In this paper, we consider the role of conversations in contributing to healthcare quality improvement. More specifically, we suggest that conversations can be important in responding to what we call ’normative complexity’. As well as reflecting on the value of conversations, the aim is to introduce the dimension of normative complexity as something that requires theoretical and practical attention alongside the more recognised challenges of complex systems, which we label, for short, as ’explanatory complexity’. In brief, normative complexity relates to (...) the inherent difficulty of deciding what kinds of changes are ’improvements’ or, more broadly, what is valuable in healthcare. We suggest that explanatory and normative complexity intersect and that anyone interested in healthcare improvement needs to be sensitive to both. After briefly introducing the idea of normative complexity, we consider some contrasting examples of conversations, reflecting on how they do and might contribute to healthcare quality. We discuss both conversations that are deliberately organised and facilitated (’orchestrated conversations’) and more informally occurring and routine conversations. In the first half of the paper, we draw on some examples of orchestrated and routine conversations to open up these issues. In the second half of the paper, we bring some more theoretical lenses to bear on both conversations and normative complexity, summarise what we take to be the value of conversations and draw together some of the implications of our discussion. In summary, we argue that conversations can play a crucial role in negotiating the normative complexity of healthcare quality improvement because of their capacity to hold together a plurality of perspectives, to contribute and respond to emergence and to help underpin institutional conditions for empathy and imagination. (shrink)

"L'oeuvre d'art est une tentative vers l'unique, elle s'affirme comme un tout, comme un absolu et, en même temps, elle appartient à un système de relations complexes [...]. Elle est matière et elle est esprit, elle est forme et elle est contenu [...]. Elle est créatrice de l'homme, créatrice du monde et elle installe dans l'histoire un ordre qui ne se réduit à rien d'autre." Un Eloge de la main complète ce texte. "La main arrache le toucher à sa passivité (...) réceptive, elle l'organise pour l'expérience et pour l'action [...]. Elle se mesure avec la matière qu'elle métamorphose, avec la forme qu'elle transfigure. Educatrice de l'homme, elle le multiplie dans l'espace et dans le temps." [Source : 4e de couv.]. (shrink)

What is health policy for? In Health and the Good Society, Alan Cribb addresses this question in a way that cuts across disciplinary boundaries. His core argument is that biomedical ethics should draw upon public health values and ethics; specifically, he argues that everybody has some share of responsibility for health, including a responsibility for promoting greater health equality. In the process, Cribb argues for a major rethink of the whole project of health education.

This Hackett edition, first published in 1981, is an unabridged and unaltered republication of the seventh edition as published by Macmillan and Company, Limited. From the forward by John Rawls: In the utilitarian tradition Henry Sidgwick has an important place. His fundamental work, The Methods of Ethics, is the clearest and most accessible formulation of what we may call 'the classical utilitarian doctorine.' This classical doctrine holds that the ultimate moral end of social and individual action is the greatest (...) net sum of the happiness of all sentient beings. Happinesss is specified by the net balance of pleasure over pain, or, as Sidgwick preferred to say, as the net balance of agreeable over disagreeable consciousness.... (shrink)

In this paper, we argue that there are important ethical questions about healthcare improvement which are underexplored. We start by drawing on two existing literatures: first, the prevailing, primarily governance-oriented, application of ethics to healthcare ‘quality improvement’ (QI), and second, the application of QI to healthcare ethics. We show that these are insufficient for ethical analysis of healthcare improvement. In pursuit of a broader agenda for an ethics of healthcare improvement, we note that QI and ethics can, in some respects, (...) be treated as closely related concerns and not simply as externally related agendas. To support our argument, we explore the gap between ‘quality’ and ‘ethics’ discourses and ask about the possible differences between ‘good quality healthcare’ and ‘good healthcare’. We suggest that the word ‘quality’ both adds to and subtracts from the idea of ‘good healthcare’, and in particular that the technicist inflection of quality discourses needs to be set in the context of broader conceptualisations of healthcare improvement. We introduce the distinction between quality as a measurable property and quality as an evaluative judgement, suggesting that a core, but neglected, question for an ethics of healthcare improvement is striking the balance between these two conceptions of quality. (shrink)

Translational research is now a critically important current in academic medicine. Researchers in all health-related fields are being encouraged not only to demonstrate the potential benefits of their research but also to help identify the steps through which their research might be ‘made practical’. This paper considers the prospects of a corresponding movement of ‘translational ethics’. Some of the advantages and disadvantages of focusing upon the translation of ethical scholarship are reviewed. While emphasising the difficulties of crossing the gap between (...) scholarship and practice, the paper concludes that a debate about the business of translation would be useful for medical ethics. (shrink)

In this paper I consider the routine moral burden of occupying a professional role and having to negotiate tensions between the normative expectations attached to that role and one's own personal moral compass. Using an example to introduce this central issue I then seek to explore it through a discussion of the tensions between, and spaces between, ‘identifying’ with one's role and ‘separating’ oneself from one's role. I suggest that ethical integrity at work is revealed through the successful negotiation of (...) these tensions, but that such negotiation depends upon the power and other resources available to individual professionals. Finally I argue that this discussion of ‘the ethics of role occupation’ has important implication for ‘the ethics of role construction’ and adds weight to concerns about the potential moral costs of managerialism. (shrink)

One of the major works of an important modem philosopher, Matter and Memory investigates the autonomous yet interconnected planes formed by matter and perception on the one hand and memory and time on the other. Henry Bergson (1859-1941) was awarded the Nobel Prize in 1927. His works include Time and Free Will, An Introduction to Metaphysics, Creative Evolution, and The Creative Mind.

In this editorial essay I explore the possibilities of ‘improvement scholarship’ in order to set the scene for the theme of, and the other papers in, this issue. I contrast a narrow conception of quality improvement research with a much broader and more inclusive conception, arguing that we should greatly extend the existing dialogue between ‘problem-solving’ and ‘critical’ currents in improvement research. I have in mind the potential for building a much larger conversation between those people in ‘improvement science’ who (...) are expressly concerned with tackling the problems facing healthcare and the wider group of colleagues who are engaged in health-related scholarship but who do not see themselves as particularly interested in quality improvement, indeed who may be critical of the language or concerns of QI. As one contribution to that conversation I suggest that that the increasing emphasis on theory and rigour in improvement research should include more focus on normative theory and rigour. The remaining papers in the issue are introduced including the various ways in which they handle the ‘implicit normativity’ of QI research and practice, and the linked theme of combining relatively ‘tidy’ and potentially ‘unruly’ forms of knowledge. (shrink)

Of all the developments in twentieth century physics, none has given rise to more heated debates than the changes in our understanding of science precipitated by the quantum revolution''. In this revolution, Niels Bohr's dramatically non-classical theory of the atom proved to be the springboard from which the new atomic physics drew it's momentum. Furthermore, Bohr's contribution was crucial not only because his interpretation of quantum mechanics became the most widely accepted view but also because in his role as educator (...) and spokesman for atomic physics Bohr was very much the patron spirit of the entire quantum revolution. The conceptual framework which he proposed to provide a new viewpoint for understanding the quantum theoretical description of atomic systems became for most of this century the dominant outlook of countless productive experimental and theoretical physicists. He called this new framework complementarity''. (shrink)

"Science et méthode" de Henri Poincaré. Mathématicien, physicien et philosophe français (1854-1912).

" Vivid . . . immense clarity . . . the product of a brilliant and extremely forceful intellect." — Journal of the Royal Naval Scientific Service "Still a sheer joy to read." — Mathematical Gazette "Should be read by any student, teacher or researcher in mathematics." — Mathematics Teacher The originator of algebraic topology and of the theory of analytic functions of several complex variables, Henri Poincare (1854–1912) excelled at explaining the complexities of scientific and mathematical ideas to lay (...) readers. Science and Method, written in 1908, has been appreciated by a wide audience of nonprofessionals and translated into many languages. It defines the basic methodology and psychology of scientific discovery, particularly in regard to mathematics and mathematical physics. Drawing on examples from many fields, it explains how scientists analyze and choose their working facts, and it explores the nature of experimentation, theory, and the mind. 1914 edition. Translated by Francis Maitland. (shrink)

"With its signal distinction between 'intuition' and 'analysis' and its exploration of the different levels of Duration, _An Introduction to Metaphysics_ has had a significant impact on subsequent twentieth century thought. The arts, from post-impressionist painting to the stream of consciousness novel, and philosophies as diverse as pragmatism, process philosophy, and existentialism bear its imprint. Consigned for a while to the margins of philosophy, Bergson’s thought is making its way back to the mainstream. The reissue of this important work comes (...) at an opportune time, and will be welcomed by teachers and scholars alike." --Peter A. Y. Gunter, University of North Texas. (shrink)

Available from UMI in association with The British Library. Requires signed TDF. ;This thesis considers the place of values in comparative political inquiry. After a review of the debate in the philosophy of social science between the positivist and hermeneutic approaches , the argument is divided into two parts. The first part looks at the origins, and consequences, of the attempt to establish a positivistic value-free comparative political science. The second part considers the basis, and the potential nature, of a (...) self-consciously normative discipline of comparative politics. ;The idea of value-freedom is criticised; it is argued: that the failure to take into account the values of the comparative theorist results in the imposition of a non-neutral framework on the phenomena under investigation; and that the failure to take into account the values of the agents under investigation makes it impossible to properly describe or explain political phenomena. ;Examples are used to illustrate these points but also to show how, and why, the rhetoric of neutrality is sustained in practice. It is suggested that mainstream comparative political science conflates a positivist epistemology and a quantitative research methodology. This mixture results in a variety of confusions but is seen to protect comparative politics from "the problem of relativism", which is treated as the principal weakness of the hermeneutic approach. ;Two possible foundations for a normative comparative politics are considered. Firstly, the idea that it is possible to found comparative politics on a non-relative moral theory is reviewed and rejected. It is argued that the best candidates for such a theory, utilitarianism and "thin" theories of the good, cannot be established a priori. Secondly, the assumption that the existence of a plurality of cultures, moral beliefs, and theoretical perspectives leads to relativism is rejected. Instead it is argued that the existence of diversity and disagreement itself provides the basis for a coherent and self-critical discipline, and enhances the scope of comparative politics. (shrink)

This text attempts to show why the academic split between ethics and social sciences has been disastrous and argues that advances in vigour and sensitivity are made possible by closing this artificial divide.

This paper uses the recent history of marketization and privatization in the UK National Health Service as a case study through which to explore the relationship between health-care organization and health-care goods. Phases and processes of marketization are briefly reviewed in order to show that, although the scope of both marketization and privatization reforms have, until recently, been very heavily circumscribed (and can only be understood in the context of the rise of managerialism), they have nonetheless had a major impact (...) on the “value field” of UK health services. The second half of the paper draws upon the concerns of the critics of market-style reforms to set out and explore the ways in which organizational reform and the shifts in institutional norms consequent upon it construct health-care goods and argues that the investigation of this organization-goods axis ought to have a central place in health-care ethics. (shrink)

This commentary welcomes the work of Ives et al. on Standards of practice in Empirical Bioethics, and especially the dialogical spirit in which the standards have been constructed and offered. It also raises some questions about the consistent interpretation and use of such standards.

A monumental work by an important modern philosopher, Matter and Memory (1896) represents one of the great inquiries into perception and memory, movement and time, matter and mind. Nobel Prize-winner Henri Bergson surveys these independent but related spheres, exploring the connection of mind and body to individual freedom of choice. Bergson’s efforts to reconcile the facts of biology to a theory of consciousness offered a challenge to the mechanistic view of nature, and his original and innovative views exercised a profound (...) influence on other philosophers--including James, Whitehead, and Santayana--as well as novelists such as Dos Passos and Proust. Matter and Memory is essential to an understanding of Bergson’s philosophy and its legacy. (shrink)

We argue that the privatisation of education needs to be understood through an ethical lens, and suggest a broad framework through which privatisation policies and practices might be ethically audited. These policies and practices -- it is suggested -- are creating new ethical spaces and new clusters of goals, obligations and dispositions. Whatever the merits of our particular reading of these changes, we would call for an urgent public debate on these questions -- one that looks beyond broad ideological questions (...) to consider the effects of privatisation on the nature of the services provided. (shrink)

Bringing together evolutionary biology, psychology, and philosophy, Henry Plotkin presents a new science of knowledge, one that traces an unbreakable link between instinct and our ability to know.

The gold coin found in 1978 among the many treasures of the Tillya Tepe burials in northwestern Afghanistan by the Russian archaeologist Viktor Sarianidi and his team has provoked much debate. Suggestions have been made that it depicts the first representation of the Buddha. This article shows that it does not show the Buddha, but Heracles, representing the Buddha’s guardian Vajrapani. The coin also throws into doubt the early first century CE date of the burials, placing them in the late (...) first century to early second century CE.. The coin also draws attention to the connection between many objects in the burials and Gandhāra, particularly the site of Sirkap at Taxila. (shrink)

Giroux argues that challenge gives new meaning to the importance of resistance, the relevance of pedagogy, and the significance of political agency.

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

There are various reasons why efforts to promote “support for self-management” have rarely delivered the kinds of sustainable improvements in healthcare experiences, health and wellbeing that policy leaders internationally have hoped for. This paper explains how the basis of failure is in some respects built into the ideas that underpin many of these efforts. When support for self-management is narrowly oriented towards educating and motivating patients to adopt the behaviours recommended for disease control, it implicitly reflects and perpetuates limited and (...) somewhat instrumental views of patients. It tends to: restrict the pursuit of respectful and enabling ‘partnership working’; run the risk of undermining patients’ self-evaluative attitudes ; limit recognition of the supportive value of clinician-patient relationships; and obscure the practical and ethical tensions that clinicians face in the delivery of support for self-management. We suggest that a focus on enabling people to live well with their long-term conditions is a promising starting point for a more adequate conception of support for self-management. We then outline the theoretical advantages that a capabilities approach to thinking about living well can bring to the development of an account of support for self-management, explaining, for example, how it can accommodate the range of what matters to people for living well, help keep the importance of disease control in perspective, recognize social influences on people’s values, behaviours and wellbeing, and illuminate more of the rich potential and practical and ethical challenges of supporting self-management in practice. (shrink)

This paper critically examines the extent to which health promoting wearable technologies can provide people with greater autonomy over their health. These devices are frequently presented as a means of expanding the possibilities people have for making healthier decisions and living healthier lives. We accept that by collecting, monitoring, analysing and displaying biomedical data, and by helping to underpin motivation, wearable technologies can support autonomy over health. However, we argue that their contribution in this regard is limited and that—even with (...) respect to their ‘autonomy enhancing’ potential—these devices may deliver costs as well as benefits. We proceed by rehearsing the distinction that can be drawn between procedural autonomy and substantive-relational autonomy. While the information provided by wearable technologies may support deliberation and decision-making, in isolation these technologies do little to provide substantive opportunities to act and achieve better health. As a consequence, wearable technologies risk generating burdens of anxiety and stigma for their users and reproducing existing health inequalities. We then reexamine the extent to which wearable technologies actually support autonomous deliberation. We argue that wearable technologies that subject their users to biomedical and consumerist epistemologies, norms and values also risk undermining processes of genuinely autonomous deliberation. (shrink)

League tables are just one example of the growing importance of "institutional success" in the health service. What are the implications of attaching importance to institutional success, and what impact might this have on professional ethics? This paper considers these issues and argues that public policy processes which centre on institutional performance, and which co-opt professional loyalties to this end, shift the balance between person-centred and impersonal standpoints in health care (from the former and towards the latter). There is no (...) attempt to make a global ethical appraisal of this putative shift but rather to raise a matter of concern for those committed to a person-centred conception of professional ethics. (shrink)

What is good prescribing? In this paper we will look at the kinds of criteria which are relevant to evaluating prescribing. In particular we wish to challenge, or at least re-frame, the picture of prescribing as an essentially technical process. In so doing we hope to indicate something more general about the power, and limitations, of technical rationality in health care, and to contribute something to work in health care technology assessment. Finally we hope this discussion will act as a (...) stimulus towards a much needed revision of the way ‘good’ prescribing is defined by current policies, guidelines and protocols. (shrink)

There is no technical language with which to speak of patients' quality of life, there are no standard measures and no authority to validate criteria of measurement. It is well known that 'professionals' tend, often for institutional reasons, to play down or undervalue factors which are not defined by their particular expertise. It is fortunate that, despite this tendency, there is a growing interest in broadening the evaluation of medical care, but there is still a need to clarify what is (...) at issue in considerations of quality of life. This article examines the strengths and weaknesses of one approach to assessing quality of life, and sketches out the implications for anyone concerned to establish a framework within which both medical and non-medical objectives of care can be taken into account. (shrink)

Nordenfelt has presented a very useful philosophical analysis of the nature and ethics of health promotion. The first section of this paper is a response to the starting point of that analysis—the equation of health promotion with health promotion action. It is argued that this starting point leads to a serious ambiguity, and that this ambiguity is characteristic of other writing about health promotion, including that of the WHO. The second section of this paper explores the implications of this ambiguity, (...) as it appears in the wider health promotion literature, for drawing the borders of health promotion. (shrink)

"La Valeur de la Science" de Henri Poincaré. Mathématicien, physicien et philosophe français (1854-1912).

I HEARTILY accept the motto, “That government is best which governs least;” and I should like to see it acted up to more rapidly and systematically. Carried out, it finally amounts to this, which also I believe,—“That government is best which governs not at all;” and when men are prepared for it, that will be the kind of government which they will have. Government is at best but an expedient; but most governments are usually, and all governments are sometimes, inexpedient. (...) The objections which have been brought against a standing army, and they are many and weighty, and deserve to prevail, may also at last be brought against a standing government. The standing army is only an arm of the standing government. The government itself, which is only the mode which the people have chosen to execute their will, is equally liable to be abused and perverted before the people can act through it. Witness the present Mexican war, the work of comparatively a few individuals using the standing government as their tool; for, in the outset, the people would not have consented to this measure. This American government,—what is it but a tradition, though a recent one, endeavoring to transmit itself unimpaired to posterity, but each instant losing some of its integrity? It has not the vitality and force of a single living man; for a single man can bend it to his will. It is a sort of wooden gun to the people themselves. But it is not the less necessary for this; for the people must have some complicated machinery or other, and hear its din, to satisfy that idea of government which they have. Governments show thus how successfully men can be imposed on, even impose on themselves, for their own advantage. It is excellent, we must all allow. Yet this government never of itself furthered any enterprise, but by the alacrity with which it got out of its way. It does not keep the country free. It does not settle the West. It does not educate. The character inherent in the Ameri-. (shrink)

This paper presents findings from an empirical study that explored the meaning of ethics in the everyday work of neuroscientists. Observation and interviews were carried out in one neuroscience research group that was involved in bench-to-bedside translational research. We focus here specifically on the scientists’ perceptions of bioethics. Interviewees were often unfamiliar with bioethics as a discipline, particularly the more junior members of the group. Those who were aware of its existence largely viewed it as something distant from them, and (...) as either too abstract, not relevant or an alien imposition on their work. Some interviewees themselves pointed to the need for better ‘bridge building’ between ethical principles and real-world examples drawn from scientific practice, and we argue that this space is where a more empirically grounded ethics may be useful in terms of actually engaging scientists at both the bench and the bedside. (shrink)

Both an ideal entrée for beginning readers and a solid text for scholars, the second edition of Peter Kalkavage's acclaimed translation of Plato's _Timaeus_ brings enhanced accessibility to a rendering well known for its faithfulness to the original text. An extensive essay offers insights into the reading of the work, the nature of Platonic dialogue, and the cultural background of the _Timaeus_. Appendices on music, astronomy, and geometry provide additional guidance. A brief outline of the themes of the work, a (...) detailed glossary, and a selected bibliography are also included. (shrink)

Nursing Law and Ethics explores a variety of key legal and ethical issues in nursing practice using a thought-provoking and holistic approach. It addresses both what the law requires and what is right, and explores whether these two are always the same. The book provides an overview of the legal, ethical and professional dimensions of nursing, followed by exploration of key issues in greater depth. This edition features updated legislation and new material on patient safety. Key topics are accompanied by (...) both a legal and an ethical perspective, covering both law and ethics Case examples throughout place concepts in a real-life context Written by experts in the field and includes contributions from leading nurses, lawyers and ethicists Accessible, relevant, and comprehensive, this title is ideal for pre- and post-registration nurses. (shrink)

Background: Poverty and social deprivation have adverse effects on health outcomes and place a significant burden on healthcare systems. There are some actions that can be taken to tackle them from within healthcare institutions, but clinicians who seek to make frontline services more responsive to the social determinants of health and the social context of people’s lives can face a range of ethical challenges. We summarise and consider a case in which clinicians introduced a poverty screening initiative into paediatric practice (...) using the discourse and methodology of healthcare quality improvement. -/- Discussion: Whilst suggesting that interventions like the PSI are a potentially valuable extension of clinical roles, which take advantage of the unique affordances of clinical settings, we argue that there is a tendency for such settings to continuously reproduce a narrower set of norms. We illustrate how the framing of an initiative as QI can help legitimate and secure funding for practical efforts to help address social ends from within clinical service, but also how it can constrain and disguise the value of this work. A combination of methodological emphases within QI and managerialism within healthcare institutions leads to the prioritisation, often implicitly, of a limited set of aims and governing values for healthcare. This can act as an obstacle to a genuine broadening of the clinical agenda, reinforcing norms of clinical practice that effectively push poverty ‘off limits.’ We set out the ethical dilemmas facing clinicians who seek to navigate this landscape in order to address poverty and the social determinants of health. -/- Conclusions: We suggest that reclaiming QI as a more deliberative tool that is sensitive to these ethical dilemmas can enable managers, clinicians and patients to pursue health-related values and ends, broadly conceived, as part of an expansive range of social and personal goods. (shrink)

This paper argues that recent ethics research guidelines fit poorly onto the kinds of research undertaken in the humanities, where a research conversation often forms a distinctive method of investigation that has no scientific equivalent The NH&MRC ethics guidelines pay little attention to the issues raised in humanities and social science research. Also, ethics committees are constituted primarily to look at ethical issues that arise from medical and scientific research, causing extra problems for those in the humanities and social sciences.

It is argued that the principles of classical physics are inimical to the development of a satisfactory science of consciousness The problem is that insofar as the classical principles are valid consciousness can have no e ect on the behavior and hence on the survival prospects of the organisms in which it inheres Thus within the classical framework it is not possible to explain in natural terms the development of consciousness to the high level form found in human beings In (...) quantum theory on the other hand consciousness can be dynamically e cacious quantum the ory does allows consciousness to in uence behavior and thence to evolve in accordance with the principles of natural selection However this evo lutionary requirement places important constraints upon the details of the formulation of the quantum dynamical principles.. (shrink)

For the past 30 years, Paget Henry has been one of the most articulate and creative voices in Caribbean scholarship, making seminal contributions to the study of Caribbean political economy, C.L.R. James studies, critical theory, phenomenology, and Africana philosophy. This volume includes some of his most important essays from across his remarkable career, providing an introduction to a broad range of pressing contemporary themes and to the unique mind of one of the leading Caribbean intellectuals of his generation.

The possibility of employing human enhancement interventions to aid in future space missions has been gaining attention lately. These possibilities have included one of the more controversial kinds of enhancements: biomedical moral enhancement. However, the discussion has thus far remained on a rather abstract level. In this paper we further this conversation by looking more closely at what type of interventions with what sort of effects we should expect when we are talking about biomedical moral enhancements. We suggest that a (...) more grounded way to picture moral enhancement, at least in the near term, is to envision a form of cognitive enhancement that also provides some moral benefits by heightening the enhanced person's capability for acting according to their own subjective moral code. While this concept of moral adherence enhancement also has relevance for the moral enhancement discussion more widely, in this paper we apply it specifically in the context of space missions. We argue that there are weighty reasons to consider making biomedical enhancements of the proposed kind a mandatory feature of early-phase long-distance space travel because these missions are high-stakes in nature and take place in an environment where the enhancement could be seen as conferring important advantages while negating many of the traditional arguments weighed against it. (shrink)

Patient safety is a central aspect of healthcare quality, focusing on preventable, iatrogenic harm. Harm, in this context, is typically assumed to mean physical injury to patients, often caused by technical error. However, some contributions to the patient safety literature have argued that disrespectful behavior towards patients can cause harm, even when it does not lead to physical injury. This paper investigates the nature of such dignitary harms and explores whether they should be included within the scope of patient safety (...) as a field of practice. We argue that dignitary harms in health care are—at least sometimes—preventable, iatrogenic harms. While we caution against including dignitary harms within the scope of patient safety just because they are relevantly similar to other iatrogenic harms, we suggest that thinking about dignitary harms can help to elucidate the value of patient safety, and to illuminate the evolving relationship between safety and quality. (shrink)