Social inclusion/exclusion involves just/unjust social relations and social structures enabling or constraining opportunities for participation and health. In this paper, social inclusion/exclusion is explored as a dialectic. Three discourses – discourses on recognition, capabilities, and equality and citizenship – are identified within Canadian literature. Each discourse highlights a different view of the injustices leading to social exclusion and the conditions supporting inclusion and social justice. An Integrated Framework for Social Justice that incorporates the three discourses is developed and used to (...) critique the dominant focus on distributive justice within foundational Canadian nursing documents. We propose a broader conceptualization of social (in)justice that includes both relational and structural dimensions. Opportunities for multilevel interventions to promote social justice are identified. This framework is congruent with nursing's moral imperative to promote health equity and with the multiple roles played by nurses to promote social justice in everyday practice. (shrink)

The paper argues for more attention to be paid to validity in program evaluation than to method. The aspect of validity addressed here is the correspondence of evaluation ethics with the professional ethics of those subject to the evaluation. Examples are given, drawn from evaluation reports.

This title is playful, of course. It is designed merely to attract curiosity and attention … It dates back to a childhood game of which I have forgotten both rules and stakes. An imaginary sovereign was roused from his indifference and responded with an approximate repetition of Marie-Antoinette's suggestion that if the people were hungry, food should be thrown to them. I took such caricatures of kings as anti-models, replacing bread with symbols. Now we are all too disturbed, individually and (...) collectively, by the economic discomfort which is a generalized hunger and, in too many parts of the world and - not only in the third world - by actual famines, not to be aware, on a daily basis, of the responsibility it is to cultivate and transmit to others substance which is purely symbolic. Certain statistics, which now form part of our daily life, are capable of discrediting definitively the ivory tower which our universities are accused of representing, or of having represented in the past. In my own country, Canada, one child in five lives in poverty. The economic worth of the poorest forty-eight countries in the world is equal to the combined wealth of the ten richest individuals. There were twenty million refugees in 1997. One billion two hundred million human beings are short of fresh water this year, etc. This type of figure is, sadly, all too familiar. And it is a case of preaching to the converted to assert the extent to which culture, education and all their constituent disciplines are nourishment of a different order to physical food, because intellectual work is genuine work, providing a living for those who work at it professionally, and above all also those who benefit from its immediate and continuing fruits - i.e. ideally, the whole of society, and in all countries. In this respect - and this is implicit, but through depending habitually on what is implicit nothing is ever sufficiently explicit - it is generally acknowledged (thanks to UNESCO in particular) to what extent the development of economic resources is linked with the advancement and communication of knowledge, on a scale which is regional as well as national, within cities, rural communities, families. (shrink)

Now that the age-old dream, which never materialized, of a universal language has evaporated, we note that English is in the process of becoming if not the universal at least an omnipresent language. In many multilingual countries it has become the language of communication. Globally it is imposing itself as the language of business, aviation and scientific research. Is this a pure benefit for humanity, or does it conceal risks or even dangers? Is the spreading of English a secondary effect (...) of Americanization? Is linguistic diversity being sacrificed? Only if the countries affected submit to linguistic and cultural homogenization. The ideal - which remains within reach - would be to accept English as a practical tool of communication without ceasing to strive for the maintenance and strength of other languages in symbiosis with their own cultures. (shrink)

As a medical student doing a rotation, I was feeling positive as we knocked on the door of an elderly lady who I'd seen just 2 days earlier. Even though seriously ill for many months, this patient had always lived life in her own way, refusing to go to a nursing home. It was clear that her condition had deteriorated rapidly, and the nurse informed me privately that she was dying, sooner rather than later.

In an effort to create a mechanism for addressing a critical need of providing medicines for economically developing countries, the Chiron Corporation and the Global Alliance for TB Drug Development have entered into an innovative public-private partnership. In the following interview, Craig Wheeler discusses the origins and nature of this agreement that could set a pattern for how corporations and nonprofit organizations can work together in drug development.

Our attitudes toward aging change in that “old” depends on where you are. When I was 16, and my sister Nancy was 29, I suddenly realized, to my horror, that one of us was about to be 30. I went around saying to everyone, “Poor Nancy, she's almost 40,” because to me at that time, 30 and 40 were about the same. Later, when Nancy was 40, she said she didn't mind because, according to me, she had been 40 for (...) a decade. (shrink)

I defend one way of solving the Impermissibility Problem—that is, the problem that on moralized approaches to coercion, coerciveness and permissibility are mutually exclusive. This brings up intuitive difficulties for cases such as taxation, which seem to be both coercive and permissible. I gloss three popular theories of coercion—the moralized baseline, nonmoralized baseline, and enforcement approaches—and conclude that only the nonmoralized baseline approach clearly solves the problem. However, Robert Nozick’s famous “slave case” raises another serious issue for the nonmoralized baseline (...) approach. So, in order to solve both the slave case and the Impermissibility Problem, I draw on Grant Lamond’s discussion of the coerciveness of law to propose the pro tanto wrong approach. On this approach, coercion is not impermissible simpliciter, but requires some sort of special justification. The pro tanto wrong approach is moralized, but on it, moralization comes in coercion’s need for justification, not in whether it is, in fact, justified. Thus impermissibility is neither necessary nor sufficient for coerciveness, and the Impermissibility Problem is avoided. I conclude that solving the problem in this way is desirable because it preserves a core belief of liberalism: certain acts, including taxation, may be both coercive and permissible. (shrink)

According to Frankena, “the moral point of view is what Alison Wilde and Heather Badcock did not have.” Most of us, however, are not such extreme examples. We are capable of the moral point of view, but we fail to take the necessary time or make the required efforts. We resist pulling ourselves from other distractions to focus on the plight of others and what we might do to ameliorate their suffering. Perhaps compassion is rooted in understanding what it is (...) that connects us with others rather than what separates us, and rests on developing sufficient awareness, to internalize what our actions, or lack of them, mean in the lives of others. (shrink)

In an attempt to provide some clarification in the abortion issue it has recently been proposed that since 'brain death' is used to define the end of life, 'brain life' would be a logical demarcation for life's beginning. This paper argues in support of this position, not on empirical grounds, but because of what it reflects of what is valuable about the term 'life'. It is pointed out that 'life' is an ambiguous concept as it is used in English, obscuring (...) the differences between being alive and having a life, a crucial distinction for bioethical questions. The implications of this distinction for the moral debate about abortion are discussed. (shrink)

From the celebrated author of When Bad Things Happen to Good People , a profound and practical book about doing well by doing good. For decades now, from the pulpit and through his writing, Harold Kushner has been helping people navigate the rough patches of life: loss, guilt, crises of faith. Now, in this compelling new work, he ad-dresses an equally important issue: our craving for significance, the need to know that our lives and our choices mean something. We (...) sometimes do great things, and sometimes terrible things, to reassure ourselves that we matter to the world. We sometimes confuse fame, power, and wealth with true achievement. But finally we need to think of ourselves as good people, and we are troubled when we compromise our integrity in the pursuit of what we think of as success. Harold Kushner tells us that the path to a truly successful and significant life is through friendship, through family, and through acts of generosity and self-sacrifice. He describes how, in affecting the life of even one person in a positive way, we make a difference in the world, and prove that we do in fact matter. Persuasive and sympathetic, anecdotal and commonsensical, Living a Life That Matters inspires and uplifts. (shrink)

Is your ethics committee developing a project that would be of interest to other committees? If so, send a brief description to Cynthia B. Cohen, Ph.D., J.D., The Hastings Center, 255 Elm Road, Briarcliff Manor, NY 10510. Does your committee have questions about a difficult case (of general interest) that you would like to see addressed? Send them to Thomasine Kushner, Ph.D., Health and Medical Sciences Program, T-7, Room 106, University of California, Berkeley, CA 94720.

According to Frankena, “the moral point of view is what Alison Wilde and Heather Badcock did not have.” Most of us, however, are not such extreme examples. We are capable of the moral point of view, but we fail to take the necessary time or make the required efforts. We resist pulling ourselves from other distractions to focus on the plight of others and what we might do to ameliorate their suffering. Perhaps compassion is rooted in understanding what it is (...) that connects us with others rather than what separates us, and rests on developing sufficient awareness, to internalize what our actions, or lack of them, mean in the lives of others. (shrink)

In the fall of 2001, Baxter International, Inc., was faced with a crisis after more than 50 people died using Baxter dialyzers. In this interview, Harry M. Jansen Kraemer, Jr., Chairman and Chief Executive Officer of Baxter, and Sally Benjamin Young, Vice President, Communications, discuss how the company managed this emergency situation.

A profoundly inspiring yet practical guide to well-being from one of modern Judaism's most beloved sages.As a congregational rabbi for half a century and the bestselling author of When Bad Things Happen to Good People and twelve other books on faith, ethics, and how to translate the timeless wisdom of religious thought into dealing with everyday challenges, Harold Kushner knows a thing or two about living a good life. In this compassionate new work, Kushner distills nine essential lessons (...) from the sum of his teaching, study and experience, offering a lifetime's worth of spiritual food for thought, pragmatic advice, inspiration for better living, and strength for trying times. With vital, original insights into everything from belief ("there is no commandment in Judaism to believe in God"), to conscience (the Garden of Eden story as you've never heard it), to mercy ("forgiveness is a favor you do yourself, not a favor to the person who offended you"), grounded in Kushner's brilliant readings of Scripture, history and popular culture, Nine Essential Things I've Learned About Life is a capstone addition to Kushner's oeuvre. (shrink)

Since the middle of the 20th century, suicidology, as a group of disciplines working to understand and prevent suicide, has reinforced the long-held view that suicide is caused first and foremost b...

In many countries the debate over the role that physicians may play in ending life has been limited to the judiciary and other law making institutions, professional medical organizations; and academics. Because of their multidisciplinary and diverse membership, ethics committees may be a particularly appropriate venue through which these discussions can be expanded to include a much larger community. In addition, ethics committees generally act in only advisory capacities because they do not actually make decisions, so they may provide a (...) forum for open discussions in ways that the court and the medical boards cannot. (shrink)

Philosophical concerns cannot be excluded from even a cursory examination of the physician-patient relationship. Two possible alternatives for determining what this relationship entails are the teleological (outcome) approach vs the deontological (process) one. Traditionally, this relationship has been structured around the 'clinical model' which views the physician-patient relationship in teleological terms. Data on the actual content of general medical practice indicate the advisability of reassessing this relationship, and suggest that the 'clinical model' may be too limiting, and that a more (...) appropriate basis for the physician-patient relationship is one described in this paper as the 'relational model'. (shrink)

The failure of medical codes to provide adequate guidance for physicians' moral dilemmas points to the fact that some rules of analysis, informed by moral theory, are needed to assist in resolving perplexing ethical problems occurring with increasing frequency as medical technology advances. Initially, deontological and teleological theories appear more helpful, but critcisms can be lodged against both, and neither proves to be sufficient in itself. This paper suggests that to elude the limitations of previous approaches, a method of moral (...) decision making must be developed incorporating both coherence methodology and some independently supported theoretical foundations. Wide Reflective Equilibrium is offered, and its process described along with a theory of the person which is used to animate the process. Steps are outlined to be used in the process, leading to the application of the method to an actual case. (shrink)

The Baby Fae experiment has highlighted the growing trend in medicine of using animal parts in the treatment of humans. This paper raises the question of the logical and moral justification for these current practices and their proposed expansion. We argue that the Cognitive Capacity Principle establishes morally justified necessary and sufficient conditions for the use of non-human animals in medical treatments and research. Some alternative sources for medical uses are explored as well as some possible programmes for their implementation.

The article is devoted to the analysis of the legal theories of P.I. Novgorodtsev and B.A. Kistyakovsky, based on the moral philosophy of I. Kant in comparison with the psychological theory of law of L.I. Petrazhitsky. The unity of the positions of Novgorodtsev and Kistyakovsky in focusing on the ethical aspects of law, as well as highlighting morality as the highest principle, is revealed. Attention is paid to the disclosure of neo-Kantian motives in the philosophy of law and in the (...) context of the development of the theory of natural law in Russia. The main content of the article is a consistent analysis of Novgorodtsevʼs ideas in their dynamics, compared with the neo-Kantian philosophy of law of Kistyakovsky. It is emphasized that the psychological theory of the source of Petrazhitskyʼs legal relations is in the same intention of thought with the motives of the Russian neo-Kantians, which allows them to be compared in the history of the development of the Russian theory of law. The modern scientific literature is analyzed in order to identify the problem of comparing different approaches in the history of Russian philosophy of law, in which German transcendental philosophy is one of the key foundations. The question of the independence of Russian scientists in the construction of ethical and legal doctrines is actualized, but, at the same time, a single motive is emphasized with the Kantian provision on the need to establish a general civil society on the principles of a developed system of rules and norms. (shrink)

While Eastern and Western cultures agree that life is sacred, and that morality demands its protection, they differ sharply as to how the term life is to be interpreted, and therefore what prohibitions against killing should entail. l examine some of these conflicting perspectives, explore life as an ambiguous term, and suggest are interpretation of the concept, which permits moral ruIes against killing to be applied more rationally.

Dans Capitale de l’amour. Filles et lieux de plaisir à Paris au xixe siècle, l’historienne Lola Gonzalez-Quijano aborde l’histoire de la prostitution dans le Paris du xixe siècle. L’œuvre incontournable avec laquelle toutes les études sur le sujet sont en dialogue est le travail magistral d’Alain Corbin, Filles de Noce. L’argument de ce dernier, que la structure de la prostitution variait en fonction des contours modulables de la demande sexuelle masculine, a révolutionné le champ de recherch...

The word obesity invokes multiple connotations that contain a realm of disparate descriptions ranging from disease to disdain. There are also few other human conditions that cause increased morbidity and mortality and affect millions of individuals worldwide yet is still viewed by many as a character fault or moral failure. Herein we have the opportunity to read the personal reflections of individuals with obesity who have struggled with their weight over a lifetime. Through a series of 12 narratives, the authors (...) collectively share their shame, humiliation, dignity, inner strength and advice for health professionals who they entrust. (shrink)

As duplicating techniques in art become more sophisticated and less easily detectable, Concern mounts as to what the status of these aesthetic clones should be. Can they be considered works of art; and to what extent do they share in the value of the original? this paper examines these questions, Using examples from audio and visual arts, And concludes that talk of an original and its copies has to do with the art market and not with the creative process. The (...) implication for aesthetic clones is that they are no different from their originals as far as aesthetic value is concerned. (shrink)

Baby Theresa, in her short 9-day life, cast a national spotlight on the question “Should anencephalic infants be used for organ procurement?” In denying her parents′ wishes to donate the baby's healthy organs to other children in need of kidneys, liver, heart, and lungs, Circuit Court Judge Estella Moriarty said, “I cannot authorized someone to take your baby's life, however short, however unsatisfactory, to save another child.”In citing a1988 Florida statute that does not allow a person to be declared dead (...) while any part of the brain is functioning, Judge Moriarty ruled that doctors could only remove organs not vital to Theresa Ann's life. As the baby slowly died, so too did her vital organs. (shrink)