The availability of willing providers of medical assistance in dying in Canada has been an issue since a Canadian Supreme Court decision and the subsequent passing of federal legislation, Bill C14, decriminalised MAiD in 2016. Following this legislation, Hamilton Health Sciences in Ontario, Canada, created a team to support access to MAiD for patients. This research used a qualitative, mixed methods approach to data collection, obtaining the narratives of providers and supporters of MAiD practice at HHS. This study occurred at (...) the outset of MAiD practice in 2016, and 1 year later, once MAiD practice was established. Our study reveals that professional identity and values, personal identity and values, experience with death and dying, and organisation context are the most significant contributors to conscientious participation for MAiD providers and supporters. The stories of study participants were used to create a model that provides a framework for values clarification around MAiD practice, and can be used to explore beliefs and reasoning around participation in MAiD across the moral spectrum. This research addresses a significant gap in the literature by advancing our understanding of factors that influence participation in taboo clinical practices. It may be applied practically to help promote reflective practice regarding complex and controversial areas of medicine, to improve interprofessional engagement in MAiD practice and promote the conditions necessary to support moral diversity in our institutions. (shrink)

Core indexicals like ‘I’, ‘here’, and ‘now’ sometimes appear to refer to an object, place, or time other than the speaker, location, or time of utterance. This presents well-known problems for Kaplan's view, which treats reference shifting as a violation of the character rules that give the meaning of indexicals. I propose a view according to which indexical reference is essentially a matter of the mutually-accepted perspective of interlocutors. It follows that contexts need not be ‘proper’ in Kaplan's sense, and (...) a successful convergence of perspectives is needed for indexical reference to succeed. I provide reasons for embracing these conclusions. (shrink)

Denunciations of child sexual abuse in the sport context have been increasing in the last decades. Studies estimate that between 14 and 29% of athletes have been victim of at least one form of sexual violence in sport before the age of 18. However, studies suggest that many do not disclose their experience of CSA during childhood. This finding is alarming since studies have shown that the healing process usually starts with disclosure. Moreover, little is known about the healing process (...) of CSA experienced in the sport context. The aim of the study is to present a single case study of a CSA in sport to better understand the global experience over time from the perspective of the athlete. A narrative inquiry approach was adopted. Three non-structured interviews were conducted with the participant. Three pathways in the survivor journey have been identified through inductive thematic analysis: pathway to understanding, pathway to disclosure, and pathway to healing. These pathways represent distinct processes but are intertwined as they are dynamic and iterative. Indeed, the survivor explained how she had been, and is still, going back and forth between them. Results are consistent with those found in the literature on CSA in the general population. It suggests that theoretical models of CSA in the general population could be applied to CSA in sport. Practical implications include a need for education and clearer boundaries in the coach-athlete relationship. Sport stakeholders also need to be better equipped to recognize the signs of sexual violence in sport. Our results indicate that qualitative research could be a potential avenue to help victims heal from CSA. It gives them the chance to talk about and make sense of their abuse in a safe space. Finally, our results demonstrate the importance of reviewing the current justice system for victims. It should be based on a trauma-informed approach that places the victim at the center of the judicial process. (shrink)

In debates about the proper analysis of demonstrative expressions, ostensive gestures and speaker intentions are often seen as competing for primary importance in securing reference. Underlying some of these debates is the mistaken assumption that ostensive gestures always make the demonstrated object maximally salient to interlocutors. When we abandon this assumption and focus on an object’s mutually-recognized salience itself, rather than on how the object came to be salient, we can work towards a more promising analysis with a uniform treatment (...) of demonstrative reference whether or not there is an ostensive gesture, and whether reference is ordinary or deferred. (shrink)

Within the class of indexicals, a distinction is often made between “pure” or “automatic” indexicals on one hand, and demonstratives or “discretionary” indexicals on the other. The idea is supposed to be that certain indexicals refer automatically and invariably to a particular feature of the utterance context: ‘I’ refers to the speaker, ‘now’ to the time of utterance, ‘here’ to the place of utterance, etc. Against this view, I present cases where reference shifts from the speaker, time, or place of (...) utterance to some other object, time, or place. I consider and reject the claim that these counterexamples to the automatic indexical theory all involve non-literal uses of indexicals and argue that they cannot be explained away on the grounds that they involve conversational implicature or pretense. (shrink)

Fashion design is a feminized occupation, but there is a widespread perception that gay male designers are advantaged in receiving awards, publicity, and praise. This article develops the notion of a “glass runway” to explain this inequality. First, using design canons and lists of award recipients, I show that men, especially gay men, receive more consecration than women. Second, I show how men and women are consecrated differently by analyzing the content of 157 entries in Voguepedia’s design canon and 96 (...) fashion media articles. Attributions of value and legitimacy construct a gendered image of the ideal fashion designer through discourses of art and culture that reinforce essentialist ideas about gender difference. Because cultural value is ambiguous, processes of valorization are shaped by gender essentialism, pushing male cultural producers down the glass runway and into the spotlight of fame, consecration, and legitimation. Finally, the case of fashion design offers insights into how intersecting inequalities can shape the glass runway. Gay designers experience both valorization and discrimination from intersections of gender and sexuality. (shrink)

The COVID-19 pandemic introduced significant disruptions and challenges to the learning environment for many post-secondary students with many shifting entirely to remote online learning. Barriers to academic success already experienced in traditional face-to-face classes may be compounded in the online environment and exacerbated by stressors related to the pandemic. In 2020–2021, post-secondary institutions were faced with the reality of rolling out fully online instruction with limited access to resources for assisting students in this transition. Instructional interventions that target students’ ability (...) to self-regulate their learning have been shown to improve academic performance and self-regulated learning competencies have also been found to mediate the effect of SRL interventions on higher education. However, few studies have examined the efficacy of fully online SRL intervention on mitigating the impact of psychological distress and academic challenges on academic success. This study examined the moderating roles of self-regulatory practices and SRL intervention in buffering the influence of COVID-related psychological distress and academic challenges on academic outcomes and academic challenges) in a Canadian sample of undergraduate students. We found levels of metacognitive and motivational challenges fully mediated the impact of COVID distress on GPA, SRL adapting practices moderated the impact of metacognitive challenges on GPA, and semester-long SRL intervention buffered the impact of COVID distress on academic challenges and resulted in lower levels of social-emotional, cognitive, and metacognitive challenges for first year undergraduate students. (shrink)

Criminalizing arson is both easy and hard. On the substantive merits, the conduct of damaging property by fire uncontroversially warrants criminal sanction. Indeed, punishment for such conduct is overdetermined, as the conduct threatens multiple harms of concern to the criminal law: both damage to property and injury to people. Yet the same multiplicity of harms or threats that makes it easy to criminalize arson (in the sense of deciding to proscribe the underlying behavior) also makes it hard to criminalize arson (...) (in the sense of formulating the offense(s) that will address that behavior). This article asks whether adopting one or more arson offenses is the best way for criminal law to address the conduct in question, or whether that conduct is more properly conceptualized, criminalized, and punished as multiple distinct offenses. (shrink)

There is an expectation that all researchers will act ethically and responsibly in the conduct of research involving humans and animals. While research ethics is mentioned in quality indicators and codes of responsible researcher conduct, it appears to have little profile in doctoral assessment. There seems to be an implicit assumption that ethical competence has been achieved by the end of doctoral candidacy and that there is no need for candidates to report on the ethical dimensions of their study nor (...) for examiners to assess this integral aspect of researcher development. In the context of ensuring that institutions are fulfilling their responsibility of producing ethically sensitive and competent researchers, it is salient to investigate whether doctoral thesis examiners make comment about ethical issues in their reports. This study analysed an archive of examiner reports to identify the frequency, magnitude and nature of examiner comment about ethics. Although comment was rare examiners provided: prescriptive instruction on ethical review processes; formative instruction on the design, conduct, and reporting of research projects; and positive or negative judgments about a candidate's ethical competence, the latter often aligned with meeting, or not meeting, 'doctoral standards'. The scarcity of ethics in examination criteria and examiner reports implies a silence that needs to be addressed to ensure graduating candidates are prepared to conduct ethical and responsible research. (shrink)

The number of admissions to hospitals of patients without a proxy decision maker is rising. Very often these patients need fairly immediate medical intervention for which informed consent—or informed refusal—is required. Many have recommended that there be a process in place to make these decisions, and that it include a variety of perspectives. People are particularly wary of relying solely on medical staff to make these decisions. The University Hospitals Case Medical Center recruits community members from its Ethics Committee to (...) serve on a subcommittee, the Patients Without Proxies (PWP) Committee, which works with medical staff during the decision-making process for these patients. Generally, the community members go to the bedside to observe patients. This article looks at how those unused to observing hospitalized patients who are sick and/or dying are affected, comparing them to mock jurors in a research study who are exposed to graphic photographs related to a fabricated crime scene. Judgments made by the mock jurors are affected by viewing such images. The personal experience of witnessing unfamiliar and shocking scenes affects their subsequent judgments. While it may be difficult to tease out whether observing patients causes PWP members to be benefited or harmed, they are affected by what they see. If a variety of perspectives is desirable to reduce possible bias or error, this article argues that at least one community member should refrain from seeing the patient in order to add a different and valuable voice to the decision-making process. Members of the subcommittee base their judgments on the various kinds of information available. Sometimes the things they see, hear, or feel may affect them particularly deeply, and affect their judgments as well. In this article I explore the idea that something like this may be happening in a particular kind of clinical ethics case consultation. (shrink)

Empathy is widely touted as a springboard for social change. Within the academy, ‘identification’ is often used to promote the social value of literary and cultural studies. But to what degree have scholars, in seeking to defend the value of literary and cultural studies, conceived the act of reading in problematic ways? ‘An Ethics of Reading’ argues that adopting a Lacanian paradigm of self (reader) and text (other) to discuss the act of textual interpretation reduces a complex event involving multiple (...) actors to a simple dualism, while ineluctably consigning any act of interpretation to simple projection. Turning instead to psychoanalyst Jean Laplanche’s concept of the enigmatic signifier, this article rethinks the relation between reader and cultural text – reconceiving the act of interpretation by situating it within a dynamic of transference, as opposed to projection. When conceived via this Laplanchian framework, reading becomes not only an effective path to cognition and knowledge, but a radical means of subjective transformation. (shrink)

Between 1992 and 1996, a small number of women in the UK were forced by the courts to undergo caesarean section against their expressed refusal. Analysis of the reported cases reveals the blanket assumption of maternal incompetence and the widespread use of thinly veiled coercion. Such attitudes and practices are themselves frequently compounded by inadequate communication. Medical discretion in such problematic cases seems to err on the side of safety and so appears to favour the life of the fetus over (...) maternal autonomy. Despite current policy’s placement of the pregnant woman at the centre of maternity care, obstetricians’ concerns appear to lie more with the unborn fetus. In other words, there seems to be a point at which the value of fetal life begins to outweigh, not so much the life of the woman, but her right to self-determination, her plans and her choices. While it is important to acknowledge that these court ordered caesareans represent an unusual extreme within contemporary maternity care in this country, that they have happened brings into sharp relief some of the stereotypical assumptions about women. These are assumptions that underlie much of current medical practice and may compromise or disempower women in other ways during their experience of pregnancy and labour. Using the first and last of the six reported cases as contextual illustrations, this article focuses on the complex interplay of processes that have brought the medical profession to a position in which their own self-conviction and determination to do what they believe is best for their patients has resulted in gross denial of women’s autonomy and the use of the law to override pregnant women’s refusal of consent. (shrink)

This essay examines the symbolic significance of blood in the twentieth century and its role in determining the composition of a national community along racial lines. By drawing parallels between Nazi notions of blood and racial purity and historically contemporaneous U.S. policies regarding blood and blood products, Polsky reveals a disturbing proximity in discourse and policy. While the Nazis attempted to locate Jewish racial essence and inferiority in blood and instituted eugenic measures and laws forbidding racial admixture, similar policies existed (...) in the U.S. based on the so-called one drop rule that systematically discriminated against African Americans. (shrink)

In response to Gilbert Meilaender 's innovative interpretation of Augustine and of Roman Catholic teaching, the author suggests that Meilaender attributes to Augustine a more positive view of sexual pleasure than the texts will support, that modern Roman Catholic teaching suggests that love should have priority over procreation as a meaning of sex; and that the moral logic of Meilaender's argument does not require a rejection of all reproductive technologies. Nonetheless, the author agrees that a more critical attitude should be (...) adopted toward the reasons for which technologically assisted reproduction is promoted and undertaken, as well as toward its social impact. (shrink)

In the clinical setting, not enough attention is paid to the role that emotion plays. It is at worst ignored or avoided, isolating those who are suffering, at best treated as something to help another to endure. This is the result, in part, of an impoverished idea that views emotion as mere feelings. However, emotions are not just feelings, they are cognitive. If we look beneath the surface, emotions can provide information about values and beliefs, some of which may be (...) false or unreasonable. When they are motivating decisions that seriously affect the lives of others, there is a moral obligation to ferret them out and correct or deal with them. Attention needs to be paid to the emotions of healthcare providers as well as to the emotions of patients and their loved ones, and more done to train healthcare providers to deal effectively and productively with emotion – their own and others’. A son tearfully requests everything be done for his dying father. He fears limiting treatment means his father will be ignored. A physician orders another course of chemotherapy because she cannot bear for this patient to die. The patient, fearing he will painfully suffocate to death, agrees. Paying attention to emotions and bringing to light the beliefs and values behind them can only enhance the care and consideration of all involved. (shrink)

Roman Catholic social ethics traditionally has affirmed moral objectivity, universal moral goods, and progressive social reform - premises that guide just war theory. In recent decades these guiding values have been challenged by contemporary critical philosophies, confessional or communitarian religious ethics, and the fact of cultural pluralism. I A the middle of this century, thinkers like John Courtney Murray gave Catholic ethics a more historical turn, while retaining an essentially realist and meliorist approach to morality and politics. Now this confidence (...) and optimism are questioned anew by ethnopolitical violence, the ambiguities of humanitar- ian intervention, and uncertain attempts at reconciliation and restoration. Such developments show that the central quandary of Christian and po- litical ethics is not the achievement of agreement on basic human goods ; it is the expansion of the circle of solidarity in which basic goods are shared in practice. I will suggest that Christian symbols can help evoke the sense of human solidarity that is necessary to sustain peace, and that transformative efforts toward peace in violence-torn societies can be successful. (shrink)

Several discourses about theology, church, and politics are occurring among Christian theologians in the United States. One influential strand centers on the communitarian theology of Stanley Hauerwas, who calls on Christians to witness faithfully against liberalism in general and war in particular. Jeffrey Stout, in his widely discussed "Democracy and Tradition" (2004), responds that religious people ought precisely to endorse those democratic and liberal American traditions that join religious and secular counterparts to battle injustice. Hauerwas, Stout, and many of their (...) interlocutors envision liberal U.S. culture as the context of Christian social ethics. The ensuing debate rarely incorporates Catholic scholars, feminist scholars, scholars of color, or international and liberationist voices. Their inclusion could enhance an understanding of the role of the church in society, and support a common morality in the face of global pluralism. More importantly, it could broaden the scope of discourse on religion and politics to envision global Christian social ethics. (shrink)

Pope Francis both grants the right to use armed force in self-defense and regards all war as ‘a defeat for humanity’. This seeming paradox can be explained by the fact that what is a theoretically just use of force (according to the criteria of just war theory) inevitably results in unjust violence when carried out in practice. The undertaking, processes and practices of war are highly susceptible to what Augustine called the libido dominandi. The theory of just war is carried (...) forward in institutions of actual war-making that foster escalation, discourage restraint, and adapt the theory itself to accommodate increasing violence. ‘Just war’ fails to embody the social and institutional virtue of justice. Thus, as Pope Francis exhorts, the Christian ethics of war and peace should prioritize the theory of just peace and the cultivation of peacebuilding dispositions, practices, and institutions. These strategies favor justice, but success is not guaranteed. (shrink)

A definitive theory for ethical decision making in nursing is still only conjecture. The literature confirms that there have been numerous examinations of ethical decision making in nursing, with most proposing either the justice or the care orientation, or a combination of both. In the absence of a definitive theory, this exploratory work sets out, via grounded theory, to shed some light on the methods used every day by nurses to make ethical decisions in the clinical area. The data show (...) that some factors, such as doctors, colleagues and the organization, profoundly influence ethical decision making. The informants used both care and justice to formulate decisions, which is known as the combined approach. As a result of these findings, this article concludes with tentative suggestions and recommendations for practice. (shrink)

Recent years have witnessed a concern among theological bioethicists that secular debate has grown increasingly "thin," and that "thick" religious traditions and their spokespersons have been correspondingly excluded. This essay disputes that analysis. First, religious and theological voices compete for public attention and effectiveness with the equally "thick" cultural traditions of modern science and market capitalism. The distinctive contribution of religion should be to emphasize social justice in access to the benefits of health care, challenging the for-profit global marketing of (...) research and biotechnology to wealthy consumers. Second, religion and theology have been and are still socially effective in sponsoring activism for practical change, both locally and globally. This claim will be supported with specific examples; with familiar concepts like subsidiarity and "mid- dle axioms"; and with recent analyses of "participatory democracy" and of emerging, decentralized forms of global governance. (shrink)

Paulin and Cahill‐Lane explore the origins of event processing and event prediction in animal evolution. They propose that the evolutionary benefit of being able to predict and thus to quickly react to anticipated events may have triggered the evolution of the earliest nervous systems.

Rape, claims Ann J. Cahill, affects not only those women who are raped, but all women who experience their bodies as rapable and adjust their actions and self-images accordingly. Rethinking Rape counters legal and feminist definitions of rape as mere assault and decisively emphasizes the centrality of the body and sexuality in a crime which plays a crucial role in the continuing oppression of women.

Objectification is a foundational concept in feminist theory, used to analyze such disparate social phenomena as sex work, representation of women's bodies, and sexual harassment. However, there has been an increasing trend among scholars of rejecting and re-evaluating the philosophical assumptions which underpin it. In this work, Cahill suggests an abandonment of the notion of objectification, on the basis of its dependence on a Kantian ideal of personhood. Such an ideal fails to recognize sufficiently the role the body plays (...) in personhood, and thus results in an implicit vilification of the body and sexuality. The problem with the phenomena associated with objectification is not that they render women objects, and therefore not-persons, but rather that they construct feminine subjectivity and sexuality as wholly derivative of masculine subjectivity and sexuality. Women, in other words, are not objectified as much as they are derivatized, turned into a mere reflection or projection of the other. Cahill argues for an ethics of materiality based upon a recognition of difference, thus working toward an ethics of sexuality that is decidedly ­and simultaneously ­incarnate and intersubjective. (shrink)

Spontaneous intrusive recollections follow traumatic events in clinical and non-clinical populations. To determine whether any relationship exists between SIRs and enhanced memory for emotional events, participants viewed emotional or neutral films, had their memory for the films tested two days later, and estimated the number of SIRs they experienced for each film. SIR frequency related positively to memory strength, an effect more pronounced in the emotional condition. These findings represent the first demonstration of a relationship between SIRs occurring after an (...) emotional experience and subsequent memory strength for that experience. The results are consistent with the possibility that emotional arousal leads both to elevated SIR frequency and better memory, and that the covert rehearsal associated with SIRs enhances memory for emotional relative to neutral stimuli. Additional evidence of menstrual cycle influences on SIR incidence in female participants appears to merit consideration in future work. (shrink)