A project featuring scholars in nursing ethics was planned in 2005. The goal was to document the contributions of some 24 selected American nurse ethicists to bioethics, and to discuss and explore the future trajectory of that work through a two-day working seminar. This article outlines the beginnings of bioethics in the USA and the specific contribution of nurse scholars to the debate, the preparation for the seminar, the results of the project, and the possible application of such a model (...) for teaching and archiving in the future. Documentation of the work carried out at the seminar resulted in the publication of a book. Short biographies of the participants at the seminar are included in Appendix 1. (shrink)

Ethical dilemmas abound in the neonatal intensive care unit as hour-to-hour life and death decisions are made for premature or compromised newborns. This book is a rich tapestry of parental perceptions woven from the many stories parents tell about their experiences with a baby in the unit, as well as major events after discharge related to the ethical decision making.

Knowledge about moral development and elderly persons is very limited. A hermeneutical interpretative study was conducted with healthy elderly persons (n = 20) in order to explore and describe their moral orientation based on the paradigms of justice (Kohlberg) and care (Gilligan). The types of moral reasoning, dominance, alignment and orientation were determined. All but one participant included both types of reasoning when discussing an ethical conflict. None of the men’s moral reasoning was dominated by caring, but justice dominated the (...) reasoning of four women. The implications for ethical decision-making and future research are discussed. (shrink)

Although thousands of articles and books appear annually in the field of nursing ethics, the sheer volume of scholarly publications points to the need to provide assessment and focus, and that is what this book offers. Nursing and Healthcare Ethics documents the work of nurse scholars in ethics, and goes well beyond a mere documentation of what has transpired and a list of what can be done in the future. It creatively looks back to assess previous accomplishments and forward to (...) find new directions and strengthen future scholarly contributions in nursing ethics. Critical thinking activities, organized by the book s themes (such as vulnerability, care and caring, diversity and disparity, and pain and suffering) are examples of applying these scholarly insights into practice. This book is intended not only for undergraduate and graduate students in academic settings, but also for those in professional development programs. (shrink)

This thoughtful reflection on a valuable questionnaire survey of patients' attitudes regarding being told that their dentist had been infected with hepatitis B is of very direct relevance to HIV, as the authors show.1 The measured tone and analytical approach are a welcome change from the stridency that has characterised some of the debate elsewhere. I am very conscious that more time and effort has gone into drafting and redrafting, amending, revising and refining policy in this area than in any (...) other area of HIV control, with the probable exception of blood transfusion. Yet this is the setting that has the lowest risk among all established routes. Why has it been so hard to establish a satisfactory policy and practice to deal with this situation?Many factors, of course, apply. However, much seems to stem from a prevailing view, fostered by recent political administrations, that health care can be delivered in a risk-free way. This has also been linked with a “blame culture”, where adverse outcomes are seen as someone's fault, and where the professions are regarded with distrust. It has been fuelled by levels of concern about risk for HIV that have stemmed more from media “stories” about risk than careful risk assessment.Hence Blatchford et al comment that public anxiety about HIV relative to hepatitis B was a factor in assessing how the incident was handled, implying that HIV was of greater concern - even though the risk of transmission is some two orders of magnitude less. Interestingly, they also comment that, because the risk of death with HIV is higher than for hepatitis B, this balances the overall risk. I am not sure of the validity of this argument, …. (shrink)

Dr de Zulueta articulates some important and commonly held concerns about the anonymised screening programme for HIV in pregnant women, which is one of a number of such programmes that are current. However, in my view, many of these concerns reflect a failure to understand two key distinctions.In both these regards, there is a danger of putting up a “straw man” for challenge. In this commentary, I wish to pick up some of these issues to help to resolve the apparent (...) ethical tensions that Dr de Zulueta has set out.Firstly, the unlinked seroprevalence surveillance programmes, including that on pregnant women, comprise research studies that are designed to inform policy and practice, as well as individual decision making. They are not screening for the purpose of clinical care. The anonymisation is a procedural research tool, which enables the studies to be done in a way that does not undermine consent or individual autonomy. The ethical standards and duties expected of professionals are thus, in this specific regard, those that relate to the conduct of clinical research. That research is evidently designed to improve the quality of clinical care as a result of the information and insight gained. The duty of care is to apply the results of properly conducted and valid research in order to improve clinical practice on behalf of the individuals receiving care, in this case the mother and unborn child. The research conducted, in this case by a particular form of screening procedure, is not the same as a screening procedure done for clinical purposes to identify individuals who could benefit from an intervention. The ethical debate must therefore focus on the purpose in applying the procedure, not on the procedure itself, regardless of intent.Secondly, it is vital to distinguish, in debating such …. (shrink)

Guest Editors' introductionFor this special issue of the Journal of Medical Ethics we have assembled articles that reflect some of the newer issues or fresh perspectives. There is a mix of approaches including forward looks, present dilemmas and reflections on the past, now that sufficient time has elapsed to allow a considered view. We are most grateful to our wide range of contributors for their thoughtful analyses of several key areas of contemporary debate. Our own contributions include the following editorials (...) in which each of us has considered, from his own perspective, the impact of AIDS on medical ethics, a case study and a lexicon that allows brief probing of some topics.The impact of aids on medical ethics -1ANTHONY J PINCHINGMedical ethics has been matured through being tested and refined through the multifaceted challenge of AIDS. As with the society and social values from which its moral framework is derived, so medical ethics has been subjected to intense scrutiny by the emergence of this new disease. Few areas of ethical discourse have been untouched. This infection is so intensely private in its transmission, the disease so isolating and so personally devastating in its impact, it readily distinguishes the reality of what people are and do, from the rhetoric of what others may feel they should be and do. AIDS has forced us to recognise that respecting individual rights is a critical safeguard for the health of the community, as well as for the person. These issues are well illustrated by the interweaving issues of patient empowerment, respect for confidentiality, and patient advocacy and activism.EMPOWERMENTPhysicians in this field have been struck by the way in which people affected have wanted to be involved in decision making. While this has often been ascribed to their social groups, it probably was more a reflection of their younger age and a generation change …. (shrink)

A group of activist clinicians have offered to volunteer for clinical trials of live attenuated HIV vaccines. This has provided an important conceptual challenge to medical ethics, and to work on the development of HIV vaccines. In exploring these issues, this article highlights how the HIV field has altered the content as well as the tone of ethical discourse. The balance of expertise and authority between research subjects and triallists is profoundly changed, raising questions about the limits of voluntarism and (...) differing perspectives on risk-benefit analysis. Care is needed to ensure that the novelty of the situation does not confuse the central ethical and scientific issues. (shrink)

Passmore is one of the most outstanding historians of the contemporary philosophical scene. He seems to have read everything, digested it, and has an uncanny ability to empathize with diverse philosophical viewpoints and elucidate them in a clear, witty, cogent style. Although the first three quarters of this revised edition is basically the same as earlier editions, we now have additions to his account of Ayer, Popper, Wittgenstein and Sartre; enlarged sections on Austin, Jaspers and Heidegger; a new section on (...) Merleau-Ponty and a chapter bringing us right up to the present discussions of the mind-body problem in Anglo-Saxon philosophy. With this revised edition, one feels more acutely the pinch of the limitations that Passmore initially set for himself, viz., to treat the ideas of those writers that entered into the public domain of philosophical discussion in England during the past hundred years. Consequently his treatment of continental thinkers is not nearly as complete or perceptive as his treatment of British philosophers, or his chapters on "classical" American thinkers which are among the best written by anybody.—R. J. B. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:610 Feminist Studies 43, no. 3. © 2017 by Raina J. León Pandora’s Box Opens and Terence Crutcher Dies Raina J. León Fresh from the bath, my husband comes nude, beard trimmed, still glistening and pinked. He shares the fullness of his skin, freckles and moles in their constellations. What little fat on his lank jiggles, begs for pinch as he turns to the closet to dig. I (...) am encapsulated by covers. No sleep for hours since I woke to watch the video I couldn’t with him awake. How I watched it, over and over, and knew this might be how I die: a broken-down car, my hands up, helicopters above with a man saying, a real bad dude, must be, and then shot, because Terence is me, like Sandy and Aisha... because just that day, earlier, I was transformed into child, questioned on the body of my work, made invisible and hypervisible, bleeding shadow for another’s feet. One leads to another in a mass of entangled links. Now, he moves. He does not feel the cold I dread out there where reality gnashes. Raina J. León 611 Inside the cocoon, the smell of last night’s tremble sweat, I can imagine entrance into another dreaming, breathe in and out our twining. He slips on boxers, then soft cotton shirt, then jeans. All black, his style. In my mourning, I call him close, and he comes to bed. With his body, he creates another womb as suddenly the weeping starts, says, when you are ready, tell me, because he doesn’t know how the world turns, yet in that moment, there is a hope.... (shrink)

Seamus heaney says that the best lyrics unite “reader and poet and poem in an experience of enlargement, of getting beyond the confines of the first person singular, of widening the lens of receptivity until it reaches and is reached by the world beyond the self.”1 In “Crossing Brooklyn Ferry,”2 the ferry crossing acts as a catalyst for meditations about the self, the interaction between self and other, their common experience of the physical world across time, and how to forge (...) bonds that overcome the intense separateness of each individual. From these meditations arise an apprehension of time that blends past, present, and future; philosophical speculations about individual human identity during corporeal.. (shrink)

This article demonstrates how class and racial dynamics generate different styles of activism among women's movement organizations. Based on a comparative study of two feminist organizations—one composed of lower-class women of color and another of upper-class white women—it charts the formation of divergent types of gender politics. First, it explores how differences in the class and racial backgrounds of the memberships create distinct organizational needs; second, how these divergent political interests motivate contrasting organizational ideologies, activities, and structures; and finally how (...) they motivate different approaches to the wider women's movement. At the conclusion, implications are drawn for cross-class/race alliances among grassroots women's organizations. (shrink)