Probability is not an unambiguous concept within the sciences or in vernacular language, yet it is fundamental to much of behavior analysis. The present paper examines some problems this ambiguity creates in general,as well as within the experimental analysis of behavior, in particular. As background material, we first introduce the three most common theories of probability in mathematics and science, discussing their advantages and disadvantages, and their relevance to behavior analysis. Next, we discuss the concept of probability as encountered in (...) the writings of B.F. Skinner and in the contemporary behavior analysis more generally, the latter being based on material drawn from the professional literature and from a questionnaire survey. Although the exercise is basically a descriptive one, we do conclude with some suggestions that may promote more effective action on those occasions when behavior analysts speak of "probability.". (shrink)

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

We describe our efforts to address theoretical opportunities and methodological challenges that arose in the context of our ethnographic investigation of research labs in four different fields of bioengineering science. The multiyear study compared the common and specific features of four sites of interdisciplinary practice and aimed to analyze personal and collective goals, problem formulations, methods, technologies, and social organization within each lab. In the second phase of the study we sought to inform curriculum development for biomedical engineering from the (...) ethnographic study, with the broader goal of positioning students to engage in the kind of thinking scientists actually do. Evaluating thinking in action posed considerable challenges, and required us to develop an approach to assessing the extent to which students enrolled in the new course were “thinking like a biomedical engineer.” Our principal point of emphasis for this chapter is that honest confrontation of the challenges of ethnographic study of science practice must lead to caution, yet that ethnographic study of science enables innovative adaptations of methods and can yield vital insights into psychological dimensions of science, including interdisciplinary science. (shrink)

Volume 20, Issue 10, October 2020, Page 61-63.

In lieu of an abstract, here is a brief excerpt of the content:preface The essays in this special issue on Indigenous Feminisms in Settler Contexts engage feminist politics from multiple Indigenous geographies, histories, and standpoints. What emerges is a panoramic view of Indigenous feminist scholarship’s conceptual, linguistic, and artistic activism at this moment in time. We learn of praxis aimed at reclaiming Indigenous languages and ecological perspectives and the varied modes of resistance, survivance, and persistence. We also unpack the complex (...) racial/gender politics of colonial encounters in contexts where white women cared intimately for Indigenous children, or where they helped to recover Indigenous oral traditions, and we note how modes of help can also reproduce imperial power relations. Some essays, art works, and poems extend the geographic ambit of critiques of settler colonialism beyond American contexts: they deploy feminist rubrics to critique the continuing violent settlement of Palestine and Kashmir to demonstrate that the occupation of “marginal” places is constitutive of state-​ society relations; others describe how Australian Aboriginal and Sámi artists engage the question of Indigenous visibility. In different ways, they each show how staying in place, against all odds, can be radical. Our first two articles examine the politics of praxis. Michelle M. Jacob, Virginia R. Beavert, Regan Anderson, Leilani Sabzalian, and Joana Jansen analyze Indigenous feminist praxis surrounding Ichishkíin Indigenous language education. The “artivism” of Sámi artists Maxida 284Preface and Timimie Märak, which expresses concern for land and water rights, gender and sexuality, and Indigenous rights in Northern Europe takes center stage in Kyle Bladow’s essay. The next three articles interrogate historical records shaping Indigenous lives in northern Canada, southwest Pacific, and southwestern United States and Mexico. Val Marie Johnson examines how white women staff members’ intimate care relations at residential schools for Inuvialuit, Inuinnait, and Iñupiat peoples in Canada were bound up with the latter’s dispossession. Carolyn J. Eichner recounts the encounter between the Indigenous Kanak people and Louise Michel, a feminist and participant in the revolutionary Paris Commune of 1871 who was banished to New Caledonia for seven years; Eichner argues that although Michel was staunchly anti-imperialist, her liberatory political project bore the temporal logics of colonization. Drawing on examples of Nahua reconfigurations of Christian scripture, Kenna Neitch proposes the language of “persistence” as a heuristic for avoiding the reactive, relational connotations that can pervade scholarly usages of “resistance” rhetoric. Next, our review essay by Jennifer McLerran describes recent Indigenous feminist scholarship that recasts the concept of sovereignty. Our News and Views piece focuses on modalities of occupation in the context of Kashmir: Nosheen Ali, Mona Bhan, Sahana Ghosh, Hafsa Kanjwal, Zunaira Komal, Deepti Misri, Shruti Mukherjee, Nishant Upadhyay, Saiba Varma, and Ather Zia argue that occupation is foundational to the making and reproduction of nationstates, and not exceptional to state power. The varied forms of resistance to occupation are examined by Sara Ihmoud in her article about how a group of Palestinian women, the Murabitat al-Haram, agitate for religious freedom simply by “staying in place.” Rabab Abdulhadi comments on shifts in contemporary settler colonial discourse in Israel, noting the increasingly overt and unapologetic deployment of highly sexualized and gendered images. Marina Tyquiengco examines the art of Australian Aboriginal artist Fiona Foley, specifically her Black Velvet series. Art and myth are also fused in Shantell Powell’s textual and visual rendering of Inuit memory. This issue features a range of poetry on topics such as language loss, human-land relationships, and sexual violence, written by Katherine Agyemaa Agard, Kei Kaimana, and Kai Minosh Pyle, and curated by our creative writing editor, Alexis Pauline Gumbs. In “Átaw Iwá Ichishkíin Sínwit: The Importance of Ichishkíin Language in Advancing Indigenous Feminist Education,” Michelle M. Jacob, Preface 285 Virginia R. Beavert, Regan Anderson, Leilani Sabzalian, and Joana Jansen examine Indigenous feminist praxis surrounding Ichishkíin-language education. They critique how Western education systems inflict pernicious forms of violence within Native communities, engaging in practices of linguistic genocide and alienating Indigenous peoples from their homelands. In response, Native peoples, along with non-Native allies, are engaging in educational and political activism to reclaim and revitalize Indigenous languages and ecological perspectives. In examining the foundational teaching of Ichishk... (shrink)

In their article “The Bioethics of Environmental Injustice: Ethical, Legal, and Clinical Implications of Unhealthy Environments,” Ray and Cooper (2024) invite us to prioritize environmental health...

The speed and scale of the COVID‐19 pandemic has highlighted the limits of current health systems and the potential promise of non‐establishment research such as “DIY” research. We consider one example of how DIY research is responding to the pandemic, discuss the challenges faced by DIY research more generally, and suggest that a “trust architecture” should be developed now to contribute to successful future DIY efforts.

Women working in the sciences face obstacles at virtually every step along their career paths. From subtle slights to blatant biases, deep systemic problems block women from advancing or push them out of science and technology entirely. Women in Science Now examines solutions to this persistent gender gap, offering new perspectives on how to make science more equitable and inclusive for all. This book shares stories and insights of women from a range of backgrounds working in various disciplines, illustrating the (...) journeys that brought them to the sciences, the challenges they faced along the way, and the important contributions they have made to their fields. Lisa M. P. Munoz combines these narratives with a wealth of data to illuminate the size and scope of the challenges women scientists face, while highlighting research-based solutions to help overcome these obstacles. She presents groundbreaking studies in social psychology and organizational behavior that are informing novel approaches for combating historic and ongoing inequities. Through a combined focus on personal experiences and social-science research, this timely book provides both a path toward greater gender equity and an inspiring vision of science and scientists. (shrink)

This study addresses the nature of the contribution made by Christian feminist thinkers who claim that mutuality is a necessary part of a Christian social ethical framework. The theological method employed is analytical and comparative toward the end of illuminating, testing, and demonstrating the thesis: mutuality is a formal norm for Christian social ethics that functions along with love and justice to promote a balance of power that is required for optimum human flourishing, a flourishing set within the interdependent context (...) of the whole of creation. ;Chapter One analyzes selected primary sources of Rosemary Radford Ruether, Carter Heyward, Beverly Wildung Harrison, and Elizabeth A. Johnson isolating their definition and treatment of the term, "mutuality." A consensus definition of mutuality drawn from definitions by the four feminists. It is concluded that, similar to the tripartite nature of justice, mutuality has four forms--cosmic, gender, generative, and social. ;Chapters Two and Three illustrate several moments in the history of Christian thought wherein antecedents of the feminists' notion of mutuality are found. Selected primary works of Thomas Aquinas, John Duns Scotus, Martin Buber, and H. Richard Niebuhr are examined. ;Chapter Four compares the four feminists' definition of mutuality with definitions of formal norm by Josef Fuchs, Lisa Sowle Cahill, and Timothy E. O'Connell, determining that mutuality is a formal norm for Christian social ethics. Chapter Five is a case study. Utilizing our definition, it is shown how consideration of mutuality and its four forms influences the ethical analyses of George Weigel, Jean Bethke Elshtain, and Stanley Hauerwas in determining if the Persian Gulf War was a just war. It is concluded that the probative value of the formal norm, mutuality, is multifaceted. First and foremost, it requires the moral agent to deal concretely in moral reflection and moral decision-making. Specific and careful attention needs to be given to the reality revealing questions in the concrete, as well as in the abstract. Second, mutuality requires the moral agent to probe the dynamics of power in an ethical dilemma and to seek out ways to shape those dynamics to serve power-with. It is a complement to and corrective of love and justice. Third, engaging the norm of mutuality presses the moral agent toward inclusivity drawing into the process of moral reflection concern for the thriving and flourishing of all involved. More than the norms of love and justice, mutuality places humans in a perspective within the whole of creation. (shrink)

Contemporary biomedical ethics and environmental ethics share a common ancestry in Aldo Leopold's and Van Rensselaer Potter's initial broad visions of a connected biosphere. Over the past five decades, the two fields have become strangers. Public health ethics, a new subfield of bioethics, emerged from the belly of contemporary biomedical ethics and has evolved over the past 25 years. It has moved from its traditional concern with the tension between individual autonomy and community health to a wider focus on social (...) justice and solidarity. Public health has a broad focus that includes individual, community, and environmental health. Public health ethics attends to these broad commitments reflected in the increasing concern with the connectedness of health of individuals to the health of populations, to the health of animals, to the health of the environment; it is well situated to reconnect all three “fields” of ethics to promote a healthier planet. (shrink)

The question of whether clinical ethics consultants may engage in patient advocacy in the course of consultation has not been addressed, but it highlights for the field that consultants? allegiances, and the boundaries of appropriate professional practice, must be better understood. I consider arguments for and against patient advocacy in clinical ethics consultation, which demonstrate that patient advocacy is permissible, but not central to the practice of consultation. I then offer four recommendations for consultants who engage in patient advocacy, and (...) consider the implications of this issue for the field.1. (shrink)

This paper presents an analysis of emotional and affectively toned discourse in biomedical engineering researchers’ accounts of their problem solving practices. Drawing from our interviews with scientists in two laboratories, we examine three classes of expression: explicit, figurative and metaphorical, and attributions of emotion to objects and artifacts important to laboratory practice. We consider the overall function of expressions in the particular problem solving contexts described. We argue that affective processes are engaged in problem solving, not as simply tacked onto (...) reasoning but as integral to it. The examples we present illustrate the close relation of emotion to problem solving and experimentation; they also implicate social and cultural dimensions of emotion expression. The analysis underscores a need to consider emotional expression to be intimately and importantly tied to the cognitive achievements and social negotiations of laboratory practices. (shrink)

Public health ethics is a nascent field, emerging over the past decade as an applied field merging concepts of clinical and research ethics. Because the “patient” in public health is the population rather than the individual, existing principles might be weighted differently, or there might be different ethical principles to consider. This paper reviewed the evolution of public health ethics, the use of bioethics as its model, and the proposed frameworks for public health ethics through 2010. Review of 13 major (...) public health ethics frameworks published over the past 15 years yields a wide variety of theoretical approaches, some similar foundational values, and a few similar operating principles. Coming to a consensus on the reach, purpose, and ends of public health is necessary if we are to agree on what ethical underpinnings drive us, what foundational values bring us to these underpinnings, and what operating principles practitioners must implement to make ethical decisions. If public health is distinct enough from clinical medicine to warrant its own set of ethical and philosophical underpinnings, then a decision must be made as to whether a single approach is warranted or we can tolerate a variety of equal but different perspectives. (shrink)

A major obstacle to broad support of clinical ethics consultation is suspicion regarding the nature of the moral expertise it claims to offer. The suspicion seems to be confirmed when the field fails to make its moral expertise explicit. In this vacuum, critics suggest the following:Clinical ethics consultation's legitimacy depends on its ability to offer an expertise in moral matters.Expertise in moral matters is knowledge of a singular moral truth which applies to everyone.The claim that a clinical ethics consultant can (...) offer knowledge of a singular moral truth in virtue of her professional training is absurd, false, or gravely immoral.Therefore,The field is illegitimate. (shrink)

For over 100 years, the field of contemporary public health has existed to improve the health of communities and populations. As public health practitioners conduct their work – be it focused on preventing transmission of infectious diseases, or prevention of injury, or prevention of and cures for chronic conditions – ethical dimensions arise. Borrowing heavily from the ethical tools developed for research ethics and bioethics, the nascent field of public health ethics soon began to feel the limits of the clinical (...) model and began creating different frameworks to guide its ethical challenges. Several public health ethics frameworks have been introduced since the late 1990s, ranging from extensions of principle-based models to human rights and social justice perspectives to those based on political philosophy. None has coalesced as the framework of choice in the discipline of public health. This paper examines several of the most-known frameworks of public health ethics for their common theoretical underpinnings and values, and suggests next steps toward the formulation of a single framework. (shrink)

The legitimacy of clinical ethics consultation is often implied to rest on the legitimacy of moral expertise. In turn, moral expertise seems subject to many serious critiques, the success of which implies that clinical ethics consultation is illegitimate. I explore a number of these critiques, and forward “ethics expertise,” as distinct from “moral expertise,” as a way of avoiding these critiques. I argue that “ethics expertise” succeeds in avoiding most of the critiques, captures what clinical ethics consultants might justifiably do, (...) and expresses a subject matter which can be taught and assessed. (shrink)

Confronting any science studies or learning sciences researcher in the 21st century is the reality of interdisciplinary science. New hybrid fields1 collaboratively build new concepts, combine models from two or more disciplines and forge inter-reliant relationships among specialists with different skill sets to solve new problems. This paper emerges from our recognition that inescapable psychological factors, including identity dynamics, must be described and analyzed in order to better understand the social and cognitive practices specific to interdisciplinary science. In analysis of (...) the foundations and opportunities for an... (shrink)

Public health emergencies expose social injustice and health disparities, resulting in calls to address their structural causes once the acute crisis has passed. The COVID-19 pandemic is highlighting and exacerbating global, national, and regional disparities in relation to the benefits and burdens of undertaking critical basic public health mitigation measures such as physical distancing. In the United States, attempts to address the COVID-19 pandemic are complicated by striking racial, economic, and geographic inequities. These synergistic inequities exist in both urban and (...) rural areas but take on a particular character and impact in areas of rural poverty. Rural areas face a diverse set of structural challenges, including inadequate public health, clinical, and other infrastructure and economic precarity, hampering the ability of communities and individuals to implement mitigation measures. Public health ethics demands that personnel address both the tactical, real-time adjustment of typical mitigation tools to improve their effectiveness among the rural poor as well as the strategic, longer-term structural causes of health and social injustice that continue to disadvantage this population. (shrink)

The attempt to critique the profession of clinical ethics consultation by establishing the impossibility of ethics expertise has been a red herring. Decisions made in clinical ethics cases are almost never based purely on moral judgments. Instead, they are all-things-considered judgments that involve determining how to balance other values as well. A standard of justified decision-making in this context would enable us to identify experts who could achieve these standards more often than others, and thus provide a basis for expertise (...) in clinical ethics consultation. This expertise relies in part on what Richard Zaner calls the “expert knowledge of ethical phenomena”. (shrink)

Despite increased interest in “intuition” within cognitive psychology, the conceptual framework of this notion remains problematic. This paper argues that conceptual shortcomings stem from a tendency to ignore the philosophical heritage of intuition or to dismiss the relevance of this heritage to contemporary theory. The paper outlines major understandings of intuition within psychology and prominent philosophical traditions, highlighting important points of inconsistency in these and examining consequences of the inconsistency. It also considers psychological conceptions of intuition that more readily overlap (...) with philosophical accounts and offers some suggestions toward a more philosophically informed notion of intuition relevant to contemporary psychological theory. (shrink)

The American Journal of Bioethics, Volume 12, Issue 8, Page W1-W3, August 2012.

Teaching competency in bioethics has been a concern of the field since its start. In 1976, The Hastings Center published the first report on the teaching of contemporary bioethics. Graduate programs culminating in an MA or PhD were not needed at the time, concluded the report. “In the future, however,” the report speculated, “the development and/or changing social priorities may at some point allow, or even require, the creation of new academic structures for graduate education in bioethics.” Although that future (...) might be upon us, the creation of a terminal degree in bioethics has its detractors. Scholars have debated whether bioethics is a discipline with its own methods and theoretical grounding, a multidisciplinary field bringing various professional perspectives to bear on particular types of problems, a set of problem-solving skills to resolve moral disagreements, or something else entirely. Whether or not efforts to develop the methods and theory of bioethics have matured to the point that it is now a discipline in the strictest sense, new bioethics training programs have appeared at all postsecondary levels. In this essay, we examine the number and types of U.S. programs and degrees in this growing field. (shrink)

Seth MacFarlane’s space adventure, The Orville, is not “Family Guy in Space.” It is a social commentary of the most direct and compelling sort. Through satire, humor, and symbolism, The Orville explores the potential dangers of religion. It does so in individual episodes, such as “If the Stars Should Appear” and “Mad Idolatry,” as well as through the series as a whole in its depiction of how the Union resolves its political differences with the Krill and the Moclans. In this (...) chapter, we will look at how The Orville criticizes religion, both generally and specifically. We will see that while it is not a condemnation of all religious believers, it is a critique of religion itself, suggesting that it can become dangerous when it merges religious dogma with political power. (shrink)

Electroencephalography-neurofeedback has become a valuable tool in the field of psychology, e.g., to improve cognitive function. Nevertheless, a large percentage of NF users seem to be unable to control their own brain activation. Therefore, the aim of this study was to examine whether a different kind of visual feedback could positively influence NF performance after one training session. Virtual reality seems to have beneficial training effects and has already been reported to increase motivational training aspects. In the present study, we (...) tested 61 young healthy adults to investigate, whether 3D VR-based NF training has a more beneficial effect on the sensorimotor rhythm power increase than a mere 2D conventional NF paradigm. In the 3D group, participants had to roll a ball along a predefined path in an immersive virtual environment, whereas the 2D group had to increase the height of a bar. Both paradigms were presented using VR goggles. Participants completed one baseline and six feedback runs with 3 min each, in which they should try to increase SMR power over Cz. Half of the participants received real feedback whereas the other half received sham feedback. Participants receiving 3D VR-based feedback showed a linear increase in SMR power over the feedback runs within one training session. This was the case for the real as well as for the sham 3D feedback group and might be related to more general VR-related effects. The 2D group receiving the conventional bar feedback showed no changes in SMR power over the feedback runs. The present study underlines that the visual feedback modality has differential effects on the NF training performance and that 3D VR-based feedback has advantages over conventional 2D feedback. (shrink)

Movement of leukocytes from peripheral blood into tissues, also called leukocyte extravasation, is absolutely essential for immunity in higher organisms. Over the past decade, our understanding of the molecular mechanisms involved in white blood cell extravasation during both normal immune surveillance and the generation of protective immune responses has taken a great leap forward with the discovery of the chemokine gene superfamily. Chemokines are low-molecular-weight cytokines whose major collective biological activity appears to be that of chemotaxis of both specific and (...) overlapping subsets of leukocytes. They are therefore likely to play a critical role in the directed movement of leukocytes from the bloodstream into tissue. These molecules are almost exclusively secreted and act as extracellular messengers for the immune system. However, emerging data also show that various members of the chemokine gene superfamily exert other biological effects outside the immune system. All nucleated cells and all tissues examined to date are capable of expressing at least some chemokines, and it seems likely therefore that by the time all the chemokines are identified, and all their biological functions elucidated, we will find that, as a family, these molecules perform an extracellular messenger role in all tissues and systems of the body. BioEssays 1999;21:17–28. © 1999 John Wiley & Sons, Inc. (shrink)

What about Confucian bioethics should compel our interest? Apart from the fact that Confucianism grounds the belief system of a great number of people, a Confucian bioethics poses a profound challe...

Abram Brummett and Christopher Ostertag offer critiques of my argument that clinical ethics consultants have expertise but are not “ethics experts”. My argument begins within our less-than-ideal world and asks what a justification of a clinical ethics consultation recommendation might look like under those conditions. It is a challenge to what could be called an “inflationary” position on ethics expertise that requires agreement on or rational proof of metaethical facts about the values at stake in clinical ethics consultation. Brummett and (...) Ostertag critique three distinct steps in the argument. Two of those I have a brief answer for, and an assessment of the third demonstrates that Brummett and Ostertag do not consider the premise upon which I based my account. Instead, they assert a counter-premise without argument, which at best results in a stalemate between our two accounts. However, the reasons supporting my premise still seem to me to be stronger, so I am in the end unconvinced by their critiques. (shrink)

We historically and conceptually situate distributed cognition by drawing attention to important similarities in assumptions and methods with those of American ?functional psychology? as it emerged in contrast and complement to controlled laboratory study of the structural components and primitive ?elements? of consciousness. Functional psychology foregrounded the adaptive features of cognitive processes in environments, and adopted as a unit of analysis the overall situation of organism and environment. A methodological implication of this emphasis was, to the extent possible, the study (...) of cognitive and other processes in the natural (real world) contexts in which they occur. We therefore emphasize commonalities and differences between functional psychology and D-Cog. One purpose of the comparison is to consider the extent to which criticisms directed at functional psychology are relevant to D-Cog. We also examine the relation between functional psychology and philosophical pragmatism and conclude that D-Cog's conceptual framework would be strengthened through more explicit adoption of philosophical pragmatism, consistent with the eventual trajectory of functional psychology. (shrink)

This article presents the first author's experiences as an Australian doctoral student undertaking a PhD by publication in the arena of the social sciences. She published nine articles in refereed journals and a peer-reviewed book chapter during the course of her PhD. We situate this experience in the context of current discussion about doctoral publication practices, in order to inform both postgraduate students and academics in general. The article discusses recent thinking about PhD by publication and identifies the factors that (...) students should consider prior to adopting this approach, in terms of university requirements, supervisors' attitudes, the research subject matter, intellectual property, capacity and working style, and issues of co-authorship. It then outlines our perceptions of the advantages and disadvantages of undertaking a PhD by publication. We suggest that, in general, the advantages outweigh the disadvantages. We conclude by reflecting on how the first author's experiences relate to current discussions about fostering publications by doctoral students. (shrink)

The ethical (and philosophical) issues arising in citizen science are fascinating, challenging, and potentially pathbreaking in that they force us to reconsider the conceptual and regulatory catego...

To address the growing costs associated with chronic illness care, many countries, both developed and developing, identify increased patient self‐management or self‐care as a focus of healthcare reform. Health coaching, an implementation strategy to support the shift to self‐management, encourages patients to make lifestyle changes to improve the management of chronic illness. This practice differs from traditional models of health education because of the interactional dynamics between nurse and patient, and an orientation to care that ostensibly centres and empowers patients. (...) The theoretical underpinnings of coaching reflect these differences, however in its application, the practices arranged around health coaching for chronic illness self‐management reveal the social regulation and professional management of everyday life. This becomes especially problematic in contexts defined by economic constraint and government withdrawal from activities related to the ‘care’ of citizens. In this paper, we trace the development of health coaching as part of nursing practice and consider the implications of this practice as an emerging element of chronic illness self‐management. Our purpose is to highlight health coaching as an approach intended to support patients with chronic illness and at the same time, problematize the tensions contained in (and by) this practice. (shrink)

Clinical ethics consultation is on the horns of a dilemma. One horn skewers the field for its lack of standards, while the other horn skewers it for proposing arbitrary or deeply contested foundations. I articulate the dilemma by discussing several critiques of the field and the challenge of formulating standards and suggest that the solution lies, at least until a robust consensus emerges, with establishing a list of proscriptive standards to guide the field.