One INTRODUCTION: IN SEARCH OF THE VOICES OF NURSES IN CHINA Two motives launched this study to search for the voices of nurses in China. ...

Obstetric ultrasound is the well-recognized prenatal test used to visualize and determine the condition of a pregnant woman and her fetus. Apart from the clinical application, some businesses have started promoting the use of fetal ultrasound machines for nonmedical reasons. Non-medical fetal ultrasound (also known as ‘keepsake’ ultrasound) is defined as using ultrasound to view, take a picture, or determine the sex of a fetus without a medical indication. Notwithstanding the guidelines and warnings regarding ultrasound safety issued by governments and (...) professional bodies, the absence of scientifically proven physical harm to fetuses from this procedure seems to provide these businesses with grounds for rapid expansion. However, this argument is too simplistic because current epidemiological evidence is not synchronous with advancing ultrasound technology. As non-medical fetal ultrasound has aroused very significant public attention, a thorough ethical analysis of this topic is essential. Using a multifaceted approach, we analyse the ethical perspective of non-medical fetal ultrasound in terms of the expectant mother, the fetus and health professionals. After applying four major theories of ethics and principles (the precautionary principle; theories of consequentialism and impartiality; duty-based theory; and rights-based theories), we conclude that obstetric ultrasound practice is ethically justifiable only if the indication for its use is based on medical evidence. Non-medical fetal ultrasound can be considered ethically unjustifiable. Nevertheless, the ethical analysis of this issue is time dependent owing to rapid advancements in ultrasound technology and the safety issue. The role of health professionals in ensuring that obstetric ultrasound is an ethically justifiable practice is also discussed. (shrink)

This paper reports part of a longitudinal research project, which sought to capture students’ conceptualization of caring practice as they progressed to different levels of study in a nursing diploma programme in Hong Kong. Model emulation was found to be an effective means of focusing students’ learning processes on the moral aspects of nursing practice. The theory of model emulation from a Chinese perspective and how it is applied to create a learning context to allow students to acquire a moral (...) sense of nursing are discussed. The participating students are invited to be sincere enquirers in the pursuit of the good embedded in practice through introspective self-examination and dialogue. They are asked to describe and share their experience of positive and negative examples of nursing in written accounts. Van Kaam’s phenomenological method was adopted to explicate the good and bad constituents of nursing from these examples, with the students assuming an active role in the explication process. The explication reveals that the students were able to articulate the good and bad practices in a variety of patient care situations. (shrink)

While the movement to ensure patient’s rights to information and informed consent spreads throughout the world, patient rights of this kind have yet to be introduced in mainland China. Nonetheless, China is no different from other parts of the world in that nurses are expected to shoulder the responsibility of safeguarding patients’ best interests and at the same time to uphold their right to information. This paper expounds on the principle of protectiveness grounded in traditional Chinese medical ethics concerning the (...) practice of informed consent. Nurses in China have a moral obligation to treat patients with sincerity. This notion carries a strong sense of parental protectiveness. As far as information-giving is concerned, nurses in China are ambivalent about the notion of truthfulness. The findings of an empirical study undertaken in seven Chinese cities reveal that nurses in China experience similar difficulties related to the disclosure of information as their counterparts in other parts of the world. A nurse’s narrative, the Chan case, is used to illustrate the typical difficult situation that nurses in China often encounter in looking after vulnerable patients who would like to learn more about their therapeutic regimens. The moral tension embedded in nursing practice is analysed. It is found that most nurses would prefer to tell the truth to patients, but their primary ethical justification is not that of respect for patients’ autonomy or safeguarding patients’ right to self-determination. Rather, it is basically beneficent in nature; that is, they base their decision to reveal the truth on whether or not patients will receive more relevant treatment and better nursing care. (shrink)

This article reports a survey of nurses in different cultural settings to reveal their perceptions of ethical role responsibilities relevant to nursing practice. Drawing on the Confucian theory of ethics, the first section attempts to understand nursing ethics in the context of multiple role relationships. The second section reports the administration of the Role Responsibilities Questionnaire (RRQ) to a sample of nurses in China (n = 413), the USA (n = 163), and Japan (n = 667). Multidimensional preference analysis revealed (...) the patterns of rankings given by the nurses to the statements they considered as important ethical responsibilities. The Chinese nurses were more virtue based in their perception of ethical responsibilities, the American nurses were more principle based, and the Japanese nurses were more care based. The findings indicate that the RRQ is a sensitive instrument for outlining the embedded sociocultural factors that influence nurses’ perceptions of ethical responsibilities in the realities of nursing practice. This study could be important in the fostering of partnerships in international nursing ethics. (shrink)

Nursing research in China is at an early stage of development and little is known about the practices of Chinese nurse researchers. This interview study carried out at a university in central China explores the informed consent practices of Chinese nurse researchers and the cultural considerations of using a western technique. Nine semistructured interviews were conducted in English with assistance and simultaneous translation from a Chinese nurse with research experience. The interviews were analyzed by one western and two Chinese researchers (...) and major themes were identified. All participants endorsed informed consent as ethically required. Differences were noted between some of the informed consent practices typically recommended in the USA and those identified in this study, such as: recruitment using local and government officials, recruiting directly from medical records without special permission, family consultation in consent and consent control, and not revealing randomization to intervention groups receiving different treatments. (shrink)

The essays in this book clarify the technical, legal, ethical, and social aspects of the interaction between eHealth technologies and surveillance practices. The book starts out by presenting a theoretical framework on eHealth and surveillance, followed by an introduction to the various ideas on eHealth and surveillance explored in the subsequent chapters. Issues addressed in the chapters include privacy and data protection, social acceptance of eHealth, cost-effective and innovative healthcare, as well as the privacy aspects of employee wellness programs using (...) eHealth, the use of mobile health app data by insurance companies, advertising industry and law enforcement, and the ethics of Big Data use in healthcare. A closing chapter draws on the previous content to explore the notion that people are 'under observation', bringing together two hitherto unrelated streams of scholarship interested in observation: eHealth and surveillance studies. In short, the book represents a first essential step towards cross-fertilization and offers new insights into the legal, ethical and social significance of being 'under observation'. (shrink)

There are two main approaches to how statistical patterns are extracted from sequences: The transitional probability approach proposes that statistical learning occurs through the computation of probabilities between items in a sequence. The chunking approach, including models such as PARSER and TRACX, proposes that units are extracted as chunks. Importantly, the chunking approach suggests that the extraction of full units weakens the processing of subunits while the transitional probability approach suggests that both units and subunits should strengthen. Previous findings using (...) sequentially organized, auditory stimuli or spatially organized, visual stimuli support the chunking approach. However, one limitation of prior studies is that most assessed learning with the two-alternative forced-choice task. In contrast, this pre-registered experiment examined the two theoretical approaches in sequentially organized, visual stimuli using an online self-paced task—arguably providing a more sensitive index of learning as it occurs—and a secondary offline familiarity judgment task. During the self-paced task, abstract shapes were covertly organized into eight triplets (ABC) where one in every eight was altered (BCA) from the canonical structure in a way that disrupted the full unit while preserving a subunit (BC). Results from the offline familiarity judgment task revealed that the altered triplets were perceived as highly familiar, suggesting the learned representations were relatively flexible. More importantly, results from the online self-paced task demonstrated that processing for subunits, but not unit-initial stimuli, was impeded in the altered triplet. The pattern of results is in line with the chunking approach to statistical learning and, more specifically, the TRACX model. (shrink)

Foucault contra Habermas is an incisive examination of, and a comprehensive introduction to, the debate between Foucault and Habermas over the meaning of enlightenment and modernity. It reprises the key issues in the argument between critical theory and genealogy and is organised around three complementary themes: defining the context of the debate; examining the theoretical and conceptual tools used; and discussing the implications for politics and criticism. In a detailed reply to Habermas' Philosophical Discourse of Modernity, this volume explains the (...) difference between Habermas' philosophical practice and Foucault's between the analytics of truth and the politics of truth. Many of the most difficult arguments in the exchange are subject to a detailed critical analysis. This examination also includes discussion of the ethics of dialogue; the practice of criticism; the politics of recognition, and the function of civil society and democracy. (shrink)

The concept of medical necessity is often used to explain or justify certain decisions—for example, which treatments should be allowed under certain conditions—as though it had an obvious, agreed-upon meaning as well as an inherent normative force. In introducing this special issue of Clinical Ethics on medical necessity, we argue that the term, as used in various discourses, generally lacks a definition that is clear, non-circular, conceptually plausible, and fit for purpose. We propose that future work on this concept should (...) address three main questions: what medical necessity is (i.e., what makes something medically necessary, as opposed to something else); what the concept does (what ‘work’ is it doing when invoked in different settings); and what should follow, normatively, from the fact that something is indeed medically necessary (on some plausible conception). (shrink)

Pure mathematics can play an indispensable role explaining empirical phenomena if recent accounts of insect evolution are correct. In particular, the prime life cycles of cicadas and the geometric structure of honeycombs are taken to undergird an inference to the best explanation about mathematical entities. Neither example supports this inference or the mathematical realism it is intended to establish. Both incorrectly assume that facts about mathematical optimality drove selection for the respective traits and explain why they exist. We show how (...) this problem can be avoided, identify limitations of explanatory indispensability arguments, and attempt to clarify the nature of mathematical explanation. (shrink)

Lloyd analyzes every proposed evolutionary explanation of female orgasm and argues that all but one suffers from serious evidential errors. Lloyd attributes these errors to two main biases: androcentrism and adaptationism. This paper begins by arguing that the explanation Lloyd favors—the by-product account—is guilty of the androcentrism which supposedly implicates the other explanations of female orgasm with numerous evidential discrepancies. This suggests that there is another error afflicting orgasm research in addition to the biases Lloyd identities. I attempt to diagnose (...) and characterize this additional error. In short, I think the error is using an imprecise definition of the trait in question. Further, Lloyd takes her analysis to support Longino’s contextual empiricist model of scientific objectivity. I consider what implications this analysis has for contextual empiricism. Finally, I argue that theorizing about female orgasm should be done from a conceptual engineering approach. (shrink)

This paper argues for two conclusions: (1) evaluating the success of engineered concepts necessarily involves empirical work; and (2) the Carnapian Explication criterion precision ought to be a methodological standard in conceptual engineering. These two conclusions provide a new analysis of the race and gender debate between Sally Haslanger and Jennifer Saul. Specifically, the argument identifies the resources Haslanger needs to respond to Saul’s main objections. Lastly, I contrast the methodology advocated here with the so-called “method of cases” and draw (...) out some general implications for how we should think about concepts. (shrink)

In _Biocultural Creatures_, Samantha Frost brings feminist and political theory together with findings in the life sciences to recuperate the category of the human for politics. Challenging the idea of human exceptionalism as well as other theories of subjectivity that rest on a distinction between biology and culture, Frost proposes that humans are biocultural creatures who quite literally are cultured within the material, social, and symbolic worlds they inhabit. Through discussions about carbon, the functions of cell membranes, the activity (...) of genes and proteins, the work of oxygen, and the passage of time, Frost recasts questions about the nature of matter, identity, and embodiment. In doing so, she elucidates the imbrication of the biological and cultural within the corporeal self. In remapping the relation of humans to their habitats and arriving at the idea that humans are biocultural creatures, Frost provides new theoretical resources for responding to political and environmental crises and for thinking about how to transform the ways we live. (shrink)

This paper argues for two conclusions: (1) evaluating the success of engineered concepts necessarily involves empirical work; and (2) the Carnapian Explication criterion precision ought to be a methodological standard in conceptual engineering. These two conclusions provide a new analysis of the race and gender debate between Sally Haslanger and Jennifer Saul. Specifically, the argument identifies the resources Haslanger needs to respond to Saul’s main objections. Lastly, I contrast the methodology advocated here with the so-called “method of cases” and draw (...) out some general implications for how we should think about concepts. (shrink)

Paternalism is widely viewed as presumptively justifiable for children but morally problematic for adults. The standard explanation for this distinction is that children lack capacities relevant to the justifiability of paternalism. I argue that this explanation is more difficult to defend than typically assumed. If paternalism is often justified when needed to keep children safe from the negative consequences of their poor choices, then when adults make choices leading to the same negative consequences, what makes paternalism less justified? It seems (...) true that ordinary adults have capacities enabling them to promote their interests in ways most children lack. This can explain why paternalism is more often justified towards children than adults. What is not explained, however, is why paternalism would be justifiable for children, but not adults, when neither possess the relevant interest-promoting capacities—exactly the cases when paternalism towards adults might be considered. I argue that this dilemma undercuts capacities-based explanations for the belief that childhood is distinctively relevant for the permissibility of paternalism. I then address defenses of both consequentialist and deontological versions of the capacities-based explanation. Absent this capacities-based explanation, I argue that the intuition that less demanding justificatory standards apply to paternalism when directed at children than when directed towards adults presents unresolved problems for egalitarians. (shrink)

The niche is allegedly the conceptual bedrock underpinning the most prominent, and some would say most important, theorizing in ecology. We argue this point of view is more aspirational than veridical. Rather than critically dissect existing definitions of the concept, the supposedly significant work it is thought to have done in ecology is our evaluative target. There is no denying the impressive mathematical sophistication and theoretical ingenuity of the ecological modeling that invokes ‘niche’ terminology. But despite the pervasive labeling, we (...) demonstrate that niche talk is nothing more than a gloss on theory developed without it, that doesn’t need it, and that doesn’t benefit from it. (shrink)

Augustine of Hippo is often regarded as the champion of the doctrine of weakness of the will. John M. Rist in his 1994 'Augustine: Ancient Thought Baptized' draws an interesting analogy between Aristotle's 'akrasia' and Augustine's 'concupiscentia'. However, such an analogy without further qualification is defective and misleading because it implies that Augustine commits himself to the notion that since everyone is perpetually akratic and, thus, always morally blameworthy. I argue that, for Augustine, weakness of the will has equivocal meanings (...) and is manifested in four kinds of case--their scope goes far beyond Aristotle's discussion of 'akrasia' in Book Seven of the 'Nicomachean Ethics'. There are, therefore, considerable differences between Aristotle's and Augustine's account of weakness of the will. Consequently, for Augustine, moral responsibility for the moral agent also varies in each of the four cases. (shrink)

Déjà vu and involuntary autobiographical memories (IAMs) are differentiated by a number of factors including metacognition. In contrast to IAMs, déjà vu activates regions associated with self-awareness including the right dorsolateral prefrontal cortex.

In his Letters on the Aesthetic Education of Man, Friedrich Schiller draws a striking connection between aesthetic value and individual and political freedom, claiming that, ‘it is only through beauty that man makes his way to freedom’. However, contemporary ways of thinking about freedom and aesthetic value make it difficult to see what the connection could be. Through a careful reconstruction of the Letters, we argue that Schiller’s theory of aesthetic value serves as the key to understanding not only his (...) view of aesthetic engagement, but also his distinctive account of individual and political freedom. In Part I, we develop a reconstruction of Schiller's view that aesthetic value is the only path to individual freedom and in Part II we analyze how Schiller connects aesthetic value to political freedom. In the end, we show that Schiller defends a non-hedonic, action-oriented, communitarian theory of aesthetic value and a theory of freedom that makes the aesthetic not just supererogatory but fundamental for any fully autonomous life. Although we have lost touch with this way of thinking about aesthetic value and freedom, we submit that it is illuminating for contemporary thinking about both. (shrink)

Thomas Hobbes is an iconic figure who serves as an easy reference for pundits commenting on the brutality of war as well as for critics of a distinctly modern individualism in which calculating and rapacious self-interest is the cause of the violence, destruction, and exploitation endemic to the contemporary world. Frost's reading of Hobbes's philosophy shows us that underlying such visions of self and politics is another iconic figure: that of the Cartesian subject. What gives the iconic Hobbes his hardcore (...) individualism and its corollary accounts of instrumentalism, conflict, and absolutism is a Cartesian rendering of the self as split into mind and body. Carefully elaborating Hobbes's materialist ontology, _Lessons from a Materialist Thinker_ challenges both our implicit Cartesian assumptions about the self and the commonplace Hobbes that so readily figures violence in our political imagination. Through his materialism, Hobbes presents an alternative modern account of self-consciousness, reason, agency, power, freedom, and responsibility. In doing so, he shows that our fundamental intersubjectivity and interdependence require that we pursue peace above all else. (shrink)

This article analyzes a popular meme that has spread rapidly among Chinese internet users in the last few years, ‘garlic chives’ ( jiucai), as a self-mockery of the bio-economic subject in contemporary China. This metaphor refers to those ordinary Chinese people who are constantly lured to participate in all kinds of economic activities, but whose investments are destined to be consumed by the establishment. Through a close study of this popular meme and the social conditions from which it arises, this (...) article demonstrates two main features of the Chinese economic subject that supports the state’s economic sovereignty: the thriving of self-sufficient and rule-abiding individuals, and the quality of these individuals as hard working and capable of producing wealth on their own. This article offers a critique of PRC’s post-socialist governmentality, and it provides insights about the relation between the biological and the political in our complicated world order. (shrink)

It has become typical to read Kant and Merleau-Ponty as offering competing approaches to perceptual experience. Kant is interpreted as an ‘intellectualist’ who regards perception as conceptual ‘all the way out’, while Merleau-Ponty is seen as Kant’s challenger, who argues that perception involves non-conceptual, embodied ‘coping’. In this paper, however, I argue that a closer examination of their views of perception, especially with respect to the notion of ‘schematism’, reveals a great deal of historical and philosophical continuity between them. By (...) analyzing Kant’s theory of schematism, the interpretation of it by the Neo-Kantian Pierre Lachièze-Rey, and Merleau-Ponty’s theory of the body schema, we find that aspects of Merleau-Ponty’s theory of perception are better understood as a development of Kant’s theory of perception. (shrink)

The ubiquitin proteasome system is a potent regulatory mechanism used to control protein stability in numerous cellular processes, including neural development. Many neurodegenerative diseases are featured by the accumulation of UPS‐associated proteins, suggesting the UPS dysfunction may be crucial for pathogenesis. Recent experiments have highlighted the UPS as a key player during synaptic development. Here we summarize recent discoveries centered on the role of the UPS in synapse remodeling and draw attention to the potential link between the synaptic UPS dysfunction (...) and the pathology of neurodegenerative diseases. BioEssays 30:1075–1083, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

Psychopathy is a disorder characterized by severe and frequent moral violations in multiple domains of life. Numerous studies have shown psychopathy-related limbic brain abnormalities during moral processing; however, these studies only examined negatively valenced moral stimuli. Here, we aimed to replicate prior psychopathy research on negative moral judgments and to extend this work by examining psychopathy-related abnormalities in the processing of controversial moral stimuli and positive moral processing. Incarcerated adult males (N = 245) completed a functional magnetic resonance imaging protocol (...) on a mobile imaging system stationed at the prison. Psychopathy was assessed using the Hare Psychopathy Checklist–Revised (PCL-R). Participants were then shown words describing three types of moral stimuli: wrong (e.g., stealing), not wrong (e.g., charity), and controversial (e.g., euthanasia). Participants rated each stimulus as either wrong or not wrong. PCL-R total scores were correlated with not wrong behavioral responses to wrong moral stimuli, and were inversely related to hemodynamic activity in the anterior cingulate cortex in the contrast of wrong > not wrong. In the controversial > noncontroversial comparison, psychopathy was inversely associated with activity in the temporal parietal junction and dorsolateral prefrontal cortex. These results indicate that psychopathy-related abnormalities are observed during the processing of complex, negative, and positive moral stimuli. (shrink)

In his Letters on the Aesthetic Education of Man, Friedrich Schiller draws a striking connection between aesthetic value and individual and political freedom, claiming that, ‘it is only through beauty that man makes his way to freedom’. However, contemporary ways of thinking about freedom and aesthetic value make it difficult to see what the connection could be. Through a careful reconstruction of the Letters, we argue that Schiller’s theory of aesthetic value serves as the key to understanding not only his (...) view of aesthetic engagement, but also his distinctive account of individual and political freedom. Whereas in Part I, we developed a reconstruction of Schiller's view that aesthetic value is the only path to individual freedom, in Part II we analyze how Schiller connects aesthetic value to political freedom. In the end, we show that Schiller defends a non-hedonic, action-oriented, communitarian theory of aesthetic value and a theory of freedom that makes the aesthetic not just supererogatory but fundamental for any fully autonomous life. Although we have lost touch with this way of thinking about aesthetic value and freedom, we submit that it is illuminating for contemporary thinking about both. (shrink)

In the Critique of Pure Reason, Kant describes schematism as a (A141/B180–1). While most commentators treat this as Kant's metaphorical way of saying schematism is something too obscure to explain, I argue that we should follow up Kant's clue and treat schematism literally as Kunst. By letting our interpretation of schematism be guided by Kant's theoretically exact ways of using the term Kunst in the Critique of Judgment we gain valuable insight into the nature of schematism, as well as its (...) connection to Kant's concerns in the third Critique. (shrink)

My aim in this paper is to offer a systematic analysis of a feature of Kant’s theory of perception that tends to be overlooked, viz., his account of how the imagination forms images in perception. Although Kant emphasizes the centrality of this feature of perception, indeed, calling it a ‘necessary ingredient’ of perception, commentators have instead focused primarily on his account of sensibility and intuitions on the one hand, and understanding and concepts on the other. However, I show that careful (...) attention to what he says about the nature of images, their connection to the imagination, and their role in perception in his Metaphysics Lectures, as well as in the Deduction and Schematism chapters of the first Critique reveals that Kant is working with a richer, more nuanced framework for perception than is often attributed to him. I contend that it is only once we have a revised framework for Kant’s theory of perception in place that we will be able to make further headway in debates, e.g., about whether or not he is a conceptualist about perception. (shrink)