This is the first book to take nursing ethics beyond stock 'moral concepts' to a critical examination of the fundamental assumptions underlying the very nature of nursing. It takes as its point of departure the difficulties nurses experience practising within the confines of a bioethical model of health and illness and a hierarchical, technocratic health care system. The contributors go on to deal openly and honestly with controversial issues faced by nurses, such as euthanasia and HIV.

This is the first book to take nursing ethics beyond stock 'moral concepts' to a critical examination of the fundamental assumptions underlying the very nature of nursing. It takes as its point of departure the difficulties nurses experience practising within the confines of a bioethical model of health and illness and a hierarchical, technocratic health care system. The contributors go on to deal openly and honestly with controversial issues faced by nurses, such as euthanasia and HIV.

A team of renowned philosophers and a new generation of thinkers come together to offer the first book-length examination of the relationship between philosophical anthropology and animal studies.

This article considers the development of nurse-led services as a part of a pilot study and explores the therapeutic nature of the role of the nurse. In particular it suggests a need for reconsideration of the fundamental values of nurse-led care in the context of changing organizational culture. Within the UK there has been pressure from policy makers to extend the role of the specialist nurse and create new nursing roles, shifting the boundaries between professional health groups. The philosophy of (...) nurse-led initiatives has therefore been driven mainly from a service redesign and clinical need standpoint rather than necessarily focusing on enhancing patients’ experience and the changes in organizational culture required to achieve this. While several studies have focused on the safety, comparative cost and comparative patient outcomes in nurse-led care in relation to traditional or doctor-led care, little attention has been given to the changing organizational values underlying the nursing role. Exploring this context is essential if new nursing roles are to provide more than relief for bottlenecks in the system and also meet their potential for providing patient centred and innovative models of care. (shrink)

This article takes issue with procedural reductionism, which is the inclination to reduce all matters of judgement and responsibility to the following of some procedure or rule. Two scenarios provide content for a discussion of professional discretion in the context of accountability. The author shows that in professional life there will always be situations that stand beyond the rules of procedures and require the unique judgement of the professional at the time. While this judgement may be determined by the facts (...) available in a situation of uncertainty, it cannot be reduced to the facts (including facts about rules and procedures). The moral judgement will still have an essential indeterminancy about it. (shrink)

In this article I attempt to transcend the mainstream conception of health care ethics, including nursing ethics, by bringing into the foreground a tension between a sense of life and an industrial-bureaucratic style of health care, with its emphasis on the systematic and procedural work culture necessary for mass production. I use the concept of ‘a sense of life’ to draw attention to the wisdom, sensitivity and responsibility that is necessary for the authentic care of others to be given a (...) chance in the development of modern health care. I emphasize the mindfulness that the professional requires for genuine care, and how the systematic organization of modern health care, on the whole, ignores, obstructs and even suppresses such mindfulness. (shrink)

Western civilization has probably reached an impasse, expressed as a crisis on all fronts: economic, technological, environmental and political. This is experienced on the cultural level as a moral crisis or an ethical deficit. Somehow, the means we have always assumed as being adequate to the task of achieving human welfare, health and peace, are failing us. Have we lost sight of the primacy of human ends? Governments still push for economic growth and technological advances, but many are now asking: (...) economic growth for what, technology for what? Health care and nursing are caught up in the same inversion of human priorities. Professionals, such as nurses and midwives, need to take on social responsibilities and a collective civic voice, and play their part in a moral regeneration of society. This involves carrying civic rights and duties into the workplace. (shrink)

Social, legal and health-care changes have created an increasing need for ethical review within end-of-life care. Multiprofessional clinical ethics committees (CECs) are increasingly supporting decision-making in hospitals and hospices. This paper reports findings from an analysis of formal summaries from CEC meetings, of one UK hospice, spanning four years. Using qualitative content analysis, five themes were identified: timeliness of decision-making, holistic care, contextual openness, values diversity and consensual understanding. The elements of an engaged clinical ethics in a hospice context is (...) not generally acknowledged nor its elements articulated. Findings from this study have the potential to explain some of the most challenging ethical problems and to contribute to their resolution. It may also guide future deliberation and raise CEC members' awareness of the recurrent issues and values of their CEC practice. (shrink)

The authors believe there is a need for novel ways of enhancing professional judgment and discretion in the contemporary healthcare environment. The objective is to provide a framework to guide a discursive analysis of an ongoing clinical scenario by a small group of healthcare professionals to achieve consensual understanding in the decision-making necessary to resolve specific healthcare inadequacies and promote organisational learning. REPVAD is an acronym for the framework’s five decision-making dimensions of reasoning, evidence, procedures, values, attitudes and defences. The (...) design is set out in terms of well-defined definitions of the dimensions, a rationale for using REPVAD, and explications of dimensions one at a time. Furthermore, the REPVAD process of application to a scenario is set out, and a didactic scenario is given to show how REPVAD works together with a sample case. A discussion is fleshed out in four real life student cases, and a conclusion indicates strengths and weaknesses and the possibility of further development and transferability. In terms of findings, the model has been tried, tested and refined over a number of years in the development of advanced practitioners at university healthcare faculties in two European countries. Consent was obtained from the four participating students. (shrink)

Abortion is one of the great moral debates of the epoch. Is there a rational method by which the debate can be resolved? Can bioethics' promise of such a method be fulfilled? Surely, a strictly rational approach can establish solid grounds for our beliefs once and for all. We would then be justified in deeming as unreasonable anyone who does not accept the perfectly rational conclusions. I present two scenarios to show that there can be no such philosophically grounded method (...) and therefore no such facts to which everyone must agree. This does not mean that it is in fact impossible for people to reach agreement. It simply means that there is no incontrovertibly rational means by which they must do so. (shrink)

China, India, Brazil and other major Third World nations have long refused to sign the Nuclear Non‐proliferation Treaty. This position might at first sight appear to be without any question morally unjustified and even irrational. Yet their claim that the treaty is ‘discriminatory’ merits the serious attention which it has not received. Only if certain aspects of this claim are accepted by the nuclear weapons signatories does a moral and rational onus to sign become unquestionable.

The assumptions of philosophy need scrutiny as much the assumptions of medicine do. Scrutiny shows that the philosophical method of bioethics is compromised, for it shares certain fundamental assumptions with medicine itself. To show this requires an unorthodox style of philosophy — a literary one. To show the compromised status of bioethics the paper discusses some seminal utilitarian discussions of the definition of death, of whether it is a bad thing, and of when it ought to occur.

The paper attempts to account for the confusion over the validity of the concept of schizophrenia in terms of two closely related aspects of conceptual indeterminacy. Firstly, it is identified on the basis of a breakdown in intelligibility, but what constitutes such a breakdown is indeterminate. Secondly, the concept sits between the categories of natural disease or illness on the one hand, and character trait or moral failing or gift on the other. This entails an indeterminacy in attempting to define (...) the role that physiological explanation could have. Light may be thrown on the concept by exploring a distinction between a life story in which the schizophrenic condition emerges as the conclusion of the story and a causal process in which the condition is the end result or final consequence. (shrink)

This article takes issue with procedural reductionism, which is the inclination to reduce all matters of judgement and responsibility to the following of some procedure or rule. Two scenarios provide content for a discussion of professional discretion in the context of accountability. The author shows that in professional life there will always be situations that stand beyond the rules of procedures and require the unique judgement of the professional at the time. While this judgement may be determined by the facts (...) available in a situation of uncertainty, it cannot be reduced to the facts (including facts about rules and procedures). The moral judgement will still have an essential indeterminancy about it. (shrink)

Finocchiaro offers an interpretation of Antonio Gramscis Prison Notebooks. He is interested in Gramscis thoughts on politics, social science, and religion but tells us that he is not concerned directly with the content of these. Such details are best worked out after we know what he means by religion, science and politics (5). He thinks that Gramscis conceptual framework must be identified first so that one can then proceed to find more order in the Notebooks (5). There follows an extended (...) discussion of what Gramsci says about his method and the method of Croce, Bukharin, and Machiavelli. Unfortunately, the crucial question of the relation of Gramscis thought to that of Marx is not considered in any depth. (shrink)

Originally published in 1967, this book aims to develop an ethical theory which remedies the defects of Utilitarianism while recognising the truths upon which Utilitarians have insisted. Its thesis is offered as a challenge to all schools of moral philosophy which have flourished in the twentieth century. Dr Grice argues that there are two kinds of Judgement of moral obligation. Social Contract theory, in a form which avoids the classical objections, is employed in setting out the ground of basic obligations; (...) and the ultra obligations of individual men are found to be grounded in their own characters. He then demonstrates that the theory offered, unlike Utilitarianism, throws light on judgements of rights and justice. Moral good is seen eventually as the coping stone, not the foundation stone of morality. (shrink)

This study discovers a pattern to Diderot's thinking, a fundamental dualism attributable largely to the attitudes and assumptions of the time and giving a common structure to his ideas and writing. Geoffrey Bremner draws widely on Diderot's works in studying his ideas on perception and action, aesthetics, ethics and politics, as well as his plays and fiction. The subtlety of the textual analysis and the analogies Dr Bremner draws provide a convincing and illuminating argument for his interpretation. He supports (...) this but emphasising the intellectual circumstances in which Diderot wrote and demonstrating his links to other eighteenth- and seventeenth-century writers. His study will therefore make a valuable contribution to the reassessment of the period that is currently underway, as well as to the central, elusive problem presented by Diderot's thought itself. (shrink)

This study discovers a pattern to Diderot's thinking, a fundamental dualism attributable largely to the attitudes and assumptions of the time and giving a common structure to his ideas and writing. Geoffrey Bremner draws widely on Diderot's works in studying his ideas on perception and action, aesthetics, ethics and politics, as well as his plays and fiction. The subtlety of the textual analysis and the analogies Dr Bremner draws provide a convincing and illuminating argument for his interpretation. He supports (...) this but emphasising the intellectual circumstances in which Diderot wrote and demonstrating his links to other eighteenth- and seventeenth-century writers. His study will therefore make a valuable contribution to the reassessment of the period that is currently underway, as well as to the central, elusive problem presented by Diderot's thought itself. (shrink)

One of the ideas elaborated in my recent book is what I called the hermeneutical\nprinciple of the asymmetry between negative and positive evaluation: ’this\nprescribes that the textual evidence needed to justify a negative, unfavourable\nevaluation must be of a high quality, strength, and rigor, whereas for a positive\nevaluation less exacting standards are sufficient’ (Finocchiaro, 1988: 247). There,\nI applied this principle to several cases, relating in one way or another to\nGramsci: some were his critiques of other authors, some were my own critiques\nof (...) his ideas, and some were critiques by others; and the issues involved such\nquestions as the status of Marxism as a religion, as a science, and as politics.\nI believe the principle ought to be applied to book reviews. Now, Geoffrey\nHunt’s recent review of my book in this journal (Hunt, 1990) seems to me to be a\nclear violation of this principle, and therefore an answer to it will not only set the\nrecord straight, but may prove generally instructive. That is, his review devotes a\ngreat deal of space to criticizing my work, and very little to analysing, describing,\nor even summarizing it; and whatever description we find, it is largely inaccurate,\nunfair, and one-sided. In short, what he advances is a negative evaluation of my\nbook not properly and adequately documented and justified. (shrink)

A Nobel Prize winner, Dr. Szent-Györgyi concerns himself with the underlying forces and conditions that have prevented the realization of the higher possibilities of the American Dream, and, by extension, of all mankind. He addresses himself especially to the youth of the world in his attempt to show how man, the more he progresses technologically, seems the more to regress psychologically and socially, until he resembles his primate ancestors in a state of high schizophrenia. The fundamental question asked by this (...) book is: Why is it that most of the scientific research that is done to elevate human life serves in the end to destroy it? That this phenomenon exists is unarguable. How to alter it is the problem the author tackles. He finds the possibility, indeed the instrument of our survival, in our youth. Dr. Szent-Györgyi calls upon youth the world over to organize and exercise their power to create a new world. He implores them not to waste their energies in petulance and frustration-the world is ripe for the radical changes needed for man's survival, and for youth to fritter away their opportunity would be to compound the tragedy and seal the fate of mankind. Born into the fourth generation of a noted family of scientists in Hungary, Albert Szent-Györgyi decided at an early age to devote his life to biological research. As a medical student he required international recognition for his studies in microscopic anatomy. The First World War, which he spent in the service of the Austro-Hungarian army, caused a break in his career. After the war he left his devastated country to work for ten years in various countries, notably Germany, Holland, England and the United States. He then returned to his native Hungary to help rebuild science there. In 1937, he won the Nobel Prize for his studies on metabolism and for the discovery of ascorbic acid (Vitamin C). He soon found himself in conflict with the growing movement of Nazism, was arrested, escaped, and was hunted for years by the secret service of Hitler. After World War II, disappointed by Soviet colonialism and the terrorist methods of Stalin, he left Hungary and found refuge at the Marine Biological Laboratory of Woods Hole, Massachusetts. (shrink)

v. 1. Psychological issues.--v. 2. Structural issues.--v. 3. Awareness and self-awareness.--v. 4. Clinical issues.

Memory is everywhere in Blade Runner 2049. From the dead tree that serves as a memorial and a site of remembrance (“Who keeps a dead tree?”), to the ‘flashbulb’ memories individuals hold about the moment of the ‘blackout’, when all the electronic stores of data were irretrievably erased (“everyone remembers where they were at the blackout”). Indeed, the data wiped out in the blackout itself involves a loss of memory (“all our memory bearings from the time, they were all damaged (...) in the blackout”). Memory, and lack of it, permeates place, where from the post-blackout Las Vegas Deckard remembers it as somewhere you could “forget your troubles.” Memory is a commodity, called upon and consumed by the Wallace Corporation, purchased from the memory-maker, Dr Ana Stelline, who constructs and implants “the best memories” in replicants so as to instil in them real human responses. Memory is ubiquitous in Blade Runner 2049, involving humans, replicants, objects, and machines. Even “God,” we are told, “remembered Rachael.” Nowhere, though, is the depiction of memory more important than in the attempt to solve a question of identity. Officer K has a memory of his past. Even though he knows it is an implant, it is a memory he is emotionally attached to, frequently narrating it to Joi, his digital girlfriend. But it is a memory that starts to puzzle and trouble him. When K discovers the remains of a dead replicant, a female NEXUS-7, he uncovers a secret—this replicant was pregnant and died during childbirth, a discovery that could “break the world.” K is charged with hunting down the child and making the problem disappear. Yet as K starts seeking answers to the question of the child’s identity he gets inextricably caught up in the mystery. Is he merely Officer K, or is he Joe, the miracle child of Rachael and Deckard? The answer to this question hinges on K’s memory. But is the memory genuine? Is the memory his? Blade Runner 2049 encourages us to think deeply about the nature of memory, identity, and the relation between them. Indeed, the film does not just serve as a starting point for thinking about philosophical issues related to memory and identity. Rather, as we show in this chapter, the film seems to offer a view on these philosophical issues. Blade Runner 2049 offers us a view of memory as spread out over people, objects, and the environment, and it shows us that memory’s role in questions of identity goes beyond merely accurately recalling one’s past. Identity depends not on memory per se, but partly on what we use memory for. (shrink)

In this paper, a pre-assessment of the Byzantine era of Aigai will be presented. Besides the western Anatolian cities of Pergamum, Ephesus and Smyrna, Aigai is the only city which achieved to cope with the rough terrain among the Aspordenon Mountains north of Smyrna. This city located 17 km east of the Yeni Şakran town in the province Izmir, also known as Köseler castle due to its location on Mount Gün near the Köseler village in the province of Manisa, and (...) is one of the twelve cities within the Aeolian region mentioned by Herodotus. Thanks to the detailed studies by R. Bohn and C. Schuchhardt on inscriptions from Aigai, the city was first introduced to the academical world in 1889. Archaeological studies started in 2004 and were conducted by Prof. Dr. Ersin Doğer. While the archaeological and written sources about the history and civilization of pre-Byzantine Aigai are rather well-known, in this paper it will be attempted to give an overview of the scarce written sources about the Byzantine era and to evaluate them in the light of so-far unpublished architecture and small finds. Since 2004, area based excavations have been carried out in the necropolis of the city, at Demirkapı and the insula situated east of the Tiberius gate which are the entrance points of the city, in the Bouleuterion, Agora and Macellum to its east, in the cisterns nos. I and II and in the easternmost part of the acropolis. The residential areas, built by the last inhabitants of the region, the Byzantines, by using spolia of older buildings, are badly preserved. The architecture, which, due to its location on a hillside, has been harmed by landslides and torrents, but also by human destruction such as treasure hunts and stone borrowing, is very fragile. The only preserved architecture so far is a sacral building dated to the 12th or 13th century. Abundant pottery and glass small finds, together with some metal objects and coins, enable us to get an idea of the Byzantine era in Aigai and provide a foresight to further studies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 25.2 (2001) 233-250 [Access article in PDF] Narrative Theory and Function: Why Evolution Matters Michelle Scalise Sugiyama I It may seem a strange proposition that the study of human evolution is integral to the study of literature, yet that is exactly what this paper proposes. The reasons for this are twofold. Firstly, the practice of storytelling is ancient, pre-dating not only the advent of writing, but (...) of agriculture and permanent settlement as well. Secondly, narrative is ultimately a product of the mind, which in turn is the product of a long history of evolution by natural selection. Thus, an understanding of why and how humans create and consume narrative requires an understanding of (1) features of ancestral environments and (2) features of the mind that made the emergence of this phenomenon possible.There can be little doubt that narrative emerged in human prehistory. Language, an obvious prerequisite for storytelling, is likely to have emerged by at least 50,000 and possibly 250,000 years ago, depending upon whether one places one's trust in archaeological or anatomical evidence. 1 The most reasonable estimate is offered by Geoffrey Miller, who points out that, given its universality, the language faculty must have emerged by the time ancestral Homo sapiens began migrating out of Africa approximately 100,000 years ago. 2 Although the oldest known written narrative (The Epic of Gilgamesh) dates back only 5,000 years, the written literary traditions of many ancient cultures are known to be rooted in longstanding oral traditions. 3 The fact that many modern foraging peoples have rich and complex oral traditions further suggests that the emergence of narrative is not linked to the development of agriculture 10,000 years ago. Moreover, other forms of symbolic expression, such as the cave paintings, Venus figurines, and engraved bone [End Page 233] and antler that have been found at various sites throughout Europe, date back approximately 30,000 years, and rock paintings in Australia may date back even farther. 4 Since humans were physiologically capable of speech long before they began producing these artifacts, storytelling is likely to be at least as ancient as these other representational forms. Indeed, one scholar situates the "dawn of the oral tradition" within this period (Pfeiffer, p. 189). Given, then, that modern humans (Homo sapiens sapiens) have been in existence for approximately 100,000 years 5 and are the only hominid species or subspecies known for certain to exhibit storytelling behavior, we can safely say that oral narrative is a product of our hunting-and-gathering past, likely to have emerged between 30,000 and 100,000 years ago.The universality of narrative is further testimony to its being an ancient cognitive phenomenon. Literate or not, all known cultures, past and present, practice storytelling. 6 Moreover, all normally developing humans acquire the ability to process and generate stories: studies of Western children indicate that the ability to tell stories emerges spontaneously between the ages of two-and-a-half and three, and children as young as thirty months can distinguish between narrative and non-narrative uses of language. 7 In contrast to reading, writing, and arithmetic, no special education is required for narrative competence to develop, nor is there any evidence that oral literacy is acquired through contact with other cultures; although subject matter is often exchanged between groups, the practice of storytelling itself arises independently among even the most isolated peoples. Nor does any type of culture have a monopoly on narrative sophistication: the stories of hunter-horticulturalist societies are no less observant, insightful, or artful than those of agrarian or industrial societies.As with language, narrative takes the same basic form across cultures, which David Bordwell and Kristin Thompson define as "a chain of events in cause-effect relationship occurring in time." Given the preponderance of human agents in narrative, most narrative theorists would probably modify this barebones description to include character (usually understood to have a human psychology), goal-oriented action, and resolution. Frank Kermode, for example, defines the "proprieties" of narrative as "connexity, closure, and character," and John... (shrink)

A different picture of learning is suggested by Karl Popper's account of knowledge growing through 'conjectures and refutations'. The facts of human language are best explained by taking language acquisition to be a case of Popperian learning.