The Tuskegee Syphilis Experiment (TSE) has shaped African Americans’ views of the American health care system, contributing to a reluctance to participate in biomedical research and a suspicion of the medical system. This essay examines public discourses surrounding President Clinton’s attempt to restore African Americans’ trust by apologizing for the TSE. Through a narrative reading, we illustrate the failure of this text as an attempt to reconcile the United States Public Health Service and the African American public. We conclude by (...) noting the limitations of rhetoric when equal prominence is not given to policy proposals in national apologies. (shrink)

Peer learning involves processes whereby inexperienced persons learn from persons with more experience. Previous research has shown the benefit of peer learning to the rehabilitation process of people with spinal cord injuries and others using a wheelchair, yet discussions of problematic aspects are scant. Thus, the purpose of this article is to highlight two problems with peer learning. By presenting a vignette elaborated from a phenomenologically oriented case study of a wheelchair skills program at a Norwegian rehabilitation unit, the problem (...) of a naive view of empathy and the danger of inflicting symbolic violence are reflected upon. These reflections, though tentative, draw attention to the ethical responsibility of rehabilitation professionals who use peer learning as a part of their intervention. (shrink)

Qualitative research methods in sport often advocate that to understand others, obtain significant knowledge and do ethically admirable research we should empathise with our participants by imagining being them. In philosophy, it is likewise often assumed that we can overcome differences between people through moral imagination: putting ourselves in the place of others, we can share their points of view, merge with them, and enter into their embodied worlds. Drawing partly on the view that imagination is embodied and the philosophy (...) of Bakhtin and Levinas, along with research on people's experiences of becoming disabled through playing sport, this paper problematises the assumption that we can imagine ourselves differently situated or being another person. It argues that our imagination and ability to put ourselves in the place of others is constrained partly by embodied experience and otherness. Some reflections on what this might mean for disability and sport research are then offered. (shrink)

Ethics consultation in institutions of the healthcare system has been given a standard form based on three pillars: education, the development of guidelines and concrete ethics consultation in case conferences. The spread of ethics committees, which perform these tasks on an organizational level, is a remarkable historic achievement. At the same time it cannot be denied that modern ethics consultation neglects relevant aspects of care ethics approaches. In our essay we present an “ethics of care” approach as well as an (...) empirical pilot project—“Ethics from the bottom up”—which organizes ethics consultation based on this focus. Findings and philosophy of the project will be discussed as far as relevant for ethics consultation in the healthcare system. (shrink)

Within the fields of social medicine and the medical humanities, chronic illness is acknowledged not just as an individually but as a socially transformative experience. The proliferation of published ‘illness narratives’ in recent years attests to the socially compelling nature of this particular story of transformation. Indeed, illness narratives have, in the past decade or so, become a rich source of interest in sociological and medical anthropological work for their capacity to map the material transformation of person to patient, of (...) an assumed to a newly fluid model of subjectivity. Their significance is particularly visible in the cultural context of the west, where more people live both to be diagnosed with chronic illnesses (such as cancer) and to survive them. With a focus on two recently published Australian works, Eating the Underworld: A Memoir in Three Voices (2001), by the psychologist Doris Brett, and Tiger’s Eye: A Memoir (2001), by the historian Inga Clendinnen, this paper will consider how the illness experience marks a transformation of embodied subjectivity that, in turn, triggers transformations of other kinds. These works have quite different intents, but they provide models for exploring how physical and individual transformation through illness becomes the occasion for reconsidering the body of history, and of the resonances of history in social memory. (shrink)

Depression is a debilitating condition, but it can also be an awakening: one that calls attention to what is termed dimensions of expertise that come with the spatial and temporal structure of human beings and that are necessary for offering some counter to the debilitating force of the condition. Expertise has a significant ontological status: it is directly associated with who we are as creatures who can hear and respond to the call of conscience, desire acknowledgment and have an obligation (...) to share this life-giving gift with others, and whose very being is characterized by a perfectionist impulse to better its standing in the world. A story concerned with medical expertise is offered to illustrate in concrete terms these specific matters. (shrink)

In this article, we will consider how the regulation of populations is not just a feature of prisons, but of all institutions and organisations that control members though hierarchies, divisions and norms. While nurses and other allied health professionals are considered to be predominantly self‐regulatory, practice is guided by a code of conduct and codes of ethics that act as rules that serve to uphold the safety of the patient, whether they are a sick person in a hospital bed or (...) an inmate in a prison. The codes of conduct espouse a number of rules that to a certain extent govern the behaviour of individual and groups of practitioners through reciprocal rewards and punishments. Supervision is one method of monitoring the effectiveness of the codes of conduct and ethics while regulating both the minimum standard of individual practice and of training organisations. It is posited that one of the possible effects of clinical supervision is to make the person effectively self‐regulatory as, an autonomous practitioner. We take the view that professional autonomy is a highly problematic concept requiring closer examination. (shrink)

This essay begins with a metaphor describing who enters the field of humanities in medicine and healthcare and the types of work they do. The role of witness is discussed, underscoring tensions between witnessing and analyzing. The essay then turns to my own background as an example of how each professional in this field brings something distinct. I briefly describe the three basic principles of my work with narrative: the injunction to keep the stories in the foreground, the work of (...) amplifying and connecting stories, and the need for generous interpretation. The second half of the essay tells three illness stories, describing their importance to me over several decades. These stories are by Audre Lorde, Reynolds Price, and Stewart Alsop, dealing with problems of silences imposed on ill people, problems caused by physicians’ perceived lack of time, and dilemmas of the end of life, respectively. (shrink)

Victims of disaster suffer, not only at the very moment of the disaster, but also years after the disaster has taken place, they are still in an emotional journey. While many moral perspectives focus on the moment of the disaster itself, a lot of work is to be done years after the disaster. How do people go through their suffering and how can we take care of them? Research on human suffering after a major catastrophe, using an ethics of care (...) perspective, is scarce. People suffering from disasters are often called to be in distress and their emotional difficulties ‘medicalised’. This brings them often into a situation of long term use of medication, and one can wonder if medication is of help to them in the long run. In our paper, we will explore another moral perspective, focusing on the importance of the victims’ narrative and their lived experiences. We will use Paul Ricoeur’s phenomenological reflections from ‘Suffering is not the same as pain’ for conceptualizing human suffering and how to apply it to victims of disaster. Ricoeur suggests that suffering is not a quantity that can be measured, but a characteristic that should be studied qualitatively in interpersonal and narrative contexts. Above all, the perspective of care and listening could offer an opportunity to reconcile people from their loss and suffering. (shrink)

This paper suggests ways in which a philosophy modelled as dance provides the means of challenging political structures that emphasise control and constraint at the expense of spontaneity and creativity. Through combining Arendt’s claim that spontaneity is the quintessential human quality with Nietzsche’s modelling of philosophy as disruptive dancing, the possibilities of modelling philosophy as dance are explored. Envisaging philosophical practice in this way provides a corrective to the prioritising of certainty in philosophical method, thus enabling further reflection on what (...) it means to promote human flourishing. (shrink)

The patient–physician relationship is of primary importance for medical ethics, but it also teaches broader lessons about ethics generally. This is particularly true for the philosopher Emmanuel Levinas whose ethics is grounded in the other who “faces” the subject and whose suffering provokes responsibility. Given the pragmatic, situational character of Levinasian ethics, the “face of the other” may be elucidated by an analogy with the “face of the patient.” To do so, I draw on examples from Martin Winckler’s fictional physician (...) narratives. In addition, I explore how the standpoint of the physician conceals a related but often unacknowledged dimension of care: the obligation to nurse. For both nurse and physician, one question encapsulates Levinas’ medical ethics: “What does the patient say?” Using this as my guiding question, I examine the context within which physician, nurse, and patient meet in order to highlight their shared vulnerability and the care relationship that binds them together. (shrink)

This article applies the anthropological concept of liminality to reconceptualize palliative care ethics. Liminality possesses both spatial and temporal dimensions. Both these aspects are analyzed to provide insight into the intersubjective relationship between patient and caregiver in the context of palliative care. Aristotelian practical wisdom, or phronesis, is considered to be the appropriate model for palliative care ethics, provided it is able to account for liminality. Moreover, this article argues for the importance of liminality for providing an ethical structure that (...) grounds the doctrine of double effect and overcomes the impasse of phronesis in the treatment of the terminally ill. (shrink)

Mental health nurses are frequently confronted by intense emotions within the therapeutic relationship. In this philosophical hermeneutic inquiry, five mental health nurses were interviewed to extend our understandings of how nurses are impacted by the interplay with the often emotion-laden narratives of their patients. Findings exposed the nurses journeyed between fluctuating needs to separate and protect their private from their work life. In order for this fluctuation to occur, they developed a sense of the world as requiring a sanctuary. This (...) ontological place of home is the extent to which they felt safe and sheltered in order for this process of awareness of self as person and self as nurse to unfold. This research brings to the forefront the ways in which mental health nursing practice, education, and research are reciprocally moved by the practical day-to-day activities of being in therapeutic relationships. (shrink)