This article considers the moral notion of care in the context of Quality of Care discourses. Whilst care has clear normative implications for the delivery of health care it is less clear how Quality of Care, something that is centrally involved in the governance of UK health care, relates to practice.

Cet article sur l’état de la recherche sur le genre et la (les) sexualité(s) dans les études sur les années 68 fait suite à une année de colloques et de rétrospectives médiatiques célébrant le quarantième anniversaire, ainsi qu’à une élection présidentielle américaine où les deux candidats, avec chacun leur mode d’autorité charismatique genrée – l’un héros militaire du Vietnam, l’autre jeune homme dynamique proposant « un nouveau Camelot » –, se sont implicitement situés par rapport à la rupt...

This book examines the intersections of bioethics, human rights and health equity. It does so through the contextual lenses of nation states while presenting global themes on rights, colonialism and bioethics. The book is framed by the following propositions on indigenous health: it is a human rights issue; it is located within the politics of colonization; and subjugated indigenous knowledges require restoring.

In the social sciences and in everyday speech we often talk about groups as if they behaved in the same way as individuals, thinking and acting as a singular being. We say for example that "Google intends to develop an automated car", "the U.S. Government believes that Syria has used chemical weapons on its people", or that "the NRA wants to protect the rights of gun owners". We also often ascribe legal and moral responsibility to groups. But could groups literally (...) intend things? Is there such a thing as a collective mind? If so, should groups be held morally responsible? Such questions are of vital importance to our understanding of the social world. In this lively, engaging introduction Deborah Tollefsen offers a careful survey of contemporary philosophers? answers to these questions, and argues for the unorthodox view that certain groups should, indeed, be treated as agents and deserve to be held morally accountable. Tollefsen explores the nature of belief, action and intention, and shows the reader how a belief in group agency can be reconciled with our understanding of individual agency and accountability. _Groups as Agents_ will be a vital resource for scholars as well as for students of philosophy and the social sciences encountering the topic for the first time. (shrink)

Community engagement to protect and empower participating individuals and communities is an ethical requirement in research. There is however limited evidence on effectiveness or relevance of some of the approaches used to improve ethical practice. We conducted a study to understand the rationale, relevance and benefits of community engagement in health research. This paper draws from this wider study and focuses on factors that shaped Community Advisory Group members’ selection processes and functions in Malawi. A qualitative research design was used; (...) two participatory workshops were conducted with CAG members to understand their roles in research. Workshop findings were triangulated with insights from ethnographic field notes, key informant interviews with stakeholders, focus group discussions with community members and document reviews. Data were coded manually and thematic content analysis was used to identify main issues. Results have shown that democratic selection of CAG members presented challenges in both urban and rural settings. We also noted that CAG members perceived their role as a form of employment which potentially led to ineffective representation of community interests. We conclude that democratic voting is not enough to ensure effective representation of community's interests of ethical relevance. CAG members’ abilities to understand research ethics, identify potential harms to community and communicate feedback to researchers is critical to optimise engagement of lay community and avoid tokenistic engagement. (shrink)

Humans have become increasingly datafied with the use of digital technologies that generate information with and about their bodies and everyday lives. The onto-epistemological dimensions of human–data assemblages and their relationship to bodies and selves have yet to be thoroughly theorised. In this essay, I draw on key perspectives espoused in feminist materialism, vital materialism and the anthropology of material culture to examine the ways in which these assemblages operate as part of knowing, perceiving and sensing human bodies. I draw (...) particularly on scholarship that employs organic metaphors and concepts of vitality, growth, making, articulation, composition and decomposition. I show how these metaphors and concepts relate to and build on each other, and how they can be applied to think through humans’ encounters with their digital data. I argue that these theoretical perspectives work to highlight the material and embodied dimensions of human–data assemblages as they grow and are enacted, articulated and incorporated into everyday lives. (shrink)

Australia has one of the harshest regimes for the processing of asylum seekers, people who have applied for refugee status but are still awaiting an answer. It has received sharp rebuke for its policies from international human rights bodies but continues to exercise its resolve to protect its borders from those seeking protection. One means of doing so is the detention of asylum seekers who arrive in Australia by boat. Health care providers who care for asylum seekers in these conditions (...) experience a conflict of “dual loyalty,” whereby their role in preserving and maintaining the health of patients can run counter to their employment in detention facilities. Many psychiatrists who have worked in the detention setting engage in forms of political activism in order to change the process of seeking refuge. (shrink)

What is the trouble with schools and why should we want to make ‘school trouble’? Schooling is implicated in the making of educational and social exclusions and inequalities as well as the making of particular sorts of students and teachers. For this reason schools are important sites of counter- or radical- politics. In this book, Deborah Youdell brings together theories of counter-politics and radical traditions in education to make sense of the politics of daily life inside schools and explores (...) a range of resources for thinking about and enacting political practices that make ‘school trouble’. The book offers a solid introduction to the much-debated issues of ‘intersectionality’ and the limits of identity politics and the relationship between schooling and the wider policy and political context. It pieces together a series of tools and tactics that might destabilize educational inequalities by unsettling the knowledges, meanings, practices, subjectivities and feelings that are normalized and privileged in the ‘business as usual’ of school life. Engaging with curriculum materials, teachers’ lesson plans and accounts of their pedagogy, and ethnographic observations of school practices, the book investigates a range of empirical examples of critical action in school, from overt political action pursued by educators to day-to-day pedagogic encounters between teachers and students. The book draws on the work of Michel Foucault, Judith Butler, Ernesto Laclau and Chantel Mouffe, and Gilles Deleuze and Felix Guattari to make sense of these practices and identify the political possibilities for educators who refuse to accept the everyday injustices and wide-reaching social inequalities that face us. _School Trouble_ appears at a moment of political and economic flux and uncertainty, and when the policy moves that have promoted markets and private sector involvement in education around the globe have been subject to intense scrutiny and critique. Against this backdrop, renewed attention is being paid to the questions of how politics might be rejuvenated, how societies might be made fair, and what role education might have in pursing this. This book makes an important intervention into this terrain. By exploring a politics of discourse, an anti-identity politics, a politics of feeling, and a politics of becoming, it shows how the education assemblage can be unsettled and education can be re-imagined. The book will be of interest to advanced undergraduate and postgraduate students and scholars in the fields of education, sociology, cultural studies, and social and political science as well as to critical educators looking for new tools for thinking about their practice. (shrink)

This commentary is an attempt to begin to identify and think through some of the ways in which sociocultural theory may contribute to understandings of the relationship between humans and digital data. I develop an argument that rests largely on the work of two scholars in the field of science and technology studies: Donna Haraway and Annemarie Mol. Both authors emphasised materiality and multiple ontologies in their writing. I argue that these concepts have much to offer critical data studies. I (...) employ the tropes of companion species, drawn from Haraway, and eating data, from Mol, and demonstrate how these may be employed to theorise digital data–human assemblages. (shrink)

Australia's policy of mandatory indefinite detention of those seeking asylum and arriving without valid documents has led to terrible human rights abuses and cumulative deterioration in health for those incarcerated. We argue that there is an imperative to research and document the plight of those who have suffered at the hands of the Australian government and its agents. However, the normal tools available to those engaged in health research may further erode the rights and well being of this population, requiring (...) a rethink of existing research ethics paradigms to approaches that foster advocacy research and drawing on the voices of those directly affected, including those bestowed with duty of care for this population. (shrink)

Background While community engagement is increasingly promoted in global health research to improve ethical research practice, it can sometimes coerce participation and thereby compromise ethical research. This paper seeks to discuss some of the ethical issues arising from community engagement in a low resource setting. Methods A qualitative study design focusing on the engagement activities of three biomedical research projects as ethnographic case studies was used to gain in-depth understanding of community engagement as experienced by multiple stakeholders in Malawi. Data (...) was collected through participant observation, 43 In-depth interviews and 17 focus group discussions with community leaders, research staff, community members and research participants. Thematic analysis was used to analyse and interpret the findings. Results The results showed that structural coercion arose due to an interplay of factors pertaining to social-economic context, study design and power relations among research stakeholders. The involvement of community leaders, government stakeholders, and power inequalities among research stakeholders affected some participants’ ability to make autonomous decisions about research participation. These results have been presented under the themes of perception of research as development, research participants’ motivation to access individual benefits, the power of vernacular translations to influence research participation, and coercive power of leaders. Conclusion The study identified ethical issues in community engagement practices pertaining to structural coercion. We conclude that community engagement alone did not address underlying structural inequalities to ensure adequate protection of communities. These results raise important questions on how to balance between engaging communities to improve research participation and ensure that informed consent is voluntarily given. (shrink)

The ArgumentThis paper sets out a framework for understanding how the scientific community constructs computer simulation as an epistemically and pragmatically useful methodology. The framework is based on comparisons between simulation and the loosely-defined categories of “theoretical work” and “experimental work.” Within that framework, the epistemological adequacy of simulation arises from its role as a mathematical manipulation of a complex, abstract theoretical model. To establish that adequacy demands a detailed “theoretical” grasp of the internal structure of the computer program. Simultaneously, (...) the pragmatic usefulness of simulation arises from its role as a “virtual laboratory.” That role is made possible by black-boxing the internal structure of the program, such that the scientist can interact with the computer in an intuitive, “experimental” manner. Thus simulation is rendered authoritative, opening up encoded theories to a novel, “experimental” type of manipulation. (shrink)

In everyday discourse and in the context of social scientific research we often attribute intentional states to groups. Contemporary approaches to group intentionality have either dismissed these attributions as metaphorical or provided an analysis of our attributions in terms of the intentional states of individuals in the group.Insection1, the author argues that these approaches are problematic. In sections 2 and 3, the author defends the view that certain groups are literally intentional agents. In section 4, the author argues that there (...) are significant reasons for social scientists and philosophers of social science to acknowledge the adequacy of macro-level explanations that involve the attribution of intentional states to groups. In section 5, the author considers and responds to some criticisms of the thesis she defends. (shrink)

Has the diversity of corporate boards of directors improved? Should it? What role does diversity play in reducing corporate wrongdoing? Will diversity result in a more focused board of directors or more board autonomy? Examining the state of Tennessee as a case study, the authors collected data on the board composition of publicly traded corporations and compared those data to an original study conducted in 1995. Data indicate only a modest improvement in board diversity. This article discusses reasons for the (...) scarcity of women on boards and concludes that, to enhance strategic decisions, board membership should reflect the corporation''s consumer population. Thus, women are a critical but overlooked resource. Areas for future research are also considered. (shrink)

According to many, joint intentional action must be understood in terms of joint intentions. Most accounts of joint intention appeal to a set of sophisticated individual intentional states. The author argues that standard accounts of joint intention exclude the possibility of joint action in young children because they presuppose that the participants have a robust theory of mind, something young children lack. But young children do engage in joint action. The author offers a revision of Michael Bratman’s analysis of joint (...) intention that reflects the socio-cognitive abilities young children do have. This revision makes sense of joint action among young children and equally well explains simple joint actions involving adults. Key Words: collective intentionality • joint action • child’s theory of mind • joint attention. (shrink)

Economists and other social scientists in this century have often supported economic arguments by referring to positions taken by philosophers of science. This important new book looks at the reliability of this practice and, in the process, provides economists, social scientists, and historians with the necessary background to discuss methodological matters with authority. Redman first presents an accurate, critical, yet neutral survey of the modern philosophy of science from the Vienna Circle to the present, focusing particularly on logical positivism, sociological (...) explanations of science (Polanyi, Fleck, Kuhn), the Popper family, and the history of science. She then deals with economic methodology in the twentieth century, looking at a wide range of methodological positions, especially those supported by positions from the philosophy of science. She considers the myth of the feasibility of falsification in economics and, within the context of its significance for economics, discusses the interpretation of Kuhn's philosophy of science as consensus and the danger such a view represents to science. Appendices review the history of the is-ought dispute and list economists whose first works deal with methodological topics. Comprehensive, readable, and accessible to those with little background knowledge, Redman's book will appeal to a wide range of social scientists and philosophers of science. (shrink)

Digital health technologies are often advocated as a way of helping people monitor, promote and manage their health, care for others and reduce the burden on healthcare systems. Yet these technologies have also been subject to criticism for limiting human flourishing and exacerbating socioeconomic disadvantage. Bioethical appraisals of digital health technologies tend to take a conventional risk‐benefit approach, positioning the human subject as a rational, autonomous agent who is acted on by technologies. In this paper, I present a case for (...) adopting an alternative more‐than‐human perspective on bioethics. A more‐than‐human approach considers human‐technological assemblages and agencies as distributed, relational, situated and emergent. To illustrate the insights that this perspective can offer, I draw on the findings of four empirical projects I have conducted on people’s use of digital devices and platforms used for health‐related purposes, including social media groups and online forums, mobile apps and wearable devices. I conclude with the argument that a more‐than‐human approach to bioethics can begin to incorporate a new ‘zoë ethics’ that can acknowledge and address the deeper affective, multisensory and relational dimensions of humans’ encounters with and enactments of material things and nonhuman creatures. (shrink)

In “Group Testimony” (2007) I argued that the testimony of a group cannot be understood (or at least cannot always be understood) in a summative fashion; as the testimony of some or all of the group members. In some cases, it is the group itself that testifies. I also argued that one could extend standard reductionist accounts of the justification of testimonial belief to the case of testimonial belief formed on the basis of group testimony. In this paper, I explore (...) the issue of group testimony in greater detail by focusing on one putative source of testimony, that of Wikipedia. My aim is to the answer the following questions: Is Wikipedia a source of testimony? And if so, what is the nature of that source? Are we to understand Wikipedia entries as a collection of testimonial statements made by individuals, some subset of individuals, or is Wikipedia itself (the organization or the Wikipedia community) the entity that testifies? If Wikipedia itself is a source of testimony, what resources do we have for assessing the trustworthiness of such an unusual epistemic source? In answering these questions I hope to further elucidate the nature of collective epistemic agency (Tollefsen 2006), of which group testimony is a paradigm example. When a mans Discourse begineth…at some saying of another, of whose ability to know the truth, and of whose honesty in not deceiving, he doubteth not; and then the Discourse is not so much concerning the Thing, as the Person; and the Resolution is called Beleefe, and Faith: Faith in the man. (1651/1991, Ch. 7; p. 48). (shrink)

The fact that much of our knowledge is gained through the testimony of others challenges a certain form of epistemic individualism. We are clearly not autonomous knowers. But the discussion surrounding testimony has maintained a commitment to what I have elsewhere called epistemic agent individualism. Both the reductionist and the anti-reductionist have focused their attention on the testimony of individuals. But groups, too, are sources of testimony - or so I shall argue. If groups can be testifiers, a natural question (...) to ask is whether our beliefs based on the testimony of groups are ever justified and whether such a justification is to be conferred inferentially or non-inferentially. I consider and dismiss the possibility of extending an anti-reductionist account of justification to our group testimonial beliefs. I also argue against a version of reductionism that would have our group testimonial beliefs justified only in so far as we were able to monitor the trustworthiness of members of the group. However, there are forms of reductionism that can be extended to make sense of the justification of our group testimonial beliefs. There are mechanisms for monitoring the trustworthiness and competency of a group (rather than its members) and, further, a variety of background beliefs allow us to assess the testimony of a group for reliability. (shrink)

Although there have been a number of recent discussions about the emotions that we bring with us to our epistemic endeavors, there has been little, if any, discussion of the emotions we bring with us to epistemic appraisal. This paper focuses on a particular set of emotions, the reactive attitudes. As Peter F. Strawson and others have argued, our reactive attitudes reveal something deep about our moral commitments. A similar argument can be made within the domain of epistemology. Our "epistemic (...) reactive attitudes" reveal our epistemic commitments. Reflection on the role they play in our practice of epistemic appraisal can contribute to a number of different debates in contemporary epistemology, including the nature of epistemic norms and epistemic responsibility. (shrink)

Research on linguistic interaction suggests that two or more individuals can sometimes form adaptive and cohesive systems. We describe an “alignment system” as a loosely interconnected set of cognitive processes that facilitate social interactions. As a dynamic, multi-component system, it is responsive to higher-level cognitive states such as shared beliefs and intentions (those involving collective intentionality) but can also give rise to such shared cognitive states via bottom-up processes. As an example of putative group cognition we turn to transactive memory (...) and suggest how further research on alignment in these cases might reveal how such systems can be genuinely described as cognitive. Finally, we address a prominent critique of collective cognitive systems, arguing that there is much empirical and explanatory benefit to be gained from considering the possibility of group cognitive systems, especially in the context of small-group human interaction. (shrink)

L'étude du cycle carnavalesque de trois villages alpins, situés dans une enclave slave en Italie du nord (vallée de Resia), permet de suivre les étapes traversées par l'adolescente à l'intérieur de la fête, moment clef de son identification sexuelle et sociale. Les trois exemples choisis ont mis en lumière des stratégies différentes qui utilisent un couple de masques bäbac/maškira, couple qui correspond à l'opposition structurelle entre le modèle de la fille « sauvage » et celui de la demoiselle policée. Si (...) pour devenir une « jeune fille à marier », on doit passer par ces figures, l'identité ainsi acquise n'est pas fixée une fois pour toutes. En un jeu de miroirs, le sexe opposé et les autres classes d'âge éclairent ces parcours féminins sans cesse mouvants, au croisement des rites collectifs et du vécu singulier. (shrink)

Autism is one of the most compelling, controversial, and heartbreaking cognitive disorders. It presents unique philosophical challenges as well, raising intriguing questions in philosophy of mind, cognitive science, and philosophy of language that need to be explored if the autistic population is to be responsibly served. Starting from the "theory of mind" thesis that a fundamental deficit in autism is the inability to recognize that other persons have minds, Deborah R. Barnbaum considers its implications for the nature of consciousness, (...) our understanding of the consciousness of others, meaning theories in philosophy of language, and the modality of mind. This discussion lays the groundwork for consideration of the value of an autistic life, as well as the moral theories available to persons with autism. The book also explores questions about genetic decision making, research into the nature of autism, and the controversial quest for a cure. This is a timely and wide-ranging book on a disorder that commends itself to serious ethical examination. (shrink)

In his Feature Article ‘Represent me: please: Towards an ethics of digital twins in medicine’1, Mattias Braun considers several important bioethical issues in relation to the use of digital twin simulations in health and medical contexts. He focuses on the ways these simulations are used or are proposed to be deployed in these domains, including to what extent they are a ‘true’ or ‘real’ representation of human bodies. In this response, I want to take a step back and delve into (...) the metaphor of the ‘digital twin’. I consider the implications of using this metaphor in the context of medical care and how this choice of language participates in what science and technology scholars term the ‘sociomaterial imaginaries’ that are used to support and promote novel technologies.2 Language is important. It matters. The choice of language is both symbolic and persuasive. It intervenes in political and policy debates and research and healthcare funding decisions.2 It has material effects and affects: to some of which Braun has gestured in his piece. The …. (shrink)

Background:Ethical issues are increasingly being reported by care-providers; however, little is known about the nature of these issues within the nursing home. Ethical issues are unavoidable in healthcare and can result in opportunities for improving work and care conditions; however, they are also associated with detrimental outcomes including staff burnout and moral distress.Objectives:The purpose of this review was to identify prior research which focuses on ethical issues in the nursing home and to explore staffs’ experiences of ethical issues.Methods:Using a systematic (...) approach based on Aveyard (2014), a literature review was conducted which focused on ethical and moral issues, nurses and nursing assistants, and the nursing home.Findings:The most salient themes identified in the review included clashing ethical principles, issues related to communication, lack of resources and quality of care provision. The review also identified solutions for overcoming the ethical issues that were identified and revealed the definitional challenges that permeate this area of work.Conclusions:The review highlighted a need for improved ethics education for care-providers. (shrink)

Corporate social responsibility (CSR) has repeatedly been described as an “essentially contested concept,” which means that its signification is subject to continuous struggle. We argue that the “CSR institution” (CSRI; i.e., the set of standards and rules regulating corporate conduct under the banner of CSR) is legitimized by narratives which “decontest” the underlying concept of CSR in a manner that safeguards the CSRI from calls for alternative institutional arrangements. Examining several such narratives from a structuralist perspective, we find them to (...) be permeated with six recurrent ambiguities that we show to be reflective of three deep-set taboos: the taboo of the noncongruency between corporate profit objectives and societal needs, the taboo of multinational firms’ continued contribution to the emergence of global socioenvironmental issues, and the taboo of the CSRI’s moderate results in solving these problems. We contend that the perpetuation of these taboos contributes to inhibiting substantial change in the way of doing business, and we sketch out possibilities for initiating a “recontestation” of CSR’s meaning. (shrink)

In modern, Western societies the purpose of schooling is to ensure that school-goers acquire knowledge of pre-existing practices, events, entities and so on. The knowledge that is learned is then tested to see if the learner has acquired a correct or adequate understanding of it. For this reason, it can be argued that schooling is organised around a representational epistemology: one which holds that knowledge is an accurate representation of something that is separate from knowledge itself. Since the object of (...) knowledge is assumed to exist separately from the knowledge itself, this epistemology can also be considered ‘spatial.’ In this paper we show how ideas from complexity have challenged the spatial epistemology’ of representation and we explore possibilities for an alternative ‘temporal’ understanding of knowledge in its relationship to reality. In addition to complexity, our alternative takes its inspiration from Deweyan ‘transactional realism’ and deconstruction. We suggest that ‘knowledge’ and ‘reality’ should not be understood as separate systems which somehow have to be brought into alignment with each other, but that they are part of the same emerging complex system which is never fully ‘present’ in any (discrete) moment in time. This not only introduces the notion of time into our understanding of the relationship between knowledge and reality, but also points to the importance of acknowledging the role of the ‘unrepresentable’ or ‘incalculable’. With this understanding knowledge reaches us not as something we receive but as a response, which brings forth new worlds because it necessarily adds something (which was not present anywhere before it appeared) to what came before. This understanding of knowledge suggests that the acquisition of curricular content should not be considered an end in itself. Rather, curricular content should be used to bring forth that which is incalculable from the perspective of the present. The epistemology of emergence therefore calls for a switch in focus for curricular thinking, away from questions about presentation and representation and towards questions about engagement and response. (shrink)

Argues that the central cognitive component of ethical virtue for Aristotle is awareness of the value of particulars.

The debate surrounding the issue of collective moral responsibility is often steeped in metaphysical issues of agency and personhood. I suggest that we can approach the metaphysical problems surrounding the issue of collective responsibility in a roundabout manner. My approach is reminiscent of that taken by P.F. Strawson in “Freedom and Resentment” (1968). Strawson argues that the participant reactive attitudes – attitudes like resentment, gratitude, forgiveness and so on – provide the justification for holding individuals morally responsible. I argue that (...) the framework of the reactive attitudes extends to collectives and provides the justification for holding collectives morally responsible. (shrink)