This is the first book to take nursing ethics beyond stock 'moral concepts' to a critical examination of the fundamental assumptions underlying the very nature of nursing. It takes as its point of departure the difficulties nurses experience practising within the confines of a bioethical model of health and illness and a hierarchical, technocratic health care system. The contributors go on to deal openly and honestly with controversial issues faced by nurses, such as euthanasia and HIV.

This is the first book to take nursing ethics beyond stock 'moral concepts' to a critical examination of the fundamental assumptions underlying the very nature of nursing. It takes as its point of departure the difficulties nurses experience practising within the confines of a bioethical model of health and illness and a hierarchical, technocratic health care system. The contributors go on to deal openly and honestly with controversial issues faced by nurses, such as euthanasia and HIV.

This article takes issue with procedural reductionism, which is the inclination to reduce all matters of judgement and responsibility to the following of some procedure or rule. Two scenarios provide content for a discussion of professional discretion in the context of accountability. The author shows that in professional life there will always be situations that stand beyond the rules of procedures and require the unique judgement of the professional at the time. While this judgement may be determined by the facts (...) available in a situation of uncertainty, it cannot be reduced to the facts (including facts about rules and procedures). The moral judgement will still have an essential indeterminancy about it. (shrink)

In this article I attempt to transcend the mainstream conception of health care ethics, including nursing ethics, by bringing into the foreground a tension between a sense of life and an industrial-bureaucratic style of health care, with its emphasis on the systematic and procedural work culture necessary for mass production. I use the concept of ‘a sense of life’ to draw attention to the wisdom, sensitivity and responsibility that is necessary for the authentic care of others to be given a (...) chance in the development of modern health care. I emphasize the mindfulness that the professional requires for genuine care, and how the systematic organization of modern health care, on the whole, ignores, obstructs and even suppresses such mindfulness. (shrink)

This article considers the development of nurse-led services as a part of a pilot study and explores the therapeutic nature of the role of the nurse. In particular it suggests a need for reconsideration of the fundamental values of nurse-led care in the context of changing organizational culture. Within the UK there has been pressure from policy makers to extend the role of the specialist nurse and create new nursing roles, shifting the boundaries between professional health groups. The philosophy of (...) nurse-led initiatives has therefore been driven mainly from a service redesign and clinical need standpoint rather than necessarily focusing on enhancing patients’ experience and the changes in organizational culture required to achieve this. While several studies have focused on the safety, comparative cost and comparative patient outcomes in nurse-led care in relation to traditional or doctor-led care, little attention has been given to the changing organizational values underlying the nursing role. Exploring this context is essential if new nursing roles are to provide more than relief for bottlenecks in the system and also meet their potential for providing patient centred and innovative models of care. (shrink)

Western civilization has probably reached an impasse, expressed as a crisis on all fronts: economic, technological, environmental and political. This is experienced on the cultural level as a moral crisis or an ethical deficit. Somehow, the means we have always assumed as being adequate to the task of achieving human welfare, health and peace, are failing us. Have we lost sight of the primacy of human ends? Governments still push for economic growth and technological advances, but many are now asking: (...) economic growth for what, technology for what? Health care and nursing are caught up in the same inversion of human priorities. Professionals, such as nurses and midwives, need to take on social responsibilities and a collective civic voice, and play their part in a moral regeneration of society. This involves carrying civic rights and duties into the workplace. (shrink)

Social, legal and health-care changes have created an increasing need for ethical review within end-of-life care. Multiprofessional clinical ethics committees (CECs) are increasingly supporting decision-making in hospitals and hospices. This paper reports findings from an analysis of formal summaries from CEC meetings, of one UK hospice, spanning four years. Using qualitative content analysis, five themes were identified: timeliness of decision-making, holistic care, contextual openness, values diversity and consensual understanding. The elements of an engaged clinical ethics in a hospice context is (...) not generally acknowledged nor its elements articulated. Findings from this study have the potential to explain some of the most challenging ethical problems and to contribute to their resolution. It may also guide future deliberation and raise CEC members' awareness of the recurrent issues and values of their CEC practice. (shrink)

The authors believe there is a need for novel ways of enhancing professional judgment and discretion in the contemporary healthcare environment. The objective is to provide a framework to guide a discursive analysis of an ongoing clinical scenario by a small group of healthcare professionals to achieve consensual understanding in the decision-making necessary to resolve specific healthcare inadequacies and promote organisational learning. REPVAD is an acronym for the framework’s five decision-making dimensions of reasoning, evidence, procedures, values, attitudes and defences. The (...) design is set out in terms of well-defined definitions of the dimensions, a rationale for using REPVAD, and explications of dimensions one at a time. Furthermore, the REPVAD process of application to a scenario is set out, and a didactic scenario is given to show how REPVAD works together with a sample case. A discussion is fleshed out in four real life student cases, and a conclusion indicates strengths and weaknesses and the possibility of further development and transferability. In terms of findings, the model has been tried, tested and refined over a number of years in the development of advanced practitioners at university healthcare faculties in two European countries. Consent was obtained from the four participating students. (shrink)

Abortion is one of the great moral debates of the epoch. Is there a rational method by which the debate can be resolved? Can bioethics' promise of such a method be fulfilled? Surely, a strictly rational approach can establish solid grounds for our beliefs once and for all. We would then be justified in deeming as unreasonable anyone who does not accept the perfectly rational conclusions. I present two scenarios to show that there can be no such philosophically grounded method (...) and therefore no such facts to which everyone must agree. This does not mean that it is in fact impossible for people to reach agreement. It simply means that there is no incontrovertibly rational means by which they must do so. (shrink)

China, India, Brazil and other major Third World nations have long refused to sign the Nuclear Non‐proliferation Treaty. This position might at first sight appear to be without any question morally unjustified and even irrational. Yet their claim that the treaty is ‘discriminatory’ merits the serious attention which it has not received. Only if certain aspects of this claim are accepted by the nuclear weapons signatories does a moral and rational onus to sign become unquestionable.

The assumptions of philosophy need scrutiny as much the assumptions of medicine do. Scrutiny shows that the philosophical method of bioethics is compromised, for it shares certain fundamental assumptions with medicine itself. To show this requires an unorthodox style of philosophy — a literary one. To show the compromised status of bioethics the paper discusses some seminal utilitarian discussions of the definition of death, of whether it is a bad thing, and of when it ought to occur.

The paper attempts to account for the confusion over the validity of the concept of schizophrenia in terms of two closely related aspects of conceptual indeterminacy. Firstly, it is identified on the basis of a breakdown in intelligibility, but what constitutes such a breakdown is indeterminate. Secondly, the concept sits between the categories of natural disease or illness on the one hand, and character trait or moral failing or gift on the other. This entails an indeterminacy in attempting to define (...) the role that physiological explanation could have. Light may be thrown on the concept by exploring a distinction between a life story in which the schizophrenic condition emerges as the conclusion of the story and a causal process in which the condition is the end result or final consequence. (shrink)

This article takes issue with procedural reductionism, which is the inclination to reduce all matters of judgement and responsibility to the following of some procedure or rule. Two scenarios provide content for a discussion of professional discretion in the context of accountability. The author shows that in professional life there will always be situations that stand beyond the rules of procedures and require the unique judgement of the professional at the time. While this judgement may be determined by the facts (...) available in a situation of uncertainty, it cannot be reduced to the facts (including facts about rules and procedures). The moral judgement will still have an essential indeterminancy about it. (shrink)

Finocchiaro offers an interpretation of Antonio Gramscis Prison Notebooks. He is interested in Gramscis thoughts on politics, social science, and religion but tells us that he is not concerned directly with the content of these. Such details are best worked out after we know what he means by religion, science and politics (5). He thinks that Gramscis conceptual framework must be identified first so that one can then proceed to find more order in the Notebooks (5). There follows an extended (...) discussion of what Gramsci says about his method and the method of Croce, Bukharin, and Machiavelli. Unfortunately, the crucial question of the relation of Gramscis thought to that of Marx is not considered in any depth. (shrink)

One of the ideas elaborated in my recent book is what I called the hermeneutical\nprinciple of the asymmetry between negative and positive evaluation: ’this\nprescribes that the textual evidence needed to justify a negative, unfavourable\nevaluation must be of a high quality, strength, and rigor, whereas for a positive\nevaluation less exacting standards are sufficient’ (Finocchiaro, 1988: 247). There,\nI applied this principle to several cases, relating in one way or another to\nGramsci: some were his critiques of other authors, some were my own critiques\nof (...) his ideas, and some were critiques by others; and the issues involved such\nquestions as the status of Marxism as a religion, as a science, and as politics.\nI believe the principle ought to be applied to book reviews. Now, Geoffrey\nHunt’s recent review of my book in this journal (Hunt, 1990) seems to me to be a\nclear violation of this principle, and therefore an answer to it will not only set the\nrecord straight, but may prove generally instructive. That is, his review devotes a\ngreat deal of space to criticizing my work, and very little to analysing, describing,\nor even summarizing it; and whatever description we find, it is largely inaccurate,\nunfair, and one-sided. In short, what he advances is a negative evaluation of my\nbook not properly and adequately documented and justified. (shrink)

Are historians storytellers? Is it possible to tell true stories about the past? These are just a couple of the questions raised in this comprehensive collection of texts about philosophy, theory, and methodology of writing history. Drawing together seminal texts from philosophers and historians, this volume presents the great debate over the narrative character of history from the 1960s onwards. The History and Narrative Reader combines theory with practice to offer a unique overview of this debate and illuminates the practical (...) implications of these philosophical debates for the writing of history. The editor's introduction offers a succinct survey of the subject to support the readings, which explore the role of narrative in everything from historical understanding and human action to linguistics and the practice of history. Including the work of F. R. Ankersmit, David Carr, Hayden White, W. H. Dray, and Frederick Olafson; a detailed bibliography; and a glossary of key concepts, this collection will prove an invaluable resource for students of historical theory and methodology. (shrink)

ABSTRACT The Great Exhibition of 1851 is generally interpreted as a thoroughly secular event that celebrated progress in science, technology, and industry. In contrast to this perception, however, the exhibition was viewed by many contemporaries as a religious event of considerable importance. Although some religious commentators were highly critical of the exhibition and condemned the display of artifacts in the Crystal Palace as giving succor to materialism, others incorporated science and technology into their religious frameworks. Drawing on sermons, tracts, and (...) the religious periodical press, this essay pays close attention to the ways in which science and technology were endowed with providentialist significance and particularly examines the notion of human progress used by a number of Christian writers, especially Congregationalists, who set scientific and technological progress within a teleological religious perspective. This discussion sheds fresh light not only on the Great Exhibition itself but also on the deployment of natural theology in mid-nineteenth-century Britain. (shrink)

This extraordinary book offers a clear and compelling biography of Jacques Derrida along with one of Derrida's strangest and most unexpected texts. Geoffrey Bennington's account of Derrida leads the reader through the philosopher's familiar yet widely misunderstood work on language and writing to the less familiar themes of signature, sexual difference, law, and affirmation. In an unusual and unprecedented "dialogue," Derrida responds to Bennington's text by interweaving Bennington's text with surprising and disruptive "periphrases." Truly original, this dual and dueling (...) text opens new dimensions in Derrida's thought and work. "Bennington is a shrewd and well-informed commentator whose book should do something to convince the skeptics... that Jacques Derrida's work merits serious attention."—Christopher Norris, _New Statesman & Society_ "Geoffrey Bennington and Jacques Derrida have presented a fascinating example of what might be called post-structuralist autobiography."—Laurie Volpe, _French Review_ "Bennington's account of what Derrida is up to is better in almost all respects—more intelligent, more plausible, more readable, and less pretentious—than any other I have read."—Richard Rorty, _Contemporary Literature_. (shrink)

I first argue that the Matrix trilogy is a Gnostic cyber-epic; I then use this interpretive lens to review the films' treatment of fundamental questions in epistemology, metaphysics, and value theory.

Subtle-body practices are found particularly in Indian, Indo-Tibetan and East Asian societies, but have become increasingly familiar in Western societies, especially through the various healing and yogic techniques and exercises associated with them. This book explores subtle-body practices from a variety of perspectives, and includes both studies of these practices in Asian and Western contexts. The book discusses how subtle-body practices assume a quasi-material level of human existence that is intermediate between conventional concepts of body and mind. Often, this level (...) is conceived of in terms of an invisible structure of channels, associated with the human body, through which flows of quasi-material substance take place. Contributors look at how subtle-body concepts form the basic explanatory structure for a wide range of practices. These include forms of healing, modes of exercise and martial arts as well as religious practices aimed at the refinement and transformation of the human mindbody complex. By highlighting how subtle-body practices of many kinds have been introduced into Western societies in recent years, the book explores the possibilities for new models of understanding which these concepts open up. It is a useful contribution to studies on Asian Religion and Philosophy. (shrink)

The words we call slurs are just plain vanilla descriptions like ‘cowboy’ and ‘coat hanger’. They don't semantically convey any disparagement of their referents, whether as content, conventional implicature, presupposition, “coloring” or mode of presentation. What distinguishes 'kraut' and 'German' is metadata rather than meaning: the former is the conventional description for Germans among Germanophobes when they are speaking in that capacity, in the same way 'mad' is the conventional expression that some teenagers use as an intensifier when they’re emphasizing (...) that social identity. That is, racists don’t use slurs because they’re derogatory; slurs are derogatory because they’re the words that racists use. To use a slur is to exploit the Maxim of Manner (or Levinson’s M-Principle) to signal one’s affiliation with a group that has a disparaging attitude towards the slur’s referent. This account is sufficient to explain all the familiar properties of slurs, such as their speaker orientation and “nondetachability,” with no need of additional linguistic mechanisms. It also explains some features of slurs that are rarely if ever explored; for example the variation in tone and strength among the different slurs for a particular group, the existence of words we count as slurs, such as 'redskin', which almost all of their users consider to be respectful, and the curious absence in Standard English of any commonly used slurs—by which I mean words used to express a negative attitude toward an entire group—for Muslims and women. (shrink)

ABSTRACT The Great Exhibition of 1851 is generally interpreted as a thoroughly secular event that celebrated progress in science, technology, and industry. In contrast to this perception, however, the exhibition was viewed by many contemporaries as a religious event of considerable importance. Although some religious commentators were highly critical of the exhibition and condemned the display of artifacts in the Crystal Palace as giving succor to materialism, others incorporated science and technology into their religious frameworks. Drawing on sermons, tracts, and (...) the religious periodical press, this essay pays close attention to the ways in which science and technology were endowed with providentialist significance and particularly examines the notion of human progress used by a number of Christian writers, especially Congregationalists, who set scientific and technological progress within a teleological religious perspective. This discussion sheds fresh light not only on the Great Exhibition itself but also on the deployment of natural theology in mid-nineteenth-century Britain. (shrink)

Norms are a pervasive yet mysterious feature of social life. In Explaining Norms, four philosophers and social scientists team up to grapple with some of the many mysteries, offering a comprehensive account of norms: what they are; how and why they emerge, persist and change; and how they work.

This illustrated tale introduces children to the wondrous teachings from the Muslim theologian and mystic al-Ghazali (1058–1111CE) This enchanting tale illustrates how that the human heart is like a rusty mirror which, when polished through beautiful doings, is able to reflect the real essence of all things. In addition to this story is a poem by the renowned poet, Coleman Barks. Both draw on the same account found in Ghazali's The Marvels of the Heart, Book XXI, of his magnum opus,The (...) Revival of Religious Sciences. (shrink)