Shared decision-making involves health professionals and patients/clients working together to achieve true person-centred health care. However, this goal is infrequently realized, and most barriers are unknown. Discussion between philosophers, clinicians, and researchers can assist in confronting the epistemic and moral basis of health care, with benefits to all. The aim of this paper is to describe what shared decision-making is, discuss its necessary conditions, and develop a definition that can be used in practice to support excellence in maternity care. Discussion (...) between the authors, with backgrounds in philosophy, clinical maternity care, health care management, and maternity care research, assisted the team to confront established norms in maternity care and challenge the epistemic and moral basis of decision-making for caesarean section. The team concluded that shared decision-making must start in pregnancy and continue throughout labour and birth, with equality in discourse facilitated by the clinician. Clinicians have a duty of care for the adequacy of women's knowledge, which can only be fulfilled when relevant knowledge is offered freely and when personal beliefs and biases that may impinge on decision-making (defeaters) are disclosed. Informed consent is not shared decision-making. Key barriers include existing cultural norms of “the doctor knows best” and “patient acquiescence” that prevent defeaters being acknowledged and discussed and can lead to legal challenges, overuse of medical intervention and, in some areas, obstetric violence. Shared decision-making in maternity care can thus be defined as an enquiry by clinician and expectant woman aimed at deciding upon a course of care or none, which takes the form of a dialogue within which the clinician fulfils their duty of care to the client's knowledge by making available their complete knowledge (based on all types of evidence) and expertise, including an exposition of any relevant and recognized potential defeaters. Research to develop measurement tools is required. (shrink)

In recent years there has been an explosion of interest in Artificial Intelligence (AI) both in health care and academic philosophy. This has been due mainly to the rise of effective machine learning and deep learning algorithms, together with increases in data collection and processing power, which have made rapid progress in many areas. However, use of this technology has brought with it philosophical issues and practical problems, in particular, epistemic and ethical. In this paper the authors, with backgrounds in (...) philosophy, maternity care practice and clinical research, draw upon and extend a recent framework for shared decision-making (SDM) that identified a duty of care to the client's knowledge as a necessary condition for SDM. This duty entails the responsibility to acknowledge and overcome epistemic defeaters. This framework is applied to the use of AI in maternity care, in particular, the use of machine learning and deep learning technology to attempt to enhance electronic fetal monitoring (EFM). In doing so, various sub-kinds of epistemic defeater, namely, transparent, opaque, underdetermined, and inherited defeaters are taxonomized and discussed. The authors argue that, although effective current or future AI-enhanced EFM may impose an epistemic obligation on the part of clinicians to rely on such systems' predictions or diagnoses as input to SDM, such obligations may be overridden by inherited defeaters, caused by a form of algorithmic bias. The existence of inherited defeaters implies that the duty of care to the client's knowledge extends to any situation in which a clinician (or anyone else) is involved in producing training data for a system that will be used in SDM. Any future AI must be capable of assessing women individually, taking into account a wide range of factors including women's preferences, to provide a holistic range of evidence for clinical decision-making. (shrink)

First-person reports of Major Depressive Disorder reveal that when an individual becomes depressed a profound change or ‘shift’ to one’s conscious experience occurs. The depressed person reports that something fundamental to their experience has been disturbed or shifted; a change associated with the common but elusive claim that when depressed one finds oneself in a ‘different world’ detached from reality and other people. Existing attempts to utilise these phenomenological observations in a psychiatric context are challenged by the fact that this (...) experiential ‘shift’ characteristic of depression appears mysterious and resists analysis in scientific terms. This paper offers a way out of this predicament. The hypothesis proposed is that when an individual becomes depressed, the individual departs from a state of ordinary wakeful consciousness and enters a distinctive global state of consciousness akin to dreaming and the psychedelic state. After unpacking and motivating this hypothesis in the context of research in consciousness science, I outline two of its important implications for the neurobiology of depression and psychedelic psychiatry. The upshot is a promising and conceptually well-motivated hypothesis about depression which is apt for empirical uptake and development. (shrink)

Aphantasia is a recently discovered disorder characterised by the total incapacity to generate visual forms of mental imagery. This paper proposes that aphantasia raises important theoretical concerns for the ongoing debate in the philosophy and science of consciousness over the nature of dreams. Recent studies of aphantasia and its neurobehavioral correlates reveal that the majority of aphantasics, whilst unable to produce visual imagery while awake, nevertheless retain the capacity to experience rich visual dreams. This finding constitutes a novel explanandum for (...) theories of dreaming. Specifically, I argue that the recent dream reports of aphantasics constitute an empirical challenge to the emerging family of views which claim that dreams are essentially imaginative experiences, constitutively involving the kinds of mental imagery which aphantasics, ex-hypothesi, lack. After presenting this challenge in the context of Jonathan Ichikawa’s recent arguments for this view, I argue that this empirical challenge may be overcome if the imagination theorist abandons Ichikawa’s account of dreaming in favour of a modified version. This involves the claim that dreams are essentially inactive and constitutively involve non voluntary forms of imagination. I conclude with a suggestion for further research which can test the viability of this alternative hypothesis, and move the debate forward. (shrink)

This chapter discusses the nature of software maintenance in light of software’s ontological status. A realist view of software need not commit us to the otiose position that software maintenance is impossible. Many philosophers and computer scientists have been concerned with drawing attention to software’s dual nature, its being both symbolic and physical, abstract and concrete. There are strong connections to be found between this topic and recent investigations in the philosophy of linguistics, particularly the metaphysics of words. It is (...) shown, contra Irmak, that software can be best understood through a realist type-token distinction employing an ontology of composite objects that was put forward by Katz. This approach employs both non-spatiotemporal abstract types and tokens of those types. Further developing Katz’s realist approach can help to make better sense of the dual nature of computational artefacts and their maintenance than the alternatives outlined. Young claims that a prevalent imbalanced view of maintenance as solely conservative is due to a misunderstanding of the nature of artefacts as being realisations of their producers’ intentions. This is a problem for theories of artefacts that employ intentions, such as the one involved with the realist view of software and software maintenance. Software maintenance on this view is not solely conservative but also adaptive and enhancive, constituting a source of counterexamples to Young’s claim. An alternative explanation of the imbalanced view is provided, based on observations by software engineers, especially Sommerville. (shrink)

Purpose – The aim of this study is to study the implementation of G2B initiatives for small- and medium-sized enterprises in Hong Kong, focusing on the underlying importance, benefits and challenges. Design/methodology/approach – The context of this study was initially established based on comparisons with B2B initiatives. However, it is also learned from the literature that the transformational aspect of e-Government development has not been materialized, whereas the extended web assessment method, the three-ring model and DeLone and McLean’s IS success (...) model were therefore identified to derive and build the theoretical G2B success model, thereby developing the online survey instrument of this study. Specifically, a positivist paradigm was adopted to investigate the impact of each G2B success factor on the overall satisfaction with using the G2B systems under examination from the perspective of SMEs, rather than simply placing emphasis on the number of electronic services provided and the investments spent. Findings – The research findings were compiled based on both the multiple regression analysis and EWAM analysis results, thus making the necessary improvements in the appropriate service aspects of the G2B systems concerned. Originality/value – The main study concluded that prevalent G2B initiatives in Hong Kong have been largely connected to pursuing conservative paradigms in public service provision. The new e-Government strategic agenda is therefore laid out for increasing the overall transparency of new public management based on the provision of resilient-based public services, thereby advancing the democratic empowerment of all the G2B stakeholders involved and also maximizing the multifold effects of value creations. (shrink)

This paper discusses the vast continuum between the letter of the law (legality) and the spirit of the law (ethics or morality). Further, the authors review the fiduciary duties owed by the firm to its various publics. These aspects must be considered in developing a corporate code of ethics. The underlying qualitative characteristics of a code include clarity, comprehensiveness and enforceability. While ethics is indigenous to a society, every code of ethics will necessarily reflect the corporate culture from which that (...) code stems and be responsive to the innumerable situations for which it was created. Several examples have been provided to illustrate the ease of applicability of these concepts. (shrink)

Background Home-based care workers mainly work alone in the patient’s home. They encounter a diverse patient population with complex health issues. This inevitably leads to several ethical challenges. Aim The aim is to gain insight into ethical challenges related to patient autonomy in home-based care and how home-based care staff handle such challenges. Research design The study is based on a 9-month fieldwork, including participant observation and interviews in home-based care. Data were analysed with a thematic analysis approach. Participants and (...) research context The study took place within home-based care in three municipalities in Eastern Norway, with six staff members as key informants. Ethical considerations The Norwegian Agency for Shared Services in Education and Research evaluated the study. All participants were competent to consent and signed an informed consent form. Findings A main challenge was that staff found it difficult to respect the patient’s autonomy while at the same time practicing appropriate care. We found two main themes: Autonomy and risk in tension; and strategies to balance autonomy and risk. These were explicated in four sub-themes: Refusing and resisting care; when choosing to live at home becomes risky; sweet-talking and coaxing; and building trust over time. Staff’s threshold for considering the use of coercion appeared to be high. Conclusions Arguably, home-based care staff need improved knowledge of coercion and the legislation regulating it. There is also a need for arenas for ethics reflection and building of competence in balancing ethical values in recurrent ethical problems. (shrink)

In the wake of modernity, women's sexuality was positioned in a way that created a beauty/narcissism double bind that is still with us today. My concern in this article is that the subject position of “fashion model” serves as a constant reminder of this split, which is directed at all women and weakens the generalized woman's political agency. Fashion models themselves experience harassment and humiliation as well as pleasure and desire in their work as fashion models. However, the small portion (...) of feminist work that has engaged explicitly with the fashion-model business sees it mainly as an enterprise that is alienating and hostile to women. Although I do not entirely disagree with this analysis, it neglects the meaning of beauty and what beauty does to us with regard to creativity and pleasure. I wish to explore how some of the work experience of fashion models intersects with and challenges the beauty/narcissism double bind. I suggest that rather than grounding our understanding of the subject position “fashion model” and the fashion business solely in their reinforcement of the beauty/narcissism double bind, we should pay attention to the importance of what beauty and aspects of narcissism may mean. (shrink)

In the state of Victoria, Australia in the late 1950s and early 1960s, restorative treatment was introduced into the state‐subsidised benevolent homes, and they were reclassified as geriatric hospitals. In the process, the nursing care of incapacitated old people was identified in terms of particular skills and knowledge, and specific forms of training were established for nurses at two levels of training: nurses’ aides and supervisory nurses with a postbasic qualification. These institutional changes were complemented by the introduction of a (...) nursing role into the body responsible for overseeing care for the aged in Victoria. Little was made of this opportunity to establish a leading role for nurses in the field of care for the aged. However, this episode raises fertile questions for further research into the development of nursing in Australia, as a set of practices divided along the lines of acute and chronic illness. (shrink)

The performance artists Florian Feigl and Fjóla Gautadóttir engage with production conditions of artistic work through their ways of managing time in performances. Informed by Marxist and feminist theories on affective and reproductive work, and with references to the history of performance art, I demonstrate how, contrary to myths of inspiration and virtuosity, production conditions co-create artistic authorship. Thereby, I reexamine what traditionally is termed as the aesthetics of production. An aesthetics of production is, I suggest, not about natural talent (...) and originality of the soloist artist genius but is founded on the interdependency of life and work, and what enables the artist to do work. Feigl and Gautadóttir’s performances include what has been excluded as disturbances by idealist aesthetics of production: the sociality, temporality and economy of the artistic work. By proposing a feminist-materialist aesthetics of production, I claim that the artist’s work is not only working by the numbers of the present production conditions, but is also performing and intervening within the infrastructures of art. (shrink)

Understanding the biological basis of consciousness is one of the central challenges for modern science. Is a mature scientific explanation really possible, and if so, how should consciousness science be organized so as to achieve this? This thesis is a collection of four papers which approach these questions via an account of the natural categories or ‘kinds’, drawn from philosophy of science, to which paradigmatic mental phenomena like consciousness belong. The central claims defended in the thesis are twofold. Firstly, that (...) to facilitate a mature science of consciousness it is crucial to explicitly introduce a new organizing concept of consciousness modelled on the kinds of concepts which underpin previous successful explanations of other natural phenomena – that of a natural kind concept of consciousness. This draws on the general observation that some concepts are better suited to scientific theorizing about the world than others, and thus that progress in scientific and philosophical domains can be (and indeed, has often been) made by working to refine our existing conceptual schemes to reflect this. Secondly, that a mature science of consciousness will be one which recognizes the reality and explanatory importance of a particular category of mental phenomena called ‘global states of consciousness’ which includes dreaming and wakefulness. Examination of this latter claim leads to a third idea explored and motivated in the thesis which brings consciousness science into closer connection with psychiatry. This is the hypothesis that Major Depressive Disorder involves a change to a subject’s global state of consciousness, marking a change from a state of ordinary wakeful consciousness to an altered ‘depressive state’ of consciousness akin to a dream or psychedelic state. (shrink)

What drives moral revolutions like the legal abolition of slavery and women’s right to vote? The importance of having an answer to this question lies in the hope of it being able to help us create moral progress in the future. This can be changing harmful practices and traditions like honour killing, child marriage, genital mutilation and political corruption. Furthermore, a wrong or insufficient picture of the dynamics of change, held by e.g. politicians or NGOs and incorporated into laws and (...) institutions, can lead to misfired inventions, wasted resources and possibly human harm. If we lack conceptual clarity and empirical insights, we will have trouble making good decisions. However, before answering the above question we need to consider what answering it entails. This article therefore discusses which form an understanding of the dynamics of moral revolutions should take in order to best help us create progress. I do so by critically investigating one currently dominant way of approaching this issue, namely the idea that we should produce a general explanatory theory of the fundamental dynamics of change. In order to expose the problems in this approach, I engage with a contemporary example of it, namely Appiah’s work on moral revolutions, and demonstrate that honour codes cannot have the explanatory role, which Appiah claims for them. The article concludes by pointing to alternative models of understanding the dynamics of moral revolutions and changes. (shrink)

This article considers an interpretative model for the study of Heraclitus, which was first put forward by Alexander Mourelatos in 1973, and draws upon a related model put forward by Julius Moravcsik beginning in 1983. I further develop this combined model and provide a motivation for an interpretation of Heraclitus. This is also of interest for modern metaphysics due to the recurrence of structurally similar problems, including the ‘colour exclusion’ problem that was faced by Wittgenstein. Further, I employ the model (...) to shed new light on Heraclitus’ image of the river, while relating potential readings to various contemporary metaphysical views. (shrink)

I offer an examination of a core element in the reflectiveness of Heraclitus’ thought, namely, his rebuke of polymathy . In doing so, I provide a response to a recent claim that Heraclitus should not be considered to be a philosopher, by attending to his paradigmatically philosophical traits. Regarding Heraclitus’ attitude to that naïve form of ‘wisdom’, i.e., polymathy, I argue that he does not advise avoiding experience of many things, rather, he advises rejecting experience of things as merely many (...) independent things in their manifoldness , and, instead, to understand their unity and thereby to unify our knowledge of them. (shrink)

Jerrold J. Katz often explained his semantic theory by way of an analogy with physical atomism and an attendant analogy with chemistry. In this chapter, I track the origin and uses of these analogies by Katz, both in explaining and defending his decompositional semantic theory, through the various phases of his work throughout his career.

The three main kinds of theory in normative ethics, namely, consequentialism, deontology, and virtue ethics, are often presented as the ‘palette’ from which we may choose, or use as a starting point for an investigation. However, this way of doing ethics and philosophy, by the palette, may be leading some of us astray. It has led some to believe that all that there is to ethics, and to ethics of AI, is given in terms of these already devised petrified categories (...) of theory. It has also led others to abandon normative ethics and philosophy altogether and to resort to descriptive methods that are then used to justify action. I wish to argue that (1) we should not abandon traditional philosophical approaches, but (2a) this does not entail that the petrified palette should constitute the beginning of our philosophical investigations. Further, (2b) I recommend a non-methodological approach in which it is instead radical questions that spur these investigations, which arise through consideration of the practical actions (potential or otherwise) of machines and their programmers. (shrink)

Total quality management (TQM) has become a basic business practice in organizations throughout the world. Implementation of TQM in these organizations has been driven by the desire to increase profits in the highly competitive business world. Total quality management techniques are designed to improve performance.Concurrently, organizations are striving to eradicate the concept that the termbusiness ethics is an oxymoron. Corporate codes of conduct have been developed to indicate the outside boundaries of acceptable organizational behavior and companies are espousing and enforcing (...) the ideals contained within these codes. (shrink)

A virtue centred approach to ethics has been criticized for being vague owing to the nature of its central concept, the paradigm person. From the perspective of the practitioner the most damaging charge is that virtue ethics fails to be action guiding and, in addition to this, it does not offer any means of act appraisal. These criticisms leave virtue ethics in a weak position vis-à-vis traditional approaches to ethics. The criticism is, however, challenged by Hursthouse in her analysis of (...) the accounts of right action offered by deontology, utilitarianism and virtue ethics. It is possible to defend the action guiding nature of virtue ethics: there are virtue rules and exemplars to guide action. Insights from Aristotle’s practical approach to ethics are considered alongside Hursthouse’s analysis and it is suggested that virtue ethics is also capable of facilitating action appraisal. It is at the same time acknowledged that approaches to virtue ethics vary widely and that the challenges offered here would be rejected by those who embrace a radical replacement virtue approach. (shrink)

A prominent trend in moral philosophy today is the interest in the rich textures of actual human practices and lives. This has prompted engagements with other disciplines, such as anthropology, history, literature, law and empirical science, which have produced various forms ofcontextual ethics. These engagements motivate reflections on why and how context is important ethically, and such metaethical reflection is what this article undertakes. Inspired by the work of the later Wittgenstein and the Danish theologian K.E. Løgstrup, I first describe (...) one of the ways in which context plays a central role with regard to ethical meaning and normativity. I then examine how ‘context’ is to be defined, and finally I discuss some of the questions which arise when giving context prominence in ethics – namely, how to delimit the scope of relevant context, the relevant traits of a particular context and what ‘the ethical’ is. (shrink)

A prominent trend in moral philosophy today is the interest in the rich textures of actual human practices and lives. This has prompted engagements with other disciplines, such as anthropology, history, literature, law and empirical science, which have produced various forms of contextual ethics. These engagements motivate reflections on why and how context is important ethically, and such metaethical reflection is what this article undertakes. Inspired by the work of the later Wittgenstein and the Danish theologian K.E. Løgstrup, I first (...) describe one of the ways in which context plays a central role with regard to ethical meaning and normativity. I then examine how ‘context’ is to be defined, and finally I discuss some of the questions which arise when giving context prominence in ethics – namely, how to delimit the scope of relevant context, the relevant traits of a particular context and what ‘the ethical’ is. (shrink)

This article is presented as a defence of voluntary active euthanasia from a virtue perspective and it is written with the objective of generating debate and challenging the assumption that killing is necessarily vicious in all circumstances. Practitioners are often torn between acting from virtue and acting from duty. In the case presented the physician was governed by compassion and this illustrates how good people may have the courage to sacrifice their own security in the interests of virtue. The doctor's (...) action created huge tensions for the nurse, who was governed by the code of conduct and relevant laws. Appraising active euthanasia from a virtue perspective can offer a more compassionate approach to the predicament of practitioners and clients. The tensions arising from the virtue versus rules debate generates irreconcilable difficulties for nurses. A shift towards virtue would help to resolve this problem and support the call for a change in the law. The controversial nature of this position is acknowledged. The argument is put forward on the understanding that many practitioners will not agree with the conclusions reached. (shrink)

The international economy is changing at a rapid rate. The alteration and reduction of both geographical and political borders, coupled with the growing interdependence of socially, politically, economically, and legally diverse countries, have caused multinational corporate entities to revise various policies. These revisions include revisions in marketing strategies, strategic alliances, product and service strategies and, perhaps most importantly as it affects all strategies, a MNC's approach to ethical systems. The truly global company must come to grips with the legal and (...) moral atmosphere in which it operates. The concept of moral rights, those transcending legal or political rights, drives us to review four international codes of conduct and to attempt to develop one international uniform code that might be applicable to any business, in any country or culture. (shrink)

The idea of moral certainties is venerable, highly contentious, and nevertheless alive. What I call “hinge ethics” (in analogy to hinge epistemology) combines three currents – meta-ethical concerns about the scope and limits of moral knowledge and objectivity, the idea of limits of doubt as articulated in On Certainty, and sympathies for Wittgensteinian ideas about ethics. This essay critically assesses hinge ethics, focusing on Nigel Pleasants’ work. My main objection is not that Wittgensteinian ideas about certainty cannot be transferred from (...) the domain of physical phenomena to the moral domain. Nor shall I nail my colours to the mast of moral relativism. Instead my main tack will be as follows: Several of the views hinge ethicists detect in or derive from On Certainty are intriguing and ingenious, yet either unwarranted and/or not echt Wittgensteinian. Purported moral certainties like the wrongness of killing are neither ineffable, nor non-propositional, nor quasi-transcendental preconditions of moral thought and action. In so far as morality has scaffolding foundations, it is not certainties but capacities. At least some of these capacities are cognitive, a matter of social cognition. (shrink)

In the recent literature on the ontology and metaphysics of words, Jerrold J. Katz’ type-realist or ‘Platonist’ view is often mentioned but never spelt out in detail. This is perhaps understandable in light of the fact that his most developed statements on this matter are effectively offshoots of his main discourse in Realistic Rationalism (Katz, 1998a). His direct statements about the metaphysics of words are few and far between and are scattered across the text. This situation has often led to (...) misunderstandings or misconstruals about the exact nature of his view, some of which is buried in footnotes, and some of which must be reconstructed. Hence, criticisms of Katz’ approach have been wide of the mark or otherwise unproductive. In this article, I provide a remedy for this situation by drawing together and abstracting the relevant material regarding the metaphysics of words from its context and reconstructing the theory. I also develop the view further through resolving some potential problems and omissions, and by responding to recent criticism that the approach has received in the burgeoning literature on the philosophy of words. I hope that this will help to clarify the theory and lead to further debate and development on all sides of the discussion. (shrink)

“Don’t think, but look!” (Wittgenstein 2009: § 66). This insistient advice has served as methodological inspiration for several influential thinkers in the broad range of ‘empirically informed’ philosophy, which has flourished over the last decades. There is, however, a worrisome tension between Wittgenstein’s work and these turns to practices, history, science, field work, and everyday life: Wittgenstein is in general doing something different from what the thinkers who claim to be inspired by him are doing. An argument for the legitimacy (...) of the move from Wittgenstein to empirically informed philosophy is so far missing in the literature. This article shows how this move can be justifiable within a Wittgensteinian frame, philosophically beneficial, and at times even necessary. (shrink)

Euthanasia has once again become headline news in the UK, with the announcement by Dr Michael Irwin, a former medical director of the United Nations, that he has helped at least 50 people to die, including two between February and July 1997. He has been quoted as saying that his ‘conscience is clear’ and that the time has come to confront the issue of euthanasia. For the purposes of this article, the term ‘beneficent voluntary active euthanasia’ (BVAE) will be used: (...) beneficent from the prima facie principle of beneficence, to do good, and voluntary to indicate that this must be carried out at the request of a competent client. This implies adherence to another prima facie principle, that of respect for autonomy. Active implies that something is done or given with the intention of hastening death. The word euthanasia itself simply means ‘good death’. This article examines the moral positions of two nurses and one junior doctor towards the subject of BVAE and an attempt is made to represent the main conflicting moral positions. The central arguments against BVAE and counterarguments are presented. The conclusion reached is that consenting adults should not be prevented from availing themselves of BVAE if another consenting adult (a medical doctor) is available and capable of carrying out their wishes. This being the case, it is suggested that BVAE should be available as an option in hospices and in the community. The aims of this article are: to generate debate among professionals; to present a three-way discussion that might be useful as a focus for educational purposes, particularly at undergraduate level; to challenge professionals to confront the issue of euthanasia; and to plead the case of those who request assistance in exercising autonomy by gaining control over their own deaths. (shrink)

The problems of exposing students to real life situations in which they can gain an insight into the dilemmas experienced by clients and staff are highlighted. The value of the Greek notion of catharsis (katharsis: a cleansing) is discussed and the use of literature is suggested as a means of providing students with vicarious experience of the real, but often inaccessible, situations in which nurses may have to make moral decisions.

"We shall become more Scandinavian." This sentence was pronounced in 2013 by French President François Hollande's entourage.1 It was the starting point for new legislation, notably on transparency, along with a general attempt to diminish the gap between the ruling class and ordinary people. Hollande was seemingly trying to transform "French political culture, a Latin culture, into a Scandinavian culture."2Hollande was not alone in this attempt. During the 2017 presidential campaign, Emmanuel Macron stated that his political project was "exactly like (...) the Scandinavian model," adding that this Scandinavian model "works much better than ours."3 He also pointed out that he saw the "moralization" of public life as one... (shrink)

Gaining ethical clearance to conduct a study is an important aspect of all research involving humans but can be time-consuming and daunting for novice researchers. This article stems from a larger ethnographic study that examined research capacity building in Irish nursing and midwifery. Data were collected over a 28-month time frame from a purposive sample of 16 nurse or midwife research fellows who were funded to undertake full-time PhDs. Gaining ethical clearance for their studies was reported as an early ‘rite (...) of passage’ in the category of ‘labouring the doctorate’. This article penetrates the complexities in Irish clinical research ethics by describing the practices these nurse and midwife researchers encountered and the experiences they had. The key issue of representation that occurred in the context of ‘medicalized’ research ethics is further explored including its meaning for nursing or midwifery research. (shrink)

SCL (TAL1/TCL5) is a member of the helix‐loop‐helix family of transcription factors. Originally identified because of its involvement in a tumour‐specific chromosomal translocation, overexpression of the SCL gene is the most common molecular abnormality found in human T cell leukaemia. Transgenic models have now formally demonstrated that overexpression of SCL within the T cell lineage is capable of causing malignant transformation. Gene targeting experiments have revealed that the SCL gene is crucial for the development of primitive haematopoiesis in the mouse (...) and is also required for the generation of all adult haematopoietic lineages. Biochemical studies have indicated some of the proteins which interact with SCL and this has refined the hypotheses concerning the mechanisms by which SCL plays a role in leukaemogenesis and haematopoietic development. (shrink)

Legitimacy challenges are part of human societies. Whenever we recognise a person, law, ideal or institution as authoritative, questions can be raised about their legitimacy. Why follow this law? Why strive to honour this moral ideal? If such questions are repeatedly raised, they pose an undermining threat to the authorities in question. This is good if the challenged law or ideal is harmful, but problematic, if it is beneficial. Where the first kind of legitimacy challenges are raised by ethical pioneers (...) and moral critics, the last kind are posed by cynics, who disregard the demands of law and morality when they conflict with their interests. The threat to human society caused by cynicism is part of the reason why philosophers since Plato have sought to address and rid society of it.This article discusses how philosophy can deal with cynicism. It does so by firstly looking at how Anthony Holiday defends a moral realist theory and disproves ‘the theory of cynicism’ as well as tries to subvert real life cynics. Secondly, the work of the later Wittgenstein is used to discuss Holiday’s approach, finding it to some extent wanting in both its theoretical and practical aims.Lastly, inspired by Stanley Cavell’s thinking it is suggested that cynicism calls for not only problem solving and problem dissolving, but also something we might call reconciliation. (shrink)

Moral certainty refers to those aspects of morality- moral acting, feeling, and thinking-that are beyond doubt, explanation, and justification. The essays in this book explore the concept of moral certainty and its application and usefulness in contemporary moral debates. The notion of moral certainty, which is inspired by the philosophy of Ludwig Wittgenstein, is emerging as a key reference point in contemporary moral philosophy. An investigation of the implications of moral certainty is called for, given that so many discussions in (...) moral philosophy concern the possibility of justifying our moral beliefs. The concept of moral certainty also feeds directly into the emerging field of hinge epistemolo,gy. The chapters in this volume tackle the following issues: meta-questions around whether and how we can make sense of the concept of moral certainty; the role of moral certainty in contemporary debates on gender, racism, bias and historically unjust practices; ways in which radical change in society engendered by new technologies might affect moral certainties; the role of the notion of moral certainty in the debates on free will and moral responsibility. Philosophical Perspectives on Moral Certainty will appeal to researchers and advanced students working on ethics and moral philosophy, epistemology, philosophy of technology, and Wittgenstein. (shrink)

The theme of change is one of the most prominent traits of Wittgenstein’s later work, and his writings have inspired many contemporary thinkers’ discussions of changes in e.g. concepts, ‘aspect-seeing’, practices, worldviews, and forms of life. However, Wittgenstein’s conception of the dynamics of change has not been investigated in its own right. The aim of this paper is to investigate which understanding of the dynamics of changes can be found in the later Wittgenstein’s work. I will argue that what emerges (...) is a rich and complex picture that has the potential to aid our thinking in politics and elsewhere when developing strategies for creating changes. It can do so both as source of inspiration and by countering tempting, yet ultimately problematic ways of conceptualizing change like the hope for transforming harmful traditions and social practices with the help of a general explanatory theory of the fundamental dynamics of changes. (shrink)