Introduction: Nurses who work in an emergency department regularly care for acute patients in a fast-paced environment, being at risk of suffering high levels of burnout. This situation makes them especially vulnerable to be accountable for decisions they did not have time to consider or have been pressured into. Research objective: The objective of this study was to find which factors influence ethical, legal and professional accountability in nursing practice in an emergency department. Research design: Data were analysed, codified and (...) triangulated using qualitative ethnographic content analysis. Participants and research context: This research is set in a large emergency department in the Midlands area of England. Data were collected from 186 nurses using participant observation, 34 semi-structured interviews with nurses and ethical analysis of 54 applicable clinical policies. Ethical considerations: Ethical approval was granted by two research ethics committees and the National Health Service Health Research Authority. Results: The main result was the clinical nursing accountability cycle model, which showed accountability as a subjective concept that flows between the nurse and the healthcare institution. Moreover, the relations among the clinical nursing accountability factors are also analysed to understand which factors affect decision-making. Discussion: The retrospective understanding of the factors that regulate nursing accountability is essential to promote that both the nurse and the healthcare institution take responsibility not only for the direct consequences of their actions but also for the indirect consequences derived from previous decisions. Conclusion: The decision-making process and the accountability linked to it are affected by several factors that represent the holistic nature of both entities, which are organised and interconnected in a complex grid. This pragmatic interpretation of nursing accountability allows the nurse to comprehend how their decisions are affected, while the healthcare institution could act proactively to avoid any problems before they happen. (shrink)

Introduction: Clinical policies control several aspects of clinical practice, including individual treatment and care, resource management and healthcare professionals’ etiquette. This article presents Clinical Policy Ethics Assessment Tool, an ethical assessment tool for clinical policies that could be used not only by clinical ethics committees but also by policy committees or other relevant groups. Aim: The aim of this study was to find or create a tool to identify ethical issues and/or confirm ethical validity in nursing practice policies, protocols and (...) guidelines. Methodology: The development of Clinical Policy Ethics Assessment Tool involved first a literature review, followed by modification of the Research Protocol Ethics Assessment Tool, which was created to identify research protocols’ ethical issues, and finally, a trial of Clinical Policy Ethics Assessment Tool to ensure its reliability and validity. Ethical consideration: The policies analysed trialling Clinical Policy Ethics Assessment Tool were in the public domain and did not contain any confidential information. Despite that, Clinical Policy Ethics Assessment Tool also had the approval of a research ethics committee. Results: Research Protocol Ethics Assessment Tool was chosen as the template for a Clinical Policy Ethics Assessment Tool, to which several modifications were added to adapt it to work within a nursing practice context. Clinical Policy Ethics Assessment Tool was tested twice, which resulted in a general test–retest reliability coefficient = 0.86, r = 0.84, α1 = 0.817, α2 = 0.824 and interclass correlation coefficient = 0.874. Discussion: Contemporary nursing practice in a developed country is often ruled by clinical policies. The use of Clinical Policy Ethics Assessment Tool could confirm the ethical validity of those clinical practice policies, impacting on nurses’ education, values and quality of care. Conclusion: Clinical Policy Ethics Assessment Tool has the potential to detect ethical issues and facilitate the correction and improvement of clinical policies and guidelines in a structured way. This is especially so as it has shown reliability in detecting issues in clinical policies involving human participants and in encouraging policymakers to consider common ethical dilemmas in nursing practice. (shrink)

Contemporary healthcare practice has been progressively more regulated to increase efficiency, service user safety and practice quality. However, ethical issues in clinical practice that have not been implemented into regulations are undervalued by policymakers and healthcare institutions Considering the issues found by other authors, the use of a simple tool for policymakers to consider recurrent ethical issues could reduce those issues in a policy-driven clinical practice. The lack of tools to support structured ethical assessment of clinical policies was the main (...) reason to create the Clinical Policy Ethics Assessment Tool, but we realised of its possible advantages: limiting ethical dilemmas posed by policies, ensuring ethical practice by the use of policies and developing a consistent process for policymakers, institutions and healthcare professionals. Nonetheless, even if a tool can be implemented and it supports the creation of policies that reduce ethical issues, if the healthcare professionals are not aware of them they will not be implemented and the issues will continue. (shrink)

Contemporary healthcare practice has been progressively more regulated to increase efficiency, service user safety and practice quality. However, ethical issues in clinical practice that have not been implemented into regulations are undervalued by policymakers and healthcare institutions Considering the issues found by other authors, the use of a simple tool for policymakers to consider recurrent ethical issues could reduce those issues in a policy-driven clinical practice. The lack of tools to support structured ethical assessment of clinical policies was the main (...) reason to create the Clinical Policy Ethics Assessment Tool, but we realised of its possible advantages: limiting ethical dilemmas posed by policies, ensuring ethical practice by the use of policies and developing a consistent process for policymakers, institutions and healthcare professionals. Nonetheless, even if a tool can be implemented and it supports the creation of policies that reduce ethical issues, if the healthcare professionals are not aware of them they will not be implemented and the issues will continue. (shrink)

In this paper I explore the contours of a picture of normative epistemology that speaks centrally to the question of how to inquire rather than just the question of what to believe. What if normative epistemology were expanded to encompass inquiry in full? I argue that while a 'zetetic epistemology' builds on traditional normative epistemology in many appealing ways, it also faces some challenges.

Emerging infectious diseases remain a significant and dynamic threat to the health of individuals and the well-being of communities across the globe. Over the last decade, in response to these threats, increasing scientific consensus has mobilised in support of a One Health approach so that OH is now widely regarded as the most effective way of addressing EID outbreaks and risks. Given the scientific focus on OH, there is growing interest in the philosophical and ethical dimensions of this approach, and (...) a nascent OH literature is developing in the humanities. One of the key issues raised in this literature concerns ethical frameworks and whether OH merits the development of its very own ethical framework. In this paper, we argue that although the OH approach does not demand a new ethical framework, an OH approach does furnish the theoretical resources to support a novel ethical framework, and there are benefits to developing one that may be lost in its absence. We begin by briefly explaining what an OH approach to the threats posed by EIDs entails before outlining two different ways of construing ethical frameworks. We then show that although on one account of ethical frameworks there is no need for OH to generate its own, there may be advantages for its advocates in doing so. (shrink)

Journal of Philosophy of Education, EarlyView.

Using an approach developed in the context of human bioethics, we argue that chimpanzees in research can be regarded as vulnerable subjects. This vulnerability is primarily due to communication barriers and situational factors—confinement and dependency—that make chimpanzees particularly susceptible to risks of harm and exploitation in experimental settings. In human research, individuals who are deemed vulnerable are accorded special protections. Using conceptual and moral resources developed in the context of research with vulnerable humans, we show how chimpanzees warrant additional safeguards (...) against harm and exploitation paralleling those for human subjects. These safeguards should include empowering third parties to act as surrogate decision makers for chimpanzees, ensuring participant “assent,” and avoiding recruitment of animal subjects based merely on convenience. (shrink)

This book introduces the experience and process of gestation into the philosophy of Merleau-Ponty, Levinas and Derrida as a feminist project of maternal emancipation.

: In response to allegations that China is a "shame culture," scholars of Confucian ethics have made use of new studies in psychology, anthropology, and philosophy that present shame in a more favorable light. These studies contend that shame involves internalization of social moral codes. By adapting these new internal models of shame, Confucian ethicists have attempted to rehabilitate the emphasis on shame in early Confucianism, but in doing so they have inadvertently highlighted the striking absence in early Confucian texts (...) of such prominent shame metaphors as being seen, particularly with genitals exposed. This essay analyzes these visual metaphors for shame, in contrast to contact metaphors, and considers the implications for Confucian ethics that they might be two different types of shame. (shrink)

_Strange Wonder_ confronts Western philosophy's ambivalent relationship to the Platonic "wonder" that reveals the strangeness of the everyday. On the one hand, this wonder is said to be the origin of all philosophy. On the other hand, it is associated with a kind of ignorance that ought to be extinguished as swiftly as possible. By endeavoring to resolve wonder's indeterminacy into certainty and calculability, philosophy paradoxically secures itself at the expense of its own condition of possibility. _Strange Wonder_ locates a (...) reopening of wonder's primordial uncertainty in the work of Martin Heidegger, for whom wonder is first experienced as the shock at the groundlessness of things and then as an astonishment that things nevertheless _are_. Mary-Jane Rubenstein traces this double movement through the thought of Emmanuel Levinas, Jean-Luc Nancy, and Jacques Derrida, ultimately thematizing wonder as the awesome, awful opening that exposes thinking to devastation as well as transformation. Rubenstein's study shows that wonder reveals the extraordinary in and through the ordinary, and is therefore crucial to the task of reimagining political, religious, and ethical terrain. (shrink)

Innovative surgery raises four kinds of ethical challenges: potential harms to patients; compromised informed consent; unfair allocation of healthcare resources; and conflicts of interest. Lack of adequate data on innovations and lack of regulatory oversight contribute to these ethical challenges. In this paper these issues and the extent to which problems may be resolved by better evidence-gathering and more comprehensive regulation are explored. It is suggested that some ethical issues will be more resistant to resolution than others, owing to special (...) features of both surgery and innovation. (shrink)

Financial and nonfinancial conflicts of interest in medicine and surgery are troubling because they have the capacity to skew decision making in ways that might be detrimental to patient care and well-being. The recent case of the Articular Surface Replacement (ASR) hip provides a vivid illustration of the harmful effects of conflicts of interest in surgery.

R. S. Peters and a small group of contemporaries set the foundations for analytic philosophy of education in the 1960s, a field which continues to this day. This article asks about the value of analytic philosophy of education today, and proposes alterations to its initial aims and methods to make its value clearer. I outline some critiques of analytic philosophy of education, and respond by clarifying its aims. The key insight is that if analytic philosophy of education is explicitly aligned (...) with recent trends in social philosophy to focus on ameliorative analysis, then its value and relevance as a method in educational studies becomes clearer. Ameliorative analysis starts with the social role that a concept plays, and analyses it with this purpose in mind. I illustrate how R. S. Peters analysis of education would be approached differently with ameliorative analysis in mind, and conclude by pointing to some interesting points of discussion that arise from this approach. (shrink)

In this article, I outline three critiques of analytic philosophy; that it is irrelevant to individuals and society; unconstructive; and excessively technical. These critiques are linked to skepticism about the educational value of analytic philosophy. In response, I suggest that if analytic philosophy provides constructive guidance about prominent and pressing questions, then it holds potential educational value. I identify a body of prominent and pressing questions that are addressed by analytic philosophy as a discipline. Because analytic philosophy is often concerned (...) with the analysis of ordinary concepts, there is at least some potential educational value to analytic philosophy insofar as it provides guidance about the meaning of ordinary concepts that ground ordinary questions. Taking P. F. Strawson's paradigmatically analytic account of philosophy, I show that analytic philosophy can directly address ordinary questions in a constructive manner. Analytic philosophy is neither irrelevant, unconstructive, nor excessively technical. (shrink)

Prompted by the ever-increasing cesarean rate, this paper considers the interpretive disjunct between two significant strands of feminist analysis that have arisen in the last four decades as a consequence of the phenomenon of medicalized birth. In contrast to the dominant paradigm of bioethical “Principalism,” both modes of analysis, understood as “the critique of industrialized labor” and “the critique of idealized labor,” are attentive to the way in which social discourses inform bioethical deliberation and practice, but significantly diverge in the (...) nature of their accounts. The “industrialization critique” understands the culture of medical intervention to be impelled by an “obstetric desire” to appropriate women's reproductive potency, whereas the “idealization critique” relates new mothers’ “low childbirth satisfaction” to a pernicious normative ideal propagated by the natural childbirth movement. This paper will explore the anatomy of both critiques and interrogate their fidelity to the phenomenological insight of the body as chiasm between material and ideal. I will argue that while the insights of the idealization critique are well grounded, we must exercise caution about the critique's tendency to reductively understand the embodied experience of labor as entirely discursively produced, a gesture that risks re-performing the dematerialization of women often effected through obstetric intervention itself. (shrink)

In this paper we propose a new way of conceptualizing animals in experimentation – the animal-as-patient. Construing and treating animals as patients offers a way of successfully addressing some of the entrenched epistemological and ethical problems within a practice of animal experimentation directed to human clinical benefit. This approach is grounded in an epistemological insight and builds on work with so-called ‘pet models’. It relies upon the occurrence and characterization of analogous human and nonhuman animal diseases, where, if certain criteria (...) of homology and mechanism are met, the animal simultaneously becomes a patient and a spontaneous model of the human disease. (shrink)

We thank Zohar Lederman and Benjamin Capps for engaging with our paper on One Health and ethical frameworks, however we want to take issue with them on three points. First, they appear to misunderstand the distinction we appeal to between ethical theory and ethical frameworks, and so misinterpret what we are trying to achieve in our paper. Second, in spite of what they seem to imply, we agree that an OH approach can obscure differences in values, and that to progress (...) the field there needs to be recognition of competing values and their implications for OH. Finally, we are puzzled by their interest in pursuing a deliberative process, as this seems at odds with other positions they take in their paper, and also opens up many questions that need to be addressed. (shrink)

For understanding early Chinese "theories of language" and views about the relation of speech to a nonalphabetic script, a thorough analysis of early Chinese metalinguistic terminology is necessary. This article analyzes the function of ming & (name) in early Chinese texts as a first step in that direction. It argues against the regular treatment of this term in early Chinese texts as the equivalent of "word." It examines ming in light of early Chinese ideas about sense perception, the mythology about (...) the origin or music and writing, and changes occurring in the writing system in the third century B.C.E. This lays the groundwork for a more informed response to Derrida's speculation about Chinese logocentrism. It is explained that, in early Chinese texts, certain concepts associated with logocentrism (e.g., reality/appearance, presence/absence) function in a way that is neither the same as, nor exactly the reverse of, the Western philosophical episteme. Thus, attempts to reconstruct attitudes toward "language" in early China should note the importance of sound in interpreting ming. Moreover, interpretations of apparent denigrations of writing in early Chinese texts should, before diagnosing logocentrism, consider the context of the reliability of the visual. (shrink)

As part of a trend in modern cognitive science, cognitive linguist, George Lakoff, and philosopher, Mark Johnson claim to provide a biologically-based account of subsymbolic meaningful experiences. They argue that human beings understand objects by extrapolating from their sensory motor activities and primary perceptions. Lakoff and Johnson’s writings have generated a good deal of interest among scholars of Early China because they maintain that “our common embodiment allows for common stable truths.” Although there are many grounds on which Lakoff and (...) Johnson’s theories have been criticized, this essay focuses in particular on problems related to their schema of Self as Container. Lakoff and Johnson contend that there are no pure experiences outside of culture, while nevertheless arguing that the experience of being a closed-off container is “direct.” “The concepts OBJECT, SUBSTANCE and CONTAINER emerge directly,” they write. “We experience ourselves as entities, separate from the rest of the world—as containers with an inside and an outside.” By “emerge directly,” they do not mean emerging free of culture, but rather that some experiences within culture, specifically physical experiences, are more directly given than others. My study explores the pitfalls of presuming the “direct” experience of containment makes good sense of texts from Early China (ca. 500–100 B.C.E). (shrink)

Psychological continuity theories have been the dominant theories of personal identity over time, and the phenomenal approach has largely been neglected because of the bridge problem. I propose a hybrid account of the persistence of the self that draws on both psychological and phenomenal influences while avoiding the problems that both theories face in their 'pure' form. Such a hybrid theory retains the benefits of a phenomenal account of intra-streamal unity, and provides a better account of inter-streamal unity with the (...) use of a psychological-continuity theory. (shrink)

While simulation has been a staple of Social Studies curricula since the 1960s, few current studies have sought to understand the mechanisms behind how simulations may influence students’ learning and behavior. Learning theories around student engagement – specifically interest development theory (Hidi & Renninger, 2006) – may help explain students’ commitment to future political action. To incorporate this theory into the democratic education literature, this study asks: Do situational interest and simulation frequency uniquely contribute to students’ commitment to vote in (...) the future? Data included 260 students from 19 classrooms, 9 teachers, in 9 schools, recruited as part of a larger mixed-methods study on Project Based Learning. Hierarchical Linear Modeling (HLM) techniques were used to examine the relationship between individual outcomes and predictors across different classrooms and teachers. Analysis of data suggests both frequency of simulations and situational interest directly predict students’ commitment to vote but do not uniquely contribute to the outcome. Findings suggest situational interest may play an important role in influencing students’ learning and future political behavior. (shrink)

This book introduces the experience and process of gestation into the philosophy of Merleau-Ponty, Levinas and Derrida as a feminist project of maternal emancipation.

Perelman and Olbrechts-Tyteca's practical reasoning theory has attracted a great deal of interest since its publication in 1969. Their most important assertion, however, that argument is the logical basis for practical decision-making, has been under-utilized, primarily because it was not sufficiently operationalized for research purposes. This essay presents an operationalization of practical reasoning for use in analyzing argument logics that emerge through group interaction. Particular elements of discourse and argument are identified as responding to principles put forward by Perelman and (...) Olbrechts-Tyteca, and are viewed as fitting together in a kind of logical argument structure that is well suited to the study of practical arguments in decision-making. Both the content elements and the logical argument structure are illustrated using examples from two studies examining decision logics in public participation and jury decision-making. Advantages of this approach and proposed recognition of a new `filtered' type of argument structure are discussed. (shrink)

1. Educational concepts play an important role in educational studies. Educational concepts roughly correspond to terms or words pertaining to education. They include terms such as ‘schooling’, ‘te...

For well over a millennium, public institutions have sought to limit the spread of disease. This article claims that shared political narratives about collective solidarity and belonging expressed in ideas about citizenship shape and constrain public health interventions. While a Sanitarian medical paradigm fit the mid-nineteenth-century British citizenship regime better than one based on limiting contagion by quarantine, full implementation of the “sanitary idea” had to wait upon adjustments after 1870 in the predominantly liberal citizenship regime, and particularly in the (...) institutions of governance and ideas about the responsibility mix. (shrink)

Though it involves significant harms and is a widespread and entrenched practice, legal punishment lacks a sure philosophical footing. In spite of frequent attempts by utilitarians, retributivists and so called "mixed solution" advocates the problem of justifying punishment remains. This book aims to redress this shortcoming by turning to the German thinkers Kant and Hegel and their idealism to fashion punishment's justification. In the case of Kant this is achieved by developing his construction of justice, while for Hegel it involves (...) taking seriously his theory of recognition and aspects of his logic. In applying ideas from this tradition to a contemporary problem, this book will appeal to both those interested in Kant and Hegel scholarship and its recent resurgence, as well as to students of jurisprudence. (shrink)

Volume 19, Issue 6, June 2019, Page 28-29.