The duty to protect patient welfare underpins undergraduate medical ethics and patient safety teaching. The current syllabus for patient safety emphasises the significance of organisational contribution to healthcare failures. However, the ongoing over-reliance on whistleblowing disproportionately emphasises individual contributions, alongside promoting a culture of blame and defensiveness among practitioners. Diane Vaughan’s ‘Normalisation of Deviance’ provides a counterpoise to such individualism, describing how signals of potential danger are collectively misinterpreted and incorporated into the accepted margins of safe operation. NoD is an (...) insidious process that often goes unnoticed, thus minimising the efficacy of whistleblowing as a defence against inevitable disaster. In this paper, we illustrate what can be learnt by greater attention to the collective, organisational contributions to healthcare failings by applying NoD to The Morecambe Bay Investigation. By focusing on a cluster of five ‘serious untoward incidents’ occurring in 2008, we describe a cycle of NoD affecting trust handling of events that allowed poor standards of care to persist for several years, before concluding with a poignant example of the limitations of whistleblowing, whereby the raising of concerns by a senior consultant failed to generate a response at trust board level. We suggest that greater space in medical education is needed to develop a thorough understanding of the cultural and organisational processes that underpin healthcare failures, and that medical education would benefit from integrating the teaching of medical ethics and patient safety to resolve the tension between systems approaches to safety and the individualism of whistleblowing. Data sharing not applicable as no datasets generated and/or analysed for this study. (shrink)

We thank the commentators for their thoughtful engagement with our paper.1 In different ways, they make the same substantial point: our suggested interventions are not enough to solve the problems of organisational failure. On this we wholeheartedly agree. Organisational failure in healthcare is complex and multifaceted, it cannot be solved by one intervention in medical education. We did not intend to imply that our proposals alone would solve organisational failure, and this positioning misconstrues the aims of our paper. We had (...) more modest ambitions, we wanted to shift the analytical emphasis away from the individual and explore the implications raised by our analysis for our piece of the jigsaw—medical education. Having stepped away from such grand claims, the commentators make some valid points to which we would like to respond more specifically. Jesudason makes the distinction that normalisation of deviance (NoD) is well suited to understand institutional misfeasance but not malfeasance.2 We are inclined to agree; NoD can do some things but not all. Likewise, …. (shrink)

Poovey has argued that the anesthetized “unresisting body” can offer no impediment to a doctor's interpretation of its conduct. In contrast, drawing on ethnographic data of anesthetic practice, this article suggests that the technological augmentation of the body required by present-day anesthesia enhances the ability of an unconscious body to convey its needs and shape the course of the anesthetic. In analyzing the expressions of anesthesia's cyborgs, the author draws on Haraway, Latour, and Suchman to reconsider the characteristics of agency (...) and how an unconscious body might “resist” or inform a doctor's interpretation. This attempt to explore the nature and distribution of agency within a collective is intended as a contribution to the debates surrounding medical dominance and those theorizing the role of technology in health care. (shrink)

Daniel Taylor and Dawn Goodwin present a case study of the Morecambe Bay Inquiry (MBI), which examined the high rate of maternal and neonatal deaths over a period of 9 years (2004–2013), within the small maternity unit of Furness General Hospital (FGH), one of the three hospitals comprising Morecambe Bay Hospitals Trust.1 They examine this through a conceptual lens, and provide a solution involving changes in medical education. This commentary explores both these elements. First, they use the lens (...) of ‘Normalisation of Deviance’ (NoD) to explain organisational failure. However, other available lenses such as ‘Sociology of Disasters’, ‘Organisational Silence’ and ‘Comfort-seeking Behaviour’ may point to different problems and solutions. More justification for their choice of the lens of NoD would have been useful. Similarly, more justification for their focus on a cluster of five ‘serious untoward incidents’ (SUIs) occurring in 2008 would also have been useful. They suggest that before 2008, the perinatal mortality rate was low, patient satisfaction was high and recent level 2 accreditation of maternity services by the Clinical Negligence Scheme for Trusts all suggested standards of care within the obstetric department were adequate. This stream of positive signals is likely to have contributed towards a genuine belief of safe operation within the maternity unit by staff and board members. However, as they acknowledge, the first problem can be seen in 2004. According to the MBI,2 there were SUIs in the years before and after 2008, but this …. (shrink)

Communities often unite during a crisis, though some cope by ascribing blame or stigmas to those who might be linked to distressing life events. In a preregistered two-wave survey, we evaluated the dehumanization of Asians and Asian Americans during the COVID-19 pandemic. Our first wave revealed dehumanization was prevalent, between 6.1% and 39% of our sample depending on measurement. Compared to non-dehumanizers, people who dehumanized also perceived the virus as less risky to human health and caused less severe consequences for (...) infected people. They were more likely to be ideologically Conservative and believe in conspiracy theories about the virus. We largely replicated the results 1 month later in our second wave. Together, many Americans dehumanize Asians and Asian Americans during the COVID-19 pandemic with related perceptions that the virus is less problematic. Implications and applications for dehumanization theory are discussed. (shrink)

"Using hundreds of examples from newsrooms large and small, author Ron F. Smith challenges readers to determine how they would face moral dilemmas on the job. Chapters evaluate the search for principles, accountability, truth and objectivity, errors and corrections, diversity, "faking" the news, reporters and their sources, privacy, the government watch, deception, compassion, the business of news, journalists and their communities, and financial concerns. New to this edition: a chapter on improving coverage of minorities, expanded discussion of broadcast journalism and (...) reporting on the Internet, and stories from recent front pages and TV news programs."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved. (shrink)

Prior research on the psychology of retribution is complicated by the difficulty of separating retributive and general deterrence motives when studying human offenders . We isolate retribution by investigating judgments about punishing animals, which allows us to remove general deterrence from consideration. Studies 2 and 3 document a “victim identity” effect, such that the greater the perceived loss from a violent animal attack, the greater the belief that the culprit deserves to be killed. Study 3 documents a “targeted punishment” effect, (...) such that the responsive killing of the actual “guilty” culprit is seen as more deserved than the killing of an almost identical yet “innocent” animal from the same species. Studies 4 and 5 extend both effects to participants' acceptance of inflicting pain and suffering on the offending animal at the time of its death, and show that both effects are mediated by measures of retributive sentiment, and not by consequentialist concerns. (shrink)

Sustainable practices are commended to us both out of prudential regard for our own future and out of principled concern for the ‘right to life’ of endangered species, ecosystems and ways of life and for intergenerational justice among our own kind. The larger point of the ‘sustainability ethic’ might be more political, however. Insisting that any practice we adopt now must be sustainable into the indefinite future constitutes an institutional check preventing us from taking unfair advantage of our privileged temporal (...) position vis‐a‐vis our successors. (shrink)

Sustainable practices are commended to us both out of prudential regard for our own future and out of principled concern for the ‘right to life’ of endangered species, ecosystems and ways of life and for intergenerational justice among our own kind. The larger point of the ‘sustainability ethic’ might be more political, however. Insisting that any practice we adopt now must be sustainable into the indefinite future constitutes an institutional check preventing us from taking unfair advantage of our privileged temporal (...) position vis‐a‐vis our successors. (shrink)

In neocolonial contexts of globalization, the epistemological terrain of radical diversity poses significant ethical challenges to transnational feminisms. In view of historical associations between knowledge and discourses of love which were conditioned by imperialist brands of humanism and benevolence under colonialism, this paper argues for a deconstructionist approach to conceptualizing love in relation to knowledge and for an ethics that severs the association with benevolence, instead making alterity the basis for its account.

According to Alberto Coffa in The Semantic Tradition from Kant to Carnap, Kant’s account of mathematical judgment is built on a ‘semantic swamp’. Kant’s primitive semantics led him to appeal to pure intuition in an attempt to explain mathematical necessity. The appeal to pure intuition was, on Coffa’s line, a blunder from which philosophy was forced to spend the next 150 years trying to recover. This dismal assessment of Kant’s contributions to the evolution of accounts of mathematical necessity is fundamentally (...) backward-looking. Coffa’s account of how semantic theories of the a priori evolved out of Kant’s doctrine of pure intuition rightly emphasizes those developments, both scientific and philosophical, that collectively served to undermine the plausibility of Kant’s account. What is missing from Coffa’s story, apart from any recognition of Kant’s semantic innovations, is an attempt to appreciate Kant’s philosophical context and the distinctive perspective from which Kant viewed issues in the philosophy of mathematics. When Kant’s perspective and context are brought out, he can not only be seen to have made a genuinely progressive contribution to the development of accounts of mathematical necessity, but also to be relevant to contemporary issues in the philosophy of mathematics in underappreciated ways. (shrink)

Some photographs show determinate features of a scene because the photographed scene had those features. This dependency relation is, rightly, a consensus in philosophy of photography. I seek to refute many long-established theories of photography by arguing that they are incompatible with this commitment. In Section II, I classify accounts of photography as either single-stage or multi-stage. In Section III, I analyze the historical basis for single-stage accounts. In Section IV, I explain why the single-stage view led scientists to postulate (...) “latent” photographic images as a technical phenomenon in early chemical photography. In Section V, I discredit the notion of an invisible latent image in chemical photography and, in Section VI, extend this objection to the legacy of the latent image in digital photography. In Section VII, I appeal to the dependency relation to explain why the notion of a latent image makes the single-stage account untenable. Finally, I use the multi-stage account to advance debate about “new” versus “orthodox” theories of photography. (shrink)

In this imaginative and provocative book, Barbara Goodwin explores the question of how lottery systems can achieve egalitarian social justice in societies with seemingly ineradicable inequalities. She begins with the utopian fable of Aleatoria, a country not unlike our own in the not-too-distant-future, where most goods are distributed by lottery--even the right to have children. She then analyzes the philosophical arguments for and against lottery distribution and a comparison of "justice by lottery" with other contemporary theories of justice. (...) class='Hi'>Goodwin also applies her theory to practical problems in the real world which could be--or have been--justly resolved by the use of lotteries, such as military drafts, jury duty, and immigration eligibility. She demonstrates that in many areas, including that of political power, a regular and random reallocation of goods would be a fairer and more democratic method than the distributive systems found in liberal democracies today. (shrink)

According to Roger Scruton, it is not possible for photographs to be representational art. Most responses to Scruton’s scepticism are versions of the claim that Scruton disregards the extent to which intentionality features in photography; but these cannot force him to give up his notion of the ideal photograph. My approach is to argue that Scruton has misconstrued the role of causation in his discussion of photography. I claim that although Scruton insists that the ideal photograph is defined by its (...) ‘merely causal’ provenance, in fact he fails to take the causal provenance of photographs seriously enough. To replace Scruton’s notion of the ideal photograph, I offer a substantive account of the causal provenance of photographs, centred on the distinctive role of ‘the photographic event’. I conclude that, with a proper understanding of the photographic process, we have good reason to re-open the question of photography as a representational art. (shrink)

Drawing from our interdisciplinary qualitative study of LGBTI conservative Christians and their allies, we name an especially toxic form of shame—what we call sacramental shame—that affects the lives of LGBTI and other conservative Christians. Sacramental shame results from conservative Christianity's allegiance to the doctrine of gender complementarity, which elevates heteronormativity to the level of the sacred and renders those who violate it as not persons, but monsters. In dispensing shame as a sacrament, nonaffirming Christians require constant displays of shame as (...) proof that LGBTI church members love God and belong in the community. Part of what makes this shame so harmful is that parents and pastors often dispense it with sincere expressions of care and affection, compounding the sense that one's capacity to give and receive love is damaged. We foreground LGBTI Christian movements to overcome sacramental shame by cultivating nonhubristic pride, and conclude by discussing briefly their new understandings of love and justice that could have far‐reaching benefits. (shrink)

: In neocolonial contexts of globalization, the epistemological terrain of radical diversity poses significant ethical challenges to transnational feminisms. In view of historical associations between knowledge and discourses of love which were conditioned by imperialist brands of humanism and benevolence under colonialism, this paper argues for a deconstructionist approach to conceptualizing love in relation to knowledge and for an ethics that severs the association with benevolence, instead making alterity the basis for its account.

This paper provides a typology of appeals to authority, identifying three distinct types: that which is based on a command; that which is based on expertise; and that which is based on dignity. Each type is distinguished with respect to the reaction that a failure to follow it ordinarily evokes. The rhetorical roots of Locke's ad verecundiam are traced to the rhetorical practices of ancient Rome.

Photography is valued as a medium for recording and visually reproducing features of the world. I seek to challenge the view that photography is fundamentally a recording process and that every photograph is a record—a view that I claim is based on a ‘single-stage’ misconception of the process. I propose an alternative, ‘multi-stage’ account in which I argue that causal registration of light is not equivalent to recording and reproducing an image. Intervention or non-intervention by photographers is more sophisticated than (...) the traditional view allows. Using the multi-stage account, I describe four models for producing photographic images and pictures. (shrink)

The author explores how the discursive practices of social texts relate to the subjectivities of readers. Employing Dorothy Smith's notion of femininity as textually mediated discourse, the author analyzes how teenage girls read the depictions of femininity in the glossy advertisements of fashion magazines. Through interviews with 48 girls aged 13 to 17 years, she explores both why and how young girls negotiate “what it means to be a woman.” Most young girls in her study draw on stereotypical meanings of (...) adult femininity. By giving these stereotypes truth status, these readers valorize not only patriarchal meanings of womanhood but also naturalize associations between femininity and the commodities through which this femininity is expressed as the everyday doing of gender. The author concludes by discussing implications of this study for both a feminist theory and a feminist politics of culture. (shrink)

Bridging disciplines have much to teach us about how to combine analytical tools to tackle problems and questions that cross traditional disciplinary boundaries. This article uses examples from the older bridging disciplines of geography and anthropology in order to consider what the relatively young undertaking labeled “interdisciplinary studies” can learn from their long existence. It explains what is meant by the fallacy of nomothetic claim and considers the fruitful production of answers and solutions by viewing process (methodology) not domain (academic (...) turf), as the key to interdisciplinary success. Staking claim to interdisciplinarity is shown to be unproductive while finding the need for interdisciplinary approaches and following the mandates of that need in the pursuit of solutions to problems and questions strengthens both the disciplines and the development of interdisciplinary studies. (shrink)

Concerns regarding corporate ethics have grown steadily throughout the past decade. In order to remain competitive, many organizational leaders are faced with the challenge of creating an ethical environment within their organization. A model is presented showing the process and elements necessary for the institutionalization of organizational ethics. The transformational leadership style lends itself well to the creation of an ethical environment and is suggested as a means to facilitate the institutionalization of corporate ethics. Finally, the benefits of using transformational (...) leadership are demonstrated through the components of a psychological contract, organizational commitment, and ethical culture to institutionalize organizational ethics. (shrink)

This article is concerned with the use of correspondence as research data. It focuses on the author's own experience of this method and considers the methodological implications of correspondence as a research method for research in general and feminist research in particular. We argue that at present this method is not often used, even though it provides rich data and is a potential powerful tool for feminist research.

German philosopher Martin Heidegger stirred educators when in 1951 he claimed teaching is more difficult than learning because teachers must ‘learn to let learn’. However in the main he left the aphorism unexplained as part of a brief four-paragraph, less than two-page set of observations concerning the relationship of teaching to learning; and concluded at the end of those observations that to become a teacher is an ‘exalted matter’. This paper investigates both of Heidegger's claims, interpreting letting learn in the (...) context of Heidegger's larger philosophical project, and suggesting why in light of that project to become a teacher is an exalted concern. The methodology guiding the inquiry is largely hermeneutic, the purpose of the essay to interpret teaching from a Heideggerian perspective: its nature and general method. (shrink)

In 2003, the South Carolina Supreme Court upheld the conviction of Regina McKnight, an African American woman who was convicted at the age of twenty‐two for committing “homicide by child abuse.” She became the first woman in the United States to be arrested, prosecuted, and convicted for experiencing a stillbirth. Rather than an outlier case in the annals of American jurisprudence that stretched law beyond reason while restraining compassion and justice, McKnight's conviction inspired similar prosecutions of other poor black women (...) and then of other women. More than one‐third of states consider pregnant women's illicit drug use a form of child abuse, resulting in unprecedented forms of criminal and civil punishment. Laws previously understood to protect pregnant women from domestic violence during pregnancy, such as fetal protection laws, now serve as the vehicles for prosecuting pregnant women. What these prosecutions and laws expose are the multitudinous ways in which the criminalization of poor pregnant women—and normalization of that criminalization, such that even doctors and nurses are expected to participate in it—serve to humiliate women, interfere with their reproductive health, and ultimately rob women of reproductive autonomy. (shrink)

In this article, we will consider how the regulation of populations is not just a feature of prisons, but of all institutions and organisations that control members though hierarchies, divisions and norms. While nurses and other allied health professionals are considered to be predominantly self‐regulatory, practice is guided by a code of conduct and codes of ethics that act as rules that serve to uphold the safety of the patient, whether they are a sick person in a hospital bed or (...) an inmate in a prison. The codes of conduct espouse a number of rules that to a certain extent govern the behaviour of individual and groups of practitioners through reciprocal rewards and punishments. Supervision is one method of monitoring the effectiveness of the codes of conduct and ethics while regulating both the minimum standard of individual practice and of training organisations. It is posited that one of the possible effects of clinical supervision is to make the person effectively self‐regulatory as, an autonomous practitioner. We take the view that professional autonomy is a highly problematic concept requiring closer examination. (shrink)

In this article, we contribute to sociological literatures on morality, professional and institutional contexts, and morally stigmatized ‘dirty work’ by emphasizing and exploring how they mutually inform one another in lawyers’ work activities. Drawing on interview data with 58 practitioners in the commercial legal industry in Singapore, we analyze how they experience professional and institutional constraints on the expressions of morality in their work. Our findings illustrate how a dominant managerial and economic focus maintains and reproduces a constrained form of (...) morality, limited to instrumental, utilitarian and commercial ends, and subordinated to lucrative client and firm interests. We discuss our findings in terms of the need to research and reform professions in ways that support more rounded and unconstrained moral reflexivity and autonomy in how work is undertaken and valued. This in turn has implications for how organizations and professions might achieve alternative moral institutional orders, and for legal work to avoid the moral and social taints of dirty work. (shrink)

Past research suggests that people process verbal quantifiers differently from numerical ones, but this suggestion has yet to be formally tested. Drawing from traditional correlates of dual-process...

We are told by philosophers that photographs are a distinct category of image because the photographic process is mind-independent. Furthermore, that the experience of viewing a photograph has a special status, justified by a viewer’s knowledge that the photographic process is mind-independent. Versions of these ideas are central to discussions of photography in both the philosophy of art and epistemology and have far-reaching implications for science, forensics and documentary journalism. Mind-independence (sometimes ‘belief independence’) is a term employed to highlight what (...) is important in the idea that photographs can be produced naturally, mechanically, accidentally or automatically. Insofar as the process is physical, natural, mechanical or causal it can occur without human agency or intervention, entirely in the absence of intentional states. Presented innocuously, the idea is that although photographs are dependent on natural or mechanical processes, they can be produced independently of human agency – particularly human beliefs. Presented in a stronger form, the claim is that even if human agency is heavily involved in the production process, the definitive features that make the photograph a photograph and determine its salient properties are nonetheless independent of human minds. In epistemic debates, mind-independence is viewed as essential for explaining why photographs occupy a distinct category among images and justifying a variety of claims about their privileged epistemic and affective status in science, forensics, popular culture and journalism. But, in the philosophy of art, claims about mind-. (shrink)

Professor Brian Goodwin (1931-2007) was a visionary biologist, mathematician and philosopher. Understanding organisms as dynamics wholes, he worked to develop an alternate view to extreme Darwinism based solely on genetic factors. He was a pioneer in the field of theoretical biology.

Organic chemistry provides fertile ground for scholars interested in understanding the role of non-linguistic representations in scientific thinking. In this discipline, it is not plausible to regard diagrams as simply heuristic aids for expressing or applying what is essentially a linguistic theory. Instead, it is more plausible to think of linguistic representation as supplementing theories whose principal expression is diagrammatic. Among the many sorts of diagrams employed by organic chemists, structural formulas are the most important. In this paper, by examining (...) two central episodes in the development of structural formulas—Kekulé’s proposal of a structure for benzene and Ingold’s explanation of dipole moments in terms of ‘mesomerism’—I investigate how the norms for the production and interpretation of structural formulas evolve in response to experimental results and theoretical developments. I conclude that one principal way in which structural formulas embody the theory of organic chemistry is through these evolving norms. (shrink)

Many U.S. corporations and the goods they produce negatively impact our society without breaking any laws. We are all too familiar with the tobacco industry's effect on public health and health care costs for smokers and nonsmokers, as well as the role of profit in the pharmaceutical industry's research priorities. It's Legal but It Ain't Right tackles these issues, plus the ethical ambiguities of legalized gambling, the firearms trade, the fast food industry, the pesticide industry, private security companies, and more. (...) Aiming to identify industries and goods that undermine our societal values and to hold them accountable for their actions, this collection makes a valuable contribution to the ongoing discussion of ethics in our time. This accessible exploration of corporate legitimacy and crime will be important reading for advocates, journalists, students, and anyone interested in the dichotomy between law and legitimacy. Nikos Passas is Professor in the College of Criminal Justice at Northeastern University. Neva Goodwin is Co-director of the Global Development and Environment Institute at Tufts University. (shrink)