The doctor patient relationship starts with a story. Doctors' notes, a patient's chart, the recommendations of ethics committees and insurance justifications all hinge on written and verbal narrative interaction. The "practice" of narrative profoundly affects decision making, patient health and treatment and the everyday practice of medicine. In this edited collection, the contributors provide conceptual foundations, practical guidelines and theoretical considerations central to the practice of narrative ethics.

The purpose of this study was to illuminate the ethically difficult situations experienced by care providers working in a nursing home. Individual interviews using a narrative approach were conducted. A phenomenological-hermeneutic method developed for researching life experience was applied in the analysis. The findings showed that care providers experience ethical challenges in their everyday work. The informants in this study found the balance between the ideal, autonomy and dignity to be a daily problem. They defined the culture they work in (...) as not supportive. They also thought they were not being seen and heard in situations where they disagree with the basic values of the organization. The results are discussed in terms of Habermas’s understanding of modern society. Care settings for elderly people obviously present ethical challenges, particularly in the case of those suffering from dementia. The care provider participants in this study expressed frustration and feelings of powerlessness. It is possible to understand their experiences in terms of Habermas’s theory of modern society and the concept of the system’s colonization of the life world. (shrink)

In this timely and highly original merging of theory and practice, conflict photographer and critical theorist Rita Leistner applies Marshall McLuhan's semiotic theories of language, media, and technology to iPhone photographs taken during a military embed in Afghanistan. In a series of what Leistner calls iProbes—a portmanteau of iPhone and probe—Leistner reveals the face of war through the extensions of man. As digital photography becomes more ubiquitous, and as the phones we carry with us become more advanced, the process (...) of capturing images becomes more democratic and more spontaneous. Leistner's photos result from both access and impulse. Looking for Marshall McLuhan in Afghanistan will appeal anyone with an interest in the conflicts in the Middle East, the seminal communications theorist, or iPhone apps and photography. (shrink)

A variety of crucial and still most relevant ideas about nothingness or emptiness have gained profound philosophical prominence in the history and development of a number of South and East Asian traditions--including in Buddhism, Daoism, Neo-Confucianism, Hinduism, Korean philosophy, and the Japanese Kyoto School. These traditions share the insight that in order to explain both the great mysteries and mundane facts about our experience, ideas of "nothingness" must play a primary role. This collection of essays brings together the work of (...) twenty of the world's prominent scholars of Hindu, Buddhist, Daoist, Neo-Confucian, Japanese and Korean thought to illuminate fascinating philosophical conceptualizations of "nothingness" in both classical and modern Asian traditions. The unique collection offers new work from accomplished scholars and provides a coherent, panoramic view of the most significant ways that "nothingness" plays crucial roles in Asian philosophy. It includes both traditional and contemporary formulations, sometimes putting Asian traditions into dialogue with one another and sometimes with classical and modern Western thought. The result is a book of immense value for students and researchers in Asian and comparative philosophy. (shrink)

BACKGROUND: Little is known about how hospitalized patients share decisions with physicians. METHODS: We conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. A research assistant (RA) approached newly hospitalized patients and their physicians before morning rounds and obtained consent. The RA audio recorded morning rounds, and then separately interviewed both patient and physician. Coding was done using integrated analysis. RESULTS: Most patients were white (61%) and half were female. Most (...) physicians were male (66%) and of Southeast Asian descent (66%). All physicians explained the plan of care to the patients; most believed that their patient understood. However, many patients did not. Physicians rarely asked the patient for their opinion. In all those cases, the decision had been made previously by the doctors. No decisions were made with the patient. Patients sometimes disagreed. CONCLUSIONS: Shared decision-making may not be the norm in hospital care. Although physicians do explain treatment plans, many hospitalized patients do not understand enough to share in decisions. When patients do assert their opinion, it can result in conflict. PRACTICE IMPLICATIONS: Some hospitalized patients are interested in discussing treatment. Improving hospital communication can foster patient autonomy. (shrink)

'Manning successfully argues that theory and ethics should once again be reunited...thorough and provocative...'—THE MIDWEST BOOK REVIEW.

Across two studies, a wide age range of participants was interviewed about the nature of death. All participants were living in rural Madagascar in a community where ancestral beliefs and practices are widespread. In Study 1, children (8–17 years) and adults (19–71 years) were asked whether bodily and mental processes continue after death. The death in question was presented in the context of a narrative that focused either on the corpse or on the ancestral practices associated with the afterlife. Participants (...) aged 8 years and older claimed that death brings an end to most bodily and mental processes. Nevertheless, particularly in the context of the religious narrative, they claimed that certain mental processes continue even after death. This assertion of an afterlife was more evident among adults than children, especially with respect to cognitive processes, such as knowing and remembering. In Study 2, 5‐ and 7‐year‐olds were asked similar questions in connection with the death of a bird and a person. Seven‐year‐olds consistently claimed that bodily and mental processes cease at death, whereas 5‐year‐olds were unsystematic in their replies. Together, the two studies replicate and extend findings obtained with Western children showing that, in the course of development, different conceptions of death are elaborated—a biological conception in which death terminates living processes and a religious conception in which death marks the beginning of a new form of spiritual existence. (shrink)

In this paper, I consider the claim that a corporation cannot be held to be morally responsible unless it is a person. First, I argue that this claim is ambigious. Person flags three different but related notions: metaphysical person, moral agent, moral person. I argue that, though one can make the claim that corporates are metaphysical persons, this claim is only marginally relevant to the question of corporate moral responsibility. The central question which must be answered in discussions of corporate (...) moral responsibility is whether corporations are moral agents or moral persons. I argue that, though we can make a case for saying corporations are moral agents, they are not moral persons, and hence, we can hold them responsible. In addition, we need not treat them the way we would be obligated to treat a moral person; we needn't have the same scruples about holding a corporation morally responsible as we would a moral person. (shrink)

This essay collects four decades of my own reflections, as an anthropologist and feminist, on gender and coloniality across various contexts in Latin America. It also highlights the decolonial methodology and vocabulary that I have had to develop in my various roles as scholar, public intellectual, and expert witness over the years. Briefly, what I present here is a decolonial feminist perspective that argues for the existence of a patriarchal political order in communal societies before colonization. Yet, in my view, (...) precolonial gender has a dual structure that is plural in essence and differs markedly from the binary gender structure of colonial-modern societies, which works in terms of a One and its marginalized others. As I argue, the capturing and transformation of precolonial dual gender structures by the modern gender system exacerbates inequality, increases violence against women, and disempowers them politically. For that reason, I speak of “low-intensity” and “high-intensity” patriarchal systems. (shrink)

I have become curious about reciprocity within clinical practice. A vast topic that mobilizes considerations of money, knowledge, kinship, power, culture, and uses of the body, reciprocity is a strong means by which to achieve the egality required of just health care. Within health care, reciprocity might enable not only so‐called shared decision‐making and patient autonomy. It might open the door to mutual acknowledgement of the value of each participant's beliefs and habits. It might appear as a humble realization that (...) no one understands what health is and a concurrent welcoming curiosity about one another's conception of how the body and speech and mind work. From the intimate to the international levels of care, such forms of reciprocity may culminate in the radical and powerful state of reciprocal recognition.In this short essay, I will focus on one aspect of reciprocity in health care: the narrative and potentially reciprocal nature of attention in health care. A critical element in the development of therapeutic alliance, clinical accuracy, and effective practice, attention requires a donation of the self as a vessel into which can enter that which is perceived or, from the other side, a penetrating of that which is perceived so that one sees it from within its own vessel. (shrink)

We consider the problem of moral disjunction in professional and business activities from a virtue-ethical perspective. Moral disjunction arises when the behavioral demands of a role conflict with personal morality; it is an important problem because most people in modern societies occupy several complex roles that can cause this clash to occur. We argue that moral disjunction, and the psychological mechanisms that people use to cope with it, are problematic because they make it hard to pursue virtue and to live (...) with integrity. We present role coadunation as a process with epistemic and behavioral aspects that people can use to resolve moral disjunction with integrity. When role coadunation is successful, it enables people to live virtuous lives of appropriate narrative disunity and to honor their identity-conferring commitments. We show how role coadunation can be facilitated by interpretive communities and discuss the emergence and ideal features of those communities. (shrink)

In the history of philosophy as well as in most recent discussions, empathy is held to be a key concept that enables a basic understanding of the other while at the same time acting as the foundation of our moral emotionality. In this paper I want to show why empathy is the wrong candidate for both of these tasks. If we understand empathy as projection, i.e. a process of imaginary self-transposition, we are bound to presuppose a fully established interpersonal sphere. (...) If we consider empathy as synonymous with compassion it is highly questionable if we ever reach the other person in his or her otherness. Max Scheler and other early phenomenologists offer very fruitful approaches to both problems without resorting to empathy. I will present some of their thoughts and focus especially on Scheler’s claim about the connection between the experience of the real other and the intentionality of compassion. (shrink)

If our sense of the past is inevitably shaped by the explanatory logic of narrative, then the stories that we create in turn reveal the inescapable presence and ...

Proposing that the interaction between reader and literature involves four “modes of textual engagement” — recognition, enchantment, knowledge, and shock — The Uses of Literature bridges the gap between literary theory and common-sense beliefs about why we read literature.

Avec la précarisation des sociétés salariales se sont développées les économies non-marchandes et non-monétaires mais aussi des économies informelles et de survie. L'espace public apparaît alors fragmenté par des inégalités et des injustices là où les individus et les groupes se mobilisent pour l'accès à une « place » et aux biens moraux. Mais en même temps l'espace public contient des espaces intermédiaires où des résistances collectives au processus de précarisation salariale et la lutte pour la reconnaissance produisent des micro-organisations (...) sociales qui naissent de l'agencement, voire la superposition de formes économiques marchandes et non-marchandes liées à une économie solidaire.Growing precarity within wage-based societies has led to the advent of parallel economies that are neither mercantile nor money-based, as well as informal economies and economies of subsistance. The public sphere thus appears to be fractured by inequalities and injustices, given the mobilising of individuals and groups in the struggle for a "place" and access to moral goods. Yet at the same time, we can find intermediate spaces in the public sphere in which collective forms of resistance to the increasing precarity of wage-based existences and the struggle for recognition have led to the emergence of social micro-organisations borne of the coexistence or even interpenetration of market and non-market economic forms related to an economy of solidarity. (shrink)

La société chinoise aujourd’hui peut être définie comme produisant différentes formes de compressed modernities où se contractent et s’entrelacent des temporalités historiques, sociales, politiques, économiques, mais aussi individuelles et collectives. Nous introduisons ici la notion de temporalité « contractée » qui favorise la superposition, l’intensification et la multiplication de risques sociaux, économiques, écologiques et sanitaires. Temporalités et espaces s’agencent en Chine de manière flagrante dans la production de mobilités, migrations et circulations très intenses aujourd’hui. La conquête de soi apparaît comme (...) une question d’intensité liée à l’accélération des temporalités sociales et économiques objectives et subjectives ; se construit alors la figure d’un Individu compressé dans la société chinoise. Les temporalités collectives favorisent des micromobilisations où s’ouvrent des micro-arènes publiques et où se construit, en contexte autoritaire, de la démocratie « par le bas ». (shrink)