This thesis draws on poststructuralism/postmodernism to present a feminist investigation into the human body, its modes of (self)identification, and its insertion into systems of bioethics. I argue that, contrary to conventional paradigms, the boundaries not only of the subject, but of the body too, cannot be secured. In exploring and contesting the closure and disembodiment of the ethical subject, I propose instead an incalculable, but nonetheless fully embodied, diversity of provisional subject positions. My aim is to valorise women and situate (...) them within a reconceived ethics which takes account of the embodied feminine. My project entails an analysis and deconstruction of the binaries of those dominant strands of postEnlightenment thought that shape epistemology, ontology, and ethics, which in turn set the parameters of modern bioethics. More importantly, it goes on to reclaim a radical sexual difference beyond the binary, in which the female is no longer the other of the male. My enquiry, then, is strongly influenced by the discursive approach offered by both Foucault and Derrida in differential ways, but I counter their indifference to feminist concerns by qualifying their insights in the light of strategies developed by Irigaray and Spivak, among others. The main method of investigation has been through library research of primary and secondary sources in mainstream and feminist philosophy, and in bioethics. In addition, archival work in both textual and iconographic collections was carried out at the Wellcome Institute for the History of Medicine. The contribution made by this thesis is to go beyond modernist feminisms - which would simply revise and add women into existing paradigms - to radically displace and overflow the mechanisms by which women are devalued. And in developing a postmodern critique around some issues in bioethics, I have suggested a new ethics of the body which precedes the operation of moral codes. (shrink)

Going through reproductive experiences (especially pregnancy and childbirth) in contemporary Western societies almost inevitably involves interaction with medical practitioners and various medical technologies in institutional context. This has important consequences for women as embodied subjects. A critical appraisal of these consequences—coming dominantly from feminist scholarship—relied on a problematic theory of both technology and the subject, which are in contemporary approaches no longer considered as given, coherent and well individualized wholes, but as complex constellations that are locally situated and that can (...) only be described empirically. In this study, we will be relying on the developments in phenomenological theory to reconceptualize women as technologically mediated embodied subjects and on the new paradigms in philosophy of technology and STS to reconstruct medical technology as situated—with the aim of reconceptualizing their relationship and exploring different possibilities for the mediating role of medical technology. It will be argued that technologization of female reproductive processes and alienating consequences for women are not necessary or directly interrelated. The role of technology varies from case to case and depends mainly on the nontechnological and relational aspects of institutional context, in which medical practitioners play a decisive role. (shrink)

Enhancing body awareness has been described as a key element or a mechanism of action for therapeutic approaches often categorized as mind-body approaches, such as yoga, TaiChi, Body-Oriented Psychotherapy, Body Awareness Therapy, mindfulness based therapies/meditation, Feldenkrais, Alexander Method, Breath Therapy and others with reported benefits for a variety of health conditions. To better understand the conceptualization of body awareness in mind-body therapies, leading practitioners and teaching faculty of these approaches were invited as well as their patients to participate in focus (...) groups. The qualitative analysis of these focus groups with representative practitioners of body awareness practices, and the perspectives of their patients, elucidated the common ground of their understanding of body awareness. For them body awareness is an inseparable aspect of embodied self awareness realized in action and interaction with the environment and world. It is the awareness of embodiment as an innate tendency of our organism for emergent self-organization and wholeness. The process that patients undergo in these therapies was seen as a progression towards greater unity between body and self, very similar to the conceptualization of embodiment as dialectic of body and self described by some philosophers as being experienced in distinct developmental levels. (shrink)

Recent discussions concerning the ethics of nursing care have gained added impetus from articulations of die so‐called ‘ethic of carersquo; in moral philosophy. This paper addresses the question of recognizing and elaborating the ethics of nursing care by exploring the problems and the possibilities of diese intersecting discourses. In the first part of the paper it is argued that appropriation of ‘the ethic of care’ by nursing theorists as the central value of nursing, in contradistinction to other moral values such (...) as beneficence or justice, runs the risk of reinforcing the conventional approaches to ethics that ‘the ethic of care’ seeks to overturn. Central to ‘the ethic of care’ is the recognition that caring entails a focus on the particularities and context of the relationships in which it is expressed. Accordingly die application of a unitary concept of care to the context of nursing relations may seriously distort dieir diverse and complex‐specific ediical possibilities. The dynamic complexity of nursing ethics may be more adequately understood by working through an array of specific examples of nursing practice highlighting the differences and similarities between them and other ethical practices of care. Experience of a set of examples in this way will draw attention to the multiplicity, ambiguity, and particularity of the ethics of nursing while facilitating the ability to recognize how other practices may or may not be understood as examples of ediical nursing care. In the second part of the paper a beginning is made on this project by addressing the work of several different theorists of care who have examined different practices of nursing from the overlapping perspectives of nurses, patients and the socio‐historical construction of their relationships. (shrink)

Working at the bedside and within communities as patient advocates, nurses frequently intervene to advance individuals’ health and well-being. However, the International Council of Nurses’ Code of Ethics asserts that nurses should expand beyond the individual model and also promote a rights-enabling environment where respect for human dignity is paramount. This article applies the results of an ethnographic human rights study with displaced populations in Rwanda to argue for a rights-based social advocacy role for nurses. Human rights advocacy strategies include (...) sensitization, participation, protection, good governance, and accountability. By adopting a rights-based approach to advocacy, nurses contribute to health agendas that include more just social relationships, equitable access to opportunities, and health-positive living situations for all persons. (shrink)

In this paper Gadow's philosophical themes are developed considering the pedagogical relation – the relation of teacher and student, nurse and patient, self and world. Relational pedagogy is discussed through exploration of embodiment (being the teaching), improvisation (doing the teaching), and interdependence (locating the teaching in a reciprocal world as home). The pedagogical relation explores the lived space between teacher and learner, nurse and patient, where new knowledge is constructed. Such knowledge ‘resounds bodily’ and is always under construction.

Post–dualist philosophies of nursing acknowledge embodiment as a condition of human existence. Philosophical writing, however, remains abstract and disembodied. A philosophical framework that embraces embodiment needs to recover the materiality of language; its text needs to include language that is not only rational and clear but sensuous and ambiguous. I describe three cultural narratives of women's embodiment and compare them with an imaginative narrative, a nurse's poem about women in labour. I propose, not that philosophers become poets, but that they (...) abandon a dualist position in which language is either literal or metaphorical, adopting instead the poet's approach in which any word or object has unlimited meanings. I argue that, without fixed reference points, language embodies rather than escapes contingency. Finally, I discuss two forms of philosophical writing – irony and motet – that savour contingency, illustrating philosophy as endless redescription, aiming not for finality but for the grace of a dancer's deliberate fall. (shrink)

Background: Patients with a traumatic injury often require intensive care for life-saving treatments. Physical suffering and emotional stress during critical care can be alleviated by ethical caring provided by nurses. The relationship between body and self are fundamentally inseparable. Nurses need to understand the impacts of traumatic injury on a patient’s body and self. Aim: To understand the meaning of traumatic injury for body and self for patients receiving intensive care. Research design: A qualitative descriptive study using Giorgi’s phenomenological approach. (...) Participants and research context: Patients receiving intensive care for physical trauma were selected by purposive sampling (N = 15) from a medical center in Taiwan. Individual in-depth, face-to-face audiotaped interviews, guided by semi-structured questions, were used to collect data. Each interview lasted 30–60 min. Audiotaped interviews were transcribed and analyzed. Ethical considerations: This study was approved by the Institutional Review Board of the medical center. Findings: The impact of the experience of traumatic injury on participants’ body and self was described by three main themes: (1) Searching for the meaning of the injured body, (2) Feeling trapped in the bed, and (3) The carer and the cared-for. Discussion and conclusion: The implications of the three themes described in the findings are as follows: Trauma as a source of meaning; Body and self are mutually limiting or mutually enabling; and Ethical relationships. The experience of needing intensive care following a traumatic injury on the body and self was dynamic and mutual. The experience of the injury changed the relationship between body and self, and gave new meaning to life. Nurses play a crucial role in continuity of care by understanding the meaning of a traumatic injury for patient’s body and self that facilitates ethical care and recovery from injury. (shrink)

Anita Silvers (1998) has criticized those who argue that members of marginalized groups are vulnerable to a special threat posed by physician-assisted suicide (PAS) and voluntary active euthanasia (VAE). She argues that paternalistic measures prohibiting PAS/VAE in order to protect these groups only serve to marginalize them further by characterizing them as belonging to a definitively weak class. I offer a new conception of vulnerability, one that demonstrates how rich, educated, white males, who are typically regarded as having their autonomy (...) enhanced by their social status, are just as, if not more, vulnerable to threats posed by PAS/VAE as a result of the harmful social messages at work just below the surface of contemporary Western culture. I use this new conception of vulnerability to reinforce arguments for continued statutory prohibitions on PAS/VAE. (shrink)

Embodied knowledge in chronic illness and injury When people experience chronic illness or serious injury, changes occur not just within their physical bodies but also in their embodiments, that is, how they view the world through their bodies. For such patients, dualistic (mind–body) notions of the body as object and the mind as subject can devalue experiences that are necessary for healing and for managing everyday problems related to their illness or injury. Nurses need to be able to guide people (...) with illness or injury to new levels of wellness, but may lack appropriate theoretical conceptualizations. Philosophies that underlie embodied knowledge — in particular, philosophies of Merleau‐Ponty and Polanyi — were explored yielding two new ways to understand the body. The body as ‘silent partner’ fosters an appreciation of the body's own subjectivity that can be enhanced in nursing care through sensitivity, listening, and creative coaching. Nurses can assist their patients to identify new and positive understandings of what their bodies mean to them after bodily changes. The body as ‘informant’ holds much promise for solving some of the everyday problems that people with chronic illness or injury experience. By using phenomenological and other naturalistic methods, researchers and patients can find clues to solving such problems, clues that are known through daily living but hidden beneath conscious awareness. As a result, some of the practical know‐how of the body as ‘informant’ can be transformed into testable nursing interventions. (shrink)

The aim of this study is to illuminate the significance of the long-term influence of bodily changes on the perception of self after stroke by means of narrative interviews with 23 stroke survivors. A phenomenological-hermeneutic approach inspired by the philosophy of Merleau-Ponty and Ricoeur is the methodological framework. Zahavi’s understanding of the embodied self and Leder’s concept of dys-appearance along with earlier research on identity guide the comprehensive understanding of the theme. The meaning of bodily changes after stroke can be (...) understood as living with an altered perception of self. Stroke survivors perceive their bodies as fragile, unfamiliar and unreliable and tend to objectify them. The weak and discomforting body that ‘cannot’ demands constant, comprehensive awareness to keep itself in play. These long-term and often permanent consequences of bodily weakness may turn stroke survivors’ intentionality inwards, away from external activities and projects and relationships with others. Negative judgements from others are added to lost roles and positions and threaten the vulnerable self. Stroke survivors try to regain familiarity with their body by their life-long project of testing its boundaries. Mastering important tasks helps them strengthen their self-concept. Health care workers should be aware of the embodied self and engage in long-term dialogues with stroke survivors to strengthen positive perceptions of body and self. More research is needed to understand destructive post-stroke phenomena such as fatigue and pain and to find effective methods to help stroke survivors regain wholeness of body and self. (shrink)

The focus of this article is the life and work of the French thinker Michel de Certeau, here presented as a philosopher of special interest for nursing. Although in some countries he is relatively unknown, international authors from scientific disciplines regard his texts as a fundamental source in the opening of new intellectual perspectives on current global problems. Some nurses have also considered his ideas as a useful aid for reflecting on their professional activities, and their most important research is (...) cited. Over these pages, we also examine how Certeau's work can enrich nursing philosophy in regard to three specific issues: resistance practices in nursing in the face of pressure from health institutions; the social configuration of nursing knowledge; and the importance of the body in current nursing practice. (shrink)

Many patients experience aspects of treatment and care as dehumanizing because the body is considered separate from the self and its life context. An attempt to transcend viewing persons in dualistic terms is posed by phenomenologists who focus not on “the body” as such but on what it means to be “embodied.” In this paper, we review the relevance of the phenomenology of the body for health care and report the results of comparing Sally Gadow’s phenomenological insights about body-self unity (...) with a qualitative analysis of patients’ accounts of satisfaction with the outcome of hand surgery. We illustrate the ways in which our findings were and were not congruent with Gadow’s conceptualization of embodiment and highlight aspects that are ambiguous. We conclude that the body-self dialectical relationship should be recast as a body-self-society trialectic and discuss the implications of this new conceptualization for clinical practices. (shrink)