SCOTT A and WILSON L. Nursing Inquiry 2011; 18: 40–49 Valued identities and deficit identities: Wellness Recovery Action Planning and self-management in mental healthWellness Recovery Action Planning (WRAP) is a self-management programme for people with mental illnesses developed by a mental health consumer, and rooted in the values of the ‘recovery’ movement. The WRAP is noteworthy for its construction of a health identity which is individualised, responsibilised, and grounded in an ‘at risk’ subjectivity; success with this programme requires development (...) of an intensely focused health lifestyle. We draw on Bourdieu and Giddens to argue that what is being developed is a ‘reflexive health habitus’, which is not equally accessible to all social groups, and is in tension with WRAP’s recovery-orientated aims. However, it is understandable that such a programme developed in mental health, because people with mental illness are highly stigmatised as ‘a risk’ and viewed as in need of risk management. By developing their own form of self-monitoring ‘at risk’ identity, mental health consumers are, paradoxically, able to construct themselves as ideal health citizens and no longer a risk, thus re-entering the moral community. We conclude by suggesting some changes to WRAP practice. (shrink)

Drawing on recent feminist discussions, this collection critically reassesses ideas about agency, exploring the relationship between agency and coercion in greater depth and across a range of disciplinary perspectives and ethical contexts.

In the influential 1995 article “Social Conditions as Fundamental Causes of Disease,” Bruce Link and Jo Phelan described social and political factors as “fundamental causes” of death and disease. Whitney Pirtle has recently declared racial capitalism another such fundamental cause. Using the case of the water crisis in Flint, Michigan, she has argued that racial capitalism's role in that situation meets each of the criteria Link and Phelan's article outlines: racial capitalism influenced multiple disease outcomes, affected disease outcomes through multiple (...) risk factors, involved access to flexible resources that can be used to minimize both risks and the consequences of disease, and was reproduced over time through the continual replacement of intervening mechanisms. We argue for Pirtle's conclusion using the extensive literature on racial capitalism and case studies concerning housing in the United States and Brazil and what Naomi Klein has termed “corona capitalism” in India. If races correspond to hierarchies of material security, as suggested by Ruth Wilson Gilmore, then these hierarchies and their causal effects are fundamental determinants of public health. (shrink)

First published in 1998. Routledge is an imprint of Taylor & Francis, an informa company.

Wilson et al. focus on one class of AGL tasks: the cognitively demanding task of detecting non‐adjacent dependencies (NADs) among items. They provide a typology of the different types of NADs in natural languages and in AGL tasks. A range of cues affect NAD learning, ranging from the variability and number of intervening elements to the presence of shared prosodic cues between the dependent items. These cues, important for humans to discover non‐adjacent dependencies, are also found to facilitate NAD (...) learning in several nonhuman animal species. (shrink)

Wilson et al. focus on one class of AGL tasks: the cognitively demanding task of detecting non‐adjacent dependencies (NADs) among items. They provide a typology of the different types of NADs in natural languages and in AGL tasks. A range of cues affect NAD learning, ranging from the variability and number of intervening elements to the presence of shared prosodic cues between the dependent items. These cues, important for humans to discover non‐adjacent dependencies, are also found to facilitate NAD (...) learning in several nonhuman animal species. (shrink)

The naturalistic fallacy is mentioned frequently by evolutionary psychologists as an erroneous way of thinking about the ethical implications of evolved behaviors. However, evolutionary psychologists are themselves confused about the naturalistic fallacy and use it inappropriately to forestall legitimate ethical discussion. We briefly review what the naturalistic fallacy is and why it is misused by evolutionary psychologists. Then we attempt to show how the ethical implications of evolved behaviors can be discussed constructively without impeding evolutionary psychological research. A key is (...) to show how ethical behaviors, in addition to unethical behaviors, can evolve by natural selection. (shrink)

The naturalistic fallacy is mentionedfrequently by evolutionary psychologists as anerroneous way of thinking about the ethicalimplications of evolved behaviors. However,evolutionary psychologists are themselvesconfused about the naturalistic fallacy and useit inappropriately to forestall legitimateethical discussion. We briefly review what thenaturalistic fallacy is and why it is misusedby evolutionary psychologists. Then we attemptto show how the ethical implications of evolvedbehaviors can be discussed constructivelywithout impeding evolutionary psychologicalresearch. A key is to show how ethicalbehaviors, in addition to unethical behaviors,can evolve by natural selection.

Neural Geographies draws together recent feminist and deconstructive theories, early Freudian neurology and contemporary connectionist theories of cognition. In this original work, Elizabeth A. Wilson explores the convergence between Derrida, Freud and recent cognitive theory to pursue two important issues: the nature of cognition and neurology, and the politics of feminist and critical interventions into contemporary scientific psychology. This book seeks to reorient the usual presumptions of critical studies of the sciences by addressing the divisions between the static and (...) the changeable; the natural and the political; the neuro-cognitive and the cultural that have been traditional to both scientific and critical accounts of neurology and cognition. (shrink)

The naturalistic fallacy is mentionedfrequently by evolutionary psychologists as anerroneous way of thinking about the ethicalimplications of evolved behaviors. However,evolutionary psychologists are themselvesconfused about the naturalistic fallacy and useit inappropriately to forestall legitimateethical discussion. We briefly review what thenaturalistic fallacy is and why it is misusedby evolutionary psychologists. Then we attemptto show how the ethical implications of evolvedbehaviors can be discussed constructivelywithout impeding evolutionary psychologicalresearch. A key is to show how ethicalbehaviors, in addition to unethical behaviors,can evolve by natural selection.

The promotion of the self‐managing capacities of people has become a marker of contemporary mental health practice, yet self‐management remains a largely uncontested construct in mental health settings. This discourse analysis based upon the work of Foucault investigates self‐management practices for bipolar disorder and their action upon how a person with bipolar disorder comes to think of who they are and how they should live. Using Foucault's framework for exploring the ethical self and transcripts of interviews with people living with (...) bipolar disorder, this discourse analysis finds that the discursive practices of self‐management for bipolar disorder are prescribing a restricted regime for living based upon the quintessential neo‐liberal subject using practices that are focused upon managing an unreliable and problematic self. The article concludes with the proposition that the problem of bipolar disorder (for which self‐management is an answer) is less about the object itself and more about how we construct the nature of the self. A Māori indigenous ontology is used here as an example of an alternative discursive resource through which people make sense of the self and which allows ways of thinking about self‐management that engage with ambivalence and ambiguity rather than restriction and regulation. (shrink)

The growth of positive psychology has birthed debate on the nature of what “positive” really means. Conceptualizations of positive attributes vary across psychological perspectives, and it appears these definitional differences stem from standards for “positive” espoused by three normative ethical frameworks: consequentialism, deontology, and virtue ethics. When definitions of “positive” do not align with one of these ethical schools, it appears researchers rely on preference to distinguish positive attributes. In either case, issues arise when researchers do not make their theoretical (...) alignment explicit, leading to value-laden, often subjective criteria being smuggled into science as a description of what is positive. To foster a deeper critical understanding of the different approaches, we examine how these conceptual definitions of positive attributes (mis)align with their ethical traditions or fail to align with an ethical school. (shrink)

In December 1984 Angela Weir and Elizabeth Wilson, two founding members of Feminist Review, published an article assessing contemporary British feminism and its relationship to the left and to class struggle. They suggested that the women's movement in general, and socialist-feminism in particular, had lost its former political sharpness. The academic focus of socialist-feminism has proved more interested in theorizing the ideological basis of sexual difference than the economic contradictions of capitalism. Meanwhile the conditions of working-class and black women (...) have been deteriorating. In this situation, they argue, feminists can only serve the general interests of women through alliance with working-class movements and class struggle. Weir and Wilson represent a minority position within the British Communist Party (the CP), which argues that ‘feminism’ is now being used by sections of the left, in particular the dominant ‘Eurocommunist’ left in the CP, to justify their moves to the right, with an accompanying attack on traditional forms of trade union militancy. Beatrix Campbell, who is aligned to the dominant position within the CP, has been one target of Weir and Wilson's criticisms. In several articles from 1978 onwards, and in her book Wigan Pier Revisited, Beatrix Campbell has presented a very different analysis of women and the labour movement. She has criticized the trade union movement as a ‘men's movement’, in the sense that it has always represented the interests of men at the expense of women. And she has described the current split within the CP as one extending throughout the left between the politics of the ‘old’ and the ‘new’: traditional labour movement politics as against the politics of those who have rethought their socialism to take into account the analysis and importance of popular social movements – in particular feminism, the peace and anti-racist movements. In reply to this debate, Anne Phillips has argued that while women's position today must be analysed in the context of the capitalist crisis, it is not reducible to the dichotomy ‘class politics’ versus ‘popular alliance’. Michèle Barrett, in another reply to Weir and Wilson, has argued that they have presented a reductionist and economistic approach to women's oppression, which caricatures rather than clarifies much of the work in which socialist-feminists have been engaged. To air these differences between socialist-feminists over the question of feminism and class politics, and to see their implications for the women's movement and the left, Feminist Review has decided to bring together the main protagonists of this debate for a fuller, more open discussion. For this discussion Feminist Review drew up a number of questions which were put to the participants by Clara Connolly and Lynne Segal. (Michèle Barrett was present in a personal capacity.) They cover the recent background to socialist-feminist politics, the relationship of feminism to Marxism, the role of feminists in le ft political parties and the labour movement, the issue of racism and the prospects for the immediate future. The discussion was lengthy and what follows is an edited version of the transcript. (shrink)

The last decade has seen a slow but steady increase in the number of postdoctoral scholars employed in faculties of education. In this article, seven postdoctoral scholars who worked in the same Ca...

In the United States National Science Foundation and the National Institutes of Health have mandated training STEM doctoral students in the ethical and responsible conduct of research to improve doctoral students' ethical decision-making skills; however, little is known about the process and factors that STEM faculty and graduate students use in their decision-making. This exploratory case study examined how four triads of chemistry faculty and their doctoral students recruited from three research universities in the eastern United States engaged in ethical (...) decision-making on issues of authorship, assignment of credit, and plagiarism. A mixed-methods approach involving the administration of an online survey consisting of three open-ended case studies followed by a think-aloud interview was utilized. Participants were found to use analogical reasoning and base their decision-making on a common core set of considerations including fundamental principles, social contracts, consequences, and discussion with an advisor, often using prior personal experiences as sources. Co-authorship did not appear to impact the doctoral students' ethical decision-making. Gender may play a role in graduate students' decision-making; female doctoral students appeared to be less likely to consider prior experiences when evaluating the vignettes. Graduate students' lack of knowledge of the core issues in the responsible conduct of research, coupled with their lack of research experience, and inability to identify the core considerations may lead them to make bad judgments in specific situations. Our findings help explain the minimal impact that the current responsible conduct of research training methods has had on graduate students' ethical decision-making and should lead to the development of more effective approaches. (shrink)

The evolutionarily conserved Notch signaling pathway regulates a broad spectrum of cell fate decisions and differentiation processes during fetal and postnatal life. It is involved in embryonic organogenesis as well as in the maintenance of homeostasis of self‐renewing systems. In this article, we review the role of Notch signaling in the hematopoietic system with particular emphasis on lymphocyte development and highlight the similarities in Notch function between Drosophila and mammalian differentiation processes. Recent studies indicating that aberrant NOTCH signaling is frequently (...) linked to the induction of T leukemia in humans will also be discussed. BioEssays 27:1117–1128, 2005. © 2005 Wiley Periodicals, Inc. (shrink)

This paper is part of a larger project designed to examine and ameliorate the underrepresentation of female-identified students in the philosophy department at Elon University. The larger project involved a variety of research methods, including statistical analysis of extant registration and grade distribution data from our department as well as the administration of multiple surveys. Here, we provide a description and analysis of one aspect of our research: focus groups. We ran three focus groups of female-identified undergraduate students: one group (...) consisted of students who had taken more than one philosophy class, one consisted of students who had taken only one philosophy class, and one consisted of students who had taken no philosophy classes. After analyzing the results of the focus groups, we find evidence that: one philosophy class alone did not cultivate a growth mindset among female-identified students of philosophy, professors have the potential to ameliorate students’ perceptions of philosophy; and students who have not taken philosophy are likely to see their manner of thinking as being at odds with that required by philosophy. We conclude by articulating a series of questions worthy of further study. (shrink)

Clinical Ethics, Ahead of Print. This paper is a response to a recent BMJ Blog: ‘The duty to treat: where do the limits lie?’ Members of the Surrey Heartlands Integrated Care Service Clinical Ethics Group reflected on arguments in the Blog in relation to resuscitation during the COVID-19 pandemic.Clinicians have had to contend with ever-changing and conflicting guidance from the Resuscitation Council UK and Public Health England regarding personal protective equipment requirements in resuscitation situations. St John Ambulance had different guidance (...) for first responders.The situation regarding resuscitation led the CEG to consider ethical aspects of health care professionals’ responses to the need for resuscitation during COVID-19. Members agreed that professionals should, ideally, have the level of PPE required for an aerosol generating procedure. However, there was no consensus regarding professionals’ duty to care when this is not available. On the one hand, it was agreed that the casualty/patient’s interests regarding resuscitation should be prioritised due to professionals’ contract with the public and professional privilege. On the other hand, risk thresholds were considered relevant to individual decision-making and professionals’ duty to care. All agreed that decision-making should not be influenced by rewards or reprimands. It was agreed also that decisions to resuscitate should not be considered as moral heroism or supererogatory - regardless of PPE availability - but rather as ‘minimally decent’. We agreed that it may be acceptable for professionals, with good reasons, to opt out of resuscitation attempts and these should be reflected on and discussed before the event. (shrink)

We present a new road map for research on “How the Brain Got Language” that adopts an EvoDevoSocio perspective and highlights comparative neuroprimatology – the comparative study of brain, behavior and communication in extant monkeys and great apes – as providing a key grounding for hypotheses on the last common ancestor of humans and monkeys and chimpanzees and the processes which guided the evolution LCA-m → LCA-c → protohumans → H. sapiens. Such research constrains and is constrained by analysis of (...) the subsequent, primarily cultural, evolution of H. sapiens which yielded cultures involving the rich use of language. (shrink)

We present a new road map for research on “How the Brain Got Language” that adopts an EvoDevoSocio perspective and highlights comparative neuroprimatology – the comparative study of brain, behavior and communication in extant monkeys and great apes – as providing a key grounding for hypotheses on the last common ancestor of humans and monkeys and chimpanzees and the processes which guided the evolution LCA-m → LCA-c → protohumans → H. sapiens. Such research constrains and is constrained by analysis of (...) the subsequent, primarily cultural, evolution of H. sapiens which yielded cultures involving the rich use of language. (shrink)

Peer review is a widely accepted instrument for raising the quality of science. Peer review limits the enormous unstructured influx of information and the sheer amount of dubious data, which in its absence would plunge science into chaos. In particular, peer review offers the benefit of eliminating papers that suffer from poor craftsmanship or methodological shortcomings, especially in the experimental sciences. However, we believe that peer review is not always appropriate for the evaluation of controversial hypothetical science. We argue that (...) the process of peer review can be prone to bias towards ideas that affirm the prior convictions of reviewers and against innovation and radical new ideas. Innovative hypotheses are thus highly vulnerable to being “filtered out” or made to accord with conventional wisdom by the peer review process. Consequently, having introduced peer review, the Elsevier journal Medical Hypotheses may be unable to continue its tradition as a radical journal allowing discussion of improbable or unconventional ideas. Hence we conclude by asking the publisher to consider re-introducing the system of editorial review to Medical Hypotheses. (shrink)

In their report in this supplement on research regulatory systems, Barbara Bierer and Mark Barnes note that, when research misconduct has been detected but not yet proven, the individual with institutional responsibility for oversight of research misconduct investigations “may determine that notification of relevant journals or professional societies and correction or full retraction of implicated papers or presentations is appropriate. In those cases, even when a finding of research misconduct per se has not been made or has not been explicitly (...) stated, the journal, professional society, and their readers or members may draw their own conclusions as to what led to the retraction or correction.” This statement highlights an aspect of the reviewed regulatory schemes that creates vulnerability for institutions of higher education subject to the regulations: while, as the authors suggest, it may be “appropriate” to notify third parties (that is, journals, professional societies, and other academic institutions) of suspected research misconduct, there is no regulatory obligation to provide such a notification, and, in fact, providing early (or any) notification is contrary to the confidentiality provisions of the research misconduct regulations. Moreover, the institution—and individuals acting on behalf of the institution—may face legal exposure for notifying outside entities. (shrink)

In this paper, Waters introduces American Indians who hold a Ph.D. in philosophy. Waters explains that because American Indians are unable to garner the financial, collegial, and academic support needed to rise to inclusive positions in the philosophical profession, most of our colleagues and students remain uneducated and ignorant about indigenous people and our philosophies that are still alive today on this shared American continent. America’s indigenous philosophers have important contributions to make to philosophy and culture; yet our conceptual nonexistence (...) exacerbates our veridical non- integration. It is a cultural luxury for the APA to not address these problems. In some moral worlds, the APA Board might have a positive obligation to address the status of American Indian philosophy with all due haste. Three possible ways of indexing American Indian philosophy for inclusion in the discipline are presented, each raising unique and particular problems for the profession. It is suggested a field of Indigenous philosophy (global) could emerge over time, having subfields of diverse cultural philosophies, not necessarily linked to nation states or current geopolitical regions. Concluding, given issues of invisibility, alliances, and responsibility, the APA remains historically morally bound to address and perhaps even redress American Indian exclusionism in the profession upon which it acts, and in the culture it complicitly creates. (shrink)

Pedro Almodóvar is one of the most renowned film directors of recent years. Talk to Her is one of the most discussed and controversial of all his films. Dealing principally with the issue of rape, it also offers profound insights into the nature of love and friendship whilst raising important philosophical and moral questions in unsettling and often paradoxical ways. This is the first book to explore and address the philosophical aspects of Almodóvar’s film. Opening with a helpful introduction by (...) Noël Carroll that places the film in context, specially commissioned chapters examine the following topics: The relationship between art and morality and the problem of 'immoralism' Moral injury and its role in the way we form moral judgments, including the ethics of love and friendship The nature of dialogue, sexual objectification and what 'listening to' means in the context of gender Almodóvar's use of allusion and the unmasking of appearances to explore hidden themes in human nature. Including a biography of Almodóvar, Talk to Her is essential reading for students interested in philosophy and film as well as ethics and gender. It is also provides an accessible and informative insight into philosophy for those in related disciplines such as film studies, literature and religion. Contributors: Noël Carroll, A. W. Eaton, Cynthia Freeland, Robert B. Pippin, C.D.C. Reeve, and George M. Wilson. (shrink)

Reasoning well about risk is most challenging when a woman is pregnant, for patient and doctor alike. During pregnancy, we tend to note the risks of medical interventions without adequately noting those of failing to intervene, yet when it's time to give birth, interventions are seldom questioned, even when they don't work. Meanwhile, outside the clinic, advice given to pregnant women on how to stay healthy in everyday life can seem capricious and overly cautious. This kind of reasoning reflects fear, (...) not evidence. (shrink)

The notion of virtue in general, and courage in particular, has had a hard time integrating itself into the everyday lexicon of bioethics. Following the lead of enlightenment moral philosophy, which concentrates on the theory of right action as opposed to the ancient Greeks' emphasis on the development of good character, bioethics, with some notable exceptions, has tended to relegate consideration of the virtues to the sidelines of moral argument. Recently, however, there have been calls for the necessity of “moral (...) courage” in the context of clinical ethics. As nurses, physicians, and other health care professionals confront a variety of moral contexts in which the virtue of courage is invoked to "do the right thing," stand up for patients' rights, and uphold the ethical standards of their professions, they are increasingly reminded of their moral duty to exhibit courage in the face of institutional obstacles to the proper care of their patients. For example, a nurse's hesitation to approach a physician to request increased sedation for an agitated patient out of fear of retaliation is represented in one article as a lack of courage.In this paper we offer a critical assessment of such invocations of courage. While we find courage to be an indispensable virtue in some challenging contexts, in other settings we find invocations of courage to be both an unfortunate endorsement of an oppressive status quo that can divert attention from the real problems and an undesirable and potentially destructive strategy within health care institutions whose goal is medically excellent and morally good clinical practice. As we shall argue, a call to virtuousness is not always virtuous. (shrink)

The well-known experiments of Nisbett and Wilson lead to the conclusion that we have no introspective access to our decision-making processes. Johansson et al. have recently developed an original protocol consisting in manipulating covertly the relationship between the subjects’ intended choice and the outcome they were presented with: in 79.6% of cases, they do not detect the manipulation and provide an explanation of the choice they did not make, confirming the findings of Nisbett and Wilson. We have reproduced (...) this protocol, while introducing for some choices an expert guidance to the description of this choice. The subjects who were assisted detected the manipulation in 80% of cases. Our experiment confirms Nisbett and Wilson’s findings that we are usually unaware of our decision processes, but goes further by showing that we can access them through specific mental acts. (shrink)

Since 1992, institutions accredited by The Joint Commission have been required to have a process in place that allows staff members, patients, and families to address ethical issues or issues prone to conflict. While the commission's expectations clearly have made ethics committees more common, simply having a committee in no way demonstrates its effectiveness in terms of the availability of the service to key constituents, the quality of the processes used, or the outcomes achieved. Beyond meeting baseline accreditation standards, effective (...) ethics resources are requisite for quality care for another reason. The provision of care to the sick is a practice with profound moral dimensions. Clinicians need what Margaret Urban Walker has called “moral spaces,” reflective spaces within institutions in which to explore and communicate values and ethical obligations as they undergird goals of care. Walker proposed that ethicists needed to be concerned with the design and maintenance of these moral spaces. Clearly, that concern needs to extend beyond ethicists to institutional leaders. This essay uses Walker's idea of moral space to describe individuals and groups who are actual and potential ethics resources in health care institutions. We focus on four requisite characteristics of effective resources and the challenges to achieving them, and we identify strategies to build them. In our view, such moral spaces are particularly important for nurses and their colleagues on interprofessional teams and need to be expanded and strengthened in most settings. (shrink)

Charming Cadavers. Horrific Figurations of the Feminine in Indian Buddhist Hagiographic Literature. Liz Wilson. The University of Chicago Press, Chicago 1996. xvi, 258 pp. Cloth: $55.00; £43.95. ISBN 0-226-90053-3; paper: $19.95, £15.95. ISBN 0-226-90054-1.

In this paper, I reflect on an important article by Bob Veatch in the inaugural issue of the Hastings Center Report, entitled “Experimental Pregnancy.” It is a report and elegant analysis of the Goldzieher Study, in which nearly 400 women were randomized to receive hormonal contraception or placebo absent consent or disclosure about placebo use, resulting in several pregnancies. Noting the study’s limited notoriety, I first consider the narratives that have instead dominated bioethics’ approach to pregnancy and research: thalidomide (...) and diethylstibesterol. These narratives have facilitated a narrow focus on avoiding fetal risk, to the exclusion of other ethically relevant considerations. I then revisit “Experimental Pregnancy” and offer two ways in which Bob’s analysis serves as an important corrective, first, by foregrounding research subjects, and second, by normalizing pregnancy and thus foregrounding foundational ethical considerations that are sometimes lost amidst pregnancy’s presumed exceptionalism. (shrink)

Since the U.S. Supreme Court's decision in Dobbs vs. Jackson Women's Health Organization, a growing web of state laws restricts access to abortion. Here we consider how, ethically, doctors should respond when terminating a pregnancy is clinically indicated but state law imposes restrictions on doing so. We offer a typology of cases in which the dilemma emerges and a brief sketch of the current state of legal prohibitions against providing such care. We examine the issue from the standpoints of conscience, (...) professional ethics, and civil disobedience and conclude that it is almost always morally permissible and praiseworthy to break the law and that, in a subset of cases, it is morally obligatory to do so. We further argue that health care institutions that employ or credential physicians to provide reproductive health care have an ethical duty to provide a basic suite of practical supports for them as they work to ethically resolve the dilemmas before them. (shrink)

A commentary on “Why We Should All Pay for Fertility Treatment: An Argument from Ethics and Policy,” from the March‐April 2013 issue.

By 1999, when Atul Gawande's essay “Whose Body Is It, Anyway?” appeared in The New Yorker, patient autonomy had largely trumped physician paternalism in American medical practice. Gawande uses the stories of actual patients to attempt his counter case for physicians' “talking patients through their decisions.” Toward the end of his essay, Gawande acknowledges that “many ethicists find this line of reasoning disturbing,” but he reassures his readers that “the real task isn't to banish paternalism; the real task is to (...) preserve kindness.”What troubles me, however, is not so much the ethical position Gawande takes but the way he structures his narrative to support his position. “Whose Body Is It, Anyway?” offers an important example for close scrutiny because, in my experience, it so effectively engages readers‐especially medical students‐and persuades them to accept the ethical position it puts forward. Yet Gawande's own reflections about this issue do not stop with this essay. As he has gained clinical experience, he has continued his ethical reflections, and the stories that he tells have changed significantly over the years. I will argue here that close reading and careful narrative scrutiny can alert those who read this essay apart from Gawande's later work to some of the pitfalls in this kind of narrative ethics. (shrink)

Hastings Center Report, Volume 52, Issue 1, Page 28-31, January/February 2022.