We agree with McCullough, Coverdale and Chervenak1 that ‘medical educators and academic leaders are in a pivotal and powerful position to role model’ to counter ‘incivility’ in medicine, which can include ‘dismissing’ or ‘demeaning others’. They note that ‘women may be at greater risk for experiencing incivility compared with men’, as may other individuals who experience ‘patterns of disrespect based on minority status’. The authors promote ‘professionalism’ and ‘etiquette’ to foster civility within medicine. Yet theory and experience suggest that medical (...) educators and academic leaders are also in powerful positions to mobilise these concepts to perpetuate exclusions from, and biases within, medicine, upholding racist, sexist and ableist norms. Feminist methodology reveals how ethical theorising historically excluded views and experiences of marginalised individuals and groups and provides frameworks for interrogating supposedly universal norms. Presuming dominant values and experiences reflect universal ones can further marginalise already oppressed groups and individuals. A feminist analysis reveals how ‘professionalism’ or ‘etiquette’ are historically shaped by white or male identity and experience, including norms of attire, hair, accessories, speech or behaviour. Part of the hidden curriculum of medicine becomes intuiting how leaders implicitly or explicitly define ‘professionalism’. McCullough et al define ‘professionalism’ in medicine as ‘sustained commitments to scientific and clinical excellence… making the protection and promotion of health-related interest the physician’s primary concern …. (shrink)

In “Autonomy and the Feminist Intuition,” Natalie Stoljar asks whether a procedural or a substantive approach to autonomy is best for addressing feminist concerns. In this paper, I build on Stoljar’s argument that feminists should adopt a strong substantive approach to autonomy. After briefly reviewing the problems with a purely procedural approach, I begin to articulate my own strong substantive theory by focusing specifically on the problem of internalized oppression. In the final section, I briefly address some of the concerns (...) raised by procedural theorists who are leery of a substantive approach. (shrink)

Many different and contradictory claims have been made about the political dimensions (or lack thereof) of the ancient Chinese text known as the Zhuangzi 莊子. The two main positions on this topic set the parameters of the debate. One interprets the Zhuangzi to be apathetic toward political participation, focusing on individual survival instead. The other emphasizes the text’s defiant streak and locates a deliberately subversive force within it. A third position redirects the focus of the debate to an important aspect (...) of the Zhuangzi, recognizing that the text intentionally embraces ambiguity and multivocality, and investigates the political implications of this characteristic of the text. This article further explores the Zhuangzi’s engagement with notions of social and political indeterminacy, but through the lens of role performance. Attending to the text’s portrayal of various social actors’ engagement with established roles reveals a different kind of polysemic stance that lies in the intricate dynamics between societal expectations and individual actions. The article employs these examples to examine a type of role enactment that I contend muddies the line between the place of power and the place of resistance. (shrink)

Fraudulent analysis and reporting of psychological data have the potential to contaminate the scientific knowledge base and eventuate in the unjustified expenditure of public money and scientific effort (Koocher & Keith-Spiegel, 1998). Traditionally, the field has relied on quantitative methodologists to educate researchers in proper analysis and reporting practices, and to examine these via peer review. The field has also relied on psychologists with training or board service in ethics to establish standards and implement strategies to discourage misconduct. However, this (...) division of responsibility for examination, standard setting, and deterrence is shown to compromise the effectiveness of methodologists' and ethicists' respective gatekeeping efforts. Methodologically and ethically trained specialists instead need to coordinate efforts to safeguard analysis and reporting procedures. Researchers also need to increase self-monitoring. Potential obstacles to achieving these ends are considered, and three tactics are proposed to overcome them. (shrink)

This glossary is both an introduction to the key words of feminist critical theories and a guide to their origins. Acknowledging the variety of contemporary feminist theories, the glossary includes entries on black, post-colonial, Italian, and French feminisms, and draws on a wide range of fields including semiotics, psychoanalysis, structuralism, poststructuralism, and deconstruction.

I argue that the American Congress of Obstetricians and Gynecologists (ACOG), as an organization and through its individual members, can and should be a far greater ally in the prevention of violence against women. Specifically, I argue that we need to pay attention to obstetrical practices that inadvertently contribute to the problem of violence against women. While intimate partner violence is a complex phenomenon, I focus on the coercive control of women and adherence to oppressive gender norms. Using physician response (...) to alcohol use during pregnancy and court-ordered medical treatment as examples, I show how some obstetrical practices mirror the attitudes of abusive men insofar as they try to coercively control women's behavior through manipulation and violence. To be greater allies in the prevention of violence against women, obstetricians should stop participating in practices that inadvertently perpetuate violence against women. (shrink)

Misconduct in science is often viewed and analyzed through the lenses of normative ethics and moral philosophy. However, notions and methods in the philosophy of science could also provide rather penetrative explanatory insights into the nature and causes of scientific misconduct. A brief illustration in this regard, using as examples the widely popular Popperian falsification and the Kuhnian scientific paradigm, is provided. In multiple areas of scientific research, failure to seek falsification in a Popperian manner constitutes a questionable research practice (...) and could lead to “falsification” in the context of research misconduct. On the other hand, scientific misconduct is often facilitated by its perpetrators using the familiarity, expectations and confines of a Kuhnian paradigm to blend in fabricated data/results. A rudimentary application of these philosophical notions could be useful in our understanding of the nature and cause of research misconduct, and facilitate mitigation of the latter through educational means. (shrink)

Using the moral work on trust and lying, I argue that allowing or encouraging children to believe you are their biological parent when you are not is a breach of trust in the parent-child relationship. While other approaches focus on specific harms or the rights of the child, I make a virtue theory argument based on our understanding of trust, lies, and the nature of the parent-child relationship. Drawing heavily on Nancy Potter's virtue theory of trustworthiness, I consider the nature (...) of trust in the parent-child relationship and what this means for being a trustworthy parent. (shrink)

The shift of missionary nursing from the center to the margins of nursing practice can be traced to the unceremonious closure of China as a mission field in the late 1940s. Building on a larger study of Canadian missionary nursing at the United Church of Canada North China Mission between 1888 and 1947, this paper traces Clara Preston's experiences during the last tumultuous days of the mission during the height of China's civil war. Drawing on rich data from the United (...) Church of Canada/ Victoria University Archives, private family collections (photos, letters, memoirs) as well as from three on‐site visits to the Weihui Hospital in Henan, China, this paper focuses on the questions ‘what happened during the last days of Canadian missionary nursing in China?’ and ‘why is so little known about missionary nursing?’ According to this study, three issues contributed to the silencing of missionary nursing after 1947: the self‐censorship of repatriated missionaries, the mission identity crises catalyzed by the ‘failure’ of the missionary enterprise in China, and the equating of the missionary movement with colonialism and imperialism in academic discourse. (shrink)

This article draws a parallel between the Zhuangzi’s discussions of having no sense of “oneself” or “I,” on the one hand, and its critique of institutionalized order and visions of the unification of society, on the other. Highlighting the way the text distances itself from rituals and tradition, this article identifies the source of the shift in its view on personhood not simply in the situating of humans in the wider world or in acknowledgment of natural processes of change, but (...) in the character of one’s relation to the wider world and change. Although special attention is given here to the socially and politically disengaged tone of the text, I reject the view that the Zhuangzi’s goal is to help shed the “external,” “social,” or “constructed” layers of one’s person in order to unearth a “natural” or “authentic” core. (shrink)

What is it for an imprecise credence to be justified? It might be thought that this is not a particularly urgent question for friends of imprecise credences to answer. For one might think that its answer just depends on how a well-trodden issue in epistemology plays out—namely, that of which theory of doxastic justification, be it reliabilism, evidentialism, or some other theory, is correct. I’ll argue, however, that it’s difficult for reliabilists to accommodate imprecise credences, at least if we understand (...) such credences to be determinate first-order attitudes. If I’m right, reliabilists will have to reject imprecise credences, and friends of imprecise credences will have to reject reliabilism. Near the end of the paper, I’ll also consider whether reliabilism can accommodate indeterminate credences. (shrink)

This book considers what virtue theory can tell us about parenting in relation to both moral development and specific ethical dilemmas. It is of interest to those who work in virtue theory, applied ethics, and the ethics of parenthood.

In The Assisted Reproduction of Race, Camisha Russell states: "My central aim here is to explore how notions of race and racial identity function within assisted reproductive technologies ". The way she does this may surprise some bioethicists. Moving beyond principles and traditional ethical theories, Russell instead draws on the work of critical race theory and the philosophy of technology. By showing the usefulness of these theories, she encourages bioethicists to expand our theoretical toolbox.After giving an overview of the main (...) responses critical race theorists give to what race is, Russell ultimately wants to focus more on what race does. For example, one of the points Russell makes over and over... (shrink)

We begin by distinguishing computationalism from a number of other theses that are sometimes conflated with it. We also distinguish between several important kinds of computation: computation in a generic sense, digital computation, and analog computation. Then, we defend a weak version of computationalism—neural processes are computations in the generic sense. After that, we reject on empirical grounds the common assimilation of neural computation to either analog or digital computation, concluding that neural computation is sui generis. Analog computation requires continuous (...) signals; digital computation requires strings of digits. But current neuroscientific evidence indicates that typical neural signals, such as spike trains, are graded like continuous signals but are constituted by discrete functional elements (spikes); thus, typical neural signals are neither continuous signals nor strings of digits. It follows that neural computation is sui generis. Finally, we highlight three important consequences of a proper understanding of neural computation for the theory of cognition. First, understanding neural computation requires a specially designed mathematical theory (or theories) rather than the mathematical theories of analog or digital computation. Second, several popular views about neural computation turn out to be incorrect. Third, computational theories of cognition that rely on non-neural notions of computation ought to be replaced or reinterpreted in terms of neural computation. (shrink)

Studies on end-of-life care reveal different practices regarding withholding and/or withdrawing life-sustaining treatments between countries and regions. Available data about physicians’ practices regarding end-of-life care in ICUs in Egypt is scarce. This study aimed to investigate physicians’ attitudes toward end-of-life care and the reported practice in adult ICUs in Ain Shams University Hospitals, Cairo, Egypt. 100 physicians currently working in several ICU settings in Ain Shams University Hospitals were included. A self-administered questionnaire was used for collection of data. Most of (...) the participants agreed to implementation of “do not resuscitate” orders and applying pre-written DNR orders, while only 13% almost always/often order DNR for terminally-ill patients. 52% of the participants agreed to usefulness of limiting life-sustaining therapy in some cases, but they expressed fear of legal consequences. 47% found withholding life-sustaining treatment is more ethical than its withdrawal. 16% almost always/often withheld further active treatment but continued current ones while only 6% almost always/often withdrew active therapy for terminally-ill patients. The absence of legislation and guidelines for end-of-life care in ICUs at Ain Shams University Hospitals was the main influential factor for the dissociation between participants’ attitudes and their practices. Therefore, development of a consensus for end-of-life care in ICUs in Egypt is mandatory. Also, training of physicians in ICUs on effective communication with patients’ families and surrogates is important for planning of limitation of life-sustaining treatments. (shrink)

The decline in providers and facilities that will allow a trial of labor after cesarean forces many women to choose a repeat cesarean. The choice is frequently not much of a choice, however, since the full range of options are often not on the table. This limited “choice” violates obstetricians' obligations both to respect patients' autonomy and to offer them good care. There has been a vigorous but so far not very fruitful debate in the last few years about the (...) lack of access to a trial of labor after cesarean. Some recently released documents express concern about the limited access women have to clinicians and facilities willing to offer a trial of labor after cesarean. But access is likely to remain a problem for the foreseeable future. (shrink)

This paper explores the heart and brain metaphors used in the meaning-making efforts of Chinese individuals diagnosed with depression. Past studies assert that the origin of Chinese language metaphors for thinking and feeling can be found in traditional Chinese medico-philosophical theory, where the heart is viewed as the seat of thought and emotion, and the brain, which constitutes the cognitive center in western theories of the self, is secondary. While most participants employed heart metaphors to express thinking and feeling, many (...) of the participants also employed brain metaphors. Instead of suggesting that this multiplicity implies westernization, this paper argues that cultural understandings of the self can be multiple. To appreciate this, it is necessary to look at spontaneously generated speech in a narrative context. This paper thus analyzes three participant narratives, a process that carries several implications for studies approaching the relationship between metaphor, culture, and the self. (shrink)

Oriented toward the question of God, this book sets up a dialogue between Heidegger and four medieval authors: St. Bonaventure, Meister Eckhart, Johannes Tauler, and Jan van Ruusbroec.

In this article, we discuss decision making during labor and delivery, specifically focusing on decision making around offering women a trial of labor after cesarean section. Many have discussed how humans are notoriously bad at assessing risks and how we often distort the nature of various risks surrounding childbirth. We will build on this discussion by showing that physicians make decisions around TOLAC not only based on distortions of risk, but also based on personal values rather than medical data. As (...) a result of this, we will further suggest that the party who is best epistemically situated to make decisions about TOLAC is the woman herself. (shrink)

In this essay, I argue that the daily practice of expert nurses goes far toward enacting the kind of patient autonomy feminist bioethicists envision. Nursing theorists often utilize philosophical theories in their work, but bioethicists have not paid much attention to nursing theory and what it means to be an expert nurse. This is unfortunate because expert nurses do much in their daily practice to make the ideals for autonomy put forth by feminist bioethicists a reality. With this in mind, (...) I bring these two literatures together in what I hope is a fruitful dialogue. (shrink)

The vast majority of indigenous communities are among the world’s poorest and are unlikely to be engaged in a thriving, mutually beneficial partnership with an MNC. While there are increasing studies on CSR initiatives in base of the pyramid communities, few—if any—feature the self-initiated stakeholder transition of an impoverished community. This paper examines the factors that motivated the stakeholder transformation process of an indigenous community, from its position as a non-stakeholder, one lacking in power and legitimacy, to the status of (...) being a primary stakeholder of the firm. We applied a constructivist grounded theory approach to longitudinal data to arrive at the conceptual framework. The findings presented are drawn from an in-depth case study of the Maasai, an indigenous community from East Africa. The findings point to the existence of entrepreneurial alertness that is instrumental in propelling the indigenous community to evolve from one stakeholder category to the next. Our research aims to propose a possible foundation for how communities deep in poverty can coalesce themselves to make their social needs salient to multinational organizations. (shrink)

Although Christianity's clout on sexuality has generally declined in Britain due to secularization, contemporary conservative Protestantism continues to encourage a conventional construction of sexuality — sex is only for the context of heterosexual marriage. Qualitative interviews with 26 heterosexual women and two lesbian women on how their Protestant church involvement impacted their sexuality revealed the pervasive discourse of a marital-confined sexuality and participants' sense of `accountability' to the group for carrying this out. Such accountability can result in a repressed sexuality (...) that is oppressive. Alternatively, it can produce a `sense of community' that functions as a source of empowerment. The oppressive and empowering nature of accountability, however, can be difficult to untangle because of women's religious commitment and supportive friendships found in church life. Relying on participants' accounts, this article addresses the oppression and empowerment young women experience when they negotiate their gendered identities in relation to a marital-confined sexuality. (shrink)

Bien que Caring for America ait fait l’objet de nombreuses recensions au moment de sa publication en 2012, ce n’est que maintenant, sept ans plus tard, que l’on peut saisir l’importance de son apport à la littérature sur le travail de care. Depuis une dizaine d’années, cette littérature s’étoffe, surtout dans les sciences sociales mais Caring for America s’en distingue par sa dimension historique. Eileen Boris et Jennifer Klein montrent que les caractéristiques associées par les chercheurs au...

Although mutually advantageous cooperative strategies might be an apt account of some societies, other moral systems might be needed among certain groups and contexts. In particular, in a duty-based moral system, people do not behave morally with an expectation for proportional reward, but rather, as a fulfillment of debt owed to others. In such systems, mutualistic motivations are not necessarily a key component of morality.

Philodemus of Gadara was a poet and Epicurean philosopher who, after leaving Gadara, studied in Athens under Zeno of Sidon before moving to Italy. Once in Italy, he lived in the area around the Bay of Naples, where he belonged to a circle of Epicureans that included Siro as well as the Roman poets Vergil, L. Varius Rufus, Quintilius Varus, and Plotius Tucca. His epigrams were preserved as part of the Greek Anthology, while his prose works were discovered at the (...) Villa of the Papyri in Herculaneum, carbonized by the first pyroclastic surge of Mount Vesuvius in 79 C.E. He wrote on a wide range of topics, including epistemology, ethics, theology, aesthetics, logic and science, and the history of philosophy, but not physics. In his works, he presents himself as an entirely orthodox Epicurean. He does so by explicating the teachings of earlier Epicureans (especially those of Epicurus, Metrodorus, Hermarchus, and Polyaenus), defending the positions of his teacher Zeno of Sidon, arguing against fellow Epicureans whom he perceives to have strayed from orthodoxy, and advancing Epicurean positions against other schools like the Academics, Peripatetics, Stoics, Cynics, and Cyrenaics. (shrink)

Different Beasts: Humans and Animals in Spinoza and the Zhuangzi studies conceptions of human and animal identity as articulated in the ancient Chinese text known as the Zhuangzi and in the works of the seventeenth-century European philosopher Benedict de Spinoza. By examining how, in these very different philosophies, notions of humanness and animality intersect with ideas about human unity and solidarity, social order, and categories of social difference (such as gender, descent, and ability), Different Beasts opens new paths for understanding (...) Spinoza and the Zhuangzi while also developing methodological insights into the practice of cross-cultural comparative philosophy. (shrink)