This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they (...) are constructed and their goals in supporting healthcare personnel in clinical practice. This study engages in an integrative literature review. We searched for peer-reviewed academic articles written in English between 2000 and 2016 using specific Mesh terms and manual keywords in CINAHL, MEDLINE and Psych INFO databases. In total, 54 articles worldwide described clinical ethics support approaches that include clinical ethics consultation, clinical ethics committees, moral case deliberation, ethics rounds, ethics discussion groups, and ethics reflection groups. Clinical ethics consultation and clinical ethics committees have various roles and functions in different countries. They can provide healthcare personnel with advice and recommendations regarding the best course of action. Moral case deliberation, ethics rounds, ethics discussion groups and ethics reflection groups support the idea that group reflection increases insight into ethical issues. Clinical ethics support in the form of a “bottom-up” perspective might give healthcare personnel opportunities to think and reflect more than a “top-down” perspective. A “bottom-up” approach leaves the healthcare personnel with the moral responsibility for their choice of action in clinical practice, while a “top-down” approach risks removing such moral responsibility. (shrink)

The artist's house is a prism through which to view not only the artistic practice of its inhabitant, but also to apprehend broader developments in sculpture and contemporary art in relation to domestic architecture and interior space. Based on a series of interviews and site visits with living artists about the role of their home in relation to their work, Kirsty Bell looks at the house as receptacle, vehicle, model, theater, or dream space. In-depth analyses of these contemporary examples—including Jorge (...) Pardo, Mirosław Bałka, Danh Vo, Gregor Schneider, Frances Stark, Marc Camille Chaimowicz, Dominique Gonzalez-Foerster, Paweł Althamer, Mark Leckey, Monika Sosnowska, Gabriel Orozco, Rirkrit Tiravanija, and Andrea Zittel—are contextualized by key artists of the twentieth century such as Kurt Schwitters, Alice Neel, Edward Krasiński, Carlo Mollino, and Louise Bourgeois. A two-way flow from the domestic arena to the exhibition space becomes apparent, in which the everyday has a significant role to play in the merging of such developments as installation art, relational aesthetics, expanded collage, and performance art. (shrink)

This commentary explores the potential consequence of latent racial formation in emergent climate finance data projects and draws from ethnographic research on climate finance governance conducted in Fiji. Climate finance data projects emerging in the Pacific aim to ease the flow of finance from the Global North to the South. These emergent data projects, such as renewable energy resource availability and investment mapping, are imbedded in the climate finance organizations that fund, develop, and use them. Thus, the commentary explores climate (...) finance organizations through the lens of Ray’s theory of racial organizations, highlighting the ways in which important climate-related resources are mediated through racial and colonial schemas. The racial mediation of two key resources are spotlighted in this discussion: the finance itself and knowledge. Given that the Pacific region is at the coalface of climate change’s existential effects, the just allocation of resources is imperative. In interrogating the ways in which emergent data projects may deny these resources based on hidden racial schemas, the paper cautions against new and old forms of colonization that may be mobilized through even well-meaning techno-benevolent fixes. (shrink)

The traditional medical epistemology, resting on a biomedical paradigmatic monopoly, fails to display an adequate representation of medical knowledge. Clinical knowledge, including the complexities of human interaction, is not available for inquiry by means of biomedical approaches, and consequently is denied legitimacy within a scientific context. A gap results between medical research and clinical practice. Theories of knowledge, especially the concept of tacit knowing, seem suitable for description and discussion of clinical knowledge, commonly denoted the art of medicine. A metaposition (...) allows for inquiry of clinical knowledge, inviting an expansion of the traditional medical epistemology, provided that relevant criteria for scientific knowledge within this field are developed and applied. The consequences of such approaches are discussed. (shrink)

Kirstie McClure offers a major reinterpretation of John Locke's thought that is important not only for the light it sheds on Locke but also for the questions it ...

As scholars of technology investigate changes to media alongside the growing popularity of the Internet, video games and other media devices, the descriptive characteristics of media themselves have become stretched further and further to accommodate a raft of new content, technologies and distribution platforms. This stretching becomes a problem when it becomes important to conceptually separate the formerly non-mediated communication devices, such as mobile phones, from their re-emergence as media platforms. A clear separation is important for asking questions about what (...) cultural, social, economic and political effects such media encroachment might entail. The current paper attempts such a conceptual distinction. (shrink)

The following piece is a summary of a talk given to address the subject of women writing about male protagonists and from a male point of view, arguing that in Gunn’s own work traditional male characters are posited at the centre of texts that are actually female in perspective, so allowing for the reader to have the experience of a sort of inversion of reading. She does this by prioritizing female agency: thus the traditional male becomes someone else, the male (...) gaze transported to another kind of looking that instead of containing and exerting power over the women who are seen, rather reflects them back as powerful influential figures. Gunn defines what she calls this “breaking open the gaze,” the fracturing of a singular point of view into a multiple one, a seeing and a being seen, as a key feature of her own fictions, energizing and transforming the roles of both male and female characters in her work. (shrink)

This study examines how the leading beverage company handles the strategic paradox between its core business and the social issue of obesity. A discursive analysis reveals how the organization does embrace a social goal related to obesity but not the paradoxical tension between this goal and its core business. The analysis further shows how the tension, along with the responsibility for the social goal, is projected outside the organization. This response is underpinned by the paradoxical constructions of consumers and the (...) concept of obesity in the organization’s communication. Based on these findings, I outline a new type of process for projection, one of the defensive mechanisms recognized in the literature. The findings increase our understanding of defensive responses to organizational paradoxes and help distinguish between different kinds of strategic paradoxes. They also highlight the need to further open up the complexity and multiplicity of strategic paradoxes related to corporate sustainability. (shrink)

Conceptual combination performs a fundamental role in creating the broad range of compound phrases utilised in everyday language. This article provides a novel probabilistic framework for assessing whether the semantics of conceptual combinations are compositional, and so can be considered as a function of the semantics of the constituent concepts, or not. While the systematicity and productivity of language provide a strong argument in favor of assuming compositionality, this very assumption is still regularly questioned in both cognitive science and philosophy. (...) Additionally, the principle of semantic compositionality is underspecifi ed, which means that notions of both "strong" and "weak" compositionality appear in the literature. Rather than adjudicating between different grades of compositionality, the framework presented here contributes formal methods for determining a clear dividing line between compositional and non-compositional semantics. In addition, we suggest that the distinction between these is contextually sensitive. Compositionality is equated with a joint probability distribution modeling how the constituent concepts in the combination are interpreted. Marginal selectivity is introduced as a pivotal probabilistic constraint for the application of the Bell/CH and CHSH systems of inequalities. Non-compositionality is equated with a failure of marginal selectivity, or violation of either system of inequalities in the presence of marginal selectivity. This means that the conceptual combination cannot be modeled in a joint probability distribution, the variables of which correspond to how the constituent concepts are being interpreted. The formal analysis methods are demonstrated by applying them to an empirical illustration of twenty-four non-lexicalised conceptual combinations. (shrink)

Measures and theories of information abound, but there are few formalised methods for treating the contextuality that can manifest in different information systems. Quantum theory provides one possible formalism for treating information in context. This paper introduces a quantum inspired model of the human mental lexicon. This model is currently being experimentally investigated and we present a preliminary set of pilot data suggesting that concept combinations can indeed behave non-separably.

This article examines law’s representation of embodied female identity in the context of two medical law cases, R. v. Human Fertilisation and Embryology Authority, ex parte Blood andB v. Croydon Health Authority. Through an examination of contemporary critiques of female embodiment, in particular the work of Judith Butler, two discursive strategies are suggested for their potential to reconfigure the sexed subject within legal discourse. Firstly, the act of transgression – the flight from purportedly fixed subject positions – can be read (...) in the case of Bloodand calls into question law’s ability to contain and sustain sexed identity as prediscursive and immutable. Secondly, the exposure of the historical formation of the female subjects of legal discourse, demonstrated through a genealogical reading of B v. Croydon Health Authority, contributes to the feminist theoretical project to destabilise traditional gender categories and enables us to think beyond the category of ‘Woman’. (shrink)

Sociobiology has ignored the results of psychology, which is the discipline between biology and society. Campbell's target article fills some of the gaps beautifully, but the fact that women's direct and physical aggression has increased during the past 20 years, undermines Campbell's evolutionary explanation of female aggression. The two classical types of theoretical explanations of aggression are that (1) aggression is a drive and (2) aggression is instrumental behavior. Expressive aggression, assumed to be typical of women, is no more drive (...) aggression than is men's aggression. (shrink)

Ten nurses at a university hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of nurses and physicians about being in ethically difficult situations in surgical units. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation. The main theme in the narratives was being close to and moved by the suffering of patients and relatives. The nurses' responsibility for patients and relatives was expressed as a commitment to act, and they needed to ask themselves (...) whether their responsibility had been fulfilled, that nothing had been left undone, overlooked or neglected, before they could leave the unit. When there was confirmation by the patients, relatives, colleagues and themselves that the needs of patients and relatives had been attended to in a morally and professionally satisfying manner, this increased the nurses' confidence and satisfaction in their work, and their strength to live with the burden of being in ethically difficult situations. (shrink)

This paper takes a critical perspective on corporate social responsibility and examines the ways in which an industry organization discursively manages the relationship between the industry and its stakeholders in a situation where the legitimacy of the industry is called into question. Drawing on the literature on organizational narcissism and sensemaking the paper develops the construct of narcissistic CSR orientation and empirically elaborates on three defensive rhetorical strategies through which the organization makes sense of the accountability and responsibility of the (...) industry for the negative societal effects of their business. The paper advances knowledge in the field of critical CSR by proposing a new framework for critically examining organization-stakeholder relationships and organizational responses to stakeholder demands in contexts where the interests of organizations are in conflict with the public good. (shrink)

Background The aim of this study was to explore the ethical challenges in surgery from the surgeons' point of view and their experience of being in ethically difficult situations. Methods Five male and five female surgeons at a university hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of nurses and physicians about being in such situations. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation. Results No differences in ethical reasoning between male and (...) female surgeons were found. They reasoned in both action and relational ethical perspectives. Surgeons focused on their relationships with patients and colleagues and their moral self in descriptions of the ethical challenges in their work. Dialogue and personal involvement were important in their relationships with patients. The surgeons emphasized the importance of open dialogue, professional recognition, and an inclusive and accepting environment between colleagues. Conclusion The surgeons are personally challenged by the existential realities of human life in their relationships with patients. They realized that ethical challenges are an inherent part of performing surgery and of life itself, and say that they have to learn to "live with" these challenges in a way that is confirmed both socially and by their inner moral self. This means accepting their personal and professional limitations, being uncertain, being fallible, and being humble. Living with the ethical challenges of surgery seems to contribute to the surgeons' confidence and vulnerability in their professional identity. (shrink)

Background The aim of this study was to describe the kinds of ethical dilemmas surgeons face during practice. Methods Five male and five female surgeons at a University hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of physicians and nurses about ethically difficult situations in surgical units. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation. Results No gender differences were found in the kinds of ethical dilemmas identified among male and female surgeons. (...) The main finding was that surgeons experienced ethical dilemmas in deciding the right treatment in different situations. The dilemmas included starting or withholding treatment, continuing or withdrawing treatment, overtreatment, respecting the patients and meeting patients' expectations. The main focus in the narratives was on ethical dilemmas concerning the patients' well-being, treatment and care. The surgeons narrated about whether they should act according to their own convictions or according to the opinions of principal colleagues or colleagues from other departments. Handling incompetent colleagues was also seen as an ethical dilemma. Prioritization of limited resources and following social laws and regulations represented ethical dilemmas when they contradicted what the surgeons considered was in the patients' best interests. Conclusion The surgeons seemed confident in their professional role although the many ethical dilemmas they experienced in trying to meet the expectations of patients, colleagues and society also made them professionally and personally vulnerable. (shrink)

Paramedics encounter ethical dilemmas at work, and while previous research has improved ethics education and practice, more can be learned from the lived experience of paramedics facing ethical challenges. This paper explores the lived experience of two paramedics, one with five years’ experience, the other twenty, presented with comparable cases. The participants, who were interviewed in a broader qualitative study exploring practical wisdom, were asked to select a case involving ethical decision-making from their own practice experience. Semi-structured interviews employed the (...) five-step Critical Decision Method as a framework to explore various aspects of the decision-making process. The two cases were identified as exemplars of prominent themes suitable for discussion. The findings highlighted several factors that influence paramedic ethical decision-making, including practical wisdom, communication and teamwork, clinical support, and education. This case comparison identifies a greater need to focus education on the fostering of practical wisdom, and the development of non-technical skills such as communication and teamwork, supported by interprofessional education endeavours. Furthermore, greater access to support for paramedics must be available to further evolve practical wisdom. The combination of improved education and support will likely cater for the full spectrum of ethical challenges faced by paramedics in their work. (shrink)

This paper examines the study of computer based performance monitoring (CBPM) in the workplace as an issue dominated by questions of ethics. Its central contention paper is that any investigation of ethical monitoring practice is inadequate if it simply applies best practice guidelines to any one context to indicate, whether practice is, on balance, ‘ethical’ or not. The broader social dynamics of access to procedural and distributive justice examined through a fine grained approach to the study of workplace social relations, (...) and workplace identity construction, are also important here. This has three implications, which are examined in the paper, and are as follows: First, that it is vital for any empirical investigation of the ethics of CBPM practice to take into account not only its compliance with preexisting ‘best practice’ guidelines, but also the social relations which pervade the context of its application. Second, that this necessitates a particular epistemological treatment of CBPM as something whose effects are measurable and identifiable, as well as something which has a socially constructed meaning and is tropic in nature. Third, that existing debates against which this argument is set, which regard contrasting epistemologies and ontologies as incompatible, should be addressed, and an alternative introduced. Introducing situated knowledges (Haraway 1991) and material semiotic ontologies as such an alternative, the paper proceeds to analyse the ethics of a particular case of monitoring practice, Norco. Drawing on Marx (1998) the paper concludes that a fine grain analysis of the social is vital if we are to understand fully the ethics of monitoring in the workplace. (shrink)

In its enunciation of “We the people,” the Constitution of the United States of America becomes a constitution of the flesh as it simultaneously invokes a constitution, a nation and a people. Correspondingly, its amendments as a list of rights pertaining to sex and race discrimination, and freedoms of bodily movement and action, assert the Constitution’s authority through the evocation of “natural” human bodies. In this article, I explore the way in which a sovereignty of the United States’ Constitution is (...) realised in the particularlised bodies of its citizens. The fundamental and foundational laws of the United States, and the narratives and myths used to interpret them, are in part rendered legitimate by the Constitution’s embodiment, which extends from its physical manifestation in written documents into the flesh of its citizens. In order to make this argument, I turn to the film The Matrix (1999), the success of which relies on an investment in bodies and the United States’ Constitution as matter through its interwoven narrative themes of human slavery and emancipation, reality and computer-generated simulation. At the same time, The Matrix extends its ideological play into the bodies of its audience, who experience the film’s thrillingly sensorial fantasies of constitutional rights while enjoying its affective special effects. Thus, the sovereign authority of United States constitutional law is experienced as “natural” through the phenomenological experience of cinema. (shrink)

In recent decades political philosophers have increasingly been engaged with the issue of educational equality. However, egalitarians typically focus on achieving equality in the distribution of education, and ignore the relevance of an alternative, relational conception of equality. An exception to this is Elizabeth Anderson, who applies relational egalitarian principles to education in her 2007 article ‘Fair Opportunity in Education: A Democratic Equality Perspective’. Although Anderson remains one of the few relational egalitarians to consider what this ideal requires in education, (...) her arguments have received less attention than they deserve. In this article I examine Anderson's theory of fair educational opportunities for a democratic society of equals and develop an internal critique of her approach. I suggest that the sufficientarian standard Anderson proposes for education has the propensity to undermine the process of integration and the relations of equality she aspires to. Even if all children receive a sufficient education, inequality above the threshold could result in social divisions and status differentials that encourage informal segregation because people typically prefer to associate with other people who are similar to themselves. The article will finish by considering what implications this has for Anderson's relational egalitarian approach to education. (shrink)

We have no patterns for relating across our human differences as equals.Advocating the mere tolerance of difference between women is the grossest reformism.... Differences must be not merely tolerated, but seen as a fund of necessary polarities.... Audre Lorde.

Over the past 30 years, the Australian state of Victoria has made numerous reforms to a set of jury directions purporting to address concerns that rape trials do not adequately respond to the reality of sexual offending in the community. Building on work identifying the predominant narratives mobilised in rape trials, in this article we consider whether the way in which a jury consumes information during a trial explains why the jury directions, positioned and utilised as they are, appear to (...) have been inadequate to the task of enabling juries to re-imagine evidence through alternative narrative frameworks. (shrink)

Theatre-based health policy research is an emerging field, and this article investigates the work of one of its leaders. In 2005, prominent medical geneticist and playwright Jeff Nisker and his collaborators produced Orchids, his play concerning pre-implantation genetic diagnosis, to research theatre as a tool for engaging citizens in health policy development. Juxtaposing Orchids with a concurrent disability theatre production in Vancouver entitled Ugly, I argue that disability theatre suggests important means for building inclusiveness in this kind of research and (...) complicates Nisker’s own call for international guidelines to delimit how journalists, playwrights, filmmakers, physicians and other media authors share genetics-based narratives in public. (shrink)

Recent years have seen new general notions of contextuality emerge. Most of these employ context-independent symbols to represent random variables in different contexts. As an example, the operational theory of :52108, 2005) treats an observable being measured in two different contexts identically. Non-contextuality in this approach is the impossibility of drawing ontological distinctions between identical elements of the operational theory. However, a recent collection of work seeks to exploit context-dependent symbols of random variables to interpret contextuality :150401, 2015; Dzhafarov and (...) Kujala in Phys Scr T163:014009, 2014). This approach associates contextuality with the possibility of imposing a particular joint distribution on random variables recorded under different experimental contexts. This paper compares these two different treatments of random variables and highlights the limitations of the context-dependent approach as a physical theory. (shrink)

The year 2017 is an important centenary for women in the Church. In 1917, in the darkness of World War I, a woman was ordained as a Congregational Minister for the first time in Britain. She was not a Congregationalist but a Presbyterian by upbringing. She would go on to serve a small church in one of the poorest parts of London, yet she was highly educated and from an upper middle-class family. She was a pacifist, a feminist, a wife, (...) mother and someone of deep faith. Constance Coltman’s ordination was a quiet event which attracted little attention at the time but which continues to have an effect even today. This article outlines and considers the historical, ecclesial and personal contexts within which Constance Coltman’s ordained ministry began. (shrink)

This paper examines the study of computer basedperformance monitoring (CBPM) in the workplaceas an issue dominated by questions of ethics.Its central contention paper is that anyinvestigation of ethical monitoring practice isinadequate if it simply applies best practiceguidelines to any one context to indicate,whether practice is, on balance, ethical or not. The broader social dynamics of access toprocedural and distributive justice examinedthrough a fine grained approach to the study ofworkplace social relations, and workplaceidentity construction, are also important here. This has three (...) implications, which are examinedin the paper, and are as follows: First, thatit is vital for any empirical investigation ofthe ethics of CBPM practice to take intoaccount not only its compliance withpreexisting best practice guidelines, butalso the social relations which pervade thecontext of its application. Second, that thisnecessitates a particular epistemologicaltreatment of CBPM as something whose effectsare measurable and identifiable, as well assomething which has a socially constructedmeaning and is tropic in nature. Third, thatexisting debates against which this argument isset, which regard contrasting epistemologiesand ontologies as incompatible, should beaddressed, and an alternative introduced. Introducing situated knowledges (Haraway 1991)and material semiotic ontologies as such analternative, the paper proceeds to analyse theethics of a particular case of monitoringpractice, Norco. Drawing on Marx (1998) thepaper concludes that a fine grain analysis ofthe social is vital if we are to understandfully the ethics of monitoring in theworkplace. (shrink)

Minsaas reviews Alexandra York's essay-collection, From theFountainhead to the Future. Minsaas points out certain similarities between York's campaign for a cultural renaissance and Ayn Rand's call, in The Romantic Manifesto, for a rebirth of the ideals that informed the Romantic movement. Basically sympathetic to York's project, Minsaas does, however, express certain reservations about York's activist approach, which she finds weakens the book's scholarly value. Also, she finds that York is too one-sided in her advocacy of a life-affirming and inspiring art (...) by downplaying the need for art that explores the darker sides of life in constructive ways. (shrink)

Medicine maintains a distinction between the medical symptom -- the patient''ssubjective experience and expression, and the privileged medical sign -- the objective findings observable by the doctor. Although the distinction is not consistently applied, it becomes clearly visible in the undefined, medically unexplained disorders of women patients. Potential impacts of genderized interaction on the interpretation of medical signs are addressed by re-reading the diagnostic process as a matter of social construction, where diagnosis results from human interpretation within a sociopolitical context. (...) The discussion is illustrated by a case story and empirical evidence of the gendering in the doctor-patient relationship. The theoretical analysis is supported by semiotic perspectives of bodily signs, feminist theory on experience, and Foucault''sideas about medical perception and gaze, and concludes that a medical diagnosis is seldom a biological fact, but the outcome of a process where biological, cultural and social elements are interwoven. Further deconstruction of the chain of signs from a feminist perspective, assigning validity to the voice of the woman patient, might broaden the understanding of women''shealth, illness and disease. (shrink)

(2013). Experiencing Error: How Journalists Describe What It's Like When the Press Fails. Journal of Mass Media Ethics: Vol. 28, No. 1, pp. 30-41. doi: 10.1080/08900523.2012.746529.