Ethical concerns have been raised about routine practice in paediatric gender clinics. We discuss informed consent and the risk of iatrogenesis in the prescribing of gonadotropin-releasing hormone...

This paper responds to two trends in debates about Plato's view of women in the Republic. First, many scholars argue or assume that Plato seeks to minimize the influence of femininity in the ideal city, and to make guardian women themselves as “masculine” as possible. Second, scholars who address the relationship between Plato's views of women and his psychological theory tend to focus on the reasoning and appetitive parts of the tripartite soul. In response to the first point, we argue (...) that the idea that Plato seeks to masculinize/de-feminize the city oversimplifies his treatment of Greek gender norms. Although he does want to eliminate some traditionally feminine qualities from the city, he also seeks to eliminate many masculine qualities as well. Moreover, while he tries to make guardian women more like men in some respects, he simultaneously aims to make guardian men more like Greek women in important ways. Regarding the second point, we argue that this project of reimagining gender norms is illuminated by Plato's psychology, but instead of emphasizing reason and appetite, we show how his views are connected to his account of the third, “spirited” part of the soul, thumos, and its dual hard/soft or aggressive/gentle nature. (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)

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)

As disciplines, psychology and theology share an overlapping interest in the nature and functioning of human beings. This book provides an introduction to many of the worldview issues and philosophical foundations that frame the relationship of psychology and theology, includes scholarly reflection on the integration literature, and surveys five paradigms of possible relationships between psychology and Christianity. Questions at the end of each chapter are included to help readers evaluate both the material and their own burgeoning approach to integration. This (...) book is ideal as a textbook for students of psychology and other behavioral and social sciences (social work, sociology, theology, counseling, pastoral counseling) at both the graduate and undergraduate level. It is also written for the broader readership of psychologists, counselors, pastors, and others who are interested in integration" -- Publisher description. (shrink)

Matrix degradation and tissue remodelling directed by matrix‐degrading proteases are activated in physiological situations such as wound healing and involution of the prostate, ovaries and uterus. Recently, other activities, in addition to the cleavage of matrix proteins, have been attributed to matrix proteases including the release of growth factors from the extracellular matrix and roles in the maturation of adipocytes. This review describes extracellular proteases, including MMPs, plasminogen and cathepsins involved in the tissue remodelling processes that occur in the breast (...) during pubertal mammary development and the mammary cycle of pregnancy, lactation and weaning. It particularly focuses on development and weaning, termed mammary gland involution, when the majority of remodelling occurs. It also brings together recent findings on the exciting new functions of matrix‐degrading proteases. BioEssays 27:894–903, 2005. © 2005 Wiley Periodicals, Inc. (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)

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)

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)

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)

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.

There are important ethical issues to be examined before launching any public health intervention, particularly when targeting vulnerable groups. The aim of this article is to identify and discuss ethical concerns that may arise when intervening for health behavior change among adolescents identified as overweight. These concerns originate from an intervention designed to capacitate adolescents to increase self-determined physical activity. Utilizing an ethical framework for prevention of overweight and obesity, we identified three ethical aspects as particularly significant: the attribution of (...) responsibility for health behavior, liberty to choose, and the effect on the participants’ psychosocial well-being. It is discussed whether and how measures can be taken to deal with these aspects. It seems evident that the ethical aspects are mainly concerned with the vulnerability of adolescents identified as overweight. However, we claim that when individual feedback and counseling is provided, tailored interventions have a unique potential to empower adolescents to make ethically anchored decisions about their own health behavior. (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)

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)

Patient or public involvement in health research is increasingly expected as a matter of policy. In theory, PPI can contribute both to the epistemic aims intrinsic to research, and to extrinsically valued features of research such as social inclusion and transparency. In practice, the aims of PPI have not always been clear, although there has been a tendency to encourage the involvement of so-called ordinary people who are regarded as representative of an assumed patient perspective. In this paper we focus (...) on the epistemic potential of PPI, using theoretical work in epistemology to develop a nuanced account of patients’ experiential knowledge and how this might contribute directly to conceptual development, hypothesis generation and data interpretation. We also consider how some features of health research pose barriers to this kind of epistemic contribution. Drawing on Miranda Fricker’s idea of testimonial injustice, we explore how disciplinary indicators of credibility in clinical and academic health research contexts might be wrongly applied to those involved in PPI, undermining their potential to contribute. Finally we argue for a range of strategies to maximize opportunities for patients to engage with research teams and make epistemologically significant contributions to research. (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 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)

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.

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)

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)

Health services internationally struggle to ensure health care is “person-centered” (or similar). In part, this is because there are many interpretations of “person-centered care” (and near synonyms), some of which seem unrealistic for some patients or situations and obscure the intrinsic value of patients’ experiences of health care delivery. The general concern behind calls for person-centered care is an ethical one: Patients should be “treated as persons.” We made novel use of insights from the capabilities approach to characterize person-centered care (...) as care that recognizes and cultivates the capabilities associated with the concept of persons. This characterization unifies key features from previous characterisations and can render person-centered care applicable to diverse patients and situations. By tying person-centered care to intrinsically valuable capability outcomes, it incorporates a requirement for responsiveness to individuals and explains why person-centered care is required independently of any contribution it may make to health gain. (shrink)

In this paper, we argue that there are important ethical questions about healthcare improvement which are underexplored. We start by drawing on two existing literatures: first, the prevailing, primarily governance-oriented, application of ethics to healthcare ‘quality improvement’ (QI), and second, the application of QI to healthcare ethics. We show that these are insufficient for ethical analysis of healthcare improvement. In pursuit of a broader agenda for an ethics of healthcare improvement, we note that QI and ethics can, in some respects, (...) be treated as closely related concerns and not simply as externally related agendas. To support our argument, we explore the gap between ‘quality’ and ‘ethics’ discourses and ask about the possible differences between ‘good quality healthcare’ and ‘good healthcare’. We suggest that the word ‘quality’ both adds to and subtracts from the idea of ‘good healthcare’, and in particular that the technicist inflection of quality discourses needs to be set in the context of broader conceptualisations of healthcare improvement. We introduce the distinction between quality as a measurable property and quality as an evaluative judgement, suggesting that a core, but neglected, question for an ethics of healthcare improvement is striking the balance between these two conceptions of quality. (shrink)

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)

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)

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)

Process engraver and printer Emery Walker was a pivotal figure in the English, American, and continental European Private Press Movement from the 1880s until his death in 1933. This article looks at his theories for the typography, design, and production of books, and how those theories were developed by key designers and close associates of Walker such as William Morris, T. J. Cobden Sanderson, and Bruce Rogers and through the practical teaching of figures such as J. H. Mason and Edward (...) Johnston. It examines how the theories were then taken up by the exponents of fine printing from the early 20th century through to the 1930s, focusing on the presses of Bernard Newdigate, Harry Kessler, Harold Curwen, and Francis Meynell. From these presses, and also via Stanley Morison and the Monotype Corporation, Walker’s theories are shown to have spread into mainstream book publishing in the first half of the 20th century. The article considers questions of whether the improvement in the readability of books in the early 20th century has had a continuing impact in book publishing, and makes suggestions how to access the incunabula referenced by the designers discussed, as well as collections of private press books and other early 20th-century fine printing. (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 (Spekkens in Phys Rev A 71(5):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 (Kujala et al. in Phys Rev Lett 115(15):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)

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)

(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.

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)

There are various reasons why efforts to promote “support for self-management” have rarely delivered the kinds of sustainable improvements in healthcare experiences, health and wellbeing that policy leaders internationally have hoped for. This paper explains how the basis of failure is in some respects built into the ideas that underpin many of these efforts. When support for self-management is narrowly oriented towards educating and motivating patients to adopt the behaviours recommended for disease control, it implicitly reflects and perpetuates limited and (...) somewhat instrumental views of patients. It tends to: restrict the pursuit of respectful and enabling ‘partnership working’; run the risk of undermining patients’ self-evaluative attitudes ; limit recognition of the supportive value of clinician-patient relationships; and obscure the practical and ethical tensions that clinicians face in the delivery of support for self-management. We suggest that a focus on enabling people to live well with their long-term conditions is a promising starting point for a more adequate conception of support for self-management. We then outline the theoretical advantages that a capabilities approach to thinking about living well can bring to the development of an account of support for self-management, explaining, for example, how it can accommodate the range of what matters to people for living well, help keep the importance of disease control in perspective, recognize social influences on people’s values, behaviours and wellbeing, and illuminate more of the rich potential and practical and ethical challenges of supporting self-management in practice. (shrink)

The aim of this article is to present a conceptual review and analysis of symptom understanding. Subjective bodily sensations occur abundantly in the normal population and dialogues about symptoms take place in a broad range of contexts, not only in the doctor’s office. Our review of symptom understanding proceeds from an initial subliminal awareness by way of attribution of meaning and subsequent management, with and without professional involvement. We introduce theoretical perspectives from phenomenology, semiotics, social interactionism, and discourse analysis. Drew (...) Leder’s phenomenological perspectives deal with how symptom perception occurs when any kind of altered balance brings forward a bodily attention. Corporeality is brought to explicit awareness and perceived as sensations. Jesper Hoffmeyer’s biosemiotic perspectives provide access to how signs are interpreted to attribute meaning to the bodily messages. Symptom management is then determined by the meaning of a symptom. Dorte E. Gannik’s concept “situational disease” explains how situations can be reviewed not just in terms of their potential to produce signs or symptoms, but also in terms of their capacity to contain symptoms. Disease is a social and relational phenomenon of containment, and regulating the situation where the symptoms originate implies adjusting containment. Discourse analysis, as presented by Jonathan Potter and Margaret Wetherell, provides a tool to notice the subtle ways in which language orders perceptions and how language constructs social interaction. Symptoms are situated in culture and context, and trends in modern everyday life modify symptom understanding continuously. Our analysis suggests that a symptom can only be understood by attention to the social context in which the symptom emerges and the dialogue through which it is negotiated. (shrink)