Human enhancement technologies raise serious ethical questions about health practices no longer content simply to treat disease, but which now also propose to “optimize” human beings’ physical, cognitive and psychological abilities. These technologies call for a reassessment of our relationship to health, the human body and the body's organic, identity and social functions. In nursing, such considerations are in their infancy. In this paper, we argue for the relevance of critical phenomenology as a way to better understand the ethical issues (...) related to human enhancement technologies (HET). In so doing, we seek to problematize HET and assess their influence on the future development of nursing science and practice. It is difficult to anticipate the concrete effects of HET, we suggest, because these practices reconfigure the meaning of normativity and disorient our conventional ethical landscape. In this context, we argue that the later work of Martin Heidegger and Michel Foucault invites a critical perspective into how techno‐scientific discourses modify our relationship to care, to health and to our own social and corporeal identities. Despite the traditional philosophical opposition between phenomenology and critical theory, we maintain that a hybrid critical phenomenological approach opens new ways to assess the integration of technology and practice. Our analysis understands HET as a process of “hybridization” between technological objects and human subjects. Critical phenomenology thus effectively questions anthropocentric definitions of technology, challenges the dichotomy between curative treatment and enhancement and, finally, prompts valuable reflection on the implications of HET for nursing theory and practice. (shrink)

In the Canadian forensic psychiatric context, the concepts of risk and dangerousness interact, intersect, and morph into the notion of significant threat to the safety of the public. Stemming from the results of a critical ethnography of the Ontario Review Board, this article unpacks the central role of forensic psychiatric nursing, as an example of a 'psych' discipline (e.g., psychiatry and psychology), in a system that is built to produce risky persons and to legitimize their detention and supervision. By using (...) excerpt of interviews conducted with nurses, ethnographic observations of Review Board hearings, and other documentary artifacts, the findings illustrate how rationalizations of risk and dangerousness are contingent on space, time, and observer. Depending on the time of the assessment or on the health‐care professional who performs it, different elements including, but not limited to, mental illness, interpersonal relationships, financial instability, and sexual vulnerability, are relied upon in very fluid, interchangeable, and discretionary ways to justify findings of dangerousness. Such a dynamic expands the reach of psychiatry's legitimacy at identifying risky conduct and controlling risky persons to domains very loosely associated with the notion of dangerousness. The work of Foucault and Castel provides the theoretical backdrop on which rests the discussion and the implications for nursing. (shrink)

Robert Castel is an eminent figure in the social sciences because of his innovative contributions to various social and health fields. The seminal work of this poststructuralist author and social activist has influenced several research disciplines, but has not yet had a significant impact on nursing. In this article, we will present the thinking of this man, who considered himself a sociologist, philosopher and “historian of the present.” We will examine the most important issues he explored during his career, including (...) the psychiatric apparatus, the management of risk and the social vulnerability. We believe that this thinker's perspective on diverse social issues is very relevant to nursing practice and research and to the health sciences in general. The concepts he developed and utilized with finesse provide us with a critical reading of many contemporary health issues, particularly in mental health and psychiatric nursing. Castel's critical and engaged approach incites mobilization for social justice and greater protections for marginalized and vulnerable persons. These principles of advocacy and social justice are also at the heart of the nursing profession. (shrink)