Unable to answer the call of our patients: mental health nurses’ experience of moral distress When health practitioners’ moral choices and actions are thwarted by constraints, they may respond with feelings of moral distress. In a Canadian hermeneutic phenomenological study, physicians, nurses, psychologists and non‐professional aides were asked to identify care situations that they found morally distressing, and to elaborate on how moral concerns regarding the care of patients were raised and resolved. In this paper, we describe the experience of (...) moral distress related by nurses working in mental healthcare settings who believed that lack of resources (such as time and staff) leads to dispiritedness, lack of respect, and absence of recognition (for both patients and staff) which severely diminished their ability to provide quality care. The metaphors of flashlight and hammer are used to elaborate nurses’ possible responses to intolerable situations. (shrink)

In this article, the theme of introductory engagement is developed through the conversational interviews and participatory observations I carried out with perinatal nurses and birthing women in the context of a feminist phenomenological methodology. Positioned against the landscape of hierarchical health care practices embedded with power dynamics and disembodied practices, this research explored the ways in which perinatal nurses related to birthing women in the context of relational care. The focus of attention in this article is to describe the theme (...) of introductory engagement by way of a storied phenomenological text. (shrink)

An understanding of autonomy has important significance in North American health care. Although a respect for autonomy is necessary to protect the self-determination and agency of birthing women in hospital settings, I suggest that enactments of autonomy that are independent of relationships offer only an incomplete interpretation of such a vital concept. In this article I explore an understanding of autonomy situated within the context of a relational birthing narrative. In so doing, autonomy becomes conceptualized as contextual and concrete, giving (...) rise to an embodied view of the birthing woman. (shrink)

Phenomenological interviews with queer women in rural Nova Scotia reveal significant forms of trauma experienced during labour and birth. Situating the accounts of participants within both phenomenological and intersectional analyses reveals harms enabled by structurally embedded heteronormative and homophobic healthcare practices and policies. Our account illustrates the breadth and depth of harm experienced and outlines how these violate core ethical principles and values in healthcare.

Aims and objectives. Participant narratives from a feminist and queer phe- nomenological study aim to broaden current understandings of trauma. Examin- ing structural marginalisation within perinatal care relationships provides insights into the impact of dominant models of care on queer birthing women. More specifically, validation of queer experience as a key finding from the study offers trauma-informed strategies that reconstruct formerly disempowering perinatal relationships. Background. Heteronormativity governs birthing spaces and presents considerable challenges for queer birthing women who may also have (...) an increased risk of trauma due to structurally marginalising processes that create and maintain socially constructed differences. Design. Analysis of the qualitative data was guided by feminist and queer phe- nomenology. This was well suited to understanding queer women’s storied narra- tives of trauma, including disempowering processes of structural marginalisation. Methods. Semistructured and conversational interviews were conducted with a purposeful sample of thirteen queer-identified women who had experiences of birthing in rural Nova Scotia, Canada. Results. Validation was identified as meaningful for queer women in the context of perinatal care in rural Nova Scotia. Offering new perspectives on traditional models of assessment provide strategies to create a context of care that recon- structs the birthing space insofar as women at risk do not have to come out as queer in opposition to the expectation of heterosexuality. Conclusions. Normative practices were found to further the effects of structural marginalisation suggesting that perinatal care providers, including nurses, can challenge dominant models of care and reconstruct the relationality between queer women and formerly disempowering expectations of heteronormativity that govern birthing spaces. Relevance to clinical practice. New trauma-informed assessment strategies recon- struct the relationality within historically disempowering perinatal relationships through potentiating difference which avoids retraumatising women with re- experiencing the process of coming out as queer in opposition to the expectation of heterosexuality. (shrink)

The following Acknowledgments were omitted in the original publication.

This paper draws on findings from qualitative interviews with queer and trans patients and with physicians providing care to queer and trans patients in Halifax, Nova Scotia, Canada, to explore how routine practices of health care can perpetuate or challenge the marginalization of queers. One of the most common “measures” of improved cultural competence in health care practice is self-reported increases in confidence and comfort, though it seems unlikely that an increase in physician comfort levels with queer and trans patients (...) will necessarily mean better health care for queers. More attention to current felt discomfort in patient–provider encounters is required. Policies and practices that avoid discomfort at all costs are not always helpful for care, and experiences of shared discomfort in queer health contexts are not always harmful. (shrink)

In the first of a trilogy of articles published in the New England Journal of Medicine in May 2015, physician–journalist Lisa Rosenbaum observes that the crucial question regarding conflicts of interest between physicians and commercial industry is the extent to which interactions between the two are “beneficial or harmful to patients?”. She goes on to note that the answer to this question “depends on how you define harm,”1 and argues that many of the claims of harm flowing from COI (...) are incomplete, insufficient, or are based on “suggestive extrapolations from data”. If there are benefits to be gained from physician–industry relationships, and if the evidence... (shrink)

Prolonged solitary confinement has become a widespread and standard practice in U.S. prisons—even though it consistently drives healthy prisoners insane, makes the mentally ill sicker, and, according to the testimony of prisoners, threatens to reduce life to a living death. In this profoundly important and original book, Lisa Guenther examines the death-in-life experience of solitary confinement in America from the early nineteenth century to today’s supermax prisons. Documenting how solitary confinement undermines prisoners’ sense of identity and their ability to (...) understand the world, Guenther demonstrates the real effects of forcibly isolating a person for weeks, months, or years. -/- Drawing on the testimony of prisoners and the work of philosophers and social activists from Edmund Husserl and Maurice Merleau-Ponty to Frantz Fanon and Angela Davis, the author defines solitary confinement as a kind of social death. It argues that isolation exposes the relational structure of being by showing what happens when that structure is abused—when prisoners are deprived of the concrete relations with others on which our existence as sense-making creatures depends. Solitary confinement is beyond a form of racial or political violence; it is an assault on being. (shrink)

Sexual dimorphism, symmetry, and coloration in human faces putatively signal information relevant to mate selection and reproduction. Although the independent contributions of these characteristics to judgments of attractiveness are well established, relatively few studies have examined whether individuals prioritize certain features over others. Here, participants (N = 542, 315 female) ranked six sets of facial photographs (3 male, 3 female) by their preference for starting long- and short-term romantic relationships with each person depicted. Composite-based digital transformations were applied such that (...) each image set contained 11 different versions of the same identity. Each photograph in each image set had a unique combination of three traits: sexual dimorphism, symmetry, and color cues to health. Using conjoint analysis to evaluate participants’ ranking decisions, we found that participants prioritized cues to sexual dimorphism over symmetry and color cues to health. Sexual dimorphism was also found to be relatively more important for the evaluation of male faces than for female faces, whereas symmetry and color cues to health were relatively more important for the evaluation of female faces than for male faces. Symmetry and color cues to health were more important for long-term versus short-term evaluations for female faces, but not male faces. Analyses of utility estimates reveal that our data are consistent with research showing that preferences for facial masculinity and femininity in male and female faces vary according to relationship context. These findings are interpreted in the context of previous work examining the influence of these facial attributes on romantic partner perception. (shrink)

The Gift of the Other brings together a philosophical analysis of time, embodiment, and ethical responsibility with a feminist critique of the way women’s reproductive capacity has been theorized and represented in Western culture. Author Lisa Guenther develops the ethical and temporal implications of understanding birth as the gift of the Other, a gift which makes existence possible, and already orients this existence toward a radical responsibility for Others. Through an engagement with the work of Levinas, Beauvoir, Arendt, Irigaray, (...) and Kristeva, the author outlines an ethics of maternity based on the givenness of existence and a feminist politics of motherhood which critiques the exploitation of maternal generosity. (shrink)

An outstanding reference source for the wide range of philosophical contributions made by women writing in Europe from about 1560 to 1780. It shows the range of genres and methods used by women writing in these centuries in Europe, thus encouraging an expanded understanding of our historical canon.

Between the years 1643 and 1649, Princess Elisabeth of Bohemia and René Descartes exchanged fifty-eight letters—thirty-two from Descartes and twenty-six from Elisabeth. Their correspondence contains the only known extant philosophical writings by Elisabeth, revealing her mastery of metaphysics, analytic geometry, and moral philosophy, as well as her keen interest in natural philosophy. The letters are essential reading for anyone interested in Descartes’s philosophy, in particular his account of the human being as a union of mind and body, as well as (...) his ethics. They also provide a unique insight into the character of their authors and the way ideas develop through intellectual collaboration. Philosophers have long been familiar with Descartes’s side of the correspondence. Now Elisabeth’s letters—never before available in translation in their entirety—emerge this volume, adding much-needed context and depth both to Descartes’s ideas and the legacy of the princess. Lisa Shapiro’s annotated edition—which also includes Elisabeth’s correspondence with the Quakers William Penn and Robert Barclay—will be heralded by students of philosophy, feminist theorists, and historians of the early modern period. (shrink)

Increased attention paid to inter-group genetic variability following completion of the Human Genome Project has provoked debate about race as a category of classification in biomedicine and as a biological phenomenon at the level of the genome. Philosophers of science favor a metaphysical approach relying on natural kind theorizing, the underlying assumptions of which structure the questions asked. Limitations arise the more metaphysically invested and less attuned to scientific practice these questions are. Other questions—arguably, those that matter most socially and (...) politically—remain unasked, not merely overlooked but systematically ignored and even foreclosed. Race fails as a postulated natural kind because it fails to meet expectations that as a category of classification it furnish an authoritative taxonomy that by depicting fundamental divisions in nature is conducive to fulfilling far-ranging explanatory aims. Racial, ethnic, and other group designations may nonetheless be projectible insofar as they support inductive inferences in biomedicine, but this does not render them any less social. Indeed, the statistical, contingent, accidental, localized, and interest-relative bases of such inferences serve to undercut the dichotomizing of race as either biological reality or social construct and favor the adoption of a pragmatic approach. (shrink)

The use of ‘race’ as a proxy for population structure in the genetic mapping of complex traits has provoked controversy about its legitimacy as a category for biomedical research, given its social and political connotations. The controversy has reignited debates among scientists and philosophers of science about whether there is a legitimate biological concept of race. This paper examines the genetic race concept as it developed historically in the work of Theodosius Dobzhansky from the 1930s to 1950s. Dobzhansky’s definitions of (...) race changed over this time from races as ‘arrays of forms’ or ‘clusters’ in 1933–1939, to races as genetically distinct geographical populations in 1940–1946, to races as genetically distinct ‘Mendelian populations’ in 1947–1955. Dobzhansky responded to nominalist challenges by appealing to the biological reality of race as a process. This response came into tension with the object ontology of race that was implied by Dobzhansky’s increasingly holistic treatment of Mendelian populations, a tension, the paper argues, he failed to appreciate or resolve. (shrink)

At least below the level of species, biological populations are not mind‐independent objects that scientists discover. Rather, biological populations are pragmatically constructed as objects of investigation according to the aims, interests, and values that inform particular research contexts. The relations among organisms that are constitutive of population‐level phenomena (e.g., mating propensity, genealogy, and competition) occur as matters of degree and so give rise to statistically defined open‐ended biological systems. These systems are rendered discrete units to satisfy practical needs and theoretical (...) preferences associated with specific contexts of investigation. While it may be possible to defend a realist position regarding biological relations among organisms, biological populations are “made” when contextual features determine which kinds and degrees of relations to privilege over others, and so how to bound genes in space and time. Consequently, the objectivity of population‐based approaches to species genome diversity cannot rest in the mind‐independence of populations themselves. (shrink)

A consensus view appears to prevail among academics from diverse disciplines that biological races do not exist, at least in humans, and that race -concepts and race -objects are socially constructed. The consensus view has been challenged recently by Robin O. Andreasen's cladistic account of biological race. This paper argues that from a scientific viewpoint there are methodological, empirical, and conceptual problems with Andreasen's position, and that from a philosophical perspective Andreasen's adherence to rigid dichotomies between science and society, facts (...) and values, nature and culture, and the biological and the social needs to be relinquished. DNA forensics is just one field of research that reveals how race remains both idea and object for human population biologists, an indication that it is premature to accept the existence of a no- race consensus across the disciplines. DNA forensics research also demonstrates ways in which race is reified by scientists by the representation of what is cultural or social as natural or biological, and of what is dynamic, relative, and continuous as static, absolute, and discrete. The philosophical analysis of foundational concepts of human population biology such as population, race, and ethnic group is best served by foregoing traditional objectivist approaches for a critical stance that recognises the inextricability of the biological and the social. Introduction Consensus view: biological races do not exist Andreasen's defence of the biological reality of races as clades Biological permutations of race Conclusion. (shrink)

Bioethics increasingly recognizes the impact of discriminatory practices based on social categories such as race, gender, sexual orientation or ability on clinical practice. Accordingly, major bioethics associations have stressed that identifying and countering structural discrimination in clinical ethics consultations is a professional obligation of clinical ethics consultants. Yet, it is still unclear how clinical ethics consultants can fulfill this obligation. More specifically, clinical ethics needs both theoretical tools to analyze and practical strategies to address structural discrimination within clinical ethics consultations. (...) Intersectionality, a concept developed in Black feminist scholarship, is increasingly considered in bioethical theory. It stresses how social structures and practices determine social positions of privilege and disadvantage in multiple, mutually co-constitutive systems of oppression. This article aims to investigate how intersectionality can contribute to addressing structural discrimination in clinical ethics consultations with a particular focus on mental healthcare. To this end, we critically review existing approaches for clinical ethics consultants to address structural racism in clinical ethics consultations and extend them by intersectional considerations. We argue that intersectionality is a suitable tool to address structural discrimination within clinical ethics consultations and show that it can be practically implemented in two complementary ways: 1) as an analytic approach and 2) as a critical practice. (shrink)

This paper questions the prevailing historical understanding that scientific racism "retreated" in the 1950s when anthropology adopted the concepts and methods of population genetics and race was recognized to be a social construct and replaced by the concept of population. More accurately, a "populational" concept of race was substituted for a "typological one"-this is demonstrated by looking at the work of Theodosius Dobzhansky circa 1950. The potential for contemporary research in human population genetics to contribute to racism needs to be (...) considered with respect to the ability of the typological-population distinction to arbitrate boundaries between racist society and nonracist, even anti-racist, science. I point out some ethical limits of "population thinking" in doing so. (shrink)

Comics can be ordered in a range of ways, most overtly by issue number for works within a series, and by page number for pages within works. The internal elements of a comic can also be ordered by formal details found within pages. We identify four kinds of formal details specific to comics pages or two-page spreads: how their elements are arranged, how they are viewed, what events they represent, and when information about those events is presented.

Zoos and aquariums have an enormous global reach and hence an ability to craft meaningful conservation action for threatened species, implement educational strategies to encourage human engagement, development and behavior change, and conduct scientific research to enhance the husbandry, roles and impacts of the living collection. The recreational role of the zoo is also vast- people enjoy visiting the zoo and this is often a shared experience amongst family and friends. Evaluating how the zoo influences this “captive audience” and extending (...) its reach to include a compassionate approach to animals and people can further enhance the mission, value, and relevance of their work. The modern zoo’s current aims—Conservation, Education, Research and Recreation—provide useful foundations for the activities that zoos conduct at a local and national level. However, to improve sustainability of their actions and outcomes, we feel that Wellbeing should become the fifth aim of the modern zoo for the future- both from an animal perspective and from a human perspective. This paper provides discussion and review of how Wellbeing is already a substantial part of what zoos work on as well as posing the idea of altering the Recreation aim of the zoo to one of Engagement, which potentially is more measurable and therefore can allow zoo researchers and managers further options for the collection of evidence on the local and global reach of their zoo’s aims. Education, Engagement, Conservation, Research and Wellbeing provide a more complete picture of the roles of the modern zoo for the animals, human visitors and workforce, and to society more widely. (shrink)

This commentary responds to Moti Gorin's article “What Is the Aim of Pediatric ‘Gender‐Affirming’ Care?” We argue that Gorin's case against pediatric gender‐affirming care rests upon numerous false conceptual binaries: female/male, public/private, objective/subjective, and medically necessary/elective. Drawing on feminist bioethics, we show how such dichotomous thinking is both inaccurate and marginalizing of gender minorities.

The name Erasmus of Rotterdam conjures up a golden age of scholarly integrity and the disinterested pursuit of knowledge, when learning could command public admiration without the need for authorial self-promotion. Lisa Jardine, however, shows that Erasmus self-consciously created his own reputation as the central figure of the European intellectual world. Erasmus himself—the historical as opposed to the figural individual—was a brilliant, maverick innovator, who achieved little formal academic recognition in his own lifetime. What Jardine offers here is not (...) only a fascinating study of Erasmus but also a bold account of a key moment in Western history, a time when it first became possible to believe in the existence of something that could be designated "European thought.". (shrink)

Journal of Religious Ethics, Volume 50, Issue 1, Page 7-19, March 2022.

A critically revised Aristotelian-based virtue ethics has something potentially useful to offer to those engaged in analyzing oppression and creating liberatory projects. A critical virtue ethics can help clarify one of the ways in which oppression interferes with flourishing; specifically, it helps clarify an aspect of oppression that can be called "moral damage.".

The scarcity of women’s writings in antiquity presents an intractable problem for feminists intending to integrate women’s perspectives into the existing philosophical canon. One way to undo the erasure of women is for feminists to look to the east; in China, there is an abundance of well-preserved women’s writings, along with their biographical records, as early as the 6th century BCE. This essay will provide a survey of those women’s records, focusing on the 6th century BCE to the 4th century (...) CE, as a way to reimagine the discipline of Philosophy and its canon. (shrink)

Journal of Social Philosophy, EarlyView.

The notion of optimality is often invoked informally in the literature on metacognitive control. We provide a precise formulation of the optimization problem and show that optimal time allocation strategies depend critically on certain characteristics of the learning environment, such as the extent of time pressure, and the nature of the uptake function. When the learning curve is concave, optimality requires that items at lower levels of initial competence be allocated greater time. On the other hand, with logistic learning curves, (...) optimal allocations vary with time availability in complex and surprising ways. Hence there are conditions under which optimal strategies will be relatively easy to uncover, and others in which suboptimal time allocation might be expected. The model can therefore be used to address the question of whether and when learners should be able to exercise good metacognitive control in practice. (shrink)

: Humility is a virtue that is helpful in a persons relationship with nature. A humble person sees value in nature and acts accordingly with the proper respect. In this paper, humility is discussed in three aspects. First, humility entails an overcoming of self-absorption. Second, humility involves coming into contact with a larger, more complex reality. Third, humility allows a person to develop a sense of perspective on herself and the world.

Lisa Tessman’s Moral Failure: On the Impossible Demands of Morality raises important questions about ideal theory, oppression, and the role of action guidance in normative philosophy. After a brief overview of feminist and anti-racist philosophers’ critiques of ideal theory, I examine Tessman’s claim that nonideal oppression theorists focus too narrowly on action guidance and thereby obscure other important normative issues, such as the problem of moral failure. Although I agree with Tessman’s advocacy of a wider focus—and with her suggestion (...) that situations of inevitable moral failure are particularly important to examine in contexts of oppression—I question whether nonideal oppression theorists actually emphasize action guidance to the exclusion of other concerns. I conclude with a brief examination of the way that ideal and nonideal theory have been defined and understood in debates about normative methodology, and I suggest that a move away from Rawls’s account of the ideal/nonideal distinction would benefit feminists and other oppression theorists. (shrink)

This essay explores some well-traveled territory—the area in which eating and suffering come together. I undertake two projects. First, I scrutinize some foods that are often portrayed as unambiguously either good (homegrown organic vegetables) or bad (foie gras), in an effort to complicate the stories we tell about them. What violence has been heretofore invisible in them? What compassion has been occluded? This project informs a second: an answer to the question “how should we eat?” My answer takes up Kelly (...) Oliver’s call for an ethics of “sustaining relationships.” I ground it in an alternative ontology of food, one that views foods not as substances, but as loci of relations. (shrink)

This paper is an exploration of the vice of misanthropy particularly as it manifests itself in people who love nature. Misanthropy is a hatred and disgust of humans, particularly of a group of humans. I look to wilderness to illustrate the vice of misanthropy. With regard to wilderness, misanthropy functions in three distinct spheres. First, there is misanthropy in the use of wilderness to flee other people. Second, there is misanthropy in the assumption that humans taint the wilderness. Finally, there (...) is misanthropy in the assumption that humans can only relate to nature in a way that is harmful. In the end, we need to avoid misanthropy and its attendant despair. It is important that we see ourselves, not as a determined mass of people, but rather as individual people who are able to create positive change. (shrink)

In this article we propose a philosophical critique of two general, but not exhaustive, approaches to gender studies in sport, namely gynocentric feminism and humanist feminism. We argue that both approaches are problematic because they fail clearly to distinguish or articulate their epistemological and ideological commitments. In particular, humanist feminists articulate the human condition using the sex/gender dichotomy, which fails to account adequately for gendered subjectivity. For them gender difference is a contingent feature of humanity developed through socialisation. As a (...) result, it seems that what humanist feminists regard as women in their natural ?state? is in itself ideological. The generic ?human? condition is by no means a neutral condition but rather an idea tarnished by gender history characterised by the masculine. Consequently, humanist feminists uncritically argue for inclusion in sport, with access to an equal share of the human goods available, without carefully problematising the ideological nature of the practice. Gynocentric feminists also subscribe to the sex/gender dichotomy, suggesting however, that gender subjectivity is the result of a biological imperative. For gynocentric feminists, sexual difference provides authority for adjudicating between a separate and different male and female epistemology. Accordingly, gynocentric feminists commit the genetic fallacy by condemning sport to a masculine activity and therefore incompatible with feminine value in light of its male ancestry. ?Soft? gynocentrism does not fully sanction a conception of sport which allows only traditionally female values to flourish, or at least the reason for celebrating such sports would focus upon the goods and values therein. In other words, the value of the practice for either men or women is to be found, following MacIntyre (1985), in the internal goods that characterise the particular practice. Such internal goods are, as MacIntyre argues, goods of the practice and do not belong to any particular gender or group. (shrink)