Introduction THOMAS C. HELLER AND DAVID E. WELLBERY A he essays that follow originated in a conference entitled "Reconstructing Individualism," held at ...

This historical study aims to refine understanding of the nature of nursing work. The study focuses on the 1880 crisis at Guy's Hospital in London to examine the nature and meaning of nursing work, particularly the concept of nursing work as many ‘little things.’ In this paper, an examination of Margaret Lonsdale's writing offers an original contribution to our understanding of the ways in which nursing work differs from medical practice. In this way, we use the late-nineteenth-century controversy at Guy's (...) Hospital as a prism through which to examine the contested nature of nursing work. Lonsdale's ideas are corroborated by examination of writings by nurse leaders Florence Nightingale and Eva Luckes. Luckes, in particular, elaborated what was meant by nursing as the performance of a thousand little things, which are specific to nursing work. While physicians had been performing much of what was considered to be nursing work, nurses developed some of these and other interventions into a unique body of work characterized by meticulous attention to significant details. Some implications regarding current nursing practice are discussed. (shrink)

Volume 20, Issue 10, October 2020, Page 63-65.

The purpose of this contemporary history study is to analyse nursing strategy documents produced by NHS Trusts in England in the period 2009–2013, through a process of discourse analysis. In 2013 the Francis Report on the Mid-Staffordshire NHS Foundation Trust was published. The Report highlighted the full range of organisational failures in a Trust that valued financial efficiency over patient care. The analysis that followed, however, dwelt heavily on the failings of the nurses. Nursing strategy documents at that time served (...) to set the future direction for NHS Trusts, prescribing specific value frameworks for each nursing workforce. However, the values chosen frequently conflicted with each other pitting nursing values against a managerial trope. It is argued that documents provided a response to wider NHS concerns and high-profile failures in care, particularly the Francis Report, paying lip service to staff engagement whilst maintaining a corporate focus. Nursing values were placed firmly within a managerialist discourse, one that has needed to be re-evaluated in the current Covid-19 pandemic. Wider implications of the research suggest discussion of value conflict may be beneficial within nursing education and a truly local approach to strategy creation would potentially promote staff buy-in to strategy documents. (shrink)

Current health policy, high‐profile failures and increased media scrutiny have led to a significant focus on patient experience in Britain's National Health Service (NHS). Patient experience data is typically gathered through surveys of satisfaction. The study aimed to support a better understanding of the patient experience and patients' expression of it through consideration of the aspects of the patient experience on NHS wards which are by their nature impossible to capture through patient satisfaction surveys. Existential phenomenology was used to develop (...) an in‐depth exploratory narrative, expressed through the voices of the participants. Data collection involved in‐depth face‐to‐face interviews with 12 purposively sampled participants, with analysis by means of hermeneutics. Though the individuality of each experience was apparent and cannot be overemphasised, common factors emerging from the data included uncertainty and unexpectedness, suffering and finitude, the futility of feedback and bureaucracy and absurdity. Overall, participants demonstrated how their individual personalities and expectations affected their response both to illness or injury and to their hospital admissions, highlighting feelings of vulnerability and voicelessness as a response to hospitalisation. The findings of this study provide useful insight into the patient experience on British hospital wards, and the value of an existential–phenomenological approach is demonstrated. (shrink)

Neurotrophins (NTs) are {?AUTHOR} a family of structurally related, secreted proteins that regulate the survival, differentiation and maintenance of function of different populations of peripheral and central neurons.1,2 Among these, BDNF (brain‐derived neurotrophic factor) has drawn considerable interest because both its synthesis and secretion are increased by physiological levels of activity, indicating a unique role of this neurotrophin in coupling neuronal activity to structural and functional properties of neuronal circuits. In addition to its classical neurotrophic effects, which are evident within (...) hours or days and which usually result from changes in cellular gene expression, BDNF exerts acute effects on synaptic transmission and is involved in the induction of long‐term potentiation. Many of these rapid effects of BDNF are mediated by its modulation of ion channel properties following TrkB‐mediated activation of intracellular second messenger cascades and protein phosphorylation. However, recent reports have shown that BDNF not only acts as a modulator of ion channels, but can also directly and rapidly gate a Na+ channel, thereby assigning BDNF the properties of a classical excitatory transmitter. Thus, BDNF, in addition its role as a potent neuromodulator, emerges as an excitatory transmitter‐like substance which acutely controls resting membrane potential, neuronal excitability, synaptic transmission and participates in the induction of synaptic plasticity. BioEssays 26:1185–1194, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

Recent research has pointed to the importance of the prenatal environment in the etiology of autism spectrum disorder (ASD) but the biological mechanisms which mitigate these environmental factors are not clear. Mitochondrial metabolism abnormalities, inflammation and oxidative stress as common physiological disturbances associated with ASD. Network analysis of the scientific literature identified several leading prenatal environmental factors associated with ASD, particularly air pollution, pesticides, the microbiome and epigenetics. These leading prenatal environmental factors were found to be most associated with inflammation, (...) followed by oxidative stress and mitochondrial dysfunction. Other prenatal factors associated with ASD not identified by the network analysis were also found to be significantly associated with these common physiological disturbances. A better understanding of the biological mechanism which mediate the effect of prenatal environmental factors can lead to insights of how ASD develops and the development of targeted therapeutics to prevent ASD from occuring. (shrink)

Some have argued that specifically moral demands or norms are justified by the constraints of rationality. On this view, any agent who comes to doubt, challenge, or reject the authority of moral demands does so on penalty of irrationality. According to this view, the agent who asks the question Why be moral? can be given a rational justification for the demands that morality makes on her, regardless of her individual reasons and motives. ;I consider amoralism as a test case. Could (...) a proposed justification of morality answer to the amoralist? I develop two characterizations of amoralism: the principled objector and the amoralist from indifference. I argue that normal moral agents may adopt or succumb to either type of amoralism without forfeiting their claim to rationality, and further, that such amoralists are not best understood as demanding a justification of morality. ;Some philosophers have objected that the notion of amoralism is conceptually mistaken or incoherent. I address three forms of this argument. First, I argue that the inverted-commas argument attributed to R. M. Hare fails to show that purported amoralists cannot really make or understand value judgments. Second, I argue that Michael Smith's internalist argument against amoralism is unconvincing. Third, I consider Christine Korsgaard's argument in The Sources of Normativity that the very nature of rational action entails moral obligation. ;I conclude by discussing the way in which a justification of moral demands can only be made internal to a particular moral outlook or way of life. To attempt to respond to amoralists who are radically dissatisfied with, or dissociated from, a moral perspective with a wholesale rational justification of morality is to misunderstand the nature of their disaffection as well as to misunderstand the project of moral philosophy. However, acknowledging the limited role of justification in moral theory and argument does not entail that moral philosophy's primary enterprise is merely the explanation of moral phenomena. Moral normativity is a function of our capacity for reflection. Thus, the work of moral philosophy lies in making reflective recommendations for which norms to adopt, how to obligate oneself and others, and how to live. (shrink)

Colin Turnbull's book The Mountain People has aroused much non-academic as well as much academic interest. The success of The Ik , Peter Brook's recent stage adaptation of the book, shows how widespread this interest is. The interest centres on Turnbull's anthropological descriptions of his life with the Ik people. The Ik society is one in which the weak, the old and the children are left to fend for themselves and die. Help proffered to the needy is frowned upon. Food (...) is snatched from the mouths of the old, medicine stolen from the sick, and children left to feed and house themselves at about the age of three. Sexual codes no longer exist, cruelty is thought amusing, and the weak and dying are exploited. Turnbull believes that he has discovered a people without morality; a society that previously possessed a moral code, but which lost it. (shrink)

Dr. M is a fifty-nine-year-old internist with a successful practice in a major Eastern United States city. He has lived in this city his whole life and is a highly esteemed citizen. Because of his broader social concerns and energetic support of activities to improve access to health care and quality of care for the underserved, Dr. M became involved in a number of local and regional medical organizations and quickly rose to prominence as as a director of a (...) board of a major national organization. In this position, he was an effective, articulate spokesperson, highly respected for his integrity and thoughtfulness.Before one of the meetings of thithis s board, Dr. M personally contacted the organization's other directors, including me, to warn us that we might be hearing some scandalous news about him. He wanted us first to hear it from him personally. This was the scandalous news.Dr. M had assumed the care of a patient of a recently retired colleague. The patient was an older woman with multiple musculoskeletal complaints related to lumbar stenosis and advanced degenerative arthritis of the spine, which left her in immense pain. (shrink)

Dr. M is a fifty-nine-year-old internist with a successful practice in a major Eastern United States city. He has lived in this city his whole life and is a highly esteemed citizen. Because of his broader social concerns and energetic support of activities to improve access to health care and quality of care for the underserved, Dr. M became involved in a number of local and regional medical organizations and quickly rose to prominence as as a director of a (...) board of a major national organization. In this position, he was an effective, articulate spokesperson, highly respected for his integrity and thoughtfulness.Before one of the meetings of thithis s board, Dr. M personally contacted the organization's other directors, including me, to warn us that we might be hearing some scandalous news about him. He wanted us first to hear it from him personally. This was the scandalous news.Dr. M had assumed the care of a patient of a recently retired colleague. The patient was an older woman with multiple musculoskeletal complaints related to lumbar stenosis and advanced degenerative arthritis of the spine, which left her in immense pain. (shrink)

What is cognition? Despite the existence of a science of cognition there is no clear agreement on what makes certain phenomena cognitive, and others not. Within cognitivism the issue was neglected. Human intelligence was used as a standard, and any process—natural or artificial—that fitted this standard sufficiently could be considered ‘cognitive’. For post-cognitivist psychology the situation is different. It cannot rely on the ‘human standard’ in the same way. One might even say that the need for a post-cognitivist psychology arose (...) because cognitivism began with this most complex of all cognitive systems without a good understanding and appreciation of more basic, biological cases. Embodied cognition approaches remedy this anthropocentric bias by addressing a more varied set of processes that are not strictly limited to humans. Under these circumstances the question what we take cognition to be is more urgent. Are phenomena like insect walking (Brooks) and goal-seeking missiles (O’Regan and Noë) examples of cognition or not? What criteria do we use to answer such questions? Given this problem, the notion of perception-action coupling (or sensorimotor contingencies) becomes an important and fairly obvious option to provide a foundation for the notion of cognition. However, and intriguingly, the same problem occurs again: What are perception-action couplings? What would make something an example of perception-action coupling? Where are we to draw a line, if anywhere? It is self-evident that O’Regan and Noë’s (2001) example of a goal-seeking missile is controversial, but why exactly? What is missing? Can we ever do more than making intuitive judgments here? A way out of this dilemma may be found by developing the claim that perception-action coupling must be grounded in a biological context (Keijzer, 2001), and following what Lyon (2005) calls a biogenic approach. This option raises a whole new field of issues and topics that is of central concern for a postcognitivist psychology. (shrink)

Christine Korsgaard’sSelf-Constitution: Agency, Identity, and Integrityis an impressive endeavour to synthesize the ethics of Plato and Kant in a comprehensive account of action and agency that locates the key to understanding both in self-constitution. A purportedly comprehensive account of action and agency will fail on its own terms if it cannot adequately account for some morally salient phenomenon. Korsgaard’s account fails to adequately account for the possibility of evil actions and evil people. If self-constitution is key to action and (...) agency, then we must abandon the Platonic and Kantian elements that Korsgaard endorses.L’ouvrage de Christine Korsgaard intituléSelf-Constitution: Agency, Identity, and Integrityreprésente un remarquable travail de synthèse des éthiques platonicienne et kantienne qui, de manière exhaustive, rend compte de l’action et de l’agentivité sous le prisme de la constitution de soi. Toute tentative de saisie parfaite de l’action et de l’agentivité en termes propres ne saurait aboutir sans une prise en compte adéquate d’un quelconque phénomène moral saillant. L’approche de Korsgaard ne prend pas suffisamment en compte la possibilité du mal sous forme d’actions ou d’individus. Si la constitution de soi demeure centrale pour l’action et l’agentivité, alors il faudra mettre à l’écart les éléments platoniciens et kantiens que Korsgaard fait siens. (shrink)

"By combining recent advances in the physical sciences with some of the novel ideas, techniques, and data of modern biology, this book attempts to achieve a new and different kind of evolutionary synthesis. I found it to be challenging, fascinating, infuriating, and provocative, but certainly not dull."--James H, Brown, University of New Mexico "This book is unquestionably mandatory reading not only for every living biologist but for generations of biologists to come."--Jack P. Hailman, Animal Behaviour , review of the first (...) edition "An important contribution to modern evolutionary thinking. It fortifies the place of Evolutionary Theory among the other well-established natural laws."--R.Gessink, TAXON. (shrink)

Experimental philosophy is often presented as a new movement that avoids many of the difficulties that face traditional philosophy. This article distinguishes two views of experimental philosophy: a narrow view in which philosophers conduct empirical investigations of intuitions, and a broad view which says that experimental philosophy is just the colocation in the same body of (i) philosophical naturalism and (ii) the actual practice of cognitive science. These two positions are rarely clearly distinguished in the literature about experimental philosophy, both (...) pro and con. The article argues, first, that the broader view is the only plausible one; discussions of experimental philosophy should recognize that the narrow view is a caricature of experimental philosophy as it is currently done. It then shows both how objections to experimental philosophy are transformed and how positive recommendations can be provided by adopting a broad conception of experimental philosophy. (shrink)

This book fundamentally challenges the radical credentials of post-structuralism. Though Derrida, Foucault and Deleuze claim to have 'deconstructed' metaphysics, their work has much in common with previous attempts to 'end' the metaphysical tradition, from Kant to Nietzshe and Heidegger, and by sociology in general. Gillian Rose shows that this anti-metaphysical writing always appears in historically specific jurisprudential terms, which themselves found and recapitulate metaphysical categories. She reconsiders post-structuralism in this light and assesses the relationship between deconstruction and the earlier (...) structuralism of Saussure and Levi-Strauss. She argues in conclusion that the choice between post-structuralist nihilism and Hegelian and Marxist dialectic is spurious. (shrink)

This paper criticizes two accounts of the normativity of practical principles: the empiricist account and the rationalist or realist account. It argues against the empiricist view, focusing on the Humean texts that are usually taken to be its locus classicus. It then argues both against the dogmatic rationalist view, and for the Kantian view, through a discussion of Kant's own remarks about instrumental rationality in the second section of the Groundwork. It further argues that the instrumental principle cannot stand alone. (...) Unless there are normative principles directing us to the adoption of certain ends, there can be no requirement to take the means to our ends. The familiar view that the instrumental principle is the only requirement of practical reason is incoherent. (shrink)

A radical new assessment of Hegel revealing the problems and limitations of sociological method.

Biological individuality is a notoriously thorny topic for biologists and philosophers of biology. In this paper we argue that biological individuality presents multiple, interconnected questions for biologists and philosophers that together form a problem agenda. Using a case study of an interdisciplinary research group in ecology, behavioral and evolutionary biology, we claim that a debate on biological individuality that seeks to account for diverse practices in the biological sciences should be broadened to include and give prominence to questions about uniqueness (...) and temporality. We show that broadening the problem agenda of biological individuality draws attention to underrecognized philosophical issues and discussions and thereby organizes and enriches the existing debate. (shrink)

Does the Ship of Theseus present a genuine puzzle about persistence due to conflicting intuitions based on “continuity of form” and “continuity of matter” pulling in opposite directions? Philosophers are divided. Some claim that it presents a genuine puzzle but disagree over whether there is a solution. Others claim that there is no puzzle at all since the case has an obvious solution. To assess these proposals, we conducted a cross-cultural study involving nearly 3,000 people across twenty-two countries, speaking eighteen (...) different languages. Our results speak against the proposal that there is no puzzle at all and against the proposal that there is a puzzle but one that has no solution. Our results suggest that there are two criteria—“continuity of form” and “continuity of matter”— that constitute our concept of persistence and these two criteria receive different weightings in settling matters concerning persistence. (shrink)

I begin by discussing forms of cosmopolitanism that motivate challenges to distributive accounts of global justice. I then use Sen's version of the capabilities approach to show how distributive accounts fall short, why an overarching theory of justice is not needed, and that democracy understood as the exercise of public reasoning can do the work of identifying and addressing injustices. That said in favor of Sen, I argue that his account fails to attend to the kinds of injustices emerging from (...) relationships of power and the institutions and structures in which these relationships are embedded. To show this, I outline features of a feminist relational approach, which I then apply to Canada's attempt to address historic harms through the Indian Residential Schools Truth and Reconciliation Commission. While I agree with Sen that we do not need a theory of global justice that is universal, ideal, impartial, or abstracted from context, I aim to broaden the scope of justice beyond both distributive accounts and Sen's version of the capabilities approach. (shrink)

In this paper, we consider the question of whether there exists an essential relation between emotions and wellbeing. We distinguish three ways in which emotions and wellbeing might be essentially related: constitutive, causal, and epistemic. We argue that, while there is some room for holding that emotions are constitutive ingredients of an individual’s wellbeing, all the attempts to characterise the causal and epistemic relations in an essentialist way are vulnerable to some important objections. We conclude that the causal and epistemic (...) relation between emotions and wellbeing is much less strong than is commonly thought. (shrink)

1. Being an Animal Human beings are animals: phylum: chordata, class: mammalia, order: primates, family: hominids, species: homo sapiens, subspecies: homo sapiens sapiens. According to current scientific opinion, we evolved approximately 200,000 years ago in Africa from ancestors whom we share with the other great apes. What does it mean that we are animals? Scientifically speaking, an animal is essentially a complex, multicellular organism that feeds on other life forms. But what we share with the other animals is not just (...) a definition: it is a history – that is, it is a story – and a resulting set of attributes and circumstances, and an ecosystem, and a planet. What is the story? Living things are homeostatic systems – they maintain themselves through a process of nutrition that enables them to work constantly at replacing the fragile materials of which they are composed. Living things also work at reproducing, or contributing to the reproduction, of other living things that maintain themselves in essentially the same way. To engage in those activities is essentially what it means to be alive. And in order to engage in those activities, a living thing must be, in some way, responsive to conditions in its environment. Plants, for instance, respond to dryness, by growing deeper roots, or to sunshine, by turning their leaves in its direction. Even a unicellular organism is drawn to some things and recoils from others. (shrink)

We live, according to some, in the century of biology, where we now understand ourselves in radically new ways as the insights of genomics and neuroscience have opened up the workings of our bodies and our minds to new kinds of knowledge and intervention. Is a new figure of the human, and of the social, taking shape in the 21st century? With what consequences for the politics of life today? And with what implications, if any, for the social, cultural and (...) human sciences? These are the issues that are discussed in this article, which argues that a new relation is requred with the life sciences, beyond commentary and critique, if the social and human sciences are to revitalize themselves for the 21st century. (shrink)

This new translation presents the _Analects_ in a revolutionary new format that, for the first time in any language, distinguishes the original words of the Master from the later sayings of his disciples and their followers, enabling readers to experience China's most influential philosophical work in its true historical, social, and political context.