Medical assistance in dying legislation in Canada followed much deliberation after the Supreme Court of Canada’s ruling in Carter v. Canada. Included in this deliberation was the Special Joint Committee on Physician Assisted Dying’s recommendation to extend MAID legislation beyond the inclusion of adults to mature minors. Children's agency is a construct advanced within childhood studies literature which entails eliciting children’s voices in order to recognise children as active participants in constructing their own childhoods. Using this framework, we consider the (...) possible extension of MAID legislation to most minors. We highlight important questions regarding how insights from children’s voices could be mobilised in the life or death context of MAID. We conclude that children’s voices have the potential to help determine their eligibility for MAID; however, incorporating children's voices in the context of MAID requires careful consideration due to the complexity of voice. (shrink)

BackgroundThis paper represents a portion of the findings from one of the first research studies eliciting the lived experience of adults with an early diagnosis of Phenylketonuria living in Ireland. Ireland has one of the highest prevalence rates of PKU in Europe, however, little is known about the experience of Irish adults with PKU. Furthermore, Ireland is one of the first countries in the world to introduce neonatal screening followed by the introduction of long-term dietary therapy over 50 years ago. (...) This study presents the first comprehensive assessment of the lived experience of Irish adults with PKU on long term dietary therapy.MethodsNarrative data was collected from eleven self-selected participants, using semi-structured interviews. The interviews were divided into five sections focused on eliciting a holistic understanding of the lived experience of adults with PKU living in Ireland. Thematic analysis was guided by Colaizzi's Framework in conjunction with NVivo qualitative data analysis software.FindingsFindings from the original research encompassed a broad understanding of the lived experience of adults with PKU living in Ireland, including factors influencing dietary therapy and managing PHE blood levels. The themes being discussed within this article are those which appear to be least represented within current literature: living with PKU, including reproductive health, the importance of self-management and establishing routine, support networks in adulthood and concerns regarding aging with PKU.ConclusionIt was evident from the findings that a diagnosis of PKU can influence how adults with PKU may experience aging and their own mortality. These findings offer new insight into the vulnerability attached to the experience of aging with PKU and may be beneficial to advocacy groups and for future development of policy and practice. (shrink)

Qualitative inquiry is increasingly used to foster change in health policy and practice. Research ethics committees often misunderstand qualitative inquiry, assuming its design can be judged by criteria of quantitative science. Traditional health research uses scientific realist standards as a means-to-an-end, answering the question “So what?” to support the advancement of practice and policy. In contrast, qualitative inquiry often draws on constructivist paradigms, generating knowledge either as an end-in-itself or as a means to foster change. When reviewers inappropriately judge qualitative (...) inquiry, it restricts the ways health phenomena can be understood. Qualitative inquiry is necessary because it enables an understanding not possible within scientific explanation. When such research illuminates, it can also shed light onto the “So what?” In order to ensure an appraisal of qualitative inquiry congruent with its paradigmatic premises, we suggest the “Illumination Test,” met when findings foster rich understanding of phenomena, resulting in a reflective “aha!”. (shrink)

Abstract:Vulnerability is an important criterion to assess the ethical justification of the inclusion of participants in research trials. Currently, vulnerability is often understood as an attribute inherent to a participant by nature of a diagnosed condition. Accordingly, a common ethical concern relates to the participant’s decisionmaking capacity and ability to provide free and informed consent. We propose an expanded view of vulnerability that moves beyond a focus on consent and the intrinsic attributes of participants. We offer specific suggestions for how (...) relational aspects and the dynamic features of vulnerability could be more fully captured in current discussions and research practices. (shrink)

ObjectivesIn 2015, the Province of Quebec, Canada passed a law that allowed voluntary active euthanasia. Palliative care stakeholders in Canada have been largely opposed to euthanasia, yet there is little research about their views. The research question guiding this study was the following: How do palliative care physicians in Quebec position themselves regarding the practice of VAE in the context of the new provincial legislation?MethodsWe used interpretive description, an inductive methodology to answer research questions about clinical practice. A total of (...) 18 palliative care physicians participated in semistructured interviews at two university-affiliated hospitals in Quebec.ResultsParticipants positioned themselves in opposition to euthanasia. Their justifications were framed within their professional commitment to not hasten death, which sat in tension with the value of patients’ autonomy to choose how to die. Participants described VAE as unacceptable if it impeded opportunities to evaluate and alleviate suffering. Further, they contested government rhetoric that positioned VAE as a way to improve end-of-life care. Participants felt that VAE would diminish the potential of palliative care to relieve suffering. Dilemmas were apparent in their narratives, about reconciling respect for patient autonomy with broader palliative care values, and the value of accompanying and not abandoning patients who make requests for VAE while being committed to neither prolonging nor hastening death.ConclusionsThis study provides insight into nuanced positions of experienced palliative care physicians in Quebec and confirms expected tensions between an important stakeholder and the practice of VAE as guided by the new legislation. (shrink)

Delirium, a common syndrome in terminally ill people, presents specific challenges to a good death in end‐of‐life care. This paper examines the relational engagement between hospice nurses and their patients in a context of end‐of‐life delirium. Ethnographic fieldwork spanning 15 months was conducted at a freestanding residential hospice in eastern Canada. A shared value system was apparent within the nursing community of hospice; patients’ comfort and dignity were deemed most at stake and therefore commanded nurses’ primary attention. This overarching commitment (...) to comfort and dignity shaped all of nursing practice in this hospice, including practices related to end‐of‐life delirium. The findings of this study elaborate the ways in which hospice nurses interpreted and responded to the discomfort of their patients in delirium, as well as the efforts they made to understand their patients’ subjective experiences and to connect with them in supportive ways. In addition to what is already known about clinical assessment and treatment of delirium in palliative care settings, the findings of this study offer points of reflection for nurses anywhere who are contending with the relational challenges that delirium presents in end‐of‐life care. (shrink)

Known as the “Mother of Tibetan Buddhism” and the “Mother of Knowledge,” Yeshe Tsogyal built upon indigenous Bön philosophy and Mahāyāna Buddhism to bring about a Buddhism that is identifiably Tibetan. I report on her life, her works and teaching. Then summarize her significance as a philosopher of Tibetan Buddhist metaphysics, epistemology and ethics. Lastly, I append portions of several writings attributed to her.

This book takes a new approach to ethics by focusing on the kinds of dilemmas that confront people almost daily on the job.

Courses in the history of philosophy which exclude contributions made by women cannot legitimately claim to teach this history. This is true, not merely because those histories are incomplete, but rather because they give a biased account. I sketch the difficulties thus posed for the profession, and offer suggestions for developing a less biased, more accurate understanding of the history of philosophy.

Oliva Sabuco's New Philosophy of Human nature (1587) is an early modern philosophy of medicine that challenged the views of the successors to Aristotle, especially Galen and Ibn Sina (Avicenna). It also challenged the paradigm of the male as the epitome of the human and instead offers a gender-neutral philosophy of human nature. Now largely forgotten, it was widely read and influential amongst philosophers of medicine including DeClave, LePois, Harvey,Southey and others, particularly for its account of the role of the (...) nervous system and cerebrospinal fluid in mind-body interaction. In this article I trace its early influence by tracing provenance of the editions produced during the lifetime of its author. (shrink)

For a little more than a decade, professional organizations and healthcare institutions have attempted to develop guidelines and policies to deal with seemingly intractable conflicts that arise between clinicians and patients (or their proxies) over appropriate use of aggressive life-sustaining therapies in the face of low expectations of medical benefit. This article suggests that, although such efforts at conflict resolution are commendable on many levels, inadequate attention has been given to their potential negative effects upon particular groups of patients/proxies. Based (...) on the well-documented tendency among many African Americans to prefer more aggressive end-of-life medical interventions, it is proposed that the use of institutional policy to break decision making impasse in cases for which aggressive treatment is deemed "medically inappropriate" will fall disproportionately on that group. Finally, it is suggested that the development and application of institutional conflict-resolution policies should be evaluated in the context of historical and current experiences of marginalization and disempowerment, lest such policies exacerbate that experience. (shrink)

aspirations, the rise of western monasticism was the most note worthy event of the early centuries. The importance of monasteries cannot be overstressed as sources of spirituality, learning and auto nomy in the intensely masculinized, militarized feudal period. Drawing their members from the highest levels of society, women's monasteries provided an outlet for the energy and ambition of strong-willed women, as well as positions of considerable authority. Even from periods relatively inhospitable to learning of all kinds, the memory has been (...) preserved of a good number of women of education. Their often considerable achievements and influence, however, generally lie outside even an expanded definition of philo sophy. Among the most notable foremothers of this early period were several whose efforts signal the possibility of later philosophical work. Radegund, in the sixth century, established one of the first Frankish convents, thereby laying the foundations for women's spiritual and intellectual development. From these beginnings, women's monasteries increased rapidly in both number and in fluence both on the continent and in Anglo-Saxon England. Hilda (d. 680) is well known as the powerful abbsess of the double monastery of Whitby. She was eager for knowledge, and five Eng lish bishops were educated under her tutelage. She is also accounted the patron of Caedmon, the first Anglo-Saxon poet of religious verse. The Anglo-Saxon nun Lioba was versed in the liberal arts as well as Scripture and canon law. (shrink)

Philosophy became known as a “man’s” profession over the past three thousand years. This is an account of how, in the case of Diotima of Mantinea, the histories of philosophy came to systematically ignore, overlook, doubt and declare false the fact that some philosophers had uteruses. The effect has been a massive hysterectomy –the removal from or ignoring of women’s contributions to Philosophy as related by the major histories and encyclopedias of Philosophy. This nearly discipline-wide hysterectomy has created the false (...) impression that women cannot think philosophically. In this PowerPoint presentation I will present historical and archeological evidence relative to Diotima of Mantinea who may have been the first woman philosopher to receive a posthumous hysterectomy by later historians of philosophy. (shrink)

Concerns of public responsibility and professional certification may sometimes mean it is unethical to teach ethics.

This book presents the views of 22 women philosophers from outside the Greco-Roman and Judeo-Christian worlds. These eminent thinkers are from Mesopotamia, India, Tibet, China, Korea, Japan, Australia, America, the Philippines and Nigeria. Six philosophers, the earliest of whom predates the Greek pre-Socratics by two thousand years, lived at “the dawn of philosophy”; another six from late Antiquity through the Classical period; five more taught and wrote during the Middle Ages up to the Age of Exploration, and yet five others (...) were active during the modern period to the mid-twentieth century. Most belonged to major philosophical traditions: Hinduism, Buddhism, Confucianism, Taoism, Zen, or Sufism. The chapters of the book describe the life and views of the philosophers, outline the fundamental features of their respective schools, and contain translations of their writings. The book is intended for scholars of philosophy and women’s studies who wish to expand their knowledge of non-Western philosophical traditions and is ideally suited for undergraduate education. Comprehensive multilingual bibliographies of carefully documented sources offer scholars many promising resources for further research. (shrink)

A History of Women Philosophers, Volume I: Ancient Women Philoophers, 600 B.C. - 500 A.D., edited by Mary Ellen Waithe, is an important but somewhat frustrating book. It is filled with tantalizing glimpses into the lives and thoughts of some of our earliest philosophical foremothers. Yet it lacks a clear unifying theme, and the abrupt transitions from one philosopher and period to the next are sometimes disconcerting. The overall effect is not unlike that of viewing an expansive landscape, (...) illuminated only by a few tiny spotlights. (shrink)

In this volume we provide rich examples of non-western philosophy written by women over the last four thousand years. We begin by defining the scope of our non-western terrain: philosophy created outside the Greco-Roman, Judeo-Christian traditions. The philosophers who are the subjects of inquiry here hail from places as distant as pre-colonial Africa, the Americas, Asia and Australia. Together with our expert contributing authors we demonstrate through inquiry and analysis how these women philosophers advanced human thought about profound issues, some (...) to include the nature and treatment of women themselves. (shrink)

Service-learning has received a great deal of attention in the management education literature over the past decade, as a method by which students can acquire moral and civic values as well as gain academic knowledge and practice real-world skills. Scholars focus on student and community impact, curricular design, and rationale. However, the educational environment (“context”) in which service-learning occurs has been given less attention, although experienced educators know that the classroom is hardly a vacuum and that students learn a great (...) deal from the non-curricular aspects of their educational experience. Moral values in particular are conveyed by what is not said. Given this, I argue that the contexts in which service-learning takes place are as important as the activity itself. Three perspectives on context will be described and assessed: the “hidden” curriculum, the educational atmosphere, and the university’s orientation towards social responsibility. (shrink)

The plot thickens--in novels and our lives--forcing us from the fairy tale into a bewildering, even heartbreaking narrative. We look at the god we're holding, and find it too fragile, too brittle to meet reality. Cling tighter? Move on godless? In fact, rejecting a god image (or as C. S. Lewis puts it, allowing God to smash our limited god) opens space for deeper faith in the midst of painful life experience. In OMG, Mary Ellen Ashcroft invites readers (...) to look over her shoulder as she traces her god growth, beginning with a capricious childhood god. The loving savior who embraced her when she was eighteen, followed her into strict fundamentalism, while the god she met in an Anglican seminary shocked her by caring more about poverty than a seven-day creation, but then called her to a South Africa tipping toward revolution. An interweaving of narrative theology and creative nonfiction, OMG invites readers to grow into deeper faith, retelling their stories in the light of the biblical one, dropping inadequate gods to grasp a mysterious, awesome one. (shrink)

Emérita Quito was the first woman from the Philippines to complete a Ph.D. in Philosophy. Her early Scholastic training as an undergraduate was at the University of Santo Tomas expanded to include phenomenology and existentialism during her graduate studies at major European universities. Upon returning home she began to focus on the idea of developing a methodology for investigating indigenous Filipino philosophy. How does one reveal the concepts and principles underlying the belief systems within a country that has suffered a (...) thousand years of occupation by foreign forces, that speaks with hundreds of different dialects across more than seven thousand islands spread across more than one hundred thousand square miles? This amazing philosopher published extensively not only in western philosophy, but on that indigenous to this island nation, prior to the incursions of western nations and the introduction to the Philippines of western philosophical views. (shrink)

In this Chapter I present early Mesopotamian philosophical views and contrast them to En Hedu’Anna’s account of metaphysics, epistemology, ontology, philosophy of religion and her views on several socio-political issues. Through her writings we see her views of the cosmos, of deities, of women’s nature, gender fluidity, justifications for violence, and other significant concepts. Lastly, I summarize her influence and suggest that her work marks a new dawn, a first, for Philosophy.

The central goal of this essay is to develop a theory of justified paternalism that will be useful in evaluating and designing paternalistic public policies. The theory is designed for a society that promotes the development of characteristics of autonomy in its members. In the opening chapter I analyze widely-held legal, familial and philosophic conceptions of paternalism, discuss the inadequacies of each of those conceptions and develop a "unified" conception of paternalism. In Chapter II I analyze what it means to (...) be "morally responsible" and base this analysis on the legal, psychological and psychiatric accounts of responsibility that inform an autonomist society. From these analyses I develop two principles which inform an autonomist society: Respect for Others and Non-Interference and discuss the restraints on justifiable paternalism entailed by them. In Chapter III I discuss the roles of voluntariness and consent in the legal, phychiatric and philosophic concepts of moral responsibility and turn to an analysis of the disappointing treatments of these concepts in traditional philosophic justifications for paternalism. I argue that "unencumbered consent" is an appropriate concept of consent to utilize in any philosophic justification for paternalism that would be consistent with the concepts of moral responsibility and autonomy and the principles of respect for others and of non-interference. Chapter IV offers a decision-theoretic model justifying acting paternalistically for others. Each of the necessary conditions for justified paternalism is drawn from the aforementioned concepts and principles. In Chapter V, I show that if Rawls is to be consistent, he must adopt a theory of paternalism similar to mine, and I argue that my theory of paternalism overcomes libertarian, utilitarian and statistical arguments against it. I then apply the theory to specific forms of paternalism including involuntary commitment and guardianship, mandatory blood transfusions, flouridation of public water supplies, mandatory motorcycle helmets and seatbelts, social security taxation, mandatory education of children and suicide intervention. A 267-entry bibliography is appended. (shrink)