Background In 2001 a report on the provision of clinical ethics support in UK healthcare institutions identified 20 clinical ethics committees. Since then there has been no systematic evaluation or documentation of their work at a national level. Recent national surveys of clinical ethics services in other countries have identified wide variation in practice and scope of activities. Objective To describe the current provision of ethics support in the UK and its development since 2001. Method A postal/electronic questionnaire survey administered (...) to the chairs of all 82 clinical ethics services registered with the UK Clinical Ethics Network in July 2010. Results Response rate was 62% with the majority of responding services situated in acute trusts. All services included a clinical ethics committee with one service also having a clinical ethicist. Lay members were present in 72% of responding committees. Individual case consultation has increased since 2001 with 29% of chairs spending more than 50% of their time on this. Access to and involvement in the process of case consultation is less for patients and families than for clinical staff. There is wide variation in committee processes and levels of institutional support. Over half of the responding committees undertook some form of evaluation. Conclusion Clinical ethics services in the UK are increasing as is their involvement in case consultation. However, the significant variation in committee processes suggests that further qualitative research is needed to understand how these committees function and the role they play in their institution. (shrink)
This book explores five Platonic dialogues: Lysis, Charmides, Protagoras, Euthydemus, and the Republic. This book uses Socrates’ narrative commentary as its primary interpretive framework. No one has engaged in a sustained attempt to explore the Platonic dialogues from this angle. As a result, it offers a unique contribution to Plato scholarship. The portrait of Socrates that emerges challenges the traditional view of Socrates as an intellectualist and offers a holistic vision of philosophical practice.
Anne-Marie Schultz explores Plato’s presentation of Socrates as a philosopher who tells narratives about himself in the Theaetetus, Symposium, Apology, and Phaedo. She argues that scholars should regard Socrates as a public philosopher, while examining Socratic self-disclosive practices in the works of bell hooks, Kathy Khang, and Ta-Neishi Coates.
A virtue centred approach to ethics has been criticized for being vague owing to the nature of its central concept, the paradigm person. From the perspective of the practitioner the most damaging charge is that virtue ethics fails to be action guiding and, in addition to this, it does not offer any means of act appraisal. These criticisms leave virtue ethics in a weak position vis-à-vis traditional approaches to ethics. The criticism is, however, challenged by Hursthouse in her analysis of (...) the accounts of right action offered by deontology, utilitarianism and virtue ethics. It is possible to defend the action guiding nature of virtue ethics: there are virtue rules and exemplars to guide action. Insights from Aristotle’s practical approach to ethics are considered alongside Hursthouse’s analysis and it is suggested that virtue ethics is also capable of facilitating action appraisal. It is at the same time acknowledged that approaches to virtue ethics vary widely and that the challenges offered here would be rejected by those who embrace a radical replacement virtue approach. (shrink)
This article is presented as a defence of voluntary active euthanasia from a virtue perspective and it is written with the objective of generating debate and challenging the assumption that killing is necessarily vicious in all circumstances. Practitioners are often torn between acting from virtue and acting from duty. In the case presented the physician was governed by compassion and this illustrates how good people may have the courage to sacrifice their own security in the interests of virtue. The doctor's (...) action created huge tensions for the nurse, who was governed by the code of conduct and relevant laws. Appraising active euthanasia from a virtue perspective can offer a more compassionate approach to the predicament of practitioners and clients. The tensions arising from the virtue versus rules debate generates irreconcilable difficulties for nurses. A shift towards virtue would help to resolve this problem and support the call for a change in the law. The controversial nature of this position is acknowledged. The argument is put forward on the understanding that many practitioners will not agree with the conclusions reached. (shrink)
The death of a research participant raises numerous ethical and legal issues regarding the return of research results to related family members. This question is particularly acute in the context of genetic research since the research results from an individual may be relevant to each of the biological relatives. This paper first investigates the ethical and legal frameworks governing the return of a deceased participant's individual research results to his or her related family members. Then, it weighs the rights and (...) interests of both the deceased individual and related family members in an attempt to identify key ethical considerations underlying the return of such results. This analysis of international guidelines and national laws and regulations reveals that though the legal framework regarding privacy and confidentiality of clinical and research information is well established (albeit not homogenous), guidelines are generally absent in the post-mortem context. Nevertheless, a brief analysis of this issue through two ethical perspectives (principlism and consequentialism) allows us to identify six key elements to be taken into consideration when returning a deceased participant's research results. (shrink)
Hannah James makes a persuasive case for the use of donated bodies and body parts in surgical training, enabling high fidelity training, improved competency of surgeons and reduced risk of harm to patients from trainees ‘learning on the job’.1 She also identifies some pertinent ethical questions that arise from this practice that should be considered by training organisations, regulatory authorities and the trainees themselves. Many countries throughout the world have regulated programmes, governed by strict ethical principles, for donating bodies, usually (...) to academic institutions for the purposes of medical education.2 In the UK the Human Tissue Authority sets out guiding principles for institutions licensed to handle human tissue including donation of bodies for anatomical examination, education and research; consent, dignity, quality, and honesty and openness.3 The Nuffield Council on Bioethics, in its 2011 report, Human Bodies: donation for medicine and research, identified a number of relevant ethical values including autonomy, altruism, justice, dignity, reciprocity, maximising welfare, and honesty and respect.4 While this report did not focus specifically on donation of human tissue for education and training the principles identified are equally relevant in this context. In terms of maximising welfare whole body donation for education and training provides benefit to many patients over a relatively short time frame …. (shrink)
Until the mid-20th century, biomedical research centered on the study of specific diseases, concerned with short periods of time and small groups of living research participants. However, the growth of longitudinal population studies and long-term biobanking now forces the research community to examine the possibility of the death of their research participants.The death of a research participant raises numerous ethical and legal issues, including the return of deceased individuals’ research results to related family members. As with the return of individual (...) research results for living research participants, the question of the obligation to return a deceased person’s research results to family members has yet to be settled. This question is particularly acute in the context of genetic research since the research results from one individual may have health implications for all biological relatives. (shrink)
This article examines whether a training program in ethical decision making can change young athletes’ doping attitudes. Fifty-two young elite athletes were randomly assigned to either an ethical decision-making training group or a standard-knowledge-based educational program group. Another 17 young elite athletes were recruited for no-treatment control purposes. The ethical decision-making training comprised six 30-min online sessions in which the participants had to work through 18 ethical dilemmas related to doping. The standard-knowledge-based educational program was also conducted in six online (...) sessions of comparable length to that of the ethical training. A short version of the Performance Enhancement Attitude Scale was administered to measure the effects of the trainings on doping attitude. Prior to as well as after the intervention, the mean doping attitude scores of the young athletes were low to very low, indicating vehement rejections of doping. The results of our experiment showed that the ethical training led to an attenuation of these rejections. No intervention effect was found in the standard education group. The observed slight increase in the doping attitude score could be an indication that the ethical decision-making training was successful in breaking up the athletes’ stereotypical style of reasoning about doping. (shrink)
Although non-profit organisations typically have high representation of females on their boards, relatively little is known about the effects of gender diversity in these organisations particularly in relation to financial management. In this archival study, resource dependency theory and agency analysis are combined to provide theoretical insight and empirical analysis of gender diversity on effective financial management in member-governed, community financial institutions. The investigation is possible due to the unique characteristics of the organisational form and region being examined—credit unions in (...) Northern Ireland. The sector has not been subject to external regulation on board gender, yet a wide array of gender mix on boards ranging from 100 % male to 100 % female are in existence. In addition, effective financial management is crucial to their survival and their ability to meet member objectives. Boards with higher female representation exhibit superior financial management first, in respect of loan book quality in the period of austerity following the financial crisis and second when measured against return on assets. (shrink)
In this paper, my goal is to use an epistemic injustice framework to extend an existing normative analysis of over-medicalization to psychiatry and thus draw attention to overlooked injustices. Kaczmarek has developed a promising bioethical and pragmatic approach to over-medicalization, which consists of four guiding questions covering issues related to the harms and benefits of medicalization. In a nutshell, if we answer “yes” to all proposed questions, then it is a case of over-medicalization. Building on an epistemic injustice framework, I (...) will argue that Kaczmarek’s proposal lacks guidance concerning the procedures through which we are to answer the four questions, and I will import the conceptual resources of epistemic injustice to guide our thinking on these issues. This will lead me to defend more inclusive decision-making procedures regarding medicalization in the DSM. Kaczmarek’s account complemented with an epistemic injustice framework can help us achieve better forms of medicalization. I will then use a contested case of medicalization, the creation of Premenstrual Dysphoric Disorder in the DSM-5 to illustrate how the epistemic injustice framework can help to shed light on these issues and to show its relevance to distinguish good and bad forms of medicalization. (shrink)
Cette thèse en impose par la masse de travail qu'elle représente, mais plus encore par les questions qu'elle pose à l'histoire des femmes et par l'éclairage nouveau qu'elle apporte sur les milieux populaires. La vie privée a reçu droit de cité en histoire grâce à la haute approbation de Philippe Ariès et de Georges Duby (ainsi que de leurs nombreux collaborateurs). Le concept de vie privée reste pourtant difficile à cerner. La première audace d'Anne Marie Sohn consiste à donner (...) une dé.. (shrink)
Anne-Marie Weidler Kubanek: Nothing less than an adventure: Ellen Gleditsch and her life in science Content Type Journal Article Category Book Review Pages 1-2 DOI 10.1007/s10698-011-9119-8 Authors Marelene Rayner-Canham, Memorial University, Grenfell Campus, Corner Brook, NL, Canada Geoff Rayner-Canham, Memorial University, Grenfell Campus, Corner Brook, NL, Canada Journal Foundations of Chemistry Online ISSN 1572-8463 Print ISSN 1386-4238.
: Green consumerism is on the rise in America, but its environmental effects are contested. Does green marketing contribute to the greening of American consciousness, or does it encourage corporate greenwashing? This tenuous ethical position means that eco-marketers must carefully frame their environmental products in a way that appeals to consumers with environmental ethics and buyers who consider natural products as well as conventional items. Thus, eco-marketing constructs a complicated ethical identity for the green consumer. Environmentally aware individuals are already (...) guided by their personal ethics. In trying to attract new consumers, environmentally minded businesses attach an aesthetic quality to environmental goods. In an era where environmentalism is increasingly hip, what are the implications for an environmental ethics infused with a sense of aesthetics? This article analyzes the promotional materials of three companies that advertise their environmental consciousness: Burt's Bee's Inc., Tom's of Maine, Inc., and The Body Shop Inc. Responding to an increasing online shopping market, these companies make their promotional and marketing materials available online, and these web-based materials replicate their printed catalogs and indoor advertisements. As part of selling products to consumers based on a set of ideological values, these companies employ two specific discursive strategies to sell their products: they create enhanced notions of beauty by emphasizing the performance of their natural products, and thus infuse green consumerism with a unique environmental aesthetic. They also convey ideas of health through community values, which in turn enhances notions of personal health to include ecological well-being. This article explicates the ethical implications of a personal natural care discourse for eco-marketing strategies, and the significance of a green consumer aesthetic for environmental consciousness in general. (shrink)
_From a renowned foreign-policy expert, a new paradigm for strategy in the twenty-first century_ In 1961, Thomas Schelling’s _The Strategy of Conflict_ used game theory to radically reenvision the U.S.-Soviet relationship and establish the basis of international relations for the rest of the Cold War. Now, Anne-Marie Slaughter—one of _Foreign Policy’_s Top 100 Global Thinkers from 2009 to 2012, and the first woman to serve as director of the State Department Office of Policy Planning—applies network theory to develop a (...) new set of strategies for the post-Cold War world. While chessboard-style competitive relationships still exist—U.S.-Iranian relations, for example—many other situations demand that we look not at individual entities but at their links to one another. We must learn to understand, shape, and build on those connections. Concise and accessible, based on real-world situations, on a lucid understanding of network science, and on a clear taxonomy of strategies, this will be a go-to resource for anyone looking for a new way to think about strategy in politics or business. (shrink)
Acte essentiellement privé, le mariage grec a pour traits constants, aux époques classique et hellénistique, la dation de la mariée au marié par son père (ekdosis), ainsi que le versement d'une dot directe (proïx ou phernè) par le père ou son substitut. La riche monographie que lui consacrent A.-M. Vérilhac et Cl. Vial, à l'issue d'une collaboration de plus de dix ans, leur permet d'en étudier les différentes dimensions (sociale, économique, juridique, rituelle…) et d'en souligner ains..
The problems of exposing students to real life situations in which they can gain an insight into the dilemmas experienced by clients and staff are highlighted. The value of the Greek notion of catharsis (katharsis: a cleansing) is discussed and the use of literature is suggested as a means of providing students with vicarious experience of the real, but often inaccessible, situations in which nurses may have to make moral decisions.
Anne-Marie McCallion ABSTRACT: This is an interview with Rianna Walcott, the co-founder of Project Myopia – a student-led initiative to decolonise university curricula. The discussion explores the difference between ‘diversity’ and ‘decolonisation’: how these two concepts relate to and contradict one another. Walcott outlines some of the recent student efforts to ‘decolonise’ the university and ….
_From Illiteracy to Literature_ presents innovative material based on research with ‘non-reading’ children and re-examines the complex relationship between psychoanalysis and literature, through the lens of the psychical significance of reading: the forgotten adventure of our coming to reading. Anne-Marie Picard draws on two specific fields of interest: firstly the wish to understand the nature of literariness or the "literary effect", i.e. the pleasures we derive from reading; secondly research on reading pathologies carried out at St Anne’s Hospital, (...) Paris. The author uses clinical observations of non-reading children to answer literary questions about the reading experience, using psychoanalytic theory as a conceptual framework. The notion that reading difficulties or phobias should be seen as a symptom in the psychoanalytic sense, allows Picard to shed light on both clinical vignettes taken from children’s case histories and reading scenes from literary texts. Children experiencing difficulties in learning to read highlight the imaginary stakes of the confrontation with the arbitrary nature of the letter and the "price to pay" for one’s entrance into the Symbolic. Picard applies the lesson "taught" by these children to a series of key literary texts featuring, at their very core, this confrontation with the signifier, with the written code itself.. This book argues that there is something in literature that drives us back, again and again, to the loss we have suffered as human beings, to what we had to undergo to become human: our subjection to the common place of language. Picard shows complex Lacanian concepts "at work" in the field of reading pathologies, emphasizing close reading and a clinical attention to the "letter" of the texts, far from the "psychobiographical" attempts at psychologizing literary authors. _From Illiteracy to Literature_ presents a novel psychodynamic approach that will be of great interest to psychotherapists and language pathologists, appealing to literary scholars and those interested in the process of reading and "literariness.". (shrink)
A fundamental tenet of hermeneutic phenomenology is that people seek to create meaning of their experience from the response sited within human consciousness. The focus of this study is on the world of the lived experience as it is interpreted by participants through memory and language as accessed by interviews in order to produce an understanding of the participants’ experience. Three participants were interviewed whose adult children had died as a result of an AIDS-related illness. The interviews were recorded and (...) transcribed, and interwoven analyses sought to illustrate the participants’ lived experience of the phenomenon. An attempt was made to understand how the various phenomena relating to parental bereavement were reflected by participants in the interviews. Common themes included reactions to the knowledge of the illness, the experience of being with their dying child, coping with the pain of the loss, and spiritual and existential concerns. There are references to how others judge their grieving behaviour. Issues of retribution and punishment are prominent and these appear to place a particular burden of sorrow on the grieving parent. The study provided insight into the lived experience of bereavement and the forging of new meaning structures that can accommodate the loss. (shrink)
This essay proposes that Socrates practiced various spiritual exercises, including meditation, and that this Socratic practice of meditation was habitual, aimed at cultivating emotional self-control and existential preparedness. Contemporary research in neurobiology supports the view that intentional mental actions, including meditation, have a profound impact on brain activity, neuroplasticity, and help engender emotional self-control. This impact on brain activity is confirmed via technological developments, a prime example of how technology benefits humanity. Socrates attains the balanced emotional self-control that Alcibiades describes (...) in the Symposium because of the sustained mental effort he exerts that directly impacts his brain and his emotional and philosophical life. The essay concludes that Socratic meditative practices aimed at manifesting true dignity as human beings within the complexities of a technological world offer a promising model of self-care worthy of embracing today. (shrink)
Euthanasia has once again become headline news in the UK, with the announcement by Dr Michael Irwin, a former medical director of the United Nations, that he has helped at least 50 people to die, including two between February and July 1997. He has been quoted as saying that his ‘conscience is clear’ and that the time has come to confront the issue of euthanasia. For the purposes of this article, the term ‘beneficent voluntary active euthanasia’ (BVAE) will be used: (...) beneficent from the prima facie principle of beneficence, to do good, and voluntary to indicate that this must be carried out at the request of a competent client. This implies adherence to another prima facie principle, that of respect for autonomy. Active implies that something is done or given with the intention of hastening death. The word euthanasia itself simply means ‘good death’. This article examines the moral positions of two nurses and one junior doctor towards the subject of BVAE and an attempt is made to represent the main conflicting moral positions. The central arguments against BVAE and counterarguments are presented. The conclusion reached is that consenting adults should not be prevented from availing themselves of BVAE if another consenting adult (a medical doctor) is available and capable of carrying out their wishes. This being the case, it is suggested that BVAE should be available as an option in hospices and in the community. The aims of this article are: to generate debate among professionals; to present a three-way discussion that might be useful as a focus for educational purposes, particularly at undergraduate level; to challenge professionals to confront the issue of euthanasia; and to plead the case of those who request assistance in exercising autonomy by gaining control over their own deaths. (shrink)
In the Origins of Totalitarianism, Hannah Arendt makes the unexpected statement that totalitarian violence "is expressed much more frighteningly in the organization of its followers than in the physical liquidation of its opponents." Of course, her intention is not to deny the radical physical violence of totalitarianism but rather to understand the distinctive features of totalitarian terror. In order to fully understand the importance of what Arendt is describing, we should compare this first moment of the analysis with another assertion (...) that seems just as paradoxical and that is also in The Origins of Totalitarianism: noting totalitarianism's contempt for facts and reality, Arendt remarks that the propaganda of totalitarian movements is "invariably as frank as it is mendacious." Totalitarian propaganda does not just lie about the aims and real actions of totalitarian movements or regimes: it also gives itself the organization required to change the real world and make it "true" to its assertions, though they be utterly absurd and utterly monstrous. Through totalitarian organization the natural bonds of solidarity and communication are broken; they are replaced by distrust and informing. The objective is to pervert human plurality into a mass of fragmented individuals, to suppress the common world and substitute it with alienation from the world, from others, and from oneself. From then on, everything is blurred for the outside observer who would still like to distinguish between adherence to the regime out of conviction and submission through terror, organization, and indoctrination. The issue of knowing whether this enthusiasm is forced or sincere loses much of its pertinence. Let us keep this important point in mind when we pass judgment too rapidly on the "fanaticism" of Islamic crowds streaming down the streets of Teheran or any other totalitarian theocracy. (shrink)
Focusing on discourses and practices of identity in an Italian organization in London, this article examines the relationship between the construction of the identity of places and the construction of terrains of belonging. Various forms of cultural practices that mark out spatial and identity boundaries for the London Italian population are discussed in relation to the deployment of gender and ethnicity. Advancing a corporeal approach to identity formation, it is argued that displays of the Italian presence in London operate through (...) the repetition of regulatory norms that produces the effect of materialization of cultural belonging through the ethnicizing and gendering of individual bodies. Gender and ethnicity are deeply embedded in one another and their entwinement is to be understood as the outcome of their construction along similar bodily lines. Also, the author shows that gender and ethnicity are mutually dependent on each other for their construction; imperatives of gender serve to stabilize a fluctuating and indeterminate ethnic culture, while ethnic conventions naturalize the different positions men and women occupy in social life. (shrink)