This article focuses on emergency medical care in black urban populations, suggesting that the classification of a ?community? within clinical trial language is problematic. The article references a cultural history of black Americans with pre-hospital emergency medical treatment as relevant to contemporary emergency medicine paradigms. Part I explores a relationship between ?autonomy? and ?community.? The idea of community emerges as a displacement for the ethical principle of autonomy precisely at the moment that institutionalized medicine focuses on diversity. Part II examines (...) a clinical trial for the blood substitute PolyHeme? (Northfield Laboratories, Inc., Evanston, IL). It illustrates the ways in which bias in research paradigms and Institutional Review Board decisions attach to the notion and utility of the language of ?community.? The conclusion's contemporary anecdote makes apparent the vitality of the issues of prehospital emergency medical care and the ways in which decisions and practices fall too easily into a narrative of culturally biased treatment. (shrink)

When I first starting hearing and reading about Jacques Rancière a number of years ago, I was deeply skeptical. Wasn’t this yet another European man becoming the new political theory “It Girl”? Wasn’t the claim that Rancière had a singular, fresh approach to dissent and protest overblown, when other people—especially critical race scholars, postcolonial theorists, feminists, queer theorists, and so on—had already addressed these topics thoroughly but were rarely acknowledged in mainstream scholarship? Did we really need to deify and create (...) a cottage industry around yet one more white male Western theorist, especially one who so rarely deigns to cite his influences or the work of others? It took... (shrink)

In this challenging 1993 book John Holloway explores one of the most significant aspects of contemporary culture, arguing that over the last hundred years or so there has been a radical change in the very nature of individual consciousness. He traces a crucial shift from an 'Apollonian' ideal of human involvement in the widest range of experience to a narrower and less integrated engagement with the world. He plots this shift through a number of quite different fields: there are chapters (...) on the visual arts, on colloquial language and slang, on cartoons, on political rhetoric, and on 'personality' studies by psychologists. He goes on to examine the work of certain literary figures who seem to have recognized, and registered in imaginative terms, the pervasive but generally unrecorded changes in consciousness for which the book is arguing. (shrink)

This article focuses on emergency medical care in black urban populations, suggesting that the classification of a “community” within clinical trial language is problematic. The article references a cultural history of black Americans with pre-hospital emergency medical treatment as relevant to contemporary emergency medicine paradigms. Part I explores a relationship between “autonomy” and “community.” The idea of community emerges as a displacement for the ethical principle of autonomy precisely at the moment that institutionalized medicine focuses on diversity. Part II examines (...) a clinical trial for the blood substitute PolyHeme® (Northfield Laboratories, Inc., Evanston, IL). It illustrates the ways in which bias in research paradigms and Institutional Review Board decisions attach to the notion and utility of the language of “community.” The conclusion's contemporary anecdote makes apparent the vitality of the issues of prehospital emergency medical care and the ways in which decisions and practices fall too easily into a narrative of culturally biased treatment. (shrink)

In this challenging new book John Holloway explores one of the most significant aspects of contemporary culture, arguing that over the last hundred years or so there has been a radical change in the very nature of individual consciousness. He traces a crucial shift from an 'Apollonian' ideal of human involvement in the widest range of experience (implying a sense of the individual consciousness as spacious, orderly, and comprehensive) to a narrower and less integrated engagement with the world (and a (...) more reductive conception of consciousness as random and fragmented). He plots this shift through a number a quite different fields: there are chapters on the visual arts, on colloquial language and slang, on cartoons, on political rhetoric, and on 'personality' studies by psychologists. He goes on to examine the work of certain literary figures (notably Hardy, Edwin Muir, Wyndham Lewis, Patrick White, John Cowper Powys, and Gary Snyder) who seem to have recognized, and registered in imaginative terms, the pervasive but generally unrecorded changes in consciousness for which the book is arguing. (shrink)

A wide-ranging interview with Dipesh Chakrabarty, Distinguished Professor of History at the University of Chicago and author of The Climate of History in a Planetary Age and Provincializing Europe. Dipesh Chakrabarty is one of the leading thinkers on climate change in the humanities. He is responsible for introducing concepts like the "Anthropocene," "geological force," and "species history" into history, philosophy, and literary theory.

While the dominant approaches to the current study of political philosophy are various, with some friendlier to religious belief than others, almost all place constraints on the philosophic and political role of revelation. Mainstream secular political theorists do not entirely disregard religion. But to the extent that they pay attention, their treatment of religious belief is seen more as a political or philosophic problem to be addressed rather than as a positive body of thought from which we might derive important (...) insights about the nature of politics and the truth of the human condition. In a one-of-a-kind collection, DeHart and Holloway bring together leading scholars from various fields, including political science, philosophy, and theology, to challenge the prevailing orthodoxy and to demonstrate the role that religion can and does play in political life. Contributing authors include such important thinkers as Peter Augustine Lawler, Robert C. Koons, J. Budziszewski, Francis J. Beckwith, and James Stoner. (shrink)

In recognition of the important ethical issues posed by qualitative research in health care, the authors present key questions to aid ethical review. The purpose is to assist lay and professional members of research ethics committees in their assessment of applications involving qualitative research methods and to inform researchers intending to submit such applications for ethical approval. For the benefit of those less familiar with this type of research, the authors include an overview of different types of qualitative research, together (...) with an explanation of terms commonly used by qualitative researchers. (shrink)

There are two different ways of understanding alienation: as a condition and as a struggle. On this distinction turns the whole theory and practice of Marxism.

This article focuses on emergency medical care in black urban populations, suggesting that the classification of a "community" within clinical trial language is problematic. The article references a cultural history of black Americans with pre-hospital emergency medical treatment as relevant to contemporary emergency medicine paradigms. Part I explores a relationship between "autonomy" and "community." The idea of community emerges as a displacement for the ethical principle of autonomy precisely at the moment that institutionalized medicine focuses on diversity. Part II examines (...) a clinical trial for the blood substitute PolyHeme® (Northfield Laboratories, Inc., Evanston, IL). It illustrates the ways in which bias in research paradigms and Institutional Review Board decisions attach to the notion and utility of the language of "community." The conclusion's contemporary anecdote makes apparent the vitality of the issues of prehospital emergency medical care and the ways in which decisions and practices fall too easily into a narrative of culturally biased treatment. (shrink)

During the set-up phase of an international study of genetic influences on outcomes from sepsis, we aimed to characterise potential differences in ethics approval processes and outcomes in participating European countries. Between 2005 and 2007 of the FP6-funded international Genetics Of Sepsis and Septic Shock project, we asked national coordinators to complete a structured survey of research ethic committee approval structures and processes in their countries, and linked these data to outcomes. Survey findings were reconfirmed or modified in 2017. Eighteen (...) countries participated in the study, recruiting 2257 patients from 160 ICUs. National practices differed widely in terms of composition of RECs, procedures and duration of the ethics approval process. Eight countries used a single centralised process for approval, seven required approval by an ethics committee in each participating hospital, and three required both. Outcomes of the application process differed widely between countries because of differences in national legislation, and differed within countries because of interpretation of the ethics of conducting research in patients lacking capacity. The RECs in four countries had no lay representation. The median time from submission to final decision was 1.5 months; in nine approval was received within 1 month; six took over 6 months, and in one 24 months; had all countries been able to match the most efficient approvals processes, an additional 74 months of country or institution-level recruitment would have been available. In three countries, rejection of the application by some local RECs resulted in loss of centres; and one country rejected the application outright. The potential benefits of the single application portal offered by the European Clinical Trials Regulation will not be realised without harmonisation of research ethics committee practices as well as national legislation. (shrink)

This paper explores the analytical relevance of Foucault's notion of biopower in the context of regulating and managing non-human lives and populations, specifically those animals that are the focus of livestock breeding based on genetic techniques. The concept of biopower is seen as offering theoretical possibilities precisely because it is concerned with the regulation of life and of populations. The paper approaches the task of testing the 'analytic mettle' of biopower through an analysis of four policy documents concerned with farm (...) animal genetics: the UK's National Scrapie Plan (2003); the UK National Action Plan on Farm Animal Genetic Resources (2006); the Agriculture and Environment Biotechnology Committee's report on Animals and Biotechnology (2002); and the Farm Animal Welfare Council's report on the Welfare Implications of Animal Breeding and Breeding Technologies in Commercial Agriculture (2004). Of interest is whether and how the four policy case studies articulate a form of biopower in relation to human-livestock animal relations in the context of genetic approaches to livestock breeding, and how biopower is variably expressed in relation to the different policy issues addressed. In concluding, the paper considers the overall applicability and relevance of biopower in the context of regulating animal lives within livestock breeding, highlighting both possibilities and limitations, and offers suggestions for taking forward research on livestock populations from a neo-Foucaultian perspective. (shrink)

In this paper, we draw on Foucault's and Deleuze's theorisations of discipline and control, respectively, to understand a teacher accountability system in the US state of Texas: the Texas Teacher Evaluation and Support System (hereafter, T-TESS). Specifically, we focus on the interplay of physical and virtual modes of governance – which we develop here as physical–virtual hybridity – and the techniques that make these physical and virtual domains compatible via language interoperability, with T-TESS deployed as a representative empirical case to (...) show how such technologies work to govern teacher subjectivity. First, in-person appraiser meetings and observations re-code teachers’ linguistic behaviours, so their physical bodies and practices can become legible to and interoperable with the hybrid T-TESS system. This avoids any possible syntax errors between the linguistic expression of physical teacher speech and the digital coding language of T-TESS. Second, these digital bodies of data can now be viewed as proxies for the physical teacher body in the classroom, allowing the constant modulation in physical space (teacher bodies) and digital space (bodies of data). This is the physical–virtual hybridity of T-TESS, whereby discipline and control work symbiotically to govern both the physical and the digital expressions of teachers and their teaching. In this way, the disciplining of teachers’ language has profound effects on teachers’ bodies, both corporeal and digital. (shrink)

Bioethicists have long been concerned that seriously ill patients entering early phase (‘phase I’) treatment trials are motivated by therapeutic benefit even though the likelihood of benefit is low. In spite of these concerns, consent forms for phase I studies involving seriously ill patients generally employ indeterminate benefit statements rather than unambiguous statements of unlikely benefit. This seeming mismatch between attitudes and actions suggests a need to better understand research ethics committee members’ attitudes toward communication of potential benefits and risks (...) of early phase studies to potential subjects. We surveyed the members of two U.S. research ethics committees using a phase I gene transfer study scenario, and compared the results to a previous survey of potential subjects’ perceptions and attitudes toward benefit and risk for the same protocol. The results show that there is indeed a gap between the subjects’ perceptions and the committee members’ views on what is appropriate to be communicated to research subjects. This discrepancy is the product of both the commonly assumed optimism of the subjects and to a “protective pessimism” of the research ethics committee members. We discuss this discrepancy using “frameworks of trust” and demonstrate the need to incorporate these frameworks into the existing model of informed consent. (shrink)

This empirical work attends to the tensions and contradictions medical students articulate when they discuss their objection to industry’s influence in medicine. Findings are based on 50 semi-structured interviews with medical students who are critical of the pharmaceutical industry’s influence in medical education in the United States and Canada. These students advocate evidence-based medicine as one solution to the problems with industry influence in medicine; namely industry bias in medical research. This investigation is an effort to understand why EBM is (...) posed as a solution to industry bias in light of the literature demonstrating the ways that what is considered ‘evidence-based’ is influenced by industry. Participants articulate a struggle to find the ‘best’ evidence in a context where industry interests are integral in the production of medical knowledge. (shrink)

Robotic or automatic milking systems are novel technologies that take over the labor of dairy farming and reduce the need for human–animal interactions. Because robotic milking involves the replacement of ‘conventional’ twice-a-day milking managed by people with a system that supposedly allows cows the freedom to be milked automatically whenever they choose, some claim robotic milking has health and welfare benefits for cows, increases productivity, and has lifestyle advantages for dairy farmers. This paper examines how established ethical relations on dairy (...) farms are unsettled by the intervention of a radically different technology such as AMS. The renegotiation of ethical relationships is thus an important dimension of how the actors involved are re-assembled around a new technology. The paper draws on in-depth research on UK dairy farms comparing those using conventional milking technologies with those using AMS. We explore the situated ethical relations that are negotiated in practice, focusing on the contingent and complex nature of human–animal–technology interactions. We show that ethical relations are situated and emergent, and that as the identities, roles, and subjectivities of humans and animals are unsettled through the intervention of a new technology, the ethical relations also shift. (shrink)