Recent work in clinical nursing ethics has been influenced by two main areas of insight associated with the challenge levelled by the women's movement to traditional thinking about morality and ethics. Broadly speaking these two realms have been distinguished as articulating ‘feminist’ socio‐political and ‘feminine’ ethic of care concerns. Often these two impulses are seen as pulling against each other, or worse, the ‘feminine’ emphasis on the ethics of care is seen as reinforcing the dynamics that elicit the ‘feminist’ concern. (...) In this paper I suggest how an expanded understanding of an ethic of care in clinical settings can provide resources for dealing with both concerns. A discussion of the way institutional relations can ride rough‐shod over the ‘feminist’ insights of ethical care, in the second part of the paper, provides evidence for my conclusion that ethical nursing care depends on recognizing that both areas of insight are imperative for its success. (shrink)

In _Caring_, Peta Bowden extends and challenges recent debates on feminist ethics. She takes issue with accounts of the ethics of care that focus on alleged principles of caring rather than analysing caring in practice. Caring, Bowden argues, must be understood by 'working through examples'. Following this approach, Bowden explores four main caring practices: mothering, friendship, nursing and citizenship. Her analysis of the differences and similarities in these practices - their varying degrees of intimacy and reciprocity, formality and informality, (...) vulnerability and choice - reveals the practical complexity of the ethics of care. _Caring_ recognizes that ethical practices constantly outrun the theories that attempt to explain them, and Bowden's unique approach provides major new insights into the nature of care without resorting to indiscriminate unitary models. It will be essential reading for all those interested in ethics, gender studies, nursing and the caring professions. (shrink)

Governments are increasingly using randomized controlled trials (RCTs) to evaluate policy interventions. RCTs are often understood to provide the highest quality evidence regarding the causal efficacy of an intervention. While randomization plays an essential epistemic role in the context of policy RCTs however, it also plays an important distributive role. By randomly assigning participants to either the intervention or control arm of an RCT, people are subject to different policies and so, often, to different types and levels of benefits. In (...) this paper, I identify one necessary condition as well as a set of sufficient conditions for the permissible use of random assignment by government agencies. I argue first that random assignment is permissible only if it is consistent with governments’ duty to realize morally important outcomes. I argue second that random assignment is permissible in cases where investigators are in a state of genuine equipoise regarding all arms of the experiment and the policy to which people have a claim of justice. Finally, I defend a set of conditions under which random assignment is permissible in cases where one or more arms of a policy RCT are reasonably expected to be either superior or inferior to this policy. (shrink)

On Surface and Place is a rich and poetic exploration of surfaces which foregrounds their significance in our understanding and experience of place. Adopting weaving as its overarching metaphor, it departs from Gottfried Semper's discussion of correspondences between architecture and textiles, and emerges from the reading of photographs, a swatch of Harris Tweed and curtain wall façade juxtaposed. In juxtaposing the fabric of the city with the weave of Harris Tweed the book charts an original course across a range of (...) connected ideas and questions, combining many different themes, writers and disciplines. It presents integrated and innovative rethinkings on a number of fundamental relationships, including correlations between body and building, word and image, and between the rural and the metropolitan, and the hand-crafted and the mass-reproduced. In doing so, it seeks to foreground the very interrelationship of surface and place, as it makes a claim for the relational nature of the world in which we live. (shrink)

Soda taxes are controversial. While proponents point to their potential health benefits and the public projects that could be funded with their revenue, critics argue that they are paternalistic and regressive. In this paper, we explore the prospects for designing a just soda tax, one that appropriately balances the often-competing ethical considerations of promoting social welfare, respecting people’s autonomy, and ensuring distributive fairness. We argue that policymakers have several paths forward for designing a just soda tax, but that the considerations (...) relevant to ethical policy design are more complicated than is sometimes acknowledged. (shrink)

Policy analyses begin with a systematic overview of the policy problem they address. This includes a comprehensive discussion of the nature and context of the problem, and the institutional and behavioral factors responsible for its emergence. Problem statements must also explain why the status quo is bad or undesirable, why it is something that governments, rather than private actors, should address, and establish that the relevant government institutions have the legitimacy to intervene. In this chapter, I provide an overview of (...) the principal types of policy problems that it is morally appropriate for governments to address. Each type denotes a class of states of affairs that (1) are bad, undesirable, or unjust, (2) the government is particularly well-suited to address, and (3) arise from spheres of action over which the relevant government institutions have the right to intervene. I begin with a discussion of collective action problems, that is, states of affairs in which action by rational and self-interested private actors is collectively self-defeating. I then argue for two additional types of policy problems. First, since the goal of government action is the construction of a just legal order, not merely an efficient one, states of affairs which are unjust constitute an additional type of policy problem. Relatedly, second, whereas analyses of collective action problems typically presuppose the existence of effective government institutions which can address them, such institutions may be deficient and/or unjust. A third type of policy problem is therefore deficient government institutions. -/- . (shrink)

The Australian moratorium on human clinical trials of xenotransplantation was lifted in December 2009. This decision follows public consultations on whether xenotransplantation should or should not proceed in Australia, which occurred in 2002 and 2004. However, the public consultation, in its design and process, did not facilitate meaningful public engagement and involvement, thus marginalising the public and devaluing their social experiences and diverse knowledges. This brief article questions what constitutes adequate public consultation, and suggests that consensus conferences or citizen juries (...) should be explored as a mechanism for meaningful public engagement for future public consultation exercises in Australia. (shrink)

The body conceived of as a machinic assemblage becomes a body that is multiple. Its function or meaning no longer depends on an interior truth or identity, but on the particular assemblages it forms with other bodies. In this paper I draw on the work of Deleuze and Guattari to explore what happens to the drug using body when it is rethought as a machinic assemblage. Following an exploration of how the body of the drug user is put together and (...) stratified as a subject, and a careful manoeuvre through the bleak conception of the ‘drugged body’ provided by Deleuze and Guattari, I begin to map out some ethical alternatives. I argue that a body should, ultimately, be valued for what it can do (rather than what is essentially ‘is’), and that assemblages should be assessed in relation to their enabling, or blocking, of a body’s potential to become other. (shrink)

Recent discussions concerning the ethics of nursing care have gained added impetus from articulations of die so‐called ‘ethic of carersquo; in moral philosophy. This paper addresses the question of recognizing and elaborating the ethics of nursing care by exploring the problems and the possibilities of diese intersecting discourses. In the first part of the paper it is argued that appropriation of ‘the ethic of care’ by nursing theorists as the central value of nursing, in contradistinction to other moral values such (...) as beneficence or justice, runs the risk of reinforcing the conventional approaches to ethics that ‘the ethic of care’ seeks to overturn. Central to ‘the ethic of care’ is the recognition that caring entails a focus on the particularities and context of the relationships in which it is expressed. Accordingly die application of a unitary concept of care to the context of nursing relations may seriously distort dieir diverse and complex‐specific ediical possibilities. The dynamic complexity of nursing ethics may be more adequately understood by working through an array of specific examples of nursing practice highlighting the differences and similarities between them and other ethical practices of care. Experience of a set of examples in this way will draw attention to the multiplicity, ambiguity, and particularity of the ethics of nursing while facilitating the ability to recognize how other practices may or may not be understood as examples of ediical nursing care. In the second part of the paper a beginning is made on this project by addressing the work of several different theorists of care who have examined different practices of nursing from the overlapping perspectives of nurses, patients and the socio‐historical construction of their relationships. (shrink)

This study considers one of the cognitive mechanisms underlying the development of second language vocabulary in children: The differentiation and sharpening of lexical representations. We propose that sharpening is triggered by an implicit comparison of similar representations, a process we call contrasting. We investigate whether integrating contrasting in a learning method in which children contrast orthographically and semantically similar L2 words facilitates learning of those words by sharpening their new lexical representations. In our study, 48 Dutch-speaking children learned unfamiliar orthographically (...) and semantically similar English words in a multiple-choice learning task. One half of the group learned the similar words by contrasting them, while the other half did not contrast them. Their word knowledge was measured immediately after learning as well as 1 week later. Contrasting was found to facilitate learning by leading to more precise lexical representations. However, only highly skilled readers benefitted from contrasting. Our findings offer novel insights into the development of L2 lexical representations from fuzzy to more precise, and have potential implications for education. (shrink)

This chapter provides a critical overview and interpretation of fair subject selection in clinical and social scientific research. It first provides an analytical framework for thinking about the problem of fair subject selection. It then argues that fair subject selection is best understood as a set of four subprinciples, each with normative force and each with distinct and often conflicting implications for the selection of participants: fair inclusion, fair burden sharing, fair opportunity, and fair distribution of third-party risks. It then (...) defends an approach to navigating the conflicting imperatives of these subprinciples, one which privileges the need to include epistemically distinct groups in research, before concluding by considering the most pressing research questions regarding fair subject selection. (shrink)

The methodological device of or, as sometimes euphemistically labeled, does not enjoy much support among institutional review boards (IRBs) and a large portion of scholars in bioethics. The reasons for this have been documented sufficiently, beginning with the now-paradigmatic attack on the well-known study by Milgram and the unsavory study of Laud Humphries on male homosexual activities in public restrooms. But are the current attitudes interfering with some worthwhile approaches to data gathering that seem to have no other methodology of (...) equal effectiveness? (shrink)

This paper argues that Pedro Tabenksy's Aristotelean understanding of true happiness overlooks the constitutive significance of the virtues and values of relationships of radical dependency. Tabensky's focus on the rational and contextual aspects of personhood as the locus for our social interdependence results in friendship relationships being taken as paradigmatic for social engagements. Through a sketch of some of the unique dimensions of the asymmetrical relations upon which our bodily functioning and personal identities inevitably depend, I show that this focus (...) risks perpetuating the lack of recognition of the value and significance of caring relations familiar to us in contemporary societies today. S. Afr. J. Philos. Vol.23(4) 2004: 394-401. (shrink)

This article argues that political performance reveals the significance of the emotions, emotional feelings, affect and mood in relation to the censorship of democratic expression. Belarus Free Theatre performers spoke about fear as they gave personal accounts of imprisonment and undertook extreme physical action on aerial ropes, creating performances that evoked both emotionally felt responses and bodily affect. The aesthetic mood effect in these performances shifted from amusing audiences with the absurdity of political censorship to alarming them with the terror (...) of political persecution. Antonio Damasio points out that although aspects of the emotions merge in everyday life, ideas or impressions need to be separated out from the physiology of emotional feeling in their study. While the turn to affect emphasizes convergence and, importantly, recognizes human sensitivity to nonhuman energies, an impersonal energetic field can be distinguished from the personal and the psychological. This analysis of theatrical performance reveals the ways in which it presents social ideas of the emotions and aesthetic moods, as well as elicits the affect of bodily sensation and invites the emotionally felt responses of audience members. Theatrical performance offers a space for expressing emotions in political protest. (shrink)

Although the principle of fair subject selection is a widely recognized requirement of ethical clinical research, it often yields conflicting imperatives, thus raising major ethical dilemmas regarding participant selection. In this paper, we diagnose the source of this problem, arguing that the principle of fair subject selection is best understood as a bundle of four distinct sub-principles, each with normative force and each yielding distinct imperatives: (1) fair inclusion; (2) fair burden sharing; (3) fair opportunity; and (4) fair distribution of (...) third-party risks. We first map out these distinct sub-principles, and then identify the ways in which they yield conflicting imperatives for the design of inclusion and exclusion criteria, and the recruitment of participants. We then offer guidance for how decision makers should navigate these conflicting imperatives to ensure that participants are selected fairly. (shrink)

In this round table response, we discuss some of the problems inherent in insisting on specific consent for an activity that needs to happen rapidly as part of a package of care. The Human Tissue Authority consider that specific consent is mandatory to assess which antibiotics are appropriate on the neonatal unit, but this insistence may actually limit the autonomy which consent aims to promote. While genetic testing to determine which child will react adversely to particular antibiotics has been available (...) clinically for several years, the research proposed here is to assess whether improving the speed of testing allows decisions to be made before treatment starts. Insisting on specific consent before this activity can take place is likely to delay appropriate care in some cases. On admission to the neonatal unit, the unwell infant is routinely subjected to a range of investigations and treatments. A person with parental responsibility will usually be asked to provide consent to undertake treatments for children who do not have capacity to give consent themselves.1 For the acutely unwell child, consent will usually be sought for a package of care: the urgent nature of neonatal medicine often requires clinicians to make many decisions without explicit consent. Doctors must always act in a child’s best interests: their decisions need to protect the health and well-being of a child and hold the child’s welfare paramount in accordance with the Children Act and General Medical Council guidelines.1 2 Thus, for example, ventilation might be initiated, sedation provided, antibiotics commenced or diagnostic investigations requested without separate consent conversations or …. (shrink)

The question of the transcendent, that which operates above and beyond the material stuff of the world, remains an enduring one for feminism, bound up as it is with the foundations of feminism's corporeal politics and the definition of its political subject. With the specificity of the situated and meaningful body grounding feminist politics, the universal and neutral status of the speaking subject has been diagnosed as masculine, and unable to properly account for sexed differences. On this basis, political community, (...) collectivity forged along the lines of a common identity, is considered important in the realization of feminist political goals, yet is also problematic in view of its reliance upon a universal category of identity through which to motivate for political change. Acknowledging these tensions, this paper revisits Luce Irigaray's essay “Divine Women” to suggest that in her rethinking of the divine as a shared horizon through which women can potentially achieve autonomy, the nature of the transcendent, the universal, and the identity of the feminine are also reconfigured in surprising ways. In a specific address to the dilemma of political community, Irigaray makes available a notion of the divine that is already differently inhabited. (shrink)

"Understanding Feminism" provides an accessible guide to one of the most important and contested movements in progressive modern thought. Presenting feminism as a dynamic, multi-faceted and adaptive movement that has evolved in response to the changing practical and theoretical problems faced by women, the authors take a problem-oriented approach that maps the complex strands of feminist thinking in relation to women's struggles for equal recognition and rights, and freedom from oppressive constraints of sex, self-expression and autonomy. Each chapter focuses on (...) a different cluster of concerns, demonstrating key moves in second-wave feminist thought, as well as some of the diversity in response-strategies that encompass both socio-economic and cultural-symbolic concerns. This approach not only shows how central feminist insights, theories and strategies emerge and re-emerge across different contexts, but makes clear that far from being 'over', feminism remains a vital response to the diverse issues that women find pressing and socially important. (shrink)

The Popperian epistemology underlying Levelt's commentary and other aspects of contemporary psychology has limited application and, in particular, does not apply to the creation or development of theory, the main goal of MacKay . This is relevant to Levelt's questions, “What has changed?” and “What is the harvest?”: From a non-Popperian perspective, both changes and harvest are greater than Levelt's commentary would suggest and carry implications for the field at large.

The burden of the Christian religion is not primarily that certain attitudes are desirable nor that certain practices are comfortable, but that certain things are true. Certain facts have to be faced, certain claims recognized. Questions of the meaningfulness and truth-status of religious language are thus central to Christian apologetic. However much emphasis we give to the vital link between true belief and action - and for the Bible the two are inseparable - there is no escaping the obligation to (...) enquire into the meaning and truth of Christian affirmations as well as their personal or social effectiveness. (shrink)

Given the highly coercive and heavily surveilled dynamics of the present moment, when the tremendous pressures exerted by capital on contemporary life produce an aggressively normative 'official reality', the question of the construction of other possible worlds is crucial and perhaps more urgent than ever. This collection brings together different perspectives from the fields of philosophy, aesthetics, and art to discuss the mechanisms through which possible worlds are thought, constructed, and instantiated, forcefully seeking to overcome the contemporary moment's deficit of (...) conceptualizing alternate realities, its apparent fear of imagining possible new and compelling futures, and beginning the arduous task of producing the political dynamics necessary for actual construction. Implicit in this dynamic between the conceptual and the possible is the question of how thinking intertwines with both rationality and the inherited contingencies and structures of the world that loom before us. With no ascertainable ground on which to build, with no confidence in any 'given' that could guarantee our labours, how do we even envisage the construction site(s) of possible worlds, and with what kind of diagrams, tools, and languages can we bring them into being? (shrink)