What is health policy for? In Health and the Good Society, Alan Cribb addresses this question in a way that cuts across disciplinary boundaries. His core argument is that biomedical ethics should draw upon public health values and ethics; specifically, he argues that everybody has some share of responsibility for health, including a responsibility for promoting greater health equality. In the process, Cribb argues for a major rethink of the whole project of health education.
There have been serious controversies in the latter part of the 20th century about the roles and functions of scientific and medical research. In whose interests are medical and biomedical experiments conducted and what are the ethical implications of experimentation on subjects unable to give competent consent? From the decades following the Second World War and calls for the global banning of medical research to the cautious return to the notion that in controlled circumstances, medical research (...) on human subjects is in the best interest of the given individual and the broader population, this book addresses the key implications of experimentation on humans. This volume covers major ethical themes within biomedical research providing historical, philosophical, legal and policy reflections on the literature and specific issues in the field of research on human subjects. Focusing on special populations (the elderly, children, prisoners and the cognitively impaired) it represents the most up-to-date review of the special ethical and legal conflicts that arise with relation to experimentation on subjects from these groups. In the light of current initiatives for law reform pertaining to research ethics the world over, this volume provides a timely, comprehensive and provocative exploration of the field. The volume has been carefully organized to present important philosophical perspectives on organizing principles that should underlie any practical application. A forward-looking historical review of the regulatory regimes of principal jurisdictions, including of the legal controls already in place, provides the backdrop for future policy initiatives. Additionally, in the light of global restructuring of health care systems, several chapters have been devoted to epidemiological research and related issues. (shrink)
In this new book by the award-winning author of Just Healthcare, Norman Daniels develops a comprehensive theory of justice for health that answers three key questions: What is the special moral importance of health? When are health inequalities unjust? How can we meet health needs fairly when we cannot meet them all? The theory has implications for national and global health policy: Can we meet health needs fairly in aging societies? Or protect health in the workplace while respecting individual (...) liberty? Or meet professional obligations and obligations of justice without conflict? (shrink)
Who owns science? -- Science in America -- Thepolitics of heredity -- Dangerous ideas -- The stem Cell debate -- Valuing humanity -- Crossing lines -- In defense of "progress".
The American Medical Association enacted its Code of Ethics in 1847, the first such national codification. In this volume, a distinguished group of experts from the fields of medicine, bioethics, and history of medicine reflect on the development of medical ethics in the United States, using historical analyses as a springboard for discussions of the problems of the present, including what the editors call "a sense of moral crisis precipitated by the shift from a system of fee-for-service medicine (...) to a system of fee-for-system medicine, better known as 'managed care.'" The authors begin with a look at how the medical profession began to consider ethical issues in the 1800s and subsequent developments in the 1900s. They then address the sociological, historical, ethical, and legal aspects of the practice of medicine. Later chapters discuss current and future challenges to medical ethics and professional values. Appendixes display various versions of the AMA's Code of Ethics as it has evolved over time. Contributors: George J. Annas, J.D., M.P.H., Arthur Isak Applbaum, Ph.D., Robert B. Baker, Ph.D., Chester R. Burns, M.D., Ph.D., Arthur L. Caplan, Ph.D., Alexander Morgan Capron, J.D., Christine K. Cassel, M.D., Linda L. Emanuel, M.D., Ph.D., Eliot L. Freidson, Ph.D., Albert R. Jonsen, Ph.D., Stephen R. Latham, J.D., Ph.D., Susan E. Lederer, Ph.D., Florencia Luna, Ph.D., Edmund D. Pellegrino, M.D., Charles E. Rosenberg, Ph.D., Mark Siegler, M.D., Rosemary A. Stevens, Ph.D., Robert M. Tenery, Jr., M.D., Robert M. Veatch, Ph.D., John Harley Warner, Ph.D., Paul Root Wolpe, Ph.D. (shrink)
Machine generated contents note: PART I: OVERVIEW OF KEY INTERNATIONAL EDUCATION POLICY DEBATES * PART II: THE ROLE OF POLICY IN SOCIAL JUSTICE DEBATES * PART III: POLICY DEBATES IN INTERNATIONAL HIGHER EDUCATION * PART IV: EDUCATION POLICY DEBATES WITH LASTING CONSEQUENCES.
Although the use of new health technologies in healthcare and medicine is generally seen as beneficial, there has been little analysis of the impact of such technologies on people's lives and understandings of health and illness. This book explores how new technologies not only provide hope for cure and well-being, but also introduce new ethical dilemmas and raise questions about the "natural" body. Focusing on the ways new health technologies intervene into our lives and affect our ideas about normalcy, the (...) body and identity, New Health Technologies explores: how new health technologies are understood by lay people and patients how the outcomes of these technologies are communicated in various clinical settings how these technologies can alter our notions of health and illness and create "new illness." Written by authors with differing backgrounds in phenomenology, social psychology, social anthropology, communication studies and the nursing sciences, this book is essential reading for students andacademics of medical sociology, health and allied studies, and anyone with an interest in new health technologies. (shrink)
As one of the leading figures of the idealist movement, Bernard Bosanquet (1848-1923) made major contributions to philosophy and had a significant role in the formation of British socialpolicy. This set contains previously uncollected articles and essays that were first published in little known journals or magazines. Each volume includes new introductions and primary and secondary bibliographies.
Nanotechnology is an important platform technology which will add new features like improved biocompatibility, smaller size, and more sophisticated electronics to neuro-implants improving their therapeutic potential. Especially in view of possible advantages for patients, research and development of nanotechnologically improved neuro implants is a moral obligation. However, the development of brain implants by itself touches many ethical, social and legal issues, which also apply in a specific way to devices enabled or improved by nanotechnology. For researchers developing nanotechnology such (...) issues are rather distant from their daily work in the lab, but as soon as they use their materials or devices in medical applications such as therapy of brain diseases they have to be aware of and deal with them. This paper is intended to raise sensitivity for the ethical, legal and socialaspects (ELSA) involved in applying nanotechnology in brain implants or other devices by highlighting the short term problems of testing and clinical trials within the existing regulatory frameworks (A), the short and medium-term questions of risks in the application of the devices (B) and the long-term perspectives related to problems of enhancement (C). To identify and address such issues properly nanotechnologists should involve ethical, legal and social experts and regulatory bodies in their research as early as possible. This will help to remove pressure from regulatory bodies, to settle public concern and to prevent non-acceptable developments for the benefit of the patients. (shrink)
There is an increasingly widespread belief, both within and outside the discipline, that modern economics is irrelevant to the understanding of the real world. Economics and Reality traces this irrelevance to the failure of economists to match their methods with their subject, showing that formal, mathematical models are unsuitable to the social realities economists purport to address. Tony Lawson examines the various ways in which mainstream economics is rooted in positivist philosophy and examines the problems this causes. It focuses (...) on human agency, social structure and their interaction and explores how the understanding of this social phenomena can be used to transform the nature of economic practice. Economics and Reality concludes by showing how this newly transformed economics might set about shaping economic policy. (shrink)
Problems and choices -- Who shall live? -- The physician : the captain of the team -- The hospital : the house of hope -- Drugs : the key to modern medicine -- Paying for medical care.
Linda Morrison brings the voices and issues of a little-known, complex social movement to the attention of sociologists, mental health professionals, and the general public. The members of this social movement work to gain voice for their own experience, to raise consciousness of injustice and inequality, to expose the darker side of psychiatry, and to promote alternatives for people in emotional distress. Talking Back to Psychiatry explores the movement's history, its complex membership, its strategies and goals, and the (...) varied response it has received from psychiatry, policy makers, and the public at large. (shrink)
Yet these forces are largely ignored by a professional bioethics that concentrates on the theoretical justification of decisions.The original essays in this ...
How should medical services be distributed within society? Who should pay for them? Is it right that large amounts should be spent on sophisticated new technology and expensive operations, or would the resources be better employed in, for instance, less costly preventive measures? These and others are the questions addreses in this book. Norman Daniels examines some of the dilemmas thrown up by conflicting demands for medical attention, and goes on to advance a theory of justice in the (...) distribution of health care. The central argument is that health care, both preventive and acute, has a crucial effect on equality of opportunity, and that a principle guaranteeing equality of opportunity must underly the distribution of health-care services. Access to care, preventive measures, treatment of the elderly, and the obligations of doctors and medical administrations are fully discussed, and the theory is shown to underwrite various practical policies in the area. (shrink)
As the functional capabilities of high-tech medical products converge, supplying organizations seek new opportunities to differentiate their offerings. Embracing product sustainability-related differentiators provides just such an opportunity. This study examines the challenge organizations face when attempting to understand how customers perceive environmental and social dimensions of sustainability by exploring and defining both dimensions on the basis of a review of extant literature and focus group research with a leading supplier of magnetic resonance imaging (MRI) scanning equipment. The study (...) encompasses seven hospitals and one private imaging center in the Netherlands and identifies five socialaspects that cover 11 indicators. The authors conduct 22 customer perception interviews with key decision-making stakeholders involved in purchasing MRI scanning equipment. Respondents find environmental and social sustainability dimensions personally relevant but professionally secondary to cost, performance, and ability to use the equipment in their organizations' physical infrastructure. Finally, incorporating a product's environmental and social credentials within the marketing of MRI scanning equipment enhances the perception of the product offering in decisionmaking stakeholders' minds and provides a means of differentiation. (shrink)
Within the American context, the term Corporate Good Citizenship, a rather vague and somewhat dated notion, bears little relationship to the concept of Business Ethics. Whereas the latter refers to systematic reflection on the moral significance of the institutions, policies and behavior of business actors in the normal course of their business operations, the former is a subset of the broader notion of Corporate Social Responsibility and denotes, generally, discretionary, possibly altruistic, non-business relationships between business organizations and diverse community (...) stakeholders. A newer concept, the Corporate SocialPolicy Process, which focuses on the institutionalization within business organizations of processes facilitating individual and organizational reflection and choice regarding the moral significance of personal and organizational action together with a consideration of the likely consequences of such action, provides analytical linkages between Business Ethics and Corporate Good Citizenship which can be useful to business scholars and operating managers alike. Specific aspects of Corporate Good Citizenship, including corporate community involvements, are examined and particular attention is paid to current trends in corporate donations, including an increasing emphasis on strategic philanthropy which explicitly mixes practical and benevolent motives in company giving policies and practices. (shrink)
Over the last two decades, the framework of economic competitiveness has become the defining aim of education. This book thoughtfully and persuasively argues against this new vision of education.
Social judgement theory is particularly well suited to the study of medical judgements. Medical judgements characteristically involve decision making under uncertainty with inevitable error and an abundance of fallible cues. In medicine, as in other areas, SJT research has found wide variation among decision makers in their judgements and in the weighting of clinical information. Strategies inferred from case vignettes differ from physicians' self-described strategies and from the weights suggested by experts. These observations parallel recent findings of (...) unexplained variation in diagnosis and management in clinical practice that have been the source of concern in the medical community. The lens model provides one of the few methods for quantitatively analysing physicians' judgements. Contrary to what one might expect from the variation in strategies on paper cases, several studies suggest that, in practice, physicians' diagnostic judgements are highly accurate. Cognitive feedback has been less successful as a practical teaching tool than originally hoped, but some aspects of this methodology show promise, particularly in conjunction with the increasing emphasis on statistical decision support. All things considered, SJT has provided insight into physicians' decisions and gives the medical research community important tools for studying judgements in actual practice. (shrink)
There has been a modern epidemic of heart attacks in the western world, and this paper is concerned with this ânewâ medical condition and how it arose. Two competing theories are commonly proposed, relating either to conventional accounts of medical science, or to social construction. Whilst recognising that aspects of both theories have some validity, it is claimed that neither is wholly adequate. This issue has particular relevance for heart attacks and is explored in some detail, (...) but it also points to some more general conclusions. First that medical knowledge cannot be separated into âscientificâ and âsocialâ compartments but is united by its human aspect; and second that although medical knowledge has a special dimension, when understood in this way, it may also resonate with a more general re-examination of the relationship between scientific and human knowledge. (shrink)
What are the final limits of medicine? What should we not try to cure medically, even if we had the necessary financial resources and technology? This book philosophically addresses these questions by examining two mirror-image debates in tandem. Members of certain groups, who are deemed by traditional standards to have a medical condition, such as deafness, obesity, or anorexia, argue that they have created their own cultures and ways of life. Curing their conditions would be a form of genocide. (...) Members of other groups are seeking to provide medical treatment to what would conventionally be deemed 'cultural conditions'. Mild neurotics who take anti-depressants to elevate their mood, runners who use steroids, or men and women seeking cosmetic surgery are asking for medical treatment for problems that might be solved culturally, by changing norms, pressures, or expectations in the broader culture. Each of these two debates endeavors to locate medicine's final frontier and to articulate what it is that we should not treat medically even if we could. This volume analyzes what these two contemporary debates have to say to each other and thus offers a new way of determining medicine's final limits. (shrink)
Fundamental principles : the nature of the dispute -- Types of euthanasia -- Psychiatric assisted suicide -- Neonates -- Incompetent adults -- Human life is sacred -- The slippery slope -- Medical views -- Four methods of easing death and their effect on doctors -- Looking further ahead.
Foucault, Power, and Education invites internationally renowned scholar Stephen J. Ball to reflect on the importance and influence of Foucault on his work in educational policy.
Machine generated contents note: Table of Contents -- About the Cover -- Acknowledgments -- Introduction: The World on the Verge of a Nervous Breakdown, by Rahat Naqvi & Hans Smits -- Chapter One: Challenging the Frames of Curriculum Hans Smits & Rahat Naqvi -- Chapter Two: Facing the War in Afghanistan: A Curriculum Journey of a "Good Canadian", by David Blades -- Chapter Three: Re-Framing: Un-Neighbourly Love, Haunting Inquiry, Perfectibility, by Robert Nellis -- Chapter Four: Sound Curriculum: Recognizing the Field, (...) by Walter Gershon -- Chapter Five: Running head: After the war Narrative Reconstructions, Broken Frames: Sendai Before and After the War, by Craig McDonald -- Chapter Six: Depicting and Framing the Trauma of Another, by Patricia Kostouros -- Chapter Seven: Teaching Social Justice in English Language Arts: Working Toward Transformative Learning, Karen Magro -- Chapter Eight: Global Justice Education as a Pedagogy of Loss: Interrupting Frames of War, by Lisa Taylor -- About the Authors -- Bibliography -- Index -- Provided by publisher. (shrink)
The Blackwell Guide to Medical Ethics is a guide to the complex literature written on the increasingly dense topic of ethics in relation to the new technologies of medicine. Examines the key ethical issues and debates which have resulted from the rapid advances in biomedical technology Brings together the leading scholars from a wide range of disciplines, including philosophy, medicine, theology and law, to discuss these issues Tackles such topics as ending life, patient choice, selling body parts, resourcing and (...) confidentiality Organized with a coherent structure that differentiates between the decisions of individuals and those of socialpolicy. (shrink)
This volume explores the focus of interest in community and the emerging theoretical opposition between communitarianism and liberalism, including the practical, theoretical and ethical issues that relate to community in the healthcare professions.
Introduction : confronting numbness -- Basic facts about HIV/AIDS -- Ethical foundations -- Ethics and the beginning of life -- Ethics and relationships -- Ethics and the end of life -- Ethics and society -- Ethics and global structures -- Creating the future -- Appendix I : the mystery of God and suffering -- Appendix II : preparing now for the hour of death.
The public, mental health consumers, as well as mental health practitioners wonder about what kinds of values mental health professionals hold, and what kinds of values influence psychiatric diagnosis. Are mental disorders socio-political, practical, or scientific concepts? Is psychiatric diagnosis value-neutral? What role does the fundamental philosophical question "How should I live?" play in mental health care? In his carefully nuanced and exhaustively referenced monograph, psychiatrist and philosopher of psychiatry John Z. Sadler describes the manifold kinds of values and value (...) judgements involved in psychiatric diagnosis and classification systems like the DSM. Professor Sadler takes the reader on a fascinating conceptual tour of the inner workings of psychiatric diagnosis, considering the role of science, culture, sexuality, politics, gender, technology, human nature, patienthood, and professions in building his vision of a more humane psychiatric diagnostic process. (shrink)
Embryonic stem cells are actively debated in political and public policy arenas. However, the connections between stem cell innovation and overall health care policy are seldom elucidated. As with many controversial aspects of medical care, the stem cell debate bridges to a variety of social conversations beyond abortion. Some issues, such as translational medicine, commercialization, patient and public safety, health care spending, physician practice, and access to insurance and health care services, are core health (...) class='Hi'>policy concerns. Other issues, such as economic development, technologic progress, fiscal politics, and tort reform, are only indirectly related to the health care system but are frequently seen through a health care lens. These connections will help determine whether the stem cell debate reaches a resolution, and what that resolution might be. (shrink)
Machine generated contents note: Chapter 1 Acknowledgments -- Chapter 2 Introduction: The Chatter of the Present -- Chapter 3 Definitions of Solitude -- Chapter 4 Distraction: The Flip Side of Engagement -- Chapter 5 Antigone: Literature as "Thinking Apart" -- Chapter 6 The Workshop Model in New York City -- Chapter 7 The Folly of the "Big Idea" -- Chapter 8 The Cult of Success -- Chapter 9 Mass Personalization and the "Underground Man" -- Chapter 10 The Need for Loneliness (...) -- Chapter 11 The Practice of Solitude -- Chapter 12 Discernment and the Public Sphere -- Chapter 13 Conclusion: Setting up Shop -- Chapter 14 Bibliography -- Chapter 15 About the Author -- Chapter 16 Index. (shrink)
Psychiatry is increasingly dominated by the reductionist claim that mental illness is caused by neurobiological abnormalities such as chemical imbalances in the brain. Critical psychiatry does not believe that this is the whole story and proposes a more ethical foundation for practice. This book describes an original framework for renewing mental health services in alliance with people with mental health problems. It is an advance over the polarization created by the "anti-psychiatry" of the past.
Integrity, not distinctiveness -- Tense consensus -- Which public? -- Can a theological argument behave? -- So, what is the church good for? -- Conclusion: the via media: a Barthian Thomism.
A collection of essays by Alexander Rosenberg, the distinguished philosopher of science. The essays cover three broad areas related to Darwinian thought and naturalism: the first deals with the solution of philosophical problems such as reductionism, the second with the development of social theories, and the third with the intersection of evolutionary biology with economics, political philosophy, and public policy. Specific papers deal with naturalistic epistemology, the limits of reductionism, the biological justification of ethics, the so-called 'trolley problem' (...) in moral philosophy, the political philosophy of biological endowments, and the Human Genome Project and its implications for policy. Rosenberg's important writings on a variety of issues are here organized into a coherent philosophical framework which promises to be a significant and controversial contribution to scholarship in many areas. (shrink)
This book provides a comprehensive introduction to the human, social and economic aspects of science and technology. It examines a broad range of issues from a variety of perspectives, using examples and experiences from Australia and around the world. The authors present complex issues in an accessible and engaging form. Topics include the responsibilities of scientists, ethical dilemmas and controversies, the Industrial Revolution, economic issues, public policy, and science and technology in developing countries. The book ends with (...) a thoughtful and provocative look towards the future. It includes extensive guides to further reading, as well as a useful section on information searching skills. This book will provoke, engage, inform and stimulate thoughtful discussion about culture, society and science. Broad and interdisciplinary, it will be of considerable value to students and teachers. (shrink)
This book, based on the Round Table on Bioethics and Women held at UNESCO during the Fourth Session of the International Bioethics Committee (IBC), presents the ...
IRBs in action -- Everyone's an expert? Warrants for expertise -- Local precedents -- Documents and deliberations: an anticipatory perspective -- Setting IRBs in motion in Cold War America -- An ethics of place -- The many forms of consent -- Deflecting responsibility -- Conclusion: the making of ethical research.
I argue that work in medical ethics which attempts to humanize medicine without examining hidden assumptions (about medicine's ontology, explanations, goals, relationships) has the dehumanizing effect of legitimating practices which treat persons as abstractions. After illustrating the need to reexamine the field of medical ethics and the doctor-patient relationship in particular, I use Foucault's work to provide a social, historical framework for discussion. This background begins to demonstrate that doctor-patient relationships cannot be made satisfactory by new hospital (...) policies or interpersonal skills, but have deep-rooted problems due to medicine's place in social history. Real progress requires social or structural change. (shrink)
The paper has two aims. First, to show that we need social mechanisms to establish the policy relevance of causal claims, even if it is possible to build a good argument for those claims without knowledge of mechanisms. Second, to show that although social scientists can, in principle, do without social mechanisms when they argue for causal claims, in reality scientific practice contexts where they do not need mechanisms are very rare. Key Words: social mechanisms (...) • causal inference • socialpolicy. (shrink)
This paper explores the social and emotional consequences of three major assumptions about human action underpinning breastfeeding promotion campaigns in the UK. Drawing on Joas's critique of instrumental accounts of rational action, the paper illustrates the ways in which these campaigns firstly contribute to the moralisation of motherhood; secondly value highly individualised, de-contextualised forms of action; and thirdly promote an objectified view of the human body as a pliable instrument of human intentions. The consequences of these assumptions, as they (...) shape the efforts of mothers to care for their babies and young children in complex, unpredictable and often uncontrollable situations, provides the focus of discussion. The paper concludes that a target-driven health-promotion policy, relying on a mechanistic account of social and emotional life, is contributing to the burden of early motherhood in ways that are not conducive to infant and maternal health and attachment. (shrink)
abstract Part 1 of this essay argues that one of the most important contributions of philosophers to sound public policy may be to combat the influence of bad Philosophy (which includes, but is not limited to, bad Philosophy produced by accredited academic philosophers). Part 2 argues that the conventional conception of Practical Ethics (CPE) that philosophers bring to issues of public policy is defective because it fails to take seriously the phenomenon of the subversion of morality, the role (...) of false factual beliefs in this subversion, and the vulnerability to the exploitation of our moral powers that our social-epistemic dependency entails. Given the serious risks of the subversion of morality through the propagation of false factual beliefs, CPE's near exclusive emphasis on identifying sound moral principles greatly constrains its potential contribution to the Negative Task of Practical Ethics, the endeavour to reduce the incidence of the most grievously wrong behaviour. Practical ethicists should focus more on the ethics of believing, and develop a more sophisticated conception of the moral and epistemic virtues of individuals and of institutions, one that includes protective meta-virtues, whose function it is to guard us against the more frequent and predictable subversions of morality, including those subversions that are facilitated by the processes of belief-formation that our social institutions and practices foster. (shrink)
Approximately 47 million Latinos currently live in the United States, and nearly 25 percent of them are undocumented. The USA is a very different country from just a generation ago – culturally, socially, and demographically. Its presumed core values have been transformed largely by the changes wrought by immigration and ethnicity. A multicultural society has, in 2008, elected a multicultural president. This article examines immigration discourse, framed in terms of fear and security, and the evolution of the US immigration (...) class='Hi'>policy. Latino immigration is presented as a force that has shaped the nation's past and continues to shape the economic, demographic, and cultural future of the United States. Psychological barriers to the social integration of immigrants are also explored. This article concludes that government policy makers should encourage a more tolerant, multicultural society by integrating Latino immigrants into the social, economic, and political fabric of the nation. (shrink)
For over 30 years I have argued, in and out of print that, for both intellectual and humanitarian reasons, we urgently need a revolution in the aims and methods of academic inquiry. Instead of giving priority to the search for knowledge, academia needs to devote itself to seeking and promoting wisdom by rational means, wisdom being the capacity to realize what is of value in life, for oneself and others. Wisdom thus includes knowledge but much else besides. A basic task (...) of academia would be to help humanity learn how to create a better world. Now I find the revolution is underway – entirely independent of my own efforts to promote it. During the last ten to twenty years, all sorts of changes have taken place in academia that amount to putting aspects of wisdom-inquiry into practice – even if in complete ignorance of my work. Perhaps the most significant steps are the creation of departments, institutions and research centres concerned with socialpolicy, with problems of environmental degradation, climate change, poverty, injustice and war, and with such matters as medical ethics and community health. Nevertheless, the revolution is happening with agonizing slowness, in a dreadfully muddled and piecemeal way. It needs academics and non-academics to wake up to what is going on – or what needs to go on – to help give direction, coherence and a rationale to this nascent revolution from knowledge to wisdom. (shrink)
Through its adoption of the biomedical model of disease which promotes medical individualism and its reliance on the individual-based anthropology, mainstream bioethics has predominantly focused on respect for autonomy in the clinical setting and respect for person in the research site, emphasizing self-determination and freedom of choice. However, the emphasis on the individual has often led to moral vacuum, exaggeration of human agency, and a thin (liberal?) conception of justice. Applied to resource-poor countries and communities within developed countries, autonomy-based (...) bioethics fails to address the root causes of diseases and public health crises with which individuals or communities are confronted. A sociological explanation of disease causation is needed to broaden principles of biomedical ethics and provides a renewed understanding of disease, freedom, medical practice, patient-physician relationship, risk and benefit of research and treatment, research priorities, and health policy. (shrink)
Africa is a continent in transition amidst a revival of cultural practices. Over previous years the continent was robbed of the benefits of medical advances by unfounded cultural practices surrounding its cultural heritage. In a fast moving field like genetic screening, discussions of social and policyaspects frequently need to take place at an early stage to avoid the dilemma encountered by Western medicine. This paper, examines the potential challenges to genetic screening in Africa. It discusses (...) how cultural practices may affect genetic screening. It views genomics science as a culture which is trying to diffuse into another one. It argues that understanding the existing culture will help the diffusion process. The paper emphasizes the importance of genetic screening for Africa, by assessing the current level of burden of diseases in the continent and shows its role in reducing disease prevalence. The paper identifies and discusses the cultural challenges that are likely to confront genetic screening on the continent, such as the worldview, rituals and taboos, polygyny, culture of son preference and so on. It also discusses cultural practices that may promote the science such as inheritance practices, spouse selection practices and naming patterns. Factors driving the cultural challenges are identified and discussed, such as socialization process, patriarchy, gender, belief system and so on. Finally, the paper discusses the way forward and highlights the ethical considerations of doing genetic screening on the continent. However, the paper also recognizes that African culture is not monolithic and therefore makes a case for exceptions. (shrink)
The article identifies the challenges that multinational corporations (MNCs) from the developed world face in sub-Saharan Africa and examines the direct foreign-investment and development interests of the region. In light of these challenges and interests, it also explores answers to the question What is to be done?The occurrence of MNCs' operations in culturally pluralistic societies suggest that they use, as the basis for a corporation-formulated regional code of conduct, a value-based corporate socialpolicy process. That process should embody (...) utilitarian and situation ethics in the exercise of MNCs' prima facie operations and of their responsibilities to society. For the African normative environment, the appeal of this approach is substantiated by the notion that both utilitarian and situation ethics are at once consistent with the region's investment codes, development interests, and value systems. But more than that, utilitarian and situation ethics are consistent with corporate socialpolicy process and can assist MNCs to meet effectively their social responsibilities by helping them reverse the economic stagnation of most of the continent. (shrink)
The professionalism movement has animated medical education and practice; an extensive literature expresses and categorizes many interpretations of the concept (Hafferty 2006a; Hafferty and Levinson 2008). The inception of the current wave of the movement was in the American Board of Internal Medicine's Project Professionalism. In the face of threats from the growth of managed care and public concerns about conflict of interest, the ABIM's "Physician Charter" called for the profession to publically commit to values of patient welfare, (...) class='Hi'>social justice, and respect for patient autonomy (Brennan et al. 2002). The concept of professionalism, or the physician as occupying the role of professional, has taken hold in .. (shrink)
This paper is an analysis of the relationship of social ethics and bioethics in Roman Catholic theology. The argument of the paper is that the character of both Catholic moral theology and ecclesiology shape the broadly defined interest of the church in bioethics. The paper examines the common elements of social ethics and bioethics in Catholic teaching, describes how ecclesiology shapes Catholic public policy and uses the examples of abortion and health care to illustrate the relationship of (...) Catholic social thought and bioethics. In developing the relationship of these two dimensions of Catholic moral argument the article highlights how the appeal to natural law categories differs in social ethics and bioethics and how the two topics are received differently in the theological community. It also seeks to illustrate how the premises of Catholic social ethics remain central to public positions taken on bioethics. Keywords: ecclesiology, moral theology, natural law, social ethics CiteULike Connotea Del.icio.us What's this? (shrink)
In the following pages we discuss three historical cases of moral economies in science: Drosophila genetics, late twentieth century American astronomy, and collaborations between American drug companies and medical scientists in the interwar years. An examination of the most striking differences and similarities between these examples, and the conflicts internal to them, reveals constitutive features of moral economies, and the ways in which they are formed, negotiated, and altered. We critically evaluate these three examples through the filters of rational (...) choice, utility, and American pragmatism, using the latter to support the conclusion that there is no single vision of moral economies in science and no single theory—moral, political, social—that will explain them. These filters may not be the only means through which to evaluate the moral economies examined, but aspects of each appear prominent in all three cases. In addition, explanations for decisions are often given in the language of these theories, both at the macro (policy) level and at the local level of the moral economies we discuss. In light of such factors, the use of these frameworks seems justified. We begin with an attempt to define the nature of moral economies, then move to a consideration of scientific communities as moral communities operating within material and other constraints which we relate to wider questions of political economy and societal accountabilities. (shrink)
The relationship between psychological research and the development of socialpolicy is controversial, as is any discussion of the role of values and morals within science. Three particular instances of this controversy are evident in psychological research conducted on affirmative action, child abuse, and abortion. The American Psychological Association (APA) in fact takes a particular organizational stance on these issues. APA's Ethics Code provides some guidelines for dealing with issues of personal values as they impact psychological research and (...) the development of socialpolicy. An important distinction can be made between the issues psychological research can reasonably address using empirical data and the issues about which psychologists should take a stand. Ethical guidelines can help psychologists make this distinction as well as inform their subsequent actions. One pertinent recommendation is that psychologists, when serving in their professional role, should be clear regarding whether empiricism or personal belief is guiding their public statements. (shrink)
For the first time in history, genetics will enable science to completely identify each human as genetically unique. Will this knowledge reinforce the trend for more individual liberties or will it create a ‘brave new world’? A law policy approach to the problems raised by the human genome project shows how far our democratic institutions are from being the proper forum to discuss such issues. Because of the fears and anxiety raised in the population, and also because of its (...) wide implications on the everyday life, the human genome analysis more than any other project needs to succeed in setting up such a social assessment. Keywords: human genome project, judiciary law policy, legislative activity, new ethics institutions, methodology in law reform, public debate, social consensus CiteULike Connotea Del.icio.us What's this? (shrink)
Medical technologies and assistive devices such as ventilators and power wheelchairs are designed to sustain life and/or improve functionality but they can also contribute to stigmatization and social exclusion. In this paper, drawing from a study of ten men with Duchenne muscular dystrophy, we explore the complex social processes that mediate the lives of persons who are dependent on multiple medical and assistive technologies. In doing so we consider the embodied and emplaced (...) nature of disability and how life is lived through bodies coupled with technologies and experienced as 'techno-body-subjects in situ'. Normative implications for theory and research, including bioethics research, are discussed. (shrink)
In bioethics, discussions of justice have tended to focus on questions of fairness in access to health care: is there a right to medical treatment, and how should priorities be set when medical resources are scarce. But health care is only one of many factors that determine the extent to which people live healthy lives, and fairness is not the only consideration in determining whether a health policy is just. In this pathbreaking book, senior bioethicists Powers and (...) Faden confront foundational issues about health and justice. How much inequality in health can a just society tolerate. The audience for the book is scholars and students of bioethics and moral and political philosophy, as well as anyone interested in public health and health policy. (shrink)
Abstract Academic social scientists overwhelmingly vote Democratic, and the Democratic hegemony has increased significantly since 1970. Moreover, the policy preferences of a large sample of the members of the scholarly associations in anthropology, economics, history, legal and political philosophy, political science, and sociology generally bear out conjectures about the correspondence of partisan identification with left/right ideal types; although across the board, both Democratic and Republican academics favor government action more than the ideal types might suggest. Variations in (...) class='Hi'>policy views among Democrats is smaller than among Republicans. Ideological diversity (as judged not only by voting behavior, but by policy views) is by far the greatest within economics. Social scientists who deviate from left?wing views are as likely to be libertarian as conservative. (shrink)
How might social theory, public understanding of science and science policy best inform one another? What have been the key features of science-society relations in the modern world? How are we to re-think science-society relations in the context of globalization, hybridity and changing patterns of governance? This topical and unique book draws together the three key perspectives on science-society relations: public understanding of science, scientific and public governance, and social theory. The book presents a series of case (...) studies (including the debates on genetically modified foods and the AIDS movement in the USA) to discuss critically the ways in which social theorists, social scientists, and science policy makers deal with science-society relations. ‘Science' and 'society' combine in many complex ways. Concepts such as citizenship, expertise, governance, democracy and the public need to be re-thought in the context of contemporary concerns with globalization and hybridity. A radical new approach is developed and the notion of ethno-epistemic assemblage is used to articulate a new series of questions for the theorization, empirical study and politics of science-society relations. (shrink)
It is often assumed that the chief responsibility medical professionals bear is patient care and advocacy. The meeting of other duties, such as ensuring a more just distribution of medical resources and promoting the public good, is not considered a legitimate basis for curtailing or slackening beneficial patient services. It is argued that this assumption is often made without sufficient attention to foundational principles of professional ethics; that once core principles are laid bare this assumption is revealed as (...) largely unwarranted; and, finally, that these observations at the level of moral theory should be reflected, in various ways, in medical practice. Specifically, this essay clarifies a tension that exists between different kinds of moral principles and explores the possibility of dissipating that tension by shoring up foundational principles. The paper begins by setting out three alternative models of how best to balance patient advocacy responsibilities with broader social responsibilities. It then turns to critically assess these models and argue that one has several advantages over the others. (shrink)
Corporate social responsibility (CSR) concerns the realm of business behavior in which the firm tries to effectively manage its business and non-market environment interface. Coerced CSR refers to taking socially responsible action in response to or in anticipation of retaliation in some form (boycott, adverse publicity, introduction of regulatory laws, etc.) from interest groups who are not directly part of the market to which the firm caters. In contrast, strategic CSR or altruistic CSR refers to socially responsible activities undertaken (...) out of enlightened self-interest. The focus of this paper is to understand whether the impact of coercion is different for government-owned organizations and privately owned firms in developing countries. Activities that are in response to or in anticipationof threats by interest groups are identified and compared across publicly and privately owned firms, against the backdrop of weak enforcement of fairly stringent environmental regulation. We then generalize our observations and attempt to distinguish the intensity of pressures felt by public and privately owned firms and their speed of response. As a result of this understanding, we attempt to suggest specific policy mixes for various types of industry, depending on whether they are dominated by the public sector or private sector. (shrink)
Abstract Education in the human rights arena has tended to emphasise, at least in the United States, civil and political rights. Into the next century, this moral educational agenda should be expanded to include more emphasis upon economic, social, and solidarity rights and the notion of the interdependency of human rights, the official position of the UN Human Rights Commission. The Universal Declaration of Human Rights, reaffirmed at the recent World Conference on Human Rights, is the authoritative definition of (...) human rights standards, and increasingly referred to as customary international law. That document should provide an adequate grounding for human rights education, which should facilitate a ?human rights culture?. It is argued here that moral education should not seek ?converts? to the principles of the Declaration, but rather emphasise open discussion and scholarship in order that students choose their values. This expansion in people's consciousness in regard to a comprehensive understanding of human rights principles could directly impact constitutional change, socialpolicy and the fulfilment of human needs. (shrink)
We contend in this paper that the trade union role in socialpolicy is expanding due to the debate on women's issues. The Centrale de l'enseignement du Québec is seen as a forerunner of this trend, with its policy positions on questions previously seen as personal. The method of promotion of these interests is also new, with caucusing and networking. The significance of these changes goes beyond unionized women workers and affects all women.
Corporate socialpolicy can be viewed as three legs of a tripod: efficient production, stable employment, and a social and political environment that promotes high performance of both workers and managers.Socialpolicy process consists of achieving a balance of corporate interest with other interests in the society. Each policy position taken by the firm alters its relationships with all other interests and creates a new balance. This entails the risk of creating unfriendly interests and (...) losing the support of others, depending on the issue and shift in power. (shrink)
This article examines the difficulties encountered in teaching professionalism to medical students in the current social and political climate where economic considerations take top priority in health care decision making. The conflict between the commitment to advocate at all times the interests of one’s patients over one’s own interests is discussed. With personal, institutional, tech industry, pharmaceutical industry, and third-party payer financial imperatives that stand between patients and the delivery of health care, this article investigates how medical (...) ethics instructors are to teach professionalism in a responsible way that does not avoid dealing with the principle of justice. (shrink)
From June 26 to 27, the workshop Ironists, Reformers, or Rebels? The Role of the Social Sciences in Participatory Policy Making took place at the Collegium Helveticum of the UZH/ETH in Zurich. The organisersâ motivation was the apparently missing involvement of social scientists in public engagement processes. This impression persists because, while social scientists often observe public debates or develop participatory methods for public policy-making, they rarely take part in those processes themselves. A closer look (...) at ethics commissions, expert committees or public hearings concerned with science and technology issues shows natural scientists, physicians, lawyers and the occasional philosopher. Sociologists, anthropologists and other social scientists, on the other hand, are often not involved. Because of this imbalance, the organisersâ aim was to bring together scholars and researchers from different areas of the social sciences to consider the role of their disciplines in public policy making. This article will focus on some of the ideas about specific roles of social scientists in participatory policy-making, discussed at the workshop, and their implications and give a commentary on some future prospects of the social sciences. (shrink)
In the present paper some formal aspects of the hypothesis-directed stage of medical diagnosis are studied and an algorithm of the diagnostic problem solving process is described. A given field of medical knowledge is represented by a pair of graphs. The sentences describing observed symptoms and signs constitute the data on which the algorithm is based. In the first step, the set of true judgments is determined and the hypotheses which are impossible in a given situation are (...) rejected. In consequence the model of knowledge is modified and working hypotheses are chosen. Further steps consist in selection of hypotheses in view of testing. The set of expected symptoms is determined and these are classified according to their diagnostic value. The process ends when the conditions of arriving at a useful solution of a given problem are fulfilled. The description of the algorithm is based on a clinical example. The model aims at reflecting some of the most important structural features of the diagnosis and does not embrace the probability evaluation problems. (shrink)
A book for nurses, doctors and all who provide end of life care, this essential volume guides readers through the ethical complexities of such care, including current policy initiatives, and encourages debate and discussion on their controversial aspects. dived into two parts, it introduces and explains clinical decision making-processes about which there is broad consensus, in line with guidance documents issued by WHO, BMA, GMC, and similar bodies. The changing political and social context where 'patient choice' has (...) become a central idea, and the broadened scope of potients' best interests, have added to the complexity of decision-making in end of life care. The authors discuss issues widely encountered by GPs, nurses, and hospital clinicians. These include patient choice, consent, life-prolonging treatment, and symptom relief including sedation. Part rwo explores the more controversial current end of life care initiatives, such as advance care planning preferred place of care and death, euthanais and assited suicide, extended ideas of 'best interests', and the view that there are therapeutic duties to the relatives of Throughout their discussion the authors draw attention to loose ends and contradictions in some of the proposals. Examining the current policy of comsumerist choice, they reject its place in the health service, proposing a a realistic, fair, humane and widely adoptable system of end of life care. -/- As knowledge of ethical theories is required in training courses, and the vocabulary of ethical theory is widespread in current discussions a substantial appendix on ethical theories and terms is available online. -/- Written by the same authors as The Philosophy of Palliative Care: Critique and Reconstruction, which won the Medical Journalists' Association Specialits Book Award 2007, this new book for non-specialists is essential reading for all health care professionals involved in providing end of life care. (shrink)
The argument moves through three stages. In the first, the case is made for accepting ‘living is semiotic engagement’ as ‘a foundational statement for a postfoundational age’. This requires a thoroughgoing rejection of mind-body substance dualism, and a problematisation of humanism. In the second, the hazardous endeavour of applying the above perspective to socialpolicy begins with a consideration of the sine qua non(s) underpinning such an application. These are posited as unpredictability of outcomes and blurring of the (...) human/non-human boundary. In the third stage, the case is developed for a policy orientation that is both liberal-pragmatic (with some caveats relating to ‘liberal’) and post-humanist, and the paper concludes with some speculation concerning the precise policy outcomes of such an orientation. (shrink)
In this article, I wish to suggest that the relationship of social work and socialpolicy to “Truth” is of crucial importance for sound professional practice, and I attempt to substantiate this claim by analyzing and highlighting the very harmful consequences of ignoring, dismissing or distorting this relationship. I will show that these very definite and deleterious consequences inevitably arise as soon as Foucauldian postmodernists attempt to cut the link between professional practice in social work and (...)socialpolicy, and the ongoing quest for the “Truth” of our humanity. I then suggest that if Foucault, taken as representative of contemporary postmodernism, is the “problem,” then the solution lies in the work of a theorist such as Bosanquet, taken as representative of traditional social philosophy and political theory. I conclude with an investigation into the role of what I call “ethico-political consciousness” in both the civic and professional pursuit of Truth in social life. (shrink)
Medical explanations of socially maladaptive behaviors most often involve an appeal to neuro-physiological models. One consequence of the appeal to such models is a lack of attention to the social character of the behaviors. It is, I argue, the social character of the behaviors that, even accepting a neuro-physiological etiology, makes classification and, hence, explanation of these disorders controversial and suspect. At the heart of the problem is the difficulty, resulting from the socialaspects of (...) the disorder, in fulfilling the logical conditions of the analogical arguments employed in the explanations. The theoretical points of the paper are illustrated by a discussion of hyperactivity. CiteULike Connotea Del.icio.us What's this? (shrink)
The overall question addressed in this article is, ‘What kind of philosophy of education is relevant to educational policy makers?’ The article focuses on the following four themes: The meanings attached to the term philosophy (of education) by philosophers themselves; the meanings attached to the term philosophy (of education) by policy makers; the difference place and time makes to these meanings; how these different meanings affect the possibility of philosophy (of education) influencing policy. The question is addressed (...) using philosophical methods and empirical evidence from conversations and conversational interviews with some philosophers of education and other educational researchers. The argument begins with an investigation of different ways of understanding philosophy and philosophy of education in relation to education and educational policy. It then examines first the current policy context and secondly some evidence about the practices of policy makers in relation to ideas and to research. It goes on to present some of the findings from the conversational evidence. The article is drawn together in the penultimate section where I make some suggestions about possible fruitful relationships between doing philosophy and policy making. Finally, in the concluding section, some further—thorny—questions are raised by the analysis, especially in relationship to ethics and social justice. (shrink)
In Epistemic injustice, Miranda Fricker employs the critical concept of hermeneutical injustice. Such injustice entails unequal participation in the epistemic practices of a community that often results in an inability of dominated subjects to understand their own experiences and have them understood by their community. I argue that hermeneutical injustice can be an aspect of institutions as well communites?to the extent that they too engage in epistemic practices that seek to understand the problems and experiences of their constituents. My primary (...) example is the case of development theory and international development agencies where human beings were objectified in undesirable ways by the prevailing neoliberal economic theories that guided development practice. Here economic theory and the power to achieve its vision of unconstrained economic growth were combined in various organizations. Consequently such organizations systematically misunderstood the problems of the very people they were supposed to help. I argue that if hermeneutical injustice can be the result of the intersection of science and organizations, we need to create more participatory ways of gleaning information about social ills to alleviate institutionally mediated hermeneutical injustice. (shrink)
The third edition of this popular book has been updated to take account of the latest developments in policy and social work practice. It includes new sections on radical/emancipatory and postmodern approaches to ethics, analysis of the latest codes of ethics from over 30 different countries, additional case studies of ethical problems and dilemmas, practical exercises, and annotated further reading lists at the end of each chapter.
The Dynamics of Social Practice -- Introducing Theories of Practice -- Materials and Resources -- Sequence and Structure -- Making and Breaking Links -- Material, Competence and Meaning -- Car-Driving: Elements and Linkages Making Links -- Breaking Links -- Elements Between Practices -- Standardization and Diversity -- Individual and Collective Careers -- The Life of Elements -- Modes of Circulation -- Transportation and Access: Material -- Abstraction, Reversal and Migration: Competence -- Association and Classification: Meaning -- Packing and Unpacking (...) -- Emergence, Disappearance and Persistence -- Recruitment, Defection and Reproduction -- First Encounters: Networks and Communities -- Capture and Commitment: Careers and Carriers -- Collapse and Transformation: The Dynamics of Defection -- Daily Paths, Life Paths and Dominant Projects -- Connections Between Practices -- Bundles and Complexes -- Collaboration and Competition -- Selection and Integration -- Coordinating Daily Life -- Circuits of Reproduction -- Monitoring Practices-as-Performances -- Monitoring Practices-as-Entities -- Cross-Referencing Practices-as-Performances -- Cross-Referencing Practices-as-Entities -- Aggregation -- Elements of Coordination -- Intersecting Circuits -- Representing the Dynamics of Social Practice -- Representing Elements and Practices -- Characterizing Circulation -- Competition, Transformation and Convergence -- Reproducing Elements, Practices and Relations between Them -- Time and Practice -- Space and Practice -- Dominant Projects and Power -- Promoting Transitions in Practice -- Climate Change and Behaviour Change -- Basis of Action -- Processes of Change -- Positioning Policy -- Transferable Lessons -- Practice Theory and Climate Change Policy -- Configuring Elements of Practice -- Configuring Relations between Practices -- Configuring Careers: Carriers and Practices -- Configuring Connections -- Practice Oriented Policy Making. (shrink)
