In contrast to theoretical discussions about potential professional liability of clinical ethicists, this report gives the results of empirical data gathered in a national survey of clinical medical ethicists. The report assesses the types of activities of clinical ethicists, the extent and types of their professional liability coverage, and the influence that concerns about legal liability has on how they function as clinical ethicists. In addition demographic data on age, sex, educational background, etc. are reported. The results show that while (...) nearly one third (28.9%) of the ethicists regularly make recommendations about patient care, only 10.8% of them regularly make entries in the medical record; only approximately half (53.0%) of them are covered by professional liability (malpractice) insurance; and the vast majority (84.3%) of them say that concerns about legal liability do not influence the way they function as clinical ethicists. (shrink)

This paper presents an empirical analysis of the determinants of quantity of health insurance in the context of employer-based health insurance using the micro-level data from the 1987 National Medical Expenditure Survey (NMES). It extends the previous research by including additional factors in the analysis, which significantly affect health insurance offers by employers. This paper emphasizes two determinants of employers’ insurance offer decisions that are particularly relevant: union membership and selfinsured versus not self-insured health plans. (...) The conducted empirical analysis reported in this paper reveals the following predictors of higher health insurance coverage: union membership, not self-insured health plan(s), union membership in Midwest or South, as well as self-insured union membership. Further, other factors such as: age, male, income, for profit and other employer organizational forms, and firm’s size determine a higher level of health insurance. (shrink)

I will focus on Dworkin’s use of idealisation in his “Prudent Insurance” Ideal for healthcare. Dworkin identifies problems with the circumstances under which people make their insurance decisions in the current United States healthcare system and he sees these as being the cause of strange resource allocation outcomes. He therefore imagines idealising away these prima facie unjust circumstances to develop a hypothetical market in which people are able to make better decisions (Section “Idealisation of Circumstance”). I will identify (...) two further idealisations that Dworkin relies on in his theory. The first is to idealise people to be perfectly prudent (Section “Idealisation of Prudence”), which I consider to be justifiable, but difficult to actually apply in practise. The second is to idealise people to be perfectly self-interested (Section “Idealisation to Self-interest”). I do not see this as a justifiable idealization since it ignores principles of altruism and citizenship, which would seem to be deeply relevant to a theory of justice. (shrink)

The paper takes a look at insurance customer dishonesty as a special case of consumer ethics, understood as a way of situation handling, as a moral choice between right and wrong, such as between self-interest vs. common-interest, in other words, a “moral temptation”. After briefly raising the question if different schools, of moral philosophy would conceptualize such moral temptations differently, the paper presents ‘moral psychology’ as a frame of reference, with a focus on cognitive moral development, moral attitude (...) and moral neutralization. Conceptualization questions can’t be answered finally without thinking at the same time of empirical research design and instrument design decisions, e.g. choosing between experiment vs. questionnaire studies, designing suitable moral temptation situations as an experiment vs. questionnaires with scenario vignettes. The paper discusses then experiences from a 2004 pilot survey, with a main focus on a few insurance dishonesty scenarios with follow-up questions. The paper has an open end, i.e. outlines desirable future theoretical, empirical and practical work with insurance customer dishonesty. (shrink)

As the main sales force of life insurance companies, salespeople have accounted for more than 50% of life insurance sales channels over the years, playing a pivotal role in the development of the industry. Since the adoption of the model of employment at an agency, the commission income of life insurance salespeople has largely relied on their sales volume, which requires employee proactivity under a great number of stressors. However, because previous studies have analyzed stressors in a (...) single dimension, our understanding of the relationship between work stressors and proactive behaviors remains limited. Applying self-determination theory, we investigated differential relationships between challenge/hindrance stressors and proactive behaviors, which were expected to be mediated by passion and moderated by servant leadership. In the sample of 332 insurance salespeople, there was a positive relationship between challenge stressors and proactive behaviors. In addition, passion mediated the relationship between stressors and proactive behaviors, and servant leadership moderated the relationship between stressors and passion. Theoretical and practical implications are discussed. (shrink)

Practice guidelines are an increasingly relevant feature of health insurance. One hundred and seventy-eight million people in the United States have some form of private health insurance coverage; coverage for 150 million of them is employment-related. Traditionally, this coverage was provided by employers purchasing a group contract under which an insurance carrier provided indemnity coverage for employees—that is, the insurance company paid all usual, customary, and reasonable charges incurred by an employee for medical care, subject in (...) some cases to an annual deductible and to a percentage of covered expenses, co-paid by the employee, for each service. In recent years, however, employers in greater numbers have switched to so-called self-insurance plans in which employees’ health care claims are paid directly by the employer. (shrink)

Practice guidelines are an increasingly relevant feature of health insurance. One hundred and seventy-eight million people in the United States have some form of private health insurance coverage; coverage for 150 million of them is employment-related. Traditionally, this coverage was provided by employers purchasing a group contract under which an insurance carrier provided indemnity coverage for employees—that is, the insurance company paid all usual, customary, and reasonable charges incurred by an employee for medical care, subject in (...) some cases to an annual deductible and to a percentage of covered expenses, co-paid by the employee, for each service. In recent years, however, employers in greater numbers have switched to so-called self-insurance plans in which employees’ health care claims are paid directly by the employer. (shrink)

Public healthcare systems are increasingly refusing (temporarily) to reimburse newly approved medical treatments of insufficient or uncertain cost-effectiveness. As both patient demand for these treatments and their list prices increase, a market might arise for voluntary additional health insurance (VHI) that covers effective but (very) expensive medical treatments. In this paper, we evaluate such potential future practices of VHI in public healthcare systems from a justice perspective. We find that direct (telic) egalitarian objections to unequal access to expensive treatments (...) based on different ability to afford VHI do not stand up to scrutiny. However, such unequal access might lead to loss of self-respect among individuals, or loss of fraternity within society, rendering it more difficult for citizens to interact on equal moral footing. This would be problematic from a relational egalitarian perspective. Moreover, the introduction of VHI might turn out to have negative consequences for the comprehensiveness and/or the quality of the public healthcare services that are offered to all patients equally through basic health insurance. These consequences must be weighed against potential health gains and the value of liberty. We conclude that governments should be careful when considering the introduction of VHI in public healthcare systems. (shrink)

This paper explores the consequences of the oft ignored fact that public health insurance must actually be supplied by the state. Depending how the state is modeled, different health insurance outcomes are expected. The benevolent model of the state does not account for many actual features of public health insurance systems. One alternative is to use a standard public choice model, where state action is determined by interaction between self-interested actors. Another alternative—related to a strand in (...) public choice theory—is to model the state as Leviathan. Interestingly, some proponents of public health insurance use an implicit Leviathan model, but not consistently. The Leviathan model of the state explains many features of public health insurance: its uncontrolled growth, its tendency toward monopoly, its capacity to buy trust and loyalty from the common people, its surveillance ability, its controlling nature, and even the persistence of its inefficiencies and waiting lines. (shrink)

The great numbers of service industrial is moving in insurance field have made insurance salespeople’s job more difficult and full challenge. This condition makes that insurance salespeople ought to have self efficacy. Self efficacy is a confidance about self capability to run his job with success, also to control the conditions around for attaining the success. Self efficacy can be influenced by perception of transformational leadership style from direct superior. The subject of this (...) research is 102 insurance salespeople in a private life insurance company. Data gathering by questionnaires and analized by product moment correlation, and regression analysis to analized the dimensions. The result have proven that the hypothesis in this research is accepted, that there is a very significant positive relationship between perception of transformational leadership style from direct superior to insurance salespeople’s self efficacy (r = 0,473; p (two tailed) = 0,000 and p (one tailed) = 0,000). The relationship between each dimension in perception of transformational leadership style from direct superior to self efficacy is discussed in this research.  . (shrink)

Recent philosophical discussions of self-knowledge have focused on basic cases: our knowledge of our own thoughts, beliefs, sensations, experiences, preferences, and intentions. Empiricists argue that we acquire this sort of self-knowledge through inner perception; rationalists assign basic self-knowledge an even more secure source in reason and conceptual understanding. I try to split the difference. Although our knowledge of our own beliefs and thoughts is conceptually insured, our knowledge of our experiences is relevantly like our perceptual knowledge of (...) the external world. (shrink)

Philosophers have given sustained attention to the controversial possibility of (legal) markets in transplantable human organs. Most of this discussion has focused on whether such markets would enhance or diminish autonomy, understood in either the personal sense or the Kantian moral sense. What this discussion has lacked is any consideration of the relationship between self-ownership and such markets. This paper examines the implications of the most prominent and defensible conception of self-ownership--control self-ownership (CSO)--for both market and nonmarket (...) organ-allocation mechanisms. The paper contends that CSO rules out a large set of nonmarket mechanisms, including escheatage ("presumed consent"), compensated takings of organs, and restricted gifting. It also argues that CSO, if accompanied by an economistic concern for welfare, can underwrite varying types of markets in human organs, ranging from mutual-insurance pools to inter vivos (i.e., live donor) organ sales. (shrink)

Digital transformation has allowed to offer additional services - which complement the main product - both in terms of use, emotional and relationship terms. Focused on a traditionally rational insurance customer offering a value that explores the customer's emotions, from co-creating with the user, allows brand differentiation. Given this idea, this document has three purposes. First, identify the role of expectations and the perceived quality of the customer's digital experience. Secondly, to identify the relationship between experience and satisfaction gained (...) in private insurance web areas. Third, identify the most valued digital attributes by the user. A sample of 4,178 customers registered was analyzed using the partial least squares technique. The model is highly predictive to customer experience and evidence the important relationship between the WOW effect and satisfaction, as well as the weak but doble role that expectations play on insurance digital self-service. The model demonstrates that expectations are only relevant before web consumption, because during the process it is the perceived digital quality, in particular the usefulness, information and technology, that offer a true customer experience. This article offers high academic value because it more accurately defines the determinants of the digital insurance customer experience and its effect on customer satisfaction in digital services. While expectations influence attitude before service, this research reveals that perceived digital quality is what delivers a true customer experience. Strategically, the implications are immediate in the field of business as it shows the importance of co-creation in digital design, not only because of the significant savings in implementation costs but also because it guarantees a greater experience, essential in the loyalty of its customers. This ensures the sustainable growth of the company. (shrink)

One would hardly be a human being if the good of others, or of society at large, could not weigh with one as a cogent reason for doing what will promote goodness. So one has not fully learned about living like a rational and moral being unless one has learned to appreciate that one ought to do things out of regard for others, and not only out of regard for oneself. In the first place, not everything done for oneself is (...) done for reasons of prudence. That one ought to insure one's house, save for one's old age, not put all one's money into one venture, are precepts of prudence. But it is not a precept of prudence, though it may be a good precept that someone ought to undergo a dangerous operation as a long shot to restoring his health rather than linger under a disability forever after. (shrink)

BackgroundThe use of genetic test results in risk-rated insurance is a significant concern internationally, with many countries banning or restricting the use of genetic test results in underwriting. In Australia, life insurers’ use of genetic test results is legal and self-regulated by the insurance industry (Financial Services Council (FSC)). In 2018, an Australian Parliamentary Inquiry recommended that insurers’ use of genetic test results in underwriting should be prohibited. In 2019, the FSC introduced an industry self-regulated moratorium (...) on the use of genetic test results. In the absence of government oversight, it is critical that the impact, effectiveness and appropriateness of the moratorium is monitored. Here we describe the protocol of our government-funded research project, which will serve that critical function between 2020 and 2023.MethodsA realist evaluation framework was developed for the project, using a context-mechanism-outcome (CMO) approach, to systematically assess the impact of the moratorium for a range of stakeholders. Outcomes which need to be achieved for the moratorium to accomplish its intended aims were identified, and specific data collection measures methods were developed to gather the evidence from relevant stakeholder groups (consumers, health professionals, financial industry and genetic research community) to determine if aims are achieved. Results from each arm of the study will be analysed and published in peer-reviewed journals as they become available.DiscussionThe A-GLIMMER project will provide essential monitoring of the impact and effectiveness of the self-regulated insurance moratorium. On completion of the study (3 years) a Stakeholder Report will be compiled. The Stakeholder Report will synthesise the evidence gathered in each arm of the study and use the CMO framework to evaluate the extent to which each of the outcomes have been achieved, and make evidence-based recommendations to the Australian federal government, life insurance industry and other stakeholders. (shrink)

Sex work or prostitution marks a controversial topic for Protestant sexual ethics. It is also a multifaceted phenomenon because it can occur in very different forms: the spectrum ranges from poverty, emergency and procurement prostitution to the self-determined and insured sex worker with all imaginable shades in between. In the current economic system, goods and services are exchanged, traded, sold, acquired and paid for, so sex work can also be understood as work. For the purposes of this article, we (...) will therefore start from an understanding of sex work as care work. Care work can be understood as the satisfaction of needs and interests of third parties and the self. If sex work is discussed as care work, this has a variety of consequences. These include the fact that questions of vulnerability and integrity come to the fore. Integrity can be comprehended as self-realisation or autonomy and thus as potentially vulnerable, taking up Axel Honneth’s early reflections on the issue of recognition. Integrity in Axel Honneth’s sense can - according to a first approximation - play a role for sex work on three levels: physical or corporeal level, structural level and lifestyle or way of life level. Finally, the essay discusses the concept of negotiated or consensual morality as a contribution of Protestant ethics. (shrink)

A widely held rights-based view asserts that individuals should be permitted to self-designate characteristics such as race and gender. But some argue that there are opinions that oppose the use only of self-designation, and that these should not be ignored. Kasher and Rubinstein (Logique Anal 160:385–395, 1997) demonstrated that the latter view is equivalent to accepting that one or more of five conditions must be violated. This paper extends their analysis to allow for more than two categories, and (...) focuses on simplifying the conditions without jeopardising their conclusion. In particular, we use significantly weaker conditions of independence and of symmetry than are common in other extensions of the original proposition. (shrink)

The doctor-patient relationship is the foundation of any medical intervention. Over time, the relationship has changed, from the era of paternalism to the era of self-determination or patient autonomy, following changes resulting from consumerism and lately, in South Africa, socialised medicine as a result of the proposed National Health Insurance. The premise of this article is that patient autonomy is invariably limited by a determination of who will carry the cost of a medical intervention. In recent years, legislative (...) developments have affected the understanding of a patient and doctor through the introduction of new references, such as ‘user’, ‘data subject’ and ‘consumer’ for a patient, and ‘service provider’ and ‘responsible party’ for a doctor, each giving different meanings to the doctor-patient relationship. Recent statutory additions also include new remedies available to aggrieved patients as parties in the doctor-patient relationship. The article concludes with brief observations on how the NHI will alter the essence and nature of the doctor-patient relationship in future. (shrink)

Although the most common understanding of suicide is intentional self-killing, this conception either rules out someone who lacks mental capacity being classed as a suicide or, if acting intentionally is meant to include this sort of case, then what it means to act intentionally is so weak that intention is not a necessary condition of suicide. This has implications in health care, and has a further bearing on issues such as assisted suicide and health insurance. In this paper, (...) I argue that intention is not a necessary condition of suicide at all. Rather, I develop a novel approach that deploys the structure of a homicide taxonomy to classify and characterise suicides to arrive at a conceptually robust understanding of suicide. According to my analysis of suicide, an agent is the proximate cause of his death. Suicide is ‘self-killing,’ rather than ‘intentional self-killing.’ Adopting this understanding of suicide performs several functions: We acquire an external standard to assess diverging analyses on specific cases by appealing to homologous homicides. Following such a taxonomy differentiates types of suicides. This approach has application in addressing negative connotations about suicide. As a robust view, adding intention is an unnecessary complication. It is more consistent with psychological and sociological assessments of suicide than ‘intentional self-killing.’ It has useful applications in informing public policy. This paper’s focus is on classifying types of suicides, rather than on the moral permissibility or on underlying causes of suicidal ideation and behaviour. (shrink)

Decisions based on ethics confront nurses daily. In this account, a cardiac nurse struggles with the challenge of securing health care benefits for Justin, a patient within the American system of health care. An exercise therapy that is important for his well-being is denied. The patient’s nurse and an interested insurance agent develop a working relationship, resulting in a relational narrative based on Justin’s care. Gadow’s concept of a relational narrative and Keller’s concept of a relational autonomy guide this (...) particular case. As an ethics framework influenced by feminist ethical theory, Gadow’s, Keller’s and Tisdale’s ideas demonstrate the fluidity with which the nurse and others can work while maintaining both autonomy and engagement without being self-sacrificing. (shrink)

Decisions based on ethics confront nurses daily. In this account, a cardiac nurse struggles with the challenge of securing health care benefits for Justin, a patient within the American system of health care. An exercise therapy that is important for his well-being is denied. The patient’s nurse and an interested insurance agent develop a working relationship, resulting in a relational narrative based on Justin’s care. Gadow’s concept of a relational narrative and Keller’s concept of a relational autonomy guide this (...) particular case. As an ethics framework influenced by feminist ethical theory, Gadow’s, Keller’s and Tisdale’s ideas demonstrate the fluidity with which the nurse and others can work while maintaining both autonomy and engagement without being self-sacrificing. (shrink)

Publication date: 15 October 2018 Source: Author: Ehiosun O. Marvel NHIS was launched officially on 6th of June 2005. The Scheme is designed to provide comprehensive health care at affordable costs, covering employees of the formal sector, self-employed, as well as rural communities, the poor and the vulnerable groups. However, client satisfaction of services rendered continues to be a major concern for the improvement of NHIS. This study is designed to determine the level and causes of dissatisfaction of clients (...) accessing NHIS clinic at the Kubwa General Hospital, Kubwa, FCT, Abuja. This study employed a descriptive cross sectional survey. 279 NHIS enrollees were recruited for this study at the Kubwa General Hospital. Questionnaires were administered and the level of dissatisfaction and satisfaction of NHIS services were analyzed. The satisfaction rate was 69.2% while the dissatisfaction rate was 22.9%. The respondents were satisfied with the attitude of health workers in NHIS clinic, Kubwa. However, they were dissatisfied with waiting time, attitude of record officers and those in pharmacy department. This study found that the level of dissatisfaction with NHIS services is high despite a high satisfaction level. The Attitude of health workers may influence the dissatisfaction of enrollees. NHIS is still limited to the formal sector. (shrink)

William James’s moral and political thought was remarkably well adapted to its historical context, in particular to the emergence in the late nineteenth century of a generalized culture of uncertainty, contingency, and probability that called into question traditional conceptions of sovereign selfhood and autonomous freedom. Facing the solidification of numerous apparatus of chance, James developed a strenuous ethics rooted in a conception of freedom as self-transformation. That this ethics was attuned to the pressing problematics of his day is shown (...) by sideways glances at his contemporaries Edith Wharton, William Dean Howells, Charles Sanders Peirce, Josiah Royce, as well as then-emergent forms of everydayness such as personal health insurance. Such an ethics remains a valuable source of freedom today insofar as we remain bound to chance as an ongoing problematic conditioning our moral possibilities. (shrink)

This study examined the role of individuals’ cognitive flexibility and self-monitoring in shaping their workplace advice network centrality. Drawing on advice network generation theory, we hypothesized a positive relationship between cognitive flexibility and advice network centrality, and a moderation effect of self-monitoring on this relationship. Then, we collected two time-points data from insurance salesmen to test the hypotheses. As predicted, cognitive flexibility was positively associated with advice network centrality. Furthermore, this positive relationship was only significant for low (...) self-monitoring individuals, but not for high self-monitoring individuals. These findings indicated that individuals with high cognitive flexibility were more likely to have central positions in the advice network; however, this effect was attenuated as their self-monitoring increased. (shrink)

Discrete choice experiments (DCE) are often used to elicit preferences, for instance, in health preference research. However, DCEs only provide binary responses, whilst real-life choices are made with varying degrees of conviction. We aimed to verify whether eliciting self-reported convictions on a 0–100 scale adds meaningful information to the binary choice. Eighty three respondents stated their preferences for health states using DCE and the time trade-off method (TTO). In TTO, utility ranges were also elicited to account for preference imprecision. (...) We verified the properties of the conviction across three areas: (1) response to various choice task modifications (e.g. dominance, increase in complexity, distance from the status quo) and association with rationality violations (e.g. intransitivity); (2) association with test–retest results; (3) relation to the utility difference and imprecision estimated in TTO. Regarding (1), conviction increased in choice tasks with lower complexity, larger relative attractiveness, and lower distance to the status quo. Regarding (2), choices made with above-median conviction were sustained in 90% of the cases, compared to 68% for below-median conviction. Regarding (3), the conviction increases with utility difference and it decreases with utility imprecision; overconfidence seems to prevail: non-zero conviction is reported even for identical utilities. Self-reported conviction in DCE is associated in an intuitive way with the observed choices. It may, therefore, be useful in explaining or predicting behaviour or bridging the gap between the results of various elicitation tasks. (shrink)

This study investigates experimentally whether people in retrospective are self-aware that they engage in status-seeking behavior. Subjects participated in a real-effort task where effort translated into a donation to a charity. Within-subjects we varied the visibility of their performance (private/public feedback). On average, subjects exerted more effort in the public treatment. After the real-effort task, subjects were asked to state their retrospective beliefs about their performance in public given feedback about their performance in private, and about the performance of (...) other subjects in public given the average performance in private. Between-subjects, we varied the compensation that participants would receive for providing accurate performance estimates. Our results show a lack of self-awareness about status-seeking behavior that is robust to increased belief compensation. We also found that subjects expected others to be as status-seeking as they are themselves or even less. (shrink)

Hate speech is one of the most important conceptual categories in anti‐oppression politics today; a great deal of energy and political will is devoted to identifying, characterizing, contesting, and penalizing hate speech. However, despite the increasing inclusion of gender identity as a socially salient trait, antipatriarchal politics has largely been absent within this body of scholarship. Figuring out how to properly situate patriarchy‐enforcing speech within the category of hate speech is therefore an important politico‐philosophical project. My aim in this article (...) is twofold: first, I argue that sexist speech, though oppressive, is not hate speech. Second, I argue that misogynistic speech is hate speech, even when it is intradivisional. This is important because recognizing that the concepthate speechapplies to certain forms of patriarchy‐enforcing speech is another step in clarifying what is wrong with the practice, and how bad it is in relation to other abuses. Consequently, this article provides a more nuanced account of the kinds of expressions that can and should count as instances of hate speech. (shrink)

In Rites of Privacy and the Privacy Trade Neill constructs an original theory of natural rights and human dignity to ground our right to privacy, arguing that privacy and autonomy are innate natural properties metaphorically represented on the moral level and socially bestowed. She develops her position by drawing on works in history, sociology, metaphor, law, and the moral psychology of Lawrence Kohlberg. The resulting theory provides surprising answers to controversial and pressing questions regarding, for instance, our right to privacy (...) for medical records in various contexts and in relation to various authority structures, including government. Neill demonstrates that, while we have some entitlement to protection of privacy, entitlement does not have the moral scope suggested by currently entrenched legal and social norms. She cautions against some of the privacy privileges we currently enjoy - referring specifically to claims such as those against insurance companies to prevent access to medical records - and suggests that if they are to be continued, respect for privacy is not the reason. (shrink)

In this article I analyse two complaints of white vilification, which are increasingly occurring in Australia. I argue that, though the complainants (and white people generally) are not harmed by such racialized speech, the complainants in fact harm Australians of colour through these utterances. These complaints can both cause and constitute at least two forms of epistemic injustice (willful hermeneutical ignorance and comparative credibility excess). Further, I argue that the complaints are grounded in a dual misrecognition: the complainants misrecognize themselves (...) in their own privileged racial specificity, and they misrecognize others in their own marginal racial specificity. Such misrecognition preserves the cultural imperialism of Australia’s dominant social imaginary—a means of oppression that perpetuates epistemic insensitivity.Bringing this dual misrecognition to light best captures the indignity that is suffered by the victims of the aforementioned epistemic injustices. I argue that it is only when we truly recognize difference in its own terms, shifting the dominant social imaginary, that “mainstream Australians”can do their part in bringing about a just society. (shrink)

This book provides a philosophical examination of the extent to which legalizing same-sex marriage can contribute to ending the discrimination and social stigma faced by LGBT men and women in the Western world.

ABSTRACT In this commentary I evaluate what McGowan’s project would conclude with respect to the treatment of professional Australian Football League player Adam Goodes, who was incessantly ‘booed’ by crowds for the final two years of his career. Analysing Goodes’ case in light of McGowan’s argument leads me to two observations. First, McGowan’s norm-enactment approach is incredibly useful because it explains how words like ‘boo’ (with unstable meaning) can constitute actionable discrimination. Second, however, I wonder if a narrow focus on (...) whether such speech is legally actionable might encourage an overestimation of the power of laws to shepherd new g-norms into social practices. (shrink)

This book aims to understand why women are the targets of online hate speech and how we can stop this from occurring.

This article identifies five genres of anti-queer hate speech found in The Australian’s Facebook comments sections, exposing and analyzing the ways in which such comments are used to derogate cisgender and heterosexual women. One may be tempted to think of cis-het women as third-party victims of queerphobia; however, this article argues that these genres of anti-queer speech are, in fact, misogynistic. Specifically, it argues that these are instances of cis-hetero-misogynistic hate speech. Cis-hetero-misogyny functions as the “law enforcement branch” of a (...) cis-hetero-patriarchal gender order. Given the existence of such an order, it is clear that cis-het women’s liberation is inextricable from queer liberation. This article argues that to facilitate allyship and challenge this gender order—the order that elicits such hate speech acts—we need an epistemological revolution in the way we recognize and re-cognize human difference. (shrink)

Background The fourth section of the 1967 Abortion Act states that individuals (including health care practitioners) do not have to participate in an abortion if they have a conscientious objection. A conscientious objection is a refusal to participate in abortion on the grounds of conscience. This may be informed by religious, moral, philosophical, ethical, or personal beliefs. Currently, there is very little investigation into the impact of conscientious objection on service users in Britain. The perspectives of service users are imperative (...) in understanding the real-world consequences and potential impact of conscientious objection and should be considered when creating and reviewing policies and guidelines. This research provided a platform for women and those who can become pregnant to share their experiences and opinions at a time when these voices are largely excluded in the great tradition of Western political philosophy and law-making processes. Method Five service users were interviewed using a narrative interview approach to uncover their abortion journeys and experiences of conscientious objection. Findings The findings were presented as found poems and uncovered that doctors are not always: informing service users that they have a conscientious objection to abortion, giving service users enough information to access abortion (indirect referral), treating them non-judgmentally, and providing medically correct information. Service users did not experience burdens such as long waiting times and were still able to access legal abortion. However, service users did experience negative emotional effects, as they were often left feeling scared, angry, and hopeless when they were not referred and/or were mistreated. Conclusions Findings indicate that conscientious objection could work in practice. However, it is currently failing some individuals on an emotional level, as not all doctors are adhering to guidelines. Conscientious objection in Britain needs to be addressed, to ensure service users receive fair, impartial, non-judgmental care. (shrink)

The past two decades have been a time of heightened interest in the moral aspects of the practice of medicine. This interest has been reflected in medical education by the establishment of medical humanities programs in both preclinical and clinical education in many medical schools. It has also been reflected in the literature with a dramatic increase in journal articles on medical ethics as well as the development of medical ethics in textbooks. A number of journals have developed that are (...) specifically devoted to medical ethics, including The Journal of Medical Ethics, The Journal of Medicine and Philosophy, The Journal of Medical Humanities, Theoretical Medicine, Cambridge Quarterly of Healthcare Ethics, just to name a few. The literature includes both theoretical foundations and conceptual analyses of particular issues as well as practical advice and general suggestions for how to implement programs in medical humanities. (shrink)

The prominent call to legalise same-sex marriage in Australia raises questions concerning whether its achievement will result in amplified societal acceptance of lesbian, gay, bisexual, and transgender (LGBT) people, and on what grounds this acceptance will take place. Same-sex marriage may not challenge heteronormative and patriarchal features typically associated with marriage, and may serve to reinforce a hierarchy that promotes traditional marriage as the ideal relationship structure. This may result in only assimilationist acceptance of LGBT people. However, the consequence of (...) inclusion to marriage ought to reflect social acceptance of LGBTs as people worthy of equal treatment in dignity and in rights, regardless of perceived differences or similarities to a supposed majority standard. This article argues that justice would be best served by introducing and promoting a variety of State-sanctioned unions whilst simultaneously introducing same-sex marriage. This ‘pluralisation strategy’ would increase awareness and legitimacy of other relationship-recognition options, promoting respectful acceptance of LGBT and heterosexual people alike. (shrink)

In the wake of a pilot study that indicated that the experience of medical education appears to Inhibit moral development In medical students, increased attention needs to be given to the structure of medical education and the Influence it has on medical students. Interest in ethics and moral reasoning has become widespread in many aspects of professional and public life. Society has exhibited great interest in the ethical issues confronting physicians today. Considerable effort has been undertaken to train medical students, (...) interns, and residents In how to reason through medical-ethical dilemmas. Media attention has focused on Issues such as abortion, euthanasia, care of severely handicapped infants, organ transplantation, and so forth, producing heated debates in both the professional and lay literature over the morality of the various positions. The curriculum of medical education has paralleled and reflected this general Interest in medical ethics. Most medical schools now offer, and frequently require, course work in ethics. However, further research Is needed to better characterize and understand the relationship of medical education to moral development. (shrink)

High moral standards and adherence to a moral code have long been strong tenets of the profession of medicine, even though there have been occasional lapses that have led to renewed calls for a revitalization of moral integrity in medicine. Certainly, a moral component has generally been held to be an important aspect of the concept of a physician.

The Norman Rockwell image of the American physician who fixed the broken arm of a child, treated the father for hypertension, and brought an unborn child into this world is now almost nonexistent. Since the time of the Rockwell portrait, a highly technical medical industry has evolved. Now two-thirds of physicians are board certified in subspecialties, and patients visit an average of 3–4 different physicians per year. Today's physicians see themselves less as “benevolent and wise counselors overseeing the patient's welfare (...) and more as objective scientists applying the latest technical methods to bring about the desired end.” The intimate patient-physician relationship that was once the norm in our society is rapidly disappearing. (shrink)

The medical ethicist is a fairly recent addition to the clinical setting. The following four potential roles of the clinical ethicist are identified and discussed: consultant in difficult cases, educator of health care providers, counselor for health care providers and finally patient advocate to protect the interests of patients. While the various roles may sometimes overlap, the roles of educator and counselor are viewed as being more congruent with the education and training of medical ethicists than are the roles of (...) consultant and patient advocate. (shrink)

In recent years, the theoretical work of Gilligan in women's psychological development has led to the development of the concept of moral orientation or moral voice in contrast to the concept of moral reasoning or moral judgment developed by Kohlberg. These concepts have been of particular interest in gender studies, especially as applied to adolescence. These concepts of moral orientation and moral reasoning are being increasingly employed in healthcare ethics studies in a wide variety of settings. The recent work has (...) included studies of physicians, nurses, dentists, veterinarians, social workers, teachers of medical ethics, and hospital ethics committees. However, the study of moral development in healthcare providers has been hampered because collecting the necessary data from healthcare workers has been labor intensive and extremely time consuming. More efficient methods are needed. (shrink)