This article introduces and develops the concept of trade narrative to understand how business sectors defend against public disapproval and the threat of increased regulation or removed subsidy. Trade narrative works by accumulating lists of benefits and occluding costs, and is created by consultants for economic interests organized via trade associations. This represents an under-analysed ‘policy-based evidence machine’, the aim of which is to format the discourses of the media and political classes about the contribution of the sector in ways (...) that frame political choice about what is thinkable and doable. In doing so it supports elite power by providing a relay for intra-elite communication. Using illustrations from privatized railways, banking and pharmaceuticals in the UK and US, the argument explores how the causal arrow runs in the opposite direction from that supposed in most discussion of discourse-economy relations in the field of cultural economy. (shrink)

This article uses the example of public sector outsourcing to explore how elite power can be fallible. A contract between the state and private companies represents a complex interweaving of different kinds of power with uncertain outcomes: the experience of outsourcing in the UK and elsewhere is that it frequently goes wrong, with fiascos creating political embarrassment for states and financial problems for companies. Drawing on Deleuze and Guattari, the article explores how the contract is a political device that can (...) be both tool and weapon but which has uncertain outcomes. In doing so, it makes a distinctive contribution by arguing that elite work is often about repair and managing the political or financial consequences of failure. (shrink)

In the healthcare sector, race, ethnicity and religion have become an increasingly important factor in terms of patient care due to an increasingly diverse population. Health agencies at a national and local level produce a number of guides to raise awareness of cultural issues among healthcare professionals and hospitals may implement additional non-medical services, such as the provision of specific types of food and dress to patients or the hiring of chaplains, to accommodate the needs of patients with religious requirements. (...) However, in an attempt to address the spiritual, cultural and religious needs of patients healthcare providers often assume that ethnic minority groups are homogenous blocks of people with similar needs and fail to recognize that a diverse range of views and practices exist within specific groups themselves. This paper describes the example of the Sikh community and the provision of palliative care in hospitals and hospices. Although, the majority of patients classifying themselves as Sikhs have a shared language and history, they can also be divided on a number of lines such as caste affiliation, degree of assimilation in the west, educational level and whether baptized or not, all of which influence their beliefs and practices and hence impact on their needs from a health provider. Given that it is unfeasible for health providers to have knowledge of the multitude of views within specific religious and ethnic communities and accounting for the tight fiscal constraints of healthcare budgets, this paper concludes by raising the question whether healthcare providers should step away from catering for religious and cultural needs that do not directly affect treatment outcomes, and instead put the onus on individual communities to provide resources to meet spiritual, cultural and religious needs of patients. (shrink)

Conflict is an important consideration in the intensive care unit. In this setting, conflict most commonly occurs over the ‘best interests’ of the incapacitated adult patient; for instance, when families seek aggressive life-sustaining treatments, which are thought by the medical team to be potentially inappropriate. Indeed, indecision on futility of treatment and the initiation of end-of-life discussions are recognised to be among the greatest challenges of working in the ICU, leading to emotional and psychological ‘burnout’in ICU teams. When these disagreements (...) occur, they may be within the clinical team or among those close to the patient, or between the clinical team and those close to the patient. It is, therefore, crucial to have a theoretical understanding of decision-making itself, as unpicking misalignments in the family’s and clinical team’s decision-making processes may offer strategies to resolve conflict. Here, we relate Kahneman and Tversky’s work on cognitive biases and behavioural economics to the ICU environment, arguing that these biases could partly explain disparities in the decision-making processes for the two conflicting parties. We suggest that through the establishment of common ground, challenging of cognitive biases and formulation of mutually agreeable solutions, mediation may offer a pragmatic and cost-effective solution to conflict resolution. The litigation process is intrinsically adversarial and strains the doctor–patient–relative relationship. Thus an alternative external party should be considered, however mediation is not frequently used and more research is needed into its effectiveness in resolving conflicts in the ICU. (shrink)

A class of maize mutants, collectively known as disease lesion mimics, display discrete disease‐like symptoms in the absence of pathogens. It is intriguing that a majority of these lesion mimics behave as dominant gain‐of‐function mutations. The production of lesions is strongly influenced by light, temperature, developmental state and genetic background. Presently, the biological significance of this lesion mimicry is not clear, although suggestions have been made that they may represent defects in the plants' recognition of, or response to, pathogens. One (...) feature that is common to all lesion mimics is their association with cell death. In plants, as in animals, a number of developmental and pathological processes exist where controlled cell death, whether programmed or triggered in response to physiological or environmental stimuli, constitutes the normal aspect of life. Might disease lesion mimic mutations represent variants where regulation of desirable cell death has gone awry? In this paper we argue that this might be the case, and further conjecture that these mutants offer a unique opportunity for studying the genetic and cellular mechanisms of cell death in plants. (shrink)

We consider work extraction from two finite reservoirs with constant heat capacity, when the thermodynamic coordinates of the process are not fully specified, i.e., are described by probabilities only. Incomplete information refers to both the specific value of the temperature as well as the label of the reservoir to which it is assigned. Based on the concept of inference, we characterize the reduced performance resulting from this lack of control. Indeed, the estimates for the average efficiency reveal that uncertainty regarding (...) the exact labels reduces the maximal expected efficiency below the Carnot value ), its minimum value reproducing the well known Curzon–Ahlborn value: \ . We also estimate the efficiency before the value of the temperature is revealed. It is found that if the labels are known with certainty, then in the near-equilibrium limit the efficiency scales as \ , while if there is maximal uncertainty in the labels, then the average estimate for efficiency drops to \ . We also suggest how the inferred properties of the incomplete model can be mapped onto a model with complete information but with an additional source of thermodynamic irreversibility. (shrink)

The COVID-19 pandemic is putting the NHS under unprecedented pressure, requiring clinicians to make uncomfortable decisions they would not ordinarily face. These decisions revolve primarily around intensive care and whether a patient should undergo invasive ventilation. Certain vulnerable populations have featured in the media as falling victim to an increasingly utilitarian response to the pandemic—primarily those of advanced years or with serious existing health conditions. Another vulnerable population potentially at risk is those who lack the capacity to make their own (...) care decisions. Owing to the pandemic, there are increased practical and normative challenges to following the requirements of the Mental Capacity Act 2005. Both capacity assessments and best interests decisions may prove more difficult in the current situation. This may create a more paternalistic situation in decisions about the care of the cognitively impaired which is at risk of taking on a utilitarian focus. We look to these issues and consider whether there is a risk of patients who lack capacity to make their own care decisions being short-changed. (shrink)

Our chapter interrogates the conditions that give rise to the possibility of the Event and proposes a Lacanian-Badiouian perspective to think through conditions for the truth procedures of love and politics. First, we situate the Event, Possibility and Truth in both Badiou and Lacan, which brings forward conceptual tensions between truth and knowledge as presented in the psychoanalytic act. We propose with Badiou and Lacan that the emergence of possibility follows a logic that rupture compulsive repetition and whose effect is (...) precisely the Event which results in knowledge of a savoir faire, of transmissible quality, that grant re-inscription (a new writing of the necessary) and/or a partial inscription of the impossible. The notion of love as beyond narcissism, allows us to discuss how to reimagine politics anew, including approaching it through the problem of ecology. (shrink)

Can friendship as a political practice offer enough traction to imagine a borderless world? The startling contemporary rise in aggressive ethno-nationalism and end-times ecological crises have the same root: an inability to be together with humans as much as the natural world. Matt Hern and Am Johal suggest that porous renditions of being-together animated by friendship can spark a repoliticization of the political to surpass the foreclosures of the state, speak to a freedom of movement, and find renovated relationships (...) with the more-than-human. This volume includes interviews with Jean-Luc Nancy, Leela Gandhi and Leanne Simpson. (shrink)

The shift towards "empirical bioethics" was largely triggered by a recognition that stakeholders' views and experiences are vital in ethical analysis where one hopes to produce practicable recommendations. Such perspectives can provide a rich resource in bioethics scholarship, perhaps challenging the researcher's perspective. However, overreliance on a picture painted by a group of research participants—or on pre‐existing literature in that field—can lead to a biased view of a given context, as the subjectivity of data generated in these ways cannot (and (...) should not wholly) be escaped. In response, we propose the implementation of a complementary approach of ethno‐immersion in bioethics research. By positioning oneself in the context being researched, the researcher can better understand the realities of that context. The researcher's understanding will, naturally, be subjective too. However, it will act as a better developed and more informed outsider view, when considering the picture painted by participants and previous studies, thus enabling the researcher to introduce more nuance when analysing data. We introduce this approach after examining what we call the context detachment problem, whereby some bioethics scholarship—empirical or otherwise—fails to reflect the reality of the healthcare setting it concerns. Our proposed ethno‐immersion (which differs from formal ethnography) is then explored as a response, highlighting its benefits, and answering the question of timing within a research project. Finally, we reflect on the applicability of our proposal to non‐empirical bioethics scholarship, concluding that it remains important but may require some adjustments. (shrink)

The Indian mediascape has dramatically changed in the past 15 years. Gradual privatization and deregulation have resulted in increased entertainment-driven rather than public-service oriented news. This article explores the ethical issues Indian journalists face in such a globalized media environment. Our research was based on interactive workshops we conducted in various Indian cities. Findings from these workshops reveal that although journalists encounter serious ethical issues, media ethics is not a topic being widely discussed in Indian newsrooms and TV stations. Marketing (...) pressures, the tabloidization of news, and management and economic pressures are affecting journalism ethics and issues such as accountability, independence, and conflict of interests. A lack of professional training, especially ethics training, is affecting journalists' understanding of concepts such as privacy and accuracy. (shrink)

The Indian mediascape has dramatically changed in the past 15 years. Gradual privatization and deregulation have resulted in increased entertainment-driven rather than public-service oriented news. This article explores the ethical issues Indian journalists face in such a globalized media environment. Our research was based on interactive workshops we conducted in various Indian cities. Findings from these workshops reveal that although journalists encounter serious ethical issues, media ethics is not a topic being widely discussed in Indian newsrooms and TV stations. Marketing (...) pressures, the tabloidization of news, and management and economic pressures are affecting journalism ethics and issues such as accountability, independence, and conflict of interests. A lack of professional training, especially ethics training, is affecting journalists' understanding of concepts such as privacy and accuracy. (shrink)

Bioethics, Volume 36, Issue 4, Page 423-433, May 2022.

The freedom to choose for oneself is a part of what it means to be a human being.Jackson J In England and Wales, the Mental Capacity Act 20...