A Professor of Medical Ethics and a theatre director, also mother and daughter, talk about health, illness, suffering, performance and practice. Using the lenses of ethical and performance theory, they explore what it means to be a patient, a spectator and a practitioner and cover many plays, texts and productions: Samuel Beckett’s Not I and All That Fall, Sarah Kane’s Crave, Tim Crouch’s An Oak Tree, Enda Walsh’s Ballyturk, Annie Ryan’s adaptation of Eimear McBride’s novel A Girl Is a Half-Formed (...) Thing, Duncan MacMillan’s People, Place and Things and Henrik Ibsen’s Hedda Gabler. These were selected because first we have seen, studied or worked with each and they have continued to inspire us. Second, they offer rich and revealing insights into the ways in which meaning is/are both negotiated and contested in relation to health and illness. It is the iterative negotiation of meaning that, it is argued, is the essence of narrative practice, be it in medicine or in the theatre. The difference and divergence of perception, response and interpretation to dramatic performance can test relationships, be they professional, creative or familial. Yet, the capacity to understand, and embrace, disagreement and uncertainty is vital; fundamental to a flourishing life. For it is by recognising our part in creating narratives, broken and otherwise, that we can begin to recognise the necessary interactionism and humanity of both medicine and theatre. (shrink)

The process of seeking the consent of a patient to a medical procedure is, arguably, one of the most important skills a doctor, or indeed any clinician, should learn. In fact, the very idea that doctors may institute diagnostic or treatment processes of any sort without a patient's consent is utterly counter-intuitive to the modern practice of medicine. It was not always thus, and even now it can be reliably assumed that consent is still not sought and gained appropriately in (...) every clinical encounter. To say that it should be sought and gained in this manner elevates the value of consent to a high level. It can be instructive to ask oneself why such a value might be held to be the case. The answer to this question lies in the philosophical underpinning of clinical consent, which sits within a notion of personal autonomy, and respect for autonomous decision making. (shrink)

This discussion paper considers how seldom recognised theories influence clinical ethics committees. A companion paper examined four major theories in social science: positivism, interpretivism, critical theory and functionalism, which can encourage legalistic ethics theories or practical living bioethics, which aims for theory–practice congruence. This paper develops the legalistic or living bioethics themes by relating the four theories to clinical ethics committee members’ reported aims and practices and approaches towards efficiency, power, intimidation, justice, equality and children’s interests and rights. Different approaches (...) to framing ethical questions are also considered. Being aware of the four theories’ influence can help when seeking to understand and possibly change clinical ethics committee routines. The paper is not a research report but is informed by a recent study in two London paediatric cardiac units. Forty-five practitioners and related experts were interviewed, including eight members of ethics committees, about the work of informing, preparing and supporting families during the extended process of consent to children’s elective heart surgery. The mosaic of multidisciplinary teamwork is reported in a series of papers about each profession, including this one on bioethics and law and clinical ethics committees’ influence on clinical practice. The qualitative social research was funded by the British Heart Foundation, in order that more may be known about the perioperative views and needs of all concerned. Questions included how disputes can be avoided, how high ethical standards and respectful cooperation between staff and families can be encouraged, and how minors’ consent or refusal may be respected, with the support of clinical ethics committees. (shrink)

This paper discusses the character of medical ethics and suggests that there are significant gaps that warrant greater attention. It describes ways in which the content and form of medical ethics may exclude or marginalise perspectives and contributions, thereby reducing its influence and its potential impact on, and value to, patients, students, carers and society. To consider what it is ‘to do good medical ethics’ suggests an active approach that seeks out, and learns from, contributions beyond the traditional boundaries of (...) scholarship. (shrink)

Trust is frequently discussed with reference to the professional–patient relationship. However, trust is less explored in relation to the ways in which understanding of, and responses to, questions of ethics are discussed by both the “public” and “experts.” Public engagement activity in healthcare ethics may invoke “trust” in analysing a moral question or problem but less frequently conceives of trust as integral to “public engagement” itself. This paper explores the relationship between trust and the ways in which questions of healthcare (...) ethics are identified and negotiated by both “experts” and the public. Drawing on two examples from the author’s “public engagement” work—a radio programme for the British Broadcasting Corporation and work with a playwright and theatre—the paper interrogates the ways in which “public engagement” is often characterized. The author argues that the common approach to public engagement in questions of ethics is unhelpfully constrained by a systemic disposition which continues to privilege the professional or expert voice at the expense of meaningful exchange and dialogue. By creating space for novel interactions between the “expert” and the “public,” authentic engagement is achieved that enables not only the participants to flourish but also contributes to trust itself. (shrink)

Background This analysis is about practical living bioethics and how law, ethics and sociology understand and respect children’s consent to, or refusal of, elective heart surgery. Analysis of underlying theories and influences will contrast legalistic bioethics with living bioethics. In-depth philosophical analysis compares social science traditions of positivism, interpretivism, critical theory and functionalism and applies them to bioethics and childhood, to examine how living bioethics may be encouraged or discouraged. Illustrative examples are drawn from research interviews and observations in two (...) London paediatric cardiac units. This paper is one of a series on how the multidisciplinary cardiac team members all contribute to the complex mosaic of care when preparing and supporting families’ informed consent to surgery. Results The living bioethics of justice, care and respect for children and their consent depends on theories and practices, contexts and relationships. These can all be undermined by unseen influences: the history of adult-centric ethics; developmental psychology theories; legal and financial pressures that require consent to be defined as an adult contract; management systems and daily routines in healthcare that can intimidate families and staff; social inequalities. Mainstream theories in the clinical ethics literature markedly differ from the living bioethics in clinical practices. Conclusion We aim to contribute to raising standards of respectful paediatric bioethics and to showing the relevance of virtue and feminist ethics, childhood studies and children’s rights. (shrink)

Motivational enhancement in sport – a form of ‘neuro-doping’ – can help athletes attain greater achievements in sport. A key question is whether or not that athlete deserves that achievement. We distinguish three concepts – praiseworthiness, prizeworthiness, and admiration – which are closely related. However, in sport, they can come apart. The most praiseworthy athlete may not be the most prizeworthy, and so on. Using a model of praiseworthiness as costly commitment to a valuable end, and situating prizeworthiness within the (...) boundaries of the sport, we argue that motivational enhancement in some cases can be compatible with desert. (shrink)

This study presents a sociological profile of Peruvian female industrialists and some narratives of their struggle for personal independence and entrepreneurial success within the context of global restructuring and local deindustrialization. The study adopts the classical definition of woman's economic independence as a result of women's participation in the world of paid labor.

The Well-Ordered Universe argues that Cavendish's natural philosophy, social and political philosophy, and medical theory share an underlying concern with order. This reveals interesting connections among Cavendish's natural philosophy and her views on gender, animals and the environment, and human health, and explains her commitment to monarchy and social hierarchy.

This essay explores the viability of theologies of nonviolent peacebuilding through reflection on constructive agents under duress. John Howard Yoder’s messianic theology was once a default model of peacebuilding in Christian ethics, but he mixes eschatologies, with problematic results. This essay extends insights from participant observation in Colombia to suggest that if we relate distinct accounts of messianic and gradual eschatologies without mixing them, we articulate a relationship between church and state that is fruitful for theological peacebuilding. This relationship is (...) best described as an interplay that allows for transformative displacement. (shrink)

In the social sciences and in everyday speech we often talk about groups as if they behaved in the same way as individuals, thinking and acting as a singular being. We say for example that "Google intends to develop an automated car", "the U.S. Government believes that Syria has used chemical weapons on its people", or that "the NRA wants to protect the rights of gun owners". We also often ascribe legal and moral responsibility to groups. But could groups literally (...) intend things? Is there such a thing as a collective mind? If so, should groups be held morally responsible? Such questions are of vital importance to our understanding of the social world. In this lively, engaging introduction Deborah Tollefsen offers a careful survey of contemporary philosophers? answers to these questions, and argues for the unorthodox view that certain groups should, indeed, be treated as agents and deserve to be held morally accountable. Tollefsen explores the nature of belief, action and intention, and shows the reader how a belief in group agency can be reconciled with our understanding of individual agency and accountability. _Groups as Agents_ will be a vital resource for scholars as well as for students of philosophy and the social sciences encountering the topic for the first time. (shrink)

Decades before the environmental movement emerged in the 1960s, Adorno condemned our destructive and self-destructive relationship to the natural world, warning of the catastrophe that may result if we continue to treat nature as an object that exists exclusively for our own benefit. "Adorno on Nature" presents the first detailed examination of the pivotal role of the idea of natural history in Adorno's work. A comparison of Adorno's concerns with those of key ecological theorists - social ecologist Murray Bookchin, ecofeminist (...) Carolyn Merchant, and deep ecologist Arne Naess - reveals how Adorno speaks directly to many of today's most pressing environmental issues. Ending with a discussion of the philosophical conundrum of unity in diversity, "Adorno on Nature" also explores how social solidarity can be promoted as a necessary means of confronting environmental problems. (shrink)

The seventeenth century was a period of extraordinary invention, discovery and revolutions in scientific, social and political orders. It was a time of expansive automation, biological discovery, rapid advances in medical knowledge, of animal trials and a questioning of the boundaries between species, human and non-human, between social classes, and of the assumed naturalness of political inequality. This book gives a tour through those objects, ordinary and extraordinary, which captivated the philosophical imagination of the single most important French philosopher of (...) this period, Rene Descartes. Deborah J. Brown and Calvin G. Normore document Descartes' attempt to make sense of the complex, composite objects of human and divine invention, consistent with the fundamental tenets of his metaphysical system. Their central argument is that, far from reducing all the categories of ordinary experience to the two basic categories of substance, mind and body, Descartes' philosophy recognises irreducible composites that resist reduction, and require their own distinctive modes of explanation. (shrink)

Este artículo intenta desarrollar una deducción del concepto de sumo bien kantiano: esto es, intenta demostrar, de acuerdo con la interpretación de Dieter Henrich acerca de la deducción, que el sumo bien es un fin a la vez que un deber. Apelo a los rasgos de la razón práctica que constituyen la legitimidad de los hechos, la premisa que cualquier deducción debe tener. De acuerdo con Kant, el sumo bien consiste en la felicidad, la virtud y sus relaciones de proporcionalidad (...) y causalidad, tal que la felicidad es proporcional a, y causada por, la virtud. Sostengo, utilizando las nociones kantianas aceptadas, que Kant tiene razones convincentes para concluir que el sumo bien es, de hecho, un fin a la vez que un deber. Si esto es correcto, entonces este argumento ofrece la deducción prometida en mi título. This paper attempts a deduction of Kant's concept of the highest good: that is, it attempts to prove, in accordance with Dieter Henrich's interpretation of the notion of deduction, that the highest good is an end that is also a duty. It does this by appealing to features of practical reason that make up the legitimating facts that serve as the premises that any deduction must possess. According to Kant, the highest good consists of happiness, virtue, and relations of proportionality and causationbetween happiness and virtue, such that happiness is proportional to and caused by virtue. I argue, by drawing on accepted Kantian notions, that Kant had compelling reasons for concluding that the highest good is in fact an end that is also a duty. If correct, then this argument provides the deduction promised in my title. (shrink)

World Athletics have introduced regulations preventing female athletes with certain differences in sex development from competing in the female category. We argue these regulations are not justified and should be removed. Firstly, we examine the reasoning and evidence underlying the position that these athletes have a substantial mean difference in performance from other female athletes such that it constitutes an advantage, and argue it is not sufficient. Secondly, if an advantage does exist, it needs to be demonstrated it is unfair. (...) We argue the advantage would not be unfair because to say otherwise relies on a presupposition about whether these athletes are female, which involves contradictory and inconsistent definitions of sex. Thirdly, we contend that even if it is established that there is an advantage and it is unfair, the response of requiring athletes to take testosterone-suppressing medication is not appropriate and is unfair. (shrink)

Has the diversity of corporate boards of directors improved? Should it? What role does diversity play in reducing corporate wrongdoing? Will diversity result in a more focused board of directors or more board autonomy? Examining the state of Tennessee as a case study, the authors collected data on the board composition of publicly traded corporations and compared those data to an original study conducted in 1995. Data indicate only a modest improvement in board diversity. This article discusses reasons for the (...) scarcity of women on boards and concludes that, to enhance strategic decisions, board membership should reflect the corporation''s consumer population. Thus, women are a critical but overlooked resource. Areas for future research are also considered. (shrink)

Descartes is often accused of having fragmented the human being into two independent substances, mind and body, with no clear strategy for explaining the apparent unity of human experience. Deborah Brown argues that, contrary to this view, Descartes did in fact have a conception of a single, integrated human being, and that in his view this conception is crucial to the success of human beings as rational and moral agents and as practitioners of science. The passions are pivotal in (...) this, and in a rich and wide-ranging discussion she examines Descartes' place in the tradition of thought about the passions, the metaphysics of actions and passions, sensory representation, and Descartes' account of self-mastery and virtue. Her study is an important and original reading not only of Descartes' account of mind-body unity but also of his theory of mind. (shrink)

Numerous philosophical theories of joint agency and its intentional structure have been developed in the past few decades. These theories have offered accounts of joint agency that appeal to higher-level states that are?shared? in some way. These accounts have enhanced our understanding of joint agency, yet there are a number of lower-level cognitive phenomena involved in joint action that philosophers rarely acknowledge. In particular, empirical research in cognitive science has revealed that when individuals engage in a joint activity such as (...) conversation or joint problem solving, they become aligned at multiple levels. We argue that this phenomenon of alignment is crucial to understanding joint actions and should be integrated with philosophical approaches. In this paper, we sketch a possible integration, and draw out its implications for understanding of joint agency and collective intentionality. The result is a process-based, dynamic account of joint action that integrates both low-level and high-level states, and seeks to capture the separate processes of how a joint action is initiated and sustained. (shrink)

Autism is one of the most compelling, controversial, and heartbreaking cognitive disorders. It presents unique philosophical challenges as well, raising intriguing questions in philosophy of mind, cognitive science, and philosophy of language that need to be explored if the autistic population is to be responsibly served. Starting from the "theory of mind" thesis that a fundamental deficit in autism is the inability to recognize that other persons have minds, Deborah R. Barnbaum considers its implications for the nature of consciousness, (...) our understanding of the consciousness of others, meaning theories in philosophy of language, and the modality of mind. This discussion lays the groundwork for consideration of the value of an autistic life, as well as the moral theories available to persons with autism. The book also explores questions about genetic decision making, research into the nature of autism, and the controversial quest for a cure. This is a timely and wide-ranging book on a disorder that commends itself to serious ethical examination. (shrink)

Argues that the central cognitive component of ethical virtue for Aristotle is awareness of the value of particulars.

Idiosyncrasies of Hobbes's composition process, together with a paucity of reliable autobiographical materials and the norms of seventeenth-century manuscript production, render interpretation of his political theory particularly difficult and contentious. These difficulties are surveyed here under three headings: the process of "serial" composition, which was common in the period; the relationship between Hobbes's three political-theory texts-- the "Elements of Law, De Cive ", and "Leviathan", which is basic to defining the textual embodiment of his theory, and controversial; and his method (...) of writing. I argue that Hobbes's composition process undercut his intention to produce a deductive, logical theory of politics and opened the door to inconsistency and muddle in his arguments. (shrink)

Community engagement to protect and empower participating individuals and communities is an ethical requirement in research. There is however limited evidence on effectiveness or relevance of some of the approaches used to improve ethical practice. We conducted a study to understand the rationale, relevance and benefits of community engagement in health research. This paper draws from this wider study and focuses on factors that shaped Community Advisory Group members’ selection processes and functions in Malawi. A qualitative research design was used; (...) two participatory workshops were conducted with CAG members to understand their roles in research. Workshop findings were triangulated with insights from ethnographic field notes, key informant interviews with stakeholders, focus group discussions with community members and document reviews. Data were coded manually and thematic content analysis was used to identify main issues. Results have shown that democratic selection of CAG members presented challenges in both urban and rural settings. We also noted that CAG members perceived their role as a form of employment which potentially led to ineffective representation of community interests. We conclude that democratic voting is not enough to ensure effective representation of community's interests of ethical relevance. CAG members’ abilities to understand research ethics, identify potential harms to community and communicate feedback to researchers is critical to optimise engagement of lay community and avoid tokenistic engagement. (shrink)

Theodor W. Adorno and Jürgen Habermas both champion the goal of a rational society. However, they differ significantly about what this society should look like and how best to achieve it. Exploring the premises shared by both critical theorists, along with their profound disagreements about social conditions today, this book defends Adorno against Habermas' influential criticisms of his account of Western society and prospects for achieving reasonable conditions of human life. The book begins with an overview of these critical theories (...) of Western society. Both Adorno and Habermas follow Georg Lukács when they argue that domination consists in the reifying extension of a calculating, rationalizing form of thought to all areas of human life. Their views about reification are discussed in the second chapter. In chapter three the author explores their conflicting accounts of the historical emergence and development of the type of rationality now prevalent in the West. Since Adorno and Habermas claim to have a critical purchase on reified social life, the critical leverage of their theories is assessed in chapter four. The final chapter deals with their opposing views about what a rational society would look like, as well as their claims about the prospects for establishing such a society. Adorno, Habermas and the Search for a Rational Society will be essential reading for students and researchers of critical theory, political theory and the work of Adorno and Habermas. (shrink)

Humans have become increasingly datafied with the use of digital technologies that generate information with and about their bodies and everyday lives. The onto-epistemological dimensions of human–data assemblages and their relationship to bodies and selves have yet to be thoroughly theorised. In this essay, I draw on key perspectives espoused in feminist materialism, vital materialism and the anthropology of material culture to examine the ways in which these assemblages operate as part of knowing, perceiving and sensing human bodies. I draw (...) particularly on scholarship that employs organic metaphors and concepts of vitality, growth, making, articulation, composition and decomposition. I show how these metaphors and concepts relate to and build on each other, and how they can be applied to think through humans’ encounters with their digital data. I argue that these theoretical perspectives work to highlight the material and embodied dimensions of human–data assemblages as they grow and are enacted, articulated and incorporated into everyday lives. (shrink)

The ArgumentThis paper sets out a framework for understanding how the scientific community constructs computer simulation as an epistemically and pragmatically useful methodology. The framework is based on comparisons between simulation and the loosely-defined categories of “theoretical work” and “experimental work.” Within that framework, the epistemological adequacy of simulation arises from its role as a mathematical manipulation of a complex, abstract theoretical model. To establish that adequacy demands a detailed “theoretical” grasp of the internal structure of the computer program. Simultaneously, (...) the pragmatic usefulness of simulation arises from its role as a “virtual laboratory.” That role is made possible by black-boxing the internal structure of the program, such that the scientist can interact with the computer in an intuitive, “experimental” manner. Thus simulation is rendered authoritative, opening up encoded theories to a novel, “experimental” type of manipulation. (shrink)

This guide leads readers systematically through the arguments of Mary Shepherd's two books. Chapters 1-4 cover the arguments in the Essay Upon the Relation of Cause and Effect (1824), where Shepherd argues that causal principles can be known by reason to be necessary truths and that causal inferences can be rationally justified. Shepherd's primary target in this work is Hume, but she also addresses the views of Thomas Brown and William Lawrence. Shepherd considered her second book, Essays on the Perception (...) of an External Universe, and Other Subjects Connected with the Doctrine of Causation (1827), to be an extension of the earlier project on causation; here she appeals to the causal principles established in the first book to argue that we can know through reason that an external world of continually-existing objects must exist independently of us, as the causes of our sensations. Chapter 5 of this Guide addresses Shepherd's accounts of sensation and reasoning; Chapters 6-9 lead the reader through the arguments of the Essays, as well laying out Shepherd's views on skepticism and Berkeleyan idealism, her accounts of mind and body, her philosophy of religion, and the solutions she offers to two puzzles about vision. (shrink)

Economists and other social scientists in this century have often supported economic arguments by referring to positions taken by philosophers of science. This important new book looks at the reliability of this practice and, in the process, provides economists, social scientists, and historians with the necessary background to discuss methodological matters with authority. Redman first presents an accurate, critical, yet neutral survey of the modern philosophy of science from the Vienna Circle to the present, focusing particularly on logical positivism, sociological (...) explanations of science (Polanyi, Fleck, Kuhn), the Popper family, and the history of science. She then deals with economic methodology in the twentieth century, looking at a wide range of methodological positions, especially those supported by positions from the philosophy of science. She considers the myth of the feasibility of falsification in economics and, within the context of its significance for economics, discusses the interpretation of Kuhn's philosophy of science as consensus and the danger such a view represents to science. Appendices review the history of the is-ought dispute and list economists whose first works deal with methodological topics. Comprehensive, readable, and accessible to those with little background knowledge, Redman's book will appeal to a wide range of social scientists and philosophers of science. (shrink)

Australia has one of the harshest regimes for the processing of asylum seekers, people who have applied for refugee status but are still awaiting an answer. It has received sharp rebuke for its policies from international human rights bodies but continues to exercise its resolve to protect its borders from those seeking protection. One means of doing so is the detention of asylum seekers who arrive in Australia by boat. Health care providers who care for asylum seekers in these conditions (...) experience a conflict of “dual loyalty,” whereby their role in preserving and maintaining the health of patients can run counter to their employment in detention facilities. Many psychiatrists who have worked in the detention setting engage in forms of political activism in order to change the process of seeking refuge. (shrink)

In July 2018, the Nuffield Council of Bioethics released its long-awaited report on heritable genome editing. The Nuffield report was notable for finding that HGE could be morally permissible, even in cases of human enhancement. In this paper, we summarise the findings of the Nuffield Council report, critically examine the guiding principles they endorse and suggest ways in which the guiding principles could be strengthened. While we support the approach taken by the Nuffield Council, we argue that detailed consideration of (...) the moral implications of genome editing yields much stronger conclusions than they draw. Rather than being merely ‘morally permissible’, many instances of genome editing will be moral imperatives. (shrink)

This commentary is an attempt to begin to identify and think through some of the ways in which sociocultural theory may contribute to understandings of the relationship between humans and digital data. I develop an argument that rests largely on the work of two scholars in the field of science and technology studies: Donna Haraway and Annemarie Mol. Both authors emphasised materiality and multiple ontologies in their writing. I argue that these concepts have much to offer critical data studies. I (...) employ the tropes of companion species, drawn from Haraway, and eating data, from Mol, and demonstrate how these may be employed to theorise digital data–human assemblages. (shrink)