The norms and practices of clinical ethics took form relative to the environment and relationships of hospital care. These practices do not easily translate into the outpatient context because the environment and relational dynamics differ. Yet, as outpatient care becomes the center of health care delivery, the experiences of ethical tension for outpatient clinicians warrant greater responses. Although a substantial body of literature on the nature of the doctor–physician relationship has been developed and could provide theoretical groundwork for an outpatient (...) ethics, this literature is not sufficient to support outpatient caregivers in practical dilemmas. For physicians who are employed by or affiliated with a larger organization, a stronger alliance between clinical ethics and organizational ethics, identity, and mission will promote expansion of ethics resources in outpatient settings and address structural constraints in outpatient clinical care. (shrink)
This paper examines the meaning of space and its relationship to value. In this paper, I draw on Henri Lefebvre to suggest that our ethics produce and are produced by spaces. Space is not simply a passive material container or neutral geographic location. Space includes the ideas on which buildings are modeled, the ordering of objects and movement patterns within the space, and the symbolic meaning of the space and its objects. Although often unrecognized, space itself is value-laden, and its (...) values are suggested as people interact within that space. By reflecting on the spaces of health care, we will see that we not only must attend to the quandaries caused by the delivery of health care in non-acute places, but also to the values that produce and are produced by spaces. These values influence our moral imagination and shape us as people. (shrink)
The following views were presented at the Annual Meeting of the American Association for the Advancement of Science Seminar “Teaching Ethics in Science and Engineering”, 10–11 February 1993 organized by Stephanie J. Bird , Penny J. Gilmer and Terrell W. Bynum . Opragen Publications thanks the AAAS, seminar organizers and authors for permission to publish extracts from the conference. The opinions expressed are those of the authors and do not reflect the opinions of AAAS or its Board of Directors.
What attributions must any actor make to an other in order to engage in face-to-face interaction with that other? Edmund Husserl's use of “analogues” suggests that actors use their own experiences of themselves as a starting pointin making such attributions. Alfred Schutz and Erving Goffman claim that for face-to-face interaction to occur, an other must be recognized as copresent and reciprocity must be established. I assert here that the means for determining that these conditions have been met will vary. I (...) explore a varietyof actors and in particular their differing identifications of interactionally available others and I take as problematicthe establishment of co-presence and reciprocity. Taking others to be “analogues of ourselves” serves as a useful starting point, but worthy of detailed analysis is howand with whom an actor draws the analogy, under what circumstances it comes in for revision, and the interactional consequences of the decisions made. (shrink)
Through a wide-ranging international collection of papers, this volume provides theoretical and historical insights into the development and application of phenomenological sociology and ethnomethodology and offers detailed examples of research into social phenomena from these standpoints. All the articles in this volume join together to testify to the enormous efficacy and potential of both phenomenological sociology and ethnomethodology.
This paper shows an alternative way in which compatriot partiality could be justified within the framework of global distributive justice. Philosophers who argue that compatriot partiality is similar to racial partiality capture something correct about compatriot partiality. However, the analogy should not lead us to comprehensively reject compatriot partiality. We can justify compatriot partiality on the same grounds that liberation movements and affirmative action have been justified. Hence, given cosmopolitan demands of justice, special consideration for the economic well-being of your (...) nation as a whole is justified if and only if the country it identifies is an oppressed developing nation in an unjust global order. This justification is incomplete. We also need to say why Person A, qua national of Country A, is justified in helping her compatriots in Country A over similarly or slightly more oppressed non-compatriots in Country B. I argue that Person A’s partiality towards her compatriots admits further vindication because it is part of an oppressed group’s project of self-emancipation, which is preferable to paternalistic emancipation. Finally, I identify three benefits in my justification for compatriot partiality. First, I do not offer a blanket justification for all forms of compatriot partiality. Partiality between members of oppressed groups is only a temporary effective measure designed to level an unlevel playing field. Second, because history attests that sovereign republics could arise as a collective response to colonial oppression, justifying compatriot partiality on the grounds that I have identified is conducive to the development of sovereignty and even democracy in poor countries, thereby avoiding problems of infringement that many humanitarian poverty alleviation efforts encounter. Finally, my justification for compatriot partiality complies with the implicit cosmopolitan commitment to the realizability of global justice theories. (shrink)
Following new scientific evidence, removal of the fallopian tubes or the ovaries, or both, are options for reducing the risk of ovarian cancer. This paper examines the new scientific evidence on the origin of ovarian cancer and argues that the removal of fallopian tubes or ovaries in high-risk patients for the purpose of reducing risk of cancer is not intrinsically disordered. Although a present and serious pathology may not exist, this removal constitutes an indirect sterilization, because the immediate and primary (...) effect is the reduction in risk of a pathological condition. This effect occurs immediately, directly, and effectively, and sterilization is a secondary effect. The paper then reflects on the subsequent inadequacy of the language of “present and serious pathology” given the new evidence on ovarian cancer. National Catholic Bioethics Quarterly 14.1 : 67–79. (shrink)
The challenge is there: the social problems of technology--problems related to the environment, the energy crisis, traffic problems, social engineering--so discipline-spanning in their interactions with other realms of life... are, at bottom, problems of social and political values.... They cannot be solved, in any realistic and adequate way, without the collaboration of philosopher-generalists, broad humanists, and social science generalists working with engineers and technological experts.... The more multidisciplinary technological problems become, the more important such programs [in science, technology, and society] (...) will turn out to be. Hans Lenk, Research in Philosophy & Technology 7 : 50, 52. (shrink)
This paper identifies several kinds of intellectual mistakes that proponents of genetic engineering make, in defending their views and characterizing the views of their opponents. Results from research in the social sciences and humanities illuminate the nature of these mistakes. The mistakes themselves play a role in allowing proponents to gather support from other protagonists in the social controversies involving science and technology. Understanding the controversies requires understanding that innovations are components of complex and ill-structured social problems; the “right answer” (...) does not follow from scientific or technological breakthroughs. If the problems are identified correctly, issues of non-economic or non-market values and political and individual rights will need to be addressed. (shrink)