This article presents the findings of qualitative research which explored, from the mothers’ perspective, the process of decision-making about mode of delivery for a subsequent birth after a previous Caesarean Section. In contradiction to the clinical literature, the majority of mothers in this study were strongly of the opinion that a vaginal birth after caesarean (VBAC) posed a higher risk than an elective caesarean (EC). From the mothers’ perspective, risk discussions were primarily valuable for gaining support for their pre-determined choice, (...) rather than obtaining information. The findings posit ethical concerns with regards to informed consent and professional obstetric practice at a time when there is a documented and worrying trend towards an increase in births by caesarean section (CS). (shrink)

Because health care professions exist to provide a good for society, ethical questions are inherently part of them. Such professions and their members can be assessed based on how effective they are in developing knowledge and enacting practices that further the health and well‐being of individuals and society. The complexity of contemporary health care environments makes it important to prepare clinicians who can anticipate, recognize, and address problems that arise in practice or that prevent a profession from fulfilling its service (...) goals and obligations. Different health care professions have evolved distinct perspectives about appropriate goals for, and the purposes of, their clinicians, even when the goal of improving health and well‐being for society is shared across professions. While medicine and nursing goals are shared in principle, they differ in the particulars. Given the centrality to nursing of ethical questions, the profession has a collective responsibility to help clinicians at all levels of practice become ethically savvy and to reinforce their moral agency as needed. Both knowledge of nursing ethics and knowledge of the interdisciplinary field of bioethics are critical to nursing work. (shrink)

Issues surrounding the inclusion of transgender and intersex athletes in the women’s category in sport have spurred vigorous, and sometimes vicious, debate. The loudest voices on one edge of the de...

In the philosophy of perception, typically, everything is illuminated. Discussions of perceptual experience primarily focus on subjects situated in illuminated environs. Rarely do we see treatment of putative perceptual experience involving darkness. In this paper, I will carefully canvas and characterize the nature of experiences of darkness, marking a substantive distinction between two such kinds of experiences. Crucially, I give an account of the distinctive phenomenology of experiences of darkness, and show that neither of the two broad kinds of experiences (...) of darkness requires, as Roy Sorensen has recently suggested, the reification of unfamiliar entities to serve as objects of perceptual awareness. I will also offer potential candidates for the proper representational contents of experiences of darkness. This exploration not only reveals that such experiences pose no threat to a view like representationalism, but also demonstrates how experiences of darkness can be given their rightful place in a naturalistic theory of perceptual awareness. Atlast, darkness will be brought out from the shadows. A dungeon horrible, on all sides round, As one great furnace flamed, yet from those flames No light; but rather darkness visible ? ?John Milton, Paradise Lost. (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)

There is a growing trend in Australia to require lawyers to certify reasonable prospects of success for the cases they bring and defend. New South Wales has led the way with the Legal Profession Act 2004 (NSW) Pt 3.2 Division 10 requiring legal practitioners to certify reasonable prospects of success in all claims for damages. The requirement places a significant onus on lawyers to make a judgment about the merits of a case before it is begun, yet the common law (...) has long provided mechanisms to ensure that cases without prospects of success do not go to trial. This article considers Australian legislative provisions requiring lawyers to certify reasonable prospects of success of cases. It examines the application of the NSW legislation by the courts highlighting the difficulties of interpretation of what constitute 'reasonable prospects of success' and the application of the legislation in the context of the dynamic litigation process. It is argued that these legislated obligations on lawyers will have a detrimental effect on access to justice by denying parties, in particular plaintiffs, the opportunity to have their cases properly and fully determined in the courts. This article examines common law mechanisms for dissuading cases without prospects and argues that the general law is an effective system for ensuring that cases without prospects of success are not maintained. The Australian experience is instructive for consideration of optimal reform packages for the administration of justice and to evaluate the role of any litigation lawyer within the judicial and court process. (shrink)

Advances in life-sustaining medical technology as applied to neonatal cases frequently present ethical concerns with a strong emotional component. Neonates delivered in the gestation period of approximately 23held hostagemoral distress” regarding aggressive courses of treatment for some patients. Some of this distress results from a feeling of powerlessness regarding treatment decisions, coupled with a high intensity of hands-on contact with the patients and family. Lack of authority coupled with high responsibility may itself be a recipe for a different kind of (...) futility. (shrink)

This paper examines the extent to which parents have absorbed New Right ideas about education and acted accordingly. What emerges is that their commitment to the rhetoric of school choice is strong. However, concepts such as the market and competition are viewed less favourably. An important theme here is the avoidance by parents of any collective agenda in discussing education policy, a factor that may thwart those who attempt to predict their responses to government policy for schools.

A survey of the philosophy of sport literature reveals that arguments regarding the issue of sex segregation in athletics have been advanced from time to time, but there has been little sustained discussion, no consensus, and no change in existing practice. In this paper, an effort to advance the conversation, I begin with Jane English’s seminal 1978 article as a springboard and employ existing literature on the question of sex segregation in order to raise difficulties with English’s analysis and outline (...) the basic alternative positions that have been taken on the issue. My own contribution to the conversation is in the introduction of four distinctions – between individual and team sports, direct and indirect competition, contact and non-contact sports, and amateur and professional sports – that have not been part of the discussion about the conditions under which men and women might compete against one another. These distinctions resolve several difficulties noted by others and suggest a more nuanced conclusion about desirable changes to the structure of sporting competition. (shrink)

What is it to be a woman? What is it to be a man? We start by laying out desiderata for an analysis of 'woman' and 'man': descriptively, it should link these gender categories to sex biology without reducing them to sex biology, and politically, it should help us explain and combat traditional sexism while also allowing us to make sense of the activist view that gendering should be consensual. Using a Putnam-style 'Twin Earth' example, we argue that none of (...) the existing analyses in the feminist literature succeeds in meeting all of our desiderata. Finally, we propose a positive account that we believe can satisfy all the desiderata outlined. According to our theory, the genders 'woman' and 'man' are individuated not by their contemporary connections to sex biology, but by their historical continuity with classes that were originally closely connected to sex biology. (shrink)

In recent years there has been an increasing critique of the philosophically based reasoning in bioethics which is known as principlism. This article seeks to make a postmodern contribution to this emerging debate by using notions of power and discourse to highlight the limits and superficiality of this , rationalistic mode of reflection. The focus of the discussion will be on the principle of autonomy. Recent doctoral research on a hospice organization (Karuna Hospice Service) will be used to contextualize the (...) debate to end-of life ethical dilemmas. The conclusion will be reached that the discursive richness of this organization's notion of autonomy or choice, which incorporates a holistic respect for the individual and the active creation of alternatives, can provide important insights to our understanding of autonomy in bioethics. The concern is raised that if autonomy is reified as a principle outside of the context of discourse, it may only complement the hegemonic power of biomedicine. (shrink)

When the absence of an event causes some outcome, it is an instance of omissive causation. For instance, not eating lunch may cause you to be hungry. Recent psychological proposals concur that the mind represents causal relations, including omissive causal relations, through mental simulation, but they disagree on the form of that simulation. One theory states that people represent omissive causes as force vectors; another states that omissions are representations of contrasting counterfactual simulations; a third argues that people think about (...) omissions by representing sets of iconic possibilities – mental models – in a piecemeal fashion. In this paper, we tease apart the empirical predictions of the three theories and describe experiments that run counter to two of them. Experiments 1 and 2 show that reasoners can infer temporal relations from omissive causes – a pattern that contravenes the force theory. Experiment 3 asked participants to list the possibilities consistent with an omissive cause – it found that they tended to list particular privileged possibilities first, most often, and faster than alternative possibilities. The pattern is consistent with the model theory, but inconsistent with the contrast hypothesis. We marshal the evidence and explain why it helps to solve a long-standing debate about how the mind represents omissions. (shrink)

It is now common in health care for a diverse range of professions and disciplines to work together in regular and close contact. Thus, there are now calls in the literature for research that documents insights on the ethical dimension of multidisciplinary relationships. Recent Australian research has responded to this call by examining how a multidisciplinary team of health professionals define and operationalize the notion of ethics in an acute ward hospital setting. This article provides findings from the research study (...) that indicate that, although there is a shared conceptualization of ethics as "patient-centered care", there can be times of conflict and tension in determining what is best for the patient. The discussion begins to build an understanding of how a multidisciplinary mix of health professionals responds to ethical conflict and tension. The authors' hope and expectation is that, by keeping the research focus on what health professionals in a multidisciplinary team (MDT) actually do, rather than exclusively on how they philosophically think about ethical dilemmas, the insights can be translated into practical strategies that can be utilized to strengthen the process of ethical decision making within the health care system. (shrink)

Nurses’ bodywork: is there a body of work? The work that many nurses do involves the use of their own body as one of the tools of their occupation. Being a nurse, in many cases, means controlled, purposeful use of her or his own body oriented to the patient. This paper discusses some of the ways in which nurses’ bodies and the work that those bodies do are represented in professional and academic research accounts and made relevant in literature. Using (...) instances of bodies and bodily activity mentioned in a variety of literature, the paper discusses three categories of accounts of nursing bodywork: those which are problematised and where the nurse's body is seen as a topic for investigation, and those which are unproblematised either explicitly discussing bodily activity (for example, touch) or implicitly dealing with bodywork (for example, taking blood pressure). Four ways in which nurses’ bodies are made relevant in accounts are proposed: relational, corporate, instrumental and human.The paper discusses the prominence (or not) nurses’ bodies are given in professional and academic accounts, as a contribution to preliminary work of generating a topic for investigation and concludes with some suggestions as to how this investigative project might be taken forward, focusing primarily on an examination of methodic practices, or how bodywork is brought off and executed as a skilled but taken‐for‐granted activity. (shrink)

This book tackles the concerns of stressed teachers. Whether from nurturance suffering or from the piles of paperwork yet to be tackled, the author helps the reader sort through the causes of stress, the emotional, physical and social reactions to stress and how one can begin to plan a stress management plan.

In this paper, we examine the case of Ronda Rousey, a high profile female Mixed Martial Arts fighter in the Ultimate Fighting Championship. We argue that Rousey represents a female athlete who can be considered a gender transgressor yet simultaneously a Glamazon. The case of Rousey will be applied to gender transgressor theories to demonstrate that Rousey counters traditional discourse which holds that exhibiting stereotypically masculine traits implies not being an authentic woman. Female fighters face criticisms for being “unfeminine” or (...) “manly” because they participate in such an aggressive sport. Despite her gender divergent behaviour, as much as she transgresses, Rousey is also pinned by sporting and societal sexist culture that reinforces sex binaries and exposes pressures to adhere to hyperfemininity and heterosexual ideals. Finally, using the notions of self and power found in Michel Foucault’s later work as a springboard, we examine whether Rousey’s embrace of the Glamazon identity is an act of autonomy or evidence of false consciousness. (shrink)

Plato famously characterized philosophy as practice for dying and death; contemporary philosophers in bioethics have produced a vast literature on the quest for a good death. Yet there is a relativ...