Evidence-based medicine has been rapidly and widely adopted because it claims to provide a method for determining the safety and efficacy of medical therapies and public health interventions more generally. However, as others have noted, EBM may be riven through with cultural bias, both in the generation of evidence and in its translation. We suggest that technological and scientific advances in medicine accentuate and entrench these cultural biases, to the extent that they may invalidate the evidence we have about disease (...) and its treatment. This creates a significant ethical, epistemological and ontological challenge for medicine. (shrink)

(2013). Intractable Difficulties in Caring for People With Sickle Cell Disease. The American Journal of Bioethics: Vol. 13, No. 4, pp. 22-24. doi: 10.1080/15265161.2013.767959.

Most work on John Stuart Mill focuses on his account of civil or political liberties. But as Bruce Baum (2006) argues, Mill's commitment to “the free development of individuality” applied in the economic sphere as well as the social and political. As part of his decentralized, ‘liberal’, socialism (McCabe, 2021) he endorsed a ‘pluralist’ economy which combined consumer- and producer-co-operatives with some state provisions. This ‘utopia’ reveals a road untravelled by both socialism and liberalism, but aimed at achieving normative principles (...) dear to both – liberty, equality, security, fraternity, and progress – and which is worth serious consideration today. Dale E. Miller (2003) argues that, given the arguments of On Liberty, Mill should have been open to ‘capitalistic’ as well as ‘socialistic’ enterprises in his utopia. I argue that Mill's socialism (and his account of transition) involves a significant change in attitudes, which would rule out ‘capitalistic’ motivations and thus structures and organisations. One such structure is the labour market. Building on earlier work (McCabe, 2021) and comments by Joseph Persky (2024), I explore the implications of Mill's commitment to ending a competitive labour market whilst maintaining the plurality of economic enterprises for capital, ‘progress’, and Mill's commitment to diversity. (shrink)

Entrepreneurship is increasingly considered to be integral to development; however, social and cultural norms impact on the extent to which women in developing countries engage with, and accrue the benefits of, entrepreneurial activity. Using data collected from 49 members of a rural social enterprise in North India, we examine the relationships between social entrepreneurship, empowerment and social change. Innovative business processes that facilitated women’s economic activity and at the same time complied with local social and cultural norms that constrain their (...) agency contributed to changing the social order itself. We frame emancipatory social entrepreneurship as processes that empower women and contribute to changing the social order in which women are embedded. (shrink)

As the author of A Metaphysics for Freedom (Oxford: Oxford University Press, 2012), I respond to each of the preceding eight papers in this Special Issue.

This article uses philosopher Miranda Fricker’s work on epistemic injustice to shed light on the legal concept of the fiduciary, alongside demonstrating the wider contribution Fricker’s work can make to business ethics. Fiduciary, from the Latin fīdūcia, meaning “trust,” plays a fundamental role in all financial and business organisations: it acts as a moral safeguard of the relationship between trustee and beneficiary. The article focuses on the ethics of the fiduciary, but from a unique historical perspective, referring back to the (...) original formulation of the fiduciary within a familial context to investigate presuppositions regarding agential capabilities, whilst also paying attention to the power mechanism embedded in the trustee–beneficiary relationship. Using Fricker’s theory of pre-emptive testimonial injustice, the analysis elucidates the impact of cumulative beneficiary silencing in contemporary contexts, and the article uncovers ethical issues of an epistemological kind at the core of the fiduciary—of epistemic injustice. (shrink)

Smart cities are now an established area of technological development and theoretical inquiry. Research on smart cities spans from investigations into its technological infrastructures and design scenarios, to critiques of its proposals for citizenship and sustainability. This article builds on this growing field, while at the same time accounting for expanded urban-sensing practices that take hold through citizen-sensing technologies. Detailing practice-based and participatory research that developed urban-sensing technologies for use in Southeast London, this article considers how the smart city as (...) a large-scale and monolithic version of urban systems breaks down in practice to reveal much different concretizations of sensors, cities, and people. By working through the specific instances where sensor technologies required inventive workarounds to be setup and continue to operate, as well as moments of breakdown and maintenance where sensors required fixes or adjustments, this article argues that urban sensing can produce much different encounters with urban technologies through lived experiences. Rather than propose a “grassroots” approach to the smart city, however, this article instead suggests that the smart city as a figure for urban development be contested and even surpassed by attending to workarounds that account more fully for digital urban practices and technologies as they are formed and situated within urban projects and community initiatives. (shrink)

The role of the ‘ideal’ in political philosophy is currently much discussed. These debates cast useful light on Mill's self-designation as ‘under the general designation of Socialist’. Considering Mill's assessment of potential property-relations on the grounds of their desirability, feasibility and ‘accessibility’ (disambiguated as ‘immediate-availability’, ‘eventual-availability’ and ‘conceivable-availability’) shows us not only how desirable and feasible he thought ‘utopian’ socialist schemes were, but which options we should implement. This, coupled with Mill's belief that a socialist ideal should guide social reforms (...) (as the North Star guides mariners), reveals much more clearly the extent of his socialist commitments (even if he thought political economists would be concerned with forms of individual property for some time to come). Moreover, this framework for assessments of ‘ideal’ institutions makes a useful contribution to an ongoing contemporary debate. (shrink)

Medically unexplained symptoms (MUS) are common and costly in both primary and secondary health care. It is gradually being acknowledged that there needs to be a variety of interventions for patients with medically unexplained symptoms to meet the needs of different groups of patients with such chronic long-term symptoms. The proposed intervention described herewith is called The BodyMind Approach (TBMA) and promotes learning for self-management through establishing a dynamic and continuous process of emotional self-regulation. The problem is the mismatch between (...) the patient’s mind-set and profile and current interventions. This theoretical article, based on practice-based evidence, takes forward the idea that different approaches (other than cognitive behaviour therapy) are required for people with MUS. The mind-set and characteristics of patents with MUS are reflected upon to shape the rationale and design of this novel approach. Improving services for this population in primary care is crucial to prevent the iterative spiralling downwards of frequent GP visits, hospital appointments, and Accident and Emergency attendance, all of which are common for these patients. The approach derives from embodied psychotherapy (authentic movement in dance movement psychotherapy) and adult models of learning for self-management. It has been developed from research and practice-based evidence. In this article the problem of MUS in primary care is introduced and the importance of the reluctance of patients to accept a psychological/mental health referral in the first instance is drawn out. A description of the theoretical underpinnings and philosophy of the proposed alternative to current interventions is then presented related to the design, delivery, facilitation and educational content of the programme. The unique intervention is also described to give the reader a flavour. (shrink)

The arts provide openings for symbolic expression by engaging the sensory experience in the body they become a source of insight through embodied cognition and emotion, enabling meaning-making, and acting as a catalyst for change. This synthesis of sensation and enactive, embodied expression through movement and the arts is capitalized on in The BodyMind Approach®. It is integral to this biopsychosocial, innovative, unique intervention for people suffering medically unexplained symptoms applied in primary healthcare. The relevance of embodiment and arts practices (...) in TBMA are discussed in relation to the views of participants in the pursuit of self-management. If widely employed TBMA could have an enormous impact, reach, and significance for patients and global health services. This original pre-clinical trial of qualitative research reports on the perceptions of participant patients with generic MUS, a world-wide issue usually treated by either psychological therapy or physiotherapy. TBMA is not a therapy but a health education program founded upon the concept of an integration of psychological elements with physiological, bodily, and sensory experiences. Thematic analysis of qualitative data sets from open-ended questions in semi-structured interviews and a written questionnaire post intervention is presented. Five aspects which appear to be key to learning self-management were derived from analyzing the data: body with mind connections; importance of facilitation; potential benefits; preparedness for change; self-acceptance/compassion. This article advances the discourse on the nature of self-management for MUS through changing the mind-set and the relationship participants have with their bodily symptom/s through employing embodied methods and arts practices, challenging current, and solely verbal, psychological conceptual frameworks. Rigor lies in the method of data analysis using cross verification of credibility between reported findings and scrutiny by stakeholders. We conclude that facilitated TBMA groups employing embodied methods and arts practices can act as a method for developing the self-management of MUS and improving wellbeing. (shrink)

Imitation, the replication of observed behaviors, has been proposed as the crucial social learning mechanism for the generation of humanlike cultural complexity. To date, the single published experimental microsociety study that tested this hypothesis found no advantage for imitation. In contrast, the current paper reports data in support of the imitation hypothesis. Participants in “microsociety” groups built weight-bearing devices from reed and clay. Each group was assigned to one of four conditions: three social learning conditions and one asocial learning control (...) condition. Groups able to observe other participants building their devices, in contrast to groups that saw only completed devices, show evidence of successive improvement. These results are consistent with the hypothesis that imitation is required for cumulative cultural evolution. This study adds crucial data for understanding why imitation is needed for cultural accumulation, a central defining feature of our species. (shrink)

_The Ethics of Pregnancy, Abortion and Childbirth_ addresses the unique moral questions raised by pregnancy and its intimate bodily nature. From assisted reproduction to abortion and ‘vital conflict’ resolution to more everyday concerns of the pregnant woman, this book argues for pregnancy as a close human relationship with the woman as guardian or custodian. Four approaches to pregnancy are explored: ‘uni-personal’, ‘neighborly’, ‘maternal’ and ‘spousal’. The author challenges not only the view that there is only one moral subject to consider (...) in pregnancy, but also the idea that the location of the fetus lacks all inherent, unique significance. It is argued that the pregnant woman is not a mere ‘neighbor’ or helpful stranger to the fetus but is rather already in a real familial relationship bringing real familial rights and obligations. If the status of the fetus is conclusive for at least some moral questions raised by pregnancy, so too are facts about its bodily relationship with, and presence in, the woman who supports it. This lucid, accessible and original book explores fundamental ethical issues in a rich and often neglected area of philosophy in ways of interest also to those from other disciplines. (shrink)

Preference utilitarians are concerned to maximize the autonomous choices of individuals; for this reason, they argue that nurses ought to advocate for those patients who desire assistance with ending their lives. This approach prompts us to consider, then, the moral validity of nursing involvement in measures intended to end the lives of patients. In this article, the terms of preference utilitarianism are set out and considered in order to determine whether this approach offers sufficient philosophical support for sanctioning a role (...) for nursing in euthanasia. Ultimately, it is found that preference utilitarianism is lacking in this respect, as well as in its fitness for guiding nursing activity in general. In particular, it is found that nurses are required to exchange a handmaiden relationship with the medical profession for an equally undignified relationship with patients. If nursing involvement in measures intended to end the lives of patients is to find sufficient philosophical support, then we need to look elsewhere. (shrink)

Outlines the origin and evolution of postmodern thought over the last half century and argues that the unchecked spread and application of postmodern ideas -- from academia, to activist circles, to the public at large - presents an authoritarian ideological threat not only to liberal democracy but also to modernity itself.

In an earlier article, it was found that the terms of preference utilitarianism are insufficiently sound for guiding nursing activity in general, including in relation to nursing involvement in euthanasia. In this article, I shall examine the terms of a more traditional philosophical approach in order to determine the moral legitimacy, or otherwise, of nursing engagement in measures intended to end the lives of patients. In attempting this task, nursing practice is considered in light of what I shall call a (...) ‘nursing‐as‐healing‐praxis’ approach which includes an account of the moral purpose of nursing and the virtues necessary for realizing that purpose. Ultimately, it is concluded that the terms of this approach rule out the involvement of nurses in euthanasia such that if euthanasia can be justified at all, those outside the nursing profession must provide for its administration. (shrink)

The practice of nursing involves ongoing interactions between nurses' and clients' lived bodies. Despite this, several scholars have suggested that the “lived body” (Merleau‐Ponty, 1962) has not been given its due place in nursing practice, education or research (Draper, J Adv Nurs, 70, 2014, 2235). With the advent of electronic health records and increased use of technology, face‐to‐face assessment and embodied understanding of clients' lived bodies may be on the decline. Furthermore, staffing levels may not afford the time nurses need (...) to be as “present” with their clients in embodied ways. The failure to attend to the lived body may contribute to missed opportunities for care and decreased quality of life for both clients and healthcare practitioners. In this paper, we undertake an analysis of selected aspects of the work of Maurice Merleau‐Ponty. The aim is to advance understanding of the affordances this work may offer to enhancing client–nurse interactions within the practice of nursing. Merleau‐Ponty's notions of embodiment, intersubjectivity and intercorporeality as articulated in his seminal texts The Phenomenology of Perception (New York, NY: Routledge, 2012) and The Visible and the Invisible (Evanston, IL: Northwestern University Press, 1968) are examined. These three constructs are discussed as they relate to the lived body in client–nurse interactions in nursing practice and education. Finally, implications of how attention to “the lived body” could shape interactions and have the potential to foster increased quality of life of clients and nurses are considered. (shrink)

Cet article écrit par deux psychologues cliniciens met en évidence ce qui des difficultés apparentes entre mère et fils est le fruit du passé de violences conjugales et ce qui est de l’ordre des difficultés primaires du lien. À partir de l’étude d’une dyade mère-fils rencontrée en MECS au travers d’un dispositif praticien, trois types d’entretiens ont été mis en place : individuels, mère-enfant et fraternels. Les divers éléments de la clinique tendent à montrer que les difficultés actuelles s’originent dans (...) la relation primaire mère-fils où la problématique de la dette tient elle aussi une part importante. (shrink)

The article analyzes the ongoing Russian–Ukrainian war in terms of a colonial seizure undertaken by a fading but aggressive Russian empire. This highly political adventure is translated into more abstract terms, that is, an irresolvable conflict between existence, which is always the experience of coexistence devoid of any essence whatsoever, and imperial expansion, which is an infinite conquest of space indifferent to all forms of life. The dualism in question is backed up by the writings of two important scholars, namely, (...) the French philosopher Jean-Luc Nancy and the Russian scientist and revolutionary Peter Kropotkin. Nancy’s philosophy of being-in-common is the development of Heidegger’s concept of Mitsein, where the meaning of Mit- (co-, with) is existential and not categorical. Nancy’s philosophy challenges all forms of communal essence, of which empire is one blatant example. For Kropotkin, existence is even more all-embracing, implying a continuity of different life forms. His doctrine of mutual aid is a law that governs both society and nature, as well as evolution itself. Even morality springs from “solidarity” and the joys of social life, while sympathy or love are too narrow a basis for human ethics. Viewed from this perspective, a colonial war would not only be the greatest waste of human lives and natural resources—it would contradict the very order of things. (shrink)

As a relative concept, privacy is difficult to define in universal terms. In the New Zealand setting recent legislation aims to protect patients’ privacy but anecdotal evidence suggests that these policies are not well understood by some providers and recipients of health care. This qualitative study set out to identify some of the issues by exploring former patients’ perceptions of privacy in shared hospital rooms. The findings suggest a conditional acceptance of a loss of privacy in an environment dictated by (...) architectural structure and by fiscal and time constraints. Participants indicated an awareness that personal information could be overheard and that their preference for a choice of setting for serious discussions was desirable. Some enjoyed the support offered in shared rooms, while, for others, overhearing another person’s health issues caused unnecessary distress. The participants suggested that knowing they could be overheard constrained information disclosure. This withholding of information has implications for health professionals’ ability to diagnose and treat patients appropriately. (shrink)

Harriet Taylor Mill and Anna Wheeler are two nineteenth-century British feminists generally over-shadowed by the fame of the men with whom they co-authored. Yet both made important and interesting contributions to political thought, particularly regarding deconstruction of (i) the patriarchal institution of marriage; and (ii) the current property regime which, in dominating workers, unfairly distributing the product of labour, and encouraging ‘individualism’, they believed did little to maximize the general happiness. Both were feminists, utilitarians, and socialists. How they link these (...) elements is both interestingly similar, and interestingly different. This article has four aims. Firstly, to make a strong claim concerning their authorial hand in works often considered to be solely the work of their male co-author. Secondly, to sketch those co-authoring relationships, and consider whether Taylor and Mill may even have consciously constructed their early letters ‘On Marriage' based upon what they knew of Thompson and Wheeler’s relationship. Thirdly, to map out their shared (though not identical) claim that marriage was a form of slavery, and the proposals they offered to free women from the domination of patriarchal relationships. Fourthly, to explore the way in which both thought female emancipation would be most truly realized via cooperative socialism. (shrink)

How nursing as a profession is valued may be changing and needs to be explored and understood in a global context. We draw on data from two empirical studies to illustrate our argument. The first study explored the value of nursing globally, the second investigated the experiences of overseas trained nurses recruited to work in a migrant capacity in the UK health care workforce. The indications are that nurses perceive themselves as devalued socially, and that other health care professionals do (...) not give nursing the same status as other, socially more prestigious professions, such as medicine. Organizational and management structures within the NHS and the independent care home sector devalue overseas nurses and the contribution they make to health care. Our conclusions lead us to question the accepted sociocultural value of the global nursing workforce and its perceived contribution to global health care, and to consider two ethical frameworks from which these issues could be discussed further. (shrink)

: In this paper I address the vexed question of secondary causation in René Descartes' physics, and examine several influential interpretations, especially the one recently proposed by Dennis Des Chene. I argue that interpreters who regard Cartesian bodies as real secondary causes, on the grounds that the modes of body include real forces, contradict Descartes' account of modes. On the other hand, those who deny that Descartes affirms secondary causation, on the grounds that forces cannot be modes of extension, commit (...) Descartes to the problematic view that the undetermined and immutable will of God is the sole cause of determinate and variable motions. Des Chene's contextualist approach to Descartes' texts leads him to an intermediate position that combines elements of both interpretations. However, in my view, Des Chene's interpretation likewise fails to resolve apparent tensions in Descartes' claims. I thus propose to separate the issue of secondary causation from what Des Chene dubs 'the problem of force'. On the basis of this approach, and a study of Jesuit commentaries familiar to Descartes, I develop a new interpretation which takes seriously Descartes' claim that the laws of nature are the secondary and particular causes of particular motions and changes in motion. (shrink)

Abortion for life-limiting foetal anomaly is often an intensely painful choice for the parents; though widely offered and supported, it is surprisingly difficult to defend in ethical terms. Abortion on this ground is sometimes defended as foetal euthanasia but has features which sharply differentiate it from standard non-voluntary euthanasia, not least the fact that any suffering otherwise anticipated for the child may be neither severe nor prolonged. Such abortions may be said to reduce suffering for the family including siblings – (...) a consideration rarely stated so explicitly in defences of postnatal euthanasia – or for the woman who must in any case face the eventual loss of her baby, and for whom the abortion is seen as therapeutic in minimising pain. Finally, the abortion may be said to constitute the cessation of morally optional life support on the part of the woman, and/or to be a ‘social’ choice she is entitled to make, whether or not this in fact promotes her interests or those of her child. These defences need honest exploration: the intense parental suffering caused by the choice to end an often much-wanted pregnancy should not preclude but rather encourage the question whether this choice can indeed be ethically proposed to couples, especially compared with the neonatal palliative care (‘perinatal hospice’) approach so well received by parents who experience it. (shrink)

Poetics of futurism: Zaum, shiftology, nonsense -- Poetics of Deleuze: structure, stoicism, univocity -- The materialist manifesto -- Shiftology #1: from performativity to dramatisation -- Shiftology #2: from metaphor to metamorphosis -- The see-sawing frontier: linguistic spatiotemporalities -- Concllusion: Suffixing, prefixing.

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work.This work is in the public domain in (...) the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

The Long Fifteenth Century is intended as a companion volume to Douglas Gray's ground-breaking Oxford Book of Late Medieval Verse and Prose and incorporates a bibliography of his published writings. Gray's anthology revolutionized critical appreciation of English and Scottish literature of the `long fifteenth century' from the death of Chaucer to the Reformation, but the literature of the period as a whole remains much under-read, undervalued, and under-studied. The contributors to this volume, all leading scholars in the field, bring to (...) the fore the power of underrated writers, restore to the period writings often attributed to other centuries, open up new possibilities in neglected genres, offer radical rereadings of some more familiar works, and demonstrate how closely the literature of the period is bound up with political and social conditions. Written in honour of Douglas Gray, to mark his long and distinguished tenure of the J.R.R. Tolkein Professorship of English Literature and Language at Oxford university, the 15 essays in this volume portray the long fifteenth century as a major period of literature in its own right. They provide a comprehensive survey of fifteenth-century literature in print, from the morality play to the ballad, verse forms to prose romances, including Chaucer, Lydgate, Skelton, and Hoccleve, along with essays on the Middle French Poets and Scottish writings of the period. (shrink)

People often get angry when they perceive an injustice that affects others but not themselves. In two studies, we investigated the elicitation of third-party anger by varying moral violation and others’ outcome presented in newspaper articles. We found that anger was highly contingent on the moral violation. Others’ outcome, although relevant for compassion, were not significantly relevant for anger or less relevant for anger than for compassion. This indicates that people can be morally outraged: anger can be elicited by a (...) perceived violation of moral values alone, independent of the harm done. A severe negative consequence for others is not necessary to elicit anger. (shrink)

This article reports on exploratory research into social workers? perceptions and actions regarding ?forewarning? clients of their child abuse reporting obligations as a limitation of confidentiality at relationship onset. Ethical principles and previous research on forewarning are discussed prior to stating the research methods and presenting findings. Data obtained from South Australian social workers engaged in human service work with adult family members articulate a strong desire to practise in accordance with professional codes of ethics. However, the findings suggest that (...) proactive forewarning is extremely infrequent, with minimized forewarning accomplished only in response to client-initiated inquiry and where prior suspicions of child abuse may exist. Generally, discomfort with forewarning was found to result in its avoidance due to concerns about client retention, working in tense relationships and personal uncertainties about client's reactions towards participants. Through the avoidance of forewarning, participants are potentially supporting their own personal feelings and viewpoints more actively than the rights of others. This may correlate with having a private model of professionalism in opposition to a public model, in which relationship parameters are presented honestly and openly to clients when establishing the practice context?a problematic issue for ethical social work. (shrink)

: This paper interprets Descartes's use of the Scholastic doctrine of divine concurrence in light of contemporaneous sources, and argues against two prevailing occasionalist interpretations. On the first occasionalist reading God's concurrence or cooperation with natural causes is always mediate (i.e., concurrence reduces to God's continual recreation of substances). The second reading restricts God's immediate concurrence to his co-action with minds. This paper shows that Descartes's metaphysical commitments do not necessitate either form of occasionalism, and that he is more plausibly (...) and charitably read as appropriating elements of Scholastic views on concurrence to bridge the gap between his metaphysics and physics. (shrink)

The proposal for reproducing human generations in vitro raises the question to what extent parenthood is possible in embryos and to what extent human rights and interests are dependent on conscious awareness. This paper argues that the interest in not being made a parent non-consensually for the benefit of others persists throughout the lifespan of the individual human organism. We do not become genetic parents by learning that we are parents; rather, we discover (or fail to discover) an existing genetic (...) relationship between our offspring and ourselves. The claim to genetic parenthood of an embryo used for reproduction in vitro is, if anything, clearer than the claim of the adult for whom gametes are derived via ips cells, in that an embryo’s cells, unlike an adult’s somatic cells, are already functionally geared to producing gametes (among other types of cell). An embryo used to make gametes that are used in reproduction is immediately and non-consensually made a genetic parent and to that extent is wronged whether or not the parent embryo survives – as some could survive – the harvesting of cells. All human individuals carry objective interests in benefits appropriate to the kind of being they are; these include the stake in not being made a parent without one’s consent, whether posthumously or otherwise. (shrink)

Moral Foundations research offers rich promise, opening up key questions about how affect and cognition are integrated in moral response, and exploring how different moral discourses may supply meaning and valence to moral experience. Haidt and his colleagues also associate different discourses with different political positions. However I address three problematic areas. First to what extent Haidt has succeeded in transcending the traditional dichotomy of affect and cognition, and created an integrative model of how moral intuitions actually work. Second, the (...) analysis of cultural processes is too limited; moral responses are discursive, contextualized and constructed. Third, the political spectrum is complex and diverse; to be truly useful, the research on Moral Foundations must avoid parochial US political concerns and models. (shrink)