In this article, we address the limitations of sustainable development as an orienting educational horizon of hope and change, given that mainstream development presumes the possibility of perpetual growth and consumption on a finite planet. Facing these limitations requires us to consider the inherently violent and unsustainable nature of our modern-colonial modes of existence. Thus, we propose a shift from “education for sustainable development” to “education for the end of the world as we know it.” We contend that the predicament (...) we face is not primarily rooted in ignorance and thus solvable with more knowledge, nor primarily rooted in immorality and thus solvable with more normative values; rather, it is rooted in denials that stem from harmful desires for and investments in the continuity of the securities and satisfactions promised by modernity-coloniality. Faced with these denials, we emphasize a collective need to “grow up” so that we might “show up” differently to do the work that is needed as we face unprecedented global challenges. (shrink)

Our intention is to contribute to the development of Canadian Nursing and Medical Education (NursMed) and efforts to redress deepening, intersecting health and social inequities. This paper addresses the following two research questions: (1) What are the ways in which Decolonial, Intersectional Pedagogies can inform Canadian NursMed Education with a focus on critically examining settler‐colonialism, health equity, and social justice? (2) What are the potential struggles and adaptations required to integrate Decolonial, Intersectional Pedagogies within Canadian NursMed Education in service of (...) redressing intersecting health and social inequities? Briefly, Decolonial, Intersectional Pedagogies are philosophies of learning that encourage teachers and students to reflect on health through the lenses of settler‐colonialism, health equity, and social justice. Drawing on critical ethnographic research methods, we conducted in‐depth interviews with 25 faculty members and engaged in participant observation of classrooms in university‐based Canadian NursMed Education. The research findings are organized into three major themes, beginning with common institutional features influencing pedagogical approaches. The next set of findings addresses the complex strategies participants apply to integrate Decolonial, Intersectional Pedagogies. Lastly, the findings illustrate the emotional and spiritual toll some faculty members face when attempting to deliver Decolonial, Intersectional Pedagogies. We conclude that through the application of Decolonial, Intersectional Pedagogies teachers and students can support movements towards health equity, social justice, and unlearning/undoing settler‐colonialism. This study contributes new knowledge to stimulate dialog and action regarding the role of health professions education, specifically Nursing and Medicine as an upstream determinant of health in settler‐colonial nations such as Canada, United States, Australia, and New Zealand. (shrink)

This paper is an "ordinary language" analysis of the philosophical discussion of visual perception in the context of Twentieth Century British "sense datum" theorists, primarily G.E. Moore. -/- The title of the paper is derived from A.J. Ayer's "argument from illusion", which also forms part of the context of this paper. Both Moore and Ayer believed in sense datum theory, but Moore provides an interesting illustration that is intended to clarify (and also prove) sense datum theory in his paper, "A (...) Defence of Common Sense". Moore invites us to inspect his hand. I try to follow suit, but succeed only in falling out with the viewpoints of both Moore and Ayer. (shrink)

Many now accept the thesis that norms are somehow constitutively involved in people's contentful intentional states. I distinguish three versions of this normative thesis that disagree about the type of norms constitutively involved. Are they objective norms of correctness, subjective norms of rationality, or intersubjective norms of social practices? I show the advantages of the third version, arguing that it improves upon the other two versions, as well as incorporating their principal insights. I then defend it against two serious challenges: (...) (1) If content is constituted by others' normative judgments, how can content be causally efficacious? (2) This account appears to make having contentful thoughts a matter of people having contentful thoughts about your thoughts. That appears to be viciously circular and so can't be naturalistic. (shrink)

Representation is a pivotal concept in cognitive science, yet there is a serious obstacle to a naturalistic account of representations’ semantic content and intentionality. A representation having a determinate semantic content distinguishes correct from incorrect representation. But such correctness is a normative matter. Explaining how such norms can be part of a naturalistic cognitive science is what I call the normativity problem. Teleosemantics attempts to naturalize such norms by showing that evolution by natural selection establishes neural mechanisms’ functions, and such (...) functions provide the normativity requisite for a determinate semantic content. I argue that such attempts fail, because when specifying functions, and thus semantic contents, that are determinate enough to enable misrepresentation, they must tacitly appeal to human normative practices, especially the practice of giving intentional states as reasons for actions. I present a different tactic: using evolution by natural selection to avoid rather than solve the normativity problem. Representations’ semantic contents and their intentional targets are irreducibly normative. Semantics and intentionality are constituted within human normative practices. However, evolution by natural selection can be used to naturalistically explain the transition from a world without human beings and human normative practices — and thus without any distinction between thoughts that may be called “correct” or “incorrect” — to a world in which such human practices and distinctions are commonplace. (shrink)

The Hypothesis of Extended Cognition (HEC)—that many cognitive processes are carried out by a hybrid coalition of neural, bodily and environmental factors—entails that the intentional states that are reasons for action might best be ascribed to wider entities of which individual persons are only parts. I look at different kinds of extended cognition and agency, exploring their consequences for concerns about the moral agency and personal responsibility of such extended entities. Can extended entities be moral agents and bear responsibility for (...) actions, in addition to or in place of the individuals typically held responsible? What does it mean to be autonomous when one’s cognition is influenced and supported by a milieu of environmental factors? To answer these questions, I explore strong parallels between HEC’s critique of individualism in cognition, and feminist critiques of individualist accounts of self, agency, and autonomy. This relational and social conception of autonomous agency, as scaffolded and supported (or undermined and impaired) by a milieu of social, relational, and normative factors, has important lessons for HEC. Drawing together these two visions of distributed and decentralized aspects of personhood highlights how cognition, action, and responsibility are inextricably linked. It also encourages a reconceptualization of all cognition and all concerns about responsibility for actions, not simply as sometimes extended around individuals, but as fundamentally communal, social, and normative, with individual cognition and individual moral responsibility being derivative special cases, not the paradigm examples. Individuals are merely one of many possible loci of cognition, action, and responsibility. (shrink)

This paper investigates the idea of clinical autonomy. Whilst there is a considerable literature on moral autonomy there is very little on clinical autonomy except as a sociological phenomenon. Using the results of interviews with Community Psychiatric Nurses in England, the three main theories that they have about clinical autonomy are examined. It is argued that there are substantial problems with these theories and an alternative way of understanding clinical autonomy is proposed, the idea of contractual space.

Agricultural decision making is characterized by two challenges common to multiple arenas: linking science to decision making and linking science and decision making across multiple levels. The U.S. agricultural research, education, and extension system was designed to address these challenges. By investigating this system, this study deepens the understanding of science and decision making, specifically exploring the notion of boundary organizations in two significant ways. First, it provides a preliminary test of the hypothesis that boundary organizations mediate between the shifting (...) domains of science and policy, finding that they are instrumental in creating and maintaining an integrated system of assessment and decision making for addressing depletion of the High Plains Aquifer. Second, it extends the concept of boundary organization beyond the science-policy dimension to incorporate the dimension of levels of organization—not only bridging science and policy but linking science and policy across different levels. (shrink)

A patient's experience unfolds through a nurse's personal conversation with herself. Conveyed through three voices, the nurse's dialogue highlights her many internal struggles; those with her conscience on what she understands to be best practice, those important to her as a person, those of an ethical nature that profoundly affect one's search for meaning, and those in the personal–professional realm driven in part by institutional culture. These multivoiced knowledges are confronted in ways that foreground language and understanding as performative acts. (...) At the same time, another journey is co‐constructed with the reader, one that weaves in‐between the symbolic and the real, engaging the imaginary in (inter)play. The nurse's response to the inner conversation with her ‘self/selves’ problematizes practice, illuminates the patient's perspective while highlighting the nurse's sense of her marginal position. Insight into reified and hegemonic assumptions, strategies of how control is maintained through organizational surveillance, trust and moral agency help to foreground personal expectations as the nurse begins to grapple with her own feelings of betrayal. Tackling these insights offers opportunities to rethink oppressive practices in the provision of care. It also enables an alternative appreciation of the everyday dilemmas confronting nurses and offers new meaning to practice. (shrink)

Despite the increase in global research on health inequalities, more needs to be done to strengthen efforts to inform local interventions. In this article, we ask what determines the local capacity to engage in research on health inequalities. A bibliometric analysis identified Spain as the 10th highest global contributor to this research field (1966–2015), yet a significant proportion of this production was affiliated to just a few institutions in Barcelona. How and why has the city produced so much health inequalities (...) research over four decades? A realist explanatory case study was conducted to test and refine six causal mechanisms, and identify the contextual conditions that might have activated them to generate this outcome. Data was triangulated from 10 semi-structured interviews, and scientific and grey literature. Our findings confirmed that several of our proposed mechanisms - functioning under certain conditions over time - explain the large volume of health inequalities research in Barcelona. Based on these findings, key lessons from the city's experience are suggested. Further research is needed on this topic. (shrink)

Typical hermeneutical approaches to the Deuteronomic Code, and to scriptural legal codes more generally, attend to genre either for the sake of historical-critical concerns as an end in themselves, or as a gateway to abstracted content. This article argues, conversely, that the genre of the code is not disconnected from its content, and that its form—imaginative, pragmatic propositions based on communal hope—can and should be imitated in the practice of theological ethics. As best seen in Deuteronomy 15, the communicative genius (...) of the code is that it (1) imagines a specific, viable future, (2) empowers moral agency, (3) forges communal identity, and (4) addresses unique historical situations. Appropriating the genre, rather than the content, thus has unique potential to give traction to modern ethical scholarship through conscious, kerygmatic contingency. (shrink)

This paper investigates the idea of clinical autonomy. Whilst there is a considerable literature on moral autonomy there is very little on clinical autonomy except as a sociological phenomenon. Using the results of interviews with Community Psychiatric Nurses in England, the three main theories that they have about clinical autonomy are examined. It is argued that there are substantial problems with these theories and an alternative way of understanding clinical autonomy is proposed, the idea of contractual space.

Since people can often successfully interpret utterances that flout or ignore conventions, Davidson concludes that shared conventions are neither necessary nor sufficient for linguistic interpretation. This conclusion is based on an overly narrow conception of what it is to know, and to share, a language. Rather than, as Davidson argues, simply interpreting the meaning the speaker intends their words to be interpreted as having (and their words’ truth conditions), successful interpretation requires interpreting the illocutionary act the speaker intends to be (...) interpreted as performing (and the act’s felicity conditions). This change in focus highlights the need for many types of shared conventions, beyond the conventional meanings of words that Davidson considers and dismisses as unnecessary. When any one convention is ignored or flouted, interpretation is possible because the apparently unconventional utterance nonetheless conforms to a host of other shared conventions. Conventions are necessary for linguistic interpretation. (shrink)

Wittgenstein's notorious sample of a ‘complete primitive language’ is often thought to be closer in kind to animal forms of communication than human language. Indeed, it has been criticised on precisely these grounds. But such debates make little sense if we take seriously Wittgenstein's idea that language is a family resemblance concept. So, rather than argue that the builders’ game ‘really is a language’, I propose to turn the debate on its head and welcome the comparison. By changing our perspective (...) in this way, I suggest that we can see that the learning of language is crucially dependent on forms of communication that are animal in nature. I then discuss how these lessons might shed light on empirical research into both the ontogenetic and phylogenetic origins of linguistic communication. (shrink)

pSara Ahmed’s emWillful Subjects/em develops an account of willfulness as a site of simultaneous oppression and resistance: a diagnosis attributed to particular (not-quite-)subjects and to modes of behavior that are thereby diminished, pathologized, and controlled, and a “diagnosis” that may be positively affirmed as a way of living and doing otherwise. This essay puts Ahmed’s work on willfulness in conversation with María Lugones’ decolonial feminism, particularly her theory of active subjectivity. With Lugones, we offer, one can better understand the resistant (...) potential of willfulness, not simply as the willful subject possessing an oppositional “will of her own” (which risks reinscribing a unitary notion of the self), but rather, as exercising a different kind of subjectivity altogether—one that relies on multiplicity and arises through relationships across non-dominant difference. Extending the connections that Ahmed herself draws between willfulness and “madness,” we further explore the willful elements in experiences relating to mental illness and cognitive disability, categories of experience that we understand to be important (and undertheorized) aspects of what Aníbal Quijano has termed “the coloniality of power.”/p. (shrink)

There has always been a tension between a critique of ‘real existing conditions’ and meta-theoretical paradigms through which the tasks of critique can both be anchored and images of humankind explored.

This article provides a comparative institutional analysis between El Niño/southern Oscillation forecasting systems in the Pacific and southern Africa with a focus on how scientific information is connected to the decision-making process. With billions of dollars in infrastructure and private property and human health and well-being at risk during ENSO events, forecasting systems have begun to be embraced by managers and firms at multiple levels. The study suggests that such systems need to consciously support the coproduction of knowledge. A critical (...) component of such coproduction seems to be managing the boundaries between science and policy and across disciplines, scale, and knowledges to create information that is salient, credible, and legitimate to multiple audiences. This research suggests institutional mechanisms that appear to be useful in managing such boundaries, including mechanisms for structuring convening, translation, collaboration, and mediation functions. (shrink)

Objectives: To test the range of beliefs regarding the ethics of testing, in resource poor settings, new therapies that are less efficacious but more affordable and feasible than the best current therapeutic standard. Design: Using a web-based survey, we presented a hypothetical scenario proposing to test a therapy for HIV disease ("therapeutic inoculation") known to be less efficacious than highly active antiretroviral therapy (HAART). Respondents evaluated various trial designs as ethical or unethical. Participants: 604 subscribers to two listservs for individuals (...) interested in international health research ethics. Main outcome measures: Proportion of respondents endorsing trials testing this "substandard" therapy, and proportion endorsing placebo-controlled trials. Results: There were 215 respondents from 47 countries. Forty-five percent of respondents were from low or middle income countries; 96% devoted at least some time to research activities; and 75% had "some" or "considerable" research experience in developing countries. Of respondents, 97% (95% CI 94.7 to 99.4) endorsed testing therapeutic inoculation, without HAART, in patients with HIV disease; 86% (95% CI 81.4% to 90.7%) endorsed testing against placebo. Sixty-eight percent explicitly endorsed principles where the standard of care for subjects in clinical trials is determined by local, not universal, standards. There were no differences in responses based on respondent education-level or the income-level of their country of citizenship. Conclusion: There was broad agreement that a therapy of potential local benefit may be tested, even when that therapy is known to be inferior to the standard of care in wealthy countries. Most agreed that a placebo control may be used in some circumstances. (shrink)

In the trauma surrounding mass disasters, the need to identify victims accurately and as soon as possible is critical. DNA identification testing is increasingly used to identify human bodies and remains where the deceased cannot be identified by traditional means. This form of testing compares DNA taken from the body of the deceased with DNA taken from their personal items or from close biological relatives. DNA identification testing was used to identify the victims of the terrorist attack on the World (...) Trade Center in New York on September 11, 2001, and of the victims of the Tsunami that hit Asia on December 26, 2004. Shortly after the 9/11 attack, police investigators asked the victims' families for personal items belonging to the missing, and for DNA samples from family members themselves. The New York medical examiner's office coordinated the DNA identification testing program; however, some of the identification work was contracted out to private laboratories. (shrink)

Omnipresent calls for more women in university administration assume these women will prioritize using resources and power to increase female representation, especially in STEM fields where women are most underrepresented. However, empirical evidence is lacking for systematic differences in female versus male administrators’ attitudes. Do female administrators agree on which strategies are best, and do men see things differently? To answer this question, we explored United States college and university administrators’ opinions regarding policies, strategies, and structural changes in their organizations (...) designed to increase women professors’ representation and retention in STEM fields. A comprehensive review of past research yielded a database of potentially-effective, recommended policies (e.g., increasing emphasis on teaching, service, and administration during promotion reviews; stopping the tenure clock for childbearing; providing on-campus childcare; couples-hiring; sharing tenure lines; having more women chair search committees; setting gender quotas for promotion). A survey based on these recommended policies was sent to provosts, deans, associate deans, and department chairs of STEM fields at 96 public and private research universities (formerly called R1s) across the U.S. These administrators were asked to rate the quality and feasibility of each recommended policy; 474 provided data, of which 334 contained complete numerical data used in the analyses, so our results are based on a large, geographically diverse group of administrators at research universities. Our data revealed that female administrators perceived the 44 strategies to be higher in quality overall than did male administrators--but not higher in feasibility--with 9 policies perceived differently when rated by women versus men administrators, after imposing conservative statistical controls. There was broad general agreement on the relative rankings of the 44 policies in terms of their perceived quality. Overall, our national survey of U.S. administrators supported the assertion that placing women in administrative roles creates greater emphasis on the importance of enacting policies to attract and retain women in STEM. Topics of disagreement between women and men regarding strategy quality are important focuses of future policy and planning, because female administrators may have insights into how to retain women professors that male administrators do not share. (shrink)

This paper addresses the ethical issues of secondary uses of samples collected for identification purposes following mass disasters. It studies norms governing secondary use of samples , ultimately concluding that limited secondary research uses of these samples should be permissible.