Cultural Consultation is a clinical process that emerged from anthropological critiques of mental healthcare. It includes attention to therapeutic communication, research observations and research methods that capture cultural practices and narratives in mental healthcare. This essay describes the work of a Cultural Consultation Service (ToCCS) that improves service user outcomes by offering cultural consultation to mental health practitioners. The setting is a psychiatric service with complex and challenging work located in an ethnically diverse inner city urban area. Following a period (...) of 18 months of cultural consultation, we gather the dominant narratives that emerged during our evaluation of our service. Results: These narratives highlight how culture is conceptualized and acted upon in the day-to-day practices of individual health and social care professionals, specialist psychiatric teams and in care systems. The findings reveal common narratives and themes about culture, ethnicity, race and their perceived place and meaningfulness in clinical care. These narratives express underlying assumptions and covert rules for managing, and sometimes negating, dilemmas and difficulties when considering “culture” in the presentation and expression of mental distress. The narratives reveal an overall “culture of understanding cultural issues” and specific “cultures of care”. These emerged as necessary foci of intervention to improve service user outcomes. Conclusion: Understanding the cultures of care showed that clinical and managerial over-structuring of care prioritises organisational proficiency, but it leads to inflexibility. Consequently, the care provided is less personalised and less accommodating of cultural issues, therefore, professionals are unable to see or consider cultural influences in recovery. (shrink)

The principles of the 3Rs—replacement, refinement, and reduction—strongly shape discussion of methods for performing more humane animal research and the regulation of this contested area of technoscience. This special issue looks back to the origins of the 3Rs principles through five papers that explore how it is enacted and challenged in practice and that develop critical considerations about its future. Three themes connect the papers in this special issue. These are the multiplicity of roles enacted by those who use and (...) care for animals in research, the distribution of “feelings that matter” across species and spaces of laboratory animal practice, and the growing importance of “cultures of care” in animal research. (shrink)

Can we speak of a feminine approach to caring for the body? If there is such an approach, how does culture influence or even construct it? Do we need a new culture of care in the medical field? Wha...

Undisputedly, the United States’ health care system is in the midst of unprecedented complexity and transformation. In 2014 alone there were well over thirty‐five million admissions to hospitals in the nation, indicating that there was an extraordinary number of very sick and frail people requiring highly skilled clinicians to manage and coordinate their complex care across multiple care settings. Medical advances give us the ability to send patients home more efficiently than ever before and simultaneously create ethical (...) questions about the balance of benefits and burdens associated with these advances. Every day on every shift, nurses at the bedside feel an intense array of ethical issues. At the same time, administrators, policy‐makers, and regulators struggle to balance commitments to patients, families, staff members, and governing boards. Ethical responsibilities and the fiduciary, regulatory, and community service goals of health care institutions are not mutually exclusive; they must go hand in hand. If they do not, our health care system will continue to lose valued professionals to moral distress, risk breaking the public's trust, and potentially undermine patient care. At this critical juncture in health care, we must look to new models, tools, and skills to confront contemporary ethical issues that impact clinical practice. The antidote to the current reality is to create a new health care paradigm grounded in compassion and sustained by a culture of ethical practice. (shrink)

Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence‐based fast‐track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients’ individual perspectives in an evidence‐based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence‐based recommendations, which specify a (...) set of rules that the patient must follow rigorously. The other is a course of democratization based on patients’ involvement in care. Referring to the analysis of the narrative, we argue that, in the current implementation of evidence‐based practice, the proposed involvement of patients resembles empty rhetoric. We argue that the principles and values from evidence‐based medicine are being lost in the transformation into the current evidence‐based hospital culture which potentially leads to a McDonaldization of nursing practice reflected as ‘one best way’. We argue for reviving ethics of care perspectives in today's evidence practice as the fundamental values of nursing may potentially bridge conflicts between evidence‐based practice and the ideals of patient participation thus preventing a practice of ‘McNursing’. (shrink)

Background: Transgender individuals experience discrimination, stigmatization, and unethical and insensitive attitudes in healthcare settings. Therefore, healthcare professionals must be knowledgeable about the ways to deliver ethical and culturally competent care. Ethical considerations: No formal ethical approval was required. Aim: To synthesize the literature and identify gaps about approaches to the provision of ethical and culturally competent care to transgender populations. Design: A Scoping Review Literature Search: Literature was searched within CINAHL, Science Direct, PubMed, Google Scholar, EMBASE, and Scopus (...) databases using indexed keywords such as “transgender,” “gender non-conforming,” “ethically sensitive care,” and “culturally sensitive care.” In total, 30 articles, which included transgender patients and their families and nurses, doctors, and health professionals who provided care to transgender patients, were selected for review. Data were extracted and synthesized using tabular and narrative summaries and thematic synthesis. Findings: Of 30 articles, 23 were discussion papers, 5 research articles, and 1 each case study and an integrative review. This indicates an apparent dearth of literature about ethical and culturally sensitive care of transgender individuals. The review identified that healthcare professionals should educate themselves about sensitive issues, become more self-aware, put transgender individual in charge during care interactions, and adhere to the principles of advocacy, confidentiality, autonomy, respect, and disclosure. Conclusions: The review identified broad approaches for the provision of ethical and culturally competent care. The identified approaches could be used as the baseline, and further research is warranted to develop and assess organizational and individual-level approaches. (shrink)

Nursing knowledge development and application are influenced by numerous factors within the context of science and practice. The prevailing culture of science along with an evolving context of increasingly technological environments and rationalization within health care impacts both the generation of nursing knowledge and the practice of nursing. The effects of the culture of science and the context of nursing practice may negatively impact the structure and application of nursing knowledge, how nurses practice, and how nurses understand (...) the patients and families for whom they care. Specifically, the nature of critical care and its highly technical environment make critical care nursing especially vulnerable to these potentially negative influences. The influences of the culture of science and the increasingly technical practice context may result in an overreliance on the natural sciences to guide critical care nursing actions and an associated marginalization of the caring relationship in critical care nursing practice. Within this environment, nursing philosophy may not be foundational to nursing actions; rather, the dominant culture of science and the rationalization of health care may be informing nursing practice. As such, the ideology and goals of nursing may not be central to the practice of critical care nursing. The purpose of this paper is to explore the influence of the culture of science on the development of nursing knowledge and theory. Further, we aim to describe the value of using conceptual frameworks, such as Roy's Adaptation Model, as a nursing philosophy to influence the development of person‐centred nursing knowledge and theory to inform critical care nursing practice as it related to the care of patients and families. In doing so, nursing philosophy is situated as foundational for nursing actions. (shrink)

I address the problem of caring for our body-mind through neuropragmatism, cybernetics, and Larry Hickman’s work on John Dewey and the philosophy of technology. The problems of body-mind health are related to Emma Dowling’s The Care Crisis. I address this crisis by drawing on Jay Schulkin’s conception of viability as the creative tension between stability and precarity. From this, I extend body-mind health to questions of democracy, leading to the proposal of body-mind-world as an elaboration of neuropragmatism’s evolutionary and (...) ecological conception of experience as Œ and Hickman’s distinction between the merely valued nature-as-nature and the valuable nature-as-culture. I conclude with a reimagination of creative democracy as a moral ideal for dealing with the care crisis. (shrink)

Our current culture is dominated by the ideology of creativity. One is supposed to create the new and not to care about the things as they are. This ideology legitimises the domination of the "creative class" over the rest of the population that is predominantly occupied by forms of care - medical care, child care, agriculture, industrial maintenance and so on. We have a responsibility to care for our own bodies, but here again our (...) culture tends to thematize the bodies of desire and to ignore the bodies of care - ill bodies in need of self-care and social care. But the discussion of care has a long philosophical tradition. The book retraces some episodes of this tradition - beginning with Plato and ending with Alexander Bogdanov through Hegel, Heidegger, Bataille and many others. The central question discussed is: who should be the subject of care? Should I care for myself or trust the others, the system, the institutions? Here, the concept of the self-care becomes a revolutionary principle that confronts the individual with the dominating mechanisms of control. (shrink)

Feminists have worked extensively to explore how our contemporary capitalist and neoliberal world creates docile subjects. One feature of this docility is the focus on fostering subjects that not only are good consumers and workers but also subjects that make good choices—that is, choices that do not disrupt capitalist postcolonial distributions of wealth, power, and control. One example of this trend is the focus in public health discourses in the last several decades of seeing unhealthy bodies as objects that need (...) better behavior management—such as the wars against smoking, obesity, and drug/alcohol abuse. At the same time, feminists are often concerned with how to foster greater well-being, including the health... (shrink)

In “Conceptions of Care,” Tove Pettersen discusses and articulates select ways in which care can be comprehended. Several difficulties related to an altruistic understanding of care are examined before the author presents the case for a more favorable concept: mature care. Mature care is intended to take into account the interests of both parties to the caring relationship. This understanding of care facilitates the expression of the relational and reciprocal aspects of caring while emphasizing (...) the equal worth of all involved. Also attended to is the embeddedness of care in wider cultural and political contexts. (shrink)

Background Ethics of care provides a framework for health care professionals to manage ethical dilemmas and moral resilience may mitigate stress associated with the process and outcomes of ethical reasoning. This review addresses the empirical study of ethics of care and moral resilience, published in the health care literature, and identifies potential research gaps. Methods and procedure Arksey O’Malley's framework was adopted to conduct this scoping review. A literature search was conducted across six databases: CINAHL Plus (...) with full text, PubMed, PsycINFO, EMBASE, Scopus and MEDLINE. We collected and synthesised information on the nature of studies including study design, methods and key findings. Results While there is an abundance of literature describing the potential strengths of an ethics of care approach to ethical reasoning and growing interest in the role of moral resilience in protecting against moral distress, both concepts have received little empirical attention. A total of six relevant publications were selected for review. No studies explored the relationship between ethics of care and moral resilience. However, studies focused upon ethics of care approach as a facilitator of patient-practitioner professional relationships and effective ethical decision making in health care practice. Current evidence explores key characteristics consistent with moral resilience in health care professionals. Conclusion This review identified a dearth of research in ethics of care and moral resilience in healthcare practice. Further empirical investigation may provide a deeper understanding of the translation of ethics of care and moral resilience to health care practice to facilitate workplace culture. (shrink)

Margaret Monahan Hogan; Catholic Health Care Institutions: Dinosaurs Awaiting Extinction or Safe Refuge in a Culture of Death, Christian bioethics: Non-Ecumenic.

In this paper, we develop a neo-Humean response to the problem of moral inclusion by bringing Humean moral philosophy into deep and serious dialogue with Latin American philosophy. Our argument for achieving this two-fold aim unfolds as follows. In section one, we elucidate Mia Sosa-Provencio’s conception of a mestiza ethics of care. We begin by highlighting its fundamental elements, especially its concern with what we refer to as the cultural embeddedness both of moral agents and of moral patients. We (...) then explain how this aspect of the mestiza ethic poses a distinctive challenge for Humean moral philosophy. In section two, we develop a neo-Humean response to this challenge. We begin by highlighting the strengths and limits of trying to develop a response by appealing to Hume’s conceptions of sympathy and humanity. We then present what we take to be the most plausible way for a neo-Humean conception of moral philosophy to offer a satisfactory reply to the challenge posed by the mestiza ethics of care, by appealing to two key concepts from outside the system of Hume’s moral philosophy: namely, sympathetic understanding and relational humility. (shrink)

A conflict within the community of those investigating business ethics is whether decision makers are motivated by an ethics of justice or an ethics of caring. The proposition put forward in this paper is that ethical orientations are strongly related to cultural backgrounds. Specifically, Hofstede's cultural stereotyping using his masculine-feminine dimension may well match a culture's reliance on justice or caring when decisions are made. A study of college graduates from six countries showed that Hofstede's dimension was remarkably accurate (...) in predicating a justice or caring orientation for decision makers from five of the six countries. (shrink)

At the beginning of the twenty-first century, with vocations to the Christian religious orders of the West in marked decline, an authentic Christian presence in health care is threatened. There are no longer large numbers of women willing to offer their life labors bound in vows of poverty, chastity, and obedience, so as to provide a real preferential option for the poor through supporting an authentic Christian mission in health care. At the same time, the frequent earlier death (...) of men leaves a large number of widows, some in need of care and some able to provide care. Drawing on the role of widows sketched in I Timothy 2, one can envision Christian widows entering a life of prayer and service in health care settings. As female monastics, such widows could reintroduce a salient Christian presence in health care. How one ties this response to the message of I Timothy 2 will depend on one’s understanding of the status of Scripture, the significance of tradition, the nature of theological epistemology, the meaning of theology, the nature of the Church, and the ontology of gender. The position taken on these issues will define the character of a Christian bioethics of care. (shrink)

Growing research evidence on the ethic of care suggests that caring should be an integral part of the pedagogical methods implemented in schools. However, the colour blind ‘community of care’ often described in the literature does not disaggregate lines of ethnicity or race and much of this existing literature concerns elementary‐ and middle‐school students. This phenomenological study examined teacher care for African American secondary students, through a theoretical lens of critical race and care theory, as it (...) was represented through the counter stories of eight ‘successful’ African American teachers. Findings revealed that teachers’ definitions and perceptions of care reflected a blend of traditional care literature, critical race theory and the literature on African American teachers before and after the US Supreme Court’s landmark Brown decision on integration. Findings also reveal the possibility of a pedagogy that I refer to as ‘culturally relevant critical teacher care’. (shrink)

This article is autoethnographic, based upon the authors’ experiences and reflections upon encountered moments of ethical tension whilst conducting research in rural Malawi. Given that knowledge production, as a process, has been marred by colonial forms of power, the project was underpinned by efforts to achieve a decolonial approach to the research, including the research ethics. The authors share of their endeavours to counterbalance the challenges of power asymmetries whilst researching and working with an Indigenous community whose reality can be (...) marginalised by the Western canon. The authors attempted to ensure that the values and customs of the researched community were respected and central to the research approach. When researchers are guided by local culture and customs, the participants are able to drive the research approach, incorporate their voice and share knowledge that is true to their context and reality. In this way, the research study is illustrative of how an ethics of care can help to facilitate decolonial research practice. (shrink)

The importance of developing cultural competence among healthcare professionals is well recognized. However, the widespread reports of insensitivity and deficiencies in care for culturally diverse patients illuminate the need to review how cultural competence development is taught, learnt and applied in practice. Unless we can alter the ‘hearts and minds’ of practising nurses to provide the care that they know they should, culturally insensitive care will continue operating in subtle ways. This paper explores the ideas behind nurses’ (...) actions and omissions when caring for culturally diverse patients and proposes the need to examine cultural competence development through a moral reasoning lens. Examining cultural competence development through a moral reasoning lens can help empower nurses, whilst nurturing commitment and courage to providing quality care that meets the needs of culturally diverse patients. The model of morality provides a framework that explores how moral motivation and behaviour occur and can provide a vehicle for critically examining the knowledge, skills and attitudes required to provide culturally responsive care. (shrink)

Beginning with a focus on the ethical foundations of caregiving in health and expanding towards problems of ethics and justice implicated in a range of issues, this book develops and expands the notion of care itself and its connection to practice. Organised around the themes of culture as a restraint on caregiving in different social contexts and situations, innovative methods in healthcare, and the way in which culture works to position care as part of a rhetorical (...) approach to dependency, responsibility, and justice, The Ethics of Carepresents case studies examining institutional responses to end-of-life issues, the notion of informed consent, biomedicine, indigenous rights and postcolonialism in care and theoretical approaches to the concept of care. Offering discussions from a variety of disciplinary approaches, including sociology, communication, and social theory, as well as hermeneutics, phenomenology, and deconstruction, this book will appeal to scholars across the social sciences with interests in healthcare, medicine, justice and the question of how we think about care as a notion and social form, and how this is related to practice. (shrink)

We do not know how much clinical physicians carrying out clinical trials in oncology and haematology struggle with ethical concerns. To our knowledge, no empirical research exists on these questions in a Nordic context. Therefore, this study aims to learn what kinds of ethical challenges physicians in Sweden, Denmark and Finland face when caring for patients in clinical trials; and what strategies, if any, they have developed to deal with them. The main findings were that clinical cancer trials pose ethical (...) challenges related to autonomy issues, unreasonable hope for benefits and the therapeutic misconception. Nevertheless, some physicians expressed that struggling with such challenges was not of great concern. This conveys a culture of hope where health care professionals and patients uphold hope and mutually support belief in clinical trials. This culture being implicit, physicians need opportunities to deliberately reflect over the characteristics that should constitute this culture. (shrink)

BackgroundDiscrimination in health care is an international challenge and a serious obstacle to justice and equality in health.Research objectiveThe purpose of this study was to design a grounded theory of discrimination in health care based on the experiences and perceptions of Iranian healthcare providers and patients.Research designThis qualitative study was conducted using by the grounded theory method.Participants and research contextData were collected through semi-structured interviews with 18 healthcare providers including 11 nurses, two physicians, two nurse’s assistants, and three (...) patients in two general hospitals in Tehran, Iran. Participants were selected through purposeful sampling and analyzed simultaneously using the Corbin and Strauss (2015) approach.Ethical considerationsThe study was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences (Ethics code: IR.USWR.REC.1398.023). Also, after explaining the objectives of the study, all the participants completed and signed the written consent form.FindingsThe “culture of discrimination” was the study’s core category, reflecting the nature of discrimination in health care. The theory of “culture of discrimination in health care” is the result of five main categories: “individual social stimuli,” “culture of discrimination,” “unintentional discrimination,” “conflict with discrimination,” and “dissatisfaction with discriminatory behavior.” These categories cover the underlying factors, strategies, and outcomes of the discrimination process in health care.DiscussionThe results of the study showed that nurses and other health care providers experience unintentional discrimination. Unintentional discrimination refers to discriminatory behaviors and practices of health care providers.ConclusionThe theory of culture of discrimination in health care can be used as a practical guide to describe and understand the role of health care providers, especially nurses. Further studies with a quantitative approach to applying this theory in medical settings are recommended. (shrink)

Global Mental Health is a field of research and practice that addresses the expansion of universal and equitable mental health care worldwide. This article explores the ways the concept of culture is employed in Global Mental Health literature. Global Mental Health advocates and critics assume an ontological separation between ‘nature’ and ‘culture’ to typify mental illness, linking it predominantly to one or the other of these two categories. Advocates of Global Mental Health view mental disorders as a (...) nature–culture hybrid, while critics see them as typically cultural phenomena. The cultural critique of Global Mental Health can be strengthened by a sociological approach to both the role of critique and the uses of the concept of culture within social sciences. As an alternative to the ontologization of culture, we propose a different theoretical approach to the social issues involved in the expansion of international public health care in mental health: Arthur Kleinman's and Didier Fassin’s moral anthropological approaches. (shrink)

Physicians and medical institutions in the United States are placing increasing emphasis on providing culturally sensitive care for patients, such as implementing a Confucian family-based model of medical decision making when caring for elderly Chinese patients. In this article, I articulate various reasons why deferring to the family is not a guarantee of culturally sensitive care, particularly when family members are first-generation Chinese-Americans. Nonetheless, I offer several suggestions to help physicians, medical institutions, and family members to provide more (...) culturally sensitive care for elderly Chinese patients. (shrink)

[full article, abstract in English; only abstract in Lithuanian] While scholars and popular writers often stress individual responsibility as a way of saving nature, there is a growing understanding that “doing one’s bit” may not be enough to address local and global environmental issues. Focusing on the concept of ecological citizenship as a starting point, our paper seeks to explore the concept of ecological citizenship and show how individualized experiences and socially and culturally embedded practices of care for the (...) environment relate to civic engagement. We connect ecological citizenship with the ethics of care and Pierre Bourdieu’s concept of habitus, which links individual experience of embodied care for environment with broader political and social issues. We argue that the perspective of the ethics of care informed by the concept of habitus broadens the concept of ecological citizenship by, on the one hand, highlighting the rational responsibility to care, and, on the other hand, by revealing how affect-based ties to the environment and established habits of caring are cultivated in local communities. Ecological citizenship based on the habitus of care can be seen as exercised in participation in the public sphere and also through caring practices where public and private fields overlap. (shrink)

This paper draws on recent re-conceptualisations of the notions of 'care' and 'caring' (Noddings, 1992; Tronío, 1993) to explore data from semi-structured interviews with the parents and key workers for about twenty children under three who were attending two London children's centres. Located in an environment of frequent new policy initiatives, including an advocacy of parental partnership, it seeks to describe the ways that these adults construct their mutual relationships, and the difficulties which may attend this process. Class and (...) cultural differences, as well as conflicting understandings of 'professionalism' are shown to inform the development of the 'triangle of care', with potential consequences for the care and welfare of the small child on whom the relationship is focused. (shrink)

This article is primarily concerned with Zygmunt Bauman's ‘adoption’ of Levinas's ethic of primordial responsibility, and his attempt to found a ‘sociological’ critique of postmodern ambivalence upon the erasure of the face and loss of moral proximity. I have argued that the reading of Levinas which Bauman presents in Modernity and the Holocaust and Postmodern Ethics is radically incompatible with the redemptive significance of the Levinasian commandment; and that consequently, his attempt to determine the cognitive and aesthetic forms involved in (...) the adiaphorising trend of postmodern societies is unable to salvage the ethical relation from its own comprehensive/totalising necessity. I have also suggested that Derrida's reading of Totality and Infinity, discloses a certain ‘provocation’ in Levinas's writing; one which gestures towards a conception of ‘the ethical’ as an unforeseen possibility deployed within the resources of social identity. Thus, the idea of ‘situating’ Bauman's thought refers to what I consider to be his ambiguous position with regard to the ‘reflective’ project of a critical theory, and the transcendent necessity of the Levinasian commandment. Ultimately, it is this ambiguity which structures Bauman's writing of the ‘postmodern condition’. For having described the overwhelming powers of cognitive and aesthetic ‘heteronomy’ in the postmodern world, his only recourse is to a ‘politics of distant consequences’ in which the absolute difference of the face would have its originary demand intensified and retransmitted. Such a programmatic demand, I have argued, is radically at odds with an ‘ethical’ reception of racial, sexual or cultural ‘otherness’. (shrink)

Care is at the heart of the Maori values system, which calls for humans to be kaitiaki, caretakers of the maun y the life-force, in each other and in nature. The relational Five Well-beings approach, based on four case studies of Maori businesses, demonstrates how business can create spiritual, cultural, social, environmental and economic well-being. A Well-beings approach entails praxis, which brings values and practice together with the purpose of consciously creating well-being and, in so doing, creates multi-dimensional wealth. (...) Underlying the Well-beings approach is an ethic of care and an intrinsic stakeholder view of business. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:A Culture of Engagement: Law, Religion, and Morality by Cathleen KavenyAllen CalhounA Culture of Engagement: Law, Religion, and Morality Cathleen Kaveny WASHINGTON, DC: GEORGETOWN UNIVERSITY PRESS, 2016. 320 pp. $98.95 / $32.95It is encouraging to read a book on the intersection of religion and law from an author as conversant with both fields as is Cathleen Kaveny. Reworking a number of columns that she wrote for (...) Commonweal magazine, Kaveny offers her concept of a "culture of engagement" as an alternative to America's polarizing culture wars. She builds a vision of engagement—typified by Pope Francis's emphasis on the church's need to "encounter" all human beings—that welcomes the influence that religious traditions and the broader culture and its laws can have on each other.Kaveny notes two ways in which the Roman Catholic tradition is particularly well situated to engage American culture and law. First, both American common law and the Catholic moral tradition use forms of "casuistry" to connect general rules with particular situations. Second, Catholic reluctance "to draw sharp lines between the pure and the tainted" can supply a salutary alternative to the Puritan tendency toward "prophetic indictment" (16).In part 1, Kaveny argues that law has both pedagogical and pragmatic qualities. In part 2, she describes the nation's struggle to balance governmental interests and religious liberty in the context of the contraception mandate in the 2010 Affordable Care Act. She faults the United States Conference of Catholic Bishops for elevating the law's pedagogical role over its pragmatic function in their attack on the mandate. She herself leans toward pragmatism; she assumes that exceptions to laws of general applicability should apply only "in the most extreme cases" (116) and that the government—not the religious claimant—should determine when exceptions apply.Kaveny also suggests that the bishops would do well to pay greater attention to the common good, as "it reflects the moral consensus of the community, which is accurately reflected in our democratic process of lawmaking" (90). Development of the grounds for this optimistic linking of a moral consensus and majority rule to the common good would have been an interesting addition to the book.Part 3 is the heart of the work, exploring ways for American society to "move beyond a culture war mentality" (120). Kaveny resists the assumption that public discourse in a society torn by culture wars is served by pitting secular and religious voices against each other. She hopes instead for persuasion based on natural law. One is left wondering, however, how persuasion based on natural law could happen in America's ideologically diverse culture. [End Page 201]Part 4 explores the effect of America's ideological pluralism on discussions among American Catholics. Kaveny describes how the church's sexual abuse scandal has fed the growing sense of disconnection between church teaching and the expectations of the Catholic laity.Part 5, a series of essays on difficult ethical controversies, hints at what interaction between the American and Catholic traditions might look like. Kaveny advocates "reframing the question" and hints at what reframing the contraception question might look like (221).Some of the book addresses specifically Catholic questions. It is valuable in that respect. Its scope extends beyond any one religious tradition, however, as it offers a picture of engagement between equals: the American legal tradition and Catholic moral teaching. Nevertheless, Kaveny makes it clear that this sort of engagement can succeed only if the American legal community understands its need to reflect changing social values and the Catholic hierarchy moves away from insisting that "error has no rights" and toward acknowledging that people do have rights even when they are in error (257).Allen CalhounPhD candidate, University of AberdeenCopyright © 2018 Society of Christian Ethics... (shrink)

Clinical exchange: one model to achieve culturally sensitive care This paper reports on a clinical exchange programme that formed part of a pre‐registration European nursing degree run by three collaborating institutions in England, Holland and Spain. The course included: common and shared learning including two summer schools; and the development of a second language before the students went on a three‐month clinical placement in one of the other base institutions’ clinical environments. The aim of the course was to enable (...) students to become culturally sensitive carers. This was achieved by developing a programme based on transcultural nursing principles in theory and practice. Data were gathered by interview, focus groups, and questionnaires from 79 exchange students, fostering the strategies of illuminative evaluation. The paper examines: how the aims of the course were met; the factors that inhibited the attainment of certain goals; and how the acquisition of a second language influenced the students’ learning about nursing. A model is presented to illustrate the process of transformative learning from the exchange experience. (shrink)

In the early twenty-first century, we stand on the threshold of welcoming robots into domains of human activity that will expand their presence in our lives dramatically. One provocative new frontier in robotics, motivated by a convergence of demographic, economic, cultural, and institutional pressures, is the development of “carebots”—robots intended to assist or replace human caregivers in the practice of caring for vulnerable persons such as the elderly, young, sick, or disabled. I argue here that existing philosophical reflections on the (...) ethical implications of carebots neglect a critical dimension of the issue: namely, the potential moral value of caregiving practices for caregivers. This value, I argue, gives rise to considerations that must be weighed alongside consideration of the likely impact of carebots on care recipients. Focusing on the goods internal to caring practices, I then examine the potential impact of carebots on caregivers by means of three complementary ethical approaches: virtue ethics, care ethics, and the capabilities approach. Each of these, I argue, sheds new light on the contexts in which carebots might deprive potential caregivers of important moral goods central to caring practices, as well as those contexts in which carebots might help caregivers sustain or even enrich those practices, and their attendant goods. (shrink)

The ethic of care provides not only a basis for understanding relationships of care at the micro level but also a potent form of political ethics, relevant to the development of welfare services. Williams (2001), for example, argues that the concept of care has the capacity to be a central referent in social policy?a point at which social and cultural transformations meet with the changing relations of welfare (Williams 2001, p. 470). English social care services are (...) currently in another period of change precipitated by the ?personalisation agenda?. This agenda is seen as having the potential to revolutionise social care, to create the conditions needed to tailor services to individual needs, and to give service users greater choice and control, including, where possible, control over their own service budgets or direct possession and management of care funds. These developments are inextricably linked to broader economic and social trends, key amongst which are the ageing of the population and changing economic conditions affecting both the labour market and the market for care services. This article applies the feminist ethic of care to an analysis of the personalisation agenda in the context of care for dependent older people. It highlights fundamental political questions posed concerning the nature and extent of older people's need for care, responsibility for meeting these needs and the associated costs. It questions whether the personalisation agenda could potentially offer a more responsive form of care, by placing more power and control in older people's hands. Key points considered are the individualisation of care and the ways in which control is conceptualised. The article concludes with an assessment of the feminist ethic of care as a basis for policy evaluation. (shrink)

In May 2019, an international conference on perinatal palliative care entitled “Yes to Life! Taking Care of the Precious Gift of Life in Its Frailty” was held in Rome. It was organized by the Italian nonprofit foundation Il Cuore in Una Goccia and the Vatican’s Dicastery for Laity, Family and Life. Pope Francis greeted the participants personally and delivered an address describing the goals and practices of perinatal palliative care as being in keeping with the teachings of (...) the Roman Catholic Church and the pastoral care of families. His endorsement represents a new pastoral development, a renewed focus on supporting families and infants who are affected by genetic... (shrink)

The aim of this paper is to get from a phenomenology of birth towards an ethics of obstetric care: Human rights violations in obstetrics are currently a globally debated phenomenon. Research suggests that maltreatment is widespread and a global phenomenon. However, the prevalence cannot yet be clearly quantified. In view of this problem, it is necessary to take the subjective perspective of those affected seriously. Narrative and phenomenological accounts of birth experiences could help to foster the dialogue between persons (...) giving birth and health professionals. First, I will present narrative accounts of birth experiences recorded by feminist phenomenologists. Second, I will interpret these narrative accounts within a feminist phenomenological framework in order to contribute to a phenomenology of birth, which, in a third step, shall help to develop an ethics of obstetric care. In engaging with the phenomenology of care outlined by feminist care ethicists, I will analyze the elements and conditions of good care, and draw conclusions for an ethic of obstetric and midwifery care. Drawing additionally on the theory of relational autonomy, my paper argues for a relational implementation of self-determination in childbirth. Lastly, I will discuss to what extent the ethical ideal of care has an affinity to the midwifery model of childbirth, and how the current situation of obstetrics prevents a women-centered birth culture. (shrink)

The title of this book embraces a subject that is very topical in the field of health care. It is a collection of papers most of which were initially presented at the Centre for Cross-Cultural Research on Women. All but one of the authors are women. The papers themselves are very disparate, covering diverse topics in a variety of ways. Subjects covered include a daughter’s story of her mother’s dying and death from undiagnosed Creutzfeldt-Jakob Disease; the problems for parents (...) raising triplets; issues arising from the Depo-Provera contraceptive debate; the nature of human rights in relation to medical care; disease prevention; methods of research in relation to HIV and men who have sex with men, and nurses’ moral/political voices as expressions of care. Each writer’s subject …. (shrink)

BackgroundBurn patients are among the most vulnerable groups of patients requiring principled ethical care. Caring for these patients often brings various ethical challenges for the members of the health care teams, especially nurses, which affect the clinical decisions made for these patients. A limited number of studies have addressed the ethical challenges of caring for burn patients for the responsible caregivers, so the present study attempted to identify these challenges. The present study aimed to explore the health professionals' (...) experiences of the ethical challenges during caring for burn patients.MethodsThis was a qualitative study with a descriptive, phenomenological design. 22 health professional practiced in public burn centers in Iran who met the inclusion criteria of the study were selected via purposeful sampling to participate in the study from June to August 2019. Data were collected using semi-structured, in-depth interviews with the individuals as well as field notes. Sampling was continued up to the data saturation. Thereafter, the collected data were analyzed using Colaizzi's method.ResultsThe findings of the study yielded 3 themes, including respect for the patient's privacy, respect for the patient's personal identity, and care challenges, as well as 9 categories.ConclusionThe findings of this study showed that the burn patients’ caregivers face some challenges in the domains of maintaining the patient's privacy, respecting the patient’s personal identity, and making the best clinical decision. Thus, providing the cultural, professional, and organizational requirements of meeting the challenges of caring for burn patients can consequently result in the caregivers’ inner peace and the improved performance. (shrink)

In recent decades, group autonomy approaches to have gained kgitimacy within both academic and policy circles. This article examines the centrality of group autonomy in the multiculturalism debate, particuhrly in the highly influential approach of Will Kymlicka. I argue that his response to the dilemmas of liberd-democratic multiculturalism relies on an underdeveloped conceptualization of group autonomy. Despite presumably good intentions, his narrow notion of cultural group autonomy obscures the requirements of minority group members' democratic capabilities and thereby works against the (...) kind of transformative change that "accommodated" groups are seeking from the state. Although some critics (Young 1990; Benhabh 2002) have gone so far as to reject autonomy-based approaches to accommodation altogether (Young 1990,251) I suggest that this position goes too far. In response, I offer an intermediary position between those that defend and those that reject an autonomy-based approach. Instead of fully rejecting autonomy as a guiàng principle for multiculturalism, I devebp an ethics of care approach to group autonomy based on relationality, which addresses the inadequacies of the dominant approach to multiculturalism. Such an account of group autonomy is a vital step toward recondling multiculturalism with the necessary components of Uberd-democratic citizenship. (shrink)