Neoliberal ideology and exclusionary policies based on racialized identities characterize the current contexts in North America and Western Europe. Nursing knowledge cannot be abstracted from social, political and historical contexts; the task of examining the influence of race and racial ideologies on disciplinary knowledge and inquiry therefore remains an important task. Contemporary analyses of the role and responsibility of the discipline in addressing race‐based health and social inequities as a focus of nursing inquiry remain underdeveloped. In this article, we examine (...) nursing's engagement with ideas about race and racism and explore the ways in which nursing knowledge and inquiry have been influenced by race‐based ideological discourses. Drawing on Henry and Tator's framework of democratic racism, we consider how strategic discursive responses—the discourses of individualism, multiculturalism, colour‐blindness, political correctness and denial—have been deployed within nursing knowledge and inquiry to reinforce the belief in an essentially fair and just society while avoiding the need to acknowledge the persistence of racist discourses and ideologies. Greater theoretical, conceptual and methodological clarity regarding race, racialization and related concepts in nursing inquiry is needed to address health and social inequities. (shrink)

Although nursing has a unique contribution to advancing social justice in health care practices and education, and although social justice has been claimed as a core value of nursing, there is little guidance regarding how to enact social justice in nursing practice and education. In this paper, we propose a critical antidiscriminatory pedagogy (CADP) for nursing as a promising path in this direction. We argue that because discrimination is inherent to the production and maintenance of inequities and injustices, adopting a (...) CADP offers opportunities for students and practicing nurses to develop their capacity to counteract racism and other forms of individual and systemic discrimination in health care, and thus promote social justice. The CADP we propose has the following features: it is grounded in a critical intersectional perspective of discrimination, it aims at fostering transformative learning, and it involves a praxis‐oriented critical consciousness. A CADP challenges the liberal individualist paradigm that dominates much of western‐based health care, and the culturalist and racializing processes prevalent in nursing education. It also situates nursing practice as responsive to health inequities. Thus, a CADP is a promising way to translate social justice into nursing practice and education through transformative learning. (shrink)

We invite systematic consideration of the metaphors of cycles and circulation as a long-term theme in the history of the life and environmental sciences and medicine. Ubiquitous in ancient religious and philosophical traditions, especially in representing the seasons and the motions of celestial bodies, circles once symbolized perfection. Over the centuries cyclic images in western medicine, natural philosophy, natural history and eventually biology gained independence from cosmology and theology and came to depend less on strictly circular forms. As potent ‘canonical (...) icons’, cycles also interacted with representations of linear and irreversible change, including arrows, arcs, scales, series and trees, as in theories of the Earth and of evolution. In modern times life cycles and reproductive cycles have often been held to characterize life, in some cases especially female life, while human efforts selectively to foster and disrupt these cycles have harnessed their productivity in medicine and agriculture. But strong cyclic metaphors have continued to link physiology and climatology, medicine and economics, and biology and manufacturing, notably through the relations between land, food and population. From the grand nineteenth-century transformations of matter to systems ecology, the circulation of molecules through organic and inorganic compartments has posed the problem of maintaining identity in the face of flux and highlights the seductive ability of cyclic schemes to imply closure where no original state was in fact restored. More concerted attention to cycles and circulation will enrich analyses of the power of metaphors to naturalize understandings of life and their shaping by practical interests and political imaginations. (shrink)

The influence of liberal political ideology on nursing sciencePrevious notions of science as impartial and value-neutral have been refuted by contemporary views of science as influenced by social, political and ideological values. By locating nursing science in the dominant political ideology of liberalism, the author examines how nursing knowledge is influenced by liberal philosophical assumptions. The central tenets of liberal political philosophy — individualism, egalitarianism, freedom, tolerance, neutrality, and a free-market economy — are primarily manifested in relation to: (i) the (...) individualistic focus of our science; (ii) our view of society as essentially egalitarian and equitable; (iii) our preference for politically neutral knowledge development, and (iv) an economy of knowledge development that supports rather than challenges the status quo. I argue that exposing, rather than ignoring, the liberal ideological values inherent in nursing science will render these assumptions open to debate, stimulate ongoing development of critically oriented knowledge, and increase our capacity to influence the social, political and economic determinants of health. (shrink)

Two fundamentally different perspectives on knowledge diffusion dominate debates about academic disciplines. On the one hand, critics of disciplinary research and education have argued that disciplines are isolated silos, within which specialists pursue inward-looking and increasingly narrow research agendas. On the other hand, critics of the silo argument have demonstrated that researchers constantly import and export ideas across disciplinary boundaries. These perspectives have different implications for how knowledge diffuses, how intellectuals gain and lose status within their disciplines, and how intellectual (...) reputations evolve within and across disciplines. We argue that highly general claims about the nature of disciplinary boundaries are counterproductive, and that research on the nature of specific disciplinary boundaries is more useful. To that end, this paper uses a novel publication and citation network dataset and statistical models of citation networks to test hypotheses about the boundaries between philosophy of science and 11 disciplinary clusters. Specifically, we test hypotheses about whether engaging with and being cited by scientific communities outside philosophy of science has an impact on one’s position within philosophy of science. Our results suggest that philosophers of science produce interdisciplinary scholarship, but they tend not to cite work by other philosophers when it is published in journals outside of their discipline. Furthermore, net of other factors, receiving citations from other disciplines has no meaningful impact—positive or negative—on citations within philosophy of science. We conclude by considering this evidence for simultaneous interdisciplinarity and insularity in terms of scientific trading theory and other work on disciplinary boundaries and communication. (shrink)

Current general restrictions on performance-enhancing drugs pose a collective action problem that cannot be solved and bring a variety of adverse consequences for sport. General prohibitions of PEDs are grounded in claims that they violate the integrity of sport. But there are decisive arguments against integrity of sport-based prohibitions of PEDs for elite sport. We defend a harm prevention approach to PED prohibition as an alternative. This position cannot support a general ban on PEDs, since it provides no basis for (...) prohibiting non-harmful PED use. We argue that a harm prevention approach to restricting PEDs is ethically justified, has better prospects of compliance, is consistent with respecting the integrity of sport, and holds at least a modest prospect of resolving the collective action problem around PED restriction. (shrink)

Our intention is to contribute to the development of Canadian Nursing and Medical Education (NursMed) and efforts to redress deepening, intersecting health and social inequities. This paper addresses the following two research questions: (1) What are the ways in which Decolonial, Intersectional Pedagogies can inform Canadian NursMed Education with a focus on critically examining settler‐colonialism, health equity, and social justice? (2) What are the potential struggles and adaptations required to integrate Decolonial, Intersectional Pedagogies within Canadian NursMed Education in service of (...) redressing intersecting health and social inequities? Briefly, Decolonial, Intersectional Pedagogies are philosophies of learning that encourage teachers and students to reflect on health through the lenses of settler‐colonialism, health equity, and social justice. Drawing on critical ethnographic research methods, we conducted in‐depth interviews with 25 faculty members and engaged in participant observation of classrooms in university‐based Canadian NursMed Education. The research findings are organized into three major themes, beginning with common institutional features influencing pedagogical approaches. The next set of findings addresses the complex strategies participants apply to integrate Decolonial, Intersectional Pedagogies. Lastly, the findings illustrate the emotional and spiritual toll some faculty members face when attempting to deliver Decolonial, Intersectional Pedagogies. We conclude that through the application of Decolonial, Intersectional Pedagogies teachers and students can support movements towards health equity, social justice, and unlearning/undoing settler‐colonialism. This study contributes new knowledge to stimulate dialog and action regarding the role of health professions education, specifically Nursing and Medicine as an upstream determinant of health in settler‐colonial nations such as Canada, United States, Australia, and New Zealand. (shrink)

Non-medical sex selection is premised on the notion that the sexes are not interchangeable. Studies of individuals who undergo sex selection for non-medical reasons, or who have a preference for a son or daughter, show that they assume their child will conform to the stereotypical roles and norms associated with their sex. However, the evidence currently available has not succeeded in showing that the gender traits and inclinations sought are caused by a “male brain” or a “female brain”. Therefore, as (...) far as we know, there is no biological reason why parents cannot have the kind of parenting experience they seek with a child of any sex. Yet gender essentialism, a set of unfounded assumptions about the sexes which pervade society and underpin sexism, prevents parents from realising this freedom. In other words, unfounded assumptions about gender constrain not only a child’s autonomy, but also the parent’s. To date, reproductive autonomy in relation to sex selection has predominantly been regarded merely as the freedom to choose the sex of one’s child. This paper points to at least two interpretations of reproductive autonomy and argues that sex selection, by being premised on gender essentialism and/or the social pressure on parents to ensure their children conform to gender norms, undermines reproductive autonomy on both accounts. (shrink)

The Ebola epidemic that broke out inWest Africa West AfricaAfrica towards the end of 2013 had been brought under reasonable control by 2015. The epidemic had severely affected three countries. This case study is about a phase I/II clinical trial Phase I/II clinical trial of a candidate Ebola virus vaccine in 2015 in a sub-Saharan AfricanSub-Saharan Africa country which had not registered any cases of the Ebola virus disease. The study was designed as a randomized double-blinded trialRandomized double blinded trial. (...) It was sponsored and funded by one of the biggest Northern multinational pharmaceutical companiesPharmaceutical companies. The protocol received ethics clearance from the relevantNational Ethics Committee national ethics committeeEthics committee. The study was coordinated and managed at the local branch of a big Northern diagnostic laboratoryDiagnostic laboratory and a laboratory of a local regional hospital. The overall study was a multi-countryMulti-country, multi-siteMulti-site trial aimed at recruiting a total of 3,000 research participantsResearch participants across four or five sub-Saharan African countries. For this country, the recruitmentRecruitment sites were two big cities, each aiming to recruit 200 participants: adults at the first site and childrenChildren at the second. The target sampleSample size was almost achieved at the first site but, before the study commenced at the second site, some members of raised the alarm that the governmentGovernment was carelessly risking the health, safetySafety and lives of citizens in the cause of an unproven vaccine that could precipitate a public health disaster. The trial was immediately suspended. A commentary on this case, and on the importance of trustTrust, is provided by Katharine Browne and Doris Schroeder at the end of this chapter. It highlights differences between this case and a phase I Ebola vaccine trial in CanadaCanada in 2014. (shrink)

Cultural safety is a relatively new concept that has emerged in the New Zealand nursing context and is being taken up in various ways in Canadian health care discourses. Our research team has been exploring the relevance of cultural safety in the Canadian context, most recently in relation to a knowledge-translation study conducted with nurses practising in a large tertiary hospital. We were drawn to using cultural safety because we conceptualized it as being compatible with critical theoretical perspectives that foster (...) a focus on power imbalances and inequitable social relationships in health care; the interrelated problems of culturalism and racialization; and a commitment to social justice as central to the social mandate of nursing. Engaging in this knowledge-translation study has provided new perspectives on the complexities, ambiguities and tensions that need to be considered when using the concept of cultural safety to draw attention to racialization, culturalism, and health and health care inequities. The philosophic analysis discussed in this paper represents an epistemological grounding for the concept of cultural safety that links directly to particular moral ends with social justice implications. Although cultural safety is a concept that we have firmly positioned within the paradigm of critical inquiry, ambiguities associated with the notions of 'culture', 'safety', and 'cultural safety' need to be anticipated and addressed if they are to be effectively used to draw attention to critical social justice issues in practice settings. Using cultural safety in practice settings to draw attention to and prompt critical reflection on politicized knowledge, therefore, brings an added layer of complexity. To address these complexities, we propose that what may be required to effectively use cultural safety in the knowledge-translation process is a 'social justice curriculum for practice' that would foster a philosophical stance of critical inquiry at both the individual and institutional levels. (shrink)

First published in 1995. Routledge is an imprint of Taylor & Francis, an informa company.

Nurse practitioners (NPs) are increasingly called on to provide high‐quality health‐care particularly for people who face significant barriers to accessing services. Although discourses of social justice have become relatively common in nursing and health services literature, critical analyses of how NP roles articulate with social justice issues have received less attention. In this study, we examine the role of NPs from a critical social justice perspective. A critical social justice lens raises morally significant questions, for example, why certain individuals and (...) groups bear a disproportionate burden of illness and suffering; what social conditions contribute to disparities in health and social status; and what social mandate NPs ought to develop in response to these realities. In our analysis, we draw on lessons learned from the initial Canadian experience with the introduction of NPs in the 1970s to consider the renewed and burgeoning interest in NPs in Canada, Australia and elsewhere. As we argue, a critical social justice perspective (in addition to the biomedical foci of NP practice) will be essential to sustaining long‐term, socially responsive NP roles and achieving greater equity in health and health‐care. (shrink)

Structural Injustice has become a hugely important concept in the field of political theory with the work of Iris Marion Young central to debates on what it is, what motivates it and how it should be addressed. In this article, I focus on a particular thread in Young’s account of structural injustice which I argue is all too often overlooked - the untraceability of structural injustice. This is not only a constant theme in Young’s account of structural injustice, it is, (...) in fact, a defining feature. By ‘untraceable’, Young means that structural injustice is distinct from other sorts of injustices for which there is a traceable agent at fault – these sorts of faut-based injustices fall under what Young calls the ‘liability model of injustice’. For the purposes of exploring the concept of structural injustice, I follow the logic of the claim that structural injustice is untraceable to see where it takes us in conversation with Young’s critics. I conclude that Young’s account is not only defensible with some clarification and development but vital politically. That said, I also find Young’s account of political responsibility for structural injustice wanting and accordingly I propose a way of understanding what I see as a dynamic transition from structural to fault-based injustices which I argue Young’s more ‘static’ account fails to accommodate. This is important, I suggest, for thinking about the ways in which responsibility for different forms of injustice operate and change. _Contemporary Political Theory_ (2023). https://doi.org/10.1057/s41296-023-00634-4. (shrink)

Stresses on healthcare systems and moral distress among clinicians are urgent, intertwined bioethical problems in contemporary healthcare. Yet conceptualizations of moral distress in bioethical inquiry often overlook a range of routine threats to professional integrity in healthcare work. Using examples from our research on frontline physicians working during the COVID-19 pandemic, this article clarifies conceptual distinctions between moral distress, moral injury, and moral stress and illustrates how these concepts operate together in healthcare work. Drawing from the philosophy of healthcare, we (...) explain how moral stress results from the normal operations of overstressed systems; unlike moral distress and moral injury, it may not involve a sense of powerlessness concerning patient care. The analysis of moral stress directs attention beyond the individual, to stress-generating systemic factors. We conclude by reflecting on how and why this conceptual clarity matters for improving clinicians’ professional wellbeing, and offer preliminary pathways for intervention. (shrink)

Knowledge of one's own states of mind is one of the varieties of self-knowledge. Do any nonhuman animals have the capacity for this variety of self-knowledge? The question is open to empirical inquiry, which is most often conducted with primate subjects. Research with a bottlenose dolphin gives some evidence for the capacity in a nonprimate taxon. I describe the research and evaluate the metacognitive interpretation of the dolphin's behaviour. The research exhibits some of the difficulties attached to the task of (...) eliciting behaviour that both attracts a higher-order interpretation while also resisting deflationary, lower-order interpretations. Lloyd Morgan's Canon, which prohibits inflationary interpretations of animal behaviour, has influenced many animal psychologists. There is one defensible version of the Canon, the version that warns specifically against unnecessary intentional ascent. The Canon on this interpretation seems at first to tell against a metacognitive interpretation of the data collected in the dolphin study. However, the model of metacognition that is in play in the dolphin studies is a functional model, one that does not implicate intentional ascent. I explore some interpretations of the dolphin's behaviour as metacognitive, in this sense. While this species of metacognitive interpretation breaks the connection with the more familiar theory of mind research using animal subjects, the interpretation also points in an interesting way towards issues concerning consciousness in dolphins. (shrink)

ABSTRACTThe political is changing its shape. Ideologies are no longer stable, but instead build hybrid combinations. Populism is getting popular. In addition, there are new forms of political exper...

Elective ventilation (EV) is ventilation applied, not in the interest of patients, but in order to secure transplantable organs. It carries with it a small risk that patients who would otherwise have died will survive in a persistent vegetative state. Is EV ever justifiable? We argue: (1) The only thing which can justify exposing patients to risk not taken for their benefit is their consent, and we cannot rely on implied consent or third party consent in the case of EV. (...) Thus, absent explicit consent of patients, EV is not justifiable. (2) It is not clear that explicit consent should be sought, or where it is offered honoured, given the potential EV has for deterring organ donors and causing stress to staff and families. (shrink)

Infantologies is a collective writing project designed to express and summarise important ideas, approaches and forms of advocacy in a short and condensed method, in order to present a network of d...

At times of crisis, existing institutional arrangements of societies are thrown into question. Crises that occur in multiple societies simultaneously present rare opportunities for comparative empirical analysis. Social theory can reveal the framing conditions of the responses to crises and the sources of variations between them. This paper compares the immediate responses of the Australian, UK and US governments to the global COVID-19 pandemic, particularly with regard to financing lockdowns, and points out significant differences between the three approaches. Drawing on (...) Polanyi’s method of institutional analysis, we compare the responses of these same national groups to an earlier crisis, the Japanese prisoner of war camps during the Second World War, to show similar patterns of integration recurring eight decades apart. This analysis shows that aspects of moral economies that are not usually apparent can become pronounced during crises, and points to the importance of enduring social imaginaries. (shrink)

In this paper we continue an ongoing dialogue that has as its goal the critical appraisal of theoretical perspectives on culture and health, in an effort to move forward scholarship on culture and health. We draw upon a programme of scholarship to explicate theoretical tensions and challenges that are manifest in the discourses on culture and health and to explore the possibilities Bourdieu's theoretical perspective offers for reconciling them. That is, we hope to demonstrate the need to move beyond descriptions (...) ‘of’ culture to an understanding of cultures as dynamic, and to show ways cultural practices create contexts that have the potential to foster or impede health.In our early research, largely undertaken in Canada's multicultural context, we sought to make visible the ways in which culture shaped conceptions of health and influenced health practices of immigrant groups. In recent years this focus has expanded to include populations that reflect the cultural and social diversity of our region. From the outset we attempted to move towards a conception of culture as negotiated, unifying, transformative and dynamic. While this position continues to hold appeal we are continually reminded that, despite our leanings towards constructivism, there is salience to the notion of culture as having enduring elements. It is this tension between the view of culture as embodied and enduring and culture as constructed and dynamic that we seek to examine.We explore whether Bourdieu's theoretical perspective offers promise for reconciling these apparently competing views. Using exemplars from our research we share insights that Bourdieu's work has offered to our analyses, thereby enabling us to move towards a view of culture that holds in tension these apparently contradictory positions of culture as both essence (albeit unstable, negotiated) and constructed. (shrink)

Premenstrual dysphoric disorder was recently moved to a full category in the DSM-5 . It also appears set for inclusion as a separate disorder in the ICD-11 . This paper argues that PMDD should not be listed in the DSM or the ICD at all, adding to the call to recognise PMDD as a socially constructed disorder. I first present the argument that PMDD pathologises understandable anger/distress and that to do so is potentially dangerous. I then present evidence that PMDD (...) is a culture-bound phenomenon, not a universal one. I also argue that even if medication produces a desired effect, there are biological correlates with premenstrual anger/distress, such anger/distress seems to occur monthly, and women are more likely than men to be diagnosed with affective disorders, none of these factors substantiates that premenstrual anger/distress is caused by a mental disorder. I argue that to assume they do is to ignore the now accepted role that one’s environment and psychology play in illness development, as well as arguments concerning the social construction of mental illness. In doing so, I do not claim that there are no women who experience premenstrual distress or that their distress is not a lived experience. My point is that such distress can be recognised and considered significant without being pathologised and that it is unethical to describe premenstrual anger/distress as a mental disorder. Further, if the credibility of women’s suffering is subject to doubt without a clinical diagnosis, then the way to address this problem is to change societal attitudes towards women’s suffering, not to label women as mentally ill. The paper concludes with some broader implications for women and society of the change in status of PMDD in the DSM-5 as well as a sketch of critical policy suggestions to address these implications. (shrink)

SALMON A, BROWNE AJ, and PEDERSON A. Nursing Inquiry 2010; 17: 336–345 ‘Now we call it research’: participatory health research involving marginalized women who use drugsIn this paper, we discuss and analyse the strategies employed and challenges encountered when conducting a recent feminist participatory action research study with highly marginalized women who were illicit drug users in an inner city area of Vancouver, Canada. Through an analysis of the political economy of participatory praxis within current neoliberal contexts, we focus on (...) three main areas: (i) reconceptualizing the pragmatics of participation; (ii) the microeconomic implications of participatory research, including ethical issues in payment for research participation; and (iii) the value and limits of using research as a tool for activism and empowerment. We conclude with a brief discussion of what we see to be some of the most salient social justice implications arising from feminist and participatory approaches to health research within neoliberal political spaces. (shrink)

Hierarchy has been a central concern of work on the modern political imaginary. The need to elucidate hierarchy’s deeper sources and its legitimations were some of the motivations behind Cornelius Castoriadis’ development of the notion of the imaginary. The work of Claude Lefort on the political imaginary similarly commences from a critical analysis of the hierarchical form of bureaucracy and its place in the constitution of totalitarian political regimes. In a different vein, Charles Taylor’s conception of the imaginary details a (...) long-term process of the erosion of preceding forms of hierarchy and their justifications. In the contemporary period, the opposition to hierarchy has penetrated organisations and institutions that had previously been shaped by it, like the family, the capitalist firm, the school, and the political movement. Despite the potentials that these initiatives suggest of a change in the political imaginary, it will be argued that forms of hierarchy have, to varying degrees, been reconstituted and that the problem of hierarchy appears in new ideological forms, both with respect to institutionalised power and the legitimating justifications for how things are organised. The critique of hierarchy was once associated with the radical democratic imaginary, however, there have recently been perverse mobilisations. (shrink)

Mental health acts allow for interference with the liberty of the individual. As such, they serve as test cases for theories of liberty, and thus the question of what Mill would think about them arises. My aim is to answer this question. I argue that Mill would embrace mental health acts to protect mentally disturbed individuals from themselves and others from them, and that they should have broad admission criteria, allow capable patients to refuse treatment, and have treatment decisions made (...) by patients or their families on the basis of substituted judgements rather than representatives of the state acting on best interest judgements. This interpretation will show that many writers who claim Mill's support cannot properly do so. It is also a combination of views that cannot be readily found in mental health acts themselves, but which, as Mill's reasons for it show, is a serious candidate for legislative adoption. (shrink)

Tools and technologies expand our capacities, including our cognitive capacities. Microscopes extend our perceptual capacities. Notebooks extend the natural limits of memory. These facts are important, for all that they are obvious. The extended cognition hypothesis wants more. Some external devices and processes are literal parts of cognitive processes themselves. When there is fast and reliable access to external data or processes, then the cognitive processes that occur uncontroversially inside the brain literally and controversially extend out into the world to (...) incorporate external structures or processes. Retrieval of an address from memory and retrieval of the same information from a notebook can both be fully cognitive processes involving fully cognitive representations. So say the proponents of extended cognition.It is an attractive metaphor. But is there any good reason to take it as literal truth? Adams and Aizawa argue that the debate on extended cognition implicates an …. (shrink)

Why do so many people remain so passive in the face of today’s massive, looming economic, political, and ecological crises, such as climate change? Despite some notable rhetorical and regulatory examples, attempts to stem climate change have, as a rule, not come to frame the activities of most citizens. The inability to confront the imperative of social transformation today is a complex, manifold problem. At root, it has to do with fundamental systemic features of a global social system that we (...) all contribute to reproducing in our everyday lives. While these features do not preclude political engagement, innovation, and action, they do undermine the bases of movements towards truly systemic transformation. This article focuses on one such feature, reification, as a social-structural foundation of passivity that impedes the social innovations required to tackle the climate crisis. (shrink)

:Team reasoning is thought to be descriptively and normatively superior to the classical individualistic theory of rational choice primarily because it can recommend coordination on Hi in the Hi-Lo game and cooperation in Prisoner's Dilemma-type situations. However, left unanswered is whether it is rational for individuals to become team members, leaving a gap between reasons for individuals and reasons for team members. In what follows, I take up Susan Hurley's attempt to show that it is rational for an individual to (...) become a team member. I argue that her account fails to show that becoming a team member is necessary to gain the advantages of coordination in Hi-Lo games or cooperation in Prisoner's Dilemma-type situations, and that individuals will often fare better reasoning as individual agents than as members of a team. I argue further that there is a more general problem for team reasoning, specifically that the conditions needed to make it rational for a team member to employ team reasoning make becoming a team member unnecessary. (shrink)

Quality improvement mechanisms increasingly use outcome measures to evaluate health care providers. This move toward outcome measures is a radical departure from the traditional focus on process measures. More radical still is the proposal to shift from relatively simple and proximal measures of outcome, such as mortality, to complex outcomes, such as quality of life. While the practical, scientific, and ethical issues associated with the use of outcomes such as mortality and morbidity to compare health care providers have been well (...) rehearsed, the specific concerns associated with the use of quality of life measures in quality of care research have received little attention. As with much research on quality of life there is a tendency to assume that the disadvantages are outweighed by the general virtue of “listening” to patients. In this paper we disagree with this assumption and argue that quality of life is a process, not an outcome. (shrink)

Responsibility has become a central concept in AI ethics; however, little research has been conducted into practitioners’ personal understandings of responsibility in the context of AI, including how responsibility should be defined and who is responsible when something goes wrong. In this article, we present findings from a 2020–2021 data set of interviews with AI practitioners and tech workers at a single multinational technology company and interpret them through the lens of feminist political thought. We reimagine responsibility in the context (...) of AI development and deployment as the product of work cultures that enable tech workers to be responsive and answerable for their products over the long and short term. From our interviews, we identify three key pain points in understanding the distribution of responsibility between actors and developing responsible design and deployment practices: (1) unstable business ecosystems and AI lifecycles, which require an approach to responsibility that accounts for the dynamic nature of these systems; (2) the issue of incentivizing engineers to take responsibility for the mundane maintenance practices essential to the functioning of AI systems and (3) the need to overcome individual and structural barriers to taking ownership over AI products and their effects. From these findings, we make three recommendations based on feminist theory: (1) organisations should move from a static model of responsibility to a dynamic and ethically motivated response-ability; (2) companies need to revalue care and maintenance practices; and (3) firms must move away from individualistic ideas of responsibility towards fostering wider cultures of responsibility. (shrink)

Immanent critique has been a defining feature of the programme of critical social theory. It is a methodology that underpins theoretical diagnoses of contemporary society, based on its linking normative and empirical modes of analysis. Immanent critique distinctively seeks to discern emancipatory or democratizing tendencies. However, the viability of immanent critique is currently in question. Habermas argued that it was necessary to revise the normative foundations of critical social theory, late-capitalist developments tended to undermine immanent critique. Although there is a (...) need for critical social theory to incorporate aspects of alternative interpretations of the contemporary period, the logics of influential theoretical perspectives on the present, especially postmodernism, the risk society and globalization, will be shown to be inconsistent with some of immanent critique's presuppositions. The synthetic aspirations of critical social theory nevertheless persist in recent attempts to reconcile positive liberty and social justice. (shrink)

The current main source of transplantable organs is from heart-beating donors. These are patients who have suffered a catastrophic brain injury, been ventilated, declared dead by neurological criteria, and had their vital functions maintained mechanically until the point of transplantation. But the demand for organs far outstrips the supply, and these patients are not the only potential donors. The idea behind non-heart-beating transplantation is to expand the donor pool by including in it patients who are in hopeless conditions but who (...) are not dying because of brain injury and hence will not suffer the neurological death necessary to become heart-beating donors. As long as we continue to hold the so-called dead donor rule, according to which dying donors cannot have their organs taken before they are dead, this requires that death be able to be declared by alternative criteria, specifically by cardiopulmonary criteria. The challenge is to find such criteria that will identify a state that the public will readily recognize as death and that will facilitate non-heart-beating transplantation. a. (shrink)

There has been much philosophical interest regarding the ‘hierarchy of evidence’ used to determine which study designs are of most value for reporting on questions of effectiveness, prognosis, and so on. There has been much less philosophical interest in the choice of outcome measures with which the results of, say, an RCT or a cohort study are presented. In this paper, we examine the FDA’s recently published guidelines for assessing the psychometric adequacy of patient-reported outcome measures. We focus on their (...) recommendations for demonstrating content validity and also for how researchers should weigh up the sum of psychometric evidence when choosing these measures. We argue that questions regarding judgment and understanding meaning of these measures should play a more central role in determining their adequacy. (shrink)

In this article, we focus on the concept of leadership ethics and make observations about transformational, transactional and servant leadership. We consider differences in how each definition of leadership outlines what the leader is supposed to achieve, and how the leader treats people in the organization while striving to achieve the organization's goals. We also consider which leadership styles are likely to be more popular in organizations that strive to maximize short run profits. Our paper does not tout or degrade (...) any of these leadership theories. Instead, it points out which theories allow reason to play more than a minimal role in ethical decision-making, as well as those that are most consistent with a firm's desire to achieve efficiency in the short run. We explain our view that the way leadership is practiced in large, bureaucratic organizations suggests that ethics is often absent from the leader's decision-making process. Consequently, we suggest that before we engage in a meaningful dialogue about what kind of leaders we might really want in business, we must consider how much short-run profit we are willing to forego in exchange for more ethical corporate cultures. (shrink)

In this article, we focus on the concept of leadership ethics and make observations about transformational, transactional and servant leadership. We consider differences in how each definition of leadership outlines what the leader is supposed to achieve, and how the leader treats people in the organization while striving to achieve the organization's goals. We also consider which leadership styles are likely to be more popular in organizations that strive to maximize short run profits. Our paper does not tout or degrade (...) any of these leadership theories. Instead, it points out which theories allow reason to play more than a minimal role in ethical decision-making, as well as those that are most consistent with a firm's desire to achieve efficiency in the short run. We explain our view that the way leadership is practiced in large, bureaucratic organizations suggests that ethics is often absent from the leader's decision-making process. Consequently, we suggest that before we engage in a meaningful dialogue about what kind of leaders we might really want in business, we must consider how much short-run profit we are willing to forego in exchange for more ethical corporate cultures. (shrink)

This paper assesses the extent to which the category of hope assists in preserving and redefining the vestiges of utopian thought in critical social theory. Hope has never had a systematic position among the categories of critical social theory, although it has sometimes acquired considerable prominence. It will be argued that the current philosophical and everyday interest in social hope can be traced to the limited capacity of liberal conceptions of freedom to articulate a vision of social transformation apposite to (...) contemporary suffering and indignity. The background to these experiences is the structural changes associated with the injustices of globalisation, the mobilisation of the capitalist imaginary and the uncertainties of the risk society. The category of hope could assist in sustaining the utopianism of critical theory through conjoining normative principles with a temporal orientation. Yet, the paradoxes of the current phase of capitalist modernisation have further denuded notions of progress. Since the theological background to the category of hope constitutes a major limitation, the utopian orientation of critique is clarified in relation to the antinomies of the turn to social hope and the potential of Habermas' discourse theory of democracy, law and morality. Despite Castoriadis' profound critique of the category of hope, its present usage in social analyses will be seen to have affinities with Honneth's conception of the struggle for recognition. (shrink)

In this book Gregory Browne rejects the views of David Hume and the Logical Positivists, and argues that there are necessary factual truths, which include a wide range of truths from many fields of knowledge. Browne argues for the necessity of Newton's Laws and truths about natural kinds, and for the factuality of definitional truths and truths of logic and mathematics. Browne synthesizes the work of Kripke, Putnam, Quine and others, but goes beyond the usual discussions of the meanings and (...) definitions of terms to discuss the references of various kinds of terms, and specifically to develop a theory of kinds, distinguishing 'Deep Kinds' and 'Shallow Kinds' . His theory of Deep Kinds does not accept all of the assumptions commonly associated wtih a theory of natural kinds. (shrink)

:This article takes up a game-theoretic perspective on California’s recently passed bill that closes all nonmedical exemptions for school-mandated vaccination. Such a perspective characterizes parental decisions to vaccinate their children as a collective action problem and reveals the presence of an incentive to free ride—to enjoy the benefits of others’ efforts to vaccinate their children without vaccinating one’s own. This article defends California’s legislation as a reasonable means of overcoming the free rider problem and of ensuring that the burdens of (...) vaccination are shared equally. (shrink)

Resistances to sexual and gender rights are shifting and need new theorisations. This article develops the analytical concept of heteroactivism by exploring its relation to abortion debates in Ireland. Heteroactivism as an analytical category examines resistances to sexual and gender rights that seek to reiterate the place of the heteronormative family (both in terms of gender norms and heterosexuality) through activisms that can stand against new legislative orders. The article investigates three texts to explore how the ‘Vote No’ campaign in (...) Ireland discussed ‘loving both’, but in the main thrust of the poster campaign instead focused on the foetus as an ‘unborn child’. Using textual and visual analysis, we show the creation of Ireland through seeking to ‘love both’ and create a distinction from the dangers, and foreign contagion, of England. The article concludes by arguing that ongoing work is needed to explore heteroactivism and its diverse manifestations, including in abortion debates. (shrink)

A pattern of research findings indicates that excessive devotion to a favorite celebrity is linked to attitudes and behaviors that are psychologically unhealthy and may predict low life satisfaction. This study examines whether four common measures of life satisfaction predict admiration for celebrities in two university samples and one community sample of young adults. Our results showed significant correlations between celebrity admiration and two measures of life satisfaction. We also found that the predictors of life satisfaction correlate with each other (...) in ways that are consistent with previous research in positive psychology. Our research suggests an inverse relationship between celebrity admiration and life satisfaction. In addition, the results contribute to establishing the validity of four contemporary life satisfaction measures. (shrink)