This article seeks to advance ethical dialogue on choosing standards of prevention in clinical trials testing improved biomedical prevention methods for HIV. The stakes in this area of research are high, given the continued high rates of infection in many countries and the budget limitations that have constrained efforts to expand treatment for all who are currently HIV-infected. New prevention methods are still needed; at the same time, some existing prevention and treatment interventions have been proven effective but are not (...) yet widely available in the countries where they most urgently needed. The ethical tensions in this field of clinical research are well known and have been the subject of extensive debate. There is no single clinical trial design that can optimize all the ethically important goals and commitments involved in research. Several recent articles have described the current ethical difficulties in designing HIV prevention trials, especially in resource limited settings; however, there is no consensus on how to handle clinical trial design decisions, and existing international ethical guidelines offer conflicting advice. This article acknowledges these deep ethical dilemmas and moves beyond a simple descriptive approach to advance an organized method for considering what clinical trial designs will be ethically acceptable for HIV prevention trials, balancing the relevant criteria and providing justification for specific design decisions. (shrink)

A growing literature examines the organizational factors that promote women’s access to positions of organizational power. Fewer studies, however, explore the implications of women in leadership positions for the opportunities and experiences of subordinates. Do women leaders serve to undo the gendered organization? In other words, is women’s greater representation in leadership positions associated with less gender segregation at lower organizational levels? We explore this question by drawing on Cohen and Huffman’s conceptual framework of women leaders as either “change agents” (...) or “cogs in the machine” and analyze a unique multilevel data set of workplaces nested within Fortune 1000 firms. Our findings generally support the “agents of change” perspective. Women’s representation among corporate boards of directors, corporate executives, and workplace managers is associated with less workplace gender segregation. Hence, it appears that women’s access to organizational power helps to undo the gendered organization. (shrink)

This article explores how ethics and religion interface in everyday life by drawing on a study examining the negotiation of religious and spiritual plurality in health care. Employing methods of critical ethnography, namely, interviews and participant observation, data were collected from patients, health care providers, administrators and spiritual care providers. The findings revealed the degree to which `lived religion' was intertwined with `lived ethics' for many participants; particularly for people from the Sikh faith. For these participants, religion was woven into (...) everyday life, making distinctions between public and private, secular and sacred spaces improbable. Individual interactions, institutional resource allocation, and social discourses are all embedded in social relationships of power that prevent religion from being a solely personal or private matter. Strategies for the reintegration of religion into nursing ethics are: adjusting professional codes and theories of ethics to reflect the influence of religion; and the contribution of critical perspectives, such as postcolonial feminism, to the understanding of lived ethics. (shrink)

Today's conversations in virtue ethics are enflamed with questions of “pagan virtues,” which often designate non-Christian virtue from a Christian perspective. “Pagan virtues,” “pagan vices,” and their historied interpretations are the subject of Jennifer Herdt's book Putting On Virtue: The Legacy of the Splendid Vices (2008). I argue that the questions and language animating Herdt's book are problematic. I offer an alternative strategy to Herdt's for reading Thomas Aquinas's Summa Theologiae. My results are twofold: (1) a different set of conclusions (...) and questions regarding the moral life that lend a fresh perspective to “pagan virtues” and (2) corresponding methodological suggestions for improving Herdt's project that would, to my mind, reaffirm her normative conclusions regarding the most viable ways forward for contemporary discussions of virtue. (shrink)

This essay reviews recent feminist scholarship, autobiographical narrative and fiction which explores nurses' engagement with empire in Africa and elsewhere in this century. Such literature suggests that while nursing work may have improved native health in colonized regions, it also contributed significantly to the establishment and stabilization of the racialized order of colonial rule. Of particular significance was colonial nursing's intervention into the reproductive practices of native women, resulting in the loss of local knowledges and autonomy, the disruption of complex (...) social links and indigenous health strategies, and the expansion of markets for western capitalism. (shrink)

In maternity care, costly high-technology interventions that have never been shown to be clinically effective continue to be used in the United States, while inexpensive and effective low-technology interventions continue to be underused. Three high-technology approaches to risk reduction—electronic fetal monitoring, cesarean section, and home uterine activity monitoring are contrasted with three low-technology approaches—prenatal care, smoking cessation, and nutrition supplementation. These technologies are examined in terms of current controversies over their safety, efficacy, and cost-effectiveness. Examination of these controversies illustrates how (...) the medical technology industry, the regulatory process, and systems of social stratification contribute to social and cultural constructions of what are regarded as reducible birth risks. (shrink)

Illness and trauma challenge self-narratives. Traumatized individuals, unable to speak about their experiences, suffer in isolation. In this paper, I explore Kristeva’s theories of the speaking subject and signification, with its symbolic and semiotic modalities, to understand how a person comes to speak the unspeakable. In discussing the origin of the speaking subject, Kristeva employs Plato’s chora (related to choreo , “to make room for”). The chora reflects the mother’s preparation of the child’s entry into language and forms an interior (...) darkroom, the reservoir of lived experience, from which self-narratives issue. Unable to speak of their suffering, traumatized individuals need someone to help them make room for a time of remembrance, someone who is a willing and capable listener. I call such a person a healing witness . Through the mediating presence of the healing witness, fragmented memories of trauma are recreated and incorporated into self-narratives that are sharable with others. Unfortunately, opportunities for witnessing are vanishing. In the last section, I examine the failure of modern media and communication technologies to bear (“hold,” “carry,” “transport”) acts of witnessing. I argue that they perturb the semiotic. According to Kristeva, meaning arises from the dialectical tension between the semiotic (drives and affects) and the symbolic (logic and rules) and is threatened by arid discourse, psychosomatic illnesses, and outbreaks of violence when the semiotic is not represented . Unless we open technology to the imaginary, we risk losing the capacity to bear witness to one another and to create narratives and connections that are meaningful. (shrink)

Inside this complete guide you will find: A guide to facilitate conversation with your family; How to create peace when war has been declared on your body; How to alleviate pain and suffering; How to choose your own end; How to use the dying process as a mechanism for personal and family growth. Filled with inspirational and helpful stories, Mortal Dilemmas... is a book that not only will prepare you for the inevitable, but will also give you a sense of (...) satisfaction and control."--P. [4] of cover. (shrink)

Abstract The aim of this paper is to examine the propaganda power of Madison’s Solidarity Sing-Along. To do so, I will modify the Epistemic Merit Model of propaganda so that it can account for a broader spectrum of propaganda. I will show how this is consistent with other accounts of musical pragmatics and the potential political function of songs and music. This will provide the ground for a robust interpretation of the political meanings of the Solidarity Sing-Along. I will assume (...) the Madison protests and the Solidarity Sing-Along can be considered a paradigm case of peaceful protest as it has been claimed that the Madison protest and the role of art within those protests set the stage for the Occupy Movement protests later in the same year. (shrink)

This paper challenges the traditional account of vulnerability in healthcare which conceptualizes vulnerability as a list of identifiable subpopulations. This list of ‘usual suspects’, focusing on groups from lower resource settings, is a narrow account of vulnerability. In this article we argue that in certain circumstances middle-class individuals can be also rendered vulnerable. We propose a relational and layered account of vulnerability and explore this concept using the case study of cord blood (CB) banking. In the first section, two different (...) approaches to ‘vulnerability’ are contrasted: categorical versus layered. In the second section, we describe CB banking and present a case study of CB banking in Argentina. We examine the types of pressure that middle-class pregnant women feel when considering CB collection and storage. In section three, we use the CB banking case study to critique the categorical approach to vulnerability: this model is unable to account for the ways in which these women are vulnerable. A layered account of vulnerability identifies several ways in which middle-class women are vulnerable. Finally, by utilizing the layered approach, this paper suggests how public health policies could be designed to overcome vulnerabilities. (shrink)

Socrates, Sports, and Students involves a philosophical justification for the inclusion of physical education in the school system. This book will appeal to physical educators and administrators interested in justifying their activity, as well as philosophers and professors in the areas of education and sport.

Socrates, Sports, and Students involves a philosophical justification for the inclusion of physical education in the school system. This book will appeal to physical educators and administrators interested in justifying their activity, as well as philosophers and professors in the areas of education and sport.

Examples of propaganda abound in contemporary society. Even though propaganda is increasingly prevalent in modern society, this phenomenon has received scant philosophical attention. This is particularly true of philosophy of art even as art, from posters and murals to films and novels, has been instrumental in the dissemination of propaganda. My dissertation develops a new model of propaganda to account for the phenomenon of art propaganda. I call this model the epistemic merit model, because I argue that propaganda essentially lacks (...) epistemic merit. ;My project proceeds in four parts: offer a diagnosis of why propaganda has virtually escaped philosophical scrutiny, survey the field of propaganda studies in the disciplines of sociology, social psychology, and communication theory, perform a conceptual analysis of propaganda, and show how my new model is particularly well-suited to cases of art propaganda. (shrink)

This paper extends Claudia Card's account of agency in the face of moral luck in order to theoretically ground the activities of feminist mothers who endeavor to raise responsible human beings. The paper addresses those who mother in gray areas—areas where mothers are victims of the evils of the institution of motherhood while having authority and influence over their children. -/- .

This paper reviews and augments important work in philosophy of education on intrinsic aims for education, of knowledge, of knowledge of values, and of rationality. A contemporary conception of knowledge as ``rationality's `data-base''' is proposed and an in-depth section on the intrinsic value of rationality is incorporated.

Maxwell J. Mehlman, Transhumanist dreams and dystopian nightmares: The promise and peril of genetic engineering, Baltimore: Johns Hopkins University Press, 2012, reviewed by Sheryl de Lacey.

During the past several years, numerous studies have been conducted regarding advance directives for health care). Studies have examined how many individuals have executed advance directives, who is more likely to execute such directives, and whether factors such as education, income, race, religiosity, or family status affect the likelihood of having executed an advance directive or one's willingness to do so. Studies have also investigated the effectiveness of different educational strategies aimed at increasing the number of individuals who execute these (...) documents. Finally, a number of researchers have looked at the implementation of advance directives.Although we now have a better understanding of some of these issues, one area that has been virtually ignored is the reliability, validity, and overall user friendliness of the advance directive forms themselves, and, in particular, of the statutory advance directive forms. (shrink)