Hastings Center Report, Volume 52, Issue 1, Page 32-41, January/February 2022.

BackgroundWhen conducting research with Indigenous populations consent should be sought from both individual participants and the local community. We aimed to search and summarise the literature about methods for seeking consent for research with Indigenous populations.MethodsA systematic literature search was conducted for articles that describe or evaluate the process of seeking informed consent for research with Indigenous participants. Guidelines for ethical research and for seeking consent with Indigenous people are also included in our review.ResultsOf 1447 articles found 1391 were excluded (...) ; 56 were relevant and included. Articles were categorised into original research that evaluated the consent process or publications detailing the process of seeking consent and guidelines for ethical research. Guidelines were categorised into international ; national and state/regional/local guidelines. In five studies based in Australia, Canada and The United States of America the consent process with Indigenous people was objectively evaluated. In 13 other studies interpreters, voice recording, videos, pictures, flipcharts and “plain language” forms were used to assist in seeking consent but these processes were not evaluated. Some Indigenous organisations provide examples of community-designed resources for seeking consent and describe methods of community engagement, but none are evaluated. International, national and local ethical guidelines stress the importance of upholding Indigenous values but fail to specify methods for engaging communities or obtaining individual consent. In the ‘Grey literature’ concerns about the consent process are identified but no solutions are offered.ConclusionConsultation with Indigenous communities is needed to determine how consent should be sought from the community and the individual, and how to evaluate this process. (shrink)

Previous research has shed light on the detrimental effects of abusive supervision. To extend this area of research, we draw upon conservation of resources theory to propose a causal relationship between abusive supervision and psychological distress, a mediating role of psychological distress on the relationship between abusive supervision and employee silence, and a moderating effect of the supervisor–subordinate relational context on the mediating effect of abusive supervision on silence. Through an experimental study, we found the causal path linking abusive supervision (...) and psychological distress. Results of both the experimental study and a field study provided evidence that psychological distress mediated the relationship between abusive supervision and silence. Lastly, we found support that this mediation effect was contingent upon the relational context in Study 2 but not in Study 1. We discuss implications for theory and practice. (shrink)

Background:At a time when British nursing has been under scrutiny for an apparent lack of compassion in education and practice, this paper based offers a perspective on the notions of vocation and altruism in nursing.Objectives:To understand the vocational and altruistic motivations of nurses through the application of Pierre Bourdieu's concepts of ‘symbolic capital’, ‘field’ and ‘habitus’ through a long interview with nurse respondents.Research design:A reflexive qualitative study was undertaken using the long interview. A thematic analysis of the data, using a (...) qualitative data software package for analysis, was undertaken. The ideas of Pierre Bourdieu (Habitus, Capital and Field) were used to analyse and explain the content of community nurses' ‘talk’.Participants:Twelve Community Nurses working in a variety of local primary care settings volunteered to participate in the study. It was a self-selecting convenience sample of nurses responding to an invitation to be interviewed.Research context:A study in support of a doctoral thesis conducted within NHS primary care settings with registered nurses.Ethical considerations:The key considerations for this study were to be mindful of the possibility of emotional harm or distress being caused to the respondents during the retelling of their experiences. It was also essential to ensure that the locations or names of patients or staff (if discussed) were anonymised. Ethical approval was sought and granted by both the Local NHS Primary Care and the University Ethics committees before the study commenced.Findings:The nurse respondents had highly individual and at times contradictory views on their motivations to nurse including their views on vocation and altruism in nursing careers.Discussion:Bourdieu's ideas apply well to the nursing context and provided a useful theoretical framework to explore the social and cultural influences on nursing careers. Gender is important consideration in all aspects of nursing but class and educational experience is an important dimension in the stories nurses tell.Conclusion:The culturally determined experiences of these nurses in practice offer an authentic and realistic insight into the complex motives and predispositions of community nurses. This paper argues that nurse motivations whether vocational or altruistic, are better understood as culturally, rather than spiritually, driven. (shrink)

Could a computer have a mind? What kind of machine would this be? Exactly what do we mean by 'mind' anyway?The notion of the 'intelligent' machine, whilst continuing to feature in numerous entertaining and frightening fictions, has also been the focus of a serious and dedicated research tradition. Reflecting on these fictions, and on the research tradition that pursues 'Artificial Intelligence', raises a number of vexing philosophical issues. Minds and Computers introduces readers to these issues by offering an engaging, coherent, (...) and highly approachable interdisciplinary introduction to the Philosophy of Artificial Intelligence.Readers are presented with introductory material from each of the disciplines which constitute Cognitive Science: Philosophy, Neuroscience, Psychology, Computer Science, and Linguistics. Throughout, readers are encouraged to consider the implications of this disparate and wide-ranging material for the possibility of developing machines with minds. And they can expect to de. (shrink)

(2009). Mellow Monday and furious Friday: The approach-related link between anger and time representation. Cognition & Emotion: Vol. 23, No. 6, pp. 1166-1180.

This article examines discourses about mixed reality as a data-rich sensing technology – specifically, engaging with discourses of time as framed by developers, engineers and in corporate PR and marketing in a range of public facing materials. We focus on four main settings in which mixed reality is imagined to be used, and in which time was a dominant discursive theme – the development of mixed reality by big tech companies, the use of mixed reality for defence, mixed reality as (...) a technology for control of populations in civil society and mixed reality as a technology used in workplace settings. Across these settings, the broad narrative is that mixed reality technologies afford overwhelmingly positive benefits like efficiency and security through their capture, relay and rendition of data – affording a form of anticipatory power to the user. The framing of temporality, we argue, is underlain by social and political values, which represent certain interests, but leave others out in the imagination of mixed reality's technological advance. (shrink)

Researchers are required to seek consent from Indigenous communities prior to conducting research but there is inadequate information about how Indigenous people understand and become fully engaged with this consent process. Few studies evaluate the preference or understanding of the consent process for research with Indigenous populations. Lack of informed consent can impact on research findings. The Picture Talk Project was initiated with senior Aboriginal leaders of the Fitzroy Valley community situated in the far north of Western Australia. Aboriginal people (...) were interviewed about their understanding and experiences of research and consent processes. Transcripts were analysed using NVivo10 software with an integrated method of inductive and deductive coding and based in grounded theory. Local Aboriginal interpreters validated coding. Major themes were defined and supporting quotes sourced. Interviews with Aboriginal leaders were facilitated by a local Aboriginal Community Navigator who could interpret if necessary and provide cultural guidance. Participants were from all four major local language groups of the Fitzroy Valley; aged 31 years and above; and half were male. Themes emerging from these discussions included Research—finding knowledge; Being respectful of Aboriginal people, Working on country, and Being flexible with time; Working together with good communication; Reciprocity—two-way learning; and Reaching consent. The project revealed how much more there is to be learned about how research with remote Aboriginal communities should be conducted such that it is both culturally respectful and, importantly, meaningful for participants. We identify important elements in community consultation about research and seeking consent. (shrink)

In the rapidly evolving healthcare environment, perhaps no role is in greater flux and redefinition than that of the clinical bioethicist. The discussion of ethics consultation in the bioethics literature has moved from an ambiguous concern regarding its proper place in the clinical milieu to the more provocative question of which methods and theories should best characterize the intellectual and practical work it claims to do. The American Society for Bioethics and Humanities addressed these concerns in its 1998 report, CoreCompetenciesforHealthCareEthicsConsultation. (...) The report tries to answer the question as to what disciplinary training, background experience, and levels of knowledge in ethics the clinical ethics consultant should have, and what specific skills and character traits the clinical ethics consultant should cultivate. In addition to acquiring knowledge of common bioethical issues, theoretical concepts in ethical theory and moral reasoning, and health-related law and policy, the report also recommends that ethics consultants demonstrate knowledge of the health beliefs and perspectives of patients and healthcare providers. In our opinion, this recommendation underscores a crucial aspect of the practice of ethics consultation in the increasingly multicultural settings of healthcare institutions. Clearly, the dynamic of American life and culture is permeated with diversity and variety as new groups suffuse their own beliefs and faith perspectives into the health sector. New immigrant groups force society to question traditional healthcare practices and to accommodate changing medical needs. (shrink)

To what extent do we pay attention to the text and images that cover our hospital walls and do we offer any critique either as professionals or service users? In the past we might have expected to see functional or helpful instructions about where to go (or not to go) and in more well‐endowed buildings, perhaps we would see some works of art, sculpture, stained glass even, with the intention to encourage, distract or even forewarn us. However, it is now (...) common in UK hospitals, for wall space to be used as a portal for a range of institutional political messages, that convey information about everything from its own values, behaviours to advertisements for products and services to requirements for rule following. Michel Foucault's ideas about Heterotopic space can help us to see that hospitals tend to fall (awkwardly) between being a public and personal health care space, and this is a possible explanation for the confused material culture and messages that are shared there. This paper draws on ethnographic methods to reflect on personal experience in order to offer a critique of the contemporary political discourse which has become 'literally' written onto our hospital walls. (shrink)

This paper examines how digital technologies might be used to improve ethical attitudes towards nonhuman animals, by exploring the case study of nonhuman apes kept in modern zoos. The paper describes and employs a socio-ethical framework for undermining anti-ape prejudice advanced by philosopher Edouard Machery which draws on classic anti-racism strategies from the social sciences. We also discuss how digital technologies might be designed and deployed to enable and enhance rather than impede the three anti-prejudice strategies of contact and interaction, (...) enlightenment, and individualization. In doing so, the paper illuminates the broad potential and limitations of digital technology to both harm and benefit animals via its effects on human ethical attitudes. This examination provides guidance for future projects and empirical work on using digital technologies to promote moral respect for a range of nonhuman animals in different settings. (shrink)

Across care settings, the practice of lying to or withholding the truth from people living with dementia is common, yet it is objected to by many. Contrary to this common discomfort, I have argued in previous work that respecting members of this group as moral equals sometimes requires deceiving them. In this paper, I test my proposed practice against complex, controversial cases, demonstrating both its theoretical strength and its practical value for those working in social care.

Lying and deceit are instruments of power, used by social actors in the pursuit of their practices as they seek to maintain social order. All social actors, nurses included, have deceit and dishonesty within their repertoire of practice. Much of this is benign, well intentioned and a function of being sociable and necessary in the pursuit of social order in the healthcare environment. Lying and deceit from a sociological point of view, is a reflection of the different modes of domination (...) that exist within a social space. French philosopher Pierre Bourdieu theorized about the way that symbolic power works within social space. The social structures and the agency of individual actors moving within it are interrelated and interdependent. Bourdieu's ideas will be used to theorize about real clinical experiences where acts of deceit can be identified and a case example will be presented. Nurses are actors in the social space of clinical care, and their world is complex, challenging, and often fraught with the contradictory demands and choices that reflect and influence their behaviours. An exploration of lying and deceit in nursing as an instrument in the modes of domination that persist enables us to challenge some of the assumptions that are made about the motives that cause or tempt nurses to lie as well as to understand the way on which they are sometimes lied to, according to the acts of domination that exist in the field. Lying or acting dishonestly is a powerful act that is intent on retaining stability and social order and could be seen to be a justification of lying and deceit. However, we need to pause and consider, in whose interests are we striving to create social order? Is it in the end about the comfort of patients or for the comfort of professionals? (shrink)

The consent and community engagement process for research with Indigenous communities is rarely evaluated. Research protocols are not always collaborative, inclusive or culturally respectful. If participants do not trust or understand the research, selection bias may occur in recruitment, affecting study results potentially denying participants the opportunity to provide more knowledge and greater understanding about their community. Poorly informed consent can also harm the individual participant and the community as a whole. Invited by local Aboriginal community leaders of the Fitzroy (...) Valley, the Kimberley, Western Australia, The Picture Talk project explores the consent process for research. Focus groups of Aboriginal community members were conducted to establish preferences for methods of seeking individual consent. Transcripts were analysed through NVivo10 Qualitative software using grounded theory with inductive and deductive coding. Themes were synthesised with quotes highlighted. Focus groups with Aboriginal community members were facilitated by a Community Navigator as a cultural guide and interpreter and a researcher. Participants were recruited from all main language groups of the Fitzroy Valley – Gooniyandi, Walmajarri, Wangkatjungka, Bunuba and Nikinya. Participants were aged ≥18 years, with 5 female groups and one male group. Themes identified include: Reputation and trust is essential; The Community Navigator is key; Pictures give the words meaning – milli milli versus Pictures; Achieving consensus in circles; Signing for consent; and Research is needed in the Valley. Aboriginal communities of the Fitzroy Valley recommend that researchers collaborate with local leaders, develop trust and foster a good reputation in the community prior to research. Local Aboriginal researchers should be employed to provide cultural guidance throughout the research process and interpret local languages especially for elders. Pictures are preferred to written text to explain research information and most prefer to sign for consent. The Fitzroy Valley welcomes research when collaborative and for the benefit of the community. Future research could include exploring how to support young people, promote health screening and improve understanding of medical knowledge. (shrink)

Elizabeth Barnes has recently developed an account of disability that is sensitive to the role of self-evaluation. To have a physical disability is, according to Barnes, to have a body that is merely different from the norm. Yet, as Barnes notes, some disabilities will genuinely frustrate some life plans. It may be the case, therefore, that a disability is instrumentally bad for a person and that acquiring one may be a genuine loss. Equally, however, a person may genuinely value a (...) disability such that it is instrumentally good for them and that they experience the acquiring of it as a gain. Notably, Barnes explicitly restricts this analysis to physical disabilities, leaving open the status of mental disabilities. Nevertheless, Barnes does not rule out the extension of her model to this category, and she expresses a desire to see future work on other disabilities built upon it. This article takes up this challenge, making the case that to possess a mental disability is merely to possess a minority mind. (shrink)

The dispute between the transgender-rights movement and “gender-critical” activists represents a stark division in British public discourse. Although the issues of contention are numerous and require their own philosophical treatment, a core metaphysical concern underlies them. Gender-critical activists, such as Kathleen Stock, tend to argue that recognizing trans women as women requires erasing the category of biological sex. This implies that all trans women are male, and thus recognizing them as women rips female biology from the root of the category (...) “woman.” In this article, I argue that this view is mistaken. As exogenously produced sex characteristics should count toward a person's sex classification, all trans women are female. (shrink)

This paper offers a narrative approach to understanding the process of clinical reasoning in complex cases involving medical uncertainty, moral ambiguity, and futility. We describe a clinical encounter in which the pediatric health care team experienced a great deal of conflict and distrust as a result of an ineffective process of interpretation and communication. We propose a systematic method for analyzing the technical, ethical, behavioral, and existential dimensions of the clinical reasoning process, and introduce the Clinical Reasoning Discussion Tool—a dialogical (...) and interpretive device aimed at improving communication, understanding, empathy, and moral deliberation in the clinical setting. (shrink)

In this article we address Emile Durkheim's theory that norms and values become more generalized and abstract in a society as it becomes more complex and differentiated. To test Durkheim's theory we examine etiquette manuals—the common texts that define normative manners and morals in American society. We perform a deductive content analysis on past and present etiquette manuals to understand what changes have occurred regarding shifting behavioral norms and values over time. Our findings suggest that a change has occurred in (...) the presentation and language of contemporary etiquette manuals, reflecting a greater change in the normative order. We find—as Durkheim would expect—that three main shifts have occurred: a shift from specific to general expectations for behavior in social settings, a shift from demanding to more suggestive rules of behavior in social situations, and a weakening in the severity of sanctions for breaches of etiquette. (shrink)

Many countries project that they will have difficulty to meet their demand for primary care based on an inadequate supply of primary care doctors. There are many reasons for this, and they tend to vary by country. The policy options available to these countries are to increase the number of local primary care doctors, recruit doctors from other countries, ration primary care, shift more primary care to specialists, or authorize other disciplines to provide primary care. This article examines lessons learned (...) in the United States over the past 50 years and proposes that expanding the use of nurse practitioners is the best solution when measured by feasibility, costs, ethics, and scope of the care delivered. Using nurse practitioners trained in country meets the World Health Organization global code of practice regarding the international recruitment of health personnel. (shrink)

This paper attempts to sort out some of the current tensions and ambiguities inherent in the field of bioethics as it continues to mature. In particular it focuses on the question of the methodological relevance of theory or ethical principles to the domain of clinical ethics. I offer an approach to reasoning about moral conflict that combines the insights of contemporary moral theorists, the philosophy of American pragmatism, and the skills of rhetorical deliberation. This synthetic approach locates a proper role (...) for moral theory in the practice of clinical ethics, thus linking abstract philosophical ideas about morality, humanity, suffering, and health to specific deeds, actions, and decisions in the concrete lives of particular individuals. The aim of this synthetic approach of bioethical inquiry is a rapprochement between theoretical knowledge in moral philosophy and the contextualized, relational, and practical understanding of what morality demands of us in our daily lives. I argue for a conception of bioethical inquiry that takes morality to be a study of certain practical, socially embedded concerns about matters of right and wrong, good and evil, as well as a study of the moral theories by which these actual concerns can be explored and critically evaluated. (shrink)

Editor’s note: Presidential Address delivered at Portland, Oregon on March 17, 2013 on the occasion of the AOS annual meeting. The submission was not edited, at the insistence of the author; this was granted as a prerogative restricted to his Presidential Address, for reasons that will be understood by a perusing of the subject matter. All infelicities are in keeping with the original submission. Author’s note: In keeping with the theme of this Address the published text aims to reproduce exactly (...) the words that were read out. The version presented here is based on a scanned image of the only copy of the original typescript with the author’s hand-written changes, retrieved from a member of the audience to whom it was given after the proceedings. Transliteration follows the conventions of the Journal, and the source references have been moved into the footnotes. Bibliographical attributions are minimal: colleagues will easily distinguish between sweeping statements which could be documented if need be, and the private opinions of the writer. (shrink)

This paper challenges the commonplace view of T.H. Green and his followers: that they divided politically into left and right groups depending on their views of socialism, state action and the individual. By examining in detail the work of Green's followers, Bernard Bosanquet and Sidney Ball, this paper shows that there was, in fact, a broad consensus between the two on questions of the role of the state. This has significant implications for the understanding of idealism, the work of Bosanquet (...) and of Green's legacy itself. (shrink)

On the 8th and 9th of September 1994, the Hegel Society of Great Britain held its annual conference at Pembroke College, Oxford. The conference was made up of six interesting papers from leading scholars in the field, all on the issue of Hegel’s relationship with the British Idealists.

Die Geheimnisse der oberen und der unteren Welt: Magie im Islam zwischen Glaube und Wissenschaft. Edited by Sebastian Günther and Dorothee Pielow. Leiden: Brill, 2019. Pp. xlii + 644. $179, €149.

As the Modernist dream of a world purged of archaic decor and ornamentaion recedes, we should remember that the diet of a raw, unmediated universe has always unsettled Homo sapiens. This book looks at some of these mediations".

Carers often interfere with the choices of people living with dementia. On neorepublican and (most) relational egalitarian views, interference can be justified if it tracks a person's interests: if it does not lead to a relationship of domination. However, the kind of environment-shaping interventions carers often pursue would be considered infantilising or objectionably paternalistic in other cases. In this paper, I defend this indirect approach and argue that it offers the best prospects of dementia care without domination.

Despite negative effects on their health and social lives, many informal carers of people living with dementia claim to be acting in accordance with a moral obligation. Indeed, feelings of failure and shame are commonly reported by those who later give up their caring responsibilities, suggesting a widespread belief that professional dementia care, whether delivered in the person's own home or in an institutional setting, ought always to be a last resort. In this paper, however, I suggest that this common (...) intuition gets things the wrong way around. Adopting a relational egalitarian framework, I argue that the most serious injustices engendered by present‐day dementia care services are contingent on broader societal structures—they can thus be ameliorated relatively easily (if resource intensively) by changing those structures. Informal dementia care, on the other hand, carries similar risks of injustice and is much more resistant to structural reform. While there may be moral obligations to provide informal dementia care in present‐day societies, then, they arise because of the deficiencies of professional care, not the virtues of its informal counterpart. Though we may be far from achieving just care arrangements in most of our societies, we must never lose sight of the fact that, when we engage in morally permitted informal dementia care, we are exercising our last resort. (shrink)

Comparing the practice of nurse practitioners to medical practice began almost 50 years ago and continues to this day. This comparison is curious since the founders of this movement did not indicate that these advanced practice nurses were to be interchangeable with physicians. Nevertheless, substantial literature indicates that nurse practitioners perform equally or better when measured against physician practice standards. This paper compares the ontology and epistemology of both professions and concludes that the philosophical foundations are so different that comparisons (...) are illogical. (shrink)