Newborn bloodspot screening programs are some of the longest running population screening programs internationally. Debate continues regarding the need for parents to give consent to having their child screened. Little attention has been paid to how meanings of consent-related terminology vary among stakeholders and the implications of this for practice. We undertook semi-structured interviews with parents, healthcare professionals and policy decision makers in two Canadian provinces. Conceptions of consent-related terms revolved around seven factors within two broad domains, decision-making and information (...) attainment. Decision-making comprised: parent decision authority; voluntariness; parent engagement with decision-making; and the process of enacting choice. Information ascertainment comprised: professional responsibilities ; parent responsibilities; and the need for discussion and understanding prior to a decision. Our findings indicate that consent-related terms are variously understood, with substantive implications for practice. We suggest that consent procedures should be explained descriptively, regardless of approach, so there are clear indications of what is expected of parents and healthcare professionals. Support systems are required both to meet the educational needs of parents and families and to support healthcare professionals in delivering information in a manner in keeping with parent needs. (shrink)
This is a pugnacious book, born of ancient controversy and attempting to return the debate to a time before the central jurisprudential questions were set by Hart and other legal positivists. Simmonds addresses those familiar with current analytical philosophy of law: those of us who know our Hart, Fuller, Dworkin, Raz, MacCormick and Kramer, and who perhaps need to have our attention drawn to Plato, Aristotle, Grotius, Hobbes and Kant. Presuming an informed readership, there is no bibliography, and it (...) incorporates ‘substantial extracts from four recent essays’, but does not say what they are. Overall, his position is that law should be understood as an attempt to realize an archetype of law, an archetype which is a moral ideal. Those suspicious of moral ideals are not likely to find moral archetypes more philosophically acceptable. Yet, if Simmonds is right, we need them in jurisprudence.Simmonds is against the positivist split between …. (shrink)
The authors of this book engage in essay form in a lively debate over the fundamental characteristics of legal and moral rights. They examine whether rights fundamentally protect individuals' interests or whether they instead fundamentally enable individuals to make choices. In the course of this debate the authors address many questions through which they clarify, though not finally resolve, a number of controversial present-day political debates, including those over abortion, euthanasia, and animal rights.
This book argues that the institutions of law, and the structures of legal thought, are to be understood by reference to a moral ideal of freedom or independence from the power of others. The moral value and justificatory force of law are not contingent upon circumstance, but intrinsic to its character. Doctrinal legal arguments are shaped by rival conceptions of the conditions for realization of the idea of law. In making these claims, the author rejects the viewpoint of much contemporary (...) legal theory, and seeks to move jurisprudence closer to an older tradition of philosophical reflection upon law, exemplified by Hobbes and Kant. Modern analytical jurisprudence has tended to view these older philosophies as confused precisely in so far as they equate an understanding of law's nature with a revelation of its moral basis. According to most contemporary legal theorists, the understanding and analysis of existing institutions is quite distinct from any enterprise of moral reflection, but the relationship between ideals and practices is much more intimate than this approach would suggest. Some institutions can be properly understood only when they are viewed as imperfect attempts to realize moral or political ideals; and some ideals can be conceived only by reference to their expression in institutions. (shrink)
We examine the closure conditions of the probabilistic consequence relation of Hawthorne and Makinson, specifically the outstanding question of completeness in terms of Horn rules, of their proposed (finite) set of rules O. We show that on the contrary no such finite set of Horn rules exists, though we are able to specify an infinite set which is complete.
-/- Background: Nurses who provide aggressive care often experience the ethical challenge of needing to preserve the hope of seriously ill patients and their families without providing false hope. -/- Research objectives: The purpose of this inquiry was to explore nurses’ moral competence related to fostering hope in patients and their families within the context of aggressive technological care. A secondary purpose was to understand how this competence is shaped by the social–moral space of nurses’ work in order to capture (...) how competencies may reflect an adaptation to a less than ideal work environment. -/- Research design: A critical qualitative approach was used. -/- Participants: Fifteen graduate nursing students from various practice areas participated. -/- Ethical considerations: After receiving ethics approval from the university, signed informed consent was obtained from participants before they were interviewed. -/- Findings: One overarching theme ‘Mediating the tension between providing false hope and destroying hope within biomedicine’ along with three subthemes, including ‘Reimagining hopeful possibilities’, ‘Exercising caution within the social–moral space of nursing’ and ‘Maintaining nurses’ own hope’, was identified, which represents specific aspects of this moral competency. -/- Discussion: This competency represents a complex, nuanced and multi-layered set of skills in which nurses must be well attuned to the needs and emotions of their patients and families, have the foresight to imagine possible future hopes, be able to acknowledge death, have advanced interpersonal skills, maintain their own hope and ideally have the capacity to challenge those around them when the provision of aggressive care is a form of providing false hope. -/- Conclusion: The articulation of moral competencies may support the development of nursing ethics curricula to prepare future nurses in a way that is sensitive to the characteristics of actual practice settings. (shrink)
The international pharmaceutical industry has made significant efforts towards ensuring compliant and ethical communication and interaction with physicians and patients. This article presents the current status of the worldwide governance of communication practices by pharmaceutical companies, concentrating on prescription-only medicines. It analyzes legislative, regulatory, and code-based compliance control mechanisms and highlights significant developments, including the 2006 and 2012 revisions of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) Code of Practice.
Marketing systems research has the potential to contribute to the well-being of individuals, communities and our environment but we need to ensure that we do not mechanistically apply inadequate approaches. This article identifies tensions and limitations within the developing marketing systems theory and literature. Using the tools of critical realism, we aim to critique the omissions in the metatheory of marketing systems research and then put forward CR to reconstruct a more comprehensive basis for the development of marketing systems theory. (...) We draw attention to the failings of current metatheory in its use of conflationary approaches to theorizing before setting out the features of a CR informed study of marketing systems. (shrink)
The essay replies to comments by Finnis, Gardner and Endicott, on my book, Law as a Moral Idea. It is questioned whether Finnis is right to suggest that governance by law is a requirement of justice. It is suggested that Hart's positivism may have rested upon an unduly private conception of morality. Gardner's suggestion that Law as a Moral Idea falsely manufactures disagreement with Hart is rejected, principally by pointing out that Gardner focuses upon only one issue, where the book (...) already acknowledges that Hart might conceivably agree, and ignores other issues where the disagreement with Hart seems indisputable. In response to Endicott, it is acknowledged that 'politics' could be understood as a moral idea comparable to the idea of 'law', but denied that this robs either thesis of interest. The nature of doctrinal reasoning and law's justificatory force is then discussed. (shrink)
Advocacy has been positioned as an ideal within the practice of nursing, with national guidelines and professional standards obliging nurses to respect patients' autonomous choices and to act as their advocates. However, the meaning of advocacy and autonomy is not well defined or understood, leading to uncertainty regarding what is required, expected and feasible for nurses in clinical practice. In this article, a feminist ethics perspective is used to examine how moral responsibilities are enacted in the perinatal nurse—patient relationship and (...) to explore the interaction between the various threads that influence, and are in turn affected by, this relationship. This perspective allows for consideration of contextual and relational factors that impact on the way perinatal nursing care is given and received, and provides a framework for exploring the ways in which patient autonomy, advocacy and choice are experienced by childbearing women and their nurses during labour and birth. (shrink)
Alan Gewirth has propounded a moral theory which commits him to the view that prescriptions can appropriately be addressed to people who have neither any moral reasons nor any prudential reasons to follow the prescriptions. We highlight the strangeness of Gewirth's position and then show that it undermines his attempt to come up with a supreme moral principle.
ABSTRACTThis paper is premised on the call to re-orientate marketing as a contributing social science. It gathers together criticisms of marketing research which identify inconsistencies that prevent our progress. It posits that we are driven to reproduce these inconsistencies because of a closed-system of practice and because of the generative absence of an effective, reflexive and integrative metatheoretical structure. In response to these problems, the paper aims to offer an integrative metatheoretical structure from which to ground our research and intervene (...) in the identified inconsistencies. The paper therefore offers a perspective on the constitution of the world, before addressing the terms and conditions on which the world is to be researched and explained. This conceptual contribution employs tools developed in the critical realist philosophy of social science to address: instances of absence within marketing research; and how these instances are generated and reproduced. It then suggests how these absences can be rectified. (shrink)
To understand the distinctive characteristics of the institutions of law, one needs to understand the idea of law. Understanding the nature of law is not ultimately a matter of achieving a careful description of social practices but a matter of grasping the idea towards which those practices must be understood as oriented. The idea of law is the focal point that enables us to make coherent sense of the otherwise diverse features of practice, but it is not itself a matter (...) of observable practice. It resembles a notional point in space that enables us to grasp the relationship between various parts of a complex drawing, although in itself it forms no part of the drawing. But how is such an idea to be investigated? We expect a clear understanding of the idea of law to explain our settled understandings about what will and will not count as an instance of legal ordering. We expect it, in other words, to explain some at least of the minimum conditions for applicability of the idea. But, since the idea of law is invoked within the practices of law, we also expect a philosophical understanding of that idea to clarify its role in guiding and orienting practice, and not simply in describing practice. Although the practices of law are oriented towards the idea of law, that idea is not straightforwardly available to be read in the surface appearance of the practices. For such practices, while involving systematic appeal to the idea of law, operate for the most part on the basis of that unreflective conformity that assists the stable functioning of most human institutions. Can we begin by identifying a "minimum specification" of the concept of law, in the form of a set of conditions without which nothing could count as law at all? From such a minimum specification, can we proceed in some orderly and intellectually defensible way towards "later phases" of the concept, with their "qualitative changes as well as additions and complications"? The possibility is worth exploring, however unfashionable may be the philosophical viewpoint from which it springs. Fuller's famous story of Rex, and his failed attempts to enact law, identifies the minimum conditions that something must satisfy in order to count as an instance of law. Fuller's theory becomes interesting when he proceeds to demonstrate that the eight desiderata (identified as minimum conditions), when taken collectively, be regarded as a guiding ideal for legal thought: the ideal that we usually label "the rule of law". Fuller claimed that his eight requirements represent an "inner morality of law". Hart's critique of Fuller appeared to suggest that the moral value of compliance with the eight requirements is wholly contingent upon the law's content, and that the eight requirements are more akin to precepts of efficiency than to moral standards. This criticism has been widely endorsed as correct. In fact, the criticism is not correct. The eight requirements are not principles of efficacy, but (when taken together) represent a moral ideal for legal systems. Fuller never really succeeded in giving a clear explanation of the moral status of his eight requirements. I argue that Fuller's eight desiderata represent an intrinsically moral ideal that we may call "freedom as independence from the power of another". This is the aspect of freedom that distinguishes the slave from the free man. My theory seeks to establish the existence of a very tight and necessary connection between law and morality. Positivists will find it impossible to deny that governance by law involves some degree of compliance with Fuller's eight requirements, and that such compliance necessarily involves the realisation of some degree of freedom as independence. If they are tempted to deny that freedom as independence is a distinct aspect of freedom, they must also argue that connections between slavery and the lack of freedom are purely contingent. If they accept that the lack of freedom as independece is what makes a slave a slave, but they deny that freedom as indepenence is a moral value, they must say that there is nothing intrinsically morally wrong with slavery: the moral wrongness of slavery would then have to be seen as stemming from purely contingent features of the slave's position. The value of freedom as independence may be thin. But it is real, it is genuinely valuable, and it is tightly connected to the existence of law. (shrink)
The essay builds on the claim that the concept of law is best understood as structured by an abstract archetype to which actual instances of law approximate, and that the archetype in question is an intrinsically moral idea: the idea of a realm of universality and necessity within which one can enjoy freedom as independence from the power of others. Reflection upon the nature of this archetype is a form of moral reflection upon experience, where we seek to grasp the (...) nature of a value by considering the forms in which the value has been partially realised. The departure from Aristotelian thought served to obscure the possibility of such a form of moral reflection. Twentieth-century theories of the nature of law have tended to focus upon the problem of law’s self-genesis, but this neglects the full extent of the philosophical problem of law’s nature. (shrink)
H.L.A. Hart’s legal positivism displaces the authority of institutions and emphasizes the independence of personal moral judgment. While such a position has an obvious appeal, we should not fail to acknowledge the extent to which values are articulated within established practices. In this essay, civility and law are offered as examples of practices that embody distinctive values and can properly be understood only by reference to such values. It is suggested that legal positivism is driven by a moral metaphysic wherein (...) abstractly conceived principles confront neutrally described facts. But values cannot, without distortion, be understood in abstraction from the practices and forms of association within which they find expression. The refusal to recognize this fact fosters moral skepticism rather than individual moral responsibility. (shrink)
By investigating the nature of the social interactions between “sledge dogs” and explorers in the first land-based exploration in Antarctica, this research contributes to an animal-human perspective in Antarctic historical studies. Consideration of the interspecies interactions provide further insight into attitudes to nonhuman animal welfare, including towards wildlife, at the turn of the twentieth century. The companionship of favored animals appeared to have alleviated some of the stresses of isolation and confinement in the inhospitable Antarctic environment.
This issue of Jurisprudence features a symposium on Nigel Simmonds's Law as a Moral Idea. There are essays by John Finnis, John Gardner, Timothy Endicott and a Reply by Nigel Simmonds. The papers are based on presentations given at a panel discussion in Oxford in December 2009. In this 'Introduction' Pavlos Eleftheriadis outlines the main themes of the book, namely that the idea of law is intrinsically moral, the distinction between analytical and normative jurisprudence is false and law (...) is not a list of rules or a chain of authorisation, but a system of thought that follows the basic principles of practical reason. (shrink)
This is a pugnacious book, born of ancient controversy and attempting to return the debate to a time before the central jurisprudential questions were set by Hart and other legal positivists. Simmonds addresses those familiar with current analytical philosophy of law: those of us who know our Hart, Fuller, Dworkin, Raz, MacCormick and Kramer, and who perhaps need to have our attention drawn to Plato, Aristotle, Grotius, Hobbes and Kant. Presuming an informed readership, there is no bibliography, and it (...) incorporates ‘substantial extracts from four recent essays’ , but does not say what they are. Overall, his position is that law should be understood as an attempt to realize an archetype of law, an archetype which is a moral ideal. Those suspicious of moral ideals are not likely to find moral archetypes more philosophically acceptable. Yet, if Simmonds is right, we need them in jurisprudence.Simmonds is against the positivist split between …. (shrink)