This article starts with a brief overview of well-known criticisms of modern democracy in order to suggest a different approach: reflecting on the principles of Western democracy in the basic horizon of the problematic of the self and wondering if the ‘multiple’ self should not be conceived as the single subjective correlate that is adequate to democratic pluralism and also as the only chance of curing ourselves of ‘fundamentalism’. I try to highlight the Derridian radical view of democracy as (...) “always still to come”, placing it in the generic framework of ‘postmodern ethics’. I distinguish between two trends in postmodern ethics and also between three kinds or models of relationship to the self, in order to argue that the ‘multiple’ self, that is the self conceived as an irreducible multiplicity of voices, positions, tendencies, vocabularies, and characters, might claim the status of an ideal that needs to be fully embraced and understood in all its consequences – some of them profoundly disturbing for the old ‘images of the self’ consecrated by our tradition, on the one side Greek and Latin, on the other, Judeo-Christian –, if we want that democracy actually become a social and political reality. I conclude this paper with a plea for resistance to biopolitical normalization. (shrink)

This essay addresses the ethical and political significance of Foucault’s late work on the ethics of care of the self and parrhesia. We argue, first, that understanding this significance requires seeing Foucault’s investigation of these classical practices against the backdrop of his identification of, and attempt to make perspicuous, the problem of biopolitical governance – specifically the paradox of relations of power and capacity. On this basis we go on, second, to consider how this turn may inform an ethics of (...) democratic governance. In constructing this case, we demonstrate the relationship between the ethics of care of the self as a practice of freedom and the tradition of moral perfectionism identified by Stanley Cavell. This allows us to show how Cavell and Foucault mutually complement each other in the articulation of an approach to an ethics of democracy and we outline the fundamental features of such an approach. (shrink)

This text through the direct use to Foucault’s work and using the concepts of ‘care of the self’ and biopolitics is questioning and analyzing resistance and practices of freedom. Mainly, from the Foucault’s courses at the College de France and the methodological tools found there, here I present a discussion about Gilles Deleuze’s contributions to Foucault’s thought and I develop a dialog where I try to explain the concepts of domination, power, ethics, esthetics and the relationship of the (...) self with himself. (shrink)

This paper examines one strand of the ‘turn to ethics’ in recent political theory by engaging with Michel Foucault's late work on ‘the care of the self.’ For contemporary thinkers interested in how democratic politics might be guided, informed, or vivified by particular ethical orientations, Foucault's inquiry into ancient ethics has proved intriguing. Might concentrated ‘work on the self’ contribute to efforts to resist and remake present-day power relations? This paper endeavors to raise doubts about the Foucauldian inspired view, which (...) regards a reflexive relation of the self to itself as a privileged site for critically engaging with existing configurations of power. To do so, I offer a close reading of Foucault's scholarship that examines his work on ethics together with his well-known theory of power. I demonstrate that Foucault's distinctive theory of power, if read carefully, alerts us to the limits of the care of the self as a strategy for making power relations more equitable, open, and responsive to democratic constituencies. As I show, disciplinary power and biopower target collectivities by ‘individualizing’ and ‘massifying,’ respectively, and thereby diminishing the potential ‘counter-power’ generated by pluralistic association. If this dimension of Foucault's thought is appreciated, the ‘care of the self’ appears as a very limited resource for challenging these de-politicizing effects. Yet this paper also draws on Foucault's thought in order to stress the importance of re-orienting debates concerning the relationship between ethics and politics toward associative rather than reflexive practices of freedom. (shrink)

A study of clinical medical ethicists was conducted to determine the various philosophical positions they hold with respect to ethical decision making in medicine and their various positions' relationship to the subjective-objective controversy in value theory. The study consisted of analyzing and interpreting data gathered from questionnaires from 52 clinical medical ethicists at 28 major health care centers in the United States. The study revealed that most clinical medical ethicists tend to be objectivists in value theory, i.e., believe that (...) value judgments are knowledge claims capable of being true or false and therefore expressions of moral requirements and normative imperatives emanating from an external value structure or moral order in the world. In addition, the study revealed that most clinical medical ethicists are consistent in the philosophical foundations of their ethical decision making, i.e., in decision making regarding values they tend not to hold beliefs which are incompatible with other beliefs they hold about values. (shrink)

In the wake of a pilot study that indicated that the experience of medical education appears to Inhibit moral development In medical students, increased attention needs to be given to the structure of medical education and the Influence it has on medical students. Interest in ethics and moral reasoning has become widespread in many aspects of professional and public life. Society has exhibited great interest in the ethical issues confronting physicians today. Considerable effort has been undertaken to train medical students, (...) interns, and residents In how to reason through medical-ethical dilemmas. Media attention has focused on Issues such as abortion, euthanasia, care of severely handicapped infants, organ transplantation, and so forth, producing heated debates in both the professional and lay literature over the morality of the various positions. The curriculum of medical education has paralleled and reflected this general Interest in medical ethics. Most medical schools now offer, and frequently require, course work in ethics. However, further research Is needed to better characterize and understand the relationship of medical education to moral development. (shrink)

James Bohman’s Democracy across borders aims to conceptualize transnational democracy. But it is more than that: Bohman begins to articulate a paradigm shift in how we conceive democracy in complex, pluralized, globalized contexts comprised of multiple, overlapping constituencies which often have broad extension in space and time. The paradigm shift is not Bohman’s alone: it has been some time in the making*two decades at least*and has multiple sources in contemporary theories of power, inclusion and exclusion, pluralism, deliberation, as (...) well as in theories of social and system complexity. The importance of Bohman’s book is that it consolidates many of these elements into an important statement that breaks with those kinds of theory that conceptualize democracy as a way of organizing relatively simple, territorial, state-organized units of political organization. My comments highlight those elements of Bohman’s argument that add up to a paradigm shift; they are critical only in the sense that there is a danger that this contribution could be overshadowed by the book’s primary focus democracy across borders, important though this is. Most of my comments aim at extracting and reconstructing the paradigm shift within Bohman’s text. (Published: 5 February 2010) Citation: Ethics & Global Politics, Vol. 3, No. 1, 2010, pp. 47-54. DOI: 10.3402/egp.v3i1.4853. (shrink)

Socialism grew up in opposition to capitalism, just as liberalism developed in reaction to feudalism. Both liberalism and socialism combined potent critiques of the existing socio‐economic order with blueprints for a desirable future society. However, liberalism provides a rather more coherent body of thought than does socialism, and its theories are linked with the emergence of a dominant system combining capitalism and liberal democracy. By contrast, no widespread socio‐economic order has as yet emerged which can be confidently or closely associated (...) with the ideas of socialism. In both cases the relationship between theories and actual systems is a contestable one, but it has been particularly problematic in the history of socialism. (shrink)

For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, the American Society (...) for Bioethics and Humanities (ASBH) has moved the professionalization debate forward in a significant way. This first code of ethics focuses on individuals who provide health care ethics consultation (HCEC) in clinical settings. The evolution of the code's development, implications for the field of HCEC and bioethics, and considerations for future directions are presented here. (shrink)

BackgroundUndocumented migrants experience multiple institutional and legal barriers when trying to access healthcare services. Due to such limitations, healthcare workers often experience ethical dilemmas when caring for undocumented migrants. This article aims to understand how individual healthcare workers who regularly take care of undocumented migrants deal with these dilemmas in practice. So far, the role of healthcare workers in this context has mainly been theorized through the lens of biopolitics, conceiving of healthcare workers as merely obedient instruments of (...) humanitarian government or gatekeeping.MethodsBased on semi-structured, in-depth interviews and ethnographic observations with healthcare workers in Belgium, we explore how they ascribe meaning, reflect upon and give shape to care practices in relation to undocumented migrants. We use Foucault’s later work on care of the self to interpret the accounts given by the healthcare workers.ResultsHealthcare workers in clinical roles exercise a certain degree of freedom in relation to the existing limitations to healthcare access of undocumented migrants. They developed techniques such as purposefully being inattentive to the undocumented status of the migrants. They also try to master their affective responses and transform their bodily attitude towards undocumented patients. They perform practical mental exercises to remind themselves of their role or position in the wider healthcare system and about their commitment to treat all patients equally. These techniques and exercises are inspired by colleagues who function as role models, inspiring them to relate in an ethical way to limitations in healthcare access. The developed care practices sometimes reproduce, sometimes transform the legal and institutional limitations to care for undocumented migrants.ConclusionsThe findings nuance the biopolitical analysis regarding the role of healthcare workers in healthcare delivery to undocumented migrants that has been dominant so far. Theoretically this article provides a reconceptualization of healthcare ethics as care of the self, an ethical practice that is somewhat independent of the traditional professional ethics.Trial Registration Medical ethics committee UZ Jette, Brussels, Belgium – Registration date: 18/05/2016 – Registration number: B.U.N. 143201628279. (shrink)

BackgroundThe COVID-19 pandemic called for a new ethical climate in the designated hospitals and imposed challenges on care quality for anti-pandemic nurses. Less was known about whether hospital ethical climate and nurses’ ethical sensitivity were associated with care quality. This study examined the association between the perceived hospital ethical climate and self-evaluated quality of care for COVID-19 patients among anti-pandemic nurses, and explored the mediating role of ethical sensitivity in this relationship.MethodsA cross-sectional study was conducted through an online survey. (...) A total of 399 anti-pandemic nurses from ten designated hospitals in three provinces of China were recruited to fill out an online survey. Multiple linear regression analysis and a bootstrap test were used to examine the relationships between ethical climate, ethical sensitivity and care quality.ResultsNurses reported mean scores of 4.43 ± 0.577 (out of 5) for hospital ethical climate, 45.00 ± 7.085 (out of 54) for ethical sensitivity, and 5.35 ± 0.661 (out of 6) for self-evaluated care quality. After controlling for covariates, perceived hospital ethical climate was positively associated with self-evaluated care quality (direct effect = 0.710, 95% confidence interval [CI] 0.628, 0.792), and was partly mediated by ethical sensitivity (indirect effect = 0.078, 95% confidence interval [CI] 0.002, 0.145).ConclusionsChinese nurses who cared for COVID-19 patients perceived high levels of hospital ethical climate, ethical sensitivity, and self-evaluated care quality. Positive perceptions of hospital ethical climate were both directly associated with a higher level of self-evaluated care quality and indirectly associated, through the mediation effect of ethical sensitivity among anti-pandemic nurses. (shrink)

In this study, we examined the perception of actual and ideal ethical climate type among 95 nurses working in the internal medicine wards of one central hospital in the state of Israel. We also examined whether nurses’ demographic characteristics influence that perception and if a relationship between perceptions of an actual and an ideal ethical climate type influences nurses’ job satisfaction. A questionnaire composed of three subquestionnaires was administered and the responses analyzed using multiple linear regressions, analysis of (...) variance and Pearson’s correlation coefficient. The results demonstrated that demographic characteristics (such as: gender, job tenure and level of education) partially influence the perception of an ideal ethical climate. Incongruence in perceptions of ‘caring’ and ‘independence’ climate types indicated a decline in nurses’ job satisfaction, while perception of actual ‘caring’ and ‘service’ climates positively influenced all aspects of job satisfaction. We recommend constructing training programs emphasizing the ethics of nursing practice and also to help lead nurses to clarify an ethical framework and guide nursing staff in dealing with ethical dilemmas. (shrink)

OBJECTIVES: The subject of patient self-determination in health care has gained broad interest because of the increasing number of incompetent patients. In an attempt to solve the problems related to doctors' decision making in such circumstances, advance directives have been developed. The purpose of this study was to examine relationships between public attitudes towards patient autonomy and advance directives. SUBJECTS AND MAIN OUTCOME MEASURES: A stratified random sample of 600 adults in northern Sweden was surveyed by a questionnaire with a (...) response rate of 78.2%. The subjects were asked about their wish for control of their health care, their concerns about health care, their treatment preferences in a life-threatening situation (both reversible and irreversible), and their attitudes towards the application of advance directives. RESULTS: Numerous relationships between various aspects of self-determination in health care (desire for control, fears of over-treatment, and choice of treatment level) in general and advance directives, in particular, were found. Those who wanted to have a say in their health care (about 94%) also mainly supported the use of an advance directive. CONCLUSIONS: The fact that almost 30% of the respondents were undecided concerning their personal use of advance directives points to a lack of knowledge and to the necessity of education of the public on these issues. (shrink)

This book advocates for the philosophical import of care in re-evaluating problems of humanitarianism in the context of the ongoing international refugee and forced migration situation. In doing so, it rethinks the human capacity to care about the suffering of distant others. At a time when emotional resources are running low, there is a need to recast what it means to care, with the aim of generating a productive movement against the rise of value fundamentalism globally—embraced in mantras of ‘good (...) and evil’ and ‘us and them’—and to confront xenophobia and oppressive politics. The author draws upon a wide array of rich traditions, including historical and contemporary writings on self-care and care of the other, to re-examine the intersection of care ethics and justice. She also rethinks the relationship between care and contestation, here analyzed in the aesthetic, ethical, political, and religious domains of human experience. From within the context of this contingent historical repetition of political oppression, the book constructs a reminder not only of what it feels like to care, but how and why we should act upon our care. Care Ethics and the Refugee Crisis is an important contribution to the growing literatures on care ethics and immigration/forced migration in philosophy. It will also appeal to scholars and advanced students working in other disciplines such as political science, refugee and migration studies, and social anthropology. (shrink)

This volume addresses whether, how, and where laws (variously defined) teach values and shape moral character in late modern liberal societies. Each author recognizes the essential value of state law in fostering peace, security, health, education, charity, trade, democracy, constitutionalism, justice, and human rights, among many other moral goods. Each author also recognizes, however, the grave betrayals of law in supporting fascism, slavery, apartheid, genocide, persecution, violence, racism, and other forms of immorality and injustice. They thus call for state laws (...) that set a basic civil morality of duty for society and for robust freedoms that protect private individuals and private groups to cultivate a higher morality of aspiration"--Back cover. (shrink)

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law and medicine, (...) truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

The Norman Rockwell image of the American physician who fixed the broken arm of a child, treated the father for hypertension, and brought an unborn child into this world is now almost nonexistent. Since the time of the Rockwell portrait, a highly technical medical industry has evolved. Now two-thirds of physicians are board certified in subspecialties, and patients visit an average of 3–4 different physicians per year. Today's physicians see themselves less as “benevolent and wise counselors overseeing the patient's welfare (...) and more as objective scientists applying the latest technical methods to bring about the desired end.” The intimate patient-physician relationship that was once the norm in our society is rapidly disappearing. (shrink)

A relational-self theory claims that one’s self is constituted by one’s relationships. The type of ethics that is said to arise from this concept of self is often called an ethics of care, whereby the focus of ethical deliberation is on preserving and nurturing those relationships. Some environmental philosophers advocating a relational-self theory tend to assume that the particular relationships that constitute the self will prioritize the natural world. I question this assumption by introducing the problem of artifact relationships. It (...) is unclear whether a relational-self theory recognizes relationships with the artificial world as beingmeaningful in any moral sense, and whether such relationships, if they can exist, should be accorded equal value to relationships with the natural world. The problem of artifact relationships becomes particularly apparent when the relational-self theory is linked to place-based ethics. If our ethics are to develop from our relations to place, and our place is largely an artificial world, is there not a danger that our ethical deliberations will tend to neglect the natural world? I adapt Holmes Rolston’s concept of “storied residence” to show how the inclusion of the artificial world will lead to different questions regarding one’s resident environment, and perhaps a different emphasis on what is valued. My aim in raising these questions is to challenge the optimism that writers such as Karen Warren and Jim Cheney have shown in supporting relational-self theories and place-based ethics. I conclude that the challenge to develop a relational-self/place-based ethic does not appear to have been met within Western environmental philosophy, which has perpetuated a silence on the matter of our embedment in the artificial world. (shrink)

Background The emerging working conditions triggered by the COVID-19 pandemic have imposed numerous ethical challenges on the nurses, which, in turn, can negatively impact the nurses’ physical and mental health, and thus their work performance through intensifying negative emotions and psychological pressures. Aim The purpose of this study was to highlight the nurses’ perceptions of the ethical challenges that they faced regarding their self-care during the COVID-19 pandemic. Research design A qualitative, descriptive study with a content analysis approach. Participants and (...) research context The data were collected through semi-structured interviews with 19 nurses working in the COVID-19 wards of two university-affiliated hospitals. These nurses were selected using a purposive sampling method and the data were analyzed using a content analysis approach. Ethical considerations The study was approved by the TUMS Research Council Ethics Committee under the code: IR.TUMS.VCR.REC.1399.594. In addition, it is based on the participants’ informed consent and confidentiality. Findings Two themes and five sub-themes were identified, including ethical conflicts (the conflict between self-care and comprehensive patient care, prioritization of life, and inadequate care) and inequalities (intra- and inter-professional inequalities). Conclusion The findings demonstrated that the nurses’ care is a prerequisite for the patients’ care. Considering that the ethical challenges faced by nurses are related to unacceptable working conditions, organizational support, and lack of access to facilities such as personal protective equipment, it seems essential to support nurses and provide adequate working conditions to provide patients with quality care. (shrink)

The aim of this paper is to offer theoretical insights into the care of the self, which often initiates therapist-patient relationships in clinical practice. The reason is that when patients care about their health status, they are inclined to establish a therapeutic relationship with physical therapists. Hence, the care for self may bridge the world of the patient's private experiences and the world of the healthcare system together with its interventions, which is represented by the physical therapist In this (...) framework, care means not only the patient's choice to undergo therapy but also his/her commitment to sustaining its effects in private life. This involves educational interventions by the physiotherapist who inscribes him/herself in his/her patients’ care of the self in order to alter their habits of physical exercise, diet, personal hygiene, body posture, etc. The argument in this paper is informed by the concepts of ethics developed by Michel Foucault and Richard Shusterman. (shrink)

High moral standards and adherence to a moral code have long been strong tenets of the profession of medicine, even though there have been occasional lapses that have led to renewed calls for a revitalization of moral integrity in medicine. Certainly, a moral component has generally been held to be an important aspect of the concept of a physician.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Christian Ethics and Commonsense Morality: An Intuitionist Account by Kevin JungAleksandar S. SantracChristian Ethics and Commonsense Morality: An Intuitionist Account Kevin Jung NEW YORK AND LONDON: ROUTLEDGE, 2014. 202 PP. $145.00In Christian Ethics and Commonsense Morality: An Intuitionist Account, Kevin Jung boldly constructs and defends a commonsense morality of intuition as a plausible ethical theory against both postmodern constructivist ethical systems and narrow objectivist theories. Following the (...) antifoundationalist ethical methods of postmodern approaches to reality and morality in chapter 1 and a moderate defense of realism in chapter 2, Jung attempts to save both objectivity and de-feasibility of moral realistic accounts, offering some modern reinterpretations of moral realism in chapters 3 and 4. All these forms of Wittgensteinian conceptions of realism unsatisfactorily lead to infinite regress in justifying claims because they are grounded only in the wishes, interests, and sentiments of the individual culture and society (60).After a brief introduction to the unique role of emotions in ethical theories, his investigation leads to reconciliation between objectivist naturalistic ethics [End Page 192] and theological forms of ethical theories. Theological ethicists can remain committed to intuitionism (objectivist and naturalistic forms of common morality) refined by particular religious expressions of morality (112). Intuitionism, broadly defined in chapter 7, is described as "initial appearances" (118); moral truths, according to Jung's intuitionist account, are "mediately self-evident" (128), not "immediately," because it still requires careful reflection and cognitive searching for objectivist grounds of morality. Jung's affirmation of the plausibility of intuitionism seems to be a final blow to all forms of postmodern and skeptical accounts of antifoundationalist forms of ethical theories; he successfully defends an intuitionist account of morality against its naturalist and religious critics.The last chapter offers three types of relationship between commonsense morality and Christian morality. The identity model reduces Christian morality to commonsense morality. The two-tier model considers Christian morality to be a superior form of morality with instrumental value of commonsense morality. And, finally, integration, Jung's favorite model, considers commonsense morality as neither identical nor subordinate but central to Christian morality (163). With this he affirms that Christian morality is unique not because of differences in moral beliefs but because "it is fully committed to recognizing the oneness of humanity and the universally accessible nature of basic moral truths for all human beings" (166). Jung's reflection is exceptionally insightful. Building the case as a good lawyer, he leads us to the defenseless nature of constructivist postmodern moral theories and their revisions as well as to a commitment of Christian morality to the objective commonsense morality. On this view, even heroic moral acts based on obedience to God (such as Christian sacrificial love) might be compatible with commonsense morality. It is surprising, however, that Jung never consulted or quoted Bernard Gert's account of the common morality, especially when discussing differences between moral duty and ideals (167). Additionally, Jung's argument that Christian morality is unexceptional since moral knowledge can be obtained through multiple sources in which God also reveals his will (178) does not sufficiently probe into the distinctiveness of God's sometimes radical demands of Jews/Christians (e.g., Abraham's sacrifice of Isaac), which come not from intuitionist accounts of objective natural reason or common sense but from faith. Christian saints are not heroes of general moral example but heroes of faith, a qualitatively different realm of human experience. Still, audiences interested in all aspects of ethics will greatly benefit from this superb engagement with recent discussions. [End Page 193]Aleksandar S. SantracWashington Adventist UniversityCopyright © 2017 Society of Christian Ethics... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Democracy and Music Education: Liberalism, Ethics, and the Politics of PracticeHeidi WesterlundPaul G. Woodford, Democracy and Music Education: Liberalism, Ethics, and the Politics of Practice ( Bloomington, Indiana University Press, 2005)Paul G. Woodford's Democracy and Music Education needs to be warmly welcomed in the field of philosophy of music education. It contributes to the discussion centering on ethics and music education—a discussion that after multiculturalism, pluralism, praxialism, and (...) other recent "isms" still awaits its appearance in a stronger sense. Woodford writes that the aim of the book is to enhance democratic ends by inviting music educators to contribute "to wider intellectual and political conversations about the nature and significance of music in our lives and those of our children."1Woodford borrows ideas from many thinkers creating an interesting synthesis and lines of thought throughout the book. His main resource in developing a liberalist music education is, however, along the ideas of the American pragmatist and educational philosopher, John Dewey. Woodford's choice is well thought out. Dewey deserves to be redeemed and recognized in music education, not the least because of various distorted interpretations of his views that have commonly been accepted in the profession in the past. Woodford argues that the music appreciation movement, which aimed at developing good musical taste equally in all children, has not in any particular way been a Deweyan democratic movement. Music educators have not acknowledged their role as agents in the [End Page 235] transformation of school and society. Instead, he states, they have continued to subscribe to the older aesthetic and utilitarian rationales and yet neither approach prepares students "to question and challenge authority and thereby to transform musical society."2It is noteworthy that Woodford does not elaborate on Dewey's central concept, experience, but unexpectedly draws upon concepts such as abstract reason or the autonomous individual to reconstruct music education. Critical conversation becomes celebrated against performance-oriented music education. The book leaves open the discussion between utilitarian and aesthetic rationales and carefully avoids Dewey's notion of the aesthetic and experimentation, which could have brought new angles in understanding his notion of democracy and its relation to the social and musical.3 Woodford tries to maintain a middle ground in the North American philosophical battlefield of music education stating that music educators "should listen more closely to one another while avoiding extremes."4 His critique targets critical theorists, radical feminist writers, and modernist as well as postmodernist ideas, while Woodford himself seeks a middle way between laissez-faire and elitist or autocratic concepts of music education.As a whole, Woodford's conceptual toolkit for promoting ethical aspects in music education are less akin to Dewey's thoughts and more to the Greek philosophers and their notions of virtues. Woodford writes, "democracy depends on the existence of good faith and generosity of spirit, of character and love for one's fellow men and women."5 These virtues are "the glue that can bind us together as society."6 How is this achieved in music education? Teaching love becomes a practical problem: explaining love requires it to be modelled and experienced, Woodford writes. However, he leaves this cornerstone of his conceptual scheme to rest on the notion of intellectual conversation.Allow me to explain briefly in what way Dewey's philosophical project differs from the Greek philosophical ethos and why abstract reason and intellectual conversation are not central concepts in Dewey's pragmatism (this does not mean that they cannot be celebrated as Woodford has done). For Dewey, the virtue of love signifies devotion, interest, and courage since genuine interest challenges us to overcome the obstacles that stand in the way.7 Interest and devotion are not just attitudes or intellectual modes in the sense of mental states, but linked to doings and active transactions with and in the environment. Interest is co-extensive with action and devotion with dedication to shared projects. This devotion to shared doings and their significance is the socially inclusive ethical side that Dewey brought to the individualistic humanistic theory of self-realization and to the theory of experience. The vision of humanistic self-realization, as has been presented in... (shrink)

Definition of the problem The COVID-19 pandemic poses a considerable challenge to the capacity and functionality of intensive care. This concerns not only resources but, above all, the physical and psychological boundaries of nursing professionals. The question of how care for others and self-care of nurses in intensive care units are related to each other in the context of the COVID-19 pandemic has not been addressed in public and scientific discourse so far. Arguments The present contribution reflects this relationship (...) with reference to the Code of Ethics of the International Council of Nurses, particularly considering principlism and the Care Ethics according to Joan Tronto. As a result, it shows a corridor of ethically justifiable care with several borders, above all: self-care must not be given up completely for the benefit of care for others, and a categorical subordination of care for others to self-care is ethically not justifiable. Conclusion The article makes an important contribution to a differentiated ethical consideration of the rights and responsibilities of intensive care nurses as moral actors within the pandemic in Germany. It, thus, provides a first starting point for a broad social and political discourse which is urgently needed not only during but also after the pandemic in order to improve the situation of intensive care nurses and those who are cared for. (shrink)

AbstractOrganizations receive multiple benefits when their members act ethically. Of interest in this study is if the actors receive benefits as well, especially as individuals look to work to fulfill psychological and social needs in addition to economic ones. Specifically, we highlight a series of ongoing ethical practices embodied in professional moral courage and their relationship to actor’s work meaningfulness and life well-being. Drawing on self-determination theory and affective events theory, we explore how exercising professional moral courage in (...) one’s work leads to positive work and life outcomes. Data from 106 administrative staff of non-profit organizations demonstrates the positive benefits of adopting ethical practices at work. Specifically, professional moral courage is found to be significantly related to both work meaningfulness and individual eudaimonic life well-being. Our findings note positive benefits for individuals who incorporate professional moral courage into their daily lives and provide support for organizations seeking to encourage it from their employees; benefits for organizations and employees go beyond just the gains from ethical behavior into other positive psychological processes. Implications for future work that considers both the psychological and normative approaches to meaningful work are discussed. (shrink)

_The Undiscovered Dewey_ explores the profound influence of evolution and its corresponding ideas of contingency and uncertainty on John Dewey's philosophy of action, particularly its argument that inquiry proceeds from the uncertainty of human activity. Dewey separated the meaningfulness of inquiry from a larger metaphysical story concerning the certainty of human progress. He then connected this thread to the way in which our reflective capacities aid us in improving our lives. Dewey therefore launched a new understanding of the modern self (...) that encouraged intervention in social and natural environments but which nonetheless demanded courage and humility because of the intimate relationship between action and uncertainty. Melvin L. Rogers explicitly connects Dewey's theory of inquiry to his religious, moral, and political philosophy. He argues that, contrary to common belief, Dewey sought a place for religious commitment within a democratic society sensitive to modern pluralism. Against those who regard Dewey as indifferent to moral conflict, Rogers points to Dewey's appreciation for the incommensurability of our ethical commitments. His deep respect for modern pluralism, argues Rogers, led Dewey to articulate a negotiation between experts and the public so that power did not lapse into domination. Exhibiting an abiding faith in the reflective and contestable character of inquiry, Dewey strongly engaged with the complexity of our religious, moral, and political lives. (shrink)

The American Medical Association enacted its Code of Ethics in 1847, the first such national codification. In this volume, a distinguished group of experts from the fields of medicine, bioethics, and history of medicine reflect on the development of medical ethics in the United States, using historical analyses as a springboard for discussions of the problems of the present, including what the editors call "a sense of moral crisis precipitated by the shift from a system of fee-for-service medicine to a (...) system of fee-for-system medicine, better known as 'managed care.'" The authors begin with a look at how the medical profession began to consider ethical issues in the 1800s and subsequent developments in the 1900s. They then address the sociological, historical, ethical, and legal aspects of the practice of medicine. Later chapters discuss current and future challenges to medical ethics and professional values. Appendixes display various versions of the AMA's Code of Ethics as it has evolved over time. Contributors: George J. Annas, J.D., M.P.H., Arthur Isak Applbaum, Ph.D., Robert B. Baker, Ph.D., Chester R. Burns, M.D., Ph.D., Arthur L. Caplan, Ph.D., Alexander Morgan Capron, J.D., Christine K. Cassel, M.D., Linda L. Emanuel, M.D., Ph.D., Eliot L. Freidson, Ph.D., Albert R. Jonsen, Ph.D., Stephen R. Latham, J.D., Ph.D., Susan E. Lederer, Ph.D., Florencia Luna, Ph.D., Edmund D. Pellegrino, M.D., Charles E. Rosenberg, Ph.D., Mark Siegler, M.D., Rosemary A. Stevens, Ph.D., Robert M. Tenery, Jr., M.D., Robert M. Veatch, Ph.D., John Harley Warner, Ph.D., Paul Root Wolpe, Ph.D. (shrink)

Background: Pediatrics ethics education should enhance medical students' skills to deal with ethical problems that may arise in the different settings of care. This study aimed to analyze the ethical problems experienced by physicians who have medical education and pediatric care responsibilities, and if those problems are associated to their workplace, medical specialty and area of clinical practice. Methods: A self-applied semi-structured questionnaire was answered by 88 physicians with teaching and pediatric care responsibilities. Content analysis was performed to analyze the (...) qualitative data. Poisson regression was used to explore the association of the categories of ethical problems reported with workplace and professional specialty and activity. Results: 210 ethical problems were reported, grouped into five areas: physician-patient relationship, end-of-life care, health professional conducts, socioeconomic issues and health policies, and pediatric teaching. Doctors who worked in hospitals as well as general and subspecialist pediatricians reported fewer ethical problems related to socioeconomic issues and health policies than those who worked in Basic Health Units and who were family doctors. Conclusions: Some ethical problems are specific to certain settings: those related to end-of-life care are more frequent in the hospital settings and those associated with socioeconomic issues and public health policies are more frequent in Basic Health Units. Other problems are present in all the setting of pediatric care and learning and include ethical problems related to physician-patient relationship, health professional conducts and the pediatric education process. These findings should be taken into consideration when planning the teaching of ethics in pediatrics.Trial registrationThis research article didn't reports the results of a controlled health care intervention. The study project was approved by the Institutional Ethical Review Committee (Report CEP-HIJG 032/2008). (shrink)

Our paper focuses on the philosophical perspective of constructing active caring masculinities agencies in the contemporary feminist discourse. Since contemporary feminisms are not simply anti-essentialist, but more importantly, polyphonic, we believe that it is far more appropriate to talk about ‘masculinities’ as opposed to ‘masculinity’. We are proposing a revised understanding of the self in which the self is not defined primarily in the dichotomous, categorical one-other relationship. We use Paul Ricoeur’s anthropology to describe the self as relational, as (...) well as Joan Tronto’s recent perspective on care which fits well with a Ricoeurian reconstruction of the self. We also engage with Raewyn Connell’s discourse on masculinity and more specifically, hegemonic masculinity. By using ‘caring masculine agencies’ as an alternative to ‘masculinity as reactive anti-femininity’, we are proposing a paradigm shift that hopefully is flexible enough to respect the dynamism inherent to any act of gender-identification. (shrink)

In this article, I distinguish two models of personal integrity. The first, wholeheartedness, regards harmonious unity of the self as psychologically healthy and volitional consistency as ethically ideal. I argue that it does so at the substantial cost of framing ambivalence and conflict as defects of character and action. To avoid these consequences, I propose an alternate ideal of humility that construes the self as multiple and precarious and celebrates experiences of loss and transformation through which learning, growth, innovation, (...) and dynamic relationship become possible. This ideal not only sustains prospects for integrity but is more suitable than wholeheartedness for recognizing practices of contestation, such as those involving potentially destabilizing encounters with difference that is common within pluralistic societies, as vital for rich, well-lived lives. (shrink)

Background The fourth section of the 1967 Abortion Act states that individuals (including health care practitioners) do not have to participate in an abortion if they have a conscientious objection. A conscientious objection is a refusal to participate in abortion on the grounds of conscience. This may be informed by religious, moral, philosophical, ethical, or personal beliefs. Currently, there is very little investigation into the impact of conscientious objection on service users in Britain. The perspectives of service users are imperative (...) in understanding the real-world consequences and potential impact of conscientious objection and should be considered when creating and reviewing policies and guidelines. This research provided a platform for women and those who can become pregnant to share their experiences and opinions at a time when these voices are largely excluded in the great tradition of Western political philosophy and law-making processes. Method Five service users were interviewed using a narrative interview approach to uncover their abortion journeys and experiences of conscientious objection. Findings The findings were presented as found poems and uncovered that doctors are not always: informing service users that they have a conscientious objection to abortion, giving service users enough information to access abortion (indirect referral), treating them non-judgmentally, and providing medically correct information. Service users did not experience burdens such as long waiting times and were still able to access legal abortion. However, service users did experience negative emotional effects, as they were often left feeling scared, angry, and hopeless when they were not referred and/or were mistreated. Conclusions Findings indicate that conscientious objection could work in practice. However, it is currently failing some individuals on an emotional level, as not all doctors are adhering to guidelines. Conscientious objection in Britain needs to be addressed, to ensure service users receive fair, impartial, non-judgmental care. (shrink)

As a form of functional diversity, spinal cord injury expressed by tetraplegia is one of the most serious events that can impact people, affecting their family and socioeconomic life. The type of care relationship established in these cases will be essential for preserving autonomy. The objective of this study was to understand how care relationships influence the autonomy of people with tetraplegia and the dynamics that trigger practices of autonomy violation, maintenance and promotion. This research is inspired by problematization (...) as a methodology using the Arch of Maguerez as an analytical approach strategy that enables an engagement between empirical and theoretical data. Some models of care relationships identified in this study either promote or violate autonomy: the protectionist model, based on the biomedical interpretation model of disability and the bodily impediments caused by spinal cord injury; the participatory model, involving the patient's interest in adapting to their new condition of family and community life, seeking to understand the practical aspects of daily life; the sharing model, in which the complicity and understanding of new forms of bodily expression allow the caregiver to be almost an extension of the tetraplegic person's body; the delegate model, which occurs in relationships with professional caregivers; and the emancipatory model, which seeks to empower the patient, highlight potentialities, and encourage autonomy. The key components of these conceptual care models guided the elaboration of hypotheses for intervention with the objective of maintaining and promoting the autonomy of people with tetraplegia through supported care. (shrink)

How might philosophically based counseling avoid becoming just one more form of private therapy, to be set alongside all the others now sold to individual consumers? Although several practitioners of philosophical counseling have sought to distinguish their approach from psychotherapeutic models, Foucault’s critique of the dominant modern model of ethical reflection might be used to argue for their essential continuity with one another, based on their common acceptance of the primacy of the imperatives of knowledge. Foucault turned in his late (...) writings to ancient Greek models of ethics as ‘care of the self ’, delineating a self-relation prior to knowledge. This paper argues for the interest and importance for philosophical counseling of the idea of ethics as ‘care of the self ’ in articulating a model of ethical reflection distinct from both rationalist and irrationalist tendencies in modern thought and focussed on self-mastery conceived as addressing our relation to otherness rather than as authenticity or autonomy. Moreover, the ‘aesthetics of existence’ that Foucault prescribes to the present has a significant and affirmative relationship to po­litical life; this distinguishes it from the private and individualistic project, dismissed by Foucault as ‘the Californian cult of the self ’, for which philosophical counseling can all too readily be mistaken. (shrink)

A study of physicians and medical students was conducted to determine the various philosophical positions they hold with respect to ethical decision-making in medicine and their epistemological presuppositions in relationship to the subjective-objective controversy in value theory. The study revealed that most physicians and medical students tend to be objectivists in value theory, i.e., believe that value judgements are knowledge claims capable of being true or false and are expressions of moral requirements and normative imperatives emanating from an external (...) value structure or moral order in the world, but that most physicians and medical students are inconsistent in the philosophical foundations of their medical ethical decision-making, i.e., in decision-making regarding values they tend to hold beliefs which are incompatible with other beliefs they hold about values. The study also revealed that most physicians and medical students think more emphasis should be placed upon medical ethics in medical education. (shrink)

A study of nurses and nursing students was conducted to determine the various philosophical positions they hold with respect to ethical decision-making in nursing and their relationship to the subjective-objective controversy in value theory. The study revealed that most nurses and nursing students tend to be subjectivists in value theory, i.e., believe that value judgments are purely personal, private expressions of one's own opinion or inner-feelings and not believe that value judgments are knowledge claims capable of being true or (...) false and therefore not expressions of moral requirements and normative imperatives emanating from an external value structure or moral order in the world. In addition, the study revealed that most nurses and nursing students are inconsistent in the philosophical foundations of their ethical decision-making, i.e., in decision-making regarding values they tend to hold beliefs which are incompatible with other beliefs they hold about values. (shrink)

From its inception, philosophy for/with children (P4wC) has sought to promote philosophical discussion with children based on the latter’s own questions and a pedagogic method designed to encourage critical, creative, and caring thinking. Communities of inquiry can be plagued by power struggles prompted by diverse identities, however. These not always being highlighted in the literature or P4wC discourse, this article proposes a two-stage model for facilitators as part of their ethical responsibility. In the first phase, they should free themselves from (...) assumptions and closed-mindedness. They should liberate themselves from pedagogy of fear and “banking education” in order to act freely in an educational space characterized by improvisation that cultivates participation of the children. Here, the text is based on normalizing education principles, counter-education and diasporic-education approaches in order to ensure openness and inclusiveness. In the second, they should embrace enabling-identity views and practices in order to make the community of inquiry as identity-broad and -rich as possible, recognizing and legitimizing the participants’ differences. Here, the text is based on principles such as recognizing power games as part of the community, ensuring multi-narratives human environment and enabling epistemic justice in order to ensure perspectival multiplicity, multiple identities, and the legitimization of difference characterized by pedagogy of search. (shrink)

Watsuji proposes a conception of the self as embodied and dynamic in constant cyclic relationship with the historical milieu. I argue that the concept of a relational individual can provide some solutions to the problem in environmental ethics of the spatial distance between an agent and the consequences of her actions. Indeed, by becoming aware of the interdependent relation between the self and the local shared milieu, one develops and recognizes feelings of care and belonging, which promote more environmentally (...) sensitive lifestyles. Furthermore, this care and awareness of interdependence can be expanded to a global level, including distant human beings and natural environments. Ethics thus emerges from the constant dynamic relation between the relational individual and the historical milieu. keywords: Watsuji Tetsurō—environmental ethics—sustainability— self—relational self— milieu— Japanese philosophy— historicity— spatial distance— Augustin Berque. (shrink)

Clinical ethics consultants are inevitably called to participate in and bear witness to emotionally challenging cases. With the move toward the professionalization of ethics consultants, the responsibility to respond to and address difficult ethical dilemmas is likely to fall to a small set of people or a single clinical ethicist. Combined with time constraints, the urgent nature of these cases, and the moral distress of clinicians and staff encountered during consultation, like other healthcare professionals such as physicians and nurses, clinical (...) ethics consultants could risk burnout. If it is true that clinical ethicists are at risk for burnout, an important strategy to avoid burnout is to develop sound self-care practices. This article reviews the goals and skills of ethics consultation and the role-specific reasons that clinical ethicists may be at risk for burnout, and argues that clinical ethicists may need to engage in self-care practices. Strategies to address burnout are reviewed and opportunities for future research are identified. (shrink)

Philosophy Compass, Volume 17, Issue 4, April 2022. -/- In a moment where needs for care are acute and their provision precarious, feminist care ethics has gained new relevance as a framework for understanding and responding to necessary interdependence. This article reviews and evaluates two long-standing critiques of care ethics in light of this recent research. First, I assess what I call the pluralist feminist critique, or the dispute over the ability of care ethics to address the needs and histories (...) of a range of marginalized subjects. I identify two forms of this critique: the first disputes the biased starting points shaping the development of the theory, and the second concerns the weaponization of care in support of domination. Although these critiques are well-established, I draw attention to recent responses that move care theory in generative directions. I argue that the pluralist feminist critique demands both self-critical transformation in dialog with other feminist schools of thought and a robust account of care ethics' normative authority. I then take up critiques those levied by mainstream ethicists concerned with care theory's adequacy as an ethical approach. I show that recent work on normative authority, conceptual uniqueness, and the grounding of responsibility must be engaged before care theory can be dismissed as “under-theorized.” In articulating these two sets of critiques and evaluating recent rebuttals to them, I argue for a pluralist feminist theory of care within which strands informed by varying philosophical schools and methods can coexist. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Underplayed Ethics and the Dilemmas of Psychiatric CareChong Siow Ann and Tamra LysaghtThe practice of psychiatry is fraught with uncertainty. The exact causes and the biological substrates underlying mental disorders remain to be elucidated; even the diagnosis of these disorders is descriptive and not based on an etiological understanding and no biological diagnostic markers have been validated. The manifestation of almost all mental disorders results from a complex interaction (...) of biological and environmental factors which encompasses the patient’s unique life history, experiences and relationship with others and the community. In the face of such uncertainties — at times extending to the types of treatment (psychiatry is generally acknowledged not be an exact science) — it has been argued that adopting a pragmatic approach is necessary.1 Accordingly, this approach necessitates high ethical standards among mental health practitioners.Some mental illnesses are associated with varying degrees and types of cognitive impairments. Others have certain symptoms like auditory hallucinations and delusions that might severely compromise the patients’ autonomy, distort their sense of reality, increase the risk of harm to themselves or others and render them incapable of making informed decisions in their treatment and participation in research.Consequently, there are issues that are particular to the provision of mental healthcare. These include the need for enforced involuntary treatment with the corollary of depriving a patient of his personal liberty even [End Page 173] though it is often justified on the grounds that it is in the patient’s best interests. However, at times, it is the legal and societal obligation of mental health practitioners to protect those who might be harmed from the patient’s action that might seem to be more pressing. In this situation of double agency, lies the tension of providing confidential care for patients and acting as “an agent of the state” where that patient’s confidentiality might be breached and his liberty infringed upon. This situation is further aggravated by the stigma that clings ever so tenaciously to those who suffer from mental disorders and where it is the norm to stereotype them as dangerous and unpredictable.Consideration of a patient’s autonomy is also challenged by characteristics that are unique to the practice of psychiatry. The prescription of certain psychotropic medications can alter how people think and feel, while psychotherapy works towards changing the patient’s views and values. The philosopher, Jennifer Radden, describes this process as “re-forming the patient’s whole self or character … akin to the responsibilities of raising children”.2 The psychotherapeutic relationship is thus particularly personal and intimate because patients are asked to provide information that often reveals their innermost feelings, fears and fantasies. This information is provided on the basis of trust and assurance of confidentiality, and with expectation of being helped.Jeremy Holmes and Gwen Adshead have elaborated on the vulnerability of patients seeking psychotherapy: they might be particularly susceptible to exploitation because their past experiences of being exploited have led to their distress and help seeking — their dependency and the extreme privacy of the therapeutic relationship make any transgression difficult to be uncovered.3 There is a calamitous combination of the “unconscious wish in the patient to be used” with the complicity of an unethical therapist seeking to fulfil his own interests.4As in any other doctor-patient relationship, the relationship between the mental healthcare practitioner and the patient is one of unequal power where the former is ascendant. While that power should be exercised to heal and to relieve suffering, it also gives the practitioner tremendous power “to harm, reject, misunderstand, or exploit patients who struggle with the experience of mental illness, which itself may generate helplessness, despair, distress, and exceptional dependence on the clinician”.5 Given the potential of doing good and harm coupled with the likelihood of being so significant in the life of the patient,6 providing care for those with mental disorders and distress is necessarily ethically exacting — arguably more so than in other medical practice settings. [End Page 174]This precariousness has led to the suggestion that ethics in psychiatry should have a special status and that the more general principles of biomedical ethics are too limited in scope to... (shrink)

In this paper, we extend Michel Foucault’s final works on the ‘care of the self’ to an empirical examination of research practice in community-based research (CBR). We use Foucault’s ‘morality of behaviors’ to analyze interview data from a national sample of Canadian CBR practitioners working with communities affected by HIV. Despite claims in the literature that ethics review is overly burdensome for non-traditional forms of research, our findings suggest that many researchers using CBR have an ambivalent but ultimately productive (...) class='Hi'>relationship with institutional research ethics review requirements. They understand and use prescribed codes, but adapt them in practice to account for the needs of participating community members, members of their research teams and the larger communities with whom they work. Complying with ethics protocols was seen as only the beginning, a minimum standard; our research suggests that the real ethical work happens in the field, where CBR practitioners encounter community members in diverse public roles and must forge ethical consensus across communities. CBR represents an ethical terrain in which practitioners challenge themselves to work differently, and as a result they care for themselves—and others—in ways that often resist the propensity for domination through public health research.‘…there are different ways to “conduct oneself” morally, different ways for the acting individual to operate, not just as an agent, but as an ethical subject of action.’ (Foucault, 1985: 26). (shrink)

This article compares three models for conceptualizing the political and ethical challenges of contemporary genetics, genomics, and postgenomics. The three analytical approaches are referred to as the state-politics model, the biopolitical model, and the infopolitical model. Each of these models is valuable for different purposes. But comparing these models in terms of their influence in contemporary discussions, the first is by far the dominant approach, the second is gaining in importance, and the third is almost entirely neglected. The widespread neglect (...) of the infopolitical dimensions of genetic sciences focused by the third model is puzzling in light of the fact that genetics, genomics, and postgenomics are all pre-eminent information sciences. The infopolitical model thus aims to bring into clearer view the specific political and ethical problems engendered by this informational nature of the genetic sciences. This model offers a way of understanding how ethically-salient and politically-fraught conceptual assumptions can be embedded in informational architectures such as algorithms and the formats (or data structures) upon which they rely. (shrink)

The general idea of this investigation is to emphasize the elusiveness of the concept of terrorism and the pitfalls of the so-called “War on Terror” by way of confronting, roughly, the reflections made in the immediate following of 9/11 by Habermas and Derrida on the legacy of Enlightenment, globalization and tolerance, with Foucault’s concept of biopolitics seen as the modern political paradigm and Agamben’s understanding of “the state of exception” in the context of liberal democratic governments. The main argument (...) will state that the modern Western individual and the modern terrorist are in a way linked together as products of the same biopolitical network. So I shall argue that religious fundamentalism and international terrorism are not external factors to the Western civilization, nor even some radical late forms of ‘Counter-Enlightenment’ threatening the Western ‘way of life,’ but phenomena revealing what we could call, borrowing J. Derrida’s biological metaphor, a “crisis of autoimmunization” of Western neo-liberal democracies. The only long-term solution to the threat of global terrorism would have to involve the “deconstruction” of our common notion of tolerance and the experience of an unconditional hospitality that is actually the inversion of the terrorist action that is threatening us “from within,” according to Derrida. But we cannot reasonably hope for this radical change in our relationship to others unless we aren’t really trying to modify the relationship to the self that is prevalent in contemporary Western societies: a vision of us as self-encapsulated monads or ‘nuclear’ selves, for whom genuine community life is, at the most, only a nostalgic evocation of a past long gone, and the respect for the others, a strategic name for moral indifference. (shrink)

This chapter presents a new version of the theory of deliberative democracy, focusing on its specificity as a future genre, and based on arguments used to defend plausibility. Moral philosophy of ethical theories is applied in this context as a form of casuistics, involving probabilities, and not limited to case studies within the framework of applied ethics. The chapter then considers relationships between the sciences, scientific practices and ethics; the interweaving of facts and values; the quarrels that exist between coexisting (...) disciplines; the competing approaches of epistemic pluralism, in both inter‐ and intra‐disciplinary forms; and argumentative coexistence in interdisciplinary contexts. It outlines the possible solution pathways, notably that of dialogical co‐argumentation. The chapter explores the question of pluralism of ethical theories with a focus on relevant elements that may modify an evaluation. In France, the precautionary principle has been enshrined in the Constitution since 2005, within the framework of the Environment Charter. (shrink)

Primary health care is characterised by timely and appropriate health care access, delivered continuously over time to a specific population, providing a comprehensive service, with coordination of care for those that need it. Practitioners deal with a multiplicity of clinical issues within longitudinal relationships, embedded in the context of families and communities. We propose that these aspects of primary care have a bearing on how matters of decision making are considered and implemented. Further, the standard account of autonomous decision making (...) is not wholly adequate when applied to clinician–patient encounters in primary care. We add considerations of the impact of illness (however defined) and self-identity as also relevant to a more measured and full account. The context of primary care is quite different from that of secondary care. Although there are generalists who work in hospitals, we argue that this aspect and the other attributes of primary care generate special ethical considerations. One of these is how autonomy, or more fully, how respect for the principle of autonomy is considered and operationalised in community practice. In this study, we describe some theoretical aspects of autonomy and seek to apply, and challenge, these aspects in the context of clinical work in primary care. In doing so we will review the descriptors of primary care: why in essence it is different from other contexts of clinical work. (shrink)

This is my translation of Gadamer's 1990 lecture "The Diversity of Languages and Understanding of the World." "In his lecture, Gadamer presents his views of language and world in a distinctively hermeneutical key. For example, he emphasizes language as that which 'belongs to conversation.' That is, language as conversation helps to bring about understanding and involves the play of dialogical exchange. 'Language is not proposition and judgment; rather, it is what it is, only when it is question and answer.' Language (...) involves another; it is on-the-way [unterwegs] to another. In fact, when addressing his question—what does world mean—Gadamer clarifies that humans and world are intimately connected; the world is that in which we are 'in the midst' and 'understanding is understanding oneself in the world.' But we are also in-the-world with others, and understanding ourselves in the world, means to understand ourselves with others. Gadamer goes so far as to say that our self-understanding as achieved in relation to others, as well as our understanding of others, should be taken in a moral and political sense. That is, the other is not there as merely a means to our ends or to exploit. Rather, 'the other indicates a principal limit to our self-love and self-centeredness. This is a general moral problem. It is also a political problem.' He goes on to emphasize the difficult task of achieving genuine solidarity with those from different cultures. Such a task requires language as conversation, the back-and-forth of dialogical exchange in which we come to understand the other and the other comes to understand us. Again and again, Gadamer underscores the task that each of has in light of our pluralistic world “to learn to bridge and reconcile the distances and differences between us and that means that we respect, look after, care for the other, and give one other a new hearing.” In contrast with the story of the Tower of Babel in which the people sought a pseudo-unity or 'oneness' driven by a will to dominate, Gadamer embraces both cultural and linguistic diversity and warns against reducing these multiple horizons 'by any special contrivance of unity [Einheitsmechanik].' He encourages us to seek out the open spaces that arise in our interactions with one another, to resist the levelling of language that information technology tends toward, and to 'cultivate language in its most distinctive possibilities.' In our present age of disinformation warfare, which threatens democracies worldwide and is a direct challenge to truth and the possibility of a meaningful dialogue with others, we would do well to linger with Gadamer’s hermeneutical and ethical insights and contemplate how we might bring these insights to bear on the global and political crises that we face today—Russia’s war of aggression against Ukraine, our climate catastrophe, and ever new forms of technical sophistry and disinformation that seek to erode our trust in truth, reality, and language itself.". (shrink)

In this paper, we extend Michel Foucault’s final works on the ‘care of the self’ to an empirical examination of research practice in community-based research (CBR). We use Foucault’s ‘morality of behaviors’ to analyze interview data from a national sample of Canadian CBR practitioners working with communities affected by HIV. Despite claims in the literature that ethics review is overly burdensome for non-traditional forms of research, our findings suggest that many researchers using CBR have an ambivalent but ultimately productive (...) class='Hi'>relationship with institutional research ethics review requirements. They understand and use prescribed codes, but adapt them in practice to account for the needs of participating community members, members of their research teams and the larger communities with whom they work. Complying with ethics protocols was seen as only the beginning, a minimum standard; our research suggests that the real ethical work happens in the field, where CBR practitioners encounter community members in diverse public roles and must forge ethical consensus across communities. CBR represents an ethical terrain in which practitioners challenge themselves to work differently, and as a result they care for themselves—and others—in ways that often resist the propensity for domination through public health research.‘…there are different ways to “conduct oneself” morally, different ways for the acting individual to operate, not just as an agent, but as an ethical subject of action.’ (Foucault, 1985: 26). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Kant and the Possibility of Progress: From Modern Hopes to Postmodern Anxieties ed. by Paul T. Wilford and Samuel A. StonerBenedikt BrunnerPaul T. Wilford and Samuel A. Stoner, editors. Kant and the Possibility of Progress: From Modern Hopes to Postmodern Anxieties. Philadelphia: University of Pennsylvania Press, 2021. Pp. 328. Hardback, $65.00.Our present does not invite, let alone suggest, particularly optimistic expectations for the future. This volume, (...) edited by Paul Wilford and Samuel Stoner, not only analyzes the historical foundations of Kant's idea of progress but also explores contemporary reflections on such questions as the following: Do we still believe in the possibility of progress? And if not, why has this ability been lost? What about liberal democracy, which is contested from many sides?In addition to a lucid introduction, which clarifies the concepts of modernity and postmodernity, the volume assembles thirteen chapters. While the first seven chapters deal with the idea of progress in Kant, the remaining six contributions shed light on the history of that idea after Kant. Within the framework of this review, only selected articles can be discussed. In chapter 1, Oliver Sensen examines the idea of moral progress in the individual. In chapter 2, Kate Moran asks the fundamental question: should we believe in moral progress? According to Kant, the human being possesses "a duty to avoid despondency" (46). Following Kant, she encourages us not to go down the road of misanthropy as a consequence of one's own or others' moral failure, but "to be generous in our assessments of others" (46). In chapter 3, Jens Timmermann takes up this aspect again and illustrates clearly how complex Kant's concept of moral progress is. Moreover, he highlights that moral progress has a double meaning for Kant: "first in a fundamental change of priorities—privileging morality over self-interest—and then in an ever-closer approximation to a perfectionist ideal of virtue" (61). Like some of the other contributors to this volume, however, Timmermann remains rather vague regarding possible avenues for further research. Two other contributions deal specifically with Kant's relationship to religion. In chapter 5, Naomi Fisher asks how God, teleology, and progress are connected in the third Critique. She argues that in the 1790s, Kant made concrete new efforts to integrate different strands of his philosophy "and to develop a more unified view of the human being as free and natural" (93). Chapter 6 is a joint contribution by the two editors of this volume entitled "Realizing the Ethical Community." Their focus is on Kant's religious writings and their role in the context of a "Reformation of Culture." They notice—an observation as important as it is exciting—that Kant tempered his ambitious goal regarding the moral betterment of human beings with his ideas about radical evil. At the same time, Kant insisted that people must become aware of their duty to improve themselves.In the second section, Kant is brought into conversation with his contemporaries and some of his successors. In chapter 8, Karl Ameriks provides an overview of the relationship between history, progress, and autonomy in Kant, Herder, and beyond. In chapter 9, Richard L. Velkley analyzes the significance of language, embodiment, and the supersensual in Fichte. In chapter 10, Mark Alznauer examines the concept of philosophical history in Hegel.The volume concludes with three different but equally stimulating contributions. In chapter 11, Ryan S. Kemp argues that Kierkegaard "relocated" the concept of the Highest Good: "Unlike Kant, who regards happiness as realizable (if at all) only in an afterlife, Kierkegaard seems to think that the person who truly embraces the self-denial of Christian love, can, even now, receive the world in joy" (200). In this approach, Kierkegaard was clearly different from his predecessors in the German idealistic tradition. In chapter 12, entitled "Kant and Benjamin on Hope, History, and the Task of Interpretation," C. Allen [End Page 159] Speight shows that Walter Benjamin stands in Kant's tradition while also diverging from him in some important respects. From Kant's universalizing assumptions, especially in relation to progress, Benjamin moved "toward a distinctive, messianically influenced sense of time where interruption and immanent... (shrink)

Only recently have ethicists been invited into the clinical setting to offer recommendations about patient care decisions. This paper discusses this new role for ethicists from the perspective of content and process issues. Among content issues are the usual ethical dilemmas such as the aggressiveness of treatment, questions about consent, and alternative treatment options. Among process issues are those that relate to communication with the patient. The formal ethics consult is discussed, the steps taken in such a consult, and whether (...) there should be a fee charged. We conclude with an examination of the risks and benefits of formal ethics consults. (shrink)

The ethical features of citizenship in democratic societies have been explored from several perspectives. This account is based on the analysis of our condition as co-practitioners in civil society and aims to address the public role of religions and to include multiple forms of citizenship. Under conditions of pluralism, one’s involvement in cooperative practices is shaped and unsettled by the presence of co-practitioners who carry different self-understandings about the relationship between their beliefs and their social agency. Social cooperation (...) is threatened when these self-understandings come into conflict. The notion of postsecularism provides a valuable clue for better understanding this kind of conflict, thanks to its focus on how the self-understanding of religious and secular actors is affected by their co-implication in the same public space. Within this framework, I suggest that a reflective consideration of the practical cooperative relationships that ordinarily characterize our agency as actors of civil society may adequately ground a normative ethics of citizenship. This reflective awareness affects the self-understanding of both religious and secular citizens, and normatively points towards a disposition to cooperatively re-arrange and re-formulate one’s own beliefs and arguments in the light of the structural co-implication of one’s own belief with the beliefs of others. The basic duties of citizenship emerge from the implications of participating in a body of social practices that extends to different communities of practice at a local, national and global level. This ethics of citizenship is therefore not bound to membership in a specific political entity. (shrink)