In theory, a human rights framework should protect and guarantee the equal provision of care and rights of all people. In practice, however, the universality that underlies human rights is enacted through citizenship rights, which rely on the individual politically ‘belonging’ to a nation-state.

Although many studies have previously examined medicalisation, we add a new dimension to the concept as we explore how contemporary oncological medicine shapes the dying self as predominantly medical. Through an analysis of multiple case studies collected within a comprehensive cancer centre in Ontario, Canada, we examine how people with late‐stage cancer and their healthcare providers enacted the process of medicalisation through engaging in the search for oncological treatments, such as experimental drug trials, despite the incurability of their disease. The (...) seven cases included 20 interviews with patients, family, physicians and nurses, the analysis of 30 documents and 5 hr of field observation. A poststructural perspective informed our study. We propose that searching for life extension enacts medicalisation by shaping the dying person afflicted with terminal cancer into new medical subjectivities that are knowledgeable, active, entrepreneurial and curative. Participants initially took up medical thinking from the formal oncology system, but then began to apply and internalise medical rationalities to alter their personhood, thereby generating new curative possibilities for themselves. For people seeking life extension, the embodied and day‐to‐day experiences of suffering and being close to death became expressed and moderated in fundamentally medicalised terms. (shrink)

This study focuses on change strategies generated through a dialogical–reflexive–participatory process designed to improve the care of families of critically ill patients in an intensive care unit (ICU) using a participatory action research in a tertiary hospital in the Balearic Islands (Spain). Eleven professionals (representatives) participated in 11 discussion groups and five in‐depth interviews. They represented the opinions of 49 colleagues (participants). Four main change strategies were created: (i) Institutionally supported practices were confronted to make a shift from professional‐centered work (...) to a more inclusive, patient‐centered approach; (ii) traditional power relations were challenged to decrease the hierarchical power differences between physicians and nurses; (iii) consensus was built about the need to move from an individual to a collective position in relation to change; and (iv) consensus was built about the need to develop a critical attitude toward the conservative nature of the unit. The strategies proposed were both transgressive and conservative; however, when compared with the initial situation, they enhanced the care offered to patients' relatives and patient safety. Transforming conservative settings requires capacity to negotiate positions and potential outcomes. However, when individual critical capacities are articulated with a new approach to micropolitics, transformative proposals can be implemented and sustained. (shrink)

For decades, nursing as a discipline has tried to establish itself within the socio‐professional and the socio‐political arenas. To date, several theorists have attempted to thoroughly define the essence (ontology) of nursing while others have proposed means (syntax) to achieve this ‘collective’ objective. Considering that this preoccupation, rooted in essentialism, is pervasive in the nursing literature, our claim is that these quests should be criticized because they impede innovative and transdisciplinary approaches to nursing theory. Our criticism includes the perspective supported (...) by the so‐called ‘postmodern nursing theorists’. We argue that the oeuvre of some nursing postmodern scholars is as prescriptive and linear as the ones they critique. Like it was done before, the discourse of these thinkers perpetuates the status quo by excluding alternative forms of knowledge that cross the boundaries of the discipline of nursing. Using the work of Deleuze and Guattari, this paper proposes an alternative way to conceive the development of nursing knowledge, which, we think, could represent an alternative way to explore the discipline of nursing. (shrink)

MIRÓ M, GASTALDO D, NELSON S and GALLEGO G. Nursing Inquiry 2012; 19: 270–280 Spanish nursing under Franco: reinvention, modernization and repression (1956–1976)This article examines Spanish nursing during a critical 20‐year period (1956–76) when, under the dictatorial government of General Franco, nursing became the target of a modernization strategy. In the national standardized system of state‐run schools, the previously distinct nursing and midwifery programmes were merged into a new training programme which created the single professional denomination of ATS–Ayudante Técnico (...) Sanitario (Technical Sanitary Assistant). Under the leadership of medicine, and with the blessing of the Catholic Church and the Sección Femenina (Women’s Section of the Falangist Party), nursing was positioned as feminized and subordinate to medicine, a predominantly male profession in mid‐twentieth century Spain. This article discusses this crucial phase of Spanish nursing history by focusing on one influential historical document (published in 1956), Professional Moral Orientation for the Sanitary Technical Assistants, a nursing textbook on professional morals for first‐year nursing students written by Rosamaria Miranda, a Catholic nun and a trained nurse. Our analysis reveals that gender‐related and technical discourses concerning disciplinary and pastoral power relations presented in this textbook legitimate the core beliefs of Franquism put forward by the politically powerful women’s branch of the ruling Falangist Party in mid‐twentieth century Spain. (shrink)

There are those who would argue that, recently, the profession of nursing has made a radical shift, while others believe that a schism has been created among both scholars and clinicians as a result of the emerging dominance of the evidence‐based nursing movement. This paper offers a philosophical critique of this movement using Gilles Deleuze and Felix Guattari’s concept of schizoanalysis. As a conclusion, the authors posit that nursing professionals maintain a stance of academic freedom of thought and scientific integrity (...) through the acceptance of multiplicity, diversity, and polyvocality, and by challenging with politically charged concepts the totalizing perspectives that often spread through the profession/discipline of nursing. (shrink)

Some philosophers have argued that Aristotle’s view of habituation gives rise to a ‘paradox of moral education.’ The inculcation of habit, they contend, seems antithetical to the cultivation of virtue. I argue that this alleged paradox arises from significant misunderstandings of Aristotle’s view. Habit formation need not be at odds with the development of the kinds of intelligent, reflective capacities required for virtue. Indeed, Aristotle seems right to insist on an important role for habit in the cultivation of virtue. I (...) suggest that habit formation is part of the story of how the virtuous come to see the world aright. (shrink)

A new research area linked to ethics, virtues, and morality is servant leadership. Scholars are currently seeking publication outlets as critics debate whether this new leadership theory is significantly distinct, viable, and valuable for organizational success. The aim of this study was to identify empirical studies that explored servant leadership theory by engaging a sample population in order to assess and synthesize the mechanisms, outcomes, and impacts of servant leadership. Thus, we sought to provide an evidence-informed answer to how does (...) servant leadership work, and how can we apply it? We conducted a systematic literature review (SLR), a methodology adopted from the medical sciences to synthesize research in a systematic, transparent, and reproducible manner. A disciplined screening process resulted in a final sample population of 39 appropriate studies. The synthesis of these empirical studies revealed: (a) there is no consensus on the definition of servant leadership; (b) servant leadership theory is being investigated across a variety of contexts, cultures, and themes; (c) researchers are using multiple measures to explore servant leadership; and (d) servant leadership is a viable leadership theory that helps organizations and improves the well-being of followers. This study contributes to the development of servant leadership theory and practice. In addition, this study contributes to the methodology for conducting SLRs in the field of management, highlighting an effective method for mapping out thematically, and viewing holistically, new research topics. We conclude by offering suggestions for future research. (shrink)

Este artigo discute como os clipes Mandume, Boa Esperança e Eminência Parda do rapper de Emicida, realizam um retorno à ferida colonial e apontam opacidades históricas, opressões e exclusões daí derivadas, como forma de conduzir a uma releitura afetiva e resistente do/no tempo e instigar ações estéticas de re-existência. Para isso, realizamos uma análise audioverbovisual dos clipes procurando observar a construção desse discurso a partir de três categorias analíticas: retorno memorialístico, corporalidade desumanizada e vida livre da violência e da morte.

Prior researchers have studied individual components of a theoretical decision-making model. This paper presents the results of a more complete study of the model components and presents limited support of theory. The study examines the relative importance of regulatory, organizational, and personal constructs on an individual''s ethical sensitivity. Auditors from the major international accounting firms, located in two southeastern cities, are surveyed. Structural equation modeling is used to allow for the simultaneous evaluation of the three constructs of interest. The results (...) indicate that the regulatory and organizational constructs are negatively correlated with the personal experience construct. The three constructs are not significant causal factors on ethical sensitivity. This result may be due to the manner in which ethical sensitivity is typically measured or may indicate that the complexity of the ethical decision-making process is not fully captured in the theoretical models. Thus, the models suggested in the prior literature and the results presented in prior studies of the individual components may need to be reconsidered. (shrink)

An important contribution of Alan Patten’s Equal Recognition is the conception of neutrality that grounds his defence of minority cultural rights. Built in to his conception of neutrality of treatment is a notion of ‘fairness’ whose effect is to provide an upfront, across the board limitation on the demands cultural minorities may legitimately make on the rest of society. There must be limits on the duty to accommodate, but it obscures more than it illuminates to build this into the content (...) of the right to equal recognition itself. We see more clearly what is at stake in these conflicts by articulating the value of self-determination independently and taking account of necessary limits to its satisfaction as part of a second-stage analysis of what duties may be claimed and against whom. Familiar principles of discrimination law exemplify this alternative model. This presents the interest in self-determination more robustly, while acknowledging that the claims of duty arising out of it are defeasible. The result is a more flexible and nuanced exploration of the complex moral issues involved when fundamental interests clash. (shrink)

Este trabalho busca discutir, a partir de dados obtidos em trabalho de campo etnográfico coletivo multissituado, elementos de uma cultura comunicacional dos torcedores no Brasil. Tradicionalmente tratados como coletivo, massa, povo ou multidão pelos meios de comunicação tradicionais, a abordagem proposta evidencia, nas falas dos próprios torcedores, uma compreensão sofisticada do universo afetivo, familiar, econômico e político que envolve o torcer por uma equipe de futebol no Brasil contemporâneo.

Job burnout, organizational commitment, and work environment continue to be important areas of research to be studied in the realm of company employment and employee retention. Job burnout is the state of physical and emotional exhaustion and perceiving one’s profession as dull or overwhelming. Meanwhile, organizational commitment refers to the company’s attitude towards the organization and their employees, encompassing loyalty, moral responsibility, and their willingness to work. And lastly, work environment provides opportunities for employees to establish connections, develop skills, and (...) maximize their full potential in performing tasks. For the current study, researchers utilized descriptive-correlational research design to investigate the influence of Work Environment towards the job burnout and organizational commitment of BPO agents in selected companies in Bulacan, Philippines. Hence, Danish Psychosocial Work Environment Questionnaire (DPQ), Maslach Burnout Inventory - General Survey (MBI-GS), and the Three-Dimensional Model of Organizational Commitment Scale (ACS, NCS, CCS) were employed to properly assess the study's objectives. Multiple Linear Regression Analysis was performed to analyze the collected data. Based on the analysis, findings show that work environment has no significant influence on the job burnout and organizational commitment of BPO Agents. Furthermore, the results of this study were thoroughly evaluated, leading to an in-depth discussion. Based on the findings, recommendations were made to benefit the stakeholders of the study and contributeto the existing body of knowledge. (shrink)

Over several articles, John McDowell sketches an analogy between virtue and perception, whereby the virtuous person sees situations in a distinctive way, a way that explains her virtuous behavior. Central to this view is his notion of silencing, a psychological phenomenon in which certain considerations fail to operate as reasons in a virtuous person's practical reasoning. Despite its influence on many prominent virtue ethicists, McDowell's ‘silencing view’ has been criticized as psychologically unrealistic. In this article, I defend a silencing view (...) of practical reasoning. I argue that the phenomenon of silencing has a narrower scope than is typically acknowledged. As a result, the view does not require the virtuous to be detached, unfeeling, or unpalatably stoic. Furthermore, I offer a psychologically plausible interpretation of McDowell's claim that the virtuous see situations in a distinctive sort of way. The salient fact at which the virtuous arrive in their view of a situation should be understood, I argue, in terms of subjective construal. (shrink)

Mediating the meaning of evidence through epistemological diversity Nursing's disciplinary recognition of ‘multiple ways of knowing’ reflects an epistemological diversity that supports nursing praxis. Nursing as praxis offers a conceptual way to explore what it is about the interface of practice, knowledge and evidence in nursing that distinguishes us as a discipline. I suggest that the relationship between evidence and knowledge is defined and mediated by the same epistemological diversity that supports nursing as praxis. Just as the meaning and truth‐value (...) of evidence is evaluated from within the body of existing disciplinary knowledge, new evidence may prompt an evaluation of the meaning and truth‐value of extant nursing knowledge. Nursing practice that relies on scientific evidence as a singular basis of practice knowledge is susceptible to exploitation by the diverse agendas operating within an ideology of evidence‐based practice and the healthcare system. Mediating the meaning of evidence for nursing practice through acknowledgement of the diverse epistemologies that underpin nursing knowledge will contribute to a disciplinary‐specific definition of what constitutes evidence for nursing, and will better direct how evidence is integrated into a disciplinary body of knowledge. (shrink)

Clinical ethicists encounter the most emotionally eviscerating medical cases possible. They struggle to facilitate resolutions founded on good reasoning embedded in compassionate care. This book fills the considerable gap between current texts and the continuing educational needs of those actually facing complex ethics consultations in hospital settings. 28 richly detailed cases explore the ethical reasoning, professional issues, and the emotional aspects of these impossibly difficult consultations. The cases are grouped together by theme to aid teaching, discussion and professional growth. The (...) cases inform any reader who has a keen interest in the choices made in real-life medical dilemmas as well as the emotional cost to those who work to improve the situations. On a more advanced level, this book should be read by ethics committee members who participate in ethics consultations, individual ethics consultants, clinicians who seek education about complex clinical ethics cases, and bioethics students. (shrink)

BackgroundDecision-making in initiating life-sustaining health technology is complex and often conducted at time-critical junctures in clinical care. Many of these decisions have profound, often irreversible, consequences for the child and family, as well as potential benefits for functioning, health and quality of life. Yet little is known about what influences these decisions. A systematic review of reasoning identified the range of reasons clinicians give in the literature when initiating technology dependence in a child, and as a result helps determine the (...) range of influences on these decisions.MethodsMedline, EMBASE, CINAHL, PsychINFO, Web of Science, ASSIA and Global Health Library databases were searched to identify all reasons given for the initiation of technology dependence in a child. Each reason was coded as a broad and narrow reason type, and whether it supported or rejected technology dependence.Results53 relevant papers were retained from 1604 publications, containing 116 broad reason types and 383 narrow reason types. These were grouped into broad thematic categories: clinical factors, quality of life factors, moral imperatives and duty and personal values; and whether they supported, rejected or described the initiation of technology dependence. The majority were conceptual or discussion papers, less than a third were empirical studies. Most discussed neonates and focused on end-of-life care.ConclusionsThere is a lack of empirical studies on this topic, scant knowledge about the experience of older children and their families in particular; and little written on choices made outside ‘end-of-life’ care. This review provides a sound basis for empirical research into the important influences on a child’s potential technology dependence. (shrink)

Radical Feminism Today offers a timely and engaging account of exactly what feminism is, and what it is not. Author Denise Thompson questions much of what has come to be taken for granted as `feminism' and points to the limitations of implicitly defining feminism in terms of `women', `gender', `difference' or `race//gender//class'. She challenges some of the most widely accepted ideas about feminism and in doing so opens up a number of hitheto closed debates, allowing for the possibility of (...) moving those debates further. (shrink)

A central trend in the development of discrimination law, in every jurisdiction, has been the movement from a requirement of intention to ground a complaint to the recognition as actionable of indirect or adverse effect discrimination. Initially, liability for discrimination was circumscribed very narrowly, requiring a form of intention that was tantamount to malice. The practical consequences of this narrow conception were apparent early on, and those concerned about them have long been agitating, with some success, for a reading or (...) redrafting of anti-discrimination statutes that would yield broader liability. Advocacy in the discrimination law context has tended to swing wildly between two extremes -- from a virtually exclusive focus on the moral blameworthiness of the defendant to an attempt to focus solely on the effects of discrimination on its victims. This article seeks to reexamine the gradual expansion of liability in discrimination law from the perspective of the key conceptual elements of liability in tort law in order to reexamine the normative underpinnings of this area of law. Viewed from a tort perspective, the enlargement of the scope of discrimination law can best be understood as resulting from an implicit expansion of the concept of fault appropriate to this context of human interaction, a change linked to an expanding conception of the human interests that discrimination law protects from infringement. From its beginnings, discrimination law implicitly recognized that deliberately refusing to contract with others out of ill will or prejudice toward an important aspect of identity such as race or sex constituted an affront to human dignity that could not be justified by the value of freedom of contract. The expansion of liability over time reflects an expansion of the concept of human dignity bound up with fair access to important opportunities and due consideration of the needs and interests of differently situated groups in the design of important social institutions. This conception of dignity constructs it as an objective interest that can be affected by implicitly discriminatory behavior as well as by conduct motivated by prejudice, requiring more robust justification than the mere claim to liberty. This approach can explain many of the advances in modern discrimination law without resorting to end-state distributive principles. (shrink)

There are significant challenges to developing a neo-Aristotelian account of a virtue of patience. First, on an Aristotelian understanding, virtue is both instrumentally good and good in itself. Yet exclusively instrumental views of patience are pervasive in the philosophical literature. Furthermore, these instrumental views present patience as more like a psychological skill than a virtue of character. Skills, however, can be misused. If patience is to be a virtue, its account must entail goodness in its possessor. Finally, there is the (...) challenge of specifying a field, or sphere of concern, for patience, given the diversity of phenomena that we tend to attribute to it. I propose a thin account of a virtue of patience that, I contend, can meet these challenges. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:diacritics 30.2 (2000) 88-112 [Access article in PDF] Milton's Aesthetics Of Eating Denise Gigante It is not a little curious that, with the exception of Ben Jonson (and he did not speak gravely about it so often), the poet in our own country who has written with the greatest gusto on the subject of eating is Milton. He omits none of the pleasures of the palate, great or (...) small. In his Latin poems, when young, he speaks of the pears and chestnuts which he used to roast at the fire with his friend Diodati. Junkets and other "country-messes" are not forgotten in his "Allegro." The simple Temptation in the Wilderness, "Command that these stones be made bread" (which was quite sufficient for a hunger that had fasted "forty days"), is turned, in Paradise Regained, with more poetry than propriety, into the set out of a great feast, containing every delicacy in and out of season. The very "names" of the viands, he says, were "exquisite." And in Paradise Lost, Eve is not only described as being skilful in paradisaical cookery ("tempering dulcet creams"), but the angel Raphael is invited to dinner, and helped by his entertainers to a series of tid-bits and contrasted relishes--Taste after taste, upheld with kindliest change. --Leigh Hunt, "Eating Songs" The title of an old play gives us a direct taste and surmise of its inwards, as the first lines of the Paradise Lost smack of the great Poem. --John Keats, "On 'Retribution, or the Chieftain's Daughter'" That Milton's Romantic readers should invoke the "taste" of his epic poetry suggests an awareness beyond the anecdotal. For as this essay will show, Milton complicates the category of physiological taste in such a manner as to form the ground for the possibility of aesthetic taste, which emerges as a distinct discourse in the early years of the eighteenth century. This is not to say that Milton is the only source for this dubious meaning-in-transition. But precisely how, prior to the interventions of Shaftesbury, Hutcheson, Hume, and the entire tradition of post-Miltonic theorists of taste, is one to read Adam's darkly sardonic postlapsarian remark: "Eve, now I see thou art exact of taste... And Palate call judicious" [PL IX.1017-20]? Critics have observed Milton's "ruthless and relentless pressure on 'taste,'" the fact that the word and its variants appear thirty times in Book IX of Paradise Lost alone [Ricks 69]. What I would like to suggest is that just as Milton is a seminal figure for the eighteenth-century aesthetic preoccupation with the sublime, 1 he is theoretically situated at the origins of the more generic thing called taste as well. [End Page 88]Of course Milton himself was aware of the epistemological implications of taste, whereby the Latin sapere can mean both "to taste" and "to know." 2 The fruit whose "mortal taste" was the source of all our woe did, after all, grow on the tree of knowledge, knowingly described by Satan as "precious of all Trees / In Paradise, of operation blest / To Sapience" [PL I.2, IX.795-97]. So too, when Adam calls Eve "exact of taste," he adds "of Sapience no small part" [PL IX.1018]. Throughout Paradise Lost and Paradise Regained, Milton plays with the epistemological connotation of taste, incorporating it even into the 1671 companion piece of the latter, Samson Agonistes, whose blind hero declares, "The way to know were not to see but taste" [1091]. At the time Milton was writing, however, taste was philosophically connected not only to knowledge and pleasure, but to morality as well. At the origins of the British empirical discourse of taste, Anthony Ashley Cooper, third Earl of Shaftesbury, inheriting this link between epistemology, aesthetics, and ethics, inquires: "Will it not be found... that what is beautiful is... true; and what is at once both beautiful and true is, of consequence, agreeable and good?" [2: 268-69]. For Milton as for Shaftesbury, the beautiful was the true was the good, and access to these ideals was bound up with the philosophic complexity... (shrink)