In a research proposal recently submitted to one of the research ethics committees in Wales, children suffering from otitis media, or ‘glue ear’ as it is more familiarly known, were to be tested for allergic reactions to a number of substances using skin-prick tests. Small lancets would be used to pierce the skin of the forearm, allowing the penetration of traces of the allergenic reagent. The size of the subsequent inflamed area of skin would be measured. To demonstrate the expected (...) correlation between glue ear and an allergic reaction, it would be necessary to see whether other children who did not suffer from glue ear also had the same reactions. If they did not, of course, then some causal association between the reaction and the disease condition could be inferred and investigated, with the hope of improving the treatment of the disease itself. (shrink)

The purpose of medical humanities is to improve the delivery of effective health care through a better understanding of disease in society, and in the individual. The interfaces between the science of medicine and the arts, philosophy, sociology and law interpret causes and effects of disease. The field of medical ethics is the most prominent offspring of this wider debate, yet the context of disease in the life of the individual and of society is profound and far-reaching. The influences of (...) medicine on the humanities and vice versa are all around, yet only recently have they been recognised in the wider world of health care. How can you encapsulate the essence of medical humanities and teach it to health professionals? Medical Humanities is designed to fill the need for a clear, well illustrated text that both provides the principles for the individual reader, and encourages discussion. The issues are explored in four main sections. Based on a highly successful seminar, and with contributions from leading writers, thinkers, and teachers, this book provides a comprehensive and authoritative reference for what is becoming a professional requirement in medicine. It will be invaluable for clinicians and students alike. (shrink)

Medicine, as Byron Good argues, reconstitutes thehuman body of our daily experience as a medical body,unfamiliar outside medicine. This reconstitution can be seen intwo ways: as a salutary reminder of the extent to which thereality even of the human body is constructed; and as anarena for what Stephen Toulmin distinguishes as theintersection of natural science and history, in which many ofphilosophy''s traditional questionsare given concrete and urgent form.This paper begins by examining a number of dualities between themedical body and the (...) body familiar in daily experience. Toulmin''s epistemological analysis of clinical medicine ascombining both universal and existential knowledge is thenconsidered. Their expression, in terms of attention,respectively, to natural science and to personal history, isexplored through the epistemological contrasts between themedical body and the familiar body, noting the traditionalphilosophical questions which they in turn illustrate. (shrink)

In this book the author argues that human musical understanding is rooted in the traditions of culture and that experience of music depends crucially on what the individual brings to it.

Many bioethics questions are resistant to journalistic exploration on account of their inherently philosophical dimensions. Such dimensions are ill-suited to what we may term the internal goods (in MacIntyre's sense) of the newspapers and mass media generally, which constrain newspaper coverage to an abbreviated form of narrative that, whilst not in itself objectionable, is nonetheless inimical to the conduct of philosophical reflection. The internal goods of academic bioethics, by contrast, include attention to philosophical questions inherent in bioethical issues and value-enquiry. (...) The danger for bioethics is that its agenda for reflective enquiry will, if dictated by this abbreviated narrative, be distorted in terms of both range and priorities, to the inevitable neglect of questions having a philosophical dimension to them. This danger can be avoided by a constructive partnership between the media and academic bioethics. The success of this partnership relies on four suggested provisos, for the meeting of which both journalists and academics bear responsibility. (shrink)

Using fictionalized case studies this series follows four patients through the medical process, from onset through Diagnosis, Treatment and PrognosisVolume 1: Symptom. Examines the idea of 'symptom' as a route to understanding the structure of clinical practice -- Volume 2: Diagnosis. Explores the meaning of 'diagnosis' as a complex, culturally mediated interaction between individuals, scientific discoveries, social negotiation and historical change. -- Volume 3: Treatment. Considers the concept of treatment as an active process which produces an outcome, be it effective, (...) inappropriate or inadequate. Enlightening reading. -- Volume 4: Prognosis. Contemplates the challenge of the prognosis, attempting to make sense of life and death. Considers, through personal and professional perspectives, the role of the medical profession in guiding patient experience.--. (shrink)

This text offers a concise explanation of how philosophical concepts underpin much medical activity, and how being aware of this can improve everyday practice. It is not a basic introduction to philosophy, but restricts itself to those aspects that have a direct impact on medical professionals.

Recruiting patients into clinical research is essential for the advancement of medical knowledge. However, when the physician undertaking the care of the patient is also responsible for recruitment into clinical research, a situation arises of an inter-role breach of confidentiality which is distinguishable from other conflicts of interest. Such discord arises as the physician utilizes confidential information obtained within the therapeutic relationship beyond its primary objective, and safeguards ought to be observed in order to avert this important, and generally overlooked, (...) problem. The moral worth of the pledge of confidentiality is based not on its innate value but on its being a promise on which subsequent interactions and disclosures are founded. Within the patient-doctor interaction, confidentiality is an important facet of the promised fidelity and, as such, a loose interpretation of the notion threatens the essence of the relationship, and any violation thereof requires compelling moral justification. To avoid conflict, patients' confidential information ought not be used for the purpose of recruitment, which needs to be undertaken through general education and non-directed appeals, and a preliminary consent to be approached for research should be obtained from the patient prior to her being identified as a suitable research subject. Securing this prior consent would avoid one source of potential, albeit unintended, coercion. (shrink)

Throughout the world, research ethics committees are relied on to prevent unethical research and protect research subjects. Given that reliance, the composition of committees and the manner in which decisions are arrived at by committee members is of critical importance. There have been Instances in which an inadequate review process has resulted in serious harm to research subjects. Deficient committee review was identified as one of the factors In a study in New Zealand which resulted in the suffering and death (...) of many women diagnosed with carcinoma in situ. (shrink)

Ted Shotter's founding of the London Medical Group 50 years ago in 1963 had several far reaching implications for medical ethics, as other papers in this issue indicate. Most significant for the joint authors of this short paper was his founding of the quarterly Journal of Medical Ethics in 1975, with Alastair Campbell as its first editor-in-chief. In 1980 Raanan Gillon began his 20-year editorship . Gillon was succeeded in 2001 by Julian Savulescu, followed by John Harris and Soren Holm (...) in 2004, with Julian Savulescu starting his second and current term in 2011. In 2000 an additional special edition of the JME, Medical Humanities , was published, under the founding joint editorship of Martyn Evans and David Greaves. In 2003 Jane Macnaughton succeeded David Greaves as joint editor. Deborah Kirklin, under whose auspices MH became an independent journal, took over in 2008, and she was succeeded in 2013 by Sue Eckstein. This short paper offers reminiscences and reflections from the two journals’ various editors.From the start the JME was committed to clearly expressed reasoned discussion of ethical issues arising from or related to medical practice and research. In particular, both Edward Shotter and Alastair Campbell, each a cleric , were at pains to make clear that the JME was not a religious journal and that it had no sort of partisan axe to grind.Campbell's appointment as founding editor was something of a surprise, as the original intention had been to appoint a medical doctor, who could be expected to know medical practice from the inside. However, in 1972 Campbell, a Joint Secretary of the Edinburgh Medical Group, had published Moral dilemmas in medicine. …. (shrink)

A Decent Proposal: Ethical Review of Clinical Research Donald Evans and Martyn Evans Centre for Philosophy and Health Care University of Wales Swansea, UK The investigation and development of modern medicines and medical technology can create numerous ethical dilemmas both for clinical researchers and research ethics committees. A Decent Proposal: Ethical Review of Clinical Research seeks to facilitate and encourage good clinical research by exploring the concerns, responsibilities, general issues and particular pitfalls associated with ethical aspects of (...) research. It provides practical guidelines for researchers on how to improve the quality of research design, while for those appointed to scrutinise research proposals it offers advice on how to apply consistent, careful and critical reasoning to the process of assessing ethical standards. As such, it will provide invaluable assistance to clinical researchers and ethics committees alike in understanding the moral challenges posed by modern health care. (shrink)

Let us give voice to this new demand: we need a critique of moral values, the value of these values should itself, for once, be examined. -Friedrich NietzscheAnyone who, stimulated by education, has come to feel the force of the various obligations in life, at some time or other comes to feel the irksomeness of carrying them out, and to recognize the sacrifice of interest involved; and, if thoughtful, he inevitably puts to himself the question: “Is there really a reason (...) why I should act in the ways in which hitherto I have thought I ought to act? … Should I not really be justified in simply trying to have a good time?” -H.A. Prichard. (shrink)

Social norms – rules governing which behaviours are deemed appropriate or inappropriate within a given community – are typically taken to be uniquely human. Recently, this position has been challenged by a number of philosophers, cognitive scientists, and ethologists, who have suggested that social norms may also be found in certain non-human animal communities. Such claims have elicited considerable scepticism from norm cognition researchers, who doubt that any non-human animals possess the psychological capacities necessary for normative cognition. However, there is (...) little agreement among these researchers about what these psychological prerequisites are. This makes empirical study of animal social norms difficult, since it is not clear what we are looking for and thus what should count as behavioural evidence for the presence (or absence) of social norms in animals. To break this impasse, we offer an approach that moves beyond contested psychological criteria for social norms. This approach is inspired by the animal culture research program, which has made a similar shift away from heavily psychological definitions of ‘culture’ and to become organized around a cluster of more empirically tractable concepts of culture. Here, we propose an analogous set of constructs built around the core notion of a normative regularity, which we define as a socially maintained pattern of behavioural conformity within a community. We suggest methods for studying potential normative regularities in wild and captive primates. We also discuss the broader scientific and philosophical implications of this research program with respect to questions of human uniqueness, animal welfare and conservation. (shrink)

The current state of British sociology of education is reviewed; noting its decline, but suggesting that its influence has been dispersed throughout educational research in Britain. It is argued that its fate is not simply a product of external attack but also derives from internal problems. Against this background, it is suggested that postmodernism can be treated as a stimulus for a fundamental reconsideration of the proper nature and role of academic research on education.

Recent theoretical and philosophical movements within the study of material culture are more carefully attending to the variety of ways in which human artefacts, institutions, and cultural developments extend, shape and alter human cognition over time. Material Engagement Theory in particular has set out to map, explore and understand the relational nature of mind and material world as can be read through cultural artefacts. Within the context of MET, the neurological concept of metaplasticity has been expanded to include the affective (...) domains of technology, materials, and things in the neurological development and architecture of the plastic human mind; a ‘transactional’ relationship between a plastic mind and a plastic material world that are correlated at the ontological level. The challenges of mapping this metaplasticity of mind lie in understanding how the mind and material culture should be understood in relation to the constantly changing lifeworlds of humans over time; the ecological, social, technological and environmental contexts that form the historical specificity of cognitive development. This paper explores how the historical specificity of metaplasticity can be made tangible through the study of material culture, focusing upon the particular activity of oil painting. It will be argued that paintings can provide clues to the historical specificity of the mind that crosses the lifeworld of human action; the technological, phenomenological, philosophical, material, and social conditions underpinning the creation of a painted mark. Drawing from a range of sources that have a root within a Deleuzian process philosophy, the paper builds an account of painting that can be read as expressing the encultured and historical manipulation of paint as an expressive material in itself; an action rendered visible that express the historical emergence of mind. (shrink)

The concept of “ethical research” holds considerable sway over the ways in which contemporary biomedical, natural, and social science investigations are funded, regulated, and practiced within a variety of countries. Some commentators have viewed this “new” means of governance positively; others, however, have been resoundingly critical, regarding it as restrictive and ethics bodies and regulations unfit for the task they have been set. Regardless, it is clear that science today is an “ethical” business. The ways in which formal and informal (...) ethical discourses and practices—what might be called “regimes of normativity”—structure scientific work and the meanings it is ascribed with have, however, been underexplored. This article attends to how science and ethics articulate; how they are, in many ways, co-produced. Exploring these processes of co-production casts into sharp relief the essential emotionality of science; the relationships investigators have with their colleagues, work, and research participants pulse with emotion, potentially shaping in important ways the very kinds of knowledge that laboratories produce. (shrink)

Outside of philosophy, the idea that workers deserve to be paid according to their productive contributions is very popular. But political philosophers have given it relatively little attention. In this paper, I argue against the attempt to use this idea about desert and contribution to vindicate significant income inequality. I claim that the inegalitarian invocation of reward according to contribution fails on its own terms when the following condition holds: the size of each worker's contribution depends on what others only (...) together do. When workers only together make another more productive, that is not reflected in the sum of their own contributions. Thus reward according to contribution recognizes individual accomplishments without recognizing their dependence on collectives, dependence that is, in complex economies, ubiquitous. (shrink)

Accession Number: ATLA0001712130; Hosting Book Page Citation: p 226-235.; Language(s): English; General Note: Bibliography: p 234-235.; Issued by ATLA: 20130825; Publication Type: Essay.

The development of the fifth edition of the American Psychiatric Association9s _Diagnostic and Statistical Manual of Mental Disorders_—the DSM-5—has reenergised and driven further forward critical discourse about the place and role of diagnosis in mental health. The DSM-5 has attracted considerable criticism, not least about its role in processes of medicalisation. This paper suggests the need for a sociology of psychiatric critique. Sociological analysis can help map fields of contention, and cast fresh light on the assumptions and nuances of debate (...) around the DSM-5; it underscores the importance of diagnosis to the governance of social and clinical life, as well as the wider discourses critical commentaries connect with and are activated by. More normatively, a sociology of critique can indicate which interests and values are structuring the dialogues being articulated, and just how diverse clinical opinion regarding the DSM can actually be. This has implications for the considerations of health services and policy decision-makers who might look to such debates for guidance. (shrink)

Regulated secretory proteins are stored within specialized vesicles known as secretory granules. It is not known how proteins are sorted into these organelles. Regulated proteins may possess targeting signals which interact with specific sorting receptors in the lumen of the trans‐Golgi network (TGN) prior to their aggregation to form the characteristic dense‐core of the granule. Alternatively, sorting may occur as the result of specific aggregation of regulated proteins in the TGN. Aggregates may be directed to secretory granules by interaction of (...) a targeting signal on the surface with a sorting receptor. Novel targeting signals which confer on regulated proteins a tendency to aggregate under certain conditions, and in so doing cause them to be incorporated into secretory granules, have been implicated. Specific targeting signals may also play a role in directing membrane proteins to secretory granules. (shrink)

There is much law and many guidelines surrounding the whole issue of the indemnity for human volunteers when it comes to clinical trials. The system that had been put in place to protect individual volunteer drug trialists seems largely to have worked by the fact that there are so few examples of legal cases being issued. However, recent events have shown that when the system fails it fails somewhat spectacularly. The difficulty for groups such as the ethics committee is that (...) lawyers look for targets to try and meet the difference between the claims and the monies available and it might therefore always be possible that the ethics committee becomes centre stage in terms of the pursuit of the action. (shrink)

This article challenges the assumption inherent in many ethics codes that duties only arise when the project is sufficiently advanced that a formal research proposal can be put before an ethics committee for approval. Certain social science methodologies do not lend themselves to a simple demarcation between the preparation and the implementation of the research. It is therefore imperative that consideration is given to researchers' ethical duties prior to formal review. The problem of demarcation and of defining a duty are (...) explored in the particular context of a potential research project involving research on taxi-drivers' experiences of crime and the strategies that they employ to avoid victimisation. Two key issues emerge. First, in what circumstances, if any, can information supplied during this gestation period be used as ‘research data’? Secondly, there are concerns about the researcher's identity and role at this stage. These issues, and others, need to be the subject of further consideration by the relevant bodies so that researchers receive meaningful guidance on the duty prior to ethics review. (shrink)

Qu’elle soit ingrate ou réussie, la vieillesse soulève des questions incontournables : celles de la mort et de la souffrance, de la responsabilité et de la vulnérabilité. Du silence et de la parole aussi. Être vulnérable, c’est être fragile, friable ; c’est avoir besoin de son prochain. La vulnérabilité est liée, notamment, à la maladie, au grand âge, à la dépendance ou au fardeau de l’aide. Or, les personnes aidées et aidantes sont surtout des femmes. Il y a les femmes (...) du grand âge et les femmes de tous les âges, qui exécutent à leurs côtés, bénévolement, un travail domestique de santé. Faisons apparaître les obstacles au respect des droits et au pouvoir d’agir de ce « couple vulnérable » aidant-aidé, dans une perspective critique et féministe du droit et de l’éthique. Brisons le silence. (shrink)

Theories of affective influences on cognition posit that negative mood may increase cognitive load, causing a decrement in task performance (Seibert & Ellis, [1991]. Irrelevant thoughts, emotional mood states, and cognitive task performance. Memory & Cognition, 19(5), 507–513), or cause a shift to more analytic thinking, which benefits tasks requiring attention to detail (Schwarz & Clore, [1983]. Mood, misattribution, and judgments of well-being: Informative and directive functions of affective states. Journal of Personality and Social Psychology, 45(3), 513–523). We previously reported (...) that individuals who are higher in the trait of emotional reactivity performed better on an inhibitory task with increasing negative mood whereas low-reactive individuals showed the converse pattern (Gabel & McAuley, [2018]. Does mood help or hinder executive functions? Reactivity may be the key. Personality and Individual Differences, 128, 94–99; [2020]. React to act: Negative mood, response inhibition, and the moderating role of emotional reactivity. Motivation and Emotion, 44(6), 862–869). Because high-reactive individuals are more accustomed to negative affect (Nock et al., [2008]. The emotion reactivity scale: Development, evaluation, and relation to self-injurious thoughts and behaviors. Behavior Therapy, 39(2), 107–116), we speculated that negative mood engendered analytic thinking but without a task-incongruent increase in cognitive load – thereby facilitating performance. Here, we induced a heuristic or analytic approach to information processing prior to performance of an inhibitory task and expected different results pending the thinking style induced. In the heuristic condition, increasing negative mood was associated with better performance for high-reactive participants but not their low-reactive counterparts. In the analytic condition, increasing negative mood was associated with better performance irrespective of emotional reactivity. Our results are consistent with the notion that negative mood engenders analytic thinking which may benefit response inhibition provided it does not increase task-incongruent cognitive load. (shrink)

This article proposes that Horace's Epodes and Ovid's Metamorphoses open with significant acrostics that comprise the first two letters, in some cases forming syllables, of successive lines: IB-AM/IAMB (Epod. 1.1–2) and IN-CO-(H)AS (Met. 1.1–3). Each acrostic, it will be argued, tees up programmatic concerns vital to the work it opens: generic identity and the interrelation of form and content (Epodes), etymology and monumentality (Metamorphoses). Moreover, as befits their placement at the head of collections, both acrostics negotiate the challenge of literary (...) commencement. The introduction reviews recent developments in acrostic studies and discusses important predecessors and parallels for Horace's and Ovid's ‘two-letter’ and syllabic acrostics. Two subsequent sections examine the acrostics singly, and a conclusion compares the dialogues that these acrostics open between author and reader, underscoring the welcome challenge which Ovid's acrostic offers to the prevailing scholarly view that this form of wordplay is a strictly visual affair. (shrink)

Building on self-professed perspectival approaches to both scientific knowledge and causation, I explore the potentially radical suggestion that perspectivalism can be extended to account for a type of objectivity in science. Motivated by recent claims from quantum foundations that quantum mechanics must admit the possibility of observer-dependent facts, I develop the notion of ‘perspectival objectivity’, and suggest that an easier pill to swallow, philosophically speaking, than observer-dependency is perspective-dependency, allowing for a notion of observer-independence indexed to an agent perspective. Working (...) through the case studies of colour perception and causal perspectivalism, I identify two places within which I claim perspectival objectivity is already employed, and make the connection to quantum mechanics through Bohr’s philosophy of quantum theory. I contend that perspectival objectivity can ensure, despite the possibility of perspective-dependent scientific facts, the objectivity of scientific inquiry. (shrink)

This is a response to an article by Stephen Gorard in a previous issue of the journal. It addresses the issue of how achievement gaps in educational performance between ethnic and other groups, and changes in these, can best be measured. The approach recommended by Gorard is compared with that of the authors he criticises. The conclusion reached is that both approaches are of value: that they provide different kinds of information. Which is the most useful on any occasion depends (...) on the purpose guiding the inquiry, and on the assumptions that can be made about the social processes being modelled. (shrink)

Children who are introduced to God, through attending church or having loved ones who speak often about God, often have a lot of questions, including this ever-popular one: What is God like? The late Rachel Held Evans loved the Bible and loved showing God's love through the words and pictures found in that ancient text. Through these pictures from the Bible, children see that God is like a shepherd, God is like a star, God is like a gardener, God (...) is like the wind, and more. God is a comforter and support. (shrink)

The Body in French Queer Thought from Wittig to Preciado: Queer Permeability identifies a common concern in French queer works for the materiality of the body, and argues for a return to the body as fundamental to queer thought and politics, from HIV onwards.

What happens when we blur time and allow ourselves to haunt or to become haunted by ghosts of the past? Drawing on archaeological, historical, and ethnographic data, Blurring Timescapes, Subverting Erasure demonstrates the value of conceiving of ghosts not just as metaphors, but as mechanisms for making the past more concrete and allowing the negative specters of enduring historical legacies, such as colonialism and capitalism, to be exorcised.

This special issue considers the significance of film to the establishment and development of scientific approaches to the mind. Bonnie Evans explores how the origins of film technologies in 1895 in France encouraged a series of innovative collaborations, influencing both psychological theorisation, and new filming techniques. Jeremy Blatter explains how Harvard psychologist Hugo Münsterberg created early films specifically designed to engage audiences using psychological tactics. Scott Curtis’ article examines how Yale psychologist Arnold Gesell was able to extract scientific data (...) from a film. Felix Rietmann’s article explores a collection of infant observation films from the 1930s and 1960s and how they developed unique narratives of mothers’ engagement with their children that did not necessarily match up with dominant scientific theories. Janet Harbord's article considers how a trilogy of films made at the Maudsley Hospital in the 1950s engaged with innovative film-making techniques that captured behaviour as discrete units. Seth Watter further examines how William S. Condon's use of the unique technology of the Bell and Howell 173BD projector in the 1960s created new understandings of human behaviour that could not have been predicted in advance, and which were highly influenced by the technology itself. Finally, Des O’Rawe explores how radical approaches in both anti-psychiatry, and documentary film-making in the 1960s created new opportunities for audiences to engage with different psychological states. All of these developments in film and psychology continue to influence understandings in both these fields to the present day. (shrink)

Country music critics and scholars have noticed an apparent contradiction between the practical identity of country music with the image of the male country singer as the 'rhinestone cowboy'. In this case, the problem is one of how we can make sense of the rural, working-class, ruggedly masculinity persona common to the genre with its elaborately embroidered, brightly colored, and highly embellished male fashion. The intractability of this problem has led some to argue that the simplest solution is to just (...) deny the legitimacy of country music authenticity discourse altogether. That is, all the genre’s talk of the rural working class is inauthentic and should be discarded. Here, I argue that by accounting for country music authenticity in terms of the genre being a dual character concept, we can fully address the skeptic's worries. Beyond merely being compatible with the Nudie suit however, this notion of authenticity is also our best way of understanding the aesthetic value of the rhinestone cowboy image at all. The resulting picture, in which the suit primarily serves as an epistemic signifier of one’s standing in the country music community, allows for the Nudie suit to function as a class, and sometimes queer, commentary on mainstream culture. (shrink)