Strike action in healthcare has been a common global phenomenon. As such action is designed to be disruptive, it creates substantial ethical tension, the most cited of which relates to patient harm, that is, a strike may not only disrupt an employer, but it could also have serious implications for the delivery of care. This article systematically reviewed the literature on strike action in healthcare with the aim of providing an overview of the major justifications for strike action, identifying relative (...) strengths and shortcomings of this literature and providing direction for future discussions, and theoretical and empirical research. Three major themes emerged related to (1) the relationship between healthcare workers, patients and society; (2) the consequences of strike action; and (3) the conduct of strike action. Those who argue against strike action generally cite the harms of such action, particularly as it relates to patients. Many also argue that healthcare workers, because of their skills and position in society, have a special obligation to their patients and society more generally. Those who see this action as not only permissible but also, in some cases, necessary have advanced several points in response, arguing that healthcare workers do not necessarily have any special obligation to their patients or society, and even if so, this obligation is not absolute. Overwhelmingly, when talking about the potential risks of strike action, authors have focused on patient welfare and the impact that a strike could have. Several directions for future work are identified, including greater explorations into how structural and systemic issues impact strike action, the need for greater consideration about the contextual factors that influence the risks and characteristics of strike action and finally the need to tie this literature to existing empirical evidence. (shrink)

BackgroundNon-violent resistance which has involved healthcare workers has been instrumental in securing a number of health-related gains and a force in opposing threats to health. Despite this, we...

While strike action has been common since the industrial revolution, it often invokes a passionate and polarising response, from the strikers themselves, from employers, governments and the general public. Support or lack thereof from health workers and the general public is an important consideration in the justification of strike action. This systematic review sought to examine the impact of strike action on patient and clinician attitudes, specifically to explore (1) patient and health worker support for strike action and (2) the (...) predictors for supporting strike action and the reasons given for engaging in strike action. A systematic scoping review was employed to identify all relevant literature, followed by a textual narrative synthesis. A total of 34 studies met inclusion criteria. Support for strike action was largely context‐dependent. A range of factors impact support for strike action; broader cultural and structural factors, such as unionisation and general acceptance of strike action; systemic factors, such as the nature of the healthcare system, including infrastructure and work conditions; the strike itself and a range of individual factors, the most notable of which was being a student or in an early career stage. There were also some surprising results, for example, during doctors strike, nurses were provided with the opportunity to expand their role, which led to greater professional autonomy and job satisfaction. (shrink)

Introduction: Non-violent resistance, carried out by healthcare workers, has been a common phenomenon. Despite this and despite the issues this type of action raises, we know little about the healthcare workers who engage in this action and their perspectives about its justification. This exploratory study sought to address this gap, examining these fundamental questions amongst a sample of healthcare workers who have engaged in acts of resistance, exploring their understanding of non-violent resistance, its justification and the barriers they faced in (...) engaging in such action. Methods: Participants were recruited through Medact's ( https://www.medact.org/ ) member database and directed to an online survey hosted on Qualtrics. While participants were unlikely to be representative of the broader UK healthcare community, participants were in an advantageous position to comment on non-violent resistance. Descriptive quantitative analysis and a content analysis were conducted. Results: The majority of participants felt that non-violent resistance could be justified dependent on its cause and/or the action in question. Within this, most felt that if action were non-violent, that if it didn't harm patients and that if the issue in question had to do with health being compromised, action was often justified. A number of others framed their justification as being a right or duty to engage in non-violent resistance. In relation to barriers to engaging in non-violent resistance, these fell into three categories: personal, professional and broader concerns related to society or the general culture found in healthcare. Within these, time and concerns about registration or the consequences of engaging in action were cited as the greatest barriers. Conclusions: These results suggest that healthcare workers who regularly engage in non-violent action carefully thought through their actions, acknowledging the diversity of actions and issues that could be challenged, for many patient care remained a primary concern. There is a need for clarity from regulatory bodies and in particular the need for dialogue between healthcare bodies and healthcare workers who continue to engage in acts of non-violent resistance. (shrink)

An international legal agreement governing the global antimicrobial commons would represent the strongest commitment mechanism for achieving collective action on antimicrobial resistance (AMR). Since AMR has important similarities to climate change—both are common pool resource challenges that require massive, long-term political commitments—the first article in this special issue draws lessons from various climate agreements that could be applicable for developing a grand bargain on AMR. We consider the similarities and differences between the Paris Climate Agreement and current governance structures for (...) AMR, and identify the merits and challenges associated with different international forums for developing a long-term international agreement on AMR. To be effective, fair, and feasible, an enduring legal agreement on AMR will require a combination of universal, differentiated, and individualized requirements, nationally determined contributions that are regularly reviewed and ratcheted up in level of ambition, a regular independent scientific stocktake to support evidence informed policymaking, and a concrete global goal to rally support. (shrink)

Progress in addiction science is hampered by disagreements and ambiguity around its core construct: addiction. Addiction Ontology (AddictO) offers a path to a solution of the kind that has addressed similar problems in other areas of science: a set of clearly and uniquely defined entities to which terms such as ‘addiction’, addictive disorder’ and ‘substance dependence ’can be applied for ease of reference while recognizing that it is the construct definitions and their unique IDs that are central, not the terms.

Numerous studies have shown almost uniformly positive opinions among patients and physicians regarding theconceptof advance directives (either a healthcare proxy or living will). Several of these studies have also shown that the actual use of advance directives is significantly lower than this enthusiasm would suggest, but they have not explained the apparent discordance. Nor have researchers explained why members of minority groups are much less likely to complete advance directives than are white patients. In this study, we used a focus (...) group methodology to examine the ways in which diverse populations of patients view the medical, philosophical, and practical issues surrounding advance directives. We were motivated by the significantly lower prevalence of advance directives among African-American and Hispanic patients at one urban teaching hospital (18% for Caucasians, 4% for African-Americans, and 2% for Hispanics). Our premise was that African-American and Hispanic populations, who have had higher rates of morbidity and mortality across numerous disease categories, and historically have had limited access to care and opportunities to discuss health concerns, may be more suspicious about the right of autonomy that an advance directive is designed to ensure. (shrink)

In this paper we examine the merit of bargaining theory, in its economic and ecological forms, as a model for understanding variation in the frequency of participation in cooperative fishing among men of Ifaluk atoll in Micronesia. Two determinants of bargaining power are considered: resource control and a bargainer’s utility gain for his expected share of the negotiated resource. Several hypotheses which relte cultural and life-course parameters to bargaining power are tested against data on the frequency of cooperative sail-fishing participation. (...) Consistent with predictions generated from bargaining theory, we show that (1) age is negatively correlated with cooperative fishing participation, (2) men of highranking clans and men with high levels of education fish less than men of low-ranking clans and less-educated men, (3) men with high expected utility gains from fishing returns fish more than men with low expected utility gains, (4) number of dependents is positively correlated with cooperative fishing participation, and (5) the number of young genetic offspring residing with a man is positively correlated with cooperative fishing participation, whereas the number of genetic offspring more than 13 years old who are residing with a man is negatively correlated with cooperative fishing participation. (shrink)

Out from the Shadows showcases the work of 18 analytical feminists from a variety of traditional areas of philosophy: social and political philosophy, normative ethics, virtue theory, metaethics, philosophy of language, metaphysics, epistemology, and philosophy of science. The collection is unique both in its focus on analytical feminism and in its breadth across the subdisciplines within philosophy. The book highlights successful uses of concepts and approaches from traditional philosophy, and illustrates the contributions that feminist approaches have made and could make (...) to the analysis of issues in key areas of traditional philosophy, while also demonstrating that traditional philosophy ignores feminist insights and feminist critiques of traditional philosophy at its own peril. (shrink)

Melatonin, the neuro‐hormone synthesized during the night, has recently seen an unexpected extension of its functional implications toward type 2 diabetes development, visual functions, sleep disturbances, and depression. Transgenic mouse models were instrumental for the establishment of the link between melatonin and these major human diseases. Most of the actions of melatonin are mediated by two types of G protein‐coupled receptors, named MT1 and MT2, which are expressed in many different organs and tissues. Understanding the pharmacology and function of mouse (...) MT1 and MT2 receptors, including MT1/MT2 heteromers, will be of crucial importance to evaluate the relevance of these mouse models for future therapeutic developments. This review will critically discuss these aspects, and give some perspectives including the generation of new mouse models. (shrink)

A cosmopolitan education must help us identify with those who are unlike us. In Martha Nussbaum’s words, students must learn “enough to recognize common aims, aspirations, and values, and enough about these common ends to see how variously they are instantiated in the many cultures and their histories.” It is commonly thought that reading serious literature will play a significant role in this process. However, this claim is challenged by theorists we call sentimentalists, who claim that the goals of cosmopolitan (...) education are better served by less sophisticated, overtly sentimental texts which take a certain moral framework as given and encourage straightforward emotional responses within the guidelines of that framework. This paper critiques the sentimentalists’ position, arguing that their conception of a ‘sentimental education’ is inadequate to prepare students for the increasingly diverse, complex, cosmopolitan world their fate it is to inhabit. (shrink)

In this paper we introduce a detailed and multi-faceted characterization of misunderstandings. The proposal attempts to capture the structure of misunderstandings in terms of several constructs: the message as intended by the speaker, the message as construed by the hearer, and the message as understood by an `objective' judge. In addition, we suggest that the message the speaker intends the hearer to retrieve and the hearer's perception of the speaker's intentions should also be taken into account. Misunderstandings can also be (...) classified according to the phase of the comprehension process at which they occur. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reclaiming the Works of Early Modern Women Authorship, Gender, and Interpretation in the Nouveau recueil de lettres des dames de ce temps (1635)1Aurora Wolfgang (bio) and Sharon Diane Nell (bio)Reclaiming the forgotten texts of women writers has been a major feminist undertaking of the last half-century. Indeed, believing in the importance of this sort of work, we have each spent much of our careers studying the women writers (...) absent from our own graduate-school education. What follows, however, is a cautionary tale about discovery and reclamation: first, our discovery of what we thought was a hitherto-neglected text by eminent seventeenth-century writer Madeleine de Scudéry—her Lettres amoureuses de divers auteurs de ce temps (1641); second, our discovery that the text was not (even as indexed in Gerritsen Collection of Women’s History microfilm collection) authored by Scudéry but was written instead by a Franciscan priest, Jacques Du Bosc. Clearly, our second discovery pointed out both our own rush to judgment as well as that of other literary scholars interested in the tenuous project of historical reclamation. In this essay, we seek to explore the implications of attribution and authorship for our cautionary tale. Does the fact that a work is not Scudéry’s Lettres amoureuses but instead Du Bosc’s Nouveau recueil de lettres des dames de ce temps (1635) diminish its importance to the history of women’s letters?The First DiscoveryWe became interested in Scudéry’s Lettres amoureuses because of a brief description of the text in Joan DeJean’s Tender Geographies, a pioneering study of women novelists of the seventeenth century. DeJean describes a one-volume work that constituted the first publication of one of the most important writers of the seventeenth century, Madeleine de Scudéry. This work was a reversal of and “forceful response to” the so-called Ovidian model of epistolary fiction in which a “seduced and abandoned” woman complains in letter form about the infidelity of her male lover. In Scudéry’s text, however, men wrote long letters complaining about the women who did not reciprocate their love (DeJean, Tender Geographies 79).We obtained a copy of the Lettres amoureuses from the Women’s History microfilm collection, which was created in the 1970s (published 1983) in order to make available [End Page 1] an extensive array of texts and documents relating to women’s lives. We were surprised to see that all of the letters in the Lettres amoureuses were written by women—not men. Moreover, most of the letters were written by women to other women. No letters by men were included at all. Our copy of Lettres amoureuses contained letters and responses written between women, meant to show the excellence of women’s writing skill. The letters discussed and debated a wide variety of topics of interest to seventeenth-century French women; more strikingly, however, they reflected a close-knit homosocial world of women who openly expressed love, devotion, desire, and longing for each other’s company.Given the differences between our copy of Lettres amoureuses and the text described by DeJean, we wondered if we were looking at the same book. Was our collection the one to which DeJean referred? Yes and no. In another DeJean article about the Lettres amoureuses, we discovered that DeJean had used a particular copy of the text, one found in the holdings of Harvard’s Houghton Library. Upon first obtaining a microfilm copy of the Houghton volume, and later examining the physical book itself in Houghton’s rare books room, we saw that it (unlike our own copy) did indeed contain only letters by men who complain about their female beloveds. At this point, we thought we had discovered a second volume to Scudéry’s work: it seemed clear to us that the Lettres amoureuses had been halved at some point in the last several centuries and that we had a chance to reunite the volumes. After all, the preface in the Houghton volume tells the reader, “Si vous receuez fauorablement ce volume, ie vous en prepare un second” [“If you receive this volume favorably, I will prepare a second one... (shrink)

Global governance has become a topic of interest to many contemporary political theorists. Issues arising from the nature of global markets and multinational corporations can no longer be locally contained. These developments signal the decline of the nation state and therewith the end of the liberal moral and political theory that justified national institutions. The alternative possible orders appear bleak, including anarchy, hegemonic power or the most horrific of all specters, the liberty crushing “world state.” Kant’s cosmopolitan theory of justice (...) can provide a third way between nationalism and its bleak alternatives, providing a measureof global governance upheld by nations without recourse to a world state. My thesis is that a juridical society of states is necessarily founded upon cosmopolitan right having universal jurisdiction and that the implementation of the norms of hospitality underlying cosmopolitan right requires global institutions based upon democratic representation and accountability. (shrink)

In this paper I argue that Kant's concept of cosmopolitan right is the philosophical basis for contemporary international human rights. The law of world citizenship or cosmopolitan right is necessary in order to secure hospitable interactions between individuals and states. Such interactions in turn create an international civil culture or "cosmopolitan condition" which 1 is the source of the further specification and eventual codification of human rights. Human rights, I conclude, are universal because of their international significance and scope and (...) are inherently linked to cosmopolitan values. (shrink)

In contrast with his major ethical works, Kant’s writings on history are replete with the theme of the social character of moral development and the interdependence of individual and community. I argue that historical-moral progress is an important part of Kant’s comprehensive ethical theory. However, in order to link the moral goals of humanity with the moral goals of individuals, judgement must have a dimension that can apprehend the purposiveness of those human achievements which are social in their significance and (...) socially transmitted. In other words, such achievements transcend individual intention. The ‘historical signs’ of such moral purposiveness provide moral orientation through the conflicting claims that arise within and between complex and historically evolving human communities. I explore the role of disinterested judgement in providing this orientation and in marking the moral disposition of the species. (shrink)

Research shows people confront social marginalization through work, yet this scholarship largely ignores people working in illicit markets. We address this gap by investigating how and to what end men in street prostitution “borrow” privilege from their more structurally advantaged clients. Drawing from interviews with men of color in street sex work, we show how they “status maneuver” to offset stigmatized identities tied to prostitution and to construct a masculinity that offers a greater sense of social worth within constrained circumstances. (...) These men ironically rely on status differences between themselves and their white, wealthy men clients to undermine their own oppression and to create possibilities for momentary associations with hegemonic masculine privilege. This research shows how barriers between the powerful and powerless are permeable, and how social hierarchies serve as resources to cope with the inequitable conditions and stigma under which some people live and work. (shrink)

Contemporary realist theories of value claim to be compatible with natural science. In this paper, I call this claim into question by arguing that Darwinian considerations pose a dilemma for these theories. The main thrust of my argument is this. Evolutionary forces have played a tremendous role in shaping the content of human evaluative attitudes. The challenge for realist theories of value is to explain the relation between these evolutionary influences on our evaluative attitudes, on the one hand, and the (...) independent evaluative truths that realism posits, on the other. Realism, I argue, can give no satisfactory account of this relation. On the one hand, the realist may claim that there is no relation between evolutionary influences on our evaluative attitudes and independent evaluative truths. But this claim leads to the implausible skeptical result that most of our evaluative judgements are off track due to the distorting pressure of Darwinian forces. The realist’s other option is to claim that there is a relation between evolutionary influences and independent evaluative truths, namely that natural selection favored ancestors who were able to grasp those truths. But this account, I argue, is unacceptable on scientific grounds. Either way, then, realist theories of value prove unable to accommodate the fact that Darwinian forces have deeply influenced the content of human values. After responding to three objections, the third of which leads me to argue against a realist understanding of the disvalue of pain, I conclude by sketching how antirealism is able to sidestep the dilemma I have presented. Antirealist theories of value are able to offer an alternative account of the relation between evolutionary forces and evaluative facts —
an account that allows us to reconcile our understanding of evaluative truth with our understanding of the many non-rational causes that have played a role in shaping our evaluative judgements. (shrink)

In many ways set theory lies at the heart of modern mathematics, and it does powerful work both philosophical and mathematical – as a foundation for the subject. However, certain philosophical problems raise serious doubts about our acceptance of the axioms of set theory. In a detailed and original reassessment of these axioms, Sharon Berry uses a potentialist approach to develop a unified determinate conception of set-theoretic truth that vindicates many of our intuitive expectations regarding set theory. Berry further (...) defends her approach against a number of possible objections, and she shows how a notion of logical possibility that is useful in formulating Potentialist set theory connects in important ways with philosophy of language, metametaphysics and philosophy of science. Her book will appeal to readers with interests in the philosophy of set theory, modal logic, and the role of mathematics in the sciences. (shrink)

In Science as Social Knowledge, Helen Longino offers a contextual analysis of evidential relevance. She claims that this "contextual empiricism" reconciles the objectivity of science with the claim that science is socially constructed. I argue that while her account does offer key insights into the role that values play in science, her claim that science is nonetheless objective is problematic.

This paper explores two questions in moral philosophy that might at first seem unrelated. The first question is practical. While it’s not a truth we like to contemplate, each of us faces the eventual loss of everyone and everything we love. Is there a way to live in full awareness of that fact without falling into anxiety or depression, or resorting to one form or another of forgetfulness, denial or numbing out? The second question is metaethical. Is it possible to (...) vindicate a strong form of ethical objectivity without positing anything metaphysically or epistemologically mysterious? In this paper, I sketch a partially Buddhist-inspired metaethical view that would, if it could be made to work, give a positive answer to both questions. The overall view is too much to defend in one paper, so I focus on developing one limited part of it. I begin by characterizing the general constructivist strategy for vindicating the objectivity of ethics. After briefly discussing Christine Korsgaard’s Kantian implementation of the strategy, I suggest an alternative implementation. I explore the idea that every agent necessarily faces what I call the problem of attachment and loss. I close with some speculative remarks about why, even though the problem of attachment and loss presents itself in a different substantive guise to each individual agent, it is still possible that the best solution to the problem is universal, and involves taking up an ethical perspective on the world. (shrink)

I propose to examine what I take to be the point at issue between subjectivist and objectivist theories of ethics and to explain that the controversy between them is unreal. It springs from a misunderstanding of the nature of appraisal sentences. What I hope to show is that if such sentences were really analysable in the way in which the critics and many of the supporters of subjectivist theories suppose, then those theories would indeed, as it is sometimes put “fail (...) to do justice to the facts of moral experience.” But it seems to me that objectivist theories are no better off. They make exactly the same mistake though in a more sophisticated way. I therefore propose to see whether any useful results can be achieved by construing appraisal sentences on rather different lines. By appraisal sentences I mean sentences of the form “I approve of …, I think well of …, I commend …, etc.” I shall call these simple appraisals, sentences of the form “… is good, … is meritorious, … is praiseworthy, etc.” I shall call these moral appraisals. In these terms, subjectivist theories assert that moral appraisals can always be expressed without change of meaning by simple appraisals, though perhaps the addition of an imperative sentence of some kind is required to complete the translation. Objectivist theories deny this possibility and claim that moral appraisals assert truths about the independent world and not psychological facts about the speaker. (shrink)

Global antimicrobial resistance (AMR) is currently governed by a decentralized regime complex composed of multiple institutions with overlapping and sometimes conflicting principles, norms, rules, and procedures. Such a decentralized regime complex provides certain advantages and disadvantages when compared to a centralized regime. A pandemic instrument can optimize the regime complex for AMR by leveraging the strengths of both centralization and decentralization. Existing climate treaties under the UNFCCC offer lessons for achieving this hybrid approach.

In this book Sharon Krause argues that moral and political deliberation must incorporate passions, even as she insists on the value of impartiality.

For the past 15 years, scholars in education have focused on Levinas’s work largely in terms of his understanding of alterity, of the self-Other relation, of ethics as ‘first philosophy’ and the significance these concepts have on rethinking educational theory and practice. What I do in this paper, by way of method, is to start from a slightly different place, from the assertion that there is indeed something ‘new’ to be explored in Levinas’s philosophy – both in terms of ideas (...) to be found within his work, and also in terms of the demands educational ideas and practices place on his work from without. That is, how does the actual, lived specificity of educational encounters occasion a different set of questions than one would otherwise pose if thinking only from within the discipline of philosophy, or from a purely theoretical point of view? In light of this, this paper explores Levinas’s ideas of sensibility, materiality, and embodiment. I see these not simply as supports for his ethical thought, but as the very core of incarnation without which his ethics makes no sense. I propose that these ideas are quintessentially pedagogical aspects of his thought – that is, they are always already rooted in a relational context of change and alteration of the subject. (shrink)

Most agree that when it comes to so-called 'first-order' normative ethics and political philosophy, constructivist views are a powerful family of positions. When it comes to metaethics, however, there is serious disagreement about what, if anything, constructivism has to contribute. In this paper I argue that constructivist views in ethics include not just a family of substantive normative positions, but also a distinct and highly attractive metaethical view. I argue that the widely accepted 'proceduralist characterization' of constructivism in ethics is (...) inadequate, and I propose what I call the 'practical standpoint characterization' in its place. I then offer a general taxonomy of constructivist positions in ethics. Since constructivism's standing as a family of substantive normative positions is relatively uncontested, I devote the remainder of the paper to addressing skeptics' worries about the distinctiveness of constructivism understood as a metaethical view. I compare and contrast constructivism with three other standard metaethical positions with which it is often confused or mistakenly thought to be compatible: realism; naturalist reductions in terms of an ideal response; and expressivism. In discussing the contrast with expressivism, I explain the sense in which, according to the constructivist, the distinction between substantive normative ethics and metaethics breaks down. I conclude by distinguishing between two importantly different debates about the mind-dependence of value. I argue that a failure to make this distinction is part of what explains why the possibility of constructivism as a metaethical view is often overlooked. (shrink)

This article tracks Corporate Social Responsibility (CSR) as an emergent organizational process that places the employee at its center. Predominantly, research on CSR tends to focus on external pressures and outcomes leading to a neglect of CSR as a dynamic and developing process that relies on the involvement of the employee as a major stakeholder in its co-creation and implementation. Utilizing case study data drawn from a study of a large multinational energy company, we explore how management relies on employees' (...) interaction with CSR as the process of initiation → implementation → maturation develops. Employee involvement grows from a minor element in the CSR initiation stage to a vital contributory factor in CSR's success in the later stages of the process. The article offers new insights into a processual and interactional approach to CSR that accounts for the actions of different actors involved at each stage. Most unusually, it also recognizes the dual impact this has on broader issues concerning the management and involvement of employees through CSR actions, and gaining legitimacy in the eyes of not only external stakeholders but internal too. (shrink)