This article examines the involvement of neonatal nurses in ethical issues, achieved through a survey of Australian neonatal nurses. The aim was to discover if nurses were involved in ethical decisions, to examine various categories of neonates and the concerns that nurses felt about them, and to determine the extent to which nurses saw themselves as advocates. A response rate of 65% was achieved from nurses in two states who worked in intensive care and special care nurseries. The findings show (...) that nurses were more likely to be involved in clinical decision making than in ethical decision making, showed the greatest concern for infants who had an uncertain prognosis, and saw themselves as advocates for their patients. The issues surrounding these findings are examined. (shrink)

One barrier to optimal pain management in the neonatal intensive care unit is how the healthcare community perceives, and therefore manages, neonatal pain. In this paper, we emphasise that healthcare professionals not only have a professional obligation to care for neonates in the NICU, but that these patients are intrinsically worthy of care. We discuss the conditions that make neonates worthy recipients of pain management by highlighting how neonates are vulnerable to pain and harm, and completely dependent on others for (...) pain management. We argue for a relational account of ethical decision-making in the NICU by demonstrating how an increase in vulnerability and dependence may be experienced by the healthcare community and the neonate’s family. Finally, an ethical framework for decisions around neonatal pain management is proposed, focussing on surrogate decision-making and the importance of compassionate action through both a reflective and an affective empathy. As empathy can be highly motivating against pain, we propose that, in addition to educational programs that raise awareness and knowledge of neonatal pain and pain management, healthcare professionals must cultivate empathy in a collective manner, where all members of the NICU team, including parents, are compassionate decision-makers. (shrink)

Introduction: Thinking, writing, and reading about the real -- Dialectic and the real : Lacan, Hegel, and the alchemy of après-coup -- 'Reality' and the real : culture as anamorphosis -- The real of sexual difference : imagining, thinking, being -- Ethics and the real : the ungodly virtues of psychoanalysis -- Politics, or, the art of the impossible.

Critical Qualitative Health Research seeks to deepen understandings of the philosophies, politics and practices shaping contemporary qualitative health related research. This accessible, lively, controversial introduction draws on current empirical examples and critical discussion to show how qualitative research undertaken in neoliberal healthcare contexts emerges and the complex issues qualitative researchers confront. This book provides readers with a critical, interrogative discussion of the histories and the legacies of qualitative research, as well as of the more recent calls for renewed criticality in (...) research to respond to global health concerns. Contributions further showcase a range of contemporary work engaging with these issues and the complex encounters with philosophies, politics and practices this involves; from seeking explicit engagements with posthuman ideas or detailed explorations of deeply engaged humanist approaches, to critical discussions of the politics and practices of emerging novel, digital and creative methods. This book offers postgraduate researchers, health researchers and students alike opportunities to engage more deeply with the emergent, complex and messy terrain of qualitative health related research. (shrink)

The work reported in this monograph was begun in the winter of 1967 in a graduate seminar at Berkeley. Many of the basic data were gathered by members of the seminar and the theoretical framework presented here was initially developed in the context of the seminar discussions. Much has been discovered since1969, the date of original publication, regarding the psychophysical and neurophysical determinants of universal, cross-linguistic constraints on the shape of basic color lexicons, and something, albeit less, can now also (...) be said with some confidence regarding the constraining effects of these language-independent processes of color perception and conceptualization on the direction of evolution of basic color term lexicons. (shrink)

Beloved author of, among many other books, the bestsellers How to Argue and Win Every Time and The Making of a Country Lawyer , Gerry Spence distills a lifetime of wisdom and observation about how we live, and how we ought to live in Seven Simple Steps to Personal Freedom . Here, in seven chapters, he delivers messages that inspire us first to recognize our servitude-to money, possessions, corporations, the status quo, and our own fears-and then shows us how (...) to begin the self-defining process toward liberation. Seven Simple Steps to Personal Freedom is a powerfully affirming, large-hearted, and life-changing book that asks us all to take the greatest risk for the greatest reward-our own freedom. (shrink)

This undergraduate textbook covers the key material for a typical first course in logic, in particular presenting a full mathematical account of the most important result in logic, the Completeness Theorem for first-order logic. Looking at a series of interesting systems, increasing in complexity, then proving and discussing the Completeness Theorem for each, the author ensures that the number of new concepts to be absorbed at each stage is manageable, whilst providing lively mathematical applications throughout. Unfamiliar terminology is kept to (...) a minimum, no background in formal set-theory is required, and the book contains proofs of all the required set theoretical results. The reader is taken on a journey starting with König's Lemma, and progressing via order relations, Zorn's Lemma, Boolean algebras, and propositional logic, to completeness and compactness of first-order logic. As applications of the work on first-order logic, two final chapters provide introductions to model theory and nonstandard analysis. (shrink)

Professor J. B. Schneewind's recent excellent volume Mill's Ethical Writings has drawn attention to the necessity of studying Mill's notes to chapter XXIII of his father's Analysis of the Phenomena of the Human Mind for a clear understanding of his theory of the moral sentiments. There are notes, however, by J. S. Mill to other chapters of that work, which should not be forgotten, because they elucidate the associationist theory of motivation which is obscurely appealed to in chapter IV of (...) Utilitarianism. Critics of Mill from F. H. Bradley onwards have made erroneous statements about the psychology that underlies Mill's justification of the principle of utility. But if Mill was going to support his ethics with a psychological theory, he should have expressed that theory at length and unambiguously in his ethical treatise. In what follows, it is pointed out where critics have been unfair to Mill through their apparent ignorance of his notes to the Analysis and of his conception of sympathy; but it is also shown that there is a puzzling inconsistency between the notes and a key passage in Utilitarianism, chapter IV. Finally, the theory of habitual volition, which is expressed at the close of that chapter, is examined. Critics have paid little attention to this theory, but it entails a serious modification of psychological hedonism, and Mill obviously attributed great importance to it. (shrink)

The doctrine of double effect, together with other moral principles that appeal to the intentions of moral agents, has come under attack from many directions in recent years, as have a variety of rationales that have been given in favor of it. In this paper, our aim is to develop, defend, and provide a new theoretical rationale for a secular version of the doctrine. Following Quinn (1989), we distinguish between Harmful Direct Agency and Harmful Indirect Agency. We propose the following (...) version of the doctrine: that in cases in which harm must come to some in order to achieve a good (and is the least costly of possible harms necessary), the agent foresees the harm, and all other things are equal, a stronger case is needed to justify Harmful Direct Agency than to justify Harmful Indirect Agency. We distinguish between two Kantian rationales that might be given for the doctrine, a “dependent right” rationale, defended by Quinn, and an “independent right” rationale, which we defend. We argue that the doctrine and the “independent right” rationale for it are not vulnerable to counterexamples or counterproposals, and conclude by drawing implications for the larger debate over whether agents' intentions are in any way relevant to permissibility and obligation. (shrink)

Sandplay is a growing field of interest for Jungian and other psychotherapists. _Sandplay - Silent Workshop of the Psyche_ by Kay Bradway and Barbara McCoard, provides an introduction to sandplay as well as extensive new material for those already using this form of therapy. Based on the authors' wide-ranging clinical work, it includes: in-depth sandplay case histories material from a wide range of adults and children over 90 illustrations in black and white and colour detailed notes on interpretation of sand (...) trays an examination of symbols and concepts used in sandplay. Clearly written and soundly based in theory, this book provides historical background for understanding sandplay as well as helpful discussion of how it works in a clinical context. Kay Bradway and Barbara McCoard bring their indispensable personal experience to the subject to stress the healing potential of sandplay. They also reflect on the nature of a therapy where the psyche works largely in silence. (shrink)

This paper starts by investigating Ackermann's interpretation of finite set theory in the natural numbers. We give a formal version of this interpretation from Peano arithmetic (PA) to Zermelo-Fraenkel set theory with the infinity axiom negated (ZF−inf) and provide an inverse interpretation going the other way. In particular, we emphasize the precise axiomatization of our set theory that is required and point out the necessity of the axiom of transitive containment or (equivalently) the axiom scheme of ∈-induction. This clarifies the (...) nature of the equivalence of PA and ZF−inf and corrects some errors in the literature. We also survey the restrictions of the Ackermann interpretation and its inverse to subsystems of PA and ZF−inf, where full induction, replacement, or separation is not assumed. The paper concludes with a discussion on the problems one faces when the totality of exponentiation fails, or when the existence of unordered pairs or power sets is not guaranteed. (shrink)

The author means to show how focusing on the sense of hearing can sharpen our understanding of Kierkegaard’s argument – in the first portion of Either/Or – that Don Giovanni ranks supreme among works of art. After explaining how he takes Kierkegaard’s case to rest on the issue of the ear being the “most spiritually qualified sense,” he shows how attending to the importance of hearing within the original Don Juan myth, as well as within Mozart and Da Ponte’s treatment (...) of it, can help us understand the myth’s dependence on and repudiation of Christianity: unlike sight, hearing places us in close spiritual intimacy with its source, even as it also opens up specific possibilities of theatricality and deceit. He concludes by arguing why hearing should be regarded as the paradigmatic sense in relation to which Kierkegaard understands the task of philosophy itself, in contrast to earlier philosophical emphases on visible intelligibility. (shrink)

In this paper the exclusive focus on large firms in the field of business ethics is challenged. Some of the idiosyncrasies of small firms are explained, and links are made between these and potential ethical issues. A review of the existing literature on ethics in small firms demonstrates the lack of appropriate research, so that to date we can draw no firm conclusions in relation to ethics in the small firm. Recommendations are made as to the way forward for small (...) firm business ethics research. Questions for investigation are suggested using micro, meso and macro perspectives. Much exploratory work needs to be done to lay the groundwork for this important area of social and commercial research in the future. (shrink)

In this article we take further the debate on the ethics of competitive intelligence gathering, which until now has been very limited. Drawing on empirical research from a mobile telephone company in the United Kingdom, we present the case that while mystery shopping is not the worst activity in which an organization might be involved, it is basically unethical. Mystery shopping involves deception and the obtaining of competitive information under false pretences. Common arguments are that ‘everyone is doing it’ and (...) that the information is in the public domain. Neither of these points convincingly justifies the requirement for an employer to ask an employee to lie and deceive others on behalf of the company. The use of students and those in low power positions in the organization is a further concern. (shrink)

Book reviewed in this article:Zsolnai, La´szlo´ The European Difference: Business Ethics in the Community of European Management Schools.

Phrase re-ordering is a well-known obstacle to robust machine translation for language pairs with significantly different word orderings. For Arabic-English, two languages that usually differ in the ordering of subject and verb, the subject and its modifiers must be accurately moved to produce a grammatical translation. This operation requires more than base phrase chunking and often defies current phrase-based statistical decoders. We present a conditional random field sequence classi- fier that detects the full scope of Arabic noun phrase subjects in (...) verb-initial clauses at the Fβ=1 61.3% level, a 5.0% absolute improvement over a statistical parser baseline. We suggest methods for integrating the classifier output with a statistical decoder and present preliminary machine translation results. (shrink)

The recent “turn to matter” evident in material feminist theories of the more‐than‐human world offers distinct posthuman understandings of the world as continuously relationally entangled, emergent or materializing. In this paper, I consider how these premises both trouble conventional understandings of matter and/or materials, but likewise potentially revise and revitalize understandings of the political for health and inequalities, and for nursing. This is both timely and much needed given contemporary contexts of austerity‐driven neoliberalism in health care and the unprecedented growth (...) in disparities of wealth and well‐being. I wish to explore whether material feminisms allow us to retheorize connections between abstract theory and material concerns like health and inequalities, differently. This is not theory in opposition to practice or activism, but theory conceptualized as sets of entangled emergent practices, but also what constitutes the political, as more fully relational to and in praxis with health‐related activism. I will argue these theories further justify how practitioners can visibly care for and care more about social and health inequalities. Drawing mainly on the work of material feminist, Karen Barad, and her bringing together of queer and feminist theory, as well as feminist new materialisms and understandings of posthumanism, I discuss how this turn to matter together with meaning might transform understandings of health and inequalities. (shrink)

Is consciousness multisensory? Obviously it is multisensory in certain ways. Human beings typically possess the capacity to have experiences in at least the five familiar sensory modalities, and quite possibly in a number of other less commonly recognised modalities as well. But there are other respects in which it is far from obvious that consciousness is multisensory. This chapter is concerned with one such respect. Οur concern here is with whether consciousness contains experiences associated with distinct modalities at the same (...) time. We will describe those who endorse a positive answer to this question as endorsing a multisensory view (MSV) of the structure of consciousness, and those who endorse a negative answer to this question as having a unisensory view (USV) of the structure of consciousness. (shrink)

The challenges posed by postmodern and poststructural theories profoundly disrupt the certainties of feminist and nursing research, yet at the same time offer possibilities for developing new epistemologies. While there are an increasing number of accounts discussing the theoretical implications of these ideas for nursing research, I wish to discuss the practical and the methodological implications of using postmodern feminist theories within empirical research. In particular, I identify the challenges I encountered through an examination of specific aspects of the research (...) process and through examples drawn from empirical research. I conclude that using postmodern feminist theories requires a continuous engagement with, and interrogation of, the modern epistemological and ontological assumptions of qualitative, feminist nursing research and, in so doing, presents the possibility for nurse scholars to begin to develop a ‘passionately interested’ methodological approach to nursing inquiry. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Response to the CommentariesSean A. SpenceIn “Free Will in the Light of Neuropsychiatry,” I have attempted to present an argument from the perspective of materialist neuroscience, pushing the latter to its logical conclusion: that if the human nervous system is consistent in its properties, then the only place for “free will” is in the non-conscious processes which underpin conscious awareness. This argument I have based on two supports: the (...) “spatial” and the “temporal” (Spence, 1995).I have contended that the sense of freedom may be lost from certain actions, thereby implying that “freedom” is a sensory process distinct from action. This might be conceptualized as having a distinct functional distribution within the nervous system (a spatial distinction). I have also argued that conscious awareness of events occurs at a finite delay, the period of “neuronal adequacy,” after those events themselves. The point here is that neurochemical events giving rise to phenomenology are likely to require a period of time (no matter how short) for their genesis. The process is “on line” before we perceive it (a temporal distinction). Thus the “freedom to act,” a motor process, is necessarily non-conscious at the point of initiation.I am grateful to Frith, Libet and Stephens for their comments. In the most part our disagreements are likely to be those of emphasis, perhaps compounded by my uses of the term “free will.”I have no major disagreement with Frith’s comments. I would, however, emphasize that it is likely that the Bereitschaftspotential, or readiness potential, does tell us something regarding intended actions. It is, for example, absent prior to the involuntary movements seen in Tourette’s syndrome (Obeso et al. 1982), and reduced in akinetic patients with Parkinson’s disease (Dick et al. 1989) or medial frontal lobe lesions (Deecke et al. 1987). The latter groups have difficulty initiating intended, internally generated, actions.With regard to the suspicion of dualism in my diagrams, the point is well taken, but I am attempting to describe a functional distinction, the precise coordinates of which remain obscure. It may well be that “consciousness” occupies no fixed location but is an activity temporarily co-extant with that association cortex (or cortices) subserving the sensory modality (or modalities) experienced phenomenologically (see Bottini et al. 1995).I have based much of my “temporal” argument on Libet’s work, and I am grateful for his response. Nevertheless, I am still of the opinion that there is a central inconsistency with his argument that conscious control exerts a veto on acts which is somehow free of material constraints. [Indeed he states that he has “no quarrel with the view that even a fully voluntary act is initiated unconsciously (non-consciously)”.] Whereas I can [End Page 99] not prove that this power of veto does not evade neurochemical processes, or that it somehow acts instantaneously and independently, with no origin in unconscious processing, I can say that I have restricted myself to arguing within a materialist perspective, with the aim of “pushing it” to its extreme. The free will which Libet retains in consciousness is one which is unique, and unconstrained by materialism. It is dualism in disguise!Stephens implies that there is a non-argument regarding consciousness acting as an initiator of events. The suggestion is that no one would argue this. Yet this is Libet’s argument. It cannot be disproved, but it is clearly (internally) inconsistent with Libet’s own impressive body of work.As for the role of consciousness in action, I have, I think, invoked a position similar to that adopted by Stephens; that consciousness is more a sensory state, allowing awareness of actions, and their consequences, and perhaps thereby facilitating the function of non-conscious initiators. It is clearly necessary for the performance of the “higher” acts which we equate with human nature, but it is not sufficient. (Indeed many of the most creative insights have “emerged” into consciousness [see Boden, 1992].) The man with a paralyzed arm may wish for his arm to move but to no avail. Over time function may slowly reappear. But if his lesion is such that he is unaware of his impairment (anosognosia), then his prognosis may... (shrink)

Each book in the series includes six 40-minute studies designed to draw you into God’s Word through basic inductive Bible study.

Despite claims of ‘evidence based policy’, the place of empirical evidence in family law reform is ambiguous. There is ongoing socio-legal analysis of the differential value and uses of quantitative data and anecdote in detailing women’s experiences and advocating for change. In this paper, we engage with these issues through a focus on how data were constructed in a key government report, Every Picture Tells a Story, which was used to officially define the problem and outline recommendations in the controversial (...) 2006-08 reform of the Australian Child Support Scheme. Our discussion focuses on two questions: what legitimacy is accorded to different kinds of evidence in family law reform processes?; and, how is this legitimacy gendered? We applied feminist critical discourse analysis to the type, source and claims of the data included in the child support chapter of the report. Our findings indicate that both quantitative data and anecdote were used to privilege fathers’ financial interests and autonomy; in contrast, women’s voices and interests were marginalised. Thus, we argue the legitimacy of data is ascribed through its relationship to the gendered definition of the ‘problems’ of child support, rather than the type of data per se. (shrink)

In this fascinating study, the author analyzes the conceptual roots of molecular biology and the social matrix in which it was developed.

People’s awareness of tactile stimuli has been investigated in far less detail than their awareness of stimuli in other sensory modalities. In an attempt to fill this gap, we provide an overview of studies that are pertinent to the topic of tactile consciousness. We discuss the results of research that has investigated phenomena such as “change blindness”, phantom limb sensations, and numerosity judgments in tactile perception, together with the results obtained from the study of patients affected by deficits that can (...) adversely affect tactile perception such as neglect, extinction, and numbsense. The similarities as well as some of the important differences that have emerged when visual and tactile conscious information processing have been compared using similar experimental procedures are highlighted. We suggest that conscious information processing in the tactile modality cannot be separated completely from the more general processing of spatial information in the brain. Finally, the importance of considering tactile consciousness within the larger framework of multisensory information processing is also discussed. (shrink)

What, exactly, makes humans human? A close look at nonhuman animal domestication practices reveals how people came to view their own uniqueness in western cultural process. The study of domestication across time shows the multiple human impulses underlying acts of animal enclosure and domestication. Animals can be beloved companions or eaten for a meal. These impulses involve contradictory moralities-a rich subject for inquiries into the dynamics of power and possession, at scales ranging from local to global.

Recently, there has been a debate focusing on the question of whether groups can literally have beliefs. For the purposes of epistemology, however, the key question is whether groups can have knowledge. More specifi cally, the question is whether “group views” can have the key epistemic features of belief, viz., aiming at truth and being epistemically rational. I argue that, while groups may not have beliefs in the full sense of the word, group views can have these key epistemic features (...) of belief. However, I argue that on Margaret Gilbert's infl uential “plural subject” account of group belief, group views are unlikely to be epistemically rational. (shrink)

Objectives—To assess perceptions of the informed consent process in patients undergoing urgent abdominal surgery.Design—A prospective observational study was carried out using structured questionnaire-based interviews. Patients who had undergone urgent abdominal surgery were interviewed in the postoperative period to ascertain their perceptions of the informed consent process. Replies were compared to responses obtained from a control group undergoing elective surgery, to identify factors common to the surgical process and those specific to urgent surgery. Patients' perceptions of received information were also compared (...) to the information perceived to have been provided by the consent obtainers. Setting—Gastrointestinal surgical service of a university teaching hospital.Patients—Seventy-four consecutive patients undergoing urgent abdominal surgery and 80 control patients undergoing elective surgery. Main measurements—Principal outcome measures were patients' perceptions of factors interfering with the ability to give informed consent, assessment of the quality of informed consent and the degree of discussion of the expected outcomes. Results—Forty-nine of the seventy-four (66%) patients undergoing urgent surgery perceived that pain did not affect their ability to give informed consent. Twenty-seven reported an adverse effect of analgesia on the ability to give informed consent. Only 22% of patients undergoing urgent surgery perceived that there had been any discussion of potential side effects and complications of surgery. Conclusion–The majority of patients in this series with acute intra-abdominal surgical conditions perceive that they retain the ability to give informed consent for surgery. There is a need for improved discussion of therapeutic options and likely outcomes. (shrink)

In this paper I take up a critical position in regard to the theme of debility around which this collection is framed. I argue that theorisations of ‘debility’ do little to progress theory and policy in regard to disability and share many of the problems inherent to the social model. I also suggest that the theorisation of debility is rooted in and reinforces ablebodied privilege. I begin with a critical analysis of the social model of disability and explore the dualisms (...) by which it either negates the body altogether or can only conceive the disabled body in negative terms. I then go on to explore how Puar's work on debility continues this negation of the disabled body. From this position I use the work of Inahara to excavate the foundations of ablebodied privilege. In Inahara's work gender is the analytic starting point, but for me white privilege is a much more effective mechanism through which to understand the impact and reproduction of ablebodied privilege— what McRuer refers to as ‘compulsory ablebodiedness'—which I argue underpins Puar's work. I conclude with some reflections upon how a critical analysis of ablebodied privilege might function and I reiterate its importance for a critical theory that goes beyond the mere repetition of binary structures of ablebodiedness and disability. (shrink)

RATIONALE: The concept of evidence-based medicine is important in providing efficient health care. The process uses research findings as the basis for clinical decision making. Evidence-based practice helps optimize current health care and enables the practitioners to be suitably accountable for the interventions they provide. Little work has been undertaken to examine how allied health professionals change their clinical practice in light of the latest evidence. The use of opinion leaders to disseminate new evidence around the management of low back (...) pain into practice has been proposed. AIMS: The aim of this study was to investigate if physiotherapists' clinical management of patients with low back pain would change following an evidence-based education package, which utilized local opinion leaders and delivered the best evidence. METHOD: Thirty musculoskeletal physiotherapists from a Community Trust in North Staffordshire were cluster randomized by location of work, to two groups. The intervention group received an evidence-based programme on the management of low back pain, including advice regarding increasing activity levels and return to normal activity and challenging patients' fears and beliefs about their pain. The control group received a standard in-service training package on the management of common knee pathologies. The physiotherapists' clinical management of patients with low back pain was measured prior to training and 6 months post training. Outcome measures were based on physiotherapists completing 'discharge summary' questionnaires, which included information relating to the use and importance of therapies for treating their low back pain patients. RESULTS: There were few significant differences in treatment options between the intervention and control groups post training. Whilst there was some indication that physiotherapists were already utilizing aspects of psychosocial management for patients with low back pain, there was little change in what physiotherapists perceived to be important to patient recovery and actual clinical practice following the intervention. CONCLUSIONS: Psychosocial factors have been identified as an important factor in the recovery of patients with low back pain. This project incorporated the latest evidence on the management of low back pain and utilized the theory of opinion leaders to disseminate this evidence into clinical practice. Whilst there were some limitations in the overall size of the study, the results help to give an insight into the challenges faced by the health care system and researchers alike to ensure quality evidence is actually utilized by practitioners for the benefits of patient care. (shrink)