Increasingly, palliative care is being referred to as an essential programme and in some cases as a human right. Once it is recognized as such, it becomes part of the lexicon of social justice in that it can be argued that all members of society should have access to such care. However, this begs the question of how that care should be enacted, particularly in rural and remote areas. This question illustrates some of Friedrich Hayek's critiques of social justice. Hayek (...) has likened social justice to a ‘moral stone’ arguing that social justice is meaningless to the extent that society is impersonal and as such cannot be just, only those individuals who make up that society can be just. When responsibility for justice is assigned to an impersonal society, ideas of social justice can become a clarion call for whom no one is directly accountable. This opens the door for questionable macro‐level political agendas that have no capacity to enact the ideal, and worse, may suppress individual moral acts towards the desired end. Further, acts of interference at the macro level with the ideal of equal opportunity run the risk of disadvantaging other members of society. Instead, he has argued that a better approach lies in finding ways to induce and support individual moral acts that promote the human good. Hayek's arguments are particularly compelling for rural palliative care. In this paper we draw upon data from an ethnographic study in rural palliative care to illustrate the potential misfit between the ethical ideal of palliative care as expressed by rural participants and the narratives of social justice. (shrink)

Background: Although attention to healthcare ethics in rural areas has increased, specific focus on rural palliative care is still largely under-studied and under-theorized. The purpose of this study was to gain a deeper understanding of the values informing good palliative care from rural individuals' perspectives. Methods: We conducted a qualitative ethnographic study in four rural communities in Western Canada. Each community had a population of 10, 000 or less and was located at least a three hour travelling distance by car (...) from a specialist palliative care treatment centre. Data were collected over a 2-year period and included 95 interviews, 51 days of field work and 74 hours of direct participant observation where the researchers accompanied rural healthcare providers. Data were analyzed inductively to identify the most prevalent thematic values, and then coded using NVivo. Results: This study illuminated the core values of knowing and being known, being present and available, and community and mutuality that provide the foundation for ethically good rural palliative care. These values were congruent across the study communities and across the stakeholders involved in rural palliative care. Although these were highly prized values, each came with a corresponding ethical tension. Being known often resulted in a loss of privacy. Being available and present created a high degree of expectation and potential caregiver strain. The values of community and mutuality created entitlement issues, presenting daunting challenges for coordinated change. Conclusions: The values identified in this study offer the opportunity to better understand common ethical tensions that arise in rural healthcare and key differences between rural and urban palliative care. In particular, these values shed light on problematic health system and health policy changes. When initiatives violate deeply held values and hard won rural capacity to address the needs of their dying members is undermined, there are long lasting negative consequences. The social fabric of rural life is frayed. These findings offer one way to re-conceptualize healthcare decision making through consideration of critical values to support ethically good palliative care in rural settings. (shrink)

Two articles in this issue of the Hastings Center Report explore two sides of the same problematic coin. In “The Limits of Surrogates’ Moral Authority and Physician Professionalism,” Jeffrey Berger discusses the moral problem of a surrogate refusing a treatment, palliative sedation, on behalf of a patient whose suffering is refractory to intensive palliative efforts provided by a multidisciplinary team. In “After the DNR: Surrogates Who Persist in Requesting Cardiopulmonary Resuscitation,” Ellen Robinson and her colleagues analyze data from a (...) study of cases in which physicians wished not to perform cardiopulmonary resuscitation on patients whom they thought it would harm. Both articles begin from the idea of a professional determination about a physician's duty to a patient that conflicted with a surrogate's determination about what should or should not be done for that patient. Berger's argument stops just short of a solution, however, because a physician's professional obligation to help patients, even within guidelines set by other professionals, is insufficient protection for patients. But if Berger's theory is right—that sometimes surrogates lack moral authority to make decisions on behalf of patients—then the Robinson team has developed a careful and public process for attending to that conflict. (shrink)

In the vast literature on architectural theory and practice, the ways in which architectural knowledge is actually taught, debated, and understood are too often ignored. The essays collected in this groundbreaking volume address the current state of architecture as an academic and professional discipline. The issues considered range from the form and content of architectural education to the architect's social and environmental obligations and the emergence of a new generation of architects. Often critical of the current paradigm, these essays offer (...) a provocative challenge to accepted assumptions about the production, dissemination, and reception of architectural knowledge. Contributors: Sherry Ahrentzen, U of Wisconsin-Milwaukee; Stanford Anderson, MIT; Carol Burns, Harvard U; Russell Ellis, UC Berkeley; Thomas Fisher, U of Minnesota; Linda Groat, U of Michigan; Kay Bea Jones, Ohio State U; David Leatherbarrow, U of Pennsylvania; A. G. Krishna Menon, TVB School of Habitat Studies, India; Garth Rockcastle, U of Minnesota; Michael Stanton, American U, Beirut; Sharon E. Sutton, U of Washington; David J. T. Vanderburgh, Université Catholique de Louvain, Belgium; and Donald Watson, Rensselaer Polytechnic Institute. (shrink)

We apply Carol Gilligan's distinction between a "male" mode of moral reasoning, focussed on justice, and a "female" mode, focussed on caring, to the reading of literature. Martha Nussbaum suggests that certain novels are works of moral philosophy. We argue that what Nussbaum sees as the special ethical contribution of such novels is in fact training in the stereotypically female mode of moral concern. We show this kind of training is appropriate to all readers of these novels, not just to (...) women. Finally, we explore what else is involved in distinctively feminist readings of traditional novels. (shrink)

How to formulate the doctrine of relativism -- Evaluating the doctrine of relativism.

The Leadership Identity Journey takes readers on a breathtaking, all-consuming, transformative journey. The invitation is to think of your life as a journey that follows a mythic path. By doing so, new possibilities emerge for thinking about leadership identity and preparation, as well as artistic research and the education field. The perspectives described in this book are supported by school leaders' insights into powerful iconic photographs relative to the five mythic life phases: the human condition, trials in life, human triumph, (...) human transformation, and human crossing, with the addition of leadership as a dimension of the life-journey model. The authors conducted their study using selected photographs framed by the universal mythic framework inspired by mythologist Joseph Campbell. (shrink)

_Material Feminisms: New Directions for Education_ provides a range of powerful theoretical and innovative methodological examples to illuminate how new material feminism can be put to work in education to open up new avenues of research design and practice. It poses challenging questions about the nature of knowledge production, the role of the researcher, and the critical endeavour arising from inter- and post-disciplinarity. Working with diffractive methodologies and new materialist ecological epistemologies, the book offers resources for hope which widen the (...) scope for how educational problems are interrogated, and provides a political counter-movement to neo-positivist, outcomes-based approaches within education. Inspired by writers such as Barad, Bennett, and Deleuze and Guattari, the book makes a radical break with cognitive, dualist, and universal conceptions of human subjectivity and intelligence in education. By taking its starting point as the co-consitutiveness of discourse, materiality, corporeality, and place, the book foregrounds educational practices as material enactments of multiple, non-linear, entangled, affective, and relational forces. It offers new insights into how gender, class, and ethnicity are constituted in, and by, material assemblages that are often submerged or ‘unseen’. This book is an essential starting place for those intrigued by what new theoretical accounts of materiality, posthumanism, and affect can offer educational research. Diffractive methodologies challenge readers to take a fuller range of actors into account than in ‘objective’ humanist methodologies, and in so doing to pay closer attention to what data is. It invites researchers to engage with long-standing feminist concerns about power and knowledge production in research processes. This book was originally published as a special issue of _Gender and Education. _. (shrink)

Debates about moral judgments have raised questions about the roles of reasoning, culture, and conflict. In response, the cognitive prototype model explains that over time, through training, and as a result of cognitive development, people construct notions of blameworthy and praiseworthy behavior by abstracting out salient properties that lead to an ideal representation of each. These properties are the primary features of moral prototypes and include social context interpretation, intentionality, consent, and outcomes. According to this model, when the properties are (...) uniform and coherent, they depict a promoral or immoral prototype, relative to the orientations of the properties. A promoral prototype is represented by an action that is supported by the culture, intentionally benevolent or other-regarding, consensual, and resulting in positive outcomes. An immoral prototype is an action that is condemned by the culture, intentionally malevolent or self-serving, lacking consent, and resulting in negative outcomes. It is hypothesized that moral prototypes will result in a high level of agreement and require effortless processing. Alternatively, when properties conflict or the situation deviates from the prototype, a nonprototype will result. It is hypothesized that nonprototypical situations will act as a source of moral disagreement and may require more effortful processing. (shrink)

This essay argues that making a diagnosis in medicine is essentially a hermeneutic enterprise, one in which interpretation skills play a major part in understanding a disease. The clinical encounter is an event comprised of two voices; one is the voice of science which is grounded in empiricism, the other is that of human experience, which is grounded in story-telling and the interpretation of those stories.Using two voices, one from the Diagnostic and Statistical Manual of Mental Disorders-III-Revised, which describes alcohol (...) abuse and alcohol dependence, and the other, that of Claire, a character in Edward Albee's play, A Delicate Balance, who is conversing with her brother-in-law, Tobias, I apply principles from Hans-Georg Gadamer's hermeneutics to the clinical diagnostic process. The essay will demonstrate that we overlook an enormous amount of information about alcoholism by an overreliance on objective data and that our hope for understanding alcoholics is in listening to their voices, and sharing the interpretation of their experiences with them. (shrink)

To illustrate the strength of Bartky's clarity of insight I focus on her discussion of shame found in two essays in Femininity and Domination. I argue that these essays as well as the other in the collection identify and offer a clear analysis of many issues central to feminism and call for Bartky to write a sequel which offers constructive suggestions of ways out.

To illustrate the strength of Bartky's clarity of insight I focus on her discussion of shame found in two essays in Femininity and Domination. I argue that these essays as well as the other in the collection identify and offer a clear analysis of many issues central to feminism and call for Bartky to write a sequel which offers constructive suggestions of ways out.

Despite substantial evidence pointing to a looming Malthusian catastrophe, governmental measures to reduce population have been opposed both by religious conservatives and by many liberals, especially liberal feminists. Liberal critics have claimed that 'utilitarian' population policies violate a 'fundamental right of reproductive liberty'. This essay argues that reproductive liberty should not be considered a fundamental human right, or certainly not an indefeasible right. It should, instead, be strictly regulated by a global agreement designed to reduce population to a sustainable level. (...) Three major points are discussed: 1) the current state of the overpopulation problem; 2) the claim of a fundamental human right of reproductive liberty; 3) an outline of a global agreement to address overpopulation as a 'tragedy of the commons'. (shrink)

A Nietzschean theodicy would claimthat God has created the world exactly the wayit is in order to produce morally autonomousagents in Nietzsche's sense: self-consciousmoral subjectivists. Both atheism and a`Nietzschean theodicy' make the sameprediction: the world will appear to containgratuitous evil. Thus, observation ofapparently gratuitous evil is not evidence foror against either hypothesis. In the absenceof any other evidence for or against theism,the most reasonable position is agnosticism.

Three experiments investigated whether a motor-linked measure (string typing speed) and an judgment-linked measure (grammatical judgment of strings) accessed the same implicit learning mechanisms in the artificial grammar learning task. Participants first studied grammatical strings through observation or through responding to each letter by typing it and then performed typing and grammatical judgment tests. Grammatical judgment test performance was better after observation than after respond learning, whereas typing test performance on higher order relations was worse after observation than after respond (...) learning (Experiment 1). Participants transferred grammatical knowledge across letter sets on the grammatical judgment test, but not on the typing test (Experiment 2). Typing speed did not differ for hits (grammatical strings classified by participants as grammatical) and misses (grammatical strings classified as nongrammatical, Experiment 3). These results are consistent with typing and grammatical judgment tests tapping independent mechanisms and indicate that implicit learning may consist of many different forms of learning rather than being a unitary learning mechanism. (shrink)

Two profound yet incompatible moral imaginations confront each other in the attempt to address Job's experience of turmoil That of the friends is grounded in a deep sense of the moral nature of creation. Job's moral imagination takes shape through an act of witness that attempts to create a community of answerability before God.

[opening paragraph]: My comment will focus on the following five claims of Humphrey's. At some points I will be drawing on his book A History of the Mind as well as the target article in this issue.

A recognition of Ezekiel's skill in manipulating the power of metaphor to illumine reality helps us to grasp the subtlety, meaning, and prophetic force of his oracles against Tyre.

Conceptions of "the self" have received significant recent attention in philosophy, anthropology, and cultural history. Scholars argue that the introspective self of the modern West is a distinctive phenomenon that cannot be projected back onto the cultures of antiquity. While acknowledging such difference is vital, it can lead to an inaccurate flattening of the ancient self. In this study, Carol A. Newsom explores the assumptions that govern ancient Israelite views of the self and its moral agency before the fall of (...) Judah, as well as striking developments during the Second Temple period. She demonstrates how the collective trauma of the destruction of the Temple catalyzed changes in the experience of the self in Israelite literature, including first-person-singular prayers, notions of self-alienation, and emerging understandings of a defective heart and will. Examining novel forms of spirituality as well as sectarian texts, Newsom chronicles the evolving inward gaze in ancient Israelite literature, unveiling how introspection in Second Temple Judaism both parallels and differs from forms of introspective selfhood in Greco-Roman cultures. (shrink)

What is the nature of communicative competence? Carol A. Kates addresses this crucial linguistic question, examining and finally rejecting the rationalistic theory proposed by Noam Chomsky and elaborated by Jerrold J. Katz, among others. She sets forth three reasons why the rationalistic model should be rejected: (1) it has not been supported by empirical tests; (2) it cannot accommodate the pragmatic relation between speaker and sign; and (3) the theory of universal grammar carries with it unacceptable metaphysical implications unless it (...) is interpreted in light of empiricism. Kates proposes an empiricist model in place of the rationalistic theory—a model that, in her view, is more consistent with recent findings in linguistics and psycholinguistics. In attempting to clarify the nature of utterance meaning, Kates develops theoretical perspectives on phenomenological empiricism and produces an account of reference and intentionality directly relevant to empirically based theories of speaking and understanding. Among the major topics addressed in the book are transformational-generative and universal grammar, cognitive theories of language acquisition, pragmatic structure, predication and topic-comment structure, and empiricism and the philosophical problem of universals. An innovative and probing work, Pragmatics and Semantics: An Empiricist Theory will be welcomed by philosophers, linguists, and psycholinguists. (shrink)

There are striking similarities between Perruchet & Vinter's SOC theory and the theories that they claim to be in opposition to. First, both kinds of theory lead to the induction of knowledge of complex patterns in the environment that serve the function of rules. Second, both involve unconscious mental processes of induction resulting in at least some conscious knowledge.

Autobiographical memory specificity has been associated with cognitive function, depression, and independence in older adults. This longitudinal study of 162 older adults moving to active supported living environments tracks changes in the role of the ability to recall specific autobiographical memory as a mediator between underlying cognitive function, or depression, and outcome perceived health or independence, across 18 months, as compared with controls not moving home. Clear improvements across time in autobiographical specificity were seen for residents but not controls, supporting (...) the role of a socially active environment, and confirmed by correlation with number of activities reported in diaries, although the impact of diary activities on the effect of time on autobiographical specificity was not found. The role of autobiographical specificity in mediating general cognition and outcome functional limitations was clear for social limitations at 12 and 18 months, but its role in mediating effects of executive function and perceived health persisted throughout. The role of specificity in mediating between depression and perceived health, IADLs, and Functional Limitations persisted throughout. Analysis examining autobiographical specificity and depression as joint mediators between cognition and independence showed a forward effect such that higher specificity scores reduced the negative mediation effect of depression on independence. Finally, data showed the reduction of many of these mediations over time, supporting the role of autobiographical memory in times of change in a person's social situation. Data support potential autobiographical memory intervention development. (shrink)