Health equity is a global concern. Although health equity extends far beyond the equitable distribution of healthcare, equitable access to healthcare is essential to the achievement of health equity. In Canada, Indigenous Peoples experience inequities in health and healthcare access. Cultural safety and trauma‐ and violence‐informed care have been proposed as models of care to improve healthcare access, yet practitioners lack guidance on how to implement these models. In this paper, we build upon an existing framework of equity‐oriented care for (...) primary healthcare settings by proposing strategies to guide nurses in operationalizing cultural safety and trauma‐ and violence‐informed care into nursing practice at the individual level. This component is one strategy to redress inequitable access to care among Indigenous Peoples in Canada. We conceptualize barriers to accessing healthcare as intrapersonal, interpersonal, and structural. We then define three domains for nursing action: practicing reflexivity, prioritizing relationships, and considering the context. We have applied this expanded framework within the context of Indigenous Peoples in Canada as a way of illustrating specific concepts and focusing our argument; however, this framework is relevant to other groups experiencing marginalizing conditions and inequitable access to healthcare, and thus is applicable to many areas of nursing practice. (shrink)

Inequities in access to oncology care among Indigenous peoples in Canada are well documented. Access to oncology care is mediated by a range of factors; however, emerging evidence suggests that healthcare providers, including nurses, play a significant role in shaping healthcare access. The purpose of this study was to critically examine access to oncology care among Indigenous peoples in Canada from the perspective of oncology nurses. Guided by postcolonial theoretical perspectives, interpretive descriptive and critical discourse analysis methodologies informed study design (...) and data analysis. Oncology nurses were recruited from across Canada to complete an online survey (n = 78). Nurses identified a range of barriers experienced by Indigenous peoples when accessing oncology care, yet located these barriers primarily at the individual and systems levels. Nurses perceived themselves as mediators of access to oncology care; however, their efforts to facilitate access to care were constrained by the dominance of biomedicine within healthcare. Nurses' constructions of access to oncology care highlight the embedded narrative of individualism within nursing practice and the relative invisibility of racism as a determinant of equitable access to care among Indigenous peoples. This suggests a need for oncology nurses to better understand and incorporate structural determinants of health perspectives. (shrink)

The Vestal Virgins are one of the most famous elements of Roman religion, yet despite their perennial appeal and the importance of some smaller scale studies of the priesthood, the priestesses have not received a monograph-length study since F. Giuzzi, Aspetti giuridici del sacerdozio romano. II sacerdozio di Vesta (Naples, 1968). Now we have books by R.L. Wildfang and M.C. Martini that could not be more different. The former offers a thorough survey of what the sources can tell us about (...) the priesthood in the period from the end of the Second Carthaginian War to the first century C.E. The latter is an analysis of early Roman historiography and the role the Vestals, in particular their periodic unchastity, played in the creation of the traditional account of the development of Rome. W's book puts forward two main arguments: (1) the Vestals were charged with the ritual purification of the city and with the storage and preparation of ritual materials, and (2) many aspects of the priesthood that have long puzzled scholars are tied to the Vestals' status as Roman citizens, but citizens who existed outside the traditional family structure. The book will be accessible to those new to the topic, but the notes will repay specialists. Ancient sources are quoted in translation, with original texts provided in an appendix. A second appendix provides a list of known Vestals. This slender volume could have been even thinner if the frequent repetitions were cut down. W's work might have been better as a hefty article, so little is there to know about the Vestals. The Classical Review vol. 58 no. 1 C The Classical Association 2008; all rights reserved This content downloaded from 204.235.148.90 on Sat, 26 Jul 2014 11:47:09 AM All use subject to JSTOR Terms and Conditions THE CLASSICAL REVIEW 213 In the Introduction, W makes a welcome distinction among types of rituals often lumped together in discussions of 'fertility' rituals, with which the Vestals are often associated (p. 4). W reserves 'fertility' to describe only those rites that deal with the reproduction of people, livestock and the growth of crops. Harvest rituals are linked to the harvesting of crops, while another set of rites, 'storage rites', are tied to the preservation of the harvest. The final group, purification rituals, aim at the cleansing of an individual, place or object of 'all forms of pollution that would render it or them unfit to come into contact with the religious sphere'. The book is arranged thematically. The first two chapters lay out all we can know about the priestesses' ritual obligations performed in the seclusion of the temple and out amongst the people. While a reader may not find W's interpretation of each of the Vestals' actions equally persuasive, the overall argument that the priestesses' activities were, by and large, purificatory is convincing. Two of the more interesting aspects of W.'s discussion are her considerations of Vesta's fire and of the water required for some of her rituals (pp. 8-11). Fire was seen by the Romans as both a fertile and a sterile force, and scholars have emphasised one or the other, or the contrast between them, in their interpretation of the Vestals. W points out that fertile fire is always described in masculine terms and is associated with Vulcan. Vesta's fire, however, is always associated with sterility and purity, and so should be understood as having a purificatory significance. W points out that Vesta's fire was used only in the manufacture of ritually necessary items: roasting spelt for mola salsa, baking brine for muries and burning ashes from the fetal cow from the Fordicidia and the tail of the October horse, both of which were used at the Parilia. For other rituals, the Vestals were required to use water, the purificatory substance par excellence, drawn only from the spring of Juturna and carried only in vessels that could not be set down. These restrictions ensured that the water was always fresh, running water that never touched profane earth. Chapters 3-5 trace out the unique position the Vestals occupied in Roman society, arguing that they existed outside the standard Roman familial and other social structures, yet remained fully part of the Roman state. W suggests that the initiation rite of captio removed the new priestess not only from her family but, more importantly, from her family cult, thus avoiding any potential contamination of familial and public cult. Virginity was required for multiple reasons, the most significant being that such a status allowed the priestess to remain a full member of the Roman state, but prevented her from being a member of a traditional family structure. Throughout the book, W makes much of the idea of Vestals as represen tatives of Roman citizen women without ever really dealing with the question to what extent any Roman woman, priestess or not, was a ciuis. Though W is probably correct, it is not entirely certain to what extent women were citizens in the Republic, and at least a reference to some key ancient sources and to recent scholarship on this question should be made (e.g. L. Peppe, Posizione giuridica e ruolo sociale della donna romana in eta repubblicana [Milan, 1984]). The sixth chapter, 'The Vestals in the Romans' History', looks at the appearance of Vestals in the early history of Rome, refining the common assumption that accusations of, and convictions for, incestum arose only in periods of great stress and danger. W adds that a priestess's involvement, or her family's involvement, in one of the groups taking part in the conflict or struggle of the moment also played a role. This chapter traces changes over the course of 300 years in the attitudes of the priestesses and the Romans more generally toward the priesthood, its role in society This content downloaded from 204.235.148.90 on Sat, 26 Jul 2014 11:47:09 AM All use subject to JSTOR Terms and Conditions 214 THE CLASSICAL REVIEW and its requirement of 30 years of chastity. The argument hangs on even less evidence than other sections of the work. In contrast to their central place in W's book, the Vestals play only a small (though crucial, in her interpretation) role in M.'s work. The basic argument of the book is that episodes of Vestal incestum are linked in the historiographic tradition to key moments in the development of the Roman state: the separation of augurium from regnum, the development of a mixed patrician-plebeian aristocracy, the creation of a monetary system and the expansion of the colonial system outside Italy. The history of Rome can be seen as alternating phases of stasis and transformation; instances of Vestal incestum mark the transitions (p. 95). The work falls into two parts that are not well integrated. The first is a useful discussion of the historiography of the Roman Republic, taking in turn each element of the story of the founding of Rome from the arrival of Aeneas to the death of Remus. M. traces how early Roman writers, especially Fabius Pictor, reshaped the tradition already present in some Greek authors, distancing Rome from the Greek world and adding an Italic element to the tale. This detailed analysis is well worth consulting and will be of interest to those working on many aspects of cultural life in the Republic. The second, larger, section of the book comprises a series of studies of the Vestals known to have been convicted of incestum during the Republic. After dealing with issues of dating and sources, M. links each case of incestum to a major event in Roman history. Not all the events are equally important for the creation of the Rome of the middle and late Republic. One wonders why M. chose to tie the conviction of Minucia, somewhere between 339 and 332, to the admission of plebeians to the praetorship in 337 rather than to the conclusion of the Latin War in 338. Some explanation is warranted. The connection M. draws is often very vague, as in the case of Sextilia (pp. 144-54), convicted and interred alive in either 275 or 274. M. sees this as marking the end of any meaningful distinction between patricians and plebeians, following as it does the first time a plebeian censor completed a lustrum. The gap of five or six years between Sextilia's conviction and Cn. Domitius Calvinus Maximus' censorship in 280 passes unremarked. Similarly, in discussing the three Vestals accused of incestum in 114-113 (pp. 188-210), M. steps away from the commonly accepted interpretation of the event as part of the continuing struggle between Gracchan and senatorial forces, arguing instead that it is tied to the establishment in 118 of the colony of Narbo Martius, Rome's first colony in Gaul. Here, as elsewhere, there is no evidence that any ancient author linked the founding of the colony and Vestal unchastity; the temporal gap makes an association even more unlikely. Ultimately, it is not possible to accept M.'s argument that Vestal incestum punctuated key stages in the development of the 'cosmo Romano' in the way she imagines. Even so, M.'s effort to reintegrate the Vestals into the larger narrative of Rome's history is thought-provoking, and it is to be hoped that it will spark further work in the same vein. The field is perhaps in a better position to undertake work on this scale now that we have W's careful and comprehensive collection and interpre tation of what there is to know about the Vestals. Yale University CELIA E. SCHULTZ celia.schultz(yale.edu This content downloaded from 204.235.148.90 on Sat, 26 Jul 2014 11:47:09 AM All use subject to JSTOR Terms and Conditions. (shrink)

The Sarbanes–Oxley Act of 2002 requires audit committees of public companies’ boards of directors to install an anonymous reporting channel to assist in deterring and detecting accounting fraud and control weaknesses. While it is generally accepted that the availability of such a reporting channel may reduce the reporting cost of the observer of a questionable act, there is concern that the addition of such a channel may decrease the overall effectiveness compared to a system employing only non-anonymous reporting options. The (...) rationale underlying this concern involves the would-be reporter’s likelihood of reporting, the seriousness with which the organization treats an anonymous report, and the organization’s ability to thoroughly follow-up the report. Thus, we explore the extent to which the availability of an anonymous reporting channel influences intended use of non-anonymous reporting channels. Further, in response to Sarbanes–Oxley and the environment of financial scandals that led to its passage, many firms are strengthening their internal audit departments, and providing them with greater independence from upper management’s direct control. Accordingly, our examination tests whether the intended use of the internal audit department as an internal reporting channel is greater when the internal audit department is of “high” versus “low” quality. Finally, the study investigates intended reporting behavior across three different cases (e.g., settings). Results show that the existence of an anonymous channel does reduce the likelihood of reporting to non-anonymous channels, that generally the internal audit department quality does not affect reporting to non-anonymous channels, and that case-setting affects the type of channel to be used. Implications from the study are discussed. (shrink)

In The Case for Animal Rights, Tom Regan argues that although all subjects-of-a-life have equal inherent value, there are often differences in the value of lives. According to Regan, lives that have the highest value are lives which have more possible sources of satisfaction. Regan claims that the highest source of satisfaction, which is available to only rational beings, is the satisfaction associated with thinking impartially about moral choices. Since rational beings can bring impartial reasons to bear on decision making, (...) Regan maintains that they have an additional possible source of satisfaction that nonrational beings do not have and, consequently, the lives of rational beings turn out to have greater value.. (shrink)

As nursing professionals, we believe access to healthcare is fundamental to health and that it is a determinant of health. Therefore, evidence suggesting access to healthcare is problematic for many Indigenous peoples is concerning. While biomedical perspectives underlie our current understanding of access, considering alternate perspectives could expand our awareness of and ability to address this issue. In this paper, we critique how access to healthcare is understood through a biomedical lens, how a postcolonial theoretical lens can extend that understanding, (...) and the subsequent implications this alternative view raises for the nursing profession. Drawing on peer‐reviewed published and gray literature concerning healthcare access and Indigenous peoples to inform this critique, we focus on the underlying theoretical lens shaping our current understanding of access. A postcolonial analysis provides a way of understanding healthcare as a social space and social relationship, presenting a unique perspective on access to healthcare. The novelty of this finding is of particular importance for the profession of nursing, as we are well situated to influence these social aspects, improving access to healthcare services broadly, and among Indigenous peoples specifically. (shrink)

Higher-order thought theories maintain that consciousness involves the having of higher-order thoughts about mental states. In response to these theories of consciousness, an attempt is often made to illustrate that nonhuman animals possess said consciousness, overlooking an alarming consequence: attributing higher-order thought to nonhuman animals might entail that they should be held morally accountable for their actions. I argue that moral responsibility requires more than higher-order thought: moral agency requires a specific higher-order thought which concerns a belief about the rightness (...) or wrongness of affecting another’s mental states. This “moral thought” about the rightness or wrongness is not yet demonstrated in even the most intelligent nonhuman animals, thus we should suspend our judgments about the “rightness” or “wrongness” of their actions while further questioning the recent insistence on developing an animal morality. (shrink)

It is common for conservationists to refer to non-native species that have undesirable impacts on humans as “invasive”. We argue that the classification of any species as “invasive” constitutes wrongful discrimination. Moreover, we argue that its being wrong to categorize a species as invasive is perfectly compatible with it being morally permissible to kill animals—assuming that conservationists “kill equally”. It simply is not compatible with the double standard that conservationists tend to employ in their decisions about who lives and who (...) dies. (shrink)

An adequate theory of rights ought to forbid the harming of animals (human or nonhuman) to promote trivial interests of humans, as is often done in the animal-user industries. But what should the rights view say about situations in which harming some animals is necessary to prevent intolerable injustices to other animals? I develop an account of respectful treatment on which, under certain conditions, it’s justified to intentionally harm some individuals to prevent serious harm to others. This can be compatible (...) with recognizing the inherent value of the ones who are harmed. My theory has important implications for contemporary moral issues in nonhuman animal ethics, such as the development of cultured meat and animal research. (shrink)

An adequate theory of rights ought to forbid the harming of animals to promote trivial interests of humans, as is often done in the animal-user industries. But what should the rights view say about situations in which harming some animals is necessary to prevent intolerable injustices to other animals? I develop an account of respectful treatment on which, under certain conditions, it’s justified to intentionally harm some individuals to prevent serious harm to others. This can be compatible with recognizing the (...) inherent value of the ones who are harmed. My theory has important implications for contemporary moral issues in nonhuman animal ethics, such as the development of cultured meat and animal research. (shrink)

Because spaying/neutering animals involves the harming of some animals in order to prevent harm to others, some ethicists, like David Boonin, argue that the philosophy of animal rights is committed to the view that spaying/neutering animals violates the respect principle and that Trap Neuter Release programs are thus impermissible. In response, I demonstrate that the philosophy of animal rights holds that, under certain conditions, it is justified, and sometimes even obligatory, to cause harm to some animals in order to prevent (...) greater harm to others. As I will argue, causing lesser harm to some animals in order to prevent greater harm to others, as TNR programs do, is compatible with the recognition of the inherent value of the ones who are harmed. Indeed, we can, and do, spay/neuter cats while acknowledging that they have value in their own right. (shrink)

The philosophy of animal rights is often characterized as an exclusively justice oriented approach to animal liberation that is unconcerned with, and moreover suspicious of, moral emotions, like sympathy, empathy, and compassion. I argue that the philosophy of animal rights can, and should, acknowledge that compassion plays an integral role in animal liberation discourse and theory. Because compassion motivates moral actors to relieve the serious injustices that other animals face, or, at the very least, compassion moves actors not to participate (...) in or cause these injustices, the philosophy of animal rights can and should recognize both a duty to cultivate compassion and a duty to promote compassion. Contra to feminist critiques of Regan’s justice-approach to ethics, the philosophy of animal rights is not committed to eschewing the moral emotions. (shrink)

Investigates the resolution of contradictions and ambiguous derogations in a code, by means of the imposition of partial orderings. Although formulated as a study in the logic of norms, it provided the initial ideas for work on the logic of theory (or belief) change, developed by the authors in a series of papers by the authors and Peter Gardenfors beginning in 1985.

A widely accepted view in epistemology is that we do not have direct control over our beliefs. And we surely do not have as much control over our beliefs as we have over simple actions. For instance, you can, if offered $500, immediately throw your steak in the trash, but a meat-eater cannot, at will, start believing that eating animals is wrong to secure a $500 reward. Yet, even though we have more control over our behavior than we have over (...) our beliefs, some of our behavior, especially moral behavior, is heavily influenced by our beliefs. Meat-eating is one example. So, if we do not have direct control over our beliefs and our beliefs influence our moral behavior, it’s no wonder meat-eaters aren’t immediately boycotting Burger King and lining up for the Beyond Burger after hearing about the mistreatment of farmed animals. So, how, or can we, inspire meat-eaters to change their beliefs regarding the moral significance of meat-eating and, consequently, their animal-eating behavior? I propose an answer to this difficult question. (shrink)

"The writer discusses the concept of kitsch. Having reviewed a variety of approaches to kitsch, he posits an historical conception of it, connecting it to modernity and defining it as a coping-mechanism for modernity. He thus suggests that kitsch is best understood as a tool in the struggle against the particular stresses of the modern world and that it uses materials at hand, fashioning from them some sort of stability largely through projecting images of nature, stasis, and continuity. He discusses (...) the relation of kitsch to fine art, arguing that fine art also has as its primary function a counter-movement to modernity. He suggests that the main difference between fine art and kitsch is that fine art, as well as its emotional function, also involves a reception context that allows it to assume an intellectual task. Among the writer's conclusions, he finds that positing a stark or absolute contrast between kitsch and fine art is unjustifiable as both have the same roots and objectives." [WilsonWeb]. (shrink)

In a recent article, Corey Wrenn argues that in order to adequately address injustices done to animals, we ought to think systemically. Her argument stems from a critique of the individualist approach I employ to resolve a moral dilemma faced by animal sanctuaries, who sometimes must harm some animals to help others. But must systemic critiques of injustice be at odds with individualist approaches? In this paper, I respond to Wrenn by showing how individualist approaches that take seriously the notion (...) of group responsibility can be deployed to solve complicated dilemmas that are products of injustice. Contra Wrenn, I argue that to adequately address injustice, acting individually, often within groups, is significantly more important than thinking systemically. (shrink)

It’s certainly wrong for employers to accept applications from only white people. Universities that open admissions to only white people surely act wrongly. But do people who date, or consider dating, only white people do something wrong? Many people say that racialized attraction is just a matter of personal preference. Against this view, it will be argued that it often constitutes wrongful discrimination.

De uma perspectiva comportamentalista radical, o eu é um repertório verbal complexo, que, como tal, tem uma gênese social. O reconhecimento da origem social do “eu” abre caminho para uma análise política, incluindo uma discussão do pa- pel das relações de poder na constituição do eu. Entretanto, uma concepção radicalmente social do “eu”, como a proposta pelo comportamentalismo, suscita um problema político: se o eu é integralmente produto do ambiente social, de onde viria uma eventual “vontade” de romper com esse (...) sistema? Parece que para reconhecer a possibilidade de ação política transformadora seria preciso preservar uma noção descontextualizada de “eu”. Considerando essa dificuldade, o objetivo deste artigo é propor uma interpretação política da constituição do “eu” no âmbito do comportamentalismo radical, mantendo no horizonte a possibilidade de uma ação política transformadora. Para tanto, destacamos como “eus” oprimidos são tornados submissos, mas também como de certas contingências podem emergir “eus” subversivos, que se opõem a um sistema social opressivo. Esse “eu” subversivo é caracterizado por um repertório de autoconhecimento mais amplo, que inclui a discriminação do papel das relações de poder e do controle promovido por instituições. Concluímos, com isso, que um “eu” socialmente constituído pode ser politicamente ativo. (shrink)

What is kitsch? The varieties of phenomena which can fall under the name are bewildering. Here, I focus on what has been called “traditional kitsch,” and argue that it often turns on the emotional effect specifically captured by Edmund Burke’s concept of “beauty” from his 1757 'A Philosophical Enquiry into the Sublime and Beautiful.' Burkean beauty also serves to distinguish “traditional kitsch” from other phenomena also often called “kitsch”—namely, entertainment. Although I argue that Burkean beauty in domestic decoration allows for (...) us to see “traditional kitsch” as resting on natural and even healthy impulses, I also argue that an all-too-common political function of traditional kitsch directs it to dangerous ends. (shrink)

Professional engineering societies which are based in the United States, such as the American Society of Mechanical Engineers (ASME, now ASME International) are recognizing that their codes of ethics must apply to engineers working throughout the world. An examination of the ethical code of the ASME International shows that its provisions pose many problems of application, especially in societies outside the United States. In applying the codes effectively in the international environment, two principal issues must be addressed. First, some Culture (...) Transcending Guidelines must be identified and justified. Nine such guidelines are identified. Second, some methods for applying the codes to particular situations must be identified. Three such methods are specification, balancing, and finding a creative middle way. (shrink)