BackgroundCurrently, most people who might need mental health care services do not receive them due to a number of reasons. Many of these reasons can be overcome by telepsychology, in other words, the use of ICT technologies for therapy ; given that it facilitates access to specialized interventions. In fact, telepsychology is currently offered as an active service in many psychotherapy centers. However, its usage, how it is perceived, and who uses it are still largely unknown.ObjectiveThe aim of this (...) study was to determine if any pattern exists in the usage of telepsychology and face-to-face psychology, to clarify people’s perception of telepsychology in terms of the advantages, barriers and efficacy of online psychotherapy, and to examine usage patterns in terms of individual characteristics and identify patients’ profiles.MethodsAn online survey was conducted on a convenience sample of 514 subjects recluted by using an online advertisement. The inclusion criteria were: to be older than 18 years old and to answer completely the questionnaire. Cluster analysis, ANOVAs, and discriminant analysis were performed to test our research objectives.ResultsThree usage clusters were found: face-to-face psychotherapy ; non-therapy ; and combined face-to-face psychotherapy and telepsychology. In addition, the perception of telepsychology varied among usage clusters, but a common perception emerged about the main telepsychology advantages, barriers and efficacy. Finally, the results showed that personal characteristics differentiated people in each of these clusters.ConclusionThe most common form of access to psychotherapy is the face-to-face form but the second way of delivery was a combination between face to face and online psychotherapy. People who combine face to face with online psychotherapy perceives this last as more efficient and with less barriers to access. Finally, some characteristic as eHealth experience and sociodemographic variables can help to identify people that will attend telepsychology initiatives. These clusters provide insight into opportunities for face-to-face and online patient engagement strategies. (shrink)

This paper introduces the notion of patterns of practice and shows the extent to which it is useful at the level of practice and at a profound philosophical level. The notion makes deep connections with ideas in the realm of the philosophy of language and thought and, in addition, it connects to virtue ethics. Using the example of whether or not to admit someone using compulsory powers or whether to treat them in the community, the notion of patterns (...) of practice can be used to demonstrate the internal and external coherence of decisions in psychiatric care and thus to offer clinical and ethical justification. (shrink)

This paper introduces the notion of patterns of practice and shows the extent to which it is useful at the level of practice and at a profound philosophical level. The notion makes deep connections with ideas in the realm of the philosophy of language and thought and, in addition, it connects to virtue ethics. Using the example of whether or not to admit someone using compulsory powers or whether to treat them in the community, the notion of patterns (...) of practice can be used to demonstrate the internal and external coherence of decisions in psychiatric care and thus to offer clinical and ethical justification. (shrink)

John Mackie’s moral error theory is so closely associated in people’s minds with his arguments from relativity and from queerness that one might overlook the fact that there may be numerous other, and possibly better, ways of establishing that metaethical position. Perhaps, indeed, there are even further resources for arguing for a moral error theory to be unearthed in Mackie’s own book. I have in mind Mackie’s thesis of moral objectification: that the “objective prescriptivity” with which our moral judgments are (...) imbued is the result of our “tendency to read our feelings into their objects” (1977: 42). Mackie invokes Hume’s famous projectivist image of the human mind’s “great propensity to spread itself on external objects,” and, indeed, it is in his book-length analysis of Hume’s moral theory (Mackie 1980) that the topic receives a more careful discussion than in Ethics: Inventing Right and Wrong. In both books he musters some considerations in favor of the thesis, and reveals to us that he thinks that “it is very largely correct” (1980: 72). (shrink)

This study explores the factors associated with neonatal mortality and maternal health care in Nepal. The subjects were 4375 births reported in the 1996 Nepal Family Health Survey. Maternal and child health care was found to have a significant association with neonatal mortality, although preceding birth interval and sex of child had stronger effects. Four aspects of maternal care were found to be highly associated with region, household ownership of assets, mothers education. This indicates that accessibility, affordability (...) and availability of maternal health care are important factors to consider in future research on neonatal mortality. (shrink)

Evolutionary theory guides an investigation of foster parent selection in two northern Thai villages with different biosocial environments: one village has high levels of labour migration and divorce, and growing numbers of parental death due to HIV/AIDS, while the other village has lower migration, divorce and parental mortality levels. Focus groups examine mothers motivations and ideals regarding foster caretaker selection, and quantitative family surveys examine real fostering outcomes: specifically, the laterality (matrilateral versus patrilateral) and genetic distance of the foster caretakers (...) of all ever-fostered children in these two villages. As predicted, in environments of high marital stability and paternity certainty, parents seem to prefer close genetic kin from either side as foster parents for their children. In low marital stability and paternity certainty environments, parents trust their own lateral kin, regardless of genetic distance, over close genetic kin from the other side. The striking exception to this pattern, however, occurs in the case of parental death, in which case children are fostered to the deceased parents sex or other factors. In general, the foster parents for girls are selected with more care, reflecting the daughter/female preference expected in traditionally matrilineal, matrilocal societies. An ordered decision-making pathway for foster parent selection is proposed, taking into consideration the key factors of (a) the circumstances driving the fostering decision, (b) the gender of the child, (c) the gender of the key decision-making parent, and (d) the degree of marital and population fluidity (and subsequent paternity certainty) in the village. (shrink)

Screening for unsuspected disease has both possible benefits and harms for those who participate. Historically the benefits of participation have been emphasized to maximize uptake reflecting a public health approach to policy; currently policy is moving towards an informed choice approach involving giving information about both benefits and harms of participation. However, no research has been conducted to evaluate the impact on health of an informed choice policy. Using psychological models, the first aim of this study was to describe an (...) explanatory framework for variation in screening uptake and to apply this framework to assess the impact of informed choices in screening. The second aim was to evaluate ethically that impact. Data from a general population survey of beliefs and attitudes towards participation in diabetes screening indicated that greater orientation to the present is associated with greater social deprivation and lower expectation of participation in screening. The results inform an explanatory framework of social patterning of screening in which greater orientation to the present focuses attention on the disadvantages of screening, which tend to be immediate, thereby reducing participation. This framework suggests that an informed choice policy, by increasing the salience of possible harms of screening, might reduce uptake of screening more in those who are more deprived and orientated to the present. This possibility gives rise to an apparent dilemma where an ethical decision must be made between greater choice and avoiding health inequality. Philosophical perspectives on choice and inequality are used to point to some of the complexities in assessing whether there really is such a dilemma and if so how it should be resolved. The paper concludes with a discussion of the ethics of paternalism. (shrink)

In this paper I seek to distinguish a feminist virtue ethics of care from (1) justice ethics, (2) narrative ethics, (3) care ethics and (4) virtue ethics. I also connect this contemporary discussion of what makes a virtue ethics of care feminist to eighteenth and nineteenth century debates about male, female, and human virtue. I conclude that by focusing on issues related to gender - primarily those related to the systems, structures, and ideologies that create and sustain (...) patterns of male domination and female subordination - we can begin to appreciate that true care and bona-fide virtue can flourish only in societies that treat all persons with equal respect and consideration. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Painting Outside the Lines: Patterns of Creativity in Modern ArtMatthew ZiffPainting Outside the Lines: Patterns of Creativity in Modern Art, by David W. Galenson. Cambridge: Harvard University Press, 2001, 272 pp., $29.95.The relationship between the market value of paintings and the chronological point in an artist's working life when the paintings were produced is the driving mechanism for exploring creativity and innovation in David W. Galenson's (...) book "Painting Outside the Lines: Patterns of Creativity in Modern Art. The working thesis of this book is that Modern artists have worked creatively and innovatively in one of two distinctly different manners. The terminology Galenson uses to describe these distinct ways of working are "finders" and "seekers." Finders are artists like Pablo Picasso, who at age 26, make startling and important innovations with little advance indication that such a burst is about to take place. Seekers are artists like Paul Cezanne, whospend their entire working lives engaged in the pursuit of a singular approach or achievement. The differences between these methodologies are carefully presented through the details of the working lives of a variety of Modern artists. French nineteenth century and early twentieth-century artists and mid-twentieth-century American artists are used as the source data for these comparisons.Early in the book Galenson presents lists of chronological events within the lives of artists and market valuation of their work within this chronology. The dramatic clarity of the relationships presented in this data sets the stage for the detailed information that follows. Factors that in some cases only partly, and in others nearly completely, explain an artist's way of working are offered through biographic information, information about the aesthetic and cultural milieu, and about the economic and educational structures that are predominant during the relevant time in the life of the artist.The relationship between the aesthetic and cultural milieu surrounding an artist and the capacity or inclination of an artist to be innovative is an important aspect of the book's analysis. The scope of the book is limited to Modern artists because of the shift that took place at the outset of Modern art, during the mid 1860s, that brought a strong emphasis on innovation and change for their own sake as an important characteristic within a work of art. This emphasis "created incentives for painters to produce new approaches to art" (p. 111). Prior to the time of Modern art, innovation and change were often unnecessary for an artist to be successful. Modern art introduced the demand that innovation and change be necessary ingredients in art, and therefore the search for innovation became a significant element within the work of many artists. The manner in which this search took place, as presented through the data at hand, reveals how individual artists viewed the need for innovation and change within their own [End Page 123] work. Paul Cezanne, for example, was aware of the impact that his painting was having on the art world, but he insisted that he was not yet finished with discoveries that would reveal the truest expression of his beliefs about aesthetic expression.In the American movement, "Abstract Expressionism," Galenson finds a useful counter example to the art scene in Paris. In the United States, especially during the 1940s and 1950s — the peak years of creative output by Abstract Expressionist artists — the demand for their work was quite low. There were few economically viable outlets for the work of de Kooning, Pollack, Rothko, and the others of this group. Consequently there is a shift in the chronological point at which these artists achieve market value success. Nearly all of these artists receivedrecognition at an older age than the French artists of the late nineteenth and early twentieth centuries.The thesis of the book, that there are two fundamentally different ways of working to produce works of art, is directly applicable to, and useful in, exploring issues of teaching and learning in design education. As a teacher of interior architecture I was interested to follow the details that Galenson presented in support of his analysis of the careers of numerous Modern artists. The methodological differences between seeking and... (shrink)

Background: The comorbidity of posttraumatic stress disorder and depression is common among people living with the HIV. Given the high prevalence and serious clinical consequences of the comorbidity of these two disorders, we conducted a latent profile analysis to examine the co-occurrence pattern of PTSD and depression in PLWH.Methods: The data for this cross-sectional study of PLWH were collected from 602 patients with HIV in China. A secondary analysis using latent profile analysis was conducted to examine HIV-related PTSD and depression (...) symptoms.Results: A four-class solution fits the data best, with the four classes characterized as asymptomatic, mild symptoms, low to moderate symptoms, and high to moderate symptoms. The severity of PTSD and depression symptoms was comparable in this solution, and no group was dominated by PTSD or depression.Conclusion: The absence of a distinct subcluster of PLWH with only PTSD or depression symptoms supports that PTSD and depression in PLWH are psychopathological manifestations after traumatic exposures. Health care staff should pay more attention to the existence of comorbid symptoms of individuals, develop integrated interventions for the symptoms cluster, and evaluate their effectiveness in clinical practice. (shrink)

BackgroundThe German guidelines for liver transplantation stipulate that every patient with alcohol-related liver disease needs to prove evidence of a 6-month abstinence period before they can be admitted to the waiting list for liver transplantation. This internationally widespread abstinence rule has been criticised as it prevents patients at least temporarily from receiving an effective and potentially life-saving therapy. This poses the question of how this abstinence rule is depicted and justified by transplantation professionals.ArgumentsIn case of the 6‑month abstinence rule, guidelines (...) are used as a tool for rationing health care. Four frames of interpretation can be reconstructed from the ethical and medical literature. Each linguistically mediated frame offers a different representation of the 6‑month abstinence rule. According to these different framings, the 6‑month waiting period is depicted (1) as a diagnostic tool to determine the regenerative capacity of the liver, (2) as a prognostic tool to determine the prospects of success of a transplantation, and (3) to determine the drinking behaviour after transplantation. In a further context, the abstinence rule (4) is interpreted as an expression of an obligation to avoid behaviour harmful to health.ConclusionThese four frames provide linguistically mediated patterns of interpretation that are used by different actors to limit the indication for liver transplantation. They give rise to different ethical questions that allow a systematic ethical assessment of the 6‑month abstinence rule. (shrink)

There is a surprising absence of systematic theological reflection on what the church’s response to refugees should be and how its response relates to wider debates on the duty of care to refugees. This article situates theological concerns within wider philosophical debate on what the duty of care to refugees consists of. The first section critically reviews the debate on how liberal democracies should respond to refugees. The second section, following Georgio Agamben’s characterisation of refugees as ‘bare life’, (...) argues that refugees unveil a deep contradiction in contemporary patterns of political sovereignty. It closes by arguing that while a theological account of political authority points to some roads beyond the crisis, the first task of the church is to properly order its own duty of care to refugees. The last section consists of an exegesis of the second clause of the Lord’s Prayer as a way of giving an account of what such care involves. (shrink)

Law wrangles with setting and applying standards for the practice of medicine in many different arenas. One of the most prominent is medical malpractice litigation in which the trial process examines a physician's performance and measures it against the standard of care. The profession's prevailing custom, with some substantial tolerance for “respectable minority” views, has been the gold standard for scrutinizing physician practice and treatment decisions in the malpractice context. Using the profession's custom as the measure against which a (...) physician's performance is judged defers to the expertise of medicine. Deference to the medical profession is attractive as a tool for reining in law. Reliance on customary practice is criticized, however, for driving physicians to the relative safety of the middle of the herd. Creating such a strong incentive for compliance with customary practice can dampen medical innovation and the diffusion of new clinical knowledge. The safety of the herd can also deprive individual patients of the best care in their particular circumstances.Several current trends are strengthening claims that professional practice patterns are an inappropriate tool for distinguishing between high‐quality and substandard care. In particular, advocacy for evidence‐based medicine aggressively asserts that the traditional way of making medical treatment decisions is largely untethered from scientific method or data, rendering professional judgment, even in the aggregate, suspect. (shrink)

A multifaceted, holistic approach to identifying potential predictors is needed to eradicate workplace bullying. The current study investigated the impact of an unfavourable organisational climate that plays a role in breeding workplace bullying. The present study also postulated that individual personality differences mediate between a caring climate and workplace bullying. Similarly, the interaction between workplace bullying and personality impacts PTSD. We also checked the role of workplace bullying as a mediator between a caring climate and PTSD. This research tested all (...) the proposed hypotheses, and the study was conducted in Pakistan. The data is analysed using the two-step partial least square structural equation modelling procedure. The first part assesses the measurement model, while in the second step, the structural model is evaluated. The results supported all the proposed hypotheses of this study. Type A behaviour moderated the caring climate—person-related bullying relationship, whereas it did not moderate the caring climate—work-related bullying in the suggested direction. Type A behaviour is moderated for both types of bullying and PTSD. Results also show significant indirect effects of a caring climate on PTSD through workplace bullying. This study will contribute theoretically to filling the literature gap on studies of climate-bullying and bullying-stress using contingency factors. (shrink)

This book, written by two central figures of generative grammar, represent the culmination of some ten years work on phonological theory and specifically on the sound system of English. As such, it is of interest to anyone concerned with phonology in general no less than to the student of English. Their description of the phonological structure of modern English, while not claiming to be exhaustive, reveals the deep and hitherto largely uncharacterized, regularities underlying this system in at least two major (...) areas: in the analysis of English stress, which is shown to be in large measure predictable at the level of both word and phrase; and in the account of vowel and consonant alternations in such cases as sane-sanity, deceive-deception, decide-decision, cone-conic and democrat-democracy respectively. Secondly the book constitutes a major contribution to general phonological theory. Thus, for example, the note of the phonological component of a generative grammar is viewed as the mapping of the abstract string of formatives that constitute the surface structure output of the syntax onto concrete phonetic space, via a series of carefully formalized rules; a clearly-defined, highly abstract view is taken of underlying phonological representations, which in turn are related in a non-arbitrary fashion to the actual phonetic output; and the choice of phonological primes is motivated in terms of certain crucial departures from the earlier set of distinctive features established by Roman Jakobson--to whom the book is dedicated. Thirdly, the book is of major importance for general linguistic theory, as it makes substantive contributions to areas such as: language change and the relation between diachrony and synchrony; the nature and ordering of grammatical rules ; or the key notion of the "cyclical" applications of rules--first introduced in this work in order to handle the assignment of English stress to words and phrases beyond the single-morpheme level, and by now a crucial feature of the transformational rules of generative syntax. In their preface, the authors describe The Sound Pattern of English as "an interim report on work in progress." That this is true is attested to by the debate now being waged on nearly every aspect of phonological theory by followers of Chomsky and Halle. The book has already given rise to considerable critical discussion, ranging from specific points such as the correctness of the particular set of distinctive features established by the authors, to far deeper issues concerning the abstractness of phonological representations, the inter-relation between phonology and the syntactic and semantic components of grammar, the place of phonetics within the field of linguistics. These very controversies should insure this book its place as a central text for all serious students of English, phonology, and language.--R. A. (shrink)

Feminized care work occupations have traditionally paid lower wages compared to non–care work occupations when controlling for human capital. However, when men enter feminized occupations, they often experience a “glass escalator,” leading to higher wages and career mobility as compared to their female counterparts. In this study, we examine whether men experience a “wage penalty” for performing care work in today’s economy, or whether the glass escalator helps to mitigate the devaluation of care work occupations. Using (...) data from the Survey of Income and Program Participation for the years 1996-2011, we examine the career patterns of low- and middle-skill men in health care occupations. We found that men in occupations that provide the most hands-on direct care did experience lower earnings compared to men in other occupations after controlling for demographic characteristics. However, men in more technical allied health occupations did not have significantly lower earnings, suggesting that these occupations may be part of the glass escalator for men in the health care sector. Minority men were significantly more likely than white men to be in direct care occupations, but not in frontline allied health occupations. Male direct care workers were less likely to transition to unemployment compared to men in other occupations. (shrink)

There are marked differences between countries with regard to reimbursement decision-making, yet few studies have tried to understand this process and its consequences by a detailed analysis of the local context and decision-making structure. This article describes reimbursement decision-making and subsequent prescribing patterns of new pharmaceuticals by means of a case study on glitazones in treatment of type 2 diabetes mellitus patients in Denmark. The study shows that institutional arrangements, providing the context in which evidence is used, are highly (...) important for understanding the reimbursement decision-making process. In particular the Danish Medicines Agency (DMA) has shaped the decision to reimburse glitazones on the basis of physician-mediated requests of individual patients. Relatively few patients have been prescribed glitazones since their introduction in 2000, suggesting that individual reimbursement may be an effective instrument in controlling overall expenditure of selected pharmaceuticals, although in the case of glitazones this has likely been achieved at the expense of equality in access to the products. The discussion focuses on the generalizability of the findings to both other pharmaceuticals in the individual reimbursement scheme in Denmark, and to other countries that are trying to balance the need to control overall pharmaceutical care expenditure with the need to secure equality in access to new drugs with therapeutic added value. (shrink)

In this article the author explores the ways in which lesbian coparents divide household, child care, and paid labor to learn whether, and the degree to which, they adopt egalitarian work and family arrangements. Informed by a brief overview of U.S. gay liberation and family politics, and the theoretical and empirical work on the household division of labor by gender, this qualitative analysis of 34 Northern California families suggests that equitable practices—a pattern of equal sharing—among these lesbian coparents are (...) the norm. Less frequently, the Rozzie and Harriet pattern of primary breadwinner/primary caregiver emerges, apparently in relation to differences in parents' relative income and their desire to offer children a “sense of family.” The experience of this minority of couples reveals a division of labor that mimics modern heterosexual expectations and highlights the powerful negative effect of economic dependency on women who are full-time caregivers. (shrink)

Background: The health professionals are involved in the paths of care for patients with different medical conditions. Their life is frequently characterized by psychopathological outcomes so that it is possible to identify consistent burdens. Besides the possibility to develop pathological outcomes, some protective factors such as resilience play a fundamental role in facilitating the adaptation process and the management of maladaptive patterns. Personal characteristics and specific indexes such as burdens and resilience are essential variables useful to study in-depth (...) ongoing conditions and possible interventions. The study was aimed at highlighting the presence and the relations among factors as personal variables, burdens, and resilience, to understand health professionals' specific structure and functions.Methods: The observation group was composed of 210 participants, 55 males, and 155 females, aged from 18 to 30 years old with a mean age of 25.92 years old. The study considered personal characteristics of the subjects, such as age, gender, years of study, days of work per week, hours of work per week, and years of work. Our study had been conducted with the use of measures related to burdens and resilience.Results: The performed analyses consisted of descriptive statistics, correlations, and regressions among the considered variables. Several significant correlations emerged among personal characteristics, CBI, and RSA variables. Specifically, age and work commitment indexes appeared to be significantly related to the development of burdens, differently from the years of study. Significant correlations emerged among personal and RSA variables, indicating precise directions for both domains. Age and gender were identified as predictors to perform multivariate regression analyses concerning CBI factors. Significant dependence relations emerged with reference to all CBI variables.Conclusion: Pathological outcomes and resilience factors represent two sides of the health professionals' experiences, also known as “invisible patients.” Greater knowledge about present conditions and future possibilities is a well-known need in literature so that the current analyses considered fundamental factors. In line with state of the art, future studies are needed in order to deepen elusive phenomena underlying maladjustment. (shrink)

Machine learning (ML) trains itself by discovering patterns of correlations that can be applied to new inputs. That is a very powerful form of generalization, but it is also very different from the sort of generalization that the west has valorized as the highest form of truth, such as universal laws in some of the sciences, or ethical principles and frameworks in moral reasoning. Machine learning’s generalizations synthesize the general and the particular in a new way, creating a multidimensional (...) model that often retains more of the complex differentiating patterns it has uncovered in the training process than the human mind can grasp. Particulars speak louder in these models than they do in traditional generalizing frameworks. This creates an odd analogy with recent movements in moral philosophy, particularly the feminist ethics of care which rejects the application of general moral frameworks in favor of caring responses to the particular needs and interests of those affected by a moral decision. This paper suggests that our current wide-spread and justified worries about ML’s inexplicability—primarily arising from its reliance on staggeringly complex patterns of particulars—may be preparing our culture more broadly for a valorizing of particulars as at least as determinative as generalizations, and that this might help further advance the importance of particulars in ideas such as those put forward by the ethics of care. (shrink)

In the last few decades, increasing attention has been given to gender issues in urban design. However, research on the urban environment continues to show large gender inequalities, which are especially evident when studying the use and enjoyment of the public space. This study aims to identify predominant patterns of use in public places and to explore the possible existence of traditional gender roles in the urban space. The study uses, three public spaces in the city of Barcelona as (...) a case study, an innovative combination of systematic observation techniques and network analysis procedures. Variables collected by EXOdES, a dedicated software analysis tool for systematic observation, are represented as nodes of a network system and analyzed using network analysis tools. Findings confirmed that, in spite of the progressive consolidation of feminist urbanism, uses in the public realm resulting from traditional gender roles remained explicitly recognizable. Whereas women’s occupation of space was related to playground and resting areas, generally involving care activities concerned with children or elderly people, men were primarily located in resting and sports areas, practicing sports, or participating in leisure activities. These patterns of use were more prone to emerge when users were part of a group than when they were alone. From a gender perspective, a contribution of the study is that it informed about main aspects of the analyzed public spaces reconfirming the existence of traditional roles in society, and the significance of exploring the public space as a key scenario where social features are explicitly exposed. From a methodological perspective, the processing of observational data with network analysis tools proved to be relevant and suitable for dealing with the intricacies of urban place analysis. Compared to more classical approaches and systems, these techniques allowed to identify and interpret complex systems composed of many variables and relationships in a relatively straightforward manner, which turns it into a useful aid for urban designers and architects. (shrink)

The article is a critical discussion of "contractualism" in moral and political philosophy as developed by john rawls and applied by w. G. Runciman. It attempts to clarify the sense in which contractualism is a moral theory and to assess its powers as a normative account of moral criticism. It argues that the structure of contractualism suggests an attractive way of formulating rival moral theories but not a way of arguing for any moral theory, That this reduces the force of (...) a contractualist critique of utilitarianism, And that contractualism is incomplete as a normative account of moral criticism. (shrink)

This article extends recent scholarship on masculinity by analyzing the effects of social structure, social relations, and gendered caregiving ideology on the care men give to kin and friends. To be sure, men spend significantly less time giving care than do women. However, much variation is contingent on the women in men's lives: It is primarily the characteristics of men's families more than employment or gendered caregiving ideology that shape the amount and kind of caregiving men provide. Our (...) findings suggest that although men's caregiving is variable and socially patterned, it is contingent on women: Wives and daughters pull men into caregiving, while adult sisters substitute for them. (shrink)

A motivation problem may arise when morally principled public policy calls for serious sacrifice, relative to ways of life and levels of well-being, on the part of the meInbers of a free society. Apart from legal or other forms of “external” coercion, what will, could, or should move people to make the sacrifices required by morality? I explore the motivation problem in the context of morally principled public policyconcerning our legacy for future generations. In this context the problem raises special (...) moral-psychological difficulties. My inquiry suggests pessimism regarding our ability to solve the motivation problem relative to what morality requires on behalf of future generations. (shrink)

The British Medical Association (BMA) has called upon the General Medical Council (GMC) to instruct all medical schools to provide identifiable and substantial courses on medical ethics in their undergraduate curricula. The author reviews a postgraduate scheme of study in the ethics of health-care and suggests that it could provide some useful guidelines for teaching the subject at the undergraduate level.

This article attends to the intimate contradictions that differentially shape and limit caring capacities and relations in a violent world, and the embodied ethical and political transformations at the heart of learning to care otherwise. From manifestos calling for ‘universal care’ in defiance of the state-sanctioned horrors of the pandemic era, to the abolitionist politics of care developed by BLM organizers through movement building and healing, and the proliferation of mutual-aid infrastructures to meet needs and distribute resources (...) in the face of overwhelming crisis and neglect—these examples and so many others illustrate with undeniable clarity that radical care is finally on the agenda. In what follows, I hope to contribute to this urgent conversation by pointing to how care is shaped in fundamentally contradictory ways under conditions of entrenched structural violence, and the limitations of normative frameworks when confronting this reality. To unambiguously valorize care in ethical and political life is to risk occluding the constitutive violence of existing social structures and norms, its impact on the intimacies of caring relations, and ultimately the ways that communities mobilize alternate economies and practices of care towards healing and social change. While it is crucial to value care and work for a more caring society, I claim that efforts to transform patterns of relational harm and develop new sensibilities should also be highlighted as integral components of radical caring praxis. (shrink)

In July 1993, the Scottish Highlands Centre for Human Caring sponsored a conference with the title Exploring the Spirituality in Caring. The papers given at the conference and included in this volume are offered as a contribution to the debate that must take place in nursing and in the wider context of health care provision. Ann Bradshaw's paper puts the debate in context arguing that nursing is fundamentally a loving response to the human being created in the image of (...) God. (shrink)