In this article I reconstruct the philosophical conditions for the emergence of the notion of counter-conduct within the framework of Michel Foucault’s study of governmentality, and I explore the reasons for its disappearance after 1978. In particular, I argue that the concept of conduct becomes crucial for Foucault in order to redefine governmental power relations as specific ways to conduct the conduct of individuals: it is initially within this context that, in Security, Territory, Population, he rethinks the problem of resistance (...) in terms of counter-conduct. However, a few months later, in What is Critique?, Foucault replaces the notion of counter-conduct with that of critical attitude, defined as the particular form that counter-conduct takes in modern times. This notion allows him to highlight the role played by the will in resistance to governmental strategies. But since the notion of counter-conduct is conceptually wider than that of critical attitude, I suggest in conclusion that it could be worth reactivating it as a “historical category which, in various forms and with diverse objectives, runs through the whole of Western history.”. (shrink)

Individuating the logic of scientific discovery appears a hopeless enterprise. Less hopeless is trying to figure out a logical way to model the epistemic attitude distinguishing the practice of scientists. In this paper, we claim that classical logic cannot play such a descriptive role. We propose, instead, one of the three-valued logics in the Kleene family that is often classified as the less attractive one, namely Hallden’s logic. By providing it with an appropriate epistemic interpretation, we can informally model (...) the scientific attitude. (shrink)

This paper explores the potential benefits and obstacles in the incorporation of a critical attitude in a critical thinking curriculum. Critical thinking entails more than just the transfer of information and critical thinking concepts to student within a course. The author suggests that professors should exemplify critical traits in the classroom to students as a means to develop a critical attitude or disposition. The adoption of a critical attitude encourages students (...) to ascertain critical concepts and tools, and cultivate a critical disposition, which would further allow students to internalize the insights and values of critical thought and thus be able to readily apply them to arguments. Despite its perceived benefits, the author is also aware of potential roadblocks in the path of developing a students’ critical disposition, such as different epistemic values and upsetting student psychological well-being. Nevertheless, the author contends that adopting a critical attitude provides students and educators with pedagogical tools and goals that enhance the overall effectiveness of critical theory courses. (shrink)

In this paper, we introduce the notion of ‘rupture’ from the French philosopher Michel Foucault, whose studies of discourse and governmentality have become prominent within nursing research during the last 25 years. We argue that a rupture perspective can be helpful for identifying and maintaining a critical potential within nursing research. The paper begins by introducing rupture as an inheritance from the French epistemological tradition. It then describes how rupture appears in Foucault's works, as both an overall philosophical approach (...) and as an analytic tool in his historical studies. Two examples of analytical applications of rupture are elaborated. In the first example, rupture has inspired us to make an effort to seek alternatives to mainstream conceptions of the phenomenon under study. In the second example, inspired by Foucault's work on discontinuity, we construct a framework for historical epochs in nursing history. The paper concludes by discussing the potential of the notion of rupture as a response to the methodological concerns regarding the use of Foucault‐inspired discourse analysis within nursing research. We agree with the critique of Cheek that the critical potential of discourse analysis is at risk of being undermined by research that tends to convert the approach into a fixed method. (shrink)

Van Fraassen has recently argued that empiricism can be construed as a stance, involving commitments, attitudes, values, and goals, in addition to beliefs and opinions. But this characterisation emerges from his recognition that to be an empiricist can not be to believe, or decide to commit to belief in, a foundational proposition, without removing any basis for a non-dogmatic empiricist critique of other philosophical approaches, such as materialism. However, noticeable by its absence in Van Fraassen's discussions is any mention of (...) Bartley's ‘pancritical rationalism’, for Bartley offers a cohesive argument that genuine dogmatism lies precisely in the act of commitment to an idea. The consequence of denying this, he thinks, is an opening of the floodgates to irrationalism: if to rely on reasoned argument in decision-making is fundamentally an act of faith, then there is a tu quoque – “I simply have a different faith” – that may be employed by those who wish to shield their views from criticism. This raises the following question: why should it be any less dogmatic to adopt particular commitments, attitudes, values, and goals, rather than a particular belief or opinion, come what may? And if Bartley is right that there is only one non-dogmatic attitude – the critical attitude – then why might this not be adopted by an empiricist, a materialist, a metaphysician, or anyone else? (shrink)

Michel Foucault’s The Birth of Biopolitics is generally acknowledged as a pioneering study of neoliberalism, presenting it not merely as an economic theory but also as a mode of government. There is much debate, however, on Foucault’s intentions in analysing neoliberalism and the place of the genealogy in his broader critical project. The Birth of Biopolitics itself lacks both an explicit judgement of neoliberalism and an explicit ethical program. In this article, I maintain that Foucault’s genealogical work on neoliberalism (...) is complementary to his notions of agency. From this perspective, Foucault’s genealogy is not a judgement of neoliberalism in terms of right or wrong but rather serves as a breeding ground for ethical conduct. The notion of the critical attitude in particular shows that Foucault’s genealogical work stands in the service of the subject’s autonomy. However, Foucault is reluctant to fill in his ethical program too much because it should gain substance only in local struggles and through the subject’s own considerations. (shrink)

Michel Foucault’s The Birth of Biopolitics is generally acknowledged as a pioneering study of neoliberalism, presenting it not merely as an economic theory but also as a mode of government. There is much debate, however, on Foucault’s intentions in analysing neoliberalism and the place of the genealogy in his broader critical project. The Birth of Biopolitics itself lacks both an explicit judgement of neoliberalism and an explicit ethical program. In this article, I maintain that Foucault’s genealogical work on neoliberalism (...) is complementary to his notions of agency. From this perspective, Foucault’s genealogy is not a judgement of neoliberalism in terms of right or wrong but rather serves as a breeding ground for ethical conduct. The notion of the critical attitude in particular shows that Foucault’s genealogical work stands in the service of the subject’s autonomy. However, Foucault is reluctant to fill in his ethical program too much because it should gain substance only in local struggles and through the subject’s own considerations. (shrink)

The association between media literacy and media ethics is discussed in this essay, and data gathered from a media literacy study with 93 public school 6th-grade students are presented. The study details the introduction and evaluation of a media literacy program that was intended to encourage learning and critical thinking about media violence, using a selection of "high-risk" portrayal factors as a foundation. Statistical comparisons between preprogram and postprogram responses and between those participating and those in a control group (...) show some increases in the comprehension of key concepts used in the study of media violence and critical thinking about the topic. Open-ended responses also demonstrate enhanced sophistication in analyzing media violence after participating in the program. (shrink)

Critical thinking is a complex, dynamic process formed by attitudes and strategic skills, with the aim of achieving a specific goal or objective. The attitudes, including the critical thinking attitudes, constitute an important part of the idea of good care, of the good professional. It could be said that they become a virtue of the nursing profession. In this context, the ethics of virtue is a theoretical framework that becomes essential for analyse the critical thinking concept in (...) nursing care and nursing science. Because the ethics of virtue consider how cultivating virtues are necessary to understand and justify the decisions and guide the actions. Based on selective analysis of the descriptive and empirical literature that addresses conceptual review of critical thinking, we conducted an analysis of this topic in the settings of clinical practice, training and research from the virtue ethical framework. Following JBI critical appraisal checklist for text and opinion papers, we argue the need for critical thinking as an essential element for true excellence in care and that it should be encouraged among professionals. The importance of developing critical thinking skills in education is well substantiated; however, greater efforts are required to implement educational strategies directed at developing critical thinking in students and professionals undergoing training, along with measures that demonstrate their success. Lastly, we show that critical thinking constitutes a fundamental component in the research process, and can improve research competencies in nursing. We conclude that future research and actions must go further in the search for new evidence and open new horizons, to ensure a positive effect on clinical practice, patient health, student education and the growth of nursing science. (shrink)

The article aims to determine how university professors critically perceive and evaluate information when interacting with the media sphere. The study's relevance is due to the insufficient elaboration of Russian teachers' attitude to the information in the media sphere, which is significant in developing students' critical thinking. The study analyzes theoretical sources and documents on critical thinking in the media sphere and the results of processing empirical data obtained from questioning teachers. The main measuring instrument is a (...) questionnaire survey of university professors with various lengths of service. The study involved 76 teachers from Ural Federal University named after the first President of Russia B.N. Yeltsin. Ural State Pedagogical University (Ekaterinburg, Russia). Linguistics University of Nizhny Novgorod (Nizhny Novgorod, Russia). The data obtained from the study of the teachers' attitude to the information content of the media sphere show a predominant critical attitude in assessing the reliability and availability of information on social networking platforms. This conclusion is important for personality traits that develop students' critical thinking. (shrink)

This book collects published and unpublished work over the last dozen years by one of today's most distinguished and provocative anthropologists. Johannes Fabian is widely known outside of his discipline because his work so often overcomes traditional scholarly boundaries to bring fresh insight to central topics in philosophy, history, and cultural studies. The first part of the book addresses questions of current critical concern. The second part extends the work of critique into the past by examining the beginning of (...) modern ethnography in the exploration of Central Africa during the late nineteenth century: the justification of a scientific attitude and the collecting of ethnographic objects. A final essay examines how the Congolese have returned the 'imperial gaze' of Belgium by the work of critical memory in popular history. The ten chapters are framed by two meditations on the relevance of theory and the irrelevance of the millennium. (shrink)

This article takes a look at our responses to the Syrian refugee crisis in Lebanon from the “micro” – or grassroots – level. Specifically, it examines how our attitudes and approaches, as responders, affect the lived experience of others during this extraordinarily sensitive time of displacement. Three areas of reflection are discussed: the reductionist approach to identity, the pathologizing of those who go through suffering, and finally the exploration of a biblical understanding of integration, by looking at the parable of (...) the workers in the vineyard. In such a dynamic, restorative, and Christ-like community, both those “workers” who arrived early and those who arrived late are equally valued. (shrink)

Since Gayle Salamon’s 2018 article “What is Critical about Critical Phenomenology?”, phenomenologists and critical theorists have offered various responses to the question this title poses. In doing this, they articulated the following considerations: is renewed criticality targeting the phenomenological method itself, does it expand its subject matter to marginalized experiences, does it retool key phenomenological concepts? One aspect of this debate that has been left under-interrogated, however, is the word “phenomenology” itself. There is after all another question (...) to ask in this context: what is phenomenological about critical phenomenology? Many avenues of response are of course possible. Phenomenology could most broadly be meant as an approach that concerns itself with what is given in experience in order to describe the structures of that givenness. From a Husserlian perspective, pure phenomenology is the science which concerns itself with phenomena in the full and diverse sense of the word—not as understood by specific natural or human sciences. What is distinctive of phenomenology is thus not what subset or type of phenomena it is interested in but how it relates to them, which, as Husserl introduces Ideas I, happens “in a completely different attitude.”. (shrink)

Quantitative studies have assessed nurses’ attitudes toward and frequency of spiritual care [SC] and which factors are of influence on this attitude and frequency. However, we had doubts about the construct validity of the scales used in these studies. Our objective was to evaluate scales measuring nursing SC. Articles about the development and psychometric evaluation of SC scales have been identified, using, Web of Science, and CINAHL, and evaluated with respect to the psychometric properties and item content of the (...) scales. Item content was evaluated by each of the five authors with respect to the following questions: Does the item (1) reflect a general opinion about SC instead of a personal willingness to offer SC; (2) reflect general psychosocial care instead of specific SC; (3) focus solely on religious care; (4) contain the words ‘spiritual’ (care/needs/health/strengths, etc.); and (5) contain multiple propositions, or have an unclear meaning? We found eight scales. Psychometric analysis of these scales was often meager and the items of all but one scale suffered from two or more of the five problems described above. This leads us to conclude that many quantitative results in this area are based on findings with questionable scales. Suggestions for improvements are provided. (shrink)

In recent years much has been said about how new democracies are backsliding or have regressed since the turn of the century when hope and optimism about the future spread of democracy was widespread. However, ideas that democracy would spread were based on institutional and governance indicators rather than from the perspective of everyday citizens. When we look at public attitudes towards democracy during this period, we can see that such optimism was perhaps misplaced or premature. Drawing on findings from (...) the AsiaBarometer and the World Values Survey, this research finds that public attitudes during this time were not overly convinced by democracy and certainly not yet satisfied with their government's performance in terms of providing basic democratic freedoms and independence. (shrink)

Upshot: The OPC responses aptly identified numerous factors teachers encounter that can impede changes in pedagogical practice in the classroom. Although some of these factors are external, beyond a teacher’s control, I discuss one internal factor - a teacher’s attitudes and beliefs about their role and the learners they support - that was raised in the responses.

The present essay is a critical study of Barwise and Perry’s book, emphasizing the logical and model-theoretical aspects of their work. I begin by presenting the authors’ criticism of the classical view of logic and semantics within the tradition of Frege, Russell and Tarski. In this connection, I discuss the so-called Frege argument (“the slingshot”). I try to show that the argument appears inconclusive, not only from a situation-theoretic perspective, but also from such alternative perspectives as orthodox Fregean semantics (...) or Russellian semantics. I then discuss the ontology of situation semantics and the way it is modeled within set theory. In particular, I compare the notion of an abstract situation with that of a possible world. The last two sections concern the model-theoretic aspects of the authors’ theory. In Section 7, I discuss how the “partial” perspective of situation semantics differs from that of classical model theory. Finally, in Section 8, different model-theoretic accounts of attitude reports within situation semantics are discussed, in particular the “relations to situations”-approach presented by the authors in Chapter 9 of S & A. The usual problems of “logical omniscience” that appear in standard Hintikka-style epistemic logic are avoided in situation semantics. I argue, however, that situation semantics is faced with analogous counter-intuitive results, unless the expressive power of the language under study is suitably restricted. (shrink)

Deonna and Teroni’s The Emotions is both an excellent introduction to philosophical work on emotions and a novel defence of their own Attitudinal Theory. After summarising their discussion of the literature I describe and evaluate their positive view. I challenge their theory on three fronts: their claim that emotions are a form of bodily awareness, their account of what makes an emotion correct, and their account of what justifies an emotion.

The present study aims to verify the psychometric properties of the Spanish versions of the Social Roles Questionnaire (SRQ; Baber & Tucker, 2006), Modern Sexism scale (MS) and Old-fashioned Sexism scale (OFS; Swim et al. Swim & Cohen, 1997). Enough support was found to maintain the original factor structure of all instruments in their Spanish version. Differences between men and women in the scores are commented on, mainly because certain sexist attitudes have been overcome with greater success in the current (...) Spanish society, while other issues, such as distribution of power in organizational hierarchies or distribution of tasks in the household, where traditional unequal positions are still maintained. In all cases, it was found that men showed greater support for sexist attitudes. The correlations between the three instruments were as expected in assessing sexist attitudes that tend to relate to each other. Eventually, we found no empirical evidence for the postulated link between sexist attitudes and traditional gender stereotypes. Our results call for the validity and effectiveness of the classic theories of gender psychology, such as gender schema theories (Well, 1981; Markus et al., 1982) and the notion of a gender belief system (Deaux & Kite, 1987; 2001). (shrink)

The questions of whether episodic memory is a propositional attitude, and of whether it has propositional content, are central to discussions about how memory represents the world, what mental states should count as memories, and what kind of beings are capable of remembering. Despite its importance to such topics, these questions have not been addressed explicitly in the recent literature in philosophy of memory. In one of the very few pieces dealing with the topic, Fernández (2006) provides a positive (...) answer to the initial questions by arguing that the propositional attitude view of memory, as I will call it, provides a simple account of how memory possesses truth-conditions. A similar suggestion is made by Byrne (2010) when he proposes that perception and episodic memory have the same kind of content, differing only in degree. Against the propositional attitude view, I will argue that episodic memory does not have propositional content, and therefore, that it is not a propositional attitude. My project here is, therefore, mainly critical. I will show that, if empirical work is to inform our philosophical theories of memory in any way, we have good reasons to deny, or at least to be skeptical, of the prospects of the propositional attitude view of episodic memory. (shrink)

This article discusses a range of recent major surveys of public attitudes toward biotechnology. The authors identify a number of problematic features of the surveys: the use of predominantly consumerist rather than civic conception of public discourse; the assumption of a unitary "general public," a "cognitive deficit" approach to public understanding of science; and the presumption of a politically neutral and instrumental ist model of science and technology. The authors then examine some alternative ap proaches to exploring perceptions of biotechnology (...) among a diversity of interested publics, including more focused dialogical surveys, consensus conferences, and parlia mentary inquiries. (shrink)

This paper discusses the role of Law and Legal Thinking in Critical Theory with specific reference to the arguments that Michael Hardt and Antonio Negri offer in their book Commonwealth. The core idea is that Critical Theory is no less radical, but much more concrete, when it is performing not only an external, but also an internal critique of the Law. It shows that the role of the law in critical theory emerges as a problem when the (...) latter claims that ‘there is no outside’ and that ‘the legal base of the system structures our lives.’ It then discusses optimistic and pessimistic strategies to overcome the problem, and argue for a demanding strategy which consist in articulating the external and the internal critique of the law. To make this point, the paper goes back to the epistemic context in which critical attitudes are deployed (the ‘Conflict of the Faculties’), describes the four theoretical moves constitutive of the historical moment in which, at the end of the 18th Century, modern law as we know it was conceived of and founded; and sketches the key moments of the history of the internal critique of the law. It then illustrates the demanding strategy with examples taken from the field of Intellectual Property, and concludes that the Law is malleable and open enough to allow the thinking and practicing of radical alternatives from within the legal system and also that alternatives spoken in the language of the law are no less radical, but certainly, more concrete than others. (shrink)

Hymen construction and nontherapeutic male circumcision are medical nonindicated interventions that give rise to specific ethical concerns. In Europe, hymen construction is generally more contested among medical professionals than male circumcision. Yet, from a standard biomedical framework, guided by the principles of autonomy, beneficence, nonmaleficence, and justice, circumcision of boys is, as this article explains, more problematic than hymen construction. While there is a growing debate on the acceptability of infant circumcision, in the case of competent minors and adults the (...) surgery is not questioned. In the case of hymenoplasty, usually requested by a competent patient, it is recommended to only perform the operation after extensive counseling and if there are compelling conditions. The article further explores why attitudes of medical professionals toward both surgeries diverge and seeks to explain how this is largely informed by gendered and socio-cultural understandings. The arti... (shrink)

Critical notice of Mark Richard's 'Context and the Attitudes: Meaning in Context, Volume 1'.

The Dutch policy objective of a fully sustainable livestock sector without mutilations by 2023 is not compatible with the routine practice of tail docking to minimize the risk of tail biting. To examine farmer attitudes towards docking, a telephone survey was conducted among 487 conventional and 33 organic Dutch pig farmers. “Biting” (of tails, ears, or limbs) was identified by the farmers as a main welfare problem in pig farming. About half of the farmers reported to have no tail biting (...) problems in their own herd. When farmers did report problems, they most often reported figures between 1 and 5 % of the animals. High incidences of tail biting were anticipated when trying to keep undocked pigs. Enrichment materials used in the conventional sector included mainly chains (52–63 % of the farms) and hanging rubber or plastic balls (22–30 %). Straw, sawdust, or wood shavings was hardly provided in conventional pig farming (2–3 %), in contrast to organic farming (88–100 % of farms). Conventional pig farmers feel a curly tail is not very important for sustainable pig farming. They consider enrichment to be less effective and tail docking to be less stressful for them and their piglets than their organic colleagues do. Pig farmers identified climate as a main risk factor for tail biting as opposed to enrichment. The objective of reducing routine tail docking requires solutions for dealing with tail biting problems at the farm level. In this process, transfer of scientific knowledge about enrichment materials and other measures to prevent and cure tail biting is critical, as is a change in farmer attitudes and awareness of the moral issues involved. (shrink)

There is an apparent tension in our everyday moral responsibility practices. On the one hand, it is commonly assumed that moral responsibility requires voluntary control: an agent can be morally responsible only for those things that fall within the scope of her voluntary control. On the other hand, we regularly praise and blame individuals for mental states and conditions that appear to fall outside the scope of their voluntary control, such as desires, emotions, beliefs, and other attitudes. In order to (...) resolve this apparent tension, many philosophers appeal to a tracing principle to argue that agents are morally responsible for those attitudes whose existence can be traced back, causally, to a voluntary action or omission in the past. My aim in this article is to critically evaluate this tracing strategy and to argue that it gives us a misguided picture of when and why we are morally responsible for our attitudes. I argue that we should accept a ‘judgment sensitivity’ condition of moral responsibility rather than a ‘voluntary control’ condition, and defend this account against various objections. (shrink)

Bernard Williams charges that the moral psychology built into R. M. Hare’s utilitarianism is incoherent in virtue of demanding a bifurcated kind of moral thinking that is possible only for agents who fail to reflect properly on their own practical decision making. I mount a qualified defence of Hare’s view by drawing on the account of the ‘reactive attitudes’ found in P. F. Strawson’s ‘Freedom and Resentment’. Against Williams, I argue that the ‘resilience’ of the reactive attitudes ensures that our (...) taking an instrumental view of our dispositions to experience guilt and compunction, as Hare calls for us to do while engaged in ‘critical’ moral thinking, will not prevent us from experiencing these feelings as people ordinarily do while we are thinking ‘intuitively’. I also consider the implications of my argument for consequentialism more generally and (briefly) Kantianism. (shrink)

The relationship between morality and law is one of the issues that has provoked considerable controversies. Among others, an important discussion is whether obeying “conventional morality” in public and/or private spheres should be legally enforced by legislators. In this paper, we will look at the controversies over the issue of the “legal enforcement of morality” in the well-known debate between Herbert Hart and Patrick Devlin. In light of Richard Hare's moral philosophy, we will begin by distinguishing three realms of morality. (...) We will then clarify Deviln's view on “conventional morality”, employing the terminology derived from Hare's moral philosophy. After elaborating the implications, consequences, and roots of “conventional morality” in Devlin's view, we will turn to the relation between law and “conventional morality”. Finally, we will criticize Devlin's approach and highlight our objections to his account. By showing the flaws of Devlin's conception of “conventional morality,” we will challenge her legal view of morals. (shrink)

BackgroundWhether patients in the vegetative state (VS), minimally conscious state (MCS) or the clinically related locked-in syndrome (LIS) should be kept alive is a matter of intense controversy. This study aimed to examine the moral attitudes of lay people to these questions, and the values and other factors that underlie these attitudes.MethodOne hundred ninety-nine US residents completed a survey using the online platform Mechanical Turk, comprising demographic questions, agreement with treatment withdrawal from each of the conditions, agreement with a series (...) of ethical principles and three personality tests.ResultsMore supported treatment withdrawal from VS (40.2 % agreed, 17.6 % disagreed) than MCS (20.6 %, 41.2 %) or LIS (25.3 %, 35.8 %). Agreement with treatment withdrawal was negatively correlated with religiosity (r = −0.272, P < 0.001), though showed no significant relationship with need for cognition or empathy, and only a partial association with utilitarian judgment in a standard moral dilemma. Support for treatment withdrawal was most strongly associated with endorsement of the importance of patient autonomy, dignity, suffering, best interests. Distributive justice was not given significant weight by most. Importantly, agreement with treatment withdrawal was noticeably higher when considered from a first as opposed to third person perspective for VS (Z = −6.056, P < 0.001), MCS (Z = −6.746, P < 0.001) and LIS (Z = −6.681, P < 0.001).ConclusionLay attitudes to withdrawal of treatment in brain damaged patients are largely shaped by values similar to those central to the secular ethical debate. Neither traditional values such as the sanctity of life nor utilitarian values relating to resource allocation seem to play a central role. Far greater weight is given to autonomy, which may explain why participants were far more willing to endorse withdrawal of treatment when the issue was presented in the first person, or in relation to a concrete case involving a patient’s explicit wishes. Surveys focusing on abstract cases presented in the third person may not provide an accurate picture of lay attitudes to these critical ethical questions. (shrink)

Are critique and the “art of governing” antithetical? The aim of this article is to examine this tension that was laid bare by the Covid-19 pandemic by introducing “critical friendship” as a conceptual framework for a constructive interdisciplinary engagement with science in a post-pandemic era. It does so by drawing on several works and insights: (i) Michel Foucault’s notion of “critical attitude” as well as his assessment of philosophy as providing a “diagnosis of the present;” (ii) Bruno (...) Latour and colleagues’ idea of a “critical zone” or what I call a horizontal epistemology of critique; (iii) Aristotle’s notion of friendship as being necessary for the “common good;” and finally (iv) Jacques Derrida’s interpretation of the messianic character of friendship in the constitution of progressive democracies. Whereas critical theory has been described as either “explanatory-diagnostic” or “emancipatory-utopian,” a critical friendship approach aims to be both diagnostic and emancipatory in an age of uncertainty and democratic backsliding. (shrink)

Objectives: Recent legislative changes within the United Kingdom have stimulated professional debate about access to patient data within research. However, there is currently little awareness of public views about such research. The authors sought to explore attitudes of the public, and their lay representatives, towards the use of primary care medical record data for research when patient consent was not being sought.Methods: 49 members of the public and four non-medical members of local community health councils in South Wales, UK gave (...) their views on the value and acceptability of three current research scenarios, each describing access to data without patient consent.Results: Among focus group participants, awareness of research in primary care was low, and the appropriateness of general practitioners as researchers was questioned. There was general support for research but also concerns expressed about data collection without consent. These included lack of respect and patient control over the process. Unauthorised access to data by external agencies was a common fear. Current data collection practices, including population based disease registers elicited much anxiety. The key informants were equally critical of the scenarios and generally less accepting.Conclusions: This exploratory study has highlighted a number of areas of public concern when medical records are accessed for research without patient consent. Public acceptability regarding the use of medical records in research cannot simply be assumed. Further work is required to determine how widespread such views are and to inform those advising on confidentiality issues. (shrink)

Introduction: The decision of “do not attempt resuscitation” in the event of cardiopulmonary arrest is usually made when the patients are critically ill and cannot make an informed choice. Although, various professional bodies have published guidelines, little is know about the patients’ own views regarding DNAR discussion.Aim: The aim of this study was to determine patients’ attitudes regarding discussing DNAR before they are critically ill.Methods: A prospective study was performed in a general out patients department. A questionnaire was distributed to (...) consecutive outpatients along with an explanatory leaflet in the adult outpatient clinic.Results: 364 patients completed the questionnaire . 90% of respondents wanted all patients to be asked regarding DNAR decision at some point during a hospital admission. The majority would not find a DNAR discussion distressing. Only 10% would find it upsetting, however, 48% of these still wanted a discussion. 37% of respondents wanted to discuss DNAR decisions on admission; 32% in outpatients; 17% at consent for surgery, 14% when they are critically ill. 87% of respondents would not object to their relatives being involved in making decisions about their resuscitation status. However, only 12% of the subjects in the study had been involved in discussing the resuscitation status of a relative and 21% would not be comfortable to discuss a relative’s resuscitation status. Although 33% of patients preferred their resuscitation status to simply be documented within their clinical notes, 77% wanted it to be more easily accessible.Conclusions: This study suggests that contrary to current practice most patients want to discuss their DNAR status prior to becoming critically ill. This includes half of the small number that find it distressing to discuss. Although most patients are comfortable with relatives being involved in discussing DNAR, a significant proportion do not want their relatives to be asked. Furthermore, once a decision has been made, the majority of patients want it to be more accessible than current practice allows. (shrink)