Background:Psychiatric nurses are regularly confronted with the uses and effects of control interventions such as mechanical restraints. Although there are evident tensions in the literature regarding the use of mechanical restraints, very little research has focused on the lived and embodied experience of their use, whether from the patient’s perspective or the perspective of nursing staff responsible for their application.Research aims: to gain access to the bodily phenomenon of being placed in mechanical restraints; to give voice to the intimate experiential (...) understanding of this experience; and through phenomenological interpretation, to understand the subjective processes and meaning-making of this experience.Research design:For this research, we adopted a distinctly ethics-oriented application of the methodology known as interpretative phenomenological analysis, that is, the interpretive dimension of the research focused on ethical practice in mental healthcare – one that is informed by experiential accounts of the lived body.Participants and research context:A total of 40 in-depth semi-structured, nondirected interviews with both nurses and patients we conducted to meet the aims of this article. Participants were recruited from an inpatient psychiatric unit of a Canadian general hospital.Ethical considerations:The research received research ethics board clearance from both the hospital where the study took place and the University of Ottawa.Findings:The comparative analysis is presented under the following headings: context of care, meaning of quality of care, emotional reactions and nurse–patient relationship, meeting the needs and need for alternatives.Discussion/conclusions:The research findings are discussed in light of current literature and implications for practice. (shrink)

Humanism in forensic psychiatry: the use of the tidal nursing model The humanist school of thought, which finds resonance in many conceptual models and theories designed to guide nursing practice, needs to be understood in the context of the total institution, where the individual is subjected to a mortification of the self, and denied autonomy. This article will engage in a critical reflection on how humanism has influenced nursing theorists and the subsequent production of conceptual models and theories, especially as (...) they relate to the field of forensic psychiatric nursing. Although humanism provides optimism for nurse–patient relations, this article explores the incapability of such a philosophy to acknowledge the power relationships between individuals and its inability to explain the day‐to‐day realities experienced in forensic nursing, where the possibility of interpersonal violence reshapes nursing care. The tidal model will be discussed in detail as an example of a recently developed humanistic nursing model. Viewed from this perspective, it is clear that humanistic philosophy and its subsequent models of care are in discordance with the highly specialized field of forensic nursing. (shrink)

The COVID-19 pandemic has highlighted the risks that can be involved in healthcare work. In this paper, we explore the issue of staff safety in clinical work using the example of personal protective equipment in the COVID-19 crisis. We articulate some of the specific ethical challenges around PPE currently being faced by front-line clinicians, and develop an approach to staff safety that involves balancing duty to care and personal well-being. We describe each of these values, and present a decision-making framework (...) that integrates the two. The aim of the framework is to guide the process of balancing these two values when staff safety is at stake, by facilitating ethical reflection and/or decision-making that is systematic, specific and transparent. It provides a structure for individual reflection, collaborative staff discussion, and decision-making by those responsible for teams, departments and other groups of healthcare staff. Overall the framework guides the decision maker to characterise the degree of risk to staff, articulate feasible options for staff protection in that specific setting and identify the option that ensures any decrease in patient care is proportionate to the increase in staff well-being. It applies specifically to issues of PPE in COVID-19, and also has potential to assist decision makers in other situations involving protection of healthcare staff. There are no data in this work. (shrink)

Frailty is a state of increased vulnerability to poor resolution of homeostasis after a stressor event. Frailty is most frequently assessed in the old using the Clinical Frailty Scale (CSF) which ranks frailty from 1 to 9. This assessment typically takes less than one minute and is not validated in patients with learning difficulties or those under 65 years old. The National Institute for Health and Care Excellence (NICE) developed guidelines that use “frailty” as one of the priority-setting criteria for (...) how scarce, but potentially lifesaving, health care resources should be allocated during the COVID-19 pandemic. Similar guidelines have been developed elsewhere. This paper discusses the ethical implications of such rationing and argues that this is an unproven and ethically problematic form of health care rationing. It specifically discusses: (1) how the frailty ascription becomes a self-fulfilling prophecy, (2) the problematic use of “frailty” in COVID-19 “triage,” (3) the circularity of the link between age and frailty, (4) indirect discrimination because of the use of a seemingly neutral criterion in health care rationing, and (5) the difficult link between comorbidities and frailty. It is found that there was no research into the use of global frailty scores as a criterion for access to acute treatment before January 2020 and so it is concerning how readily frailty scoring has been adopted to ration access to potentially lifesaving treatments. Existing gerontological frailty scoring systems have not been developed for this purpose, and repurposing them creates significant ethical issues. (shrink)

The Precautionary Principle is a highly influential feature of an extensive body of environmental law, and is also highly controversial and continues to generate scholarly debates along several dim...

This book presents a close, linear reading of Aristophanes’ Birds. It argues that the play provides a continuation and deepening of the author’s critique of the sophists found in Clouds.

This article revisits a forgotten, late project by the social psychologist Stanley Milgram: the ‘cyranoid’ studies he conducted from 1977 to 1984. These investigations, inspired by the play Cyrano de Bergerac, explored how individuals often fail to notice when others do not speak their own thoughts, but instead relay messages from a hidden source. We situate these experiments amidst the intellectual, cultural, and political concerns of late Cold War America, and show how Milgram’s studies pulled together a variety of ideas, (...) anxieties, and interests that were prevalent at that time and have returned in new guises since. In discussing the cyranoid project’s background and afterlife, we argue that its strikingly equivocal quality has lent itself to multiple reinterpretations by historians, psychologists, performers, artists, and others. Our purpose is neither to champion Milgram’s work nor to amplify the critiques already made of his methods. Rather, it is to consider the uncertain, allusive, and elusive aspects of the cyranoid project, and to seek to place that project in context, whilst asking where ‘context’ might end. We show how the experiments’ range of meanings, in different temporal registers, far exceeded the explanatory rubric that Milgram and his intellectual critics provided at that time, and ponder the risk for the historian of making anachronistic or teleological assumptions. In short, we argue, cyranoids invite our open-ended exploration of ‘voices offstage’ in social and psychological relations, and offer a useful tool for thinking about historical context and the nature of historical interpretations. (shrink)

It now seems technically feasible to culture human embryos beyond the “fourteen‐day limit,” which has the potential to increase scientific understanding of human development and perhaps improve infertility treatments. The fourteen‐day limit was adopted as a compromise but subsequently has been considered an ethical line. Does it remain relevant in light of technological advances permitting embryo maturation beyond it? Should it be changed and, if so, how and why? What justifications would be necessary to expand the limit, particularly given that (...) doing so would violate some people's moral commitments regarding human embryos? Robust stakeholder engagement preceded adoption of the fourteen‐day limit and should arguably be part of efforts to reassess it. Such engagement could also consider the need for enhanced oversight of human embryo research. In the meantime, developing and implementing reliable oversight systems should help foster high‐quality research and public confidence in it. (shrink)

It now seems technically feasible to culture human embryos beyond the “fourteen‐day limit,” which has the potential to increase scientific understanding of human development and perhaps improve infertility treatments. The fourteen‐day limit was adopted as a compromise but subsequently has been considered an ethical line. Does it remain relevant in light of technological advances permitting embryo maturation beyond it? Should it be changed and, if so, how and why? What justifications would be necessary to expand the limit, particularly given that (...) doing so would violate some people's moral commitments regarding human embryos? Robust stakeholder engagement preceded adoption of the fourteen‐day limit and should arguably be part of efforts to reassess it. Such engagement could also consider the need for enhanced oversight of human embryo research. In the meantime, developing and implementing reliable oversight systems should help foster high‐quality research and public confidence in it. (shrink)

Norman Daniels' and James Sabin's theory of “accountability for reasonableness” (A4R) is a much discussed account of due process for decision-making on health care priority setting. Central to the theory is the acceptance that people may justifiably disagree on what reasons it is relevant to consider when priorities are made, but that there is a core set of reasons, that all centre on fairness, on which there will be no disagreement. A4R is designed as an institutional decision process which will (...) ensure that only those reasons which everybody will agree are relevant and appropriate form part of decision-making. The argument which we will put forward in this paper questions whether it is a simple matter to delineate the core set of reasons and claims that it is a potential problem in A4R that it does not provide an indication of the exact content of this process. The paper first briefly outlines the content of A4R. It is argued that disagreement on what services should be high priorities cannot be resolved solely with a reference to “due process.” In order to retain consistency over time, decision-makers are required to agree and articulate what reasons qualify as relevant and how conflicting reasons are to be balanced in the course of the process. The second and main part of the paper then considers how the reason of “solidarity” can be handled within the A4R framework, and it is shown that deciding whether solidarity should be admitted to the core set of allowable reasons is not a simple matter. (shrink)

Conversational exculpature is a pragmatic process whereby information is subtracted from, rather than added to, what the speaker literally says. This pragmatic content subtraction explains why we can say “Rob is six feet tall” without implying that Rob is between 5'0.99" and 6'0.01" tall, and why we can say “Ellen has a hat like the one Sherlock Holmes always wears” without implying Holmes exists or has a hat. This article presents a simple formalism for understanding this pragmatic mechanism, (...) specifying how, in context, the result of such subtractions is determined. And it shows how the resulting theory of conversational exculpature accounts for a varied range of linguistic phenomena. A distinctive feature of the approach is the crucial role played by the question under discussion in determining the result of a given exculpature. (shrink)

Questions about necessity (or what has to be, or what cannot be otherwise) and possibility (or what can be, or what could be otherwise) are questions about modality. Fictionalism is an approach to theoretical matters in a given area which treats the claims in that area as being in some sense analogous to fictional claims: claims we do not literally accept at face value, but which we nevertheless think serve some useful function. However, despite its name, “Modal Fictionalism” in its (...) usual manifestations is not primarily fictionalism about claims of necessity and possibility, but rather a fictionalist approach to claims about possible worlds. (For instance, modal fictionalism is not normally fictionalist about the claim that “it is possible that there be a species of tail-less kangaroo”, but rather about the claim that “there is a possible world in which there is a species of tail-less kangaroo”.) The practice of taking possible worlds to be merely convenient fictions, or of treating talk about possible worlds as being useful without being literally correct, is quite common in philosophical circles. It is only recently, however, that philosophers have seriously examined the implications of taking possible worlds to be merely fictional objects, like Sherlock Holmes or a frictionless surface. (shrink)

It is the purpose of this short article to defend the realism of Holmes Rolston and other environmental philosophers against the social constructionism of Neil Evernden and others who have written on the social construction of nature. This defense is attempted through appeal to a deceptively simple example: seeing a bear in a zoo.The following four claims are defended in the effort to show the deficiencies of the anthropocentrism of social constructionists like Evernden: there is a difference between a (...) bear in a zoo and one in the wild; this difference legitimates the belief that the former is an attenuated version of the latter; the danger posed by a bear in the wild is not due to an overly active imagination; and experience of sublime beauty in the presence of a wild bear is only partly of one's own doing. (shrink)

On New year's Eve 1992 a man suffering from schizophrenia climbed into a lions' cage at the London Zoo and was badly mauled. This event provoked a full-scale moral panic among the media and government, the tragedy seeming to violate many of the comfortable myths about progress in psychiatry, echoing the impact of the civil war in former Yugoslavia which had shattered the hope of an era of unbroken European peace following the end of the cold war. Whatever we may (...) wish in reality the lion does not lie down with the lamb. Daniel the visionary, the interpreter of dreams, the one who asserted that his God, the God of angels and saints with power over man and beasts would eventually endure, while all earthly kings were found wanting, emerged from the lions’ den unscathed—but secular, psychiatric, suffering, decarcer-ated, visionless, late-twentieth-century man does not. (shrink)

Popular culture is ubiquitous. And referencing popular culture can be an excellent pedagogical tool. Used properly, it provides students with easily accessible examples—in some cases examples they have already been interested in. Given these facts, the creation and expansion of the literature on the intersection of popular culture and philosophy is not surprising. The purpose of these volumes has been controversial since their inception, but they do seem ideally suited as introductory texts. This essay examines four recent volumes in popular (...) culture and philosophy as pedagogical tools. These volumes on Sherlock Holmes, Christmas, Dr. Seuss, and Facebook all offer unique and useful tools for the teacher attempting to introduce students to philosophy. (shrink)

At the 1995 meeting of the Society for Experimental Social Psychology in Washington, D.C., Harold H. Kelley gave a presentation describing the notion of distinguishing all possible 2x2 situations and the corresponding patterns of social interaction. “The meeting participants had enjoyed a dinner reception at the French Embassy, with dancing and champagne. Holmes, Kelley, and Rusbult had returned to the hotel and were standing on the corner, when Reis leapt off a later bus and ran up to them saying, (...) ‘Why don’t we get a grant from the Rockefeller Foundation to go to the Bellagio Center on Lake Como and think and write about all those situations?’”. (shrink)

In 1990, a conference was held at Lucy Cavendish College, Cambridge, to explore the prospects for a new school of research: cognitive archeology. The fruits of that conference are now published; they are uneven in quality, but provocative. Archeology at its best is detective work that rivals anything in science or fiction--from Crick and Watson to Holmes and Watson. At its worst, it is imagination run wild, underconstrained speculations that often have the added vice of permanently distorting the data, (...) through erroneous "restorations" or just spuriously authoritative labels that then make alternative interpretations of those objects and sites all but unthinkable. It is hard to resist the gravitational pull of a good story, apparently, especially when one has just spent a long hot summer and a sizeable grant (or a lifetime and a fortune) painstakingly wresting an unprepossessing pile of ancient leftovers from the earth. One has to make something from these fragments, if not the lost city of Atlantis, then at least some exciting conclusions about the exotic habits, beliefs or rituals of the people who made them. So it is not surprising that the early romantic excesses of archeology--Agamemnon's tomb and all that--provoked a positivistic reformation movement. Parallel to the behaviorists' efforts to turn their field of psychology into hard science with all the trappings, the "processual" school of archeology demanded scrupulous data-gathering and forbade all but the most rigorously constructed interpretations, echoing Lloyd Morgan's Canon of Parsimony: thou shalt not impute more Mind than is strictly necessary to account for the data. One could venture cautious conclusions about the diet, tools and building materials, and size of the groups, but precious little else--next to nothing, of course, about what or how these ancient people thought. (shrink)

A student's future as a knowledge worker (one who "thinks for a living" with the task of problem solving) is the starting point of this book. With this in mind, the book combines a review of philosophical positions and problems with practical examples and perspectives gained from everyday challenges faced by knowledge workers in their businesses and organizations. Through the use of summative chapters, highlighted key concepts, questions for reflection, and illustrative examples on how to work with the theories presented, (...) the book provides a clear and accessible introduction to this challenging subject. Philosophy of Science primarily addresses students studying language, communication, marketing, economics, and management. However, the survey of the theoretical schools of thought - as well as the discussions on research ethics and the role of research in society - will be equally relevant for other students in the humanities and the natural and social sciences. (shrink)

This new study provides a thorough analysis of the ethical reasoning of doctors and nurses. Based on extensive interviews, Soren Holm's work demonstrates how qualitative research methods can be used to study ethical reasoning, and that the results of such studies are important for normative ethics, that is, the analysis of how health care professionals ought to act.

It is common to hear talk of the aim of belief and to find philosophers appealing to that aim for numerous explanatory purposes. What belief 's aim explains depends, of course, on what that aim is. Many hold that it is somehow related to truth, but there are various ways in which one might specify belief 's aim using the notion of truth. In this article, by considering whether they can account for belief 's standard of correctness and the epistemic (...) norms governing belief, I argue against certain prominent specifications of belief 's aim given in terms of truth, and advance a neglected alternative. (shrink)

The question that this paper tries to answer is Q: “Can good academic bioethics be done without commitment to moral theory?” It is argued that the answer to Q is an unequivocal “Yes” for most of what we could call “critical bioethics,” that is, the kind of bioethics work that primarily criticizes positions or arguments already in the literature or put forward by policymakers. The answer is also “Yes” for much of empirical bioethics. The second part of the paper then (...) provides an analysis of Q in relation to “constructive bioethics,” that is, bioethics work aimed at providing an argument for a particular position. In this part, it is argued that a number of the approaches or methods used that initially look like they involve no commitment to moral theory, nevertheless, involve such a commitment. This is shown to be the case for reflective equilibrium, mid-level theory, the use of theory fragments, and argument by analogy. (shrink)

The _Physics_ is a foundational work of western philosophy, and the crucial one for understanding Aristotle's views on matter, form, essence, causation, movement, space, and time. This richly annotated, scrupulously accurate, and consistent translation makes it available to a contemporary English reader as no other does—in part because it fits together seamlessly with other closely associated works in the New Hackett Aristotle series, such as the _Metaphysics_, _De Anima_, and forthcoming _De Caelo_ and _On Coming to Be and Passing Away_. (...) Eventually the series will include all of Aristotle's works. Sequentially numbered endnotes provide the information most needed at each juncture, while a detailed Index of Terms indicates places where focused discussion of key notions occurs. An illuminating general Introduction describes the book that lies ahead, explaining what sort of work it is and what sorts of evidence it relies on. (shrink)

For decades, nursing as a discipline has tried to establish itself within the socio‐professional and the socio‐political arenas. To date, several theorists have attempted to thoroughly define the essence (ontology) of nursing while others have proposed means (syntax) to achieve this ‘collective’ objective. Considering that this preoccupation, rooted in essentialism, is pervasive in the nursing literature, our claim is that these quests should be criticized because they impede innovative and transdisciplinary approaches to nursing theory. Our criticism includes the perspective supported (...) by the so‐called ‘postmodern nursing theorists’. We argue that the oeuvre of some nursing postmodern scholars is as prescriptive and linear as the ones they critique. Like it was done before, the discourse of these thinkers perpetuates the status quo by excluding alternative forms of knowledge that cross the boundaries of the discipline of nursing. Using the work of Deleuze and Guattari, this paper proposes an alternative way to conceive the development of nursing knowledge, which, we think, could represent an alternative way to explore the discipline of nursing. (shrink)

Morality and the invention of feminine desire -- Sexuality versus recognition : feminine desire in the ethical order -- The purest poem : Heidegger's Antigone -- From Oedipus to Antigone : revisiting the question of feminine desire -- Family politics/family ethics : Butler, Lacan, and the thing beyond the object.

Infallibilism is the view that a belief cannot be at once warranted and false. In this essay we assess three nonpartisan arguments for infallibilism, arguments that do not depend on a prior commitment to some substantive theory of warrant. Three premises, one from each argument, are most significant: if a belief can be at once warranted and false, then the Gettier Problem cannot be solved; if a belief can be at once warranted and false, then its warrant can be transferred (...) to an accidentally true belief; if a belief can be at once warranted and false, then it can be warranted and accidentally true. We argue that each of these is either false or no more plausible than its denial. Along the way, we offer a solution to the Gettier Problem that is compatible with fallibilism. (shrink)

In both environmental aesthetics and environmental ethics something of value is at stake. These are often connected: If beauty, then: duty. But not all duties are tied to beauties. Other premises, such as resource use or respect for life, might better yield duties. Human aesthetic capacities depend on aesthetic properties of value. Wildlife admirers focus on animal excellences. Biotic communities, ecosystems, have their integrities. In a participatory aesthetics, an appropriate admiration for nature transforms into our caring.

" Qualia " is an unfamiliar term for something that could not be more familiar to each of us: the ways things seem to us. As is so often the case with philosophical jargon, it is easier to give examples than to give a definition of the term. Look at a glass of milk at sunset; the way it looks to you--the particular, personal, subjective visual quality of the glass of milk is the quale of your visual experience at the (...) moment. The way the milk tastes to you then is another, gustatory quale, and how it sounds to you as you swallow is an auditory quale; These various "properties of conscious experience" are prime examples of qualia. Nothing, it seems, could you know more intimately than your own qualia ; let the entire universe be some vast illusion, some mere figment of Descartes' evil demon, and yet what the figment is made of will be the qualia of your hallucinatory experiences. Descartes claimed to doubt everything that could be doubted, but he never doubted that his conscious experiences had qualia, the properties by which he knew or apprehended them. (shrink)

There are those who would argue that, recently, the profession of nursing has made a radical shift, while others believe that a schism has been created among both scholars and clinicians as a result of the emerging dominance of the evidence‐based nursing movement. This paper offers a philosophical critique of this movement using Gilles Deleuze and Felix Guattari’s concept of schizoanalysis. As a conclusion, the authors posit that nursing professionals maintain a stance of academic freedom of thought and scientific integrity (...) through the acceptance of multiplicity, diversity, and polyvocality, and by challenging with politically charged concepts the totalizing perspectives that often spread through the profession/discipline of nursing. (shrink)

The social sciences playa variety of multifaceted roles in the policymaking process. So varied are these roles, indeed, that it is futile to talk in the singular about the use of social science in policymaking, as if there were one constant relationship between two fixed and stable entities. Instead, to address this issue sensibly one must talk in the plural about uses of dif ferent modes of social scientific inquiry for different kinds of policies under various circumstances. In some cases, (...) the influence of social scientific research is direct and tangible, and the connection between the find ings and the policy is easy to see. In other cases, perhaps most, its influence is indirect-one small piece in a larger mosaic of politics, bargaining, and compromise. Occasionally the findings of social scientific studies are explicitly drawn upon by policymakers in the formation, implementation, or evaluation of particular policies. More often, the categories and theoretical models of social science provide a general background orientation within which policymakers concep tualize problems and frame policy options. At times, the in fluence of social scientific work is cognitive and informational in nature; in other instances, policymakers use social science primarily for symbolic and political purposes in order to le gitimate preestablished goals and strategies. Nonetheless, amid this diversity and variety, troubling general questions persistently arise. (shrink)

1. Happiness, then and now -- Happiness, eudaimonia, and practical reasoning -- Happiness as eudaimonia -- Happiness and virtuous activity -- New directions from old debates -- 2. Happiness then: the sufficiency debate -- Aristotle's case against the sufficiency thesis -- 3. Happiness now: rethinking the self -- Socrates' case for the sufficiency thesis -- Epictetus and the stoic self -- The Stoics' case for the sufficiency thesis -- The embodied conception of the self -- The embodied conception and psychological (...) well-being -- The Stoics' case against the embodied conception. (shrink)