection generates duties to compensate children, even if the child’s life is on balance a benefit to her. The right to procreate is thus conditioned on prospective parent’s willingness to compensate for the harms of procreation. And because parents bear such compensatory duties, they must be accorded permissions (i.e., rights) to fulfill these duties. These rights include familiar exclusionary rights to promote children’s welfare, etc. Moreover, because subjecting children to harms or the risks thereof violates their autonomy, parental duties (and rights) include the provision of education and other goods that enable their subsequent autonomy as adults. Grounding parental rights in compensatory procreative duties avoids problems associated with appeals to the interests of children (e.g., that these interests do not seem to generate exclusive parental rights) or to the interests of parents (e.g., that these interests do not appear strong enough to permit the creation of a new, vulnerable human individual). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Parenting Adults with ASD: Lessons for Researchers and CliniciansCassandra R. Newsom, Amy S. Weitlauf, Cora M. Taylor, and Zachary E. WarrenRecent reviews of treatments for individuals with autism spectrum disorders (ASD) reveal how little we still know about how to help adolescents with ASD and their families successfully transition into adulthood (Shattuck et al., 2012b; Taylor et al., 2012a). Shattuck and colleagues found that services in the United States (...) for adults with ASD were marked by high unemployment rates, a reliance on families to provide care across the lifespan, high turnover rates in front-line service providers, insufficient transition planning for high school students, and generally insufficient services to meet current needs. In a recent Agency for Healthcare Research and Quality (AHRQ) Comparative Effectiveness Review, the authors similarly found that there is very little evidence available to pinpoint specific intervention approaches for adolescents and young adults with ASD due to a lack of good quality studies. This was especially true for evidence-based approaches to support the transition of youth with ASD to adulthood (Taylor et al., 2012a).For the last decade, with dramatic increases in both ASD awareness and estimates of ASD prevalence, our field has understandably focused intensely on improving early detection and treatment of ASD. Our diagnostic tools and understanding of ASD presentation in very young children has improved tremendously. Different from many of the young adults in these stories, who were often diagnosed in their early teens, we now aim to identify children well before their third birthdays. Research has consistently shown that early and intense ASD-specific intervention can dramatically enhance outcomes for children with ASD. As such, there has been heavy investment in attempting to take full advantage of this early window of neuro-plasticity. However, as these stories illustrate, these children grow up. Their needs change, and our systems are often poorly equipped to help them live fulfilling lives, capitalize on their talents, and obtain independence and equal access, while still providing a safe, supportive environment. Without readily accessible and understandable coordinated systems of care, parents are forced to adopt the multiple roles of case manager, teacher, therapist, community educator, advocate, job coach, housing specialist, financial planner, and often, lifelong caregiver. These stories eloquently illustrate those struggles and successes.Grief and Joy: Opposite Sides of the Same Parenting CoinThe idea of grieving a diagnosis is controversial. Many of the writers seemed to feel conflicted about their grief responses and the validity of their feelings. Research shows that many families view the diagnostic process as extremely stressful (Siklos & [End Page 199] Kerns, 2005; Heiman, 2002). Feelings of sadness, anxiety, and depression are common at the point of diagnosis and may reemerge as milestones pass unmet. Families must modify the futures they imagined for their children and begin to envision new goals and dreams. Anonymous Three described this process when she wrote:Most children grow up, go to school, get jobs, move out of their parents’ home, etc. My husband and I have had to seriously consider how much of these are even possible for a young man with autism, even one who has a good number of functional life skills.Tasks of adolescence and adulthood such as starting high school, driving a car, and moving out of the house may be delayed and hard won if met. Raising a child with ASD appears to have particular challenges. Throughout this process, families begin to redefine what “success” means. Rather than ascribing to societal standards, they find joy in personal milestones. McDonald described the triumph of teaching his nephew to shake women’s hands instead of touching their hair, an important safety goal that took three months to accomplish. Each family thereby creates its own path.People outside of the family often do not understand the complicated interplay of love and obligation as well as the frustration and fulfillment that families experience. Just like any family, the parents of children with ASD describe many joys in addition to their struggles. They see their children’s strengths in a world that too often focuses on their weaknesses. Gifted with the everyday experience of their child’s development, they see past the necessity of a... (shrink)

This article claims that postmodernity necessarily, and perhaps opportunely, undermines the bases upon which political democracy traditionally has rested; and that therefore some significant work must be done in order to redefine, restore, or otherwise reconfigure democratic values and institutions for a changed cultural condition. This situation presents the opportunity to explore the new options, positive openings, and discursive opportunities that postmodernity presents for political practice; for this the problem of agency provides a focal issue.The practices of postmodernity, taken (...) together, represent substantial challenges, not just to this or that cherished habit, but to modernity itself and all its corollaries, including its inventions of objectivity, of "the individual" , and of all the related values which still underwrite so much of what we do as citizens, consumers, and professionals not to mention as more private persons, parents, and partners. Fortunately, postmodernity does not demolish all our most cherished beliefs, values, and practices; but it does require recognition of how those beliefs, values, and practices actually function and of what alternatives they suppress. (shrink)

The publication of Frank Furedi's Paranoid Parenting in 2001 was trend-setting in the sense that it addresses parents directly in a way that is intended to be both critical and supportive, by helping parents to look through a sociological lens at their alleged predicament. Furedi's hope is that this will lead to the restoration of parental self-confidence, which he claims to be sorely lacking in contemporary (Western?) society. I argue that such a project would be more likely to succeed (...) if one were to hold a less dim view of the way both parents and other individuals are connected with their own society. By introducing a cultural-hermeneutical perspective on human agency, based on a specific reading of Heidegger and Taylor, I suggest a more constructive way to reconnect parents with the ongoing conversations in their communities and to conceptualise parenting support. (shrink)

This study provides a moral justification of the family as a child-bearing and child-rearing institution by arguing that procreation may entitle parents to their children. It begins by observing that the belief that parents have such a right is deeply ingrained in the laws and customs of Western civilization but that at present we have no satisfactory theoretical explanation of this belief; and it further underscores the need for such an explanation by pointing to the conflict between a commitment to (...) equal opportunity and the family. ;Part I first considers the historical arguments philosophers have made on behalf of the family and shows why they fail. It argues that the traditional property argument fails because it interprets parental rights in terms of an absolute property right which is incompatible with the child's rights; that natural affection fails because some parents abuse their children and because adoptive parents may display "natural affection"; and that the best interest of the child fails because it cannot provide parents with a unique claim to their children. ;It then develops the property argument in a new and fruitful way. By replacing the traditional concept of an absolute property right with the modern "bundle of rights" analysis of property, it provides a means of analyzing parental rights in a way that prohibits abuse and is therefore compatible with the child's basic rights. Finally, it examines entitlement theory and argues that, since procreation satisfies its conditions, parents who adequately care for their children are entitled to them. ;Part II examines the nature of the parental entitlement claim. It argues for the rights necessary for paternalistic agency, interprets them according to a standard analysis of ownership, and concludes that a parental right to rear the child according to parental values is consistent with the child's rights. Next it argues that, in excluding others, parents incur a special obligation to do as much as they reasonably can for their child. And finally, it places things in a historical context, argues against an interpretation of parental obligation in terms of needs, and shows how the theory might work in practice. (shrink)

While parents have long received guidance on how to raise children, a relatively new element of this involves explicit references to infant brain development, drawing on brain scans and neuroscientific knowledge. Sometimes called ‘brain-based parenting’, this has been criticised from within sociological and policy circles alike. However, the engagement of parents themselves with neuroscientific concepts is far less researched. Drawing on 22 interviews with parents/carers of children (mostly aged 0–7) living in Scotland, this article examines how they account for their (...) (non-)use of concepts and understandings relating to neuroscience. Three normative tropes were salient: information about children’s processing speed, evidence about deprived Romanian orphans in the 1990s, and ideas relating to whether or not children should ‘self-settle’ when falling asleep. We interrogate how parents reflexively weigh and judge such understandings and ideas. In some cases, neuroscientific knowledge was enrolled by parents in ways that supported biologically reductionist models of childhood agency. This reductionism commonly had generative effects, enjoining new care practices and producing particular parent and infant subjectivities. Notably, parents do not uncritically adopt or accept (sometimes reductionist) neurobiological and/or psychological knowledge; rather, they reflect on whether and when it is applicable to and relevant for raising their children. Thus, our respondents draw on everyday epistemologies of parenting to negotiate brain-based understandings of infant development and behaviour, and invest meaning in these in ways that cannot be fully anticipated (or appreciated) within straightforward celebrations or critiques of the content of parenting programmes drawing on neuropsychological ideas. (shrink)

Poor pregnancy outcomes and inequalities in these outcomes remain a major challenge, even in prosperous societies that have high-quality health care and public health policy in place. In this article, we propose that justice demands the improvement of what we call the ‘health agency’ of parents-to-be as part of a response to these poor outcomes. We take health agency to have three aspects: the capacity to form health-goals one has reason to value, the control one perceives to have (...) over achieving those health-goals and the freedom one has to achieve those health-goals. We will moreover argue that this demand of justice can be best based on a perfectionist rather than neutralist method of justification. Subsequently, we will argue that perfectionist policy may be paternalistic but not wrongfully paternalistic. This leads us to conclude that perfectionism should be adopted to inform and justify public health policy that is aimed at improving health agency in general and counteracting poor pregnancy outcomes and inequalities in perinatal health outcomes in particular. (shrink)

Is it wrong to bring new children into existence when there are so many existing children in need of parental care? Several philosophers have defended the view that prospective parents have a pro tanto​ duty to adopt rather than procreate as a means of fulfilling their interest in parenting. The most prominent argument for this view in the existing literature is the rescue-based argument, which derives an individual duty to adopt rather than procreate from a more general duty to (...) rescue or assist those in need. In this paper, I critically examine the rescue-based argument and explain why it fails. First, I argue that we do not necessarily have a duty to rescue in cases that resemble the global orphan crisis, where one’s intervention is merely sufficient to prevent serious harm to a potential victim. Second, I argue that even if we had such a duty, it would not necessarily generate a duty to adopt rather than procreate given the significant financial, emotional, and agency-related costs of adoption, particularly in current, non-ideal conditions. The upshot of these arguments is that the rescue-based argument can only generate a duty to adopt rather than procreate with respect to a relatively small constituency of orphaned children, many of whom are likely to be adopted anyway by willing volunteers. In the vast majority of cases, then, the rescue-based argument does not entail that it is wrong to create new children when there are already existing children in need of parental care. (shrink)

Epistemic impairment has been the decisive yardstick when excluding infants from political agency. One of the suggestions to bypass the epistemic requirement of political agency and to encourage the inclusion of infants in representative democracies is to resort to proxies or surrogates who share or advocate interests which may be coincidental with their interests. However, this solution is far from desirable, given that it privileges the political agency of parents, guardians and trustees over other adult citizens. This (...) article offers an alternative to this conceptual frame of reference by making a case for the political agency of infants. Firstly, it maintains that political agency can be understood in terms of the several facets involved in political representation. Secondly, it claims that the all-affected principle can be reformulated as an ‘infant-affected-interests principle’ in light of which infants are members of the class of the represented. Thirdly, it explores the ways through which this political agency can occur without having to resort to alternative conceptions of representation. The conclusion ascertains that infant enfranchisement is highly undesirable and that there are more viable forms to promote infant political agency, such as virtual representation, infant-beneficial principles of political action and ombudspersons for infants. (shrink)

European Journal of Political Theory, Volume 21, Issue 2, Page 368-389, April 2022. Epistemic impairment has been the decisive yardstick when excluding infants from political agency. One of the suggestions to bypass the epistemic requirement of political agency and to encourage the inclusion of infants in representative democracies is to resort to proxies or surrogates who share or advocate interests which may be coincidental with their interests. However, this solution is far from desirable, given that it privileges the (...) political agency of parents, guardians and trustees over other adult citizens. This article offers an alternative to this conceptual frame of reference by making a case for the political agency of infants. Firstly, it maintains that political agency can be understood in terms of the several facets involved in political representation. Secondly, it claims that the all-affected principle can be reformulated as an ‘infant-affected-interests principle’ in light of which infants are members of the class of the represented. Thirdly, it explores the ways through which this political agency can occur without having to resort to alternative conceptions of representation. The conclusion ascertains that infant enfranchisement is highly undesirable and that there are more viable forms to promote infant political agency, such as virtual representation, infant-beneficial principles of political action and ombudspersons for infants. (shrink)

Living related organ transplantation is morally problematic for two reasons. First, it requires surgeons to perform nontherapeutic, even dangerous procedures on healthy donors—and in the case of children, without their consent. Second, the transplant donor and recipient are often intimately related to each other, as parent and child, or as siblings. These relationships challenge our conventional models of medical decisionmaking. Is there anything morally problematic about a parent allowing the interests of one child to be risked for the sake of (...) another? What exactly are the interests of the prospective child donor whose sibling will die without an organ? Is the choice of a parent to take risks for the sake of her child truly free, or is the specter of coercion necessarily raised? (shrink)

Can we rely on the altruism of professionals or the public service ethos to deliver good quality health and education services? How should patients, parents and pupils behave - as grateful recipients or active consumers? The book provides new answers to these questions, and evaluates recent government policies in health services, education, social security and taxation, and puts forward proposals for policy reform: universal capital or 'demogrants', discriminating vouchers, matching grants for pensions and for long-term care and hypothecated taxes.

The implementation of international human rights laws at the national and local levels relies on the framing of norms. Recent research has shown that international norms regarding child marriage have shifted from setting a minimum age limit to building the agency of girls to resist the practice, which can be either active or passive. Active agency requires taking action for its purpose, whereas passive agency involves acting in situations with limited options. The dominant discourse on child marriage (...) often portrays girls as victims, and this article adds to the existing literature on how child brides exert agency utilizing semiotics approach. Based on an extended qualitative study conducted at _Quarit Woreda_, the Amhara Regional State of Ethiopia, the article explores how the girls have been exerting transformative agency to resist the practice, or at least exercise limited agency to enforce their marital choice. It also contrasts them with female parents, where the latter are found to uphold mythical signification being one among the central norm holders. By doing so, the contribution seeks to understand the semiotic system—the structural resources that support versus socio-cultural factors that constrain their agency. This article also discusses the multifaceted difficulties faced by girls in challenging the well-established norm and the creative strategies they use to overcome impediments through networking and collaboration pathways. Lastly, the article suggests potential future interventions that aim to enhance girls’ transformative agency which in turn supports the effective enforcement of child marriage law in the study area. (shrink)

That we treat children differently from adults is clear. The attitude of increased paternalistic standards can be seen in a number of cases – be it the rights which children have in terms of medical treatment, decisions about their lives which are left up to parents or guardians, or the prohibition of certain activities before a certain age. However, we can only treat ‘children as children’ if we can prove that this stands in great enough distinction from the adult. Either (...) it can be shown that children are significantly unique (and certainly so in relation to adults) such that different treatment on this basis is justified, or, if it cannot be shown that children are different to adults or we cannot say who is and who is not a child, then the second conclusion must be that we cannot justify children as deserving of paternalistic treatment, and must either reject paternalistic intervention altogether, or else look for a new criteria upon which to base the application of these increased paternalistic standards. The second of these conclusions is that which I will defend in this paper, and will argue that we replace the notion of childhood with that of developed agency. (shrink)

Considerable ferment exists around the changing nature of children’s play and its place in contemporary childhood. Traditional perspectives on early childhood research have tended to trivialize and obscure the possibilities inherent in children’s ways of knowing. Researchers seldom ask children what play means to them. This article proffers a relatively new image of childhood, one that presents young children as collaborators in research, as competent interpreters of their lived experience. This study investigates children’s knowledge: their knowledge about what play is, (...) how it is experienced, and its role in their lives, at school and at home. Interviews conducted with primary school students reveal how they perceive their lives in relation to the mainstream world of adults. Teachers and parents are seen as those who define, control, and sanction play. These children rely on the particularities and situatedness of everyday events to describe the meaning of play in their lives. Play emerges, to some degree, akin to a state of mind, invariably related to issues of autonomy, agency, and power. (shrink)

In the majority of research, resettled immigrant and refugee parents are often considered to be less involved with their children’s schooling than majority parents. This study challenges such research positions, based on narrative interviews about parenting in exile conducted with refugee parents resettled in Norway. Cultural psychology and positioning theory have inspired the analyses. The choice of methodology and conceptualisations have brought forth a rich vein of material, which illuminated agency and active positions in the parents’ narratives about involvement (...) with their children’s education. Involvement narratives of success achieved by parents taking action are presented as well as narratives of thwarted agency. Parents’ narrated action includes also involvement outside officialdom, such as informal contact with teachers. It is assumed that the latter involvement forms have become invisible in the majority of earlier research on refugee parents’ school involvement due to methodological choices, and may have contributed to deficit positioning of refugee parents as passive in school involvement. This article’s agency narratives form a sharp contrast to such deficit positioning. (shrink)

The children’s market has become significantly more important to marketers in recent years. They have been spending increasing amounts on advertising, particularly of food and beverages, to reach this segment. At the same time, there is a critical debate among parents, government agencies, and industry experts as to the ethics of food advertising practices aimed toward children. The␣present study examines parents’ ethical views of food advertising targeting children. Findings indicate that parents’ beliefs concerning at least some dimensions of moral intensity (...) are significantly related to their ethical judgments and behavioral intentions of food advertising targeting children as well as the perceived moral intensity of the situation. (shrink)

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

What makes a multimillion-dollar, transnational intimate industry possible when most people see it as exploitative? Using the newly emergent case of commercial surrogacy in India, this article extends the literature on stratified reproduction and intimate industries by examining how surrogacy persists and thrives despite its common portrayal as the “rent-a-womb industry” and “baby factory.” Using interview data with eight infertility specialists, 20 intended parents, and 70 Indian surrogate mothers, as well as blogs and media stories, we demonstrate how market actors (...) justify their pursuits through narrating moral frames of compassion and altruism that are not incidental but systematic to and constitutive of transnational surrogacy. We observed two predominant moral frames: surrogacy liberates and empowers Indian women from patriarchal control; and surrogacy furthers reproductive rights. Within these frames, the market exchange of money for babies is cast as compassion, which allows commissioning clients to sidestep accusations of racism, classism, and sexism. Yet, we reveal that the ability to navigate around these threats relies on racist, classist, and sexist tropes about Third World working-class women. Further, we find that surrogate mothers did not experience significant changes in economic status after surrogacy. (shrink)

A brief review of the social and educational context of Hong Kong shows that the publication of the General guidelines on moral education in schools in 1981, by the Hong Kong Education Department, marked a milestone in the development of moral education. The Guidelines explicitly asserted moral education as one function of schooling, whilst also formally recognizing the home and the community as two main influences. This paper narrates how three moral sources of influence – namely Confucian‐parental, Christian‐religious and (...) liberal‐civic – have shaped the development of moral education in Hong Kong from 1973 to 2003. It then examines in more detail: parental influence at home – the Confucian moral source in Chinese family; schooling influenced by religious sources – taking Christian schools as an example; and the Independent Commission Against Corruption as an official agency for moral education – a liberal source calling for civic morality. In conclusion, the post‐colonial emergence of nationalistic influence in the recently constituted Chinese Special Administrative Region, advocating national identity as the new core value, is traced and the implications for future moral education in Hong Kong are considered. (shrink)

What happens when neuroscientific knowledges move from laboratories and clinics into therapeutic settings concerned with the care of children? ‘Brain-based parenting’ is a set of discourses and practices emerging at the confluence of attachment theory, neuroscience, psychotherapy and social work. The neuroscientific knowledges involved understand affective states such as fear, anger and intimacy as dynamic patterns of coordination between brain localities, as well as flows of biochemical signals via hormones such as cortisol. Drawing on our own attempts to adopt brain-based (...) parenting, and engaging with various strands and critiques of new materialism and affect theory, we explore the ways in which the social sciences and humanities might fruitfully engage with neuroscientific concepts and affects. How does science-affected indeterminacy, with all its promises of ontological and experiential agency, help us to observe, wait, bind or hold together volatile mixtures of habit, speech and action? (shrink)

Learner Voice, Learner Choice offers fresh, forward-thinking supports for teachers creating an empowered, student-centered classroom. Learner agency is a major topic in today's schools, but what does it mean in practice, and how do these practices give students skills and opportunities they will need to thrive as citizens, parents, and workers in our ever-shifting climate? Showcasing authentic activities and classrooms, this book is full of diverse instructional experiences that will motivate your students to take an agile, adaptable role in (...) their own learning. This wealth of pedagogical ideas-from specific to open-ended, low-tech to digital, self-expressive to collaborative, creative to critical-will help you discover the transformative effects of providing students with ownership, agency, and choice in their learning journeys. (shrink)

Tomasello's moral psychology of obligation would be developmentally deepened by greater attention to early experiences of cooperation and shared social agency between parents and infants, evolved to promote infant survival. They provide a foundation for developing understanding of the mutual obligations of close relationships that contribute (alongside peer experiences) to growing collaborative skills, fairness expectations, and fidelity to social norms.

Cognitive incompetence cannot adequately explain the special character of children's moral status. It is, in fact, because children lack preference structures that are sufficiently stable over time that they are not ’temporally extended agents’. They are best viewed as 'special agents’, and parents have the responsibility of fostering the development of temporally extended agency and other necessary related moral capacities. Parental authority should be exercised with the view to assisting children to acquire the capacities that facilitate their transition (...) from 'special agents’ to full and functioning members of the moral community. (shrink)

In recent years, the phenomenon of moral distress has been critically examined—and for a good reason. There have been a number of different definitions suggested, some that claimed to be consistent with the original definition but in fact referred to different epistemological states. In this paper, we re‐examine moral distress by exploring its relationship with moral agency. We critically examine three conceptions of moral agency and argue that two of these conceptions risk placing nurses' values at the center (...) of moral action when it ought to be the patient's values that shape nurses' obligations. We propose that the conception of moral agency advanced by Aimee Milliken which re‐centers patient values, should be more broadly accepted within nursing. We utilize a case example to demonstrate a situation in which the values of a patient's parents (surrogates) justifiably constrained nurses' moral agency, creating moral distress. Through an examination of constraints on nurse agency in this case, we illustrate the problematic nature of ‘narrow' moral distress and the value of re‐considering moral distress. Finally, we provide an action‐oriented proposal identifying mediating steps that we argue have utility for nurses (and other healthcare professionals) to mediate between experiences of narrow moral distress and the exercise of moral agency. (shrink)

This study examined linguistic patterns in mothers’ reports about their toddlers’ involvement in everyday household work, as a way to understand the parental ethnotheories that may guide children’s prosocial helping and development. Mothers from two cultural groups – US Mexican-heritage families with backgrounds in indigenous American communities and middle-class European American families – were interviewed regarding how their 2- to 3-year-old toddler gets involved in help with everyday household work. The study’s analytic focus was mothers’ responses to interview questions (...) asking about the child’s efforts to help with a variety of everyday household work tasks. Results showed that mothers responded with linguistic patterns that were indicative of ethnotheoretical assumptions regarding children’s agency and children’s prosocial intentions, with notable contrasts between the two cultural groups. Nearly all US Mexican-heritage mothers reported children’s contributions and participation using linguistic forms that centered children’s agency and prosocial initiative, which corresponds with extensive evidence suggesting the centrality of both children’s autonomy and supportive prosocial expectations in how children’s helpfulness is supported in this and similar cultural communities. By contrast, middle-class European American mothers frequently responded to questions about their child’s efforts to help with linguistic forms that “pivoted” to either the mother as the focal agent in the child’s prosocial engagement or to reframing the child’s involvement to emphasize non-help activities. Correspondence between cultural differences in the linguistic findings and existing literature on socialization of children’s prosocial helping is discussed. Also discussed is the analytic approach of the study, uncommon in developmental psychology research, and the significance of the linguistic findings for understanding parental ethnotheories in each community. (shrink)

Parents’ perception of having no choice and strong emotions like fear about the prospect of living liver donation can lead professionals to question the voluntariness of their decision. We discuss the relation of these experiences (no choice and emotions), as they are communicated by parents in our study, to the requirement of voluntariness. The perceived lack of choice, and emotions are two themes we found in the interviews conducted within the “Living Related Donation; a Qualitative-Ethical Study” research program. As a (...) framework for the interpretation of these themes we discuss views of moral agency. We adopt a view in which relations are seen as constitutive of moral agency. Judging from this view, the perceived lack of choice can best be understood as a sign of commitment. We argue in this article that neither seeing no choice, nor emotions in themselves should be seen as compromises of a voluntary consent. However both experiences draw attention to aspects that are important to come to an evaluation of consent to donation. We discuss the story of one mother as an exemplary case to show how both themes can intertwine. (shrink)

For qualitative researchers seeking the perspectives of people with unusual characteristics or circumstances, compliance with expectations about participant anonymity can be difficult, if not impossible. In the age of internet communications and emerging research methodologies, traditional strategies require ongoing re-examination to ensure cohesion between a project’s ethical framework and its research practice. This paper reflects on the approach to informed consent used in a study with parent carers whose children had high-level support needs. A two-step process of written consent was (...) developed in response to concerns about the possible re-identification of these parents as a result of their highly individual circumstances. This approach acknowledged the potential for identification, and maximised participants’ agency in choosing the level of risk that they were comfortable to accommodate. The paper discusses the researcher’s and participants’ responses to the adapted consent process and recommends that researchers and ethics review committees remain open to the development of collaborative and innovative approaches that are also culturally and contextually relevant, to enable people to contribute perspectives that might otherwise be silenced by the very ethical frameworks that purport to protect their interests. (shrink)

This book presents new ethnographic research carried out with five children between one and five years old. It explores children's agency in relation to daily transitions across everyday life contexts such as home and day-care contexts. Based on this new research, Pernille Juhl shows how young children are active participants orientating in their everyday life transitions. She argues that we should understanding children as creative and transformative subjects co-creating together with co-participants such as parents, professionals and other children, the (...) conditions under which they live. Juhl builds on theoretical work by Holzkamp, Stetsenko, Hedegaard and Vygotsky and covers a range of theoretical approaches and concepts in her analysis such as befindlichkeit, micromovements and embodied orientation. While the research was carried out in the Danish context, the broader theoretical discussions are relevant for early childhood contexts globally, with a focus on Europe and the USA. (shrink)

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

Contributing to current debates about child welfare and child protection, this book provides a holistic view of how children develop agency, combining social, ...

This article explores the processes through which Australian recipients select unknown donors for use in assisted reproductive technologies and speculates on how those processes may affect the future life of the donor-conceived person. I will suggest that trust is an integral part of the exchange between donors, recipients, and gamete agencies in donor conception and heavily informs concepts of relatedness, race, ethnicity, kinship, class, and visibility. The decision to be transparent about a child’s genetic parentage affects recipient parents’ choices of (...) donor, about who is allowed to “know” children’s genetic backgrounds, and how important it is to be able to “pass” as an unassisted conception. In this way, recipients must trust the process, institutions, and individuals involved in their treatment, as well as place trust in the future they imagine for their child. The current market for donor gametes reproduces normative conceptions of the nuclear family, kinship, and relatedness by facilitating “matching” donors to recipients by phenotype and cultural affinities. Recipient parents who choose not to prioritize “matching,” and actively disclose the process of children’s conceptions, may embark on a project of queering heteronormative family structures and place great trust in both their own children and changing social attitudes to reduce stigma and generate acceptance for non-traditional families. (shrink)

The aim of this chapter is to question the punitive approach towards substance dependent parents, especially substance dependent parents struggling with poverty, by outlining the complex ways in which poverty can shape reasoning, and hence capacities for self-control. I will outline two ways in which poverty can shape reasoning: a rational shift from a global to a local perspective, and a more invasive one: resignation. I will argue that when people with addictions become resigned, it is especially important to not (...) hold a punitive approach, but to treat them with compassion while simultaneously bootstrapping their sense of agency. I will argue that having children can be an important turning point for people struggling with addiction, and possibly resignation. In order to successfully turn their lives around, they must feel comfortable to seek professional support without fear for retribution or stigma. This paradigm shift in how we treat substance dependent parents will be an important contribution to breaking the circle of intergenerational transmission of resignation, poverty and substance abuse. (shrink)

This article draws on ethnographic research with a nonprofit foster family agency to examine how payment affects caregivers’motivations and performance, as well as how state bureaucratic organization and professional supervision affect their carework. Findings suggest that contrary to conventional thought, economic interests and altruistic motives coexist for foster mothers. Although monetary compensation is a concern for these mostly working-class women, impetus for caring also stems from traditional gendered ideals of mothering, nurturing, and staying at home with their biological children. (...) However, state regulations and rules intervene in foster mothers’parenting and private lives and undermine their intrinsic motivations and rewards. The conclusion reflects on what this case reveals about the challenges of paid carework, especially under conditions of government supervision and regulation. (shrink)

Using the first-person plural pronoun wǒmen to refer to a child is repeatedly observed in Chinese parents’ interaction. To understand its interpersonal meanings, this study investigates this non-prototypical pronoun use in Chinese parents’ community of practice. The analysis shows that the non-prototypical use of this pronoun not only displays agency and connection between parents and children but also reveals the seemingly close but detached relationship among parents. This non-prototypical pronoun use unveils the complex and dynamic nature of relational work. (...) We argue for the significance of community of practice in relational work studies, as it can proffer social and cultural contexts to pronoun use and a situated understanding of interactants’ interpersonal relationships. The present study contributes to the documentation of the non-prototypical use of wǒmen in Chinese contexts and the comprehension of its interpersonal meanings. (shrink)

Singh's study of 150 UK and US children diagnosed with attention deficit hyperactivity disorder and prescribed psychotropic medication concludes on the basis of interviews with the children that ‘stimulants improve their capacity for moral agency … an ability to meet normative expectations’.1 Reinterpreted in lay language, she finds that, when taking Ritalin, the children conform to the wishes and expectations of their parents and teachers. They get better grades at school and show less ‘oppositional-defiance’. This is not surprising as (...) it is precisely what Ritalin is supposed to do. However, it begs a number of crucial questions. Might it not be that the failure of the child to conform to the expected norms in the non-medicated state is a legitimate expression of the child's own moral agency, rebelling against what he/she experiences as inappropriate …. (shrink)

All of us have personal ideals. We are committed to being good (enough) friends, parents, neighbors, teachers, citizens, human beings, and more. In this paper, I examine the thick and thin aspects of these ideals: (i) their substance (to internalize an ideal is to endorse a particular way of being) and (ii) their accountability to reason (to internalize an ideal is to assume that this is really a good way to be). In considering how these two aspects interact in the (...) ideal of rational agency, I address two philosophical debates that are generally conducted in isolation of each other: (i) debates over the anti-ideal of normative “fetishism” and (ii) debates over whether acting for a reason is acting “under the guise of the good.” In the final two sections of the paper, I further explore the relations among the thick and the thin. I note the role that coherence constraints play in the process whereby our ideals gain determinacy. At the same time, I argue, our ideals constrain the possibility and desirability of coherence. This has implications for a third debate: the debate over the possibility of moral dilemmas. (shrink)

In this paper, a rights-based argument for the impermissibility of abortion, infanticide and neglect of some pre-natal organisms and infants/children is advanced. I argue, in opposition to most rights-ethicists, that the potentiality for autonomous agency gives individuals negative rights. I also examine the conjecture that potential autonomous agents have positive rights in virtue of their vulnerability. According to this suggestion, once an individual obtains actual autonomous agency, he or she has merely negative rights. Possible solutions to conflicts of (...) rights between parents and their offspring are investigated. Finally, I discuss a lexical order between positive and negative rights, which may solve conflicts between the rights of potential autonomous agents and actual autonomous agents. (shrink)

Purpose: The main aim of this study was to examine the influence of organizational culture on strategy implementation in Kenya Government Tourism Agencies. Materials and Methods: The study used a positivist approach research philosophy. The research designs employed in this study were explanatory and descriptive research designs. The study population comprised of the tourism industry. The study included the ministry of tourism itself since it is the parent ministry that regulates and oversees the operations of the tourism agencies to give (...) a total of 10 areas of study. A sample of 327 was achieved based on the following formula. This study used primary data. The study used questionnaires and interview guides to collect both qualitative and quantitative data. Quantitative data was analyzed through scientific methods using the statistical package for social sciences (SPSS version 22) while qualitative data was analyzed thematically. The descriptive statistics was first used to analyze the demographic factors of the respondents using frequencies and charts. Inferential statistics such as correlation and multiple linear regression analysis were used to test the relationship among the variables as per the study hypothesis. Findings: The culture of an organization was found to play a critical role in implementation of strategies and consequently realizations of set objectives and profits in organizations. Organizational norms, ethics, employee training and organizational climate are very key in achieving success while implementing strategies. Implications to Theory, Practice and Policy: It is recommended that organizations (tourism industry) create strategy implementation promoting culture, culture of timeliness, innovative culture, ethics and one which promotes team spirit. These aspects of culture need to be reinforced and strengthened to ensure implementation of strategies is smooth and quick enough. This study thus bridges the gap between theory and practice, offering a nuanced understanding of the interplay between organizational culture and strategy implementation in a critical sector for Kenya's economy. (shrink)

Deontic modals are the topic of my dissertation. All deontic modals, yes, but justification in particular, and epistemic justification even more specifically. Deontic modals operate upon performances—they appraise performances. Positively appraised, a performance is appropriate, decent, justifiable, right, permissible, or proper; negatively appraised, inappropriate, indecent, unjustifiable, wrong, impermissible, or improper. Belief and knowledge and performances in exactly the same sense that action and intention are performances: all are products of powers that are in some sense responsive to reasons. The principal (...) difference is the direction of fit between mind and world. Knowledge and belief the product of cognitive powers aimed at adapting mind to world, action and intention the product of conative powers aimed at adapting world to mind. All are normatively evaluable and the characteristic normative appraisal of each is deontic. Epistemology, ethics, and rational choice all investigate the nature of deontic modals, differing only insofar as the central aims are epistemic, moral, or prudential in nature. In this sense, the general theory of deontic modals is the parent to epistemology, ethics, and rational choice. My project is to develop and defend a schematic theory of justification. I achieve this end by developing and defending a general theory of deontic modalities. Riffing on two pithy turns of phrase, the deontic theory may be tersely sloganized: value first and one must do the best one can. It is a teleological theory that defines all deontic concepts from the theoretically foundational notions of ability and value. Roughly, a belief is epistemically justifiable if, and only if, it is part of an epistemically optimific belief set the agent is able to have. Roughly, an act is morally justifiably if, and only if, it is part of a morally optimific action set the agent is able to perform. My pet interest is in the former. The resultant framework is enormously fruitful, especially in epistemology. (shrink)

This article reviews pertinent literature and presents findings from recent research to illustrate how CAFCASS (Children and Family Court Advisory and Support Service) private law practitioners understand, experience and manage the tension between empowerment and protection in welfare report enquiries. The traditional approach in the United Kingdom has been for children to be protected, especially when their divorced or separated parents are in conflict, but the balance is changing, as calls for the active participation of children in decisions that affect (...) them continue to grow louder. (shrink)

Background: Longitudinal studies exploring the complex interplay between family structures and residential mobility on educational achievement and failure are lacking. We investigate the interplay between the number of residential moves during late childhood, parental education level, family living situation, and the probability of completing upper secondary education. Methodology Detailed longitudinal data for a random sample of 30% of the entire Norwegian population born 1982 to 1989 ( N = 121,247) and information on all their relocations between Norwegian enumeration districts (...) from ages 10 to 18 years were extracted from the Norwegian population registries. Family structures were grouped into four intersectional family strata defined by combining categories of parental education level (distinguishing poorly educated and well-educated families) and the family’s living situation (comparing non-intact families with intact families). We applied two-level logistic regression models, which incorporated individual and family contextual factors, to estimate possible differences in completion rates of upper secondary education. Results Non-completion of secondary education (which constitutes 29% of the study sample) increases incrementally with the number of residential changes across all four family structures, but this effect was not distributed evenly between the different family strata. Individuals in “well-educated, intact families” seem to be least affected by residential moves. On the other hand, the highest disadvantage of frequent moves was among adolescents in the stratum “poorly educated, intact families.” In poorly educated families the probabilities of completing secondary school among non-intact and intact families converge toward each other as the number of moves increase. About 43% of the variation in school completion may be attributed to differences between families. The highest risk of school non-completion was found among adolescents in poorly educated families, which accounted for 74% of the non-completers. Conclusion We demonstrated underlying links between residential mobility and family structures on non-completion of upper secondary education. The adverse effect of frequent moves calls for attention in schools, public health agencies, and housing policies. The findings should be considered in a life course perspective, as the accumulation of unfavorable conditions during childhood and adolescence tends to constrict future prospects in terms of health and quality of life. (shrink)

Sperm donation is a widely accepted and increasingly common practice. In the standard case, a sperm donor sells sperm to an agency, waives his parental rights, and is absolved of parental responsibility. We tend to assume that this involves no problematic abandonment of parental responsibility. If we regard the donor as having parental responsibilities at all, we may think that his parental responsibilities are transferred to the sperm recipients. But, if a man creates a (...) child accidentally, via contraception failure, we tend to assume that the man does indeed have parental responsibilities. Assessing these contrasting conclusions requires a theory of parental responsibility. I analyze prevalent theories of what makes someone parentally responsible and show that none of these theories can withstand scrutiny. I propose a new theory of parental responsibility, which, I argue, is more plausible than the alternatives. My theory of parental responsibility is based on our ownership and control over hazardous materials, namely, our gametes. I show that neither my theory, nor the theories I reject, can support our contrasting intuitions. I conclude that sperm donors are fathers, with parental responsibility. I argue that the alternative conclusion, that neither sperm donors nor accidental fathers are parentally responsible for their resulting offspring, is less plausible. I then consider whether parental responsibility can be transferred and argue that it is far from clear that it can. Finally, I address objections and consider some practical implications of these views. (shrink)

The ongoing debate within neuroethics concerning the degree to which neuromodulation such as deep brain stimulation (DBS) changes the personality, identity, and agency (PIA) of patients has paid relatively little attention to the perspectives of prospective patients. Even less attention has been given to pediatric populations. To understand patients’ views about identity changes due to DBS in obsessive-compulsive disorder (OCD), the authors conducted and analyzed semistructured interviews with adolescent patients with OCD and their parents/caregivers. Patients were asked about projected (...) impacts to PIA generally due to DBS. All patient respondents and half of caregivers reported that DBS would impact patient self-identity in significant ways. For example, many patients expressed how DBS could positively impact identity by allowing them to explore their identities free from OCD. Others voiced concerns that DBS-related resolution of OCD might negatively impact patient agency and authenticity. Half of patients expressed that DBS may positively facilitate social access through relieving symptoms, while half indicated that DBS could increase social stigma. These views give insights into how to approach decision-making and informed consent if DBS for OCD becomes available for adolescents. They also offer insights into adolescent experiences of disability identity and “normalcy” in the context of OCD. (shrink)

This article takes an intergenerational lens to the study of fathers. It draws on evidence from two economic and social research council-funded intergenerational studies of fathers, one of which focused on four-generation British families and the other which included new migrant (Polish) fathers. The article suggests both patterns of change and continuity in fatherhood across the generations. It demonstrates how cultural forces and material conditions need to combine to facilitate change in fathers? exercise of agency and how social class (...) and the conditions of being a migrant shape fathers? practices. It argues that in seeking to recast the public debate about parenting, it is necessary to penetrate below the discursive level of talk about parenting to examine the habitual nature of many family practices, an endeavour to which an intergenerational approach is well suited. This approach enabled us to tease out the horizontal pull of within-generation influences on fathers, the vertical pull of inheritance from older to younger generations and the material and cultural conditions of fathers? current locations, all of which shape their practices. This analysis also alerted us to changes in conceptual language ? not only from fatherhood to fathering ? but also to the historical resilience of the concept of childcare as reserved largely for the role and practices of mothers. (shrink)