Life comes from physical or biological survival. But the good life comes from what we care about, what we value, what we think truly important, as distinguished from what we think merely trivial. What we care about is the source of the criteria we use to evaluate ideas, ideals, persons, events, things, and their importance in our lives. And it is these criteria that determine the judgments we make in our everyday lives. In the second edition of Thinking in (...) Education, Matthew Lipman has indicated the importance of fostering critical, creative and caring thinking in children, if one is to prepare them to make better judgments and live qualitatively better lives. He tells us that caring thinking is appreciative thinking, active thinking, normative thinking, affective thinking and empathetic thinking and then goes on to list a number of mental acts under each of these categories. Maybe it is because ‘caring thinking’ is not as common a term as ‘critical thinking’ and ‘creative thinking’ in everyday educational language that we stop for pause when we hear it. However when we read what Lipman says about caring thinking, we find ourselves nodding and saying to ourselves, ‘Yes, that makes sense. To think caringly means to think ethically, affectively, normatively, appreciatively and to actively participate in society with a concern for the common good’. In a real sense what we care about is manifest in how we perform, participate, build, contribute and how we relate to others. It is thinking that reveals our ideals as well as what we think is valuable, what we are willing to fight and suffer for. (shrink)

Clear and careful thinking is an indispensable aid in the pursuit of answers to the difficult ethical question faced by clinicians, patients, and families. In this issue of The Journal of Medicine and Philosophy devoted to issues in clinical ethics, the authors engage in this enterprise by reflecting on morally good medical decision making, conscientious objection, presumed consent in organ donation, the permissibility of surrogate decision making, and the failure of legislative limits on the scope of euthanasia in Belgium.

Abstract.There is ample evidence that humans (and other primates) possess a knowledge instinct—a biologically driven impulse to make coherent sense of the world at the highest level possible. Yet behavioral decision‐making data suggest a contrary biological drive to minimize cognitive effort by solving problems using simplifying heuristics. Individuals differ, and the same person varies over time, in the strength of the knowledge instinct. Neuroimaging studies suggest which brain regions might mediate the balance between knowledge expansion and heuristic simplification. One region (...) implicated in primary emotional experience is more activated in individuals who use primitive heuristics, whereas two areas of the cortex are more activated in individuals with a strong knowledge drive: one region implicated in detecting risk or conflict and another implicated in generating creative ideas. Knowledge maximization and effort minimization are both evolutionary adaptations, and both are valuable in different contexts. Effort minimization helps us make minor and routine decisions efficiently, whereas knowledge maximization connects us to the beautiful, to the sublime, and to our highest aspirations. We relate the opposition between the knowledge instinct and heuristics to the biblical story of the fall, and argue that the causal scientific worldview is mathematically equivalent to teleological arguments from final causes. Elements of a scientific program are formulated to address unresolved issues. (shrink)

There is ample evidence that humans (and other primates) possess a knowledge instinct—a biologically driven impulse to make coherent sense of the world at the highest level possible. Yet behavioral decision-making data suggest a contrary biological drive to minimize cognitive effort by solving problems using simplifying heuristics. Individuals differ, and the same person varies over time, in the strength of the knowledge instinct. Neuroimaging studies suggest which brain regions might mediate the balance between knowledge expansion and heuristic simplification. One region (...) implicated in primary emotional experience is more activated in individuals who use primitive heuristics, whereas two areas of the cortex are more activated in individuals with a strong knowledge drive: one region implicated in detecting risk or conflict and another implicated in generating creative ideas. Knowledge maximization and effort minimization are both evolutionary adaptations, and both are valuable in different contexts. Effort minimization helps us make minor and routine decisions efficiently, whereas knowledge maximization connects us to the beautiful, to the sublime, and to our highest aspirations. We relate the opposition between the knowledge instinct and heuristics to the biblical story of the fall, and argue that the causal scientific worldview is mathematically equivalent to teleological arguments from final causes. Elements of a scientific program are formulated to address unresolved issues. (shrink)

This rich collection of essays offers a broad array of perspectives from prominent international 'philosophy for/with children' scholars and practitioners regarding the interface between P4wC and teacher education and training curricula. The book considers the deep and varied points of contact that exist between the pedagogical and philosophical principles of the philosophical community of inquiry and teacher education and training programs. It is designed to help improve education systems worldwide as they seek to shift their attention towards the student, student (...) inter-relations, and student-other relations and foster independent high-order, critical, creative, and caring thinking within democratic, pluralistic societies. It proposes an innovative, creative way of approaching teacher education and training--a central subject in today's educational world. Offering diverse perspectives on integrating progressive educational philosophy and contemporary pedagogy, Philosophy with Children and Teacher Education is a must-read for all those studying philosophy for/with children and researching in this area. (shrink)

In order to be able to provide informed, effective and responsive mental health care and to do so in an evidence‐based, collaborative and recovery‐focused way with those who use mental health services, there is a recognition of the need for mental health professionals to possess sophisticated critical thinking capabilities. This article will therefore propose that such capabilities can be productively situated within the context of the work of the French philosopher Michel Foucault, one of the most challenging, innovative and (...) influential thinkers of the 20th century. However, rather than focusing exclusively upon the content of Foucault's work, it will be suggested that it is possible to discern a general methodological approach across that work, a methodological approach that he refers to as “the history of the present.” In doing so, Foucault's history of the present can be understood as a productive, albeit provisional, framework in which to orientate the purpose and process of critical thinking for mental health professionals by emphasizing the need to both historicize and politicize the theoretical perspectives and therapeutic practices that characterize contemporary mental health care. (shrink)

Growing interest in embedded research approaches—where research is incorporated into clinical care—has spurred numerous studies to generate knowledge relevant to the real-world needs of patients and other stakeholders. However, it also has presented ethical challenges. An emerging challenge is how to understand the nature and extent of investigators’ obligations to patient-subjects. Prior scholarship on investigator duties has generally been grounded upon the premise that research and clinical care are distinct activities, bearing distinct duties. Yet this premise—and its corresponding implications—are challenged (...) when research and clinical care are deliberately integrated. After presenting three case studies from recent pragmatic clinical trials, we identify six differences between explanatory trials and embedded research that limit the application of existing scholarship for ascertaining investigator duties. We suggest that these limitations indicate a need to account for the implications of usual care and to move beyond a narrow focus on the investigator-subject dyad, one that better reflects the team- and institution-based nature of contemporary health systems. (shrink)

In recent decades, some feminists have turned to the writings of Hannah Arendt in order to propose a truly emancipatory ethic of care or to find the principles that could lead to the political institutionalization of care. Nevertheless, the feminist interpretations of Hannah Arendt are particularly contrasted. According to Sophie Bourgault, this recourse to Hannah Arendt is deeply problematic, mainly because of her strong distinction between the private and public spheres. This article discusses the relevance of using Arendt’s concepts to (...) think about the institutionalization of care by Joan Tronto. Indeed, the most recent analyses developed on the politics of care are shaped by Arendt’s concepts such as power, amor mundi or by her conception of politics as a relationship. (shrink)

This article engages with Adriana Cavarero's framing of sexual difference, specifically in terms of how this displaces “bodies that queer”. For Cavarero, the narratable self is inescapably relational and characterized by vulnerability, which is how ethics arises in the form of a decision between caring and wounding. At the same time, Cavarero's deconstructive method of appropriating stereotypes restricts the scope of sexual difference to dimorphism. In examining the implications of this, I build on the work of Michel Foucault and (...) Judith Butler by looking to the intersexed life of Adélaïde Herculine Barbin, whose suicide in 1868 at the age of twenty‐nine was precipitated not through malice or cruelty, but through concerted care. This mode of care is anchored in the apparent self‐evidence of how we see and how we think with and through narratives that sediment in orders of power/knowledge. While agreeing with Cavarero's critique of the autonomous “I,” the article nevertheless argues for authorial audacity—the courage to name oneself—as a way of subverting asymmetrical power relations, including those that make it possible to inadvertently generate suffering through care. (shrink)

This article explores the integration of the seemingly disparate notions of care ethics and design thinking. The business community has adapted “design thinking” from engineering and architecture to facilitate innovation and problem solving through participatory processes. “Care ethics” is a relational approach to morality characterized by a concern for context, empathy, and action. Although design thinking is receiving significant attention and application in business practices, care ethics has only achieved limited traction among business ethicists in academia. “ (...) class='Hi'>Caring design” is offered as a mutually beneficial integration of the two ideas. Care ethics and design thinking have much in common. For example, the relational and responsive dimension of design thinking is analogous in some important ways, namely empathy and inquiry, to the relational and responsive approach of care ethics. The shared themes in care ethics and design thinking make the integration of the two plausible and reciprocal advantages make the combination compelling. Explicit ethical language can shape design thinking as more than a tool of productivity while the participatory processes of design thinking can aid in expanding the circle of care ethics as a social and political ethic. Furthermore, caring design may provide a palatable path for greater acceptance of care ethics among business professionals. An overview of design thinking and care ethics is offered prior to exploring how the synergies are mutually beneficial. The article concludes with a focus on how to educate the next generation of business students for caring design. (shrink)

Politics, Philosophy & Economics, Volume 21, Issue 3, Page 313-344, August 2022. This paper discusses why and how public attitudes should matter in regulating asylum and refugee protection in rich democracies, with a focus on Europe. Taking a realistic approach, I argue that public views constitute a soft feasibility constraint on effective and sustainable policies towards asylum seekers and refugees, and that a failure to take seriously and understand the attitudes of the host country’s population can have a very damaging (...) effect on refugee protection and migrants’ rights in practice. Bringing together insights from political philosophy, the politics of asylum, and research on public attitudes, I develop my argument by discussing why ‘what the people think’ should matter in asylum and refugee polices; how public views can and should matter given the well-known challenges with measuring attitudes and policy preferences; and what the prevailing public views might mean for the reform of asylum and refugee policies in Europe. (shrink)

Politics, Philosophy & Economics, Ahead of Print. This paper discusses why and how public attitudes should matter in regulating asylum and refugee protection in rich democracies, with a focus on Europe. Taking a realistic approach, I argue that public views constitute a soft feasibility constraint on effective and sustainable policies towards asylum seekers and refugees, and that a failure to take seriously and understand the attitudes of the host country’s population can have a very damaging effect on refugee protection and (...) migrants’ rights in practice. Bringing together insights from political philosophy, the politics of asylum, and research on public attitudes, I develop my argument by discussing why ‘what the people think’ should matter in asylum and refugee polices; how public views can and should matter given the well-known challenges with measuring attitudes and policy preferences; and what the prevailing public views might mean for the reform of asylum and refugee policies in Europe. (shrink)

1. At the beginning of 2014, when I was two years into my ethnographic research on sexuality among survivors of war-rapes in Bosnia-Herzegovina, my mental health deteriorated. I had spent a good am...

Three major trends in American health policy are intersecting in a fascinating way. First, managed care has grown to become the most dominant form of health-care delivery, leading to reductions in health-care costs as insurers are able to influence health-care providers with financial incentives. Second, the present growth of managed care has slowed, almost to a standstill, largely on account of consumers questioning what effects these financial incentives are having on the care of patients — questioning that has been expressed (...) in particular through lawsuits against managed care companies.Third, we are experiencing a renewed interest in the existence of medical error and how it may be reduced as a result of the Institute of Medicine’s report, To Err Is Human: Building a Safer Health System. The most important aspect of this renaissance in error reduction has been its emphasis on health care as a system that can be made better through system-oriented change. The most frustrating aspect is that the IOM did not endorse change in malpractice liability, which consistently puts the impetus for reducing medical error on the individual provider rather than the system as a whole. (shrink)

In this article, human–computer interaction is explored as a design-oriented practice nurturing the becoming of what is not-yet in future-oriented and speculative manners. Such approaches have evolved over time and now the field seems ready to take leaps targeting social and culturally infused contexts, such as those suggested by critical design, design things, adversarial design, making futures, pluriversal design and critical fabulations. It is in this respect that feminist theories, methods and imaginaries are rendered important. Feminist theory is in this (...) article considered an important companion and part of the practical tool-kit necessary for generative, speculative and ethical approaches within the field of HCI. How to think with care is explored as a meta-design strategy directed and informed by feminist onto-epistemologies – a strategy intended to ‘seed’ speculative and social justice-oriented design endeavours through generative figurations and critical dilemmas to foster abilities and sensibilities for dealing with difference differently. What is advanced is the need for meta-design space in HCI, in this article referred to as a contact zone, a feminist figuration with the intention to open up for design explorations with ethical imperatives. Four other interrelated feminist figurations are also loosely explored in order to frame how thinking with care in HCI could be advanced further, i.e. diffractive thinking, intra-activism, becoming-with and response-ability. By considering serious feminist accounts of situated knowledges and touching visions, it is argued that feminist thinking is well on its way to offering real alternatives of great importance for HCI. (shrink)

The criminal law declines to punish merely for bad attitudes that are not properly manifested in action. One might try to explain this on practical grounds, but these attempts do not justify the law’s commitment to never punishing unmanifested mental states in worlds relevantly similar to ours. Instead, a principled explanation is needed. A more promising explanation thus is that one cannot be criminally culpable merely for unmanifested bad attitudes. However, the leading theory of criminal culpability has trouble making good (...) on this claim. This is the theory that an action is criminally culpable to the extent that it manifests insufficient regard for legally protected interests. The trouble is that this theory’s defenders have not adequately explained what it is for an action to manifest insufficient regard. In this paper, I aim to provide the required account of manifestation, thereby rendering the insufficient regard theory more defensible. This, in turn, allows the view to explain the broad range of doctrines that treat unmanifested mental states as irrelevant. The resulting theory of criminal culpability is both descriptively plausible and normatively attractive. Moreover, it highlights the continuity between criminal culpability and moral blameworthiness by showing how the former functions as a stripped-down analogue of the latter. (shrink)

Three major trends in American health policy are intersecting in a fascinating way. First, managed care has grown to become the most dominant form of health-care delivery, leading to reductions in health-care costs as insurers are able to influence health-care providers with financial incentives. Second, the present growth of managed care has slowed, almost to a standstill, largely on account of consumers questioning what effects these financial incentives are having on the care of patients — questioning that has been expressed (...) in particular through lawsuits against managed care companies.Third, we are experiencing a renewed interest in the existence of medical error and how it may be reduced as a result of the Institute of Medicine’s report, To Err Is Human: Building a Safer Health System. The most important aspect of this renaissance in error reduction has been its emphasis on health care as a system that can be made better through system-oriented change. The most frustrating aspect is that the IOM did not endorse change in malpractice liability, which consistently puts the impetus for reducing medical error on the individual provider rather than the system as a whole. (shrink)

When critical thinking occurs in a collective context such as a Philosophy for Children workshop, it cannot be considered simply as an intellectual exercise, insofar as it depends on social interactions in the philosophical dialogue. This is why, in line with the works of Matthew Lipman, critical thinking should be taught and practiced as an exercise based on the development of caring thinking among children. Furthermore, open-mindedness, defined as the ability of the child to welcome intellectually (...) and ethically divergent ideas, may constitute the very fundamental precondition for critical thinking as it permits the meticulous, analytic and authentic discovery of the idea. (shrink)

Researchers do not owe their subjects the same level of care that physicians owe patients, but they owe more than merely what the research protocol stipulates. In keeping with the dynamics of the relationship between researcher and subject, they have limited but substantive fiduciary obligations.

Questions about when to limit unhelpful treatments are often raised in general medicine but are less commonly considered in psychiatry. Here we describe a survey of U.S. psychiatrists intended to characterize their attitudes about the management of suicidal ideation in patients with severely treatment-refractory illness. Respondents (n = 212) received one of two cases describing a patient with suicidal ideation due to either borderline personality disorder or major depressive disorder. Both patients were described as receiving all guideline-based and plausible emerging (...) treatments. Respondents rated the expected helpfulness and likelihood of recommending each of four types of intervention: hospitalization, additional medication changes, additional neurostimulation, and additional psychotherapy. Across both cases, most respondents said they were likely to provide each intervention, except for additional neurostimulation in borderline personality disorder, while fewer thought each intervention would be helpful. Substantial minorities of respondents indicated that they would provide an intervention they did not think was likely to be helpful. Our results suggest that while most psychiatrists recognize the possibility that some patients are unlikely to be helped by available treatments, many would continue to offer such treatments. (shrink)

This paper explores the notion of ‘expert’ health care practitioner in the context of critical thinking and health care education where scientific rather than philosophical inquiry has been the dominant mode of thought. A number of factors have forced are appraisal in this respect: the challenge brought about by the identification of complex ethical issues in clinical situations; medicine's `solving' of many of the simple health problems; the recognition that uncertainty is a common and perhaps innate feature of clinical (...) practice; debate about the concepts of illness and disease; plus insights from psychology,sociology and medical anthropology. Together these have prompted alternative ways of thinking which have the aim of identifying the best rather than the right decision (where best equates to good and right equates to correct in the sense of true or approved). It is argued that phronesis adds a necessary corrective dimension to modern Western medicine's over-emphasis on techne and is one of the factors that differentiates novice from expert practitioner. However, this attracts certain conflicts of interest: phronesis can only be gained and assessed from experience of praxis; agencies with legitimate interests in medicine such as government and professional registering bodies require more substantive criteria. (shrink)

There is a deep cultural anxiety around public expressions of maternalism and the application of maternal values to society as a whole. Julie Stephens examines why postmaternal thinking has become so influential in recent decades and why there has been a growing unease with maternal forms of subjectivity and maternalist perspectives. In moving beyond policy definitions, which emphasize the priority given to women's claims as employees over their political claims as mothers, Stephens details an elaborate process of cultural forgetting (...) that has accompanied this repudiation of the maternal. Reclaiming an alternative feminist position through an investigation of oral history, life narratives, Web blogs, and other rich and varied sources, Stephens confronts the core claims of postmaternal thought and challenges dominant representations of feminism as having forgotten motherhood. Deploying the interpretive framework of memory studies, she examines the political structures of forgetting surrounding the maternal and the weakening of nurture and care in the public domain. She views the promotion of an illusory, self-sufficient individualism as a form of social unmothering that is profoundly connected to this ethos. In rejecting both traditional maternalism and the new postmaternalism, Stephens challenges prevailing paradigms and makes way for an alternative feminist maternalism centering on a politics of care. (shrink)

It is widely agreed that education should involve the development of understanding, critical thinking, imagination, and emotions. However, this book, first published in 1990, argues that our views to these key concepts are confused and inaccurate, and therefore what we do in schools is generally inappropriate to our ideal. This book will be of interest to students of education and philosophy.

Health care organizations are increasingly asked to show accountability about their performance. This paper proposes that accountability can best be achieved through evaluative methods that are based on evidence regarding the relationship between processes of care and expected outcomes. Root cause analysis (RCA) is used as an illustration of how a generic method of inquiring can be transformed into an ongoing monitoring, evaluation, user education and accountability strategy. The role of performance indicators, as well as patient and community expectations, is (...) discussed. (shrink)

BackgroundAs part of the research project “End-of-life Communication in Nursing Homes. Patient Preferences and Participation”, we have studied how Advance Care Planning is carried out in eight Norwegian nursing homes. The concept of ACP is a process for improving patient autonomy and communication in the context of progressive illness, anticipated deterioration and end-of-life care. While an individualistic autonomy based attitude is at the fore in most studies on ACP, there is a lack of empirical studies on how family members’ participation (...) and involvement in ACP- conversations may promote nursing home patients’ participation in decisions on future treatment and end-of-life care. Based on empirical data and family ethics perspectives, the purpose of this study is to add insights to the complexity of ACP-conversations and illuminate how a family ethics perspective may improve the quality of the ACP and promote nursing home patients’ participation in advance care planning.MethodsParticipant observations of ACP-conversations in eight nursing homes. The observations were followed by interviews with patients and relatives together on how they experienced being part of the conversation, and expressing their views on future medical treatment, hospitalization and end-of-life issues.ResultsWe found that the way nursing home patients and relatives are connected and related to each other, constitutes an intertwined unit. Further, we found that relatives’ involvement and participation in ACP- conversations is significant to uncover, and give the nursing home staff insight into, what is important in the nursing home patient’s life at the time. The third analytical theme is patients’ and relatives’ shared experiences of the dying and death of others. Drawing on past experiences can be a way of introducing or talking about death.ConclusionsAn individual autonomy approach in advance care planning should be complemented with a family ethics approach. To be open to family ethics when planning for the patient’s future in the nursing home is to be open to diversity and nuances and to the significance of the patient’s former life and experiences. (shrink)

Ageing populations and rising rates of chronic disease globally have shifted key elements of disease management to ideas of integrated care and self‐management. The associated policies and programmes often focus on intervention and support beyond the sites of the hospital and clinic. These shifts have significantly impacted the delivery and practice of nursing for both nurses and the clients with whom they work. This article argues that Foucault's comments on space, place and heterotopia (1986) are useful in exploring these changes (...) from a philosophical perspective, to draw out the complexity of these programmes and add texture to discussions on the ways these shifts to localisation and the dominant discourses of self‐management and responsibility have reconfigured nursing practices. The theoretical discussion is augmented with illustrations from an Australian integrated health care programme. (shrink)

This Open Access book provides both a broad perspective and a focused examination of cow care as a subject of widespread ethical concern in India, and increasingly in other parts of the world. In the face of what has persisted as a highly charged political issue over cow protection in India, intellectual space must be made to bring the wealth of Indian traditional ethical discourse to bear on the realities of current human-animal relationships, particularly those of humans with cows. Dharma, (...) yoga, and bhakti paradigms serve as starting points for bringing Hindu--particularly Vaishnava Hindu--animal ethics into conversation with contemporary Western animal ethics. The author argues that a culture of bhakti--the inclusive, empathetic practice of spirituality centered in Krishna as the beloved cowherd of Vraja--can complement recently developed ethics-of-care thinking to create a solid basis for sustaining all kinds of cow care communities. (shrink)

Pharmacogenetics and pharmacogenomics are related facets of cutting edge therapeutic research in a field that relates pharmacological properties to the genetic characteristics of human beings. An optimistic interpretation suggests that “One-Size-Fits-All” therapeutics, whose effects can only be predicted in probabilistic terms, will give way eventually to individual tailor-made therapies with entirely predictable properties in each patient. Yet the concept of anticipating individual pharmacotherapeutic response appears to disregard some of the fundamental limitations of causal understanding in the biological world of structure–action (...) relationships. It is not simply a problem of confronting complexity – which might be overcome in time with advances in biotechnology and computing power – but the inescapable paradox of the genetic characteristics of individuals within the human species. The aleatory process of evolution ensures that with the exception of monozygotic twins, every human being is genetically unique. At the same time there appears to be more in common than divides. Pharmacogenomics provides a climate in which to explore and better understand the variable causal relationships between genetic element, protein and therapeutic or toxic actions, but can only do so in abstraction. Thus␣predictive power may be enhanced but is ultimately constrained by insuperable probabilistic considerations. (shrink)

Bruno Latour is one of the founding figures in social network theory and a broadly influential systems thinker. Although his work has always been relational, little scholarship has engaged the relational morality, ontology, and epistemology of feminist care ethics with Latour’s actor–network theory. This article is intended as a translation and a prompt to spur further interactions. Latour’s recent publications, in particular, have focused on the new climate regime of the Anthropocene. Care theorists are just beginning to address posthuman approaches (...) to care. The argument here is that Latourian analysis is helpful for such explorations, given that caring for the earth and its inhabitants is the dire moral challenge of our time. The aim here is not to characterize Latour as a care theorist but rather as a provocative scholar who has much to say that is significant to care thinking. We begin with a brief introduction to Latour’s scholarship and lexicon, followed by a discussion of care theorist Puig de la Bellacasa’s work on Latour. We then explore recent work on care and the environment consistent with a Latourian approach. The conclusion reinforces the notion that valuing relationality across humans and non-human matter is essential to confronting the Anthropocene. (shrink)

The article analyses the necessary conditions an argument for popular punishment would need to meet, and argues that it faces the challenge of a dilemma of reasonableness: either popular views on punishment are unreasonable, in which case they should carry no weight, or they are reasonable, in which case the reasons that support them, not the views, should carry weight. It proceeds to present and critically discuss three potential solutions to the dilemma, arguing that only an argument for the beneficial (...) effects of coherence between popular views and penal policy is persuasive, but that it makes popular punishment less important than proponents claim, and offers a justification proponents will find it difficult to advance. (shrink)

This paper aims to pursue two goals: first, it will explore the encounter and dialogue between Martin Heidegger’s thinking toward medicine, and in particular, psychiatry. Second, it will look toward understanding how this encounter can illuminate clinical practices and provide significant contributions within the fields of medical education and healthcare. The broader horizon of this paper is to underline how embracing a different approach to health can be of interest to both a medical and philosophical audience, inviting the former (...) to progress in their scientific skills and de-personalize texts toward a more genuine and humanistic encounter with patients, while also engendering the latter to leave the dark and dusty halls of metaphysical thinking to move into the greener pastures of the social dimension. (shrink)

This essay will focus on the moral issues relating to surrogacy in the global context, and will critique the liberal arguments that have been offered in support of it. Liberal arguments hold sway concerning reproductive arrangements made between commissioning couples from wealthy nations and the surrogates from socioeconomically weak backgrounds that they hire to do their reproductive labor. My argument in this paper is motivated by a concern for controlling harms by putting the practice of globalized commercial surrogacy into the (...) context of care ethics. As I will argue, the unstable situations into which children of global surrogacy arrangements are born is symbolic of the crisis of care that the practice raises. Using the Baby Manji case as my touch point, I will suggest that liberalism cannot address the harms experienced by Manji and children like her who are created through the global practice of assisted reproductive technology. I will argue that, if commissioning couples consider their proposed surrogacy contracts from a care ethics point of view, they will begin to think relationally about their actions, considering the practice from an ethical lens, not just an economic or contractual one. (shrink)

The discussion about robots in elderly care is populated by doom scenarios about a totally dehumanized care system in which elderly people are taken care of by machines. Such scenarios are helpful as they attend us to what we think is important with regard to the quality elderly care. However, this article argues that they are misleading in so far as they (1) assume that deception in care is always morally unacceptable, (2) suggest that robots and other information technologies necessarily (...) deceive elderly people by creating a “virtual” world as opposed to a “real” world, (3) assume that elderly people of the future have similar ICT skills and interests as the elderly people of today, and (4) assume a simplistic view of technologies. The article suggests an approach to evaluating care robots and ICT in health care which acknowledges and addresses a number of ethical problems raised by robotic care—for instance disengagement problems—while taking into account that some elderly people may need care that does not treat them as (empirically) autonomous, that many the elderly of the future are likely to be digital natives, and that the task of evaluating technologies in care is more complicated than the discussion of deception suggests. (shrink)

We care for our own future experiences. Most of us, trivially, would rather have them pleasurable than painful. When we care for our own future experiences we do so in a way that is different from the way we care for those of others (which is not to say that we necessarily care more about our own experience). Prereflectively, one would think this is because these experiences will be ours and no one else's. But then, of course, we need to (...) explain what it means to say that a future experience will be mine and how knowledge of this fact renders it rational for me to care for this experience in a special way. Indeed most philosophers take this route. But in doing so, they quickly stumble on insuperable problems. I shall argue that the problem of egocentric care, as it is sometimes called, can be solved by turning things upside down: it is much more fruitful to think that the special kind of care we feel for some future experiences (and not others) is part of what makes them ours should they occur. This requires an explanation of egocentric care for future experiences that does not draw in a theory of personal identity, but rather contributes to one. I will attempt to provide this explanation by making use of the idea of a diachronic mental holism. (shrink)

Critical thinking is a complex, dynamic process formed by attitudes and strategic skills, with the aim of achieving a specific goal or objective. The attitudes, including the critical thinking attitudes, constitute an important part of the idea of good care, of the good professional. It could be said that they become a virtue of the nursing profession. In this context, the ethics of virtue is a theoretical framework that becomes essential for analyse the critical thinking concept in (...) nursing care and nursing science. Because the ethics of virtue consider how cultivating virtues are necessary to understand and justify the decisions and guide the actions. Based on selective analysis of the descriptive and empirical literature that addresses conceptual review of critical thinking, we conducted an analysis of this topic in the settings of clinical practice, training and research from the virtue ethical framework. Following JBI critical appraisal checklist for text and opinion papers, we argue the need for critical thinking as an essential element for true excellence in care and that it should be encouraged among professionals. The importance of developing critical thinking skills in education is well substantiated; however, greater efforts are required to implement educational strategies directed at developing critical thinking in students and professionals undergoing training, along with measures that demonstrate their success. Lastly, we show that critical thinking constitutes a fundamental component in the research process, and can improve research competencies in nursing. We conclude that future research and actions must go further in the search for new evidence and open new horizons, to ensure a positive effect on clinical practice, patient health, student education and the growth of nursing science. (shrink)

Ethics consultation has become an integral part of the fabric of U.S. health care delivery. This article summarizes the second edition of the Core Competencies for Health Care Ethics Consultation report of the American Society for Bioethics and Humanities. The core knowledge and skills competencies identified in the first edition of Core Competencies have been adopted by various ethics consultation services and education programs, providing evidence of their endorsement as health care ethics consultation (HCEC) standards. This revised report was prompted (...) by thinking in the field that has evolved since the original report. Patients, family members, and health care providers who encounter ethical questions or concerns that ethics consultants could help address deserve access to efficient, effective, and accountable HCEC services. All individuals providing such services should be held to the standards of competence and quality described in the revised report. (shrink)