One INTRODUCTION: IN SEARCH OF THE VOICES OF NURSES IN CHINA Two motives launched this study to search for the voices of nurses in China. ...

This paper reports part of a longitudinal research project, which sought to capture students’ conceptualization of caring practice as they progressed to different levels of study in a nursing diploma programme in Hong Kong. Model emulation was found to be an effective means of focusing students’ learning processes on the moral aspects of nursing practice. The theory of model emulation from a Chinese perspective and how it is applied to create a learning context to allow students to acquire a moral (...) sense of nursing are discussed. The participating students are invited to be sincere enquirers in the pursuit of the good embedded in practice through introspective self-examination and dialogue. They are asked to describe and share their experience of positive and negative examples of nursing in written accounts. Van Kaam’s phenomenological method was adopted to explicate the good and bad constituents of nursing from these examples, with the students assuming an active role in the explication process. The explication reveals that the students were able to articulate the good and bad practices in a variety of patient care situations. (shrink)

Obstetric ultrasound is the well-recognized prenatal test used to visualize and determine the condition of a pregnant woman and her fetus. Apart from the clinical application, some businesses have started promoting the use of fetal ultrasound machines for nonmedical reasons. Non-medical fetal ultrasound (also known as ‘keepsake’ ultrasound) is defined as using ultrasound to view, take a picture, or determine the sex of a fetus without a medical indication. Notwithstanding the guidelines and warnings regarding ultrasound safety issued by governments and (...) professional bodies, the absence of scientifically proven physical harm to fetuses from this procedure seems to provide these businesses with grounds for rapid expansion. However, this argument is too simplistic because current epidemiological evidence is not synchronous with advancing ultrasound technology. As non-medical fetal ultrasound has aroused very significant public attention, a thorough ethical analysis of this topic is essential. Using a multifaceted approach, we analyse the ethical perspective of non-medical fetal ultrasound in terms of the expectant mother, the fetus and health professionals. After applying four major theories of ethics and principles (the precautionary principle; theories of consequentialism and impartiality; duty-based theory; and rights-based theories), we conclude that obstetric ultrasound practice is ethically justifiable only if the indication for its use is based on medical evidence. Non-medical fetal ultrasound can be considered ethically unjustifiable. Nevertheless, the ethical analysis of this issue is time dependent owing to rapid advancements in ultrasound technology and the safety issue. The role of health professionals in ensuring that obstetric ultrasound is an ethically justifiable practice is also discussed. (shrink)

While the movement to ensure patient’s rights to information and informed consent spreads throughout the world, patient rights of this kind have yet to be introduced in mainland China. Nonetheless, China is no different from other parts of the world in that nurses are expected to shoulder the responsibility of safeguarding patients’ best interests and at the same time to uphold their right to information. This paper expounds on the principle of protectiveness grounded in traditional Chinese medical ethics concerning the (...) practice of informed consent. Nurses in China have a moral obligation to treat patients with sincerity. This notion carries a strong sense of parental protectiveness. As far as information-giving is concerned, nurses in China are ambivalent about the notion of truthfulness. The findings of an empirical study undertaken in seven Chinese cities reveal that nurses in China experience similar difficulties related to the disclosure of information as their counterparts in other parts of the world. A nurse’s narrative, the Chan case, is used to illustrate the typical difficult situation that nurses in China often encounter in looking after vulnerable patients who would like to learn more about their therapeutic regimens. The moral tension embedded in nursing practice is analysed. It is found that most nurses would prefer to tell the truth to patients, but their primary ethical justification is not that of respect for patients’ autonomy or safeguarding patients’ right to self-determination. Rather, it is basically beneficent in nature; that is, they base their decision to reveal the truth on whether or not patients will receive more relevant treatment and better nursing care. (shrink)

Nursing research in China is at an early stage of development and little is known about the practices of Chinese nurse researchers. This interview study carried out at a university in central China explores the informed consent practices of Chinese nurse researchers and the cultural considerations of using a western technique. Nine semistructured interviews were conducted in English with assistance and simultaneous translation from a Chinese nurse with research experience. The interviews were analyzed by one western and two Chinese researchers (...) and major themes were identified. All participants endorsed informed consent as ethically required. Differences were noted between some of the informed consent practices typically recommended in the USA and those identified in this study, such as: recruitment using local and government officials, recruiting directly from medical records without special permission, family consultation in consent and consent control, and not revealing randomization to intervention groups receiving different treatments. (shrink)

The other contributions address philosophical problems arising in specific domains of international law, such as human rights law, international economic law, ...

Augustine of Hippo is often regarded as the champion of the doctrine of weakness of the will. John M. Rist in his 1994 'Augustine: Ancient Thought Baptized' draws an interesting analogy between Aristotle's 'akrasia' and Augustine's 'concupiscentia'. However, such an analogy without further qualification is defective and misleading because it implies that Augustine commits himself to the notion that since everyone is perpetually akratic and, thus, always morally blameworthy. I argue that, for Augustine, weakness of the will has equivocal meanings (...) and is manifested in four kinds of case--their scope goes far beyond Aristotle's discussion of 'akrasia' in Book Seven of the 'Nicomachean Ethics'. There are, therefore, considerable differences between Aristotle's and Augustine's account of weakness of the will. Consequently, for Augustine, moral responsibility for the moral agent also varies in each of the four cases. (shrink)

This book explores the relationship between the law and pervasive and persistent reasonable disagreement about justice. It reveals the central moral function and creative force of reasonable disagreement in and about the law and shows why and how lawyers and legal philosophers should take reasonable conflict more seriously. Even though the law should be regarded as the primary mode of settlement of our moral conflicts,it can, and should, also be the object and the forum of further moral conflicts. There is (...) more to the rule of law than convergence and determinacy and it is important therefore to question the importance of agreement in law and politics. By addressing in detail issues pertaining to the nature and sources of disagreement, its extent and significance, as well as the procedural, institutional and substantive responses to disagreement in the law and their legitimacy, this book suggests the value of a comprehensive approach to thinking about conflict, which until recently has been analysed in a compartmentalized way. It aims to provide a fully-fledged political morality of conflict by drawing on the analysis of topical jurisprudential questions in the new light of disagreement. Developing such a global theory of disagreement in the law should be read in the context of the broader effort of reconstructing a complete account of democratic law-making in pluralistic societies. The book will be of value not only to legal philosophers and constitutional theorists, but also to political and democratic theorists, as well as to all those interested in public decision-making in conditions of conflict. (shrink)

In _Biocultural Creatures_, Samantha Frost brings feminist and political theory together with findings in the life sciences to recuperate the category of the human for politics. Challenging the idea of human exceptionalism as well as other theories of subjectivity that rest on a distinction between biology and culture, Frost proposes that humans are biocultural creatures who quite literally are cultured within the material, social, and symbolic worlds they inhabit. Through discussions about carbon, the functions of cell membranes, the activity (...) of genes and proteins, the work of oxygen, and the passage of time, Frost recasts questions about the nature of matter, identity, and embodiment. In doing so, she elucidates the imbrication of the biological and cultural within the corporeal self. In remapping the relation of humans to their habitats and arriving at the idea that humans are biocultural creatures, Frost provides new theoretical resources for responding to political and environmental crises and for thinking about how to transform the ways we live. (shrink)

This article examines the rise and decline of the enthusiasm for intelligence testing in early twentieth-century China, focusing on the appeal, the challenges, and the critiques revolving around this psychological instrument. The introduction of intelligence testing reflected not only China’s urgent needs in modernizing its merit system, but also Chinese psychologists’ aspirations for pursuing exactitude and redefining the racial characteristics of their compatriots against foreign interpretations. But despite psychologists’ endeavors, the political and geographical fragmentation of Republican China troubled the epistemic (...) imperative of uniformity demanded by Euro-American psychometrics and therefore undermined the validity of measurement. Subsequently, the legitimacy of intelligence testing began to be questioned by several influential Chinese psychologists in the late 1920s and 30s. The difficulties in standardization and the hostility within the psychology community formed a vicious cycle, impeding the progress of nationwide testing. Through this history, the article demonstrates not only the elevation of measurement to epistemic authority in modern China, but also how its promise was challenged by a diverse and rapidly changing society. (shrink)

Moral issues have been included in the studies of consumer misbehavior research, but little is known about the joint moderating effect of moral intensity and moral judgment on the consumer’s use intention of pirated software. This study aims to understand the consumer’s use intention of pirated software in Taiwan based on the theory of planned behavior (TPB) proposed by Ajzen (Organizational Behavior and Human Decision Processes, 50, 179, 1991). In addition, moral intensity and moral judgment are adopted as a joint (...) moderator to examine their combined influence on the proposed research framework. The results obtained from this Taiwan case reveal that the antecedent constructs proposed in the TPB model–an individual’s attitude and subjective norms toward using pirated software, and perceived behavioral control to use pirated software–indeed have positive impacts on the consumer’s use intention of pirated software. In addition, the joint moderating effect of moral intensity and moral judgment is manifested in the consumer’s use intention of pirated software. The results of this study not only could substantiate the results of consumer misbehavior research, but also could provide some managerial suggestions for Taiwanese government authorities concerned and the related software industries devoted to fighting pirated software. (shrink)

Moral issues have been included in the studies of consumer misbehavior research, but little is known about the joint moderating effect of moral intensity and moral judgment on the consumer's use intention of pirated software. This study aims to understand the consumer's use intention of pirated software in Taiwan based on the theory of planned behavior proposed by Ajzen. In addition, moral intensity and moral judgment are adopted as a joint moderator to examine their combined influence on the proposed research (...) framework. The results obtained from this Taiwan case reveal that the antecedent constructs proposed in the TPB model–an individual's attitude and subjective norms toward using pirated software, and perceived behavioral control to use pirated software–indeed have positive impacts on the consumer's use intention of pirated software. In addition, the joint moderating effect of moral intensity and moral judgment is manifested in the consumer's use intention of pirated software. The results of this study not only could substantiate the results of consumer misbehavior research, but also could provide some managerial suggestions for Taiwanese government authorities concerned and the related software industries devoted to fighting pirated software. (shrink)

This article analyzes a popular meme that has spread rapidly among Chinese internet users in the last few years, ‘garlic chives’ ( jiucai), as a self-mockery of the bio-economic subject in contemporary China. This metaphor refers to those ordinary Chinese people who are constantly lured to participate in all kinds of economic activities, but whose investments are destined to be consumed by the establishment. Through a close study of this popular meme and the social conditions from which it arises, this (...) article demonstrates two main features of the Chinese economic subject that supports the state’s economic sovereignty: the thriving of self-sufficient and rule-abiding individuals, and the quality of these individuals as hard working and capable of producing wealth on their own. This article offers a critique of PRC’s post-socialist governmentality, and it provides insights about the relation between the biological and the political in our complicated world order. (shrink)

Background The review of human participant research by Research Ethics Committees or Institutional Review Boards is a complex multi-faceted process that cannot be reduced to an algorithm. However, this does not give RECs/ IRBs permission to be inconsistent in their specific requirements to researchers or in their final opinions. In England the Health Research Authority coordinates 67 committees, and has adopted a consistency improvement plan including a process called “Shared Ethical Debate” where multiple committees review the same project. Committee reviews (...) are compared for consistency by analysing the resulting minutes. Methods We present a description of the ShED process. We report an analysis of minutes created by research ethics committees participating in two ShED exercises, and compare them to minutes produced in a published “mystery shopper” exercise. We propose a consistency score by defining top themes for each exercise, and calculating the ratio between top themes and total themes identified by each committee for each ShED exercise. Results Our analysis highlights qualitative differences between the ShED 19, ShED 20 and “mystery shopper” exercises. The quantitative measure of consistency showed only one committee across the three exercises with more than half its total themes as top themes. The average consistency scores for the three exercises were 0.23, 0.35 and 0.32. There is a statistically significant difference between the ShED 19 exercise, and the ShED 20 and mystery shopper exercises. Conclusions ShED exercises are effective in identifying inconsistency between ethics committees and we describe a scoring method that could be used to quantify this. However, whilst a level of inconsistency is probably inevitable in research ethics committee reviews, studies must move beyond the ShED methodology to understand why inconsistency occurs, and what an acceptable level of inconsistency might be. (shrink)

The review of human participant research by Research Ethics Committees or Institutional Review Boards is a complex multi-faceted process that cannot be reduced to an algorithm. However, this does not give RECs/ IRBs permission to be inconsistent in their specific requirements to researchers or in their final opinions. In England the Health Research Authority coordinates 67 committees, and has adopted a consistency improvement plan including a process called “Shared Ethical Debate” where multiple committees review the same project. Committee reviews are (...) compared for consistency by analysing the resulting minutes. We present a description of the ShED process. We report an analysis of minutes created by research ethics committees participating in two ShED exercises, and compare them to minutes produced in a published “mystery shopper” exercise. We propose a consistency score by defining top themes for each exercise, and calculating the ratio between top themes and total themes identified by each committee for each ShED exercise. Our analysis highlights qualitative differences between the ShED 19, ShED 20 and “mystery shopper” exercises. The quantitative measure of consistency showed only one committee across the three exercises with more than half its total themes as top themes. The average consistency scores for the three exercises were 0.23, 0.35 and 0.32. There is a statistically significant difference between the ShED 19 exercise, and the ShED 20 and mystery shopper exercises. ShED exercises are effective in identifying inconsistency between ethics committees and we describe a scoring method that could be used to quantify this. However, whilst a level of inconsistency is probably inevitable in research ethics committee reviews, studies must move beyond the ShED methodology to understand why inconsistency occurs, and what an acceptable level of inconsistency might be. (shrink)

The essays in this book clarify the technical, legal, ethical, and social aspects of the interaction between eHealth technologies and surveillance practices. The book starts out by presenting a theoretical framework on eHealth and surveillance, followed by an introduction to the various ideas on eHealth and surveillance explored in the subsequent chapters. Issues addressed in the chapters include privacy and data protection, social acceptance of eHealth, cost-effective and innovative healthcare, as well as the privacy aspects of employee wellness programs using (...) eHealth, the use of mobile health app data by insurance companies, advertising industry and law enforcement, and the ethics of Big Data use in healthcare. A closing chapter draws on the previous content to explore the notion that people are 'under observation', bringing together two hitherto unrelated streams of scholarship interested in observation: eHealth and surveillance studies. In short, the book represents a first essential step towards cross-fertilization and offers new insights into the legal, ethical and social significance of being 'under observation'. (shrink)

This article surveys recent feminist contributions to moral philosophy with an emphasis on those works which engage with debates within mainstream ethics. The article begins by examining a tension said to arise from the two criteria a theory must meet if it is to count as feminist moral theory: the women's experience requirement and the feminist conclusion requirement. Subsequent sections deal with feminist relational theories of rights, feminist work on responsibility and feminist contractarian approaches to ethics. A final section looks (...) at the application of some feminist moral theories to the problem of abortion. (shrink)

本书对于一分为三的现实与历史、形式与内容、继承与创新等的关系,进行了论述。全书分为四部分,分别是天地之道——一分为三、人间之道——一分为三、一分为三与辩证法、一分为二之粗疏等。.

Interest in republicanism as a political theory has burgeoned in recent years, but its implications for the understanding of law have remained largely unexplored. Legal Republicanism is the first book to offer a comprehensive, critical survey of the potential for creating republican accounts of fundamental issues in law and legal theory.

Habermas does not rule out the possibility of violence in language. In fact his account explicitly licenses a broad conception of violence as ‘systematically distorted communication’. Yet he does rule out the possibility that language simultaneously imposes as it discloses. That is, his argument precludes the possibility of recognizing that there is an antinomy at the heart of language and philosophical reason. This occlusion of the simultaneously world-disclosing and world-imposing character of language feeds and sustains Habermas’s legal and political arguments, (...) where he states that in order to achieve consensus rational deliberation must eliminate force. In this paper, I claim that this argument operates through a manoeuvre that leaves Habermas’s position curiously blind to its own predicament. To explain why, I turn to Kant’s treatment of the problem of evil in Religion Within the Boundaries of Mere Reason. Here, as in the Western philosophical tradition more generally, evil has no separate existence: it is folded back into Kant’s philosophical scheme. Arendt notes that as soon as Kant identifies the problem of evil he rationalizes it into comprehensible motives. I will show how, through a move that is structurally similar to Kant’s rationalization of evil, Habermas rationalizes and attempts to eliminate violence from his consideration of law and language. In Habermas’s work, law and language appear as ciphers for reason. The case to be made here is that Habermas’s inability to recognize the paradoxical character of language and reason makes his work blind to the violence in which it is unavoidably implicated. (shrink)

The concept of medical necessity is often used to explain or justify certain decisions—for example, which treatments should be allowed under certain conditions—as though it had an obvious, agreed-upon meaning as well as an inherent normative force. In introducing this special issue of Clinical Ethics on medical necessity, we argue that the term, as used in various discourses, generally lacks a definition that is clear, non-circular, conceptually plausible, and fit for purpose. We propose that future work on this concept should (...) address three main questions: what medical necessity is (i.e., what makes something medically necessary, as opposed to something else); what the concept does (what ‘work’ is it doing when invoked in different settings); and what should follow, normatively, from the fact that something is indeed medically necessary (on some plausible conception). (shrink)

Thomas Hobbes is an iconic figure who serves as an easy reference for pundits commenting on the brutality of war as well as for critics of a distinctly modern individualism in which calculating and rapacious self-interest is the cause of the violence, destruction, and exploitation endemic to the contemporary world. Frost's reading of Hobbes's philosophy shows us that underlying such visions of self and politics is another iconic figure: that of the Cartesian subject. What gives the iconic Hobbes his hardcore (...) individualism and its corollary accounts of instrumentalism, conflict, and absolutism is a Cartesian rendering of the self as split into mind and body. Carefully elaborating Hobbes's materialist ontology, _Lessons from a Materialist Thinker_ challenges both our implicit Cartesian assumptions about the self and the commonplace Hobbes that so readily figures violence in our political imagination. Through his materialism, Hobbes presents an alternative modern account of self-consciousness, reason, agency, power, freedom, and responsibility. In doing so, he shows that our fundamental intersubjectivity and interdependence require that we pursue peace above all else. (shrink)

Many healthcare goods, such as surgical instruments, textiles and gloves, are manufactured in unregulated factories and sweatshops where, amongst other labour rights violations, workers are subject to considerable occupational health risks. In this paper we undertake an ethical analysis of the supply of sweatshop-produced surgical goods to healthcare providers, with a specific focus on the National Health Service of the United Kingdom. We contend that while labour abuses and occupational health deficiencies are morally unacceptable in the production of any commodity, (...) an additional wrong is incurred when the health of certain populations is secured in ways that endanger the health and well-being of people working and living elsewhere. While some measures have been taken to better regulate the supply chain to healthcare providers in the UK, further action is needed to ensure that surgical goods are sourced from suppliers who protect the labour and occupational health rights of their workers. (shrink)

Foucault contra Habermas is an incisive examination of, and a comprehensive introduction to, the debate between Foucault and Habermas over the meaning of enlightenment and modernity. It reprises the key issues in the argument between critical theory and genealogy and is organised around three complementary themes: defining the context of the debate; examining the theoretical and conceptual tools used; and discussing the implications for politics and criticism. In a detailed reply to Habermas' Philosophical Discourse of Modernity, this volume explains the (...) difference between Habermas' philosophical practice and Foucault's between the analytics of truth and the politics of truth. Many of the most difficult arguments in the exchange are subject to a detailed critical analysis. This examination also includes discussion of the ethics of dialogue; the practice of criticism; the politics of recognition, and the function of civil society and democracy. (shrink)

In his Letters on the Aesthetic Education of Man, Friedrich Schiller draws a striking connection between aesthetic value and individual and political freedom, claiming that, ‘it is only through beauty that man makes his way to freedom’. However, contemporary ways of thinking about freedom and aesthetic value make it difficult to see what the connection could be. Through a careful reconstruction of the Letters, we argue that Schiller’s theory of aesthetic value serves as the key to understanding not only his (...) view of aesthetic engagement, but also his distinctive account of individual and political freedom. In Part I, we develop a reconstruction of Schiller's view that aesthetic value is the only path to individual freedom and in Part II we analyze how Schiller connects aesthetic value to political freedom. In the end, we show that Schiller defends a non-hedonic, action-oriented, communitarian theory of aesthetic value and a theory of freedom that makes the aesthetic not just supererogatory but fundamental for any fully autonomous life. Although we have lost touch with this way of thinking about aesthetic value and freedom, we submit that it is illuminating for contemporary thinking about both. (shrink)

We speculate with Hegel about language, critiquing interpretations of Hegel’s views on language given by Jim Vernon, John McCumber, Stephen Houlgate, and Michael N. Forster, as well as defending Sophisticated Radical Whorfianism from the objections of Maria Francisca Reines and Jesse Prinz. Prior to discussing Forster, we explicate Hegel’s views on mechanical memory. We conclude by discussing why, although thought grows up, it does not move out.

We have followed with interest the commentaries arising from Moore and Donnellys1 argument that authorities in charge of research ethics committees should focus primarily on establishing code-consistent reviews.1 We broadly agree with Savulescu’s2 argument that ethics committees should become more expert, but in a different way and for a different reason. We have recently been working with the UK Health Research Authority analysing the outcomes of their ‘Shared Ethical Debate’ exercises.3 Each ShED exercise involves the circulation of a single research (...) project to a number of RECs. The resulting minutes from each REC are compared along with the final decisions made by each REC on the project under consideration. This process was originally an administrative exercise designed to promote greater consistency among the 60 or so ethics committees that were brought under the HRA ) umbrella within the UK National Health Service. Over 20 ShEDs have been run, and although the process has significant weaknesses and has not always been run consistently, the results of the exercises are fascinating. Broadly speaking, NHS RECs have been getting more consistent over time in terms of their decision-making, but the reasons for the final decisions as described in the committee minutes continue to vary widely. Qualitative research now needs to be done to understand why different committees can have such different discussions in relation to exactly the same research project and yet come to essentially the same conclusion. As part of our analysis of the ShED data, we looked at …. (shrink)

In contrast to those who trace civil society to “community” per se, Foucault is keen to locate this concept as it emerges at a particular moment in respect of specific exigencies of government. He suggests that civil society is a novel way of thinking about a problem, a particular problematization of government that emerges in the eighteenth century and which combines incommensurable conceptions of the subject as simultaneously a subject of right and of interests. This article takes up Foucault’s discussion (...) of the Scottish Enlightenment in The Birth of Biopolitics to trace the distinctiveness of his discussion of civil society, but also in order to suggest that we ought to pay closer attention to the tensions between commercial-civilizational and civic republican themes in the literature of the late eighteenth century than does Foucault. It is my tentative suggestion that Foucault’s account leaves out significant aspects of these debates that offer counter-valences to the dominant models of the subject available to contemporary political discourse. (shrink)