One report after another from McNair (1944) to Warnock (1978) has recommended that there should b... more One report after another from McNair (1944) to Warnock (1978) has recommended that there should be clear lines of communication between the professions of teacher and social worker. Nevertheless, liaison remains problematic. In spite of the fact that children and ...
The category 'consumer' has developed through historical conditions to the point that it now feat... more The category 'consumer' has developed through historical conditions to the point that it now features prominently not only within the sphere of private market relations but within wider areas of public life, from health, education, welfare, to law and politics. While the literature using this concept is well established, the 'health consumer' construct has provoked intense and conflicting responses. In contrast to the claim that modern patients act in the manner expected of market consumers (Haug and Lavin 1983; Sawyer et al. 1994) theorists such as Lash and Urry (1994: 207-10) draw attention to the practical, structural and ideological differences that differentiate public sector organizations from the private sector-differences which are said to make it logically impossible for patients to conduct themselves as consumers. This argument has found some support at the everyday level of social and political experience. In a study on the conduct of patients attending an Australian general practice, Peter Lloyd (1991) and his associates found that traditional consumer behaviour has neither solidified into a set of routine social practices nor been established as a new mode of reasoning. In the concrete world of living actors, it appears that people continue to think and act in a manner consonant with traditional models of patienthood. Thus, the concept is dismissed in some quarters because it fails to describe accurately the actual behaviour of patients in the concrete setting of the hospital, the clinic or the general practitioner's surgery. But to fix 'the consumer' merely in terms of a set of behaviourial traits against which actual behaviour can be assessed, reduces this complex term to a one-dimensional concept. Consumer discourse does not simply convey social experience, it plays a part in constituting social subjects, and relations between subjects. McKnight (1986) and Grace (1991) allude to this when they argue that the consumer imaginary 1 has been engineered through professional discourse and narrative, and then strategically deployed in a 'top down' fashion by the medical profession in an attempt to defuse grassroots resistance to medical power and authority. Following McKnight and Grace I propose to 'read' 'the consumer' as a historical product of social
Collections of human tissue removed from patients in the course of medical diagnosis or therapy a... more Collections of human tissue removed from patients in the course of medical diagnosis or therapy are believed to be an increasingly important resource for medical research (biobank research). As a result of a number of tissue-related "scandals" and increasing concern about ownership and privacy, the requirements to obtain consent from tissue donors are becoming increasingly stringent. The authors' data show that members of the general public perceive academic biobank researchers and their institutions to be highly trustworthy and do not see the need for recurrent, project-specific consent. They argue, on the basis of their empirical findings, that we should question the trend, at least in some settings, toward ever more stringent consent requirements for the use of tissue in research. They argue that this approach, while perhaps counterintuitive in the current regulatory environment, can be both ethically and legally sound so long as channels of communication are mainta...
Contemporary medical practice brings a diverse range of professions and disciplines together in g... more Contemporary medical practice brings a diverse range of professions and disciplines together in greater and closer contact. This situation of increasing complexity and changing professional roles gives rise to multifaceted ethical dilemmas and theoretical and practical concerns. In this essay we argue that for multidisciplinary relationships to be facilitated and to progress towards interdisciplinary teamwork, moral agents have to go beyond orthodox ethical systems and appeal to normative theory. We will argue that conceptualising ethics as a shared social practice may provide a useful starting point. This dialogic approach places greater emphasis on open deliberation and the articulation, negotiation, exploration and generation of new ethical perspectives in the here and now of clinical practice.
■ "Culture" can be understood as the way in which people make sense of the world by deploying sha... more ■ "Culture" can be understood as the way in which people make sense of the world by deploying shared meanings, attitudes, assumptions and values.
This is a pre-copyedited, author-produced PDF of an article accepted for publication in Transgeni... more This is a pre-copyedited, author-produced PDF of an article accepted for publication in Transgenic Research following peer review. The definitive publisher-authenticated version [Degeling C, Irvine R, Kerridge I. Faith-based Perspectives on the use of Chimeric organisms for medical research.
Maintaining the attention to bodily difference human and animal ontology has long been constructe... more Maintaining the attention to bodily difference human and animal ontology has long been constructed on rigid physical characterizations seemingly untouched by culture. In "Reframing the Ethical Issues in Part-Human Animal Research," Haber and Benham (2012) call into question most of the formal elements of essentialism that an earlier mode of thought took for granted. Two views on the nature of human and interspecies animal bodies are in contention here. The first offers an argument grounded in the essential developmental properties of human and animal material and biological systems such that giving life to "animals with human derived material," exemplified by animal-human hybrids and chimeras, effaces physical distinctions between animal and human. Dualism is invoked as an interpretive aid, structuring thought and shaping understanding. Against nonhuman animals, human life, in all its stages and forms, uniquely requires some fundamental form of moral consideration. Because of this presumptive obligation, an "inexorable moral confusion" is an inevitable byproduct of scientific change, since fixed constructions of animal and human bodies as unified and separate wholes are lost in any clear-cut sense (Robert and Baylis 2003).
There is considerable talk in bioethics these days about the political condition of the disciplin... more There is considerable talk in bioethics these days about the political condition of the discipline particularly the idea that 'politicization'has become a problem (Brown 2009 3. Brown, M. 2009. Three ways to politicize bioethics. American Journal of Bioethics, 9 (2): ...
Little is known about why patients with cancer do or do not donate their biopsied/cancerous tissu... more Little is known about why patients with cancer do or do not donate their biopsied/cancerous tissue to research. A review of the literature on motivations to participate in clinical research and to donate tissues/organs for therapeutic use may provide some insights relevant to tumour banking research. While more research is necessary, a better understanding of the factors that motivate patients to give or refuse consent to tumour banking may ultimately improve consent practices, public trust and donation rates.
From the MIT Press's ÔBasic Bioethics' series, Jonathan Boran has written an analysis of bioethic... more From the MIT Press's ÔBasic Bioethics' series, Jonathan Boran has written an analysis of bioethical reasoning and decision-making. Ignore the title: it doesn't reveal the intellectual foundation of the book. Against Bioethics is not a full-scale assault on contemporary bioethics. Rather, this book was prompted by Baron's misgivings about bioethical reasoning and what he takes to be a more pervasive problem: how we distinguish good outcomes from the bad. Baron has two main goals: he is eager to remove, from the heart of bioethics, fixed deontological rules and principles that prescribe or proscribe what constitutes legitimate reason. According to him, the investigation and resolution of bioethical issues and moral dilemmas should be a ratiocinative process, not a crusade. At the most general level, Baron emphasises conscious deliberation above convention when it comes to deciding between moral options. The book is about outcomes rather than principles, and technique rather than abstract philosophical theory. In addition, he seeks to construct and advance a single unified theory of bioethical reasoning that does the work of prescription. Against Bioethics is deeply indebted to applied utilitarianism, particularly the work of Richard Hare, and decision analysis. As many readers may be aware, decision analysis is a set of prescriptive quantitative methods based on utility theory that is deployed in order to determine the good, thought by many to be more a practical strategy than a philosophical approach. Decision analysis assigns utility to the benefits, outcomes or consequences of options while downplaying the importance of the moral act: ''Decision theory compares options to other real options. Ethics seems to
is perhaps best known to readers as a scholarpractitioner with an avowed commitment to humanist m... more is perhaps best known to readers as a scholarpractitioner with an avowed commitment to humanist medicine. This work follows on from an earlier volume, Confessions of a Medical Man (1999), which was primarily concerned with metaphysical questions. His latest book contributes to an ongoing interrogation of the nature of ethics in medical practice and suggests new lines of thought and inquiry. The book begins with a brief overview of the doctor-patient relationship as it has unfolded historically under a variety of social, political, and economic conditions. In response to the question, ÔWhat is wrong with modern medicine?' Tauber argues that the most pressing problem is the instantiation of a different moral tone than has traditionally governed medical practice: at the bedside and in the clinic, disillusionment and mistrust have become dominant dispositions that cut into patients and practitioners everywhere. The sources of breakdown in the doctor-patient relationship that are cited are very familiar: Tauber's account of medical practice concerns a healthcare system dominated by commodification, corporatisation, and the market. Modern healthcare institutions have been remade to resemble ''something like a glorified buttons factory'' (p. 3) and are no longer ethical, he declares. The broad malaise that has overtaken social relations and moral life has deepened for other reasons. There is a good deal of discussion about medicine's failure to acknowledge and understand the patient's lived social and psychological experiences of illness. Nor is medicine admired for its grasp of the way patients make medical decisions. Prominent among the philosophical themes in the history
The ethical arguments which underpin the call for interdisciplinary collaboration are analysed. I... more The ethical arguments which underpin the call for interdisciplinary collaboration are analysed. In particular, the concept of 'teamwork' is considered as well as the organisational, professional, personal and cultural obstacles that constitute the barriers to the effective development of interdisciplinary relationships.
One report after another from McNair (1944) to Warnock (1978) has recommended that there should b... more One report after another from McNair (1944) to Warnock (1978) has recommended that there should be clear lines of communication between the professions of teacher and social worker. Nevertheless, liaison remains problematic. In spite of the fact that children and ...
The category 'consumer' has developed through historical conditions to the point that it now feat... more The category 'consumer' has developed through historical conditions to the point that it now features prominently not only within the sphere of private market relations but within wider areas of public life, from health, education, welfare, to law and politics. While the literature using this concept is well established, the 'health consumer' construct has provoked intense and conflicting responses. In contrast to the claim that modern patients act in the manner expected of market consumers (Haug and Lavin 1983; Sawyer et al. 1994) theorists such as Lash and Urry (1994: 207-10) draw attention to the practical, structural and ideological differences that differentiate public sector organizations from the private sector-differences which are said to make it logically impossible for patients to conduct themselves as consumers. This argument has found some support at the everyday level of social and political experience. In a study on the conduct of patients attending an Australian general practice, Peter Lloyd (1991) and his associates found that traditional consumer behaviour has neither solidified into a set of routine social practices nor been established as a new mode of reasoning. In the concrete world of living actors, it appears that people continue to think and act in a manner consonant with traditional models of patienthood. Thus, the concept is dismissed in some quarters because it fails to describe accurately the actual behaviour of patients in the concrete setting of the hospital, the clinic or the general practitioner's surgery. But to fix 'the consumer' merely in terms of a set of behaviourial traits against which actual behaviour can be assessed, reduces this complex term to a one-dimensional concept. Consumer discourse does not simply convey social experience, it plays a part in constituting social subjects, and relations between subjects. McKnight (1986) and Grace (1991) allude to this when they argue that the consumer imaginary 1 has been engineered through professional discourse and narrative, and then strategically deployed in a 'top down' fashion by the medical profession in an attempt to defuse grassroots resistance to medical power and authority. Following McKnight and Grace I propose to 'read' 'the consumer' as a historical product of social
Collections of human tissue removed from patients in the course of medical diagnosis or therapy a... more Collections of human tissue removed from patients in the course of medical diagnosis or therapy are believed to be an increasingly important resource for medical research (biobank research). As a result of a number of tissue-related "scandals" and increasing concern about ownership and privacy, the requirements to obtain consent from tissue donors are becoming increasingly stringent. The authors' data show that members of the general public perceive academic biobank researchers and their institutions to be highly trustworthy and do not see the need for recurrent, project-specific consent. They argue, on the basis of their empirical findings, that we should question the trend, at least in some settings, toward ever more stringent consent requirements for the use of tissue in research. They argue that this approach, while perhaps counterintuitive in the current regulatory environment, can be both ethically and legally sound so long as channels of communication are mainta...
Contemporary medical practice brings a diverse range of professions and disciplines together in g... more Contemporary medical practice brings a diverse range of professions and disciplines together in greater and closer contact. This situation of increasing complexity and changing professional roles gives rise to multifaceted ethical dilemmas and theoretical and practical concerns. In this essay we argue that for multidisciplinary relationships to be facilitated and to progress towards interdisciplinary teamwork, moral agents have to go beyond orthodox ethical systems and appeal to normative theory. We will argue that conceptualising ethics as a shared social practice may provide a useful starting point. This dialogic approach places greater emphasis on open deliberation and the articulation, negotiation, exploration and generation of new ethical perspectives in the here and now of clinical practice.
■ "Culture" can be understood as the way in which people make sense of the world by deploying sha... more ■ "Culture" can be understood as the way in which people make sense of the world by deploying shared meanings, attitudes, assumptions and values.
This is a pre-copyedited, author-produced PDF of an article accepted for publication in Transgeni... more This is a pre-copyedited, author-produced PDF of an article accepted for publication in Transgenic Research following peer review. The definitive publisher-authenticated version [Degeling C, Irvine R, Kerridge I. Faith-based Perspectives on the use of Chimeric organisms for medical research.
Maintaining the attention to bodily difference human and animal ontology has long been constructe... more Maintaining the attention to bodily difference human and animal ontology has long been constructed on rigid physical characterizations seemingly untouched by culture. In "Reframing the Ethical Issues in Part-Human Animal Research," Haber and Benham (2012) call into question most of the formal elements of essentialism that an earlier mode of thought took for granted. Two views on the nature of human and interspecies animal bodies are in contention here. The first offers an argument grounded in the essential developmental properties of human and animal material and biological systems such that giving life to "animals with human derived material," exemplified by animal-human hybrids and chimeras, effaces physical distinctions between animal and human. Dualism is invoked as an interpretive aid, structuring thought and shaping understanding. Against nonhuman animals, human life, in all its stages and forms, uniquely requires some fundamental form of moral consideration. Because of this presumptive obligation, an "inexorable moral confusion" is an inevitable byproduct of scientific change, since fixed constructions of animal and human bodies as unified and separate wholes are lost in any clear-cut sense (Robert and Baylis 2003).
There is considerable talk in bioethics these days about the political condition of the disciplin... more There is considerable talk in bioethics these days about the political condition of the discipline particularly the idea that 'politicization'has become a problem (Brown 2009 3. Brown, M. 2009. Three ways to politicize bioethics. American Journal of Bioethics, 9 (2): ...
Little is known about why patients with cancer do or do not donate their biopsied/cancerous tissu... more Little is known about why patients with cancer do or do not donate their biopsied/cancerous tissue to research. A review of the literature on motivations to participate in clinical research and to donate tissues/organs for therapeutic use may provide some insights relevant to tumour banking research. While more research is necessary, a better understanding of the factors that motivate patients to give or refuse consent to tumour banking may ultimately improve consent practices, public trust and donation rates.
From the MIT Press's ÔBasic Bioethics' series, Jonathan Boran has written an analysis of bioethic... more From the MIT Press's ÔBasic Bioethics' series, Jonathan Boran has written an analysis of bioethical reasoning and decision-making. Ignore the title: it doesn't reveal the intellectual foundation of the book. Against Bioethics is not a full-scale assault on contemporary bioethics. Rather, this book was prompted by Baron's misgivings about bioethical reasoning and what he takes to be a more pervasive problem: how we distinguish good outcomes from the bad. Baron has two main goals: he is eager to remove, from the heart of bioethics, fixed deontological rules and principles that prescribe or proscribe what constitutes legitimate reason. According to him, the investigation and resolution of bioethical issues and moral dilemmas should be a ratiocinative process, not a crusade. At the most general level, Baron emphasises conscious deliberation above convention when it comes to deciding between moral options. The book is about outcomes rather than principles, and technique rather than abstract philosophical theory. In addition, he seeks to construct and advance a single unified theory of bioethical reasoning that does the work of prescription. Against Bioethics is deeply indebted to applied utilitarianism, particularly the work of Richard Hare, and decision analysis. As many readers may be aware, decision analysis is a set of prescriptive quantitative methods based on utility theory that is deployed in order to determine the good, thought by many to be more a practical strategy than a philosophical approach. Decision analysis assigns utility to the benefits, outcomes or consequences of options while downplaying the importance of the moral act: ''Decision theory compares options to other real options. Ethics seems to
is perhaps best known to readers as a scholarpractitioner with an avowed commitment to humanist m... more is perhaps best known to readers as a scholarpractitioner with an avowed commitment to humanist medicine. This work follows on from an earlier volume, Confessions of a Medical Man (1999), which was primarily concerned with metaphysical questions. His latest book contributes to an ongoing interrogation of the nature of ethics in medical practice and suggests new lines of thought and inquiry. The book begins with a brief overview of the doctor-patient relationship as it has unfolded historically under a variety of social, political, and economic conditions. In response to the question, ÔWhat is wrong with modern medicine?' Tauber argues that the most pressing problem is the instantiation of a different moral tone than has traditionally governed medical practice: at the bedside and in the clinic, disillusionment and mistrust have become dominant dispositions that cut into patients and practitioners everywhere. The sources of breakdown in the doctor-patient relationship that are cited are very familiar: Tauber's account of medical practice concerns a healthcare system dominated by commodification, corporatisation, and the market. Modern healthcare institutions have been remade to resemble ''something like a glorified buttons factory'' (p. 3) and are no longer ethical, he declares. The broad malaise that has overtaken social relations and moral life has deepened for other reasons. There is a good deal of discussion about medicine's failure to acknowledge and understand the patient's lived social and psychological experiences of illness. Nor is medicine admired for its grasp of the way patients make medical decisions. Prominent among the philosophical themes in the history
The ethical arguments which underpin the call for interdisciplinary collaboration are analysed. I... more The ethical arguments which underpin the call for interdisciplinary collaboration are analysed. In particular, the concept of 'teamwork' is considered as well as the organisational, professional, personal and cultural obstacles that constitute the barriers to the effective development of interdisciplinary relationships.
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