Bioethics influences public policy, scientific research, and clinical practice. Thinkers in Continental traditions have increasingly contributed scholarship to this field, and their approaches allow new insights and alternative normative guidance. In this essay, examples of the following Continental approaches in bioethics are presented and considered: phenomenology and existentialism; deconstruction; Foucauldian methodologies; and biopolitical analyses. Also highlighted are Continental feminisms and the philosophy of disability. Continental approaches are importantly diverse, but those I focus upon here reveal embedded models of individualized autonomy (...) in medical discourses and encourage awareness of medicine's normalizing edges, thereby drawing attention to lacunae in traditional bioethical frameworks. (shrink)

The following is dedicated to promoting a version of the disability critique of negative genetic selection while navigating claims that launching such a critique threatens reproductive liberty or is unavoidably antichoice. I highlight problematic conceptual assumptions regarding genetics and choice made by proponents and opponents of selection alike and bring out the underlying ableist values of the prevailing conversation. Ableism is discrimination against persons on the basis of perceived disability. I conclude that the existing social and institutional milieu surrounding genetic (...) selection threatens persons who experience difference with stigma and its accompanying political and social disadvantages. My .. (shrink)

The disability critique of negative genetic selection is frequently accused of threatening reproductive liberty. This paper describes the disability critique and defends it against that objection. It also contends that the critique can work to deflate belief in genetic determinism. Recognizing the influence of genetic determinism helps advocate for existing persons in the disability community and protects reproductive liberty. The disability critique can point to genetic determinism but does not suggest a ban or obstacles to the choice of negative genetic (...) selection; therefore, it is not antithetical to reproductive liberty, as has been charged. (shrink)

Transhumanist arguments in support of radical human enhancement are inimical to disability justice projects. Transhumanist thinkers, the strongest promoters of human enhancement, and fellow travelers who claim enhancement is a moral obligation, make arguments that rely on the denigration of disabled embodiment and lives. These arguments link disability with risk. The promotion of human enhancement is therefore open to significant disability critique despite transhumanism’s claims to allyship with disability justice activism. This chapter lays out such a disability critique of enhancement (...) and further supports its claims by describing bioethics, and therefore transhumanism, as biopolitical in the sense Michel Foucault uses the term. Finally, this chapter develops an alternative vision of enhancement. This alternative vision poses a disability-inclusive future, accepts the risks of embodiment, and lays groundwork for a counterdiscourse of enhancement. (shrink)

In this article we explore ethical issues arising in a study of home Internet use by low-income families. We consider questions of our responsibility as educational researchers and discuss the ethical implications of some unanticipated consequences of our study. We illustrate ways in which the principles of research ethics for use of human subjects can be ambiguous and possibly inadequate for anticipating potential harm in educational research. In this exploratory research of personal communication technologies, participants experienced changes that were personal (...) and relational. These unanticipated changes in their way of being complicated our research relationships, testing the boundaries of our commitment to the principle of trustworthiness and forcing us to reevaluate our responsibilities. (shrink)

CITATION: Ewuoso, C., Hall, S. & Dierickx, K. 2017. How do healthcare professionals manage ethical challenges regarding information in healthcare professional/patient clinical interactions? a review of concept- or argument-based articles and case analyses. South African Journal of Bioethics and Law, 10:75-82, doi:10.7196/SAJBL.2017.v10i2.610.

What exactly is a genetic disease? For a phrase one hears on a daily basis, there has been surprisingly little analysis of the underlying concept. Medical doctors seem perfectly willing to admit that the etiology of disease is typically complex, with a great many factors interacting to bring about a given condition. On such a view, descriptions of diseases like cancer as genetic seem at best highly simplistic, and at worst philosophically indefensible. On the other hand, there is clearly some (...) practical value to be had by classifying diseases according to their predominant cause when this can be accomplished in a theoretically satisfactory manner. The question therefore becomes exactly how one should go about selecting a single causal factor among many to explain the presence of disease. When an attempt to defend such causal selection is made at all, the standard accounts offered (Koch's postulates, Hill's epidemiological criteria, manipulability) are all clearly inadequate. I propose, however, an epidemiological account of disease causation which walks the fine line between practical applicability and theoretical considerations of causal complexity and attempts to compromise between patientcentered and population-centered concepts of disease. The epidemiological account is the most basic framework consistent with our strongly held intuitions about the causal classification of disease, yet it avoids the difficulties encountered by its competitors. (shrink)

Relatives of persons with severe mental illness face a straining life situation and need support. Exclusion of relatives in mental health care has long been reported. The aim of this study was to describe conceptions of nurses in mental health care about supporting relatives of persons with severe mental illness. Focus group interviews with nurses from all levels of mental health care in Norway were performed. A phenomenographic approach was used. The nurses found that their responsibility first and foremost was (...) the patient, especially to develop an alliance with him or her. Additional premises for supporting relatives were the context framing the nursing care, aspects of the actors, and relational concerns between them. Competing or contradictory demands were found within these premises. Two paths were identified concerning the nurses’ support of relatives: seeing the relative in the shadow of the patient or as an individual person. (shrink)

Studies of the association between wealth and fertility in industrial populations have a rich history in the evolutionary literature, and they have been used to argue both for and against a behavioral ecological approach to explaining human variability. We consider that there are strong arguments in favor of measuring fertility (and proxies thereof) in industrial populations, not least because of the wide availability of large-scale secondary databases. Such data sources bring challenges as well as advantages, however. The purpose of this (...) article is to illustrate these by examining the association between wealth and reproductive success in the United States, using the National Longitudinal Study of Youth 1979. We conduct a broad-based exploratory analysis of the relationship between wealth and fertility, employing both cross-sectional and longitudinal approaches, and multiple measures of both wealth (income and net worth) and fertility (lifetime reproductive success and transitions to first, second and third births). We highlight the kinds of decisions that have to be made regarding sample selection, along with the selection and construction of explanatory variables and control measures. Based on our analyses, we find a positive effect of both income and net worth on fertility for men, which is more pronounced for white men and for transitions to first and second births. Income tends to have a negative effect on fertility for women, while net worth is more likely to positively predict fertility. Different reproductive strategies among different groups within the same population highlight the complexity of the reproductive ecology of industrial societies. These results differ in a number of respects from other analyses using the same database. We suggest this reflects the impossibility of producing a definitive analysis, rather than a failure to identify the “correct” analytical strategy. Finally, we discuss how these findings inform us about (mal)adaptive decision-making. (shrink)

The evolution of sex in eukaryotes represents a paradox, given the “twofold” fitness cost it incurs. We hypothesize that the mutational dynamics of the mitochondrial genome would have favored the evolution of sexual reproduction. Mitochondrial DNA (mtDNA) exhibits a high‐mutation rate across most eukaryote taxa, and several lines of evidence suggest that this high rate is an ancestral character. This seems inexplicable given that mtDNA‐encoded genes underlie the expression of life's most salient functions, including energy conversion. We propose that negative (...) metabolic effects linked to mitochondrial mutation accumulation would have invoked selection for sexual recombination between divergent host nuclear genomes in early eukaryote lineages. This would provide a mechanism by which recombinant host genotypes could be rapidly shuffled and screened for the presence of compensatory modifiers that offset mtDNA‐induced harm. Under this hypothesis, recombination provides the genetic variation necessary for compensatory nuclear coadaptation to keep pace with mitochondrial mutation accumulation. (shrink)

Until recently, psychologists have conceptualised and studied trust in God (TIG) largely in isolation from contemporary work in theology, philosophy, history, and biblical studies that has examined the topic with increasing clarity. In this article, we first review the primary ways that psychologists have conceptualised and measured TIG. Then, we draw on conceptualizations of TIG outside the psychology of religion to provide a conceptual map for how TIG might be related to theorised predictors and outcomes. Finally, we provide a research (...) agenda for future empirical work in this area, as well as practical applications for counsellors and religious leaders. (shrink)

Developments in neuroscience have raised the possibility that pharmaceuticals may be used to enhance memory, mood, and attention in people who do not have an illness or disorder, a practice known as “cognitive enhancement.” We describe historical experiences with two medicinal drugs for which similar enhancement claims were made, cocaine in the late 19th and early 20th centuries, and amphetamines in the mid 20th century. These drugs were initially introduced as medicinal agents in Europe and North America before becoming more (...) widely used for a variety of purposes, including what would nowadays be considered cognitive enhancement. Their trajectory of use conformed to the typical use cycle of psychotropic drugs. There was an initial steep rise in prescribing for medical use, followed by expanded nonmedical use that was fueled by enthusiasm for the drugs’ effects. As the number of regular users increased, problems related to use (such as addiction) became apparent, societal concern increased, and laws were passed banning nonmedical use and eventually, medical use. This historical experience draws attention to the adverse side effects of enhancement use that only become apparent with regular, wide-scale use of a drug. We highlight the similarities between the enthusiasms for cocaine and amphetamines and the current enthusiasms for using prescription stimulants for cognitive enhancement. We argue bioethicists should not encourage the cognitive enhancement use of drugs such as methylphenidate in the absence of evidence on the efficacy and safety of their use for cognitive enhancement purposes. (shrink)

In Three Mystics Walk into a Tavern, Jalal ad-Din Rumi, Moses de León, and Meister Eckhart— three of the greatest mystics of all time—meet for an imaginary conversation that will inspire individuals of the twenty-first century to find their own spirituality and realize that everyone can be a mystic.

FOSTER J, CHIANG F, HILLARD RC, HALL P and HEATH A. Nursing Inquiry 2010; 17: 309–316 Team process in community‐based participatory research on maternity care in the Dominican RepublicA cross‐cultural team consisting of US trained academic midwife researchers, Dominican nurses, and Dominican community leaders have partnered in this international nursing and midwifery community‐based participatory research (CBPR) project in the Dominican Republic to understand the community experience with publicly funded maternity services. The purpose of the study was to understand community (...) perceptions of maternity services. This article highlights the activities that the research team carried out during each phase of the research process, and how they established team identity, team trust, and team efficacy. This research has created a platform for new avenues for health providers and community to partner to improve maternal‐newborn care. Community‐based participatory research is one way forward to address the past and present inequities constitutive of global health disparities. (shrink)

In a critical intervention into the bioethics debate over human enhancement, philosopher Melinda Hall tackles the claim that the expansion and development of human capacities is a moral obligation. Hall draws on French philosopher Michel Foucault to reveal and challenge the ways disability is central to the conversation. The Bioethics of Enhancement includes a close reading and analysis of the last century of enhancement thinking and contemporary transhumanist thinkers, the strongest promoters of the obligation to pursue enhancement (...) technology. With specific attention to the work of bioethicists Nick Bostrom and Julian Savulescu, the book challenges the rhetoric and strategies of enhancement thinking. These include the desire to transcend the body and decide who should live in future generations through emerging technologies such as genetic selection. Hall provides new analyses rethinking both the philosophy of enhancement and disability, arguing that enhancement should be a matter of social and political interventions, not genetic and biological interventions. Hall concludes that human vulnerability and difference should be cherished rather than extinguished. -/- This book will be of interest to academics working in bioethics and disability studies, along with those working in Continental philosophy (especially on Foucault). (shrink)

The American Journal of Bioethics, Volume 12, Issue 9, Page 26-28, September 2012.

In this paper, I critically assess transhumanist philosophy and its influence in bioethics by turning to resources in the work of Michel Foucault. I begin by outlining transhumanism and drawing out some of the primary goals of transhumanist philosophy. In order to do so, I focus on the work of Nick Bostrom and Julian Savulescu, two prominent contributors to this thinking. I then move to explicate Foucault’s work, in the early iterations of the Abnormal lecture series, on the concept of (...) vile sovereignty. Foucault used the concept of vile sovereignty to critique psychiatric witnesses that had been utilized in mid twentieth-century French courts of law. Turning back to transhumanism, I analyze transhumanist discourse on the basis of Foucault’s vile sovereignty. Transhumanists promote human enhancement in a way that rejects the body—especially the disabled body—and pose the question of what lives are worth living, as well as attempt to answer it. I conclude that because of the undeserved influence and ableism of transhumanism, it is important for feminist philosophers, philosophers of disability, and other disability scholars, who collide at the nexus of bioethical debate (especially with regard to reproductive technology and the body), to work together to intervene upon transhumanist discourse. (shrink)

Understanding disability requires understanding its social construction, and social construction can be read in cultural products. In this essay, I look to one major locus for images of persons with disabilities—horror. Horror films and fiction use disability imagery to create and augment horror. I first situate my understanding of disability imagery in the horror genre using a case study read through the work of Julia Kristeva. But, I go on to argue that trademark moves in the horror genre, which typically (...) support ableist assumptions, can be used to subvert ableism and open space for alternative social and political thinking about disability. I point to the work of Tim Burton and Stephen King to demonstrate these possibilities in horror. (shrink)

This paper calls fresh attention to ethical problems surrounding prenatal testing by focusing on genetic knowledge gained through evolving testing procedures. Advances in reproductive and prenatal genetic testing include non-invasive tests, such as Verifi and Materniti21, designed to gather detailed information regarding fetal DNA as early as 10 weeks. Meanwhile, a new method of chromosomal microarray has proved more reliable than karyotyping in detecting fetal abnormality. This method detects abnormalities in 1 out of every 60 pregnancies in which karyotyping identified (...) the fetus as “normal.” Chromosomal microarray directly compares fetal DNA to DNA from a presumptively “healthy person” to identify genetic deviations. The chromosomal microarray method thus assumes a human genetic blueprint—that is, a normal genotype, deviance from which is risky and open to medical diagnosis. But, according to philosopher and geneticist Jackie Leach Scully, there is no genetic blueprint for human beings. Rather, genetic variation is constant. Thus, notes Scully, genetic discourse could free medical discourse from the dictates of the binary between normal and abnormal, although mistaken belief in a genetic blueprint can foil this alternative way of speaking and thinking. Prenatal testing has received critical philosophical attention from both disability theorists and feminists. Adrienne Asch suggests that prenatal testing and diagnosis stigmatizes already-existing persons with disabilities by suggesting that bodily deviance is intolerable. Licia Carlson coined the phrase “prenatal prototypes” to describe the obfuscating results of genetic profiling carried out on the fetus. The philosophical conversation Asch and Carlson stimulate involves higher stakes now that testing uncovers fetal genotype and reveals mere genetic deviation in order to aid reproductive decision-making. I argue that prenatal testing, and especially the most recently developed testing procedures described above, forecloses Scully’s alternative discourse of genetic variation by supporting an ideal of a singular “healthy genotype,” deviance from which is to be uncovered and avoided. Mobilizing this insight by drawing on the work of feminist disability scholars like Asch and Carlson, I seek to foreground the play between norm and deviance. I expose the normalizing field of statistical risk, operating in excess of medical diagnosis, which requires potential parents to manage and avoid deviance itself. (shrink)

This philosophical study examines the way in which we think, argue, feel and act about sex. By extension, the author also relates this to the problems of morality and sexual behaviour in society.

Based on practical and thoroughly researched information, this book provides a much-needed framework for understanding the causes and developing solutions to the problem of sexual aggression.

In 2007 th eAustralian government declared that remote Aboriginal communities were in crisis and launched the Northern Territory Intervention.

Presents a portrait of Alamaba rivers, from their origins in the Appalachian highlands to their confluence with the Gulf of Mexico, and promotes the stewardship and preservation of these natural regions.

The partnership between a visually impaired runner (VIR) and sighted guide runner (SGR) constitutes a unique sporting dyad. The quality of these partnerships may profoundly impact the sport and physical activity (PA) experiences of visually impaired (VI) people, yet little is known about the experiences of VIRs and SGRs. This study aimed to explore qualitatively the running experiences of VIRs and SGRs. Five VIRs and five SGRs took part in in-depth, semi-structured interviews (M length = 62 minutes) exploring their running (...) journeys and perceptions of running-together. We analysed the dataset using reflexive thematic analysis. Four themes were generated, comprising: becoming and being a running team; a multifaceted intercorporeal experience; running-together promotes change; and disabling social interaction within running. Participants were generally positive about their running experiences, highlighting a range of benefits derived from the activity. Nevertheless, some examples of barriers to participation were also identified. Although the positive experiences described by the runners suggest guided running holds promise to increase PA in VI people, our findings illustrate the importance of directing attention towards developing high-quality relationships between VIRs and guides, alongside reinforcing the need for further change to promote inclusivity. (shrink)

The philosophical problem of the relation of symbol to truth is far from solved, but there have been significant advances toward its solution. It is the common Christian understanding that God is Truth , and that all truths must ultimately find union in him. This is to say that all genuine truths must be compatible. The true conclusions of genuine science must be compatible with the true conclusions of genuine theology. Or, to bring this general statement to a more particular (...) level, the true conclusions of Biblical scholarship must be compatible with the true conclusions of the natural sciences. When this compatibility is lacking, and it so often is, we must assume that the conclusions of one field of truth-seeking or the other do not partake of the Truth which is God. And there is no guarantee that theology as a field of truth-seeking cannot err. Another characteristic of genuine truth is that it is not dependent upon any particular environment or milieu —either social, cultural, philosophical, or even theological. Unless we are to make the common but dangerous division of sacred and secular, of holy and profane, claim that these areas of human experience have nothing to do the one with the other, compartmentalise our thought, and ask, ‘What has Athens to do with Jerusalem?’, it must be concluded that there is no one specifically Christian milieu . Genuine truths must be true at all times, in all places, and for all men. But since we are not gods, we must hold these truths in what St Paul called earthen vessels , vessels shaped and moulded by our particular milieu. (shrink)

Transfers of critically ill neonates are frequent phenomena. Even though parents’ participation is regarded as crucial in neonatal care, a transfer often means that parents and neonates are separated. A systematic review of the parents’ experiences of neonatal transfer is lacking. This paper describes a meta‐study addressing qualitative research about parents’ experiences of neonatal transfer. Through deconstruction and reflections of theories, methods, and empirical data, the aim was to achieve a deeper understanding of theoretical, empirical, contextual, historical, and methodological issues (...) of qualitative studies concerning parents’ experiences of neonatal transfer over the course of this meta‐study (2000–2017). Meta‐theory and meta‐method analyses showed that caring, transition, and family‐centered care were main theoretical frames applied and that interviewing with a small number of participants was the preferred data collection method. The meta‐data‐analysis showed that transfer was a scary, unfamiliar, and threatening experience for the parents; they were losing familiar context, were separated from their neonate, and could feel their parenthood disrupted. We identified ‘wavering and wandering’ as a metaphoric representation of the parents’ experiences. The findings add knowledge about meta‐study as an approach for comprehensive qualitative research and point at the value of meta‐theory and meta‐method analyses. (shrink)

The current review provides an overview of published research on teachers’ causal attributions since 1970s in the context of theoretical assumptions outlined in Weiner’s attribution theory (1972, 1985, 2000, 2001, 2010). Results across 79 studies are first examined with respect to the prevalence of teachers’ interpersonal causal attributions for student performance and misbehavior, as well as intrapersonal attributions for occupational stress. Second, findings showing significant relations between teachers’ attributions and their emotions and cognitions, as well as student outcomes, are discussed. (...) Third, an overview of results showing the prevalence and implications of teachers’ causal attributions to be moderated by critical background variables is also provided. Finally, observed themes across study findings are highlighted with respect to the fundamental attribution error and the utility of Weiner’s attribution theory for understanding how teachers’ explanations for classroom stressors impact their instruction, well-being, and student development. (shrink)

John C. Hall; III—Quantity of Pleasure, Proceedings of the Aristotelian Society, Volume 67, Issue 1, 1 June 1967, Pages 35–52, https://doi.org/10.1093/aristotel.