Emergency care in large urban hospitals across the country is in the midst of major redesign intended to deliver quality care through improved access, decreased wait times, and maximum efficiency. The central argument in this paper is that the conceptualization of quality including the documentary facts and figures produced to substantiate quality emergency care is socially organized within a powerful ruling discourse that inserts the interests of politics and economics into nurses' work. The Canadian Triage and Acuity Scale figures prominently (...) in the analysis as a high‐level organizer of triage work and knowledge production that underpins the way those who administer the system define, measure and evaluate emergency care processes, and then use this information for restructuring. Managerial targets and thinking not only dominate the way emergency work is understood, determined, and controlled but also subsume the actual work of health‐care providers in spaces called ‘wait times’, where it is systematically rendered ‘unknowable’. The analysis is supported with evidence from an extensive institutional ethnography that shows what nurses actually do to manage the safe passage of patients through their emergency care process starting with the work of triage nurses. (shrink)

Previous studies suggest that social class, class background, and social mobility have important consequences for family life. Exploring hypotheses derived from these studies, as well as the literature on intergenerational relations, the authors focus on one key aspect of family relations: adult daughters' ties to their mothers. Analyzing data from the National Survey of Families and Households, the authors explore how employed women's relations with their mothers are shaped by race, social class memberships and backgrounds, and family arrangements. Their results (...) suggest that social class and mobility exert powerful effects on women's sense of their relations with their mothers, especially among Whites. In addition, however, it is shown that mother-daughter ties among African American and White women are also influenced by family arrangements that operate somewhat independently of social class and mobility. (shrink)

This article explores female religious interaction in racially divided ‘colonial’ South Africa through the lives of five unmarried Anglican women missionaries who worked in and around Johannesburg between 1907 and 1960. It particularly analyses the quality of their personal relationships with African women converts, colleagues and students. Deaconess Julia Gilpin, in the imperial, anglicizing post-Boer War years, encouraged devout, respectable wifehood on the mine compounds, contributing to the corporate solidarity of praying mothers as a deeply entrenched feature of most black (...) churches. Dora Earthy interacted in a warmer, more egalitarian way with black churchwomen. Her transfer to Mozambique led not only to evangelistic building on African cultural traditions and pioneering anthropological research but also to the protection and validation of Christian widows’ autonomy against coerced remarriage. Frances Chilton and Dorothy Maud, despite sharply contrasting class origins, struggled to connect with more assertive networks of married women in the segregationist 1920s and 1930s, devoting their energies rather to guiding and enhancing African girlhood and youth. Hannah Stanton, in the more politically fraught 1950s, recognized the necessary independence of African actors and the limitations of outdated white liberal advocacy. Her training of African women promised new theological and organizational maturity, a potential collegiality, cut short by her detention in the 1960 State of Emergency and subsequent expulsion. The historical sweep of this survey suggests which personal and political conjunctures opened up or closed down meaningful interaction between colonized and colonizing women. It also offers a more positive evaluation of the intersection of race and religion as not invariably a ‘fatal combination’. The politics of the personal in women's joint educational, mission and social welfare ventures across the racial divide helped keep alive the idea of a single society and thus aided the surprisingly peaceful transition to democracy in South Africa in 1994. (shrink)

In most other nations, insurance for medical care is called sickness insurance, and it covers sick people. In the United States, we have “health insurance,” and its major carriers — commercial insurers, large employers, and increasingly government programs — strive to avoid sick people and cover only the healthy. This perverse logic at the heart of the American health insurance system is the key to reform debates.Focusing on sick people versus healthy people might seem a strange way to view the (...) coverage issue. Most discussions of insurance categorize people into other groupings: the insured versus the uninsured; Caucasian whites versus other racial and ethnic groups; men versus women; poor and low-income people versus everybody else; children, adults, and the elderly; or citizens versus immigrants and undocumented aliens. More recently, health researchers have begun talking about “vulnerable populations,” using most of the same demographic groupings and adding other illness-inducing factors such as social isolation, stress, and impoverished neighborhoods. But as I will show, insurance plans now use premiums, cost-sharing, and other design features in ways that indirectly divide each of these groups into the sick and the healthy, to the detriment of the sick. By shifting the costs of illness onto people who use medical care — that is, sick people — market-oriented reforms of the last few decades have eroded insurance in the name of strengthening it. (shrink)

In lieu of an abstract, here is a brief excerpt of the content: Five Poems DEBORAH WARREN Bugonia hic vero subitum dictu mirabile monstrum aspiciunt, liquefacta boum per viscera toto stridere apes utero et ruptis effervere costis. —Vergil, Georgics IV The covert’s dark, but Aristaeus sees —beyond it, in the oleandered meadow, walking to her wedding with her maids— Eurydice, as sweet as early windfall apples to the gods of the bitter dead. She runs, from shifting shade to sun (...) to shade until, in a shock of sudden sun, she sways, blinded, blundering into an adder’s kiss, and while the bridegroom waits by the bridal bed, she waits to be undressed by worms instead. But Aristaeus pays for the assault. The mead-gods visit on his apiaries wax-moth, mites, foulbrood and chalk-disease until an oracle orders a hekatomb: after nine days the myrtle-nymphs perform a miracle, and out of the carcases crawl fat new sun-furred drones to work the comb, a gift of the mead-gods who, with the poet, praise the teams of bright collaborating bees as little Romans—parvos Quirites. arion 27.1 spring/summer 2019 And what about Eurydice? The swarm goes humming on, a small Rome in a hive. The story’s not about Eurydice’s second chance, or whether she’ll survive. Eurydice’s a minor character; she’s only one girl, sui generis. Besides, no cattle-trick exists for her. The gods can let the apiaries thrive and armies—even empires—endure; one girl’s more complicated to replace. 44 five poems The Tithonus Club We can begin our visit with the Day Room where, in wheelchairs, some with canes or walkers, members sit: a fraternity so ancient that the confrères mostly ignore each other (club tradition). The dues are paid in decades; no one has an outstanding balance—Sir? Whoa, steady, there! Sit down... yes. Here’s your blanket. The badge of membership—the club regalia? Laminated ceremonial bracelets bear the motto Do Not Resuscitate (legend which, in practice, is seldom honored). Eleven-thirty, gentlemen; lunch is served, and now a little toast while the television mesmerizes the aides: Messieurs, your health! Deborah Warren 45 Aphrodite at the Old-Age Home —for Aphrodite Kalogeris “Honey,” the night nurse said to Aphrodite, “let me fix your bib. Look, Aphrodite! Here’s your juice and crackers, Aphrodite! “She doesn’t speak a blessed word of English,” the night nurse told us, “but she understands as good as if we spoke to her in Greek.” Aphrodite’s ears were as grotesque as the pore-coarse nose that bloomed across her face, but she heard her name: When Aphrodite rose and, beatific, dreamed across the room, traversing a happiness none of us could hear, she spoke a language older than herself but still her own—a dialect of beauty able to translate the fetid air. 46 five poems Climbing Etna We’d see the lava, nights, from the town square, as if the sun—an egg of fire—broke at dusk, threading its incandescent yolk down a mountain hanging in black air. Every night we’d scan the dark horizon looking for those streaks, and every night they took a while to find, however bright: Etna, it seemed, had spent the evening rising off the earth, to hover even higher, as if the mountain meant not to be found. And then, today, we ran the flows to ground, climbing up to the rolling burns of fire— closer, into the shimmering air and hiss that glanced up from the thick and red-flecked river —until our soles were smoking. But the lava sang, inside the mountain: Come, discover the fire’s origin and genesis; more—the heart of the world, in its enceinte of blind white heat. Seeing the lava course wasn’t enough, or watching the rock decant the sun; what brought us up here was the force— the hot loins—of a lightning god as dark as thunder; and, like Eve, like Semele, we wanted to approach. But there’s a spark, a jewel older than geology: stop shy of it—of finding the fire’s source, of closing in on what you shouldn’t see. Deborah Warren 47 Human Sucking strength... (shrink)

“Ignorance” is receiving an increased amount of philosophical attention. The study of it even has its own name, “agnotology.” Some ignorance remains simply a case of not having enough information, but increasingly philosophers are recognizing a whole other type of ignorance, one that is socially constructed and often actively promoted. In the first section of this paper I examine perhaps the best known type of socially constructed ignorance, “white ignorance.” White ignorance reflects a lack of genuine understanding of (...) the social realities of others and it creates injustice. In the second section of the paper, I consider what it means to “genuinely understand,” arguing that when it comes to issues of justice those with epistemic power have a moral obligation to at least attempt to understand others’ social realities. (shrink)

This book considers whether we can be epistemically responsible for undesirable beliefs, such as racist and sexist ones. The problem with holding people responsible for their undesirable beliefs is: first, what constitutes an “undesirable belief” will differ among various epistemic communities; second, it is not clear what responsibility we have for beliefs simpliciter; and third, inherent in discussions of socially constructed ignorance (like white ignorance) is the idea that society is structured in such a way that white people (...) are made deliberately unaware of their ignorance, which suggests their racial beliefs are not epistemically blameworthy. This book explores each of these topics with the aim of establishing the nature of undesirable beliefs and our responsibility for these beliefs with the understanding that there may well be (rare) occasions when undesirable beliefs are not epistemically culpable. (shrink)

Heikes challenges Enlightenment rationality's tendency to be an achievement concept which excludes non-whites and non-males. She examines post-Cartesian criticisms of modernism, and pre-modern efforts to address the functional diversity of human cognition, arguing that such approaches offer a rationality that is diverse and morally substantive.

Deborah is a thirty-three-year-old who presented to labor and delivery at thirty-seven weeks gestation with complaints of contractions. Upon arrival, she explained that her fetus, Nathan, had been diagnosed with a “lethal” condition by her primary obstetrician. At twenty-two weeks gestation, an amniocentesis confirmed trisomy 13, a chromosomal abnormality leading to miscarriage or stillbirth in nearly one-half of affected pregnancies. During the admission process, Deborah voices the worry that due to Nathan's brain and heart structure, vaginal delivery could (...) be traumatic and cause him to suffer. Deborah wishes for him to have as painless and as dignified a death as possible; cesarean section, she feels, will achieve this. Yet with her history of three prior vaginal deliveries, normally progressing labor, and poor fetal prognosis that is unlikely to improve with cesarean delivery, there is no maternal or fetal indication for a cesarean section. Should the obstetrician proceed with a cesarean delivery despite knowing that it would expose the mother to surgical risks with little or no corresponding fetal or neonatal benefit? (shrink)

This article presents narratives from 13 Indigenous early career academics (ECAs) at one university in Auckland, New Zealand. These experiences are likely to represent those of Indigenous Māori and Pasifika ECAs nationally, given the small, centralised nature of the national academy of Aotearoa New Zealand. The narratives contain testimony, fictionalised vignettes of experience, and poetic expressions. Meeting the demands of an academic role in one’s first years of working at a university is a big deal for anyone; the extra pressures (...) and challenges for Indigenous Māori and Pacific staff are immense, yet little understood by White ‘others.’ A writing workshop was the initial catalyst of this collective writing project. Through these insider narratives, this article presents a collective description of, and response to, the experience of Māori and Pasifika early career academics. (shrink)

Pre-reading language skills develop rapidly in early childhood and are related to brain structure and functional architecture in young children prior to formal education. However, the early neurobiological development that supports these skills is not well understood. Here we acquired anatomical, diffusion tensor imaging and resting state functional MRI from 35 children at 3.5 years of age. Children were assessed for pre-reading abilities using the NEPSY-II subtests 1 year later. We applied a data-driven linked independent component analysis to explore the (...) shared co-variation of gray and white matter measures. Two sources of structural variation at 3.5 years of age demonstrated relationships with Speeded Naming scores at 4.5 years of age. The first imaging component involved volumetric variability in reading-related cortical regions alongside microstructural features of the superior longitudinal fasciculus. The second component was dominated by cortical volumetric variations within the cerebellum and visual association area. In a subset of children with rs-fMRI data, we evaluated the inter-network functional connectivity of the left-lateralized fronto-parietal language network and its relationship with pre-reading measures. Higher functional connectivity between the FPL and the default mode and visual networks at 3.5 years significantly predicted better Phonological Processing scores at 4.5 years. Together, these results suggest that the integration of functional networks, as well as the co-development of white and gray matter brain structures in early childhood, support the emergence of pre-reading measures in preschool children. (shrink)

The Well-Ordered Universe argues that Cavendish's natural philosophy, social and political philosophy, and medical theory share an underlying concern with order. This reveals interesting connections among Cavendish's natural philosophy and her views on gender, animals and the environment, and human health, and explains her commitment to monarchy and social hierarchy.

It is common to hear talk of the aim of belief and to find philosophers appealing to that aim for numerous explanatory purposes. What belief 's aim explains depends, of course, on what that aim is. Many hold that it is somehow related to truth, but there are various ways in which one might specify belief 's aim using the notion of truth. In this article, by considering whether they can account for belief 's standard of correctness and the epistemic (...) norms governing belief, I argue against certain prominent specifications of belief 's aim given in terms of truth, and advance a neglected alternative. (shrink)

How and why, historian of science Lily Kay asks, did the ‘biological problem of DNA-based protein synthesis’ come to be represented ‘as an information code and a writing technology?’ What sort of metaphor was ‘code’ for these bio-geneticists? One whose run-away expansion, Derrida noted in Of Grammatology (1967), urgently required philosophical justification. Yet, 60 years later, there is still fundamental disagreement about its meaning and epistemic status. If the metaphor lacks ontological purchase, what accounts for its effectiveness? If, on the (...) other hand, scriptural metaphors get at the common root of culture and biology, what do we now mean by ‘code’? In this article, I trace several influential accounts of the metaphor’s effectiveness—making explicit the opposing notions of ‘code’ that animate them—and argue that each is too limited. Greater attention to the metaphoricity of ‘code’ yields a more philosophically productive and critical account of the metaphor of code. (shrink)

The process of seeking the consent of a patient to a medical procedure is, arguably, one of the most important skills a doctor, or indeed any clinician, should learn. In fact, the very idea that doctors may institute diagnostic or treatment processes of any sort without a patient's consent is utterly counter-intuitive to the modern practice of medicine. It was not always thus, and even now it can be reliably assumed that consent is still not sought and gained appropriately in (...) every clinical encounter. To say that it should be sought and gained in this manner elevates the value of consent to a high level. It can be instructive to ask oneself why such a value might be held to be the case. The answer to this question lies in the philosophical underpinning of clinical consent, which sits within a notion of personal autonomy, and respect for autonomous decision making. (shrink)

O êxodo rural brasileiro compreendeu um processo de grande magnitude desde o seu início, onde, em comparativo, poucos países experimentaram fluxo migratório tão intenso, tendo em vista a quantidade absoluta da população atingida. Uma das características encontradas nos movimentos migratórios brasileiros se estabelece na diferenciação por sexo. Estudos apontam que as mulheres migram mais do que os homens, além do fluxo migratório se caracterizar cada vez mais pela saída de jovens do campo. Nesse sentido, o presente artigo se propõe a (...) analisar a categoria rural, abordando a situação das mulheres migrantes no contexto do Norte de Minas. Para tanto, utilizará do levantamento bibliográfico na construção de uma revisão acerca das práticas migratórias do campo realizadas por jovens, de modo a entender e problematizar a questão do gênero no processo migratório. Como resultado parcial tem-se que as mulheres continuam migrando, sendo tal deslocamento realizado com propósitos variados e, muitas vezes, devido à ausência de políticas públicas regionais, que resultam em pouca perspectiva de valorização do campo/gênero. Sendo assim, o processo migratório, principalmente no que diz respeito à questão de gênero, não se encerra nas discussões apresentadas, sendo necessários estudos que acompanhem as distintas dimensões que o migrar implica. (shrink)

Laspro et al. (2024) present an insightful survey of ethical issues emerging in first-in-human whole eye transplants (WET). Their discussion is applicable to a broad range of first-in-human surgica...

In a recent poem, Vom Schnee, oder Descartes in Deutschland, German writer Durs Grünbein suggests that a snowy, white landscape inspired the young René Descartes to theoretically define nature. Indeed, Descartes's reduction of nature to extended matter composed of particles in movement and abiding by the laws of nature entails a reduction of all bodies' diversity to a mechanistic system in which all secondary qualities are mathematically framed. The description of colors in the Regulae ad directionem ingenii exemplifies this (...) reduction of nature to a geometrical grid with no differences—Jean-Luc Marion (Sur... (shrink)

The existential analysis -- The death of dasein -- The timeliness of dasein -- The derivation of time -- The time of being.

Philosophical aesthetics emerges out of eighteenth-century discussions of taste that paid scant attention to the experience of tasting and ingesting food. Sarah Worth diagnoses this historical oversight and offers an unexpected remedy. She argues that we should start our analysis of aesthetic taste over again, this time beginning with the pleasures of the tongue and mouth, and work out from there to consider the kinds of experience, knowledge, and appreciation that belong to eating and savoring. As she argues, our ability (...) to make gustatory discriminations and to determine what tastes good and why is not as different from our aesthetic judgments as philosophers and other aesthetic theorists might have led us to believe. In this engaging and readable book, Worth persuasively argues that food and its many tastes deserve serious philosophical consideration.Worth explores a number of puzzles that arise when we try to make sense of the concept of taste. She disentangles the metaphorical sense of taste understood as a reasoned judgment expressing aesthetic preferences from the literal sense of taste which involves our sensory experiences when food is in our mouths. She discusses good and bad taste, food and pleasure, authentic and inauthentic food, “food porn”—those impossibly glamourized images of food that we find in advertising and magazines and cookbooks and social media—and the role of recipes in the practice of cooking. She places our everyday experiences of food in the context of wider relationships and activities including cultivation, harvesting, processing, shipping, and purchasing, as well as the preparation and cooking meals for family and friends. The book is punctuated by many of the usual philosophical suspects (Plato and Aristotle, Hume and Kant, Bullough and Sibley) as well as critical and feminist theorists, food sociologists, and a number of famous chefs including Fannie Farmer, Julie Child, and Nigella Lawson. If Worth endorses a particular metaphilosophy of food, it would be that of the Slow Food movement, which is the subject of Chapter Three. (shrink)

The author examines three fundamental concepts: existence, a priori knowledge, and value. These concepts have been recurrent concerns of western philosophy and also reveal important similarities and differences between the movements from which the author takes his departure.

: This paper focuses on Princess Elisabeth of Bohemia's philosophical views as exhibited in her early correspondence with René Descartes. Elisabeth's criticisms of Descartes's interactionism as well as her solution to the problem of mind-body interaction are examined in detail. The aim here is to develop a richer picture of Elisabeth as a philosophical thinker and to dispel the myth that she is simply a Cartesian muse.

In the social sciences and in everyday speech we often talk about groups as if they behaved in the same way as individuals, thinking and acting as a singular being. We say for example that "Google intends to develop an automated car", "the U.S. Government believes that Syria has used chemical weapons on its people", or that "the NRA wants to protect the rights of gun owners". We also often ascribe legal and moral responsibility to groups. But could groups literally (...) intend things? Is there such a thing as a collective mind? If so, should groups be held morally responsible? Such questions are of vital importance to our understanding of the social world. In this lively, engaging introduction Deborah Tollefsen offers a careful survey of contemporary philosophers? answers to these questions, and argues for the unorthodox view that certain groups should, indeed, be treated as agents and deserve to be held morally accountable. Tollefsen explores the nature of belief, action and intention, and shows the reader how a belief in group agency can be reconciled with our understanding of individual agency and accountability. _Groups as Agents_ will be a vital resource for scholars as well as for students of philosophy and the social sciences encountering the topic for the first time. (shrink)

"Simone Weil's bibliography": p. [181]-194. Includes index. Introduction / George Abbott White -- The jagged edge / Michele Murray -- Simone Weil's mind / Robert Coles -- The life and death of Simone Weil / J.M. Cameron -- Simone Weil, last things / Michele Murray -- Simone Weil's Iliad / Michael K. Ferber -- Notes on Simone Weil's Iliad / Joseph H. Summers -- Patriotism and The need for roots / Conor Cruise O'Brien -- Marxism-Leninism and the language of (...) Politics magazine / Staughton Lynd -- Simone Weil's work experiences / George Abbott White. (shrink)

To raise the question of the nature of narrative is to invite reflection on the very nature of culture and, possibly, even on the nature of humanity itself. So natural is the impulse to narrate, so inevitable is the form of narrative for any report of the way things really happened, that narrativity could appear problematical only in a culture in which it was absent—absent or, as in some domains of Western intellectual and artistic culture, programmatically refused. As a panglobal (...) fact of culture, narrative and narration are less problems than simply data. As the late Roland Barthes remarked, narrative "is simply there like life itself . . . international, transhistorical, transcultural."1 Far from being a problem, then, narrative might well be considered a solution to a problem of general human concern, namely, the problem of how to translate knowing into telling,2 the problem of fashioning human experience into a form assimilable to structures of meaning that are generally human rather than culture-specific. We may not be able fully to comprehend specific thought patterns of another culture, but we have relatively less difficulty understanding a story coming from another culture, however exotic that culture may appear to us. As Barthes says, "narrative...is translatable without fundamental damage" in a way that a lyric poem or a philosophical discourse is not. · 1. Roland Barthes, "Introduction to the Structural Analysis of Narratives," Music, Image, Text, trans. Stephen Heath , p. 79.· 2. The words "narrative," "narration," "to narrate," and so on derive via the Latin gnārus and narro from the Sanskrit root gnâ . The same root yields γνωριμος : see Emile Boisacq, Dictionnaire étymologique de la langue grecque , under the entry for this word. My thanks to Ted Morris of Cornell, one of our greatest etymologists. Hayden White, professor in the program of history of consciousness at the University of California, Santa Cruz, is the author of The Tropics of Discourse: Essays in Cultural Criticism, The Greco-Roman Tradition, and Metahistory: The Historical Imagination in Nineteenth Century Europe. " The Narrativization of Real Events" appeared in the Summer 1981 issue of Critical Inquiry. Critical Responses to the present essay include Louis O. Mink's "Everyman His or Her Own Annalist", and Marilyn Robinson Waldman's "The Otherwise Unnoteworthy Year 711: A Reply to Hayden White," both in the Summer 1981 issue of Critical Inquiry. (shrink)

Decades before the environmental movement emerged in the 1960s, Adorno condemned our destructive and self-destructive relationship to the natural world, warning of the catastrophe that may result if we continue to treat nature as an object that exists exclusively for our own benefit. "Adorno on Nature" presents the first detailed examination of the pivotal role of the idea of natural history in Adorno's work. A comparison of Adorno's concerns with those of key ecological theorists - social ecologist Murray Bookchin, ecofeminist (...) Carolyn Merchant, and deep ecologist Arne Naess - reveals how Adorno speaks directly to many of today's most pressing environmental issues. Ending with a discussion of the philosophical conundrum of unity in diversity, "Adorno on Nature" also explores how social solidarity can be promoted as a necessary means of confronting environmental problems. (shrink)

The seventeenth century was a period of extraordinary invention, discovery and revolutions in scientific, social and political orders. It was a time of expansive automation, biological discovery, rapid advances in medical knowledge, of animal trials and a questioning of the boundaries between species, human and non-human, between social classes, and of the assumed naturalness of political inequality. This book gives a tour through those objects, ordinary and extraordinary, which captivated the philosophical imagination of the single most important French philosopher of (...) this period, Rene Descartes. Deborah J. Brown and Calvin G. Normore document Descartes' attempt to make sense of the complex, composite objects of human and divine invention, consistent with the fundamental tenets of his metaphysical system. Their central argument is that, far from reducing all the categories of ordinary experience to the two basic categories of substance, mind and body, Descartes' philosophy recognises irreducible composites that resist reduction, and require their own distinctive modes of explanation. (shrink)