While the impacts of the Affordable Care Act will vary across the states given their different circumstances, Massachusetts’ 2006 reform initiative, the template for national reform, provides a preview of the potential gains in insurance coverage, access to and use of care, and health care affordability for the rest of the nation. Under reform, uninsurance in Massachusetts dropped by more than 50%, due, in part, to an increase in employer-sponsored coverage. Gains in health care access and affordability were widespread, including (...) a 28% decline in unmet need for doctor care and a 38% decline in high out-of-pocket costs. (shrink)

While standard histories of Western political thought represent women’s rights as an offshoot of the earlier movement for the equal rights of men, this essay argues that the eighteenth-century push for democracy and equal rights was grounded in arguments first used to defend women’s right to moral and religious self-determination, based on their rational and spiritual equality with men. In tandem with the rise of critiques of absolute monarchy, ideal marriage, which had previously involved lordship and subjection, was transformed into (...) an equal companionate relationship based on inclination and affection. The essay argues that the transformation, by the time of the American and French revolutions, of neo-Roman republicanism—which had been aristocratic and oligarchic—into egalitarian, democratic republicanism had been mediated by the extension of arguments, widely distributed in the literature criticizing the slavery of marriage, into a general critique of slavery and support for the equal rights of men. (shrink)

The concept of phronesis is venerable and is experiencing a resurgence in contemporary discourses on professional life. Aristotle’s notion of phronesis involves reasoning and action based on ethical ideals oriented towards the human good. For Aristotle, humans possess the desire to do what is best for human flourishing, and to do so according to the application of virtues. Within health care, the pervasiveness of economic agendas, technological approaches and managerialism create conditions in which human relationships and moral reasoning are becoming (...) increasingly de‐valued. This creates a tension for nurses, and nursing leaders, as the desire to do what is morally right is often in conflict with contextual demands. In this paper, Aristotle’s writing on phronesis is examined with a focus on his classic conceptions of eudaimonia, the virtues, deliberation, judgement, and praxis. Building on Aristotle’s work, a number of contemporary views are explored with a focus on what various conceptualizations offer for the discipline of nursing. These expanded conceptions of phronesis include attention to: embodiment in practice; open‐mindedness including the capacity to stay curious and open to recognizing what we do not know; perceptiveness as a disposition towards insight and aesthetic understanding; and reflexivity as an ongoing process of interrogation and inquiry into ourselves and our actions. Drawing on these concepts, we discuss the affordances of phronesis as a morally informed guiding force to attend to modern‐day challenges in nursing practice and nursing leadership. (shrink)

The welfare mother is a powerful symbol of the supposed irresponsible, sexually promiscuous, and immoral behavior of the poor. Resting on dominant ideologies of race, class, and gender, the welfare mother suggests not a poor mother but a bad mother. Based on interviews with 34 mothers receiving public assistance, this article explores how women receiving assistance claim for themselves an identity as good mothers by defining the appropriate responsibilities of mothers to prioritize, protect, discipline, provide for, and spend time with (...) their children. The material realities of poverty combined with work requirements now attached to public assistance exacerbate contradictions between these roles and create difficulties for these mothers. This article explores these contradictions and examines the possibilities for and limits of their use as resistance strategies. (shrink)

Despite the fact that the High-Church Tory, Mary Astell, held political views diametrically opposed to the Whiggish Catharine Trotter Cockburn and Catharine Macaulay, it is here argued that their metaethical views were surprisingly similar. All were influenced by a blend of Christian universalism and Aristotelian eudaimonism, which accepted the existence of a law of nature, that we strive for happiness, and that happiness results from living in accord with our God-given nature. They differed with regard to epistemological issues; the means (...) by which we can know the law of nature, and with regard to the characterization of that nature; our telos. Traces of the ethical theories developed by these women can also be seen in the works of the philosophically informed novelists, Sarah Fielding, Jane Collier, Sarah Scott, and Hannah More. (shrink)

Argues that like more conservative feminist writers, Gabrielle Suchon and Mary Astell, writing earlier in the Eighteenth Century, Macaulay's concept of liberty is closely tied to virtue and involves free self government according to reason. Unlike these earlier writers from this concept of liberty she deduces the rationality of democratic republican government. Thus the grounds on which she builds her republicanism involve a very different concept of rational self interest to that usually assumed to ground social contract theory. For virtue (...) and the genuine self interest of rational beings are taken to coincide. (shrink)

Collecting and using tissue, blood, urine, and other human biospecimens for various types of research is not new. But for personalized medicine to realize its potential, researchers will need thousands more of these samples for genetic studies. And the particular nature of genetic research—the sensitivity of the information it reveals—has raised a host of ethical questions, some which are new to human subjects research. What counts as informed consent when a biospecimen may be stored for years and used for unforeseen (...) research? How freely can the biospecimens and the genetic information they contain be shared with other researchers? If research uncovers a genetic risk factor or some other important medical .. (shrink)

Bauer, Taub, and Parsi's review of an international sample of standards on informed consent, confidentiality, commercialization, and quality of research in tissue banking reveals that no clear national or international consensus exists for these issues. The authors' response to the lack of uniformity in the meaning, scope, and ethical significance of the policies they examined is to call for the creation of uniform ethical guidelines. This raises questions about whether harmonization should consist of voluntary international standards or international regulations that (...) include an official oversight mechanism and sanctions for noncompliance, and about who should participate in the harmonization process. Moreover, the normative assumptions and political dynamics that shape global policymaking need to be addressed. This commentary explores the policy implications and normative questions raised by the idea of international ethical guidelines for the use of biotechnologies and biotechnological resources such as stored samples of human tissue. (shrink)

An approach to Derrida's différance from the perspective of analytic philosophy of language which attempts to show both how many of Derrida's insights are influenced by analytic philosophy of language and can be related to ideas found in Quine, Wittgenstein, and Dennett, but which ultimately concludes that the linguistic idealism that he promotes is incoherent.

Within both philosophy and psychology, a new pro-emotion consensus is replacing the old dogmas that emotions disrupt practical rationality, that they are at best arational, if not outright irrational, and that we can understand what is really central to human cognition without studying them. Emotions are now commonly viewed as evolved capacities that are integral to our practical rationality. An infinite mind, unencumbered by a body, might get along just fine without emotions; but we finite embodied creatures need them if (...) we are to be capable of responding appropriately to our reasons and navigating in a risky world with poor information, limited attention, and restricted computational power. Emotions are clever design solutions to the problem of making fast decisions in response to significant practical problems posed by the natural and social worlds: we perceive a danger and fear immediately primes us to take protective action. On this view, the theory of emotions is an essential part of a theory of ecologically situated and constrained rationality - that is to say, of human rationality. (shrink)

First Published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

There is, to all appearances, a philosophic hostility to fashionable dress. Studying this contempt, this paper examines likely sources in philosophy's suspicion of change; anxiety about surfaces and the inessential; failures in the face of death; and the philosophic disdain for, denial of, the human body and human passivity. If there are feminist concerns about fashion, they should be radically different from those of traditional philosophy. Whatever our ineluctable worries about desire and death, whatever our appropriate anger and impatience with (...) the merely superficial, whatever our genuine need to mark off the serious from the trivial, feminism may be a corrective therapy for philosophy's bad humor and self-deception, as these manifest themselves when the subject turns to beautiful clothes. (shrink)

On the eve of the presidential inauguration, the U.S. health system faces rising costs of care, growing numbers of uninsured, wide variations in quality of care, and mounting public dissatisfaction. Despite spending more on health care than any other country, a recent Commonwealth Fund Commission on a High Performance Health Care System National Scorecard reports that the United States is lagging far behind other major industrialized countries — all of which provide universal health insurance — in five key domains: healthy (...) lives, access, quality, equity, and efficiency. U.S. national performance is well below benchmarks of top performance set by other countries or high performing states, hospitals, or health plans within the United States, with broad disparities in experience depending on geographic location, income, race/ethnicity, and insurance coverage. National leadership is required to manage the growing health care crisis in the United States and improve care for all Americans. (shrink)

Special Care: Medical Decisions at the Beginning of Life, by Fred FronhockPlaying God in the Nursery, by Jeff LyonsWithholding Treatment From Defective Newborn Children, Joseph E. Magnet and Eike‐Henner W. KlugeCenter for Ethics, Medicine and Public Issues Baylor College of MedicineLAW AND MORALS by Simon Lee. OxfordThe Foetus as Organ donor: Scientific, Social and Ethical Perspectives. By Peter McCullaghTransplantation Unit The Walter & Eliza Hall Institute of Medical Research.

Experimental radiobiology represented a long-standing priority for the U.S. Atomic Energy Commission, but organizational issues initially impeded the laboratory progress of this government-funded work: who would direct such interdisciplinary investigations and how? And should the AEC support basic research or only mission-oriented projects? Alexander Hollaender's vision for biology in the post-war world guided AEC initiatives at Oak Ridge, where he created and presided over the Division of Biology for nearly two decades. Hollaender's scheme, at once entrepreneurial and system-oriented, made good (...) use of the unique resources provided by the AEC and by Oak Ridge's national laboratory setting, while at the same time it restructured wartime research practices to better reflect biologists' own priorities. Because Hollaender offered many academic experimental biologists a way of envisioning military-related patronage as integral - rather than antithetical - to their professional identities, his work provides an important lens through which to examine the early post-war intellectual and institutional development of radiobiology. (shrink)

This paper is an exploration of evolving ideas, urgencies, and actions that we have experimented with in our teaching of an environmental sustainability subject with pre-service teachers at an Australian university. It is a work in progress. Through this shared educator-student teaching and learning process we feel the tensions of contradictory forces that disrupt the flow of prior teaching as we all become unsettled by hope and reality, grief, and loss, all mixed in with a sense of urgency and tempered (...) by a set of often unimaginative contemporary pedagogical practices. These tensions often resort educators like us, to perpetuate well-worn and critiqued tropes such as how to ‘care for the planet’ through ‘greening’ practices in schools such as recycling and energy conservation. Always inadequate and limited we are experimenting in our pedagogical repertoire with new ways to teach as we could no longer keep up the charade of agitating for change in the same way. In this paper we explore some of the opening and closures that effect environmental sustainability teaching. We consider how through a reimagining of sustainability education with new pedagogical openings of ‘making kin’ we first attend to these emotional tensions as a means of waking up to who we are in the Anthropocene and then find ways to identify relational ethico-onto-epistemologies in our teaching. By disrupting humanist paradigms and embracing critical posthumanist sensitivities the educators and students nuzzle into new ways of knowing and being in the world. (shrink)

Volume 75, Issue 5-6, 2019, Page 376-380.

Emergency care in large urban hospitals across the country is in the midst of major redesign intended to deliver quality care through improved access, decreased wait times, and maximum efficiency. The central argument in this paper is that the conceptualization of quality including the documentary facts and figures produced to substantiate quality emergency care is socially organized within a powerful ruling discourse that inserts the interests of politics and economics into nurses' work. The Canadian Triage and Acuity Scale figures prominently (...) in the analysis as a high‐level organizer of triage work and knowledge production that underpins the way those who administer the system define, measure and evaluate emergency care processes, and then use this information for restructuring. Managerial targets and thinking not only dominate the way emergency work is understood, determined, and controlled but also subsume the actual work of health‐care providers in spaces called ‘wait times’, where it is systematically rendered ‘unknowable’. The analysis is supported with evidence from an extensive institutional ethnography that shows what nurses actually do to manage the safe passage of patients through their emergency care process starting with the work of triage nurses. (shrink)

Traces women's defence of their moral and spiritual equality with men, from the works of Christine de Pizan, through Marguerite of Navarre, Madeleine de Scudéry, Arcangela Tarabotti, to Mary Astell and Mary Wollstonecraft, arguing that although she appears not to have been aware of these precursors, the arguments they developed paved the way for her feminism.

Volume 3, Issue 1, March 2019, Page 86-89.

This paper draws on research exploring how men narrate their long-term experiences of Weight Loss Surgery [WLS] and is specifically focused on findings relating to male embodiment. Whilst there is concern about increasing obesity and the possible role of bariatric [WLS] surgery in ameliorating this, there has been little research to date exploring men’s longer-term experiences of this. For the purposes of the present study, interviews were conducted with five men who had undergone bariatric surgery at least four years previously. (...) The transcribed interviews were subjected to narrative analysis with the additional incorporation of Watson’s “male body schema” into this process in order to facilitate focus on the embodied nature of the storied accounts obtained. The findings suggested two seemingly contrasting storylines: “ongoing struggles” and “success”. Struggles related mainly to control over eating habits and the visceral challenges of long-term side effects following surgery. Despite these struggles, the men ultimately presented an overriding storyline of embodied “success” in how the surgery had assisted them to live more normatively male lives. Importantly, narratives around struggles were presented as more private stories in contrast to the public emphasis on success. The silencing dynamic implicit in this suggests the likelihood that other men encountering similar experiences would be reticent to reveal their struggles, thereby perpetuating their suffering and leaving popular obesity and weight loss narratives unchallenged. (shrink)

Over the past year media outlets and scientific and bioethics journals have reported about several medical and scientific innovations touted as having the potential to fundamentally change not only how diseases and disorders are diagnosed and treated but even how to alter the genomes of future generations. The purported “miracle” blood-testing technology of Theranos and the potential use of the genome editing technology CRISPR-Cas9 to modify human and nonhuman organisms reflect dramatic advances in scientific understanding about the biological mechanisms of (...) humans and other living organisms. Yet evidence about whether these and other innovative biomedical technologies are safe and effective and lead to improved health outcomes for patients young and old is often in dispute. How to assess the safety and effectiveness of innovative biomedical technologies, who should be involved in that effort, and how to define risks and benefits of those technologies are questions at the intersection of values, interests, and politics. (shrink)