The Covid‐19 pandemic has highlighted many of the difficult ethical issues that health care professionals confront in caring for patients and families. The decisions such workers face on the front lines are fraught with uncertainty for all stakeholders. Our focus is on the implications for nurses, who are the largest global health care workforce but whose perspectives are not always fully considered. This essay discusses three overarching ethical issues that create a myriad of concerns and will likely affect nurses globally (...) in unique ways: the safety of nurses, patients, colleagues, and families; the allocation of scarce resources; and the changing nature of nurses’ relationships with patients and families. We urge policy‐makers to ensure that nurses’ voices and perspectives are integrated into both local and global decision‐making so as to minimize the structural injustices many nurses have faced to date. Finally, we urge nurses to seek sources of support throughout this pandemic. (shrink)

Social work is a contested tradition, torn between the demands of social governance and autonomy. Today, this struggle is reflected in the division between the dominant, neoliberal agenda of service provision and the resistance offered by various critical perspectives employed by disparate groups of practitioners serving diverse communities. Critical social work challenges oppressive conditions and discourses, in addition to addressing their consequences in individuals’ lives. However, very few recent critical theorists informing critical social work have advocated revolution. A challenging exception (...) can be found in the work of Cornelius Castoriadis (1922–97), whose explication of ontological underdetermination and creation evades the pitfalls of both structural determinism and post-structural relativism, enabling an understanding of society as the contested creation of collective imaginaries in action and a politics of radical transformation. On this basis, we argue that Castoriadis’s radical-democratic revisioning of revolutionary praxis can help in reimagining critical social work’s emancipatory potential. (shrink)

This article seeks to explicate one form of technical rationality (ie the technological development of robotics) in social work education and practice. As advances in robotics evolve, questions are raised about the role of technicist education in reducing social work practice to a set of tasks that are repeatable, formulaic and linear (ie tasks that robots are capable of performing). We conduct a critical synthesis of the literature to explore how these parallel processes potentially create a seamless transition for social (...) robots to replace the human social work workforce. Our analysis suggests that social workers need to reclaim a broader understanding of social work education and practice if we intend to retain human social work practitioners into the future. We argue that this is vital because critical social work practitioners are more capable than robots of meeting the espoused social justice values of social work. (shrink)

The Routledge Handbook of Critical Pedagogies for Social Work traverses new territory by providing a cutting-edge overview of the work of classic and contemporary theorists, in a way that expands their application and utility in social work education and practice; thus, providing a bridge between critical theory, philosophy, and social work. Each chapter showcases the work of a specific critical educational, philosophical and/or social theorist including: Henry Giroux, Michel Foucault, Cornelius Castoriadis, Herbert Marcuse, Paulo Freire, bell hooks, Joan Tronto, Iris (...) Marion Young, Karl Marx, Antonio Gramsci and many others to elucidate the ways in which their key pedagogic concepts can be applied to specific aspects of social work education and practice. The text exhibits a range of research-based approaches to educating social work practitioners as agents of social change. It provides a robust and much needed, alternative paradigm to the technique-driven ‘conservative revolution’ currently being fostered by neoliberalism in both social work education and practice. The volume will be instructive for social work educators who aim to teach for social change, by assisting students to develop counter-hegemonic practices of resistance and agency, and reflecting on the pedagogic role of social work practice more widely. The volume holds relevance for both postgraduate and undergraduate/qualifying social work and human services courses around the world. (shrink)

The question of education for democratic ‘empowerment and liberation’, and how this might guide pedagogic practice is seldom raised and extremely challenging for social work education today. This chapter takes up the proposition that social work, through its educational practices, ‘can’ deliver on its promise of ‘democratic practice’ if democracy is understood as a process and not a predefined product. We argue that such a process and its embodiment in institutions cannot exist without the formation of radically democratic subjects, people (...) (including social workers) capable of questioning dominant social forms and of creating new forms and practices. Accordingly, this chapter explores the educational implications for social work of the work of the revolutionary theorist, Cornelius Castoriadis (1921–1997). Castoriadis’ philosophy accords a crucial role to democratic pedagogy (paideía) as an essential form of praxis in the creation of a radically democratic, egalitarian and sustainable society. In particular, we examine his idea (against (neo)liberal individualisation) that ‘autonomy’ is simultaneously an individual and social project that begins in, and is always dependent upon, individual and collective self-reflection. This argument is illustrated by examples from the authors’ classroom experiences of teaching both critical reflection and critical social theory to social work students in Australian universities, on the premise that both are indispensable in social work education as a democratic practice for ‘empowerment and liberation’. The chapter outlines a brief discussion of Castoriadis, his main ideas and the pedagogic dimensions of his philosophy before bringing the latter to bear on the authors’ teaching experiences. (shrink)

After discussing de Sousa's view of emotion in akrasia, I suggest that emotions be viewed as nonconceptual perceptions of value (see Tappolet 2000). It follows that they can render intelligible actions which are contrary to one's better judgment. An emotion can make one's action intelligible even when that action is opposed by one's all-things-considered judgment. Moreover, an akratic action prompted by an emotion may be more rational than following one's better judgement, for it may be the judgement and not the (...) perception which is in error. By contrast, "cool" akrasia is genuinely puzzling; it is not clear whether it exists. (shrink)

Stem cell research is the product of cumulative, integrated effort between and within laboratories and disciplines. The many collaborative steps that lead to that special “Eureka moment”, when something that has been a puzzle perhaps for years suddenly become clear, is among the greatest pleasures of a scientific career. In this essay, the serendipitous pathway from first acquaintance with pluripotent stem cells to advanced cardiovascular models that emerged from studying development and disease will be described. Perhaps inspiration for later generations (...) of stem cell researchers simply to follow whatever they find interesting. (shrink)

The debate about the ethical implications of Artificial Intelligence dates from the 1960s :741–742, 1960; Wiener in Cybernetics: or control and communication in the animal and the machine, MIT Press, New York, 1961). However, in recent years symbolic AI has been complemented and sometimes replaced by Neural Networks and Machine Learning techniques. This has vastly increased its potential utility and impact on society, with the consequence that the ethical debate has gone mainstream. Such a debate has primarily focused on principles—the (...) ‘what’ of AI ethics —rather than on practices, the ‘how.’ Awareness of the potential issues is increasing at a fast rate, but the AI community’s ability to take action to mitigate the associated risks is still at its infancy. Our intention in presenting this research is to contribute to closing the gap between principles and practices by constructing a typology that may help practically-minded developers apply ethics at each stage of the Machine Learning development pipeline, and to signal to researchers where further work is needed. The focus is exclusively on Machine Learning, but it is hoped that the results of this research may be easily applicable to other branches of AI. The article outlines the research method for creating this typology, the initial findings, and provides a summary of future research needs. (shrink)

In this essay, I examine Robert Boyle's strategies for making imperceptible entities accessible to the senses. It is well known that, in his natural philosophy, Boyle confronted the challenge of making imperceptible particles of matter into objects of sensory experience. It has never been noted, however, that Boyle confronted a strikingly similar challenge in his natural theology – he needed to make an equally imperceptible God accessible to the senses. Taking this symmetrical difficulty as my starting point, I propose a (...) new approach to thinking about the interconnections between Boyle's natural philosophy and natural theology. For the most part, studies of science and religion in the early modern period work by seeking out the influence of explicitly stated religious beliefs on scientific ideas. I argue, by contrast, that we need to focus on Boyle's representational practices, using his attempts to represent imperceptible entities as a means of uncovering metaphysical and theological presuppositions that he did not always articulate when stating his religious beliefs. With new interpretations of bothA Discourse of Things Above Reason(1681) andSome Physico-Theological Considerations about the Possibility of the Resurrection(1675), I show that there were crucial similarities between Boyle's practices for representing both God and atoms. I go on to show, moreover, that Boyle used these practices to enact an ontological stance at odds with one of his most important professed beliefs. (shrink)

In spite of strengthened financial regulation, ethical concern continues about the promotion and distribution of financial services in Britain, including savings and investment products. Greater ethical attention needs to be paid to products, price, promotion and distribution. The authors are all faculty members of the School of Management and Finance, University of Nottingham, University Park, Nottingham NG7 2RD, UK. Correspondence should be addressed to Dr Ennew. Alison McGregor gratefully acknowledges funding provided by the Association of British Insurers.

As the range of potential uses for Artificial Intelligence, in particular machine learning, has increased, so has awareness of the associated ethical issues. This increased awareness has led to the realisation that existing legislation and regulation provides insufficient protection to individuals, groups, society, and the environment from AI harms. In response to this realisation, there has been a proliferation of principle-based ethics codes, guidelines and frameworks. However, it has become increasingly clear that a significant gap exists between the theory of (...) AI ethics principles and the practical design of AI systems. In previous work, we analysed whether it is possible to close this gap between the ‘what’ and the ‘how’ of AI ethics through the use of tools and methods designed to help AI developers, engineers, and designers translate principles into practice. We concluded that this method of closure is currently ineffective as almost all existing translational tools and methods are either too flexible or too strict. This raised the question: if, even with technical guidance, AI ethics is challenging to embed in the process of algorithmic design, is the entire pro-ethical design endeavour rendered futile? And, if no, then how can AI ethics be made useful for AI practitioners? This is the question we seek to address here by exploring why principles and technical translational tools are still needed even if they are limited, and how these limitations can be potentially overcome by providing theoretical grounding of a concept that has been termed ‘Ethics as a Service.’. (shrink)

Aims:The aim of this narrative synthesis was to explore the necessary and sufficient conditions required to define moral distress.Background:Moral distress is said to occur when one has made a moral judgement but is unable to act upon it. However, problems with this narrow conception have led to multiple redefinitions in the empirical and conceptual literature. As a consequence, much of the research exploring moral distress has lacked conceptual clarity, complicating attempts to study the phenomenon.Design:Systematic literature review and narrative synthesis (November (...) 2015–March 2016).Data sources:Ovid MEDLINE®In-Process & Other Non-Indexed Citations 1946–Present, PsycINFO®1967–Present, CINAHL®Plus 1937–Present, EMBASE 1974–24 February 2016, British Nursing Index 1994–Present, Social Care Online, Social Policy and Practice Database (1890–Present), ERIC (EBSCO) 1966–Present and Education Abstracts.Review methods:Literature relating to moral distress was systematically retrieved and subjected to relevance assessment. Narrative synthesis was the overarching framework that guided quality assessment, data analysis and synthesis.Results:In all, 152 papers underwent initial data extraction and 34 were chosen for inclusion in the narrative synthesis based on both quality and relevance. Analysis revealed different proposed conditions for the occurrence of moral distress: moral judgement, psychological and physical effects, moral dilemmas, moral uncertainty, external and internal constraints and threats to moral integrity.Conclusion:We suggest the combination of (1) the experience of a moral event, (2) the experience of ‘psychological distress’ and (3) a direct causal relation between (1) and (2) together are necessary and sufficient conditions for moral distress. (shrink)

In July 2017, China’s State Council released the country’s strategy for developing artificial intelligence, entitled ‘New Generation Artificial Intelligence Development Plan’. This strategy outlined China’s aims to become the world leader in AI by 2030, to monetise AI into a trillion-yuan industry, and to emerge as the driving force in defining ethical norms and standards for AI. Several reports have analysed specific aspects of China’s AI policies or have assessed the country’s technical capabilities. Instead, in this article, we focus on (...) the socio-political background and policy debates that are shaping China’s AI strategy. In particular, we analyse the main strategic areas in which China is investing in AI and the concurrent ethical debates that are delimiting its use. By focusing on the policy backdrop, we seek to provide a more comprehensive and critical understanding of China’s AI policy by bringing together debates and analyses of a wide array of policy documents. (shrink)

"First Published in 1998, Routledge is an imprint of Taylor & Francis, an informa company.".

BackgroundThe phenomenon of ‘moral distress’ has continued to be a popular topic for nursing research. However, much of the scholarship has lacked conceptual clarity, and there is debate about what it means to experience moral distress. Moral distress remains an obscure concept to many clinical nurses, especially those outside of North America, and there is a lack of empirical research regarding its impact on nurses in the United Kingdom and its relevance to clinical practice.Research aimTo explore the concept of moral (...) distress in nursing both empirically and conceptually.MethodologyFeminist interpretive phenomenology was used to explore and analyse the experiences of critical care nurses at two acute care trauma hospitals in the United Kingdom. Empirical data were analysed using Van Manen’s six steps for data analysis.Ethical considerationsThe study was approved locally by the university ethics review committee and nationally by the Health Research Authority in the United Kingdom.FindingsThe empirical findings suggest that psychological distress can occur in response to a variety of moral events. The moral events identified as causing psychological distress in the participants’ narratives were moral tension, moral uncertainty, moral constraint, moral conflict and moral dilemmas.DiscussionWe suggest a new definition of moral distress which captures this broader range of moral events as legitimate causes of distress. We also suggest that moral distress can be sub-categroised according to the source of distress, for example, ‘moral-uncertainty distress’. We argue that this could aid in the development of interventions which attempt to address and mitigate moral distress.ConclusionThe empirical findings support the notion that narrow conceptions of moral distress fail to capture the real-life experiences of this group of critical care nurses. If these experiences resonate with other nurses and healthcare professionals, then it is likely that the definition needs to be broadened to recognise these experiences as ‘moral distress’. (shrink)

Content skepticism about practical reason is doubt about the bearing of rational considerations on the activities of deliberation and choice. Motivational skepticism is doubt about the scope of reason as a motive. Some people think that motivational considerations alone provide grounds for skepticism about the project of founding ethics on practical reason. I will argue, against this view, that motivational skepticism must always be based on content skepticism. I will not address the question of whether or not content skepticism is (...) justified. I want only to establish the fact that motivational skepticism has no independent force. (shrink)

There has been increasing debate in recent years about the conceptualization of moral distress. Broadly speaking, two groups of scholars have emerged: those who agree with Jameton’s ‘narrow definition’ that focuses on constraint and those who argue that Jameton’s definition is insufficient and needs to be broadened. Using feminist empirical bioethics, we interviewed critical care nurses in the United Kingdom about their experiences and conceptualizations of moral distress. We provide our broader definition of moral distress and examples of data that (...) both challenge and support our conceptualization. We pre‐empt and overcome three key challenges that could be levelled at our account and argue that there are good reasons to adopt our broader definition of moral distress when exploring prevalence of, and management strategies for, moral distress. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.1 (2002) 87-90 [Access article in PDF] Phenomenological and Biological Psychiatry:Complementary or Mutual? James Morley Keywords: phenomenology, psychiatry, psychoanalysis, ontology. We feel that even if all possible scientific questions be answered the problems of life have still not been touched at all. (Witgenstein, Tractatus, 6.52) IF ONE WAS TO PERFORM a thought experiment by imagining a scientifically explained universe, how would this explained universe (...) resolve my issues of value and meaning? Would it help me to live a better life? In one sentence, Witgenstein expressed exactly the issues dividing, and defining, the phenomenological and biophysical approaches to psychiatry. (Natural) scientific questions are concerned with relations of physical causality while phenomenology is aimed at the problems of life, i.e., the elucidation of lived personal meanings.Clarifying the relation between phenomenology and the general psychiatric literature is clearly a significant undertaking. At this juncture in the history of psychiatry where the biophysical model is so dominant, the authors' efforts are especially welcome, as I wholeheartedly appreciate, and thank the authors for this endeavor. I only wish to explicate a few issues latent within the article and perhaps add a few supportive points. Explicitly or implicitly, the need for phenomenology in psychiatry is long enduring and will always persist (Ellenberger 1981, 1993). The integration of phenomenology with general psychiatric practice would certainly serve the needs of patients and society generally. But, in the present state of affairs where the biological model is so preeminent, a full accounting of the dramatic divergences between the two approaches is necessary if there is to be authentic dialogue between them.Essentially, I want to stress that phenomenology and natural science medicine are genuinely distinct paradigms for construing reality and organizing knowledge. As distinct scientific paradigms, each one is holistically self-contained. Like soap bubbles, if pushed together too forcefully one or the other may burst. In this case, it is more likely that the smaller, less prevalent paradigm would burst by becoming absorbed into the more dominant paradigm. I believe that this is precisely the risk when phenomenology is introduced to conventional psychiatry as "complementary." Whereas one could hardly object to any application of empathy and understanding toward the experiences of patients, it would be tragic if the [End Page 87] full philosophical power of phenomenology were to be overlooked in favor of its mere utility as a preliminary stage of diagnosis and assessment, a framework for bedside manners, or worst of all, an appendage to neuroscience or pharmacology. This would not be phenomenology but the very symptomatology that the authors have has so clearly distinguished from true phenomenology.This equation of phenomenology with symptomatology is exactly the misunderstanding that the authors so effectively address. However, I would hesitate to join the authors' optimism in regard to phenomenology's potential complementary role to conventional psychiatric practice. Furthermore, in the process of paradigm mix, certain constituents of each paradigm may be taken out of context and the strength of each paradigm thus diluted. For example, the very power of the experimental method is its reduction of phenomena to measurable variables that can be altered in order to discern causality. Unmeasurable variables detract form the rigor of this entire approach. Then on the other hand, phenomenological empathy is only possible within a standpoint that is severed from the causal thinking of experimental science. This is the holistic perceptual shift that cannot be accomplished when one only appends phenomenological insights to an otherwise materialist approach to psychiatry. Thus, it is not at all clear how one can be both phenomenological and nonphenomenologically natural scientific. Instead of positioning phenomenology as a potential complimentary component of natural-science psychiatry, both world views need to be examined, on their own terms, in a framework of mutuality.Empathy or the understanding of other peoples subjective experience is indeed an essential component of the application of phenomenology to clinical assessment and especially therapeutic treatment. But, to limit phenomenology to this theme alone may not honor the profoundly radical character of this paradigm. As the authors point out, phenomenology asks the practitioner to... (shrink)

Aristotle believes that an agent lacks virtue unless she enjoys the performance of virtuous actions, while Kant claims that the person who does her duty despite contrary inclinations exhibits a moral worth that the person who acts from inclination lacks. Despite these differences, this chapter argues that Aristotle and Kant share a distinctive view of the object of human choice and locus of moral value: that what we choose, and what has moral value, are not mere acts, but actions: acts (...) done for the sake of ends. Morally good actions embody a kind of intrinsic value that inspires us to do them from duty (in Kant) or for the sake of the noble (in Aristotle). The chapter traces the difference in their attitudes about doing one's duty with pleasure to a difference in their attitudes towards pleasure itself: Aristotle sees it as a perception of the good, while Kant thinks of it as mere feeling. (shrink)

Feminism and Ecological Communities presents a bold and passionate rethinking of teh ecofeminist movement. It is one of the first books to acknowledge the importance of postmodern feminist arguments against ecofeminism whilst persuasively preseenting a strong new case for econolocal feminism. Chris J.Cuomo first traces the emergence of ecofeminism from the ecological and feminist movements before clearly discussing the weaknesses of some ecofeminist positions. Exploring the dualisms of nature/culture and masculing/feminine that are the bulwark of many contemporary ecofeminist positions and (...) questioning traditional traditional feminist analyses of gender and caring, Feminism and Ecological Communities asks whether women are essentially closer to nature than men and how we ought to link the oppression of women, people of colour, and other subjugated groups to the degradation of nature. Chris J.Cuomo addresses these key issues by drawing on recent work in feminist ethics as well as teh work of diverse figures such as Aristotle, John Dewey, Donna Haraway adn Maria Lugones. A fascinating feature of the book is the use of the metaphor of the cyborg to highlight the fluidity of the nature/culture distinction and how this can enrich econfeminist ethics and politics. An outstanding new argument for an ecological feminism that links both theory and practice, Feminism and Ecological Communities bravely redraws the ecofeminist map. It will be essential reading for all those interested in gender studies, environmental studies and philosophy. (shrink)

This article presents the tradition of phenomenologically founded psychological research that was originally initiated by Amedeo Giorgi. This data analysis method is inseparable from the broader project of establishing an autonomous phenomenologically based human scientific psychology. After recounting the history of the method from the 1960’s to the present, we explain the rationale for why we view data collection as a process that should be adaptable to the unique mode of appearance of each particular phenomenon being researched. The substance of (...) the article is then devoted to a detailed outline of the method’s whole-part-whole procedure of data analysis. We then offer a sample analysis of a brief description of an ordinary daydream. This is an anxiety daydream in response to the recent Covid-19 pandemic. We present this daydream analysis in full to show the concrete hands-on 5 step process through which the researcher explicated the participants’ expressions from the particular to the general. From this brief sample analysis, the researcher offers a first-person reflection on the data analysis process to offer the reader an introduction to the diacritical nature of phenomenological psychological elucidation. (shrink)

While the phenomenon of ‘moral distress’ has been of interest to the nursing community since Jameton first described it in 1984, moral distress is now understood to effect healthcare professionals...

Technologies to rapidly alert people when they have been in contact with someone carrying the coronavirus SARS-CoV-2 are part of a strategy to bring the pandemic under control. Currently, at least 47 contact-tracing apps are available globally. They are already in use in Australia, South Korea and Singapore, for instance. And many other governments are testing or considering them. Here we set out 16 questions to assess whether — and to what extent — a contact-tracing app is ethically justifiable.

Regulation is nothing without enforcement. This particularly holds for the dynamic field of emerging technologies. Hence, this article has two ambitions. First, it explains how the EU´s new Artificial Intelligence Act (AIA) will be implemented and enforced by various institutional bodies, thus clarifying the governance framework of the AIA. Second, it proposes a normative model of governance, providing recommendations to ensure uniform and coordinated execution of the AIA and the fulfilment of the legislation. Taken together, the article explores how the (...) AIA may be implemented by national and EU institutional bodies, encompassing longstanding bodies, such as the European Commission, and those newly established under the AIA, such as the AI Office. It investigates their roles across supranational and national levels, emphasizing how EU regulations influence institutional structures and operations. These regulations may not only directly dictate the structural design of institutions but also indirectly request administrative capacities needed to enforce the AIA. (shrink)

The World Health Organisation declared COVID-19 a global pandemic on 11th March 2020, recognising that the underlying SARS-CoV-2 has caused the greatest global crisis since World War II. In this chapter, we present a framework to evaluate whether and to what extent the use of digital systems that track and/or trace potentially infected individuals is not only legal but also ethical.

Within this paper, we discuss Moral Distress Reflective Debriefs as a promising approach to address and mitigate moral distress experienced by healthcare professionals. We briefly review the empirical and theoretical literature on critical incident stress debriefing and psychological debriefing to highlight the potential benefits of this modality. We then describe the approach that we take to facilitating reflective group discussions in response to morally distressing patient cases (“Moral Distress Reflective Debriefs”). We discuss how the debriefing literature and other clinical ethics (...) activities influenced the development of our approach. In particular, we focus on the role of the clinical ethicist as a facilitator with particular emphasis on encouraging perspective-taking and nurturing ethical attunement in a supportive manner. We suggest that this approach reduces the narrowing effects of frustration and anger that are often reported when individuals experience moral-constraint distress. Finally, we provide an example of Moral Distress Reflective Debriefs, elucidating how this supportive process complements ethics consultation and can mitigate the negative effects of moral distress. (shrink)

We explore the impact of board resources arising from diverse board members on the achievement of environmental, social, and governance (ESG) goals. Employing resource dependence theory as our frame and drawing on qualitative data from 41 interviews with board directors of publicly traded and privately held companies in the United Arab Emirates (UAE), we identify three key mechanisms underpinning the achievement of ESG goals, namely, the leveraging of particular connections, the deployment of different resources, and the harnessing of a range (...) of diversity types. We find that the use of social resources is often related to environmental concerns and occasionally social goals, but rarely governance issues. We also find that financial motivations often drive environmental issues, while many of the social resources that added value occurred in the public sector. Importantly, the combining of both skill and social resources, rather than relying on each alone, was seen to increase the likelihood of achieving ESG goals. Our findings also point to the importance of board diversity in accomplishing the board's ESG goals, most especially functional diversity. We propose that such functional diversity, along with resources in the form of social resources and skills, needs to feature more prominently in order to improve ESG performance and outcomes. We highlight the implications of our work, especially regarding the establishment of board diversity policies beyond gender alone. (shrink)

Austerity, by its very nature, imposes constraints by limiting the options for action available to us because certain courses of action are too costly or insufficiently cost effective. In the context of healthcare, the constraints imposed by austerity come in various forms; ranging from the availability of certain treatments being reduced or withdrawn completely, to reductions in staffing that mean healthcare professionals must ration the time they make available to each patient. As austerity has taken hold, across the United Kingdom (...) and Europe, it is important to consider the wider effects of the constraints that it imposes in healthcare. Within this paper, we focus specifically on one theorised effect—moral distress. We differentiate between avoidable and unavoidable ethical challenges within healthcare and argue that austerity creates additional avoidable ethical problems that exacerbate clinicians’ moral distress. We suggest that moral resilience is a suitable response to clinician moral distress caused by unavoidable ethical challenges but additional responses are required to address those that are created due to austerity. We encourage clinicians to engage in critical resilience and activism to address problems created by austerity and we highlight the responsibility of institutions to support healthcare professionals in such challenging times. (shrink)

Sound moves us. Nowhere is this more apparent than in our responses to genuine emotional vocalizations, be they heartfelt distress cries or raucous laughter. Here, we present perceptual ratings and a description of a freely available, large database of natural affective vocal sounds from human infants, adults and domestic animals, the Oxford Vocal (OxVoc) Sounds database. This database consists of 173 non-verbal sounds expressing a range of happy, sad, and neutral emotional states. Ratings are presented for the sounds on a (...) range of dimensions from a number of independent participant samples. Perceptions related to valence, including distress, vocalizer mood, and listener mood are presented in Study 1. Perceptions of the arousal of the sound, listener motivation to respond and valence (positive, negative) are presented in Study 2. Perceptions of the emotional content of the stimuli in both Study 1 and 2 were consistent with the predefined categories (e.g., laugh stimuli perceived as positive). While the adult vocalizations received more extreme valence ratings, rated motivation to respond to the sounds was highest for the infant sounds. The major advantages of this database are the inclusion of vocalizations from naturalistic situations, which represent genuine expressions of emotion, and the inclusion of vocalizations from animals and infants, providing comparison stimuli for use in cross-species and developmental studies. The associated website provides a detailed description of the physical properties of each sound stimulus along with cross-category descriptions. (shrink)

Complex clinical ethics cases require a blend of compassion, sensitivity, and tenacity in order to navigate the hard work required of stakeholders. Each person comes to the table with rich historie...

Background: Little is known about what factors may contribute to the growth of a consultation service or how a practice may change or evolve across time. Methods: This study examines data collected from a busy ethics consultation service over a period of more than two decades. Results: We report a number of longitudinal findings that represent significant growth in the volume of ethics consultation requests from 19 in 1990 to 551 in 2013, as well as important changes in the patient (...) population for which ethics help is requested. The findings include (1) a steady growth in requests from primary care providers (e.g., physicians and nurses), as well as increases in ancillary services (e.g., social workers); (2) a decrease in length of stay (days) before ethics help is requested; (3) an increase in the reasons that individuals ask for help from ethics; (4) an upsurge in consults requests from areas outside the intensive care unit (ICU); (5) a decrease in patients that died during hospitalization (e.g., live discharges); and (6) growth in the numbers of patients lacking decision-making capacity. Conclusions: We believe the increases in consult requests reflect appropriate and necessary growth because recent consultations have also been associated with consultations requiring (7) additional interventions and (8) reasonably high time intensity scores. (shrink)

This essay reconsiders the links between medicine, connoisseurship, and aesthetic theory in early eighteenth-century Britain. Taking a satire on the body of the physician and collector John Woodward as its starting point, I show that medicine and connoisseurship shared a deep preoccupation with the possibility that the animal body could excessively influence the workings of the mind. Pursuing this line of argument, moreover, I will reconsider the place of mind–body dualism in eighteenth-century British medicine and aesthetics. With the exception of (...) materialists such as the philosopher-physician Bernard Mandeville, medics and aesthetic theorists tended to identify the exercise of judgment with the operations of a disembodied mind, unsullied by the embodied mechanisms of the lower body. In practice, however, the insistence that the most refined forms of judgment depended on the presence and activity of a disembodied, immaterial soul was less meaningful than it seems. When confronted by failures of judgment, medics and connoisseurs alike sought explanations in the mechanisms of the animal body. Whether or not they believed in the immateriality of the soul, they pictured the mind as a malfunctioning animal machine, to be cured through the material agency of medical therapeutics. (shrink)

By far the largest part of Nehemiah Grew?s account of a seventeenth?century collection of rarities, his Musæum Regalis Societatis (1685) is taken up with ?thick?, verbal descriptions of things in the Royal Society?s repository. Not only, Grew suggests, do his descriptions serve to signify the contents of his collection, but they enable us to discern among species and to think about the collection?s pieces in new ways. Verbal descriptions did not just signify things in the Royal Society?s collection, but had (...) the capacity to alter their meanings. The essay discusses the ?picturing? of natural things in Early Modern Europe with little direct reference to the contemporary media of graphic representation ? drawings, engravings, paintings etc. ? in order to highlight the role of the then most widely used, but now least discussed of these media, verbal descriptions. (shrink)

_Feminism and Ecological Communities_ presents a bold and passionate rethinking of the ecofeminist movement. It is one of the first books to acknowledge the importance of postmodern feminist arguments against ecofeminism whilst persuasively preseenting a strong new case for econolocal feminism. Chris J.Cuomo first traces the emergence of ecofeminism from the ecological and feminist movements before clearly discussing the weaknesses of some ecofeminist positions. Exploring the dualisms of nature/culture and masculing/feminine that are the bulwark of many contemporary ecofeminist positions and (...) questioning traditional traditional feminist analyses of gender and caring, _Feminism and Ecological Communities_ asks whether women are essentially closer to nature than men and how we ought to link the oppression of women, people of colour, and other subjugated groups to the degradation of nature. Chris J.Cuomo addresses these key issues by drawing on recent work in feminist ethics as well as teh work of diverse figures such as Aristotle, John Dewey, Donna Haraway adn Maria Lugones. A fascinating feature of the book is the use of the metaphor of the cyborg to highlight the fluidity of the nature/culture distinction and how this can enrich econfeminist ethics and politics. An outstanding new argument for an ecological feminism that links both theory and practice, _Feminism and Ecological Communities_ bravely redraws the ecofeminist map. It will be essential reading for all those interested in gender studies, environmental studies and philosophy. (shrink)

In their target article, Morain and colleagues (2019) tackle the long-standing and thorny issue of whether and when it might be ethical for a physician-investigator to obtain research consent from...

In this paper, I set an aspect of what it is to live a flourishing life against the backdrop of neo liberal trends that continue to influence educational policy across the globe. The view I set out is in sharp contrast to any narrow assumption that education’s main task is the measurement of high performing individuals who will thus contribute to an economically viable society. Instead, I explore and argue for a conception of what constitutes a flourishing life that is (...) embedded in a more pragmatist analysis of what education may be. The argument begins with developing the centrality of embodiment to aesthetic sensibility and goes on to suggest how collective understanding of this within a community could constitute a sense of performance and thus contribute to the educational aim of developing a full and flourishing life. The argument is that this way of seeing life could have implications for educational practice, the role of the teacher and could help to reconfigure how education is experienced by the young. (shrink)

In this paper, we consider the question of whether there exists an essential relation between emotions and wellbeing. We distinguish three ways in which emotions and wellbeing might be essentially related: constitutive, causal, and epistemic. We argue that, while there is some room for holding that emotions are constitutive ingredients of an individual’s wellbeing, all the attempts to characterise the causal and epistemic relations in an essentialist way are vulnerable to some important objections. We conclude that the causal and epistemic (...) relation between emotions and wellbeing is much less strong than is commonly thought. (shrink)