Narrative and exploration: toward a poetics of knowledge in nursingThe dualism of subject and object has been a traditional model for nursing knowledge. That model is portrayed here as an epistemological exile. Our self‐imposed exile from the lived world of nursing can be remedied by inquiry based on engagement rather than distance. One model for engaged inquiry is explorers'journeys in remote regions. Knowledge of a region can be local or colonial, according to the explorer's stake in the region as homeland (...) or territory. Nursing is an existential region where people live. In the exploration of nursing as homeland, knowledge takes the form of local narrative, the story of a place told by its inhabitants. Narrative inquiry offers nursing an epistemology that is both ethically and aesthetically congruent with its practice of engagement. (shrink)

Nursing practice in correctional settings is ethically unique. Its premise is the contradiction between causing harm (the purpose of imprisonment) and acting for patients’ good (the purpose of health care). I describe three ethical regions in which correctional nurses can practise, based on different philosophies: punishment as retribution, as rationality, and as paradox. Retribution and rationality resolve the ethical contradiction by relegating offenders to intractable otherness. Restorative nursing based on paradox is an oppositional practice that preserves the contradiction, making engagement (...) possible between prisoner and nurse. Endorsement by nursing of one of the three philosophies of punishment could redefine care for the entire profession. (shrink)

Post–dualist philosophies of nursing acknowledge embodiment as a condition of human existence. Philosophical writing, however, remains abstract and disembodied. A philosophical framework that embraces embodiment needs to recover the materiality of language; its text needs to include language that is not only rational and clear but sensuous and ambiguous. I describe three cultural narratives of women's embodiment and compare them with an imaginative narrative, a nurse's poem about women in labour. I propose, not that philosophers become poets, but that they (...) abandon a dualist position in which language is either literal or metaphorical, adopting instead the poet's approach in which any word or object has unlimited meanings. I argue that, without fixed reference points, language embodies rather than escapes contingency. Finally, I discuss two forms of philosophical writing – irony and motet – that savour contingency, illustrating philosophy as endless redescription, aiming not for finality but for the grace of a dancer's deliberate fall. (shrink)

This paper discusses the contribution that the work of Sally Gadow makes to understandings of interpretive inquiry and it's potential to inform and influence nursing practice, research, and education. The discussion draws on several of Gadow's published works that make explicit her understandings of what it means to be interpretive, to be open to multiple truths, to hear multiple voices, to have a history, to be experienced, and to recognize agency in language. Situating this discussion of (...) class='Hi'>Gadow's contribution in opposition to a metaphysics of genius is intended to move our understanding of particular work past the subjectivity that produced it, past the subjectivized responses to the work, past the reporting on myself – my thoughts, my perspectives, my experiences – to explore, to see the worthwhileness or even the possibilities of exploring the work itself and the worlds it evokes. This paper is a deliberate attempt to disrupt the call to the author to save us from the task of interpreting the questions that the work itself places us under. Gadow's work itself points us away from a valorization of the voice of the author of the work, a single voice, and towards a cultivation of a worldly repose where each interpretive account points us to some longstanding whole to which the work belongs and from which it gains its sense and significance. (shrink)

Sally Gadow's work is a sophisticated version of a familiar line of thought in nursing. She creates a chain of distinctions which is intended to differentiate cultural narratives, and particularly the ‘science narrative’, from imaginative narratives, especially poetry. Cultural narratives regulate and restrict; imaginative narratives are creative, liberating and potentially transcendent. These ideological effects are (supposedly) achieved through different structures of language. Scientific language, for example, is abstract and literal, while poetry is sensuous and metaphorical. In this paper, (...) I argue that Gadow's way of discriminating between science and poetry fails. In the first place, the ideological valence she assigns to each of them is unwarranted. Science and poetry can both be harnessed to the project of emancipation, just as both can be incorporated in a strategy of oppression. In the second place, the claim that poetry and science are distinguished by their respective linguistic features – specifically, that one is metaphorical and the other literal – cannot be sustained. I illustrate this argument, as Gadow illustrates hers, by reference to the concept of embodiment, and consider whether Gadow is correct in thinking that poetry, not science, makes it possible for individuals (especially women) to ‘reclaim the body’. I also suggest that Gadow's brand of postmodernism echoes Romanticism, whose defining characteristic was an insistent contrast between poetry and science. This is ‘flip side’ postmodernism, which merely opposes modernist values, preferring subjectivity to objectivity, feeling to rationality, and multiple realities to truth. It is less radical, and far less interesting, than ‘remix’ postmodernism, whose objective is not to reverse the polarities, but to reconfigure the entire circuit. (shrink)

The purpose of this paper is to describe how Sally Gadow's perspectives on existential advocacy as the moral framework for the nurse–patient relationship were synthesized with a general theory of motivation, self‐determination theory (SDT), to inform the design of a study in which the influence of interpersonal care on the process of tobacco dependence treatment was explored. Consistent with the tenets of existential advocacy, participants who perceived their care providers as interpersonally sensitive and bringing more of their whole (...) selves to the care encounter reported more autonomous motivation and felt competence for stopping smoking. The integration of existential advocacy with SDT, which led to the empirical work in which Gadow's ideas were actualized and her model supported, is described. Study findings are discussed in light of Gadow's philosophical views, and implications for nursing highlighted. (shrink)

Nurse philosopher Sally Gadow (1999) has proposed the relational narrative between patient and nurse as a ‘postmodern turn’ for nursing ethics. She has conceptualized this moral approach as the construction by patient and nurse of a coauthored narrative describing the good they are seeking, as well as the means to achieve this good. The purpose of this article is to provide an elaboration of Gadow's seminal conceptualization of relational narrative based on her writings and those of other (...) philosophers. The article will further develop relational narrative's foundations in relationship and narrative and will explore engagement as a dimension essential to its creation and growth. The elaboration first builds on the notion of relationship as foundational to this postmodern moral perspective. Narrative then is advanced as being at the heart of the patient–nurse relationship and their relational narrative, based on an exploration of narrative's role in the moral realm as an epistemology for patient and nurse. Finally, the dialogic and embodied engagement expressed by a relational narrative is developed as a critical element of the ethic. (shrink)

Sally Gadow's work is a sophisticated version of a familiar line of thought in nursing. She creates a chain of distinctions which is intended to differentiate cultural narratives, and particularly the ‘science narrative’, from imaginative narratives, especially poetry. Cultural narratives regulate and restrict; imaginative narratives are creative, liberating and potentially transcendent. These ideological effects are (supposedly) achieved through different structures of language. Scientific language, for example, is abstract and literal, while poetry is sensuous and metaphorical. In this paper, (...) I argue that Gadow's way of discriminating between science and poetry fails. In the first place, the ideological valence she assigns to each of them is unwarranted. Science and poetry can both be harnessed to the project of emancipation, just as both can be incorporated in a strategy of oppression. In the second place, the claim that poetry and science are distinguished by their respective linguistic features – specifically, that one is metaphorical and the other literal – cannot be sustained. I illustrate this argument, as Gadow illustrates hers, by reference to the concept of embodiment, and consider whether Gadow is correct in thinking that poetry, not science, makes it possible for individuals (especially women) to ‘reclaim the body’. I also suggest that Gadow's brand of postmodernism echoes Romanticism, whose defining characteristic was an insistent contrast between poetry and science. This is ‘flip side’ postmodernism, which merely opposes modernist values, preferring subjectivity to objectivity, feeling to rationality, and multiple realities to truth. It is less radical, and far less interesting, than ‘remix’ postmodernism, whose objective is not to reverse the polarities, but to reconfigure the entire circuit. (shrink)

This Handbook describes the extent and shape of computing education research today. Over fifty leading researchers from academia and industry have contributed chapters that together define and expand the evidence base. The foundational chapters set the field in context, articulate expertise from key disciplines, and form a practical guide for new researchers. They address what can be learned empirically, methodologically and theoretically from each area. The topic chapters explore issues that are of current interest, why they matter, and what is (...) already known. They include discussion of motivational context, implications for practice, and open questions which might suggest future research. The authors provide an authoritative introduction to the field and is essential reading for policy makers, as well as both new and established researchers. (shrink)

Interpreting heritability estimates through the lens of cultural evolution presents two broad and interlinking problems for educational behavior genetics. First, the problem of interpreting high heritability of educational phenotypes as indicators of the genetic basis of traits, when these findings also reflect cultural homogeneity. Second, the problem of extrapolating from genetic research findings in education to policy and practice recommendations.

Although the empirical studies of Terror Management Theory lend support to Ernest Becker's anthropology, they hardly provide a vision with the power to inspire late twentieth century humanity. Becker's own dark view of what it means to be human is, at least in part, to blame. On the basis of an exploration of the positive implications of the religious symbol of creatureliness, an alternative social theory, that of ecologico‐social democracy, is proposed as a vision that requires and may even inspire (...) heroism. (shrink)

Influences on the perception of affordances (i.e., opportunities for actions) have been primarily studied by manipulating the functional morphology of the body. However, affordances are not just determined by the functional morphology of the perceiver, but also by the physiological state of the perceiver. States of anxiety have been shown to lead to marked changes in individuals’ physiological state and their behaviour. To assess the influence of emotional state on affordance perception, the perception of action capabilities in near space was (...) examined after participants completed an anxiety-provoking task. Anxiety was induced immediately prior to tasks that assessed participants' perceived reaching ability in Experiment 1, grasping ability in Experiment 2, and the ability to pass their hands through apertures in Experiment 3. Results indicated that those participants who experienced changes in anxiety underestimated their reaching, grasping, and passing ability compared to non-anxious participants. In other words, anxious participants were more conservative in their estimations of their action capabilities. These results suggest that anxiety influences the perception for affordances in near space and are consistent with the notion that anxiety induces withdrawal behaviours. (shrink)

BackgroundMoral distress (MD) is an emotional and psychological response to morally challenging dilemmas. Moral distress is experienced frequently by nurses in the intensive care unit (ICU) and can result in emotional anguish, work dissatisfaction, poor patient outcomes, and high levels of nurse turnover. Opportunities to discuss ethically challenging situations may lessen MD and its associated sequela.ObjectiveThe purpose of this project was to develop, implement, and evaluate the impact of nursing ethics huddles on participants’ MD, clinical ethics knowledge, work satisfaction, and (...) patient care among ICU nurses.Sample and SettingThe sample, 32 nurses from three ICU settings in an 800-bed tertiary academic medical center, participated in six nursing ethics huddles over a two-month period.MethodsAlvita K. Nathaniel’s Theory of Moral Reckoning guided development of the nursing ethics huddle process.1 The Moral Distress Thermometer was administered at three data points: baseline level of MD, and pre- and post-huddle to determine changes in the subjects’ level of MD.2 Focused content analysis was used to analyze qualitative responses from questionnaires about the subjects’ perception of the effect of the huddles on work satisfaction and patient care. Knowledge attainment was evaluated via open-ended short-answer questions.ResultsOverall, use of nurse-ethicist-led nursing ethics huddles was associated with improved quality of work life, patient care, and clinical ethics knowledge. The change in pre- and post-nursing ethics huddles MD scores was statistically significant (p < 0.0001). (shrink)

The clash between the public right to know and public safety is just one of the fundamental conflicts raised by Hurst and White in this, the first definitive study of ethics in the Australian news media. Hurst and White explore the concept of ethical conduct, apply it to journalism, then draw on a wealth of local examples where the news media's conduct was challenged. They examine the attempts to codify the principles - from the policies of press councils to the (...) journalists' own codes of ethics - and show where these are inadequate, muddled or honoured in the breach. They put forward some provocative ideas for reform. (shrink)

Gadow's understanding of nursing as a relational narrative anchored in a dialectic between the fundamental subjectivity of the individual client and the objectification of his illness poses some interesting questions for nursing ethics and care. For Gadow, nursing is an encounter with the immediate vulnerability of the client and also lends it responsibilities to the medical objectification of illness aiming at disease treatment and control. Hence, nursing agency is divided between its responsibilities induced by the personal vulnerability of (...) the patient and the more impersonal, but benevolent intention shaped by medical knowledge. Medical knowledge is impersonal in the sense that it is knowledge detached from the subjectivity of the patient. But how is nursing able to reconcile the interests derived from personal and experienced vulnerability with the more impersonal and often conflicting demands of medical knowledge? This question is even more intriguing because there seems to be an objective dimension within a patient's subjectivity itself: an autonomous person can critically evaluate his own subjectivity as a basis for informed self‐interest. The sick person is thus confronted with objectivity on two important levels: the objective facts of his disease and his detachment from his own experiential vulnerability when engaged in the critical evaluation of his self‐interest. This paper will discuss the normative dimensions of these complex and, frequently, conflicting perspectives from the theoretical perspectives of Thomas Nagel's normative responsibility and Sally Gadow's clinical epistemology and relational narratives. The empirical basis for the discussion will be an ongoing study of the ethical dimensions of pain relief and sedation in an intensive care unit. (shrink)

Book reviewed in this article: What Does It Mean to Grow Old? Reflections from the Humanities. By Thomas R. Cole and Sally Gadow Our Aging Society: Paradox and Promise. Alan Pifer and Lydia Bronte.

Many patients experience aspects of treatment and care as dehumanizing because the body is considered separate from the self and its life context. An attempt to transcend viewing persons in dualistic terms is posed by phenomenologists who focus not on “the body” as such but on what it means to be “embodied.” In this paper, we review the relevance of the phenomenology of the body for health care and report the results of comparing Sally Gadow’s phenomenological insights about (...) body-self unity with a qualitative analysis of patients’ accounts of satisfaction with the outcome of hand surgery. We illustrate the ways in which our findings were and were not congruent with Gadow’s conceptualization of embodiment and highlight aspects that are ambiguous. We conclude that the body-self dialectical relationship should be recast as a body-self-society trialectic and discuss the implications of this new conceptualization for clinical practices. (shrink)

The negative impact of adverse experiences in childhood on neurodevelopment is well documented. Less attention however has been given to the impact of variations in “normative” parenting behaviors. The influence of these parenting behaviors is likely to be marked during periods of rapid brain reorganization, such as late childhood. The aim of the current study was to investigate associations between normative parenting behaviors and the development of structural brain networks across late childhood. Data were collected from a longitudinal sample of (...) 114 mother-child dyads, recruited from low socioeconomic areas of Melbourne, Australia. At the first assessment parenting behaviors were coded from two lab-based interaction tasks and structural magnetic resonance imaging scans of the children were performed. At the second assessment, approximately 18 months later MRI scans were repeated. Cortical thickness was extracted from T1-weighted images using FreeSurfer. Structural covariance networks were constructed from partial correlations of CT estimates between brain regions and estimates of network efficiency and modularity were obtained for each time point. The change in these network measures, from Time 1 to Time 2, was also calculated. At Time 2, less positive maternal affective behavior was associated with higher modularity, while negative maternal affective behavior was not related. No support was found for an association between local or global efficacy and maternal affective behaviors at Time 2. Similarly, no support was demonstrated for associations between maternal affective behaviors and change in network efficiency and modularity, from Time 1 to Time 2. These results indicate that normative variations in parenting may influence the development of structural brain networks in late childhood and extend current knowledge about environmental influences on structural connectivity in a developmental context. (shrink)

This paper offers a narrative approach to understanding the process of clinical reasoning in complex cases involving medical uncertainty, moral ambiguity, and futility. We describe a clinical encounter in which the pediatric health care team experienced a great deal of conflict and distrust as a result of an ineffective process of interpretation and communication. We propose a systematic method for analyzing the technical, ethical, behavioral, and existential dimensions of the clinical reasoning process, and introduce the Clinical Reasoning Discussion Tool—a dialogical (...) and interpretive device aimed at improving communication, understanding, empathy, and moral deliberation in the clinical setting. (shrink)

A philosophically useful account of social structure must accommodate the fact that social structures play an important role in structural explanation. But what is a structural explanation? How do structural explanations function in the social sciences? This paper offers a way of thinking about structural explanation and sketches an account of social structure that connects social structures with structural explanation.

This paper provides an account of social practices that reveals how they are constitutive of social agency, enable coordination around things of value, and are a site for social intervention. The social world, on this account, does not begin when psychologically sophisticated individuals interact to share knowledge or make plans. Instead, culture shapes agents to interpret and respond both to each other and the physical world around us. Practices shape us as we shape them. This provides resources for understanding why (...) social practices tend to be stable, but also reveals sites and opportunities for change. (shrink)

"Being and Logos" is... a philosophical adventure of rare inspiration.... Its power to illuminate the text..., its ecumenicity of inspiration, its methodological rigor, its originality, and its philosophical profundity—all together make it one of the few philosophical interpretations that the philosopher will want to re-read along with the dialogues themselves. A superadded gift is the author's prose, which is a model of lucidity and grace." —International Philosophical Quarterly "Being and Logos is highly recommended for those who wish to learn how (...) a thoughtful scholar approaches Platonic dialogues as well as for those who wish to consider a serious discussion of some basic themes in the dialogues." —The Academic Reviewer. (shrink)

Much contemporary social epistemology takes as its starting point individuals with sophisticated propositional attitudes and considers (i) how those individuals depend on each other to gain (or lose) knowledge through testimony, disagreement, and the like and (ii) if, in addition to individual knowers, it is possible for groups to have knowledge. In this paper I argue that social epistemology should be more attentive to the construction of knowers through social and cultural practices: socialization shapes our psychological and practical orientation so (...) that we perform local social practices fluently. Connecting practical orientation to an account of ideology, I argue that to ignore the ways in which cognition is socially shaped and filtered is to allow ideology to do its work unnoticed and unimpeded. Moreover, ideology critique cannot simply challenge belief, but must involve challenges to those practices through which we ourselves become the vehicles and embodiments of ideology.V. (shrink)

In this paper Gadow's philosophical themes are developed considering the pedagogical relation – the relation of teacher and student, nurse and patient, self and world. Relational pedagogy is discussed through exploration of embodiment (being the teaching), improvisation (doing the teaching), and interdependence (locating the teaching in a reciprocal world as home). The pedagogical relation explores the lived space between teacher and learner, nurse and patient, where new knowledge is constructed. Such knowledge ‘resounds bodily’ and is always under construction.

The past three years have seen a dramatic increase in our understanding of the structural organization and expression strategies of the dispersed, repetitive yeast transposon, Ty. These studies have led to a logical comparison of Ty with retroviral proviruses and other mobile, repetitive elements. Such comparisons have culminated in the hypotheses that transposition occurs via the formation of Ty‐encoded virus‐like particles and that these particles represent a basic unit of all ‘retro‐systems’.

The paper indicates how social kinds may be internally and objectively unified in a way continuous with physical kinds. It argues that the practice of theorizing is continuous with other practices to the extent that theorists, like anyone engaged in a practice, needs to make choices that are responsive to purposes (and corresponding values) guiding the practice. The paper discusses Epstein's theory of anchoring, and argues for a theory of scaffolding social kinds.

It is always awkward when someone asks me informally what I’m working on and I answer that I’m trying to figure out what gender is. For outside a rather narrow segment of the academic world, the term ‘gender’ has come to function as the polite way to talk about the sexes. And one thing people feel pretty confident about is their knowledge of the difference between males and females. Males are those human beings with a range of familiar primary and (...) secondary sex characteristics, most important being the penis; females are those with a different set, most important being the vagina or, perhaps, the uterus. Enough said. Against this background, it isn’t clear what could be the point of an inquiry, especially a philosophical inquiry, into “what gender is”. (shrink)

The purpose of this qualitative case study is to understand and critique the gendered political processes in the search for an athletic director following a merger between men’s and women’s intercollegiate athletic departments in a U.S. university. Semi-structured interviews were used to ask 55 athletic department stakeholders their perceptions of the search process and associated politics. Findings indicated gendered political activities occurred along gender-affiliated departmental lines. Political strategies contributed to gendered processes favoring certain masculinities and male candidates in the search (...) for an athletic director. While gender equity was an important consideration in the search process, because of the controversial nature of the merger and the politics expressed, the belief that hiring a man was essential to the merger’s success was widely accepted by many stakeholder groups. The findings are positioned in the critical management and sport literature. This research contributes to our understanding of the complexity of gender relations and provides insight into the gendered political processes that inform leadership searches. (shrink)

Little is known about the aims and impact of university-based ethics centers. Less is known about how centers leverage their unique campus positions to engage undergraduates in transformative ethics education. This article provides a foundation for future research on university-based ethics centers. First, this article addresses the history of ethics education in higher education, the rise of university ethics centers, and the factors necessary for successful ethics programs. Next, this piece shows the geographic distribution of ethics centers and which centers (...) provide undergraduate-focused ethics education. Finally, this article enables future research on effective ethics center structure, leadership, and outreach. (shrink)