Vulnerability is an important criterion to assess the ethical justification of the inclusion of participants in research trials. Currently, vulnerability is often understood as an attribute inherent to a participant by nature of a diagnosed condition. Accordingly, a common ethical concern relates to the participant’s decisionmaking capacity and ability to provide free and informed consent. We propose an expanded view of vulnerability that moves beyond a focus on consent and the intrinsic attributes of participants. We offer specific suggestions for how (...) relational aspects and the dynamic features of vulnerability could be more fully captured in current discussions and research practices. (shrink)
ObjectivesIn 2015, the Province of Quebec, Canada passed a law that allowed voluntary active euthanasia. Palliative care stakeholders in Canada have been largely opposed to euthanasia, yet there is little research about their views. The research question guiding this study was the following: How do palliative care physicians in Quebec position themselves regarding the practice of VAE in the context of the new provincial legislation?MethodsWe used interpretive description, an inductive methodology to answer research questions about clinical practice. A total of (...) 18 palliative care physicians participated in semistructured interviews at two university-affiliated hospitals in Quebec.ResultsParticipants positioned themselves in opposition to euthanasia. Their justifications were framed within their professional commitment to not hasten death, which sat in tension with the value of patients’ autonomy to choose how to die. Participants described VAE as unacceptable if it impeded opportunities to evaluate and alleviate suffering. Further, they contested government rhetoric that positioned VAE as a way to improve end-of-life care. Participants felt that VAE would diminish the potential of palliative care to relieve suffering. Dilemmas were apparent in their narratives, about reconciling respect for patient autonomy with broader palliative care values, and the value of accompanying and not abandoning patients who make requests for VAE while being committed to neither prolonging nor hastening death.ConclusionsThis study provides insight into nuanced positions of experienced palliative care physicians in Quebec and confirms expected tensions between an important stakeholder and the practice of VAE as guided by the new legislation. (shrink)
Medical assistance in dying legislation in Canada followed much deliberation after the Supreme Court of Canada’s ruling in Carter v. Canada. Included in this deliberation was the Special Joint Committee on Physician Assisted Dying’s recommendation to extend MAID legislation beyond the inclusion of adults to mature minors. Children's agency is a construct advanced within childhood studies literature which entails eliciting children’s voices in order to recognise children as active participants in constructing their own childhoods. Using this framework, we consider the (...) possible extension of MAID legislation to most minors. We highlight important questions regarding how insights from children’s voices could be mobilised in the life or death context of MAID. We conclude that children’s voices have the potential to help determine their eligibility for MAID; however, incorporating children's voices in the context of MAID requires careful consideration due to the complexity of voice. (shrink)
Globalization has brought people around the world closer together in ways that have created greater uncertainty in their identity politics. This has sometimes strengthened local identities, despite attempts to create ‘universal’ forms of identity that impose one standard of appropriate conduct in the face of difference. Drawing from Dialogical Self Theory and from cosmopolitanism, we propose that adequately responding to the ethical and identity challenges presented by globalization requires having Global Consciousness: “a knowledge of both the interconnectedness and difference of (...) humankind, and a will to take moral actions in a reflexive manner on its behalf”. We argue that this approach can ground a distinctively normative psychology of globalization. We consider negative and positive aspects of the golden rule in equal and close relationships, and benevolence in unequal power relationships as behaviour guides for global consciousness, and theorize about institutional leadership that supports the provision of public goods. We offer empirical tests of this approach. (shrink)
The goal of our work has been to better understand how Engaged Philosophical Inquiry can be used with young children on topics related to our local forest environment as part our foundation curriculum on sustainability. Theoretically we draw on the work of Matthew Lipman ; Philosophy for Children ; Phillip Cam, ; John Dewey, ; Gunilla Dahlberg and Peter Moss to discuss democratic community building, and ethical pedagogical approaches related to EPI and young children. Working with children of this age (...) holistically on the topic of sustainability has not been systematically researched to date. Our findings therefore contribute to better understandings of EPI and: 1) democratic community building processes; 2) the use of context to focus our discussions; 3) group membership and group size; and 4) turn taking and the role of the moderator. (shrink)
Both Hegel's philosophy and psychoanalytic theory have profoundly influenced contemporary thought, but they are traditionally seen to work in separate rather than intersecting universes. This book offers a new interpretation of Hegel's Phenomenology of Spirit and brings it into conversation the work of two of the best-known contemporary psychoanalysts, Christopher Bollas and André Green. Hegel and Psychoanalysis centers a consideration of the Phenomenology on the figure of the Unhappy Consciousness and the concept of Force, two areas that are often overlooked (...) by studies which focus on the master/slave dialectic. This book offers reasons for why now, more than ever, we need to recognize how concepts of intersubjectivity, Force, the Third, and binding are essential to an understanding of our modern world. Such concepts can allow for an interrogation of what can be seen as the profoundly false and constructed senses of community and friendship created by social networking sites, and further an idea of a "global community," which thrives at the expense of authentic intersubjective relations. (shrink)
For some time, the role of culture in language education within schools, universities and professional communication has received increasing attention. This article identifies two aporias in the discourse of intercultural communication : first, that it contains an unstated movement towards a universal consciousness; second, that its claims to truth are grounded in an implicit appeal to a transcendental moral signified.These features constitute IC discourse as ‘totality’, or as ‘metaphysics of presence’.The article draws on the work of Levinas ; and Derrida (...) to propose more considered ethical grounds for intercultural praxis. Contra a Hegelian impetus towards universal consciousness,we posit an irreducible distance and separation between the self and other. In so doing, not only are we able to supersede the field’s implicit appeal to the transcendental as a source of truth but also to counter perceptibly ‘exorbitant’ claims and actions of the intercultural other. In this vein, the article proposes a discourse ethics of responsibility by which it still becomes possible for a critical intercultural praxis to make value judgements and to take potentially transformative action vis-à-vis cultural acts that challenge the limits of intercultural tolerance and hospitality. (shrink)
The purpose of this study was to look beyond the patient as the source of difficulty and to examine the context of care encounters for factors that contributed to the construction of difficulty in the nurse-patient encounter. The study explains the origins of difficulty in the nurse-patient encounter. This explanation broadens the thinking limits previously imposed by locating difficulty within the individual. Key elements of this explanation are: knowing the patient minimizes the likelihood of difficulty in the encounter; and families, (...) availability of supplies and equipment, who is working, and care space changes are contextual factors that contribute to the construction of difficulty in the nurse-patient encounter. Awareness of these findings has implications for the strategies nurses employ in difficult encounters. (shrink)
We agree with Caplan & Waters that there are problems with the single-resource theory of sentence comprehension. However, we challenge their dual-resource alternative on theoretical and empirical grounds and point to a more coherent solution that abandons the notion of working memory resources.
In this volume, Simona Goi and Frederick M. Dolan gather stimulating arguments for the indispensability of fiction_including poetry, drama, and film_as irreplaceable sites for wrestling with nature, meaning, shortcomings, and the future of modern politics.