This article argues that traditional, regulative principles of research ethics offer insufficient guidance for research in the narrative study of lives. These principles presuppose an implicit epistemology that conceives of research participants as data sources, a conception that is argued not tenable for narrative research. The case is made by drawing on recent discussions of research ethics in the qualitative and narrative research literature. This article shows that narrative ethics is inextricably entwined with epistemological issues--namely, issues of narrative ownership and (...) the multiplicity of narrative meaning. Finally, practical recommendations are made for the ethical treatment of research participants in narrative research. The article concludes by situating our approach with respect to the broad range of contemporary perspectives on research ethics. (shrink)

In this brief note, we respond to Gottlieb and Lasser's critical commentary on our work on narrative research ethics. We argue that their concern for privileging voices needs to be balanced against the risk of exploiting some research participants, that conflicts of interest are best resolved through appropriately prioritizing ethical principles and in consultation with others, and that the researcher's ability to protect participants from harm can be enhanced through appropriate clinical training and access to clinical expertise. We welcome Gottlieb (...) and Lasser's specific recommendations for ethical practice in narrative research and encourage further ethical reflection by other researchers in this area. (shrink)

Derrida is typically taken to be the thinker most antithetical to Hegel, and deconstruction to be the philosophical antithesis to Hegel’s systematic rationality. While I do not dispute the accuracy of this perception, I argue in this paper that it does not offer an adequate or a complete picture. Specifically, much about Derrida and about deconstruction is more similar to Hegel than is typically realized. I argue that Derrida’s deconstruction shares a great affinity to the method of Hegel’s Phenomenology of (...) Spirit, so much so that we could identify and articulate a latent Hegelianism in Derrida’s approach. I begin with a description of Derrida’s own project, then offer something of an apologia for his work. Finally, I describe Hegel’s method of exposition [Darstellung] and compare it to deconstruction, pointing out the fundamental similarities between the two thinkers. (shrink)

Last year in June, British doctors went on strike for the first time since 1975. Amidst a global economic downturn and with many health systems struggling with reduced finances, around the world the issue of public health workers going on strike is a very real one. Almost all doctors will agree that we should always follow the law, but often the law is unclear or does not cover a particular case. Here we must appeal to ethical discussion. The General Medical (...) Council, in its key guidance document for practising doctors, Good Medical Practice, claims that ‘Good doctors make the care of their patients their first concern’. Is this true? And if so, how is this relevant to the issue of striking? One year on since the events, we carefully reflect and argue whether it was right for doctors to pursue strike action, and call for greater discussion of ethical issues such as the recent strikes, particularly among younger members of the profession. (shrink)

In his six 1983 lectures published under the title, Fearless Speech (2001), Michel Foucault developed the theme of free speech and its relation to frankness, truth-telling, criticism, and duty. Derived from the ancient Greek word parrhesia, Foucault's analysis of free speech is relevant to the mentoring of medical students. This is especially true given the educational and social need to transform future physicians into able citizens who practice a fearless freedom of expression on behalf of their patients, the public, the (...) medical profession, and themselves in the public and political arena. In this paper, we argue that Foucault's understanding of free speech, or parrhesia, should be read as an ethical response to the American Medical Association's recent educational effort, Initiative to Transform Medical Education (ITME): Recommendations for change in the system of medical education (2007). In this document, the American Medical Association identifies gaps in medical education, emphasizing the need to enhance health system safety and quality, to improve education in training institutions, and to address the inadequacy of physician preparedness in new content areas. These gaps, and their relationship to the ITME goal of promoting excellence in patient care by implementing reform in the US system of medical education, call for a serious consideration and use of Foucault's parrhesia in the way that medical students are trained and mentored. (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)

BackgroundUnderstanding representations of disease in various art genres provides insights into how patients and health care providers view the diseases. It can also be used to enhance patient care and stimulate patient self-management.MethodsThis paper reviews how cardiovascular diseases are represented in novels, films, and paintings: myocardial infarction, aneurysm, hypertension, stroke, heart transplantation, Marfan’s disease, congestive heart failure. Various search systems and definitions were used to help identify sources of representations of different cardiovascular diseases. The representations of the different diseases were (...) considered separately. The Common Sense Model was used a theoretical model to outline illness perceptions and self-management in the various identified novels, films, and paintings.ResultsMyocardial infarction followed by stroke were the most frequently detailed diseases in all three art genres. This reflects their higher prevalence. Representations ranged from biomedical details through to social and psychological consequences of the diseases.ConclusionsArtistic representations of cardiovascular diseases reflect cognitions, emotions, and images of prevalent disease. These representations shape views and behaviour of ill and healthy persons regarding heart diseases. As these representations are amenable to change, they deserve further research, which may be instrumental in improving the quality of life of persons struck by cardiovascular diseases. Changing illness perceptions appears to be a method to improve self-management and thereby quality of life in patients with various cardiovascular diseases. (shrink)

This paper explores how the Bayesian program benefits from allowing for objective chance as well as subjective degree of belief. It applies David Lewis’s Principal Principle and David Christensen’s principle of informed preference to defend Howard Raiffa’s appeal to preferences between reference lotteries and scaling lotteries to represent degrees of belief. It goes on to outline the role of objective lotteries in an application of rationality axioms equivalent to the existence of a utility assignment to represent preferences in Savage’s famous (...) omelet example of a rational choice problem. An example motivating causal decision theory illustrates the need for representing subjunctive dependencies to do justice to intuitive examples where epistemic and causal independence come apart. We argue to extend Lewis’s account of chance as a guide to epistemic probability to include De Finetti’s convergence results. We explore Diachronic Dutch book arguments as illustrating commitments for treating transitions as learning experiences. Finally, we explore implications for Martingale convergence results for motivating commitment to objective chances. (shrink)

Levinas and other contemporary thinkers have claimed that the philosophy of "the other" provides a devastating critique of systematic rationality as such and of Hegel as a paradigm case thereof.The critique links an ethical moment and socio-political issues to a thorough-going critique of Hegelian metaphysics and the dialectical method. I articulate the meaning of alterity as a critique of Hegel through Levinas and Marx, and then discuss possible Hegelian responses to this criticism. I conclude that this critique of Hegel pertains (...) to the character of his final synthesis rather than to questions of difference and identity, and challenge the interpretation of Hegelian closure as the realization of eschatology. (shrink)

Derrida is typically taken to be the thinker most antithetical to Hegel, and deconstruction to be the philosophical antithesis to Hegel’s systematic rationality. While I do not dispute the accuracy of this perception, I argue in this paper that it does not offer an adequate or a complete picture. Specifically, much about Derrida and about deconstruction is more similar to Hegel than is typically realized. I argue that Derrida’s deconstruction shares a great affinity to the method of Hegel’s Phenomenology of (...) Spirit, so much so that we could identify and articulate a latent Hegelianism in Derrida’s approach. I begin with a description of Derrida’s own project, then offer something of an apologia for his work. Finally, I describe Hegel’s method of exposition [Darstellung] and compare it to deconstruction, pointing out the fundamental similarities between the two thinkers. (shrink)

Background: Legislation on physician-assisted suicide is being considered in a number of states since the passage of the Oregon Death With Dignity Act in 1994. Opinion assessment surveys have historically assessed particular subsets of physicians.Objective: To determine variables predictive of physicians’ opinions on PAS in a rural state, Vermont, USA.Design: Cross-sectional mailing survey.Participants: 1052 physicians licensed by the state of Vermont.Results: Of the respondents, 38.2% believed PAS should be legalised, 16.0% believed it should be prohibited and 26.0% believed it should (...) not be legislated. 15.7% were undecided. Males were more likely than females to favour legalisation . Physicians who did not care for patients through the end of life were significantly more likely to favour legalisation of PAS than physicians who do care for patients with terminal illness . 30% of the respondents had experienced a request for assistance with suicide.Conclusions: Vermont physicians’ opinions on the legalisation of PAS is sharply polarised. Patient autonomy was a factor strongly associated with opinions in favour of legalisation, whereas the sanctity of the doctor–patient relationship was strongly associated with opinions in favour of not legislating PAS. Those in favour of making PAS illegal overwhelmingly cited moral and ethical beliefs as factors in their opinion. Although opinions on legalisation appear to be based on firmly held beliefs, approximately half of Vermont physicians who responded to the survey agree that there is a need for more education in palliative care and pain management. (shrink)

We propose a model mechanism for the initiation and spatial positioning of teeth primordia in the alligator, Alligator mississippiensis. Detailed embryological studies by Westergaard and Ferguson have shown that jaw growth plays a crucial role in the developmental patterning of the tooth initiation process. Based on biological data we develop a dynamic patterning mechanism, which crucially includes domain growth. The mechanism can reproduce the spatial pattern development of the first seven teeth primordia in each half jaw of A. mississippiensis. The (...) results for the precise spatio-temporal sequence compare well with experiment. Simulation of the model also predicts that certain transplantations can alter the spatial sequence of teeth primordia initiation. (shrink)

This paper explores a novel philosophy of ethical care in the face of burgeoning biomedical technologies. I respond to a serious challenge facing traditional bioethics with its roots in analytic philosophy. The hallmarks of these traditional approaches are reason and autonomy, founded on a belief in the liberal humanist subject. In recent years, however, there have been mounting challenges to this view of human subjectivity, emerging from poststructuralist critiques, such as Michel Foucault's, but increasingly also as a result of advances (...) in biotechnology itself. In the face of these developments, I argue that the theoretical relevance and practical application of mainstream bioethics is increasingly under strain. Traditionalists will undoubtedly resist. Together, professional philosopher-bioethicists, public health policymakers, and the global commercial healthcare industry tend to respond conservatively by shoring up the liberal humanist subject as the foundation for medical ethics and consumer decision-making, appealing to the familiar tropes of reason, autonomy, and freedom. (shrink)

Human beings, as a species, have two outstanding characteristics compared to all other species: the apparently enormous elaboration of our thought through language and symbolism, and the elaboration of our forms of social organization. The obvious question is whether these two characteristics are connected. ... Our view is that they are connected intimately. Thought and social organization are two aspects of the same larger phenomenon, or better the same larger bundle of phenomena. ... Here we bring the two streams of (...) analysis together, in what is at once an exposition of the basic structure of the systems of thought that organizations are built upon and, eo ipso, an exposition of the organizational basis and origin of human thinking as such. The resulting reconfiguring of questions, answers, and methods, we believe, cannot be described otherwise than as a new science and not just a new paradigm. (shrink)

“A society is more than a set of entities to which the same class-name applies” . Taking this obiter dictum of Whitehead's seriously, the present paper seeks to elucidate some of the more abstract properties of a society. By “society” I understand primarily human society in the sense in which it is an object of study for social theory, though part of what is said may admit of application to societies in some wider sense. An apology should perhaps be offered (...) for the terminology introduced. The writer's only excuse is that there seemed no other way of expressing the ideas in question. (shrink)

This chapter suggests that descriptive epidemiological studies like the Global Burden of Disease Study can usefully be divided into four tasks: describing individuals’ health states over time, assessing their health states under a range of counterfactual scenarios, summarizing the information collected, and then packaging it for presentation. The authors show that each of these tasks raises important and challenging ethical questions. They comment on some of the philosophical issues involved in measuring health states, attributing causes to health outcomes, choosing the (...) counterfactual against which to assess causes, aggregating and summarizing complex information across multiple domains, discounting, age-weighting, handling fetal deaths, measuring health inequalities, representing uncertainty, and assessing personal responsibility for health outcomes. (shrink)

Kovacs argues that honorary authorship and regarding each co-author of multi-authored papers as if they were sole authors when the performance of researchers is being evaluated by their publications mean that we should require authors to identify what proportion of each publication should be attributed to each co-author. Even if such attributions could be made reliably, such a change should not be made. Contributions to authorship cannot be validly quantified, and the relative merits of different publications are also neither equal (...) nor validly quantifiable. Research administrators need to recognise that whatever criteria they adopt to evaluate the performance of researchers, researchers will find a way to game the system in order to maximise their personal benefit. (shrink)

Jones' article suggests that the anthropological analysis of kinship has followed a single line of development based on a single underlying conception of meaning and method. In fact, there have been two opposed lines of development. Jones' conception is positivistic. The other is pragmatic. Pragmatic theory is superior on every recognized criterion. This briefly describes the differences.

The paper's first four sections give a taxonomy and criticism of three classes of objections to the argument from illusion. the last section raises the question whether its main premise does not misclassify perceptual accusatives (e.g. 'sensation of bentness') as individuatives that imply the existence of, say, bent particulars.

Consider the following situation. It is the first day of school, and the new third-grade students file into the classroom to be shown to their seats for the coming year. As they enter, the third-grade teacher notices one small boy who is particularly unkempt. He looks to be in desperate need of bathing, and his clothes are dirty, torn and tight-fitting. During recess, the teacher pulls aside the boy's previous teacher and asks about his wretched condition. The other teacher informs (...) her that he always looks that way, even though the boy's family is quite wealthy. The reason he appears as he does, she continues, is that the family observes an odd practice according to which the children do not receive many important things – food, clothing, bathing, even shelter – unless they specifically request them. Since the boy, like many third-graders, has little interest in bathing and clean clothes, he just never asks for them. (shrink)