In recent years there has been an increasing critique of the philosophically based reasoning in bioethics which is known as principlism. This article seeks to make a postmodern contribution to this emerging debate by using notions of power and discourse to highlight the limits and superficiality of this , rationalistic mode of reflection. The focus of the discussion will be on the principle of autonomy. Recent doctoral research on a hospice organization (Karuna Hospice Service) will be used to contextualize the (...) debate to end-of life ethical dilemmas. The conclusion will be reached that the discursive richness of this organization's notion of autonomy or choice, which incorporates a holistic respect for the individual and the active creation of alternatives, can provide important insights to our understanding of autonomy in bioethics. The concern is raised that if autonomy is reified as a principle outside of the context of discourse, it may only complement the hegemonic power of biomedicine. (shrink)

It is now common in health care for a diverse range of professions and disciplines to work together in regular and close contact. Thus, there are now calls in the literature for research that documents insights on the ethical dimension of multidisciplinary relationships. Recent Australian research has responded to this call by examining how a multidisciplinary team of health professionals define and operationalize the notion of ethics in an acute ward hospital setting. This article provides findings from the research study (...) that indicate that, although there is a shared conceptualization of ethics as "patient-centered care", there can be times of conflict and tension in determining what is best for the patient. The discussion begins to build an understanding of how a multidisciplinary mix of health professionals responds to ethical conflict and tension. The authors' hope and expectation is that, by keeping the research focus on what health professionals in a multidisciplinary team (MDT) actually do, rather than exclusively on how they philosophically think about ethical dilemmas, the insights can be translated into practical strategies that can be utilized to strengthen the process of ethical decision making within the health care system. (shrink)

This paper explores the bioethical issues associated with the diagnosis and treatment of vulvar cancer for Indigenous women in East Arnhem Land, Northern Territory, Australia. Based on a qualitative study of a vulvar cancer cluster of Indigenous women, the article highlights four main topics of bioethical concern drawn from the findings: informed consent, removal of body parts, pain management, and issues at the interface of Indigenous and Western health care. The article seeks to make a contribution towards Indigenous health and (...) bioethics and bring to light areas of further research. (shrink)

This article presents the findings of qualitative research which explored, from the mothers’ perspective, the process of decision-making about mode of delivery for a subsequent birth after a previous Caesarean Section. In contradiction to the clinical literature, the majority of mothers in this study were strongly of the opinion that a vaginal birth after caesarean (VBAC) posed a higher risk than an elective caesarean (EC). From the mothers’ perspective, risk discussions were primarily valuable for gaining support for their pre-determined choice, (...) rather than obtaining information. The findings posit ethical concerns with regards to informed consent and professional obstetric practice at a time when there is a documented and worrying trend towards an increase in births by caesarean section (CS). (shrink)

Although mainstream research institutions and health care organisations are now starting to acknowledge the important contribution of qualitative research, there are still many obstacles to obtaining funding. Consequently, at all points along the continuum of obtaining funds, enrolling participants and conducting the research, qualitative researchers will benefit from being able to refer to, or reference, a body of empirical knowledge that addresses ethical issues raised by those who have responsibility for decision-making about the implementation of research proposals. This article has (...) been written with this strategy in mind. One such ethical issue is a concern about the impact on participants of being involved in qualitative studies when they are in a vulnerable state from a distressing life experience. This article provides empirical data that describes the benefits associated with qualitative research process for parents enrolled in a longitudinal study looking at the issues associated with the diagnosis and treatment for paediatric haematological malignancies. The empirical findings affirm the significant beneficial contribution that qualitative research can make to the lives of those coping with an extremely challenging health care situation. (shrink)

The insights provided by a multi-disciplinary mix of health professionals from an acute medical ward of a regional Australian hospital indicate the value in extending the role of Hospital Ethics Committees to incorporating both ethics consultation and ethics education. It is the hope and expectation that the findings will assist other HECs in a similar stage of development.

The purpose of this article is to share with the reader the specific findings on the role of nurse as consumer advocate from a study on ethical decision-making in an emergency department (ED). Qualitative interviews were conducted with 11 health professionals (doctors and nurses) working in the ED of a hospital. The interviews were audio-recorded, transcribed verbatim and thematically analysed.In ED, where the decision-making is described as medico-centric, advocacy ipso facto necessitates a challenge to doctor decision-making. The findings indicate that (...) ED nurses experience with advocacy varied depending on the democratic qualities and communication skills of the particular doctor who had care of the consumer. It is noted that seeing the need for advocacy does not necessarily translate into effective action, as management support is essential for productive advocacy. A phenomenon of the desire not to rock the boat was reported. The findings indicate that the support of other nurses is essential for advocacy and affirm the importance of focusing on the ethical nature of the organisation as opposed to an exclusive focus on the individual. (shrink)

In recent years the literature on bioethics has begun to pose the sociological challenge of how to explore organisational processes that facilitate a systemic response to ethical concerns. The present discussion seeks to make a contribution to this important new direction in ethical research by presenting findings from an Australian pilot study. The research was initiated by the Clinical Ethics Committee of Redland Hospital at Bayside Health Service District in Queensland, Australia, and explores health professionals’ understanding of the nature of (...) ethics and their experience with ethical decision-making within an acute medical ward. This study focuses on the actual experience, understanding and attitudes of clinical professionals in a general medical ward. In particular, the discussion explores the specific findings from the study concerned with how a multi-disciplinary team of health professionals define and operationalise the notion of ethics in an acute ward hospital setting. The key issue reported is that health professionals are not only able to clearly articulate notions of ethics, but that the notions expressed by a multi-disciplinary diversity of participants share a common definitional concept of ethics as patient-centred care. The central finding is that all professional groups indicated that there is a guiding principle to address their ethical sense of the ‘good’ or the ‘ought’ and that is to act in a way that furthered the interests of patients and their families. The findings affirm the importance of a sociological perspective as a productive new direction in bioethical research. (shrink)

Despite the extensive consideration the notion of informed consent has heralded in recent decades, the unique considerations pertaining to the giving of informed consent by and on behalf of Indigenous Australians have not been comprehensively explored; to the contrary, these issues have been scarcely considered in the literature to date. This deficit is concerning, given that a fundamental premise of the doctrine of informed consent is that of individual autonomy, which, while privileged as a core value of non-Indigenous Australian culture, (...) is displaced in Indigenous cultures by the honouring of the family unit and community group, rather than the individual, as being at the core of important decision-making processes relating to the person. To address the hiatus in the bioethical literature on issues relating to informed consent for Aboriginal peoples, the following article provides findings from a two-year research project, funded by Australia’s National Health and Medical Research Council (NHMRC), conducted in the Northern Territory. The findings, situated in the context of the literature on cultural safety, highlight the difference between the Aboriginal and biomedical perspectives on informed consent. (shrink)

Introduction -- Tending the dark fire: the Boehmian notion of drive -- The night-side of nature: the early Schellingian unconscious -- The speculative psychology of dissociation: the later Schellingian unconscious -- Schellingian libido theory.

Because health care professions exist to provide a good for society, ethical questions are inherently part of them. Such professions and their members can be assessed based on how effective they are in developing knowledge and enacting practices that further the health and well‐being of individuals and society. The complexity of contemporary health care environments makes it important to prepare clinicians who can anticipate, recognize, and address problems that arise in practice or that prevent a profession from fulfilling its service (...) goals and obligations. Different health care professions have evolved distinct perspectives about appropriate goals for, and the purposes of, their clinicians, even when the goal of improving health and well‐being for society is shared across professions. While medicine and nursing goals are shared in principle, they differ in the particulars. Given the centrality to nursing of ethical questions, the profession has a collective responsibility to help clinicians at all levels of practice become ethically savvy and to reinforce their moral agency as needed. Both knowledge of nursing ethics and knowledge of the interdisciplinary field of bioethics are critical to nursing work. (shrink)

This paper examines the extent to which parents have absorbed New Right ideas about education and acted accordingly. What emerges is that their commitment to the rhetoric of school choice is strong. However, concepts such as the market and competition are viewed less favourably. An important theme here is the avoidance by parents of any collective agenda in discussing education policy, a factor that may thwart those who attempt to predict their responses to government policy for schools.

There is a growing trend in Australia to require lawyers to certify reasonable prospects of success for the cases they bring and defend. New South Wales has led the way with the Legal Profession Act 2004 (NSW) Pt 3.2 Division 10 requiring legal practitioners to certify reasonable prospects of success in all claims for damages. The requirement places a significant onus on lawyers to make a judgment about the merits of a case before it is begun, yet the common law (...) has long provided mechanisms to ensure that cases without prospects of success do not go to trial. This article considers Australian legislative provisions requiring lawyers to certify reasonable prospects of success of cases. It examines the application of the NSW legislation by the courts highlighting the difficulties of interpretation of what constitute 'reasonable prospects of success' and the application of the legislation in the context of the dynamic litigation process. It is argued that these legislated obligations on lawyers will have a detrimental effect on access to justice by denying parties, in particular plaintiffs, the opportunity to have their cases properly and fully determined in the courts. This article examines common law mechanisms for dissuading cases without prospects and argues that the general law is an effective system for ensuring that cases without prospects of success are not maintained. The Australian experience is instructive for consideration of optimal reform packages for the administration of justice and to evaluate the role of any litigation lawyer within the judicial and court process. (shrink)

Advances in life-sustaining medical technology as applied to neonatal cases frequently present ethical concerns with a strong emotional component. Neonates delivered in the gestation period of approximately 23held hostagemoral distress” regarding aggressive courses of treatment for some patients. Some of this distress results from a feeling of powerlessness regarding treatment decisions, coupled with a high intensity of hands-on contact with the patients and family. Lack of authority coupled with high responsibility may itself be a recipe for a different kind of (...) futility. (shrink)

This article offers a fresh assessment of the views of the American paleontologist and evolutionary biologist Stephen Jay Gould on the relation of science and religion. Gould is best known for his celebrated notion of “nonoverlapping magisteria,” which is often seen in somewhat negative terms as inhibiting dialogue. However, as a result of his critique of the unificationist approach to knowledge developed in Edward O. Wilson's Consilience, Gould later made increased use of the more positive notion of a “consilience of (...) equal regard,” which recognized the porous nature of disciplinary divides and the propriety of interdisciplinary dialogue. Gould's final views on the relation of science and religion, set out in The Hedgehog, the Fox, and the Magister's Pox, published after his death, affirms the distinctiveness and autonomy of science and religion on the one hand, while encouraging their constructive dialogue and productive interaction on the other. This should now be seen as Gould's definitive statement on this question. (shrink)

Mark Balaguer has written a provocative and original book. The book is as ambitious as a work of philosophy of mathematics could be. It defends both of the dominant views concerning the ontology of mathematics, Platonism and Anti-Platonism, and then closes with an argument that there is no fact of the matter which is right.

Introduction -- Fallibilism -- Contextualism -- Knowledge and reasons -- Justification -- Belief -- The value and importance of knowledge -- Infallibilism or pragmatic encroachment? -- Appendix I: Conflicts with bayesian decision theory? -- Appendix II: Does KJ entail infallibilism?

Issues surrounding the inclusion of transgender and intersex athletes in the women’s category in sport have spurred vigorous, and sometimes vicious, debate. The loudest voices on one edge of the de...

Publisher's description: The New Dictionary of Christian Apologetics is a must-have resource for professors and students, pastors and laypersons - in short, for any Christian who wishes to understand or develop a rational explanation of the Christian faith in the context of today's complex and ever-changing world. Including hundreds of articles that cover key topics, historic figures and contemporary global issues relating to the study and practice of Christian apologetics, this handy one-volume resource will make an invaluable addition to any (...) Christian library. The dictionary is divided into two parts: Part one offers a series of introductory essays that set the framework for the dictionary. These essays examine the practice and importance of Christian apologetics in light of theological, historical and cultural concerns. Part two builds on these essays to present numerous alphabetized articles on individuals, ideas, movements and disciplines that are vital to a rational explanation of the Christian faith. Both essays and articles are written by leading Christian philosophers and theologians. Together, they form an indispensable resource for Christians living in today's pluralistic age. (shrink)

This essay explores the efforts of forensic pathologists in the United States to establish the intellectual and social territory of their specialty, both inside and outside of medicine, and to control the institutional context of its practice. This process pitted forensic pathologists againstpowerful political machines for control of the coroner's office, where the application of medical knowledge legitimized social policy; against the legal profession for control of the application of forensic science in the courts; and against fellow members of the (...) American medical profession for control of entry to the specialty. (shrink)

In the academic year 1920-1921 at the University of Freiburg, Martin Heidegger gave a series of extraordinary lectures on the phenomenological significance of the religious thought of St. Paul and St. Augustine. The publication of these lectures in 1995 settled a long disputed question, the decisive role played by Christian theology in the development of Heidegger’s philosophy. The lectures present a special challenge to readers of Heidegger and theology alike. Experimenting with language and drawing upon a wide range of now (...) obscure authors, Heidegger is finding his way to Being and Time through the labyrinth of his Catholic past and his increasing fascination with Protestant theology. A Companion to Heidegger's Phenomenology of Religious Life is written by an international team of Heidegger specialists. (shrink)