In this wide-ranging interview Priscilla Alderson discusses how she came to research parental and childhood consent and became a sociologist and how, late in her career, she became convenor of the critical realism group started by Roy Bhaskar at the Institute for Education in London. She discusses aspects of her seminal research over the years on multiple subjects, such as the rights of children, and reflects on what critical realism has added to her social research.

The views of parents and staff about physical and symbolic space and its effects on ethical clinical practice are reported. Researchers observed four neonatal intensive care units (NICUs) in southern England, and interviewed 40 senior staff and the parents of 80 babies. The adults' concerns include: how space affects the sharing of information and responsibility for the babies; respect and welcoming policies; access, freedom of movement and accessibility of staff; family friendly space and privacy; aesthetic values; and 'baby-led' space. The (...) paper concludes that abstract principles of respect for autonomy and attitudes towards the baby's biological and personal space take on practical embodied meanings in clinical spaces and practices. NICU design and aesthetics convey powerful ethical messages of welcome or exclusion that endorse or undermine partnerships between staff and parents. Helping premature and impaired babies to reach their space at the centre of their family involves sensitive management. (shrink)

With precision and profundity born of 30 years of devoted study, John Boyle offers an essential introduction to St. Thomas Aquinas on Scripture, shedding helpful light on the goals, methods, and commitments that animate the Angelic Doctor's engagement with the sacred page. Because the genius of St. Thomas's approach to the Bible lies not so much in its novelty but rather in the fidelity and clarity with which he recapitulates the riches of the preceding interpretive Tradition, this initiation into (...) St. Thomas's vision of Scripture is itself an orientation to the Church's vision of Scripture, from the Fathers through and beyond the Middle Ages. St. Thomas's embeddedness within the Church's Tradition and his own historical context is integral to his approach to Scripture, yet it sets him at some distance from modern readers, for whom his interpretive vision may seem perplexing or even impenetrable. In this Primer, Boyle first provides an acclimation to this medieval context through a survey and explanation of pertinent technical terminology used by St. Thomas and characteristic of the scholastic theology of the time. With an eye to the medieval practice of considering Scripture according to the fourfold division of causes, Boyle builds on this initial foundation by exploring in turn St. Thomas's accounts of the end or use of Scripture (final cause), its divine and human authorship (efficient cause), its order and division (material cause), and its literary styles or genres (formal cause). Drawing on writings from across St. Thomas's corpus, but especially his work On the Commendation and Division of Sacred Scripture and the prologues to his biblical commentaries, Boyle masterfully elucidates both the hermeneutical principles and deep wisdom of the Angelic Doctor's approach to Scripture, imparting invaluable guidance not only for reading and understanding St. Thomas and other great masters of the Tradition, but also-and ultimately-for understanding Scripture in light of this Tradition and reading it with greater benefit and joy. (shrink)

The notion of proof is central to mathematics yet it is one of the most difficult aspects of the subject to teach and master. In particular, undergraduate mathematics students often experience difficulties in understanding and constructing proofs. Understanding Mathematical Proof describes the nature of mathematical proof, explores the various techniques that mathematicians adopt to prove their results, and offers advice and strategies for constructing proofs. It will improve students’ ability to understand proofs and construct correct proofs of their own. The (...) first chapter of the text introduces the kind of reasoning that mathematicians use when writing their proofs and gives some example proofs to set the scene. The book then describes basic logic to enable an understanding of the structure of both individual mathematical statements and whole mathematical proofs. It also explains the notions of sets and functions and dissects several proofs with a view to exposing some of the underlying features common to most mathematical proofs. The remainder of the book delves further into different types of proof, including direct proof, proof using contrapositive, proof by contradiction, and mathematical induction. The authors also discuss existence and uniqueness proofs and the role of counter examples. (shrink)

Despite recurring efforts, a gap exists across a variety of contexts between the protection of patients' safety in theory and in practice. This timely Research Handbook highlights these critical issues and suggests both legal and policy changes are necessary to better protect patients' safety. Multidisciplinary in nature, this Research Handbook features contributions from eminent academics, policy makers and medical practitioners from the Global North and South, discussing the essential facets concerning patient safety and the law. It highlights how the role (...) of legislation and case law has the potential to influence, both positively and negatively, medical practice and the quality of care. Chapters explore patient safety and the global health agenda; physiotherapy; 'non-therapeutic' clinical research with children; patient safety awareness in healthcare education; and the increasing use of robotics and artificial intelligence in healthcare. Outlining a wide range of international perspectives on patient safety and the law, this Research Handbook will appeal to academics and researchers specialising in health and medical law, human rights and healthcare regulation. It will also serve as a valuable resource for legal and medical practitioners alike, as well as clinicians and professionals working in healthcare governance. (shrink)

This discussion paper considers how seldom recognised theories influence clinical ethics committees. A companion paper examined four major theories in social science: positivism, interpretivism, critical theory and functionalism, which can encourage legalistic ethics theories or practical living bioethics, which aims for theory–practice congruence. This paper develops the legalistic or living bioethics themes by relating the four theories to clinical ethics committee members’ reported aims and practices and approaches towards efficiency, power, intimidation, justice, equality and children’s interests and rights. Different approaches (...) to framing ethical questions are also considered. Being aware of the four theories’ influence can help when seeking to understand and possibly change clinical ethics committee routines. The paper is not a research report but is informed by a recent study in two London paediatric cardiac units. Forty-five practitioners and related experts were interviewed, including eight members of ethics committees, about the work of informing, preparing and supporting families during the extended process of consent to children’s elective heart surgery. The mosaic of multidisciplinary teamwork is reported in a series of papers about each profession, including this one on bioethics and law and clinical ethics committees’ influence on clinical practice. The qualitative social research was funded by the British Heart Foundation, in order that more may be known about the perioperative views and needs of all concerned. Questions included how disputes can be avoided, how high ethical standards and respectful cooperation between staff and families can be encouraged, and how minors’ consent or refusal may be respected, with the support of clinical ethics committees. (shrink)

This paper briefly reviews highlights from decades of debates in medicine, law, bioethics, psychology and social research about children’s and parents’ views and consent to medical treatment and research. There appears to have been a rise and later a fall in respect for children’s views, illustrated among many examples by a recent book on the zone of parental discretion, which is reviewed. A return to greater respect for children’s views and consent is advocated.

Background: The law and literature about children’s consent generally assume that patients aged under-18 cannot consent until around 12 years, and cannot refuse recommended surgery. Children deemed pre-competent do not have automatic rights to information or to protection from unwanted interventions. However, the observed practitioners tend to inform young children s, respect their consent or refusal, and help them to “want” to have the surgery. Refusal of heart transplantation by 6-year-olds is accepted. Research question: What are possible reasons to explain (...) the differences between theories and practices about the ages when children begin to be informed about elective heart surgery, and when their consent or refusal begins to be respected? Research design, participants and context: Research methods included reviews of related healthcare, law and ethics literature; observations and conversations with staff and families in two London hospitals; audio-recorded semi-structured interviews with a purposive sample of 45 healthcare professionals and related experts; interviews and a survey with parents and children aged 6- to 15-years having elective surgery (not reported in this paper); meetings with an interdisciplinary advisory group; thematic analysis of qualitative data and co-authorship of papers with participants. Ethical considerations: Approval was granted by four research ethics committees/authorities. All interviewees gave their informed written consent. Findings: Interviewees explained their views and experiences about children’s ages of competence to understand and consent or refuse, analysed by their differing emphases on informed, signified or voluntary consent. Discussion: Differing views about children’s competence to understand and consent are associated with emphases on consent as an intellectual, practical and/or emotional process. Conclusion: Greater respect for children’s practical signified, emotional voluntary and intellectual informed consent can increase respectful understanding of children’s consent. Nurses play a vital part in children's practitioner-patient relationships and physical care and therefore in all three elements of consent. (shrink)

Neoliberalism, health and illness are all vast topics that range from global to local, personal to political. Critical realism offers valuable concepts, which help to extend and deepen analysis of...

As a study involving diabetes care demonstrates, children sometimes have a much more sophisticated capacity for taking charge of their own health care decisions than is usually recognized in bioethics. Protecting these children from their disease means involving them in their treatment as much as possible, helping them to understand it and take responsibility for it so that they can navigate the multitude of daily decisions that become part of the diabetes medical regimen.

Consent can only be voluntary, freely given and uncoerced. Can this legal adult standard also apply to children? High-risk surgery is seldom a wanted choice, but compared with the dangers of the un...

Children's competence to refuse or consent to medical treatment or surgery tends to be discussed in terms of the child's ability or maturity. This paper argues that the social context also powerfully influences the child's capacity to consent. Inner attributes and external influences are discussed using an analogy of the genes and the stars.

This article reviews practitioners’ evaluations of in-hospital ethics seminars. A qualitative study included 11 innovative in-hospital ethics seminars, preceded and followed by interviews with most participants. The settings were obstetric, neonatal and haematology units in a teaching hospital and a district general hospital in England. Fifty-six health service staff in obstetric, neonatal, haematology, and related community and management services participated; 12 attended two seminars, giving a total of 68 attendances and 59 follow-up evaluation interviews. The 11 seminars facilitated by an (...) ethicist addressed the key local concerns of staff about the social and ethical consequences of advances in genetics and their impact on professional policies and practice. Seminar agendas were drawn from prior interviews with 70 staff members. During evaluation interviews, participants commented on general aspects that they had enjoyed, how the sessions could be improved, timing, the mix of participants, the quality of the facilitation, whether sessions should be more challenging, after-effects of sessions, and interest in attending seminars and contacting the ethicist in future. Participants valued the increased interprofessional understanding and coherent discussion of many pressing issues that addressed important though seldom discussed ethical questions. The seminars worked well in the different hospitals and specialties. (shrink)

Equipoise is advocated as a means of achieving high scientific and ethical standards in randomised trials. As used in the context of research the word describes a state of uncertainty characterised by the belief that in a trial no arm is known to offer greater harm or benefit than any other arm. Clinicians who lack personal equipoise are advised to accept clinical or communal equipoise, based on current unresolved disagreement among the medical profession. Equipoise is mainly discussed in the literature (...) as an issue for senior doctors and research directors. Limitations of professional equipoise are reviewed, and data on the neglected topic of patients' equipoise are reported using the example of breast cancer trials. In theory, a patient who gives informed and voluntary consent to enter a randomised trial has achieved the equilibrium of equipoise. In practice, equipoise among patients ranges from personal to proxy acceptance. (shrink)

For this second edition, the editors have returned to Austin's original lecture notes, amending the printed text where it seemed necessary.

Terry Eagleton is the foremost Marxist cultural theorist of our time. In the first book-length study of this highly influential figure, David Alderson provides detailed discussions of Eagleton's Marxism and his engagements with postmodernism, as well as an evaluation of his interventions in Irish Studies. Each of the chapters in this important intervention in current theoretical debates offers accessible contextualization of the key issues and provides detailed analyses of Eagleton's literary criticism. Alderson shows that the complex relations between (...) nature, culture and ideology, body, subjectivity and authority are at the heart of Eagleton's ethical and political concerns. He goes on to demonstrate that these relations inform the theorist's critical examinations of such literary works as Wuthering Heights and The Merchant of Venice, and his treatment of W.B. Yeats and Oscar Wilde. (shrink)

The restoration of humanism to the radical left.

These essays highlight the shifting sets of relationships which determine the forms taken by desire. They argue that the spread of the subject within and across geographic, ethnic, class and gender boundaries makes a difference to the ways in which desire is theorized, experienced and represented.

Dewey's book on Democracy and Education established his credentials in the field of education and once counted as his most important book. It has been re-published in many editions and continuously in print ever since the original publication in 1916.

Though the revised edition of A Theory of Justice, published in 1999, is the definitive statement of Rawls's view, so much of the extensive literature on Rawls's theory refers to the first edition. This reissue makes the first edition once again available for scholars and serious students of Rawls's work.

Recent findings in empirical psychology show that implicit biases can affect behavior in ways that are difficult to control deliberatively. Doris argues that findings like these constitute a threat to agency, if agency is defined as the ability to reflectively, deliberatively direct one’s actions. I argue, however, that implicit biases pose no fundamental threat to agency since they can be brought under indirect deliberative control, whereby deliberative, reflective actions put in place automatic processes that automatically inhibit unwanted biases. Since automatic (...) processes can be thus used to achieve deliberatively, reflectively endorsed goals, agency should be defined as the ability to act in line with reflectively endorsed goals, whether by deliberative or automatic processes. (shrink)

Theories of discourse bring to realism new ideas about how knowledge develops and how representations of reality are influenced. We gain an understanding of the conceptual aspect of social life and the processes by which meaning is produced. This collection reflects the growing interest realist critics have shown towards forms of discourse theory and deconstruction. The diverse range of contributions address such issues as the work of Derrida and deconstruction, discourse theory, Eurocentrism and poststructuralism. What unites all of the contributions (...) is a sense that it is essential to provide a realist alternative to the hitherto dominance of social constructionism, hermeneutics and postmodernism, over many of the issues discussed. By developing a realist perspective the different authors attempt to embed discourse within the structured nature of the reality of the world. Realism can situate language, discourse and ideology within context specific, or 'causally efficacious' circumstances. Realism can help to uncover issues of power, representation, and subjectivity and how discursive and other social practices produce real effects. This can help us understand the manner in which social structures are reproduced through various forms of ideology and discourse. And by knowing this, we can start to address questions concerning human emancipation and how the world is to be transformed. (shrink)

This book continues and revises the ideas of justice as fairness that John Rawls presented in _A Theory of Justice_ but changes its philosophical interpretation in a fundamental way. That previous work assumed what Rawls calls a "well-ordered society," one that is stable and relatively homogenous in its basic moral beliefs and in which there is broad agreement about what constitutes the good life. Yet in modern democratic society a plurality of incompatible and irreconcilable doctrines--religious, philosophical, and moral--coexist within (...) the framework of democratic institutions. Recognizing this as a permanent condition of democracy, Rawls asks how a stable and just society of free and equal citizens can live in concord when divided by reasonable but incompatible doctrines? This edition includes the essay "The Idea of Public Reason Revisited," which outlines Rawls ' plans to revise _Political Liberalism,_ which were cut short by his death. "An extraordinary well-reasoned commentary on _A Theory of Justice_...a decisive turn towards political philosophy." --_Times Literary Supplement_. (shrink)

The book also includes a chronological table of significant events, select bibliography, succinct explanatory notes, and an index--all of which supply ...

The renowned philosopher John Searle reveals the fundamental nature of social reality. What kinds of things are money, property, governments, nations, marriages, cocktail parties, and football games? Searle explains the key role played by language in the creation, constitution, and maintenance of social reality. We make statements about social facts that are completely objective, for example: Barack Obama is President of the United States, the piece of paper in my hand is a twenty-dollar bill, I got married in London, (...) etc. And yet these facts only exist because we think they exist. How is it possible that we can have factual objective knowledge of a reality that is created by subjective opinions? This is part of a much larger question: How can we give an account of ourselves, with our peculiar human traits DS mind, reason, freedom, society - in a world that we know independently consists of mindless, meaningless particles? How can we account for our social and mental existence in a realm of brute physical facts? In answering this question, Searle avoids postulating different realms of being, a mental and a physical, or worse yet, a mental, a physical, and a social. There is just one reality: Searle shows how the human reality fits into that one reality. Mind, language, and civilization are natural products of the basic facts of the physical world described by physics, chemistry and biology. Searle explains how language creates and maintains the elaborate structures of human social institutions. These institutions serve to create and distribute power relations that are pervasive and often invisible. These power relations motivate human actions in a way that provides the glue that holds human civilization together. Searle shows how this account illuminates human rationality, free will, political power, and human rights. Our social world is a world created and maintained by language. (shrink)

In The Construction of Social Reality, John Searle argues that there are two kinds of facts--some that are independent of human observers, and some that require..

Children's autonomy includes, as far as possible, self-determination, bodily integrity and the right to influence outcomes. Limits to bodily integrity, which involves no touching without the child's consent or tacit agreement, are discussed. The clinical, legal and ethics literature tends to agree that children may give valid consent to major recommended treatment from around 12 years but may not refuse it until they are legal adults. Research shows that young children are more aware of their bodily integrity and autonomy, of (...) morality and decision making, than was assumed in the past. Adults therefore need to inform children and respect their initially instinctive efforts to protect their bodily integrity. Unlike assent, consent involves patients being adequately informed and being able to accept or refuse proposed treatment. Reasons are given for adults’ need to consult with children when determining their best interests. Beyond words, giving or withholding consent also involves emotions of fear, trust and courage, besides embodied reactions of cooperating with treatment or resisting it, in which young children actively engage. Some clinicians work with the informed cooperation of young children who need lifesaving treatment, and at times accept their refusal. Reasons for differences between mainstream experts’ views and clinical practices are considered. (shrink)

A Norton Library edition of Locke's Second Treatise of Government, edited by A. John Simmons.

This book comprises all of John Bell's published and unpublished papers in the field of quantum mechanics, including two papers that appeared after the first edition was published. It also contains a preface written for the first edition, and an introduction by Alain Aspect that puts into context Bell's great contribution to the quantum philosophy debate. One of the leading expositors and interpreters of modern quantum theory, John Bell played a major role in the development of our current (...) understanding of the profound nature of quantum concepts. First edition Hb (1987): 0-521-33495-0 First edition Pb (1988): 0-521-36869-3. (shrink)

Reissued here in its corrected second edition of 1864, this essay by John Stuart Mill argues for a utilitarian theory of morality. Originally printed as a series of three articles in Fraser's Magazine in 1861, the work sought to refine the 'greatest happiness' principle that had been championed by Jeremy Bentham, defending it from common criticisms, and offering a justification of its validity. Following Bentham, Mill holds that actions can be judged as right or wrong depending on whether they (...) promote happiness or 'the reverse of happiness'. Although attracted by Bentham's consequentialist framework based on empirical evidence rather than intuition, Mill separates happiness into 'higher' and 'lower' pleasures, arguing for a weighted system of measurement when making and judging decisions. Dissected and debated since its first appearance, the essay is Mill's key discussion on the topic and remains a fundamental text in the study of ethics. (shrink)

This is a brief reply to the roundtable entitled ‘Does critical realism need the concept of three domains of reality?’ in which Dave Elder-Vass, Tom Fryer, Ruth Porter Groff, Cristián Navarrete and...

Much as we would like to conceive empirical thought as rationally grounded in experience, pitfalls await anyone who tries to articulate this position, and ...

Background This analysis is about practical living bioethics and how law, ethics and sociology understand and respect children’s consent to, or refusal of, elective heart surgery. Analysis of underlying theories and influences will contrast legalistic bioethics with living bioethics. In-depth philosophical analysis compares social science traditions of positivism, interpretivism, critical theory and functionalism and applies them to bioethics and childhood, to examine how living bioethics may be encouraged or discouraged. Illustrative examples are drawn from research interviews and observations in two (...) London paediatric cardiac units. This paper is one of a series on how the multidisciplinary cardiac team members all contribute to the complex mosaic of care when preparing and supporting families’ informed consent to surgery. Results The living bioethics of justice, care and respect for children and their consent depends on theories and practices, contexts and relationships. These can all be undermined by unseen influences: the history of adult-centric ethics; developmental psychology theories; legal and financial pressures that require consent to be defined as an adult contract; management systems and daily routines in healthcare that can intimidate families and staff; social inequalities. Mainstream theories in the clinical ethics literature markedly differ from the living bioethics in clinical practices. Conclusion We aim to contribute to raising standards of respectful paediatric bioethics and to showing the relevance of virtue and feminist ethics, childhood studies and children’s rights. (shrink)

The “family rule” paper by Dr Foreman proposes a way of resolving the present uncertainty about medical law on children's consent and refusal. This commentary reviews how doctors' decisions are already well protected by English law and respected by the courts. The “family rule” appears to be likely only to complicate the already diffuse law on parental consent, and to weaken further the competent minor's position in cases of uncertainty and disagreement. It leaves the difficult questions about defining and assessing (...) children's competence unanswered. This commentary suggests that these questions would be better resolved through professionally determined standards of good practice that respect children and parents, rather than through rules or laws. (shrink)

This discussion paper is drawn from a qualitative research project comparing the effect of special and ordinary schools on the lives of children, young people and their families. Special schools are recommended by health professionals who seldom know how ineffective these schools are. We question the beneficence and justice of health professionals' advice on education for children with disabilities and other difficulties. Cooperation with local education authorities (LEAs) plays a considerable part in the work of community paediatricians, clinical medical officers, (...) therapists and other health professionals encountering children with "special needs". The "needs" range from physical disability and sensory impairment to learning difficulties and emotional or behavioural difficulties. This cooperation involves routine administrative problems, but it raises broad ethical issues too, particularly in respect of current tendencies in state schooling towards the integration or inclusion of these children in mainstream schools and classes. (shrink)