"Next to Sartre's Search for a Method and in direct opposition to it, Foucault's work is the most noteworthy effort at a theory of history in the last 50 years." -- Library Journal.

Foucault's preoccupation with the visual, specifically his positing of a sort of ‘positive unconscious of vision’, offers an entry point for examining data generated through a field study of home‐care case management practice. In Foucault's work, our attention is directed not so much to what is seen but to what can be seen and to the effects of practices of knowledge and power in constituting these particular realities. Knowledge emerges as a matter of what it is possible for knowers, for (...) nurses, to see and to say, as well as the conditions that constitute these specific possibilities for seeing and saying in a given context. Given the significance of practices of seeing in case management – seeing clients, seeing situations – examining how possibilities for understanding are constituted through ways of seeing helps us to ‘see’ the limits of currently possible practice. In the case examined in this paper, these limits constitute a gap between what a client may actually need and what it is possible, in the context of current practice, to provide. To change practice it seems important, if only as a first step, to recognize the constraints of thought in what we see. (shrink)

Michel Foucault has become famous for a series of books that have permanently altered our understanding of many institutions of Western society. He analyzed mental institutions in the remarkable Madness and Civilization; hospitals in The Birth of the Clinic; prisons in Discipline and Punish; and schools and families in The History of Sexuality. But the general reader as well as the specialist is apt to miss the consistent purposes that lay behind these difficult individual studies, thus losing sight of the (...) broad social vision and political aims that unified them. Now, in this superb set of essays and interviews, Foucault has provided a much-needed guide to Foucault. These pieces, ranging over the entire spectrum of his concerns, enabled Foucault, in his most intimate and accessible voice, to interpret the conclusions of his research in each area and to demonstrate the contribution of each to the magnificent -- and terrifying -- portrait of society that he was patiently compiling. For, as Foucault shows, what he was always describing was the nature of power in society; not the conventional treatment of power that concentrates on powerful individuals and repressive institutions, but the much more pervasive and insidious mechanisms by which power "reaches into the very grain of individuals, touches their bodies and inserts itself into their actions and attitudes, their discourses, learning processes and everyday lives" Foucault's investigations of prisons, schools, barracks, hospitals, factories, cities, lodgings, families, and other organized forms of social life are each a segment of one of the most astonishing intellectual enterprises of all time -- and, as this book proves, one which possesses profound implications for understanding the social control of our bodies and our minds. (shrink)

As one of the most massive and successful business sectors, the pharmaceutical industry is a potent force for good in the community, yet its behaviour is frequently questioned: could it serve society at large better than it has done in the recent past? Its own internal ethics, both in business and science, may need a careful reappraisal, as may the extent to which the law - administrative, civil and criminal - succeeds in guiding (and where neccessary contraining) it. The rules (...) of behavior that may be considered to apply to today's pharmaceutical industry have emerged over a very long period and the process goes on. Even the immensely detailed standards for quality, safety and efficacy laid down in drug law and regulation during the second half of the twentieth century have their limitations as tools for ensuring that the public interest is well served. In particular, national and regional regulatory agencies are heavily dependent on industrial data for their decision-making, their standards and competence vary, and even the existing network of agencies does not cover the entire world. What is more there are many areas of law and regulation affecting the industry, concerning for example the pricing of medicines, the conduct of clinical studies, the health protection of workers and concern for the environment. In some fields it is indeed hardly possible to maintain standards through regulation. Professor N.M. Graham Dukes, a physician and lawyer with long term experience in industrial research management, academic study and international drug policy, provides here a powerfully documented analysis into the way this industry thinks, acts, and is viewed, and examines the current trends pointing to change. *Provides a balanced picture of the current role of the pharmaceutical industry in society *Includes indices of conventions, laws, and regulations; as well as judicial and disciplinary cases *This is the only book addressing the legal implications of big pharma activities and ethical standards. (shrink)

No discussion of academic freedom, research integrity, and patient safety could begin with a more disquieting pair of case studies than those of Nancy Olivieri and David Healy. The cumulative impact of the Olivieri and Healy affairs has caused serious self examination within the biomedical research community. The first part of the essay analyses these recent academic scandals. The two case studies are then placed in their historical context—that context being the transformation of the norms of science through increasingly close (...) ties between research universities and the corporate world. After a literature survey of the ways in which corporate sponsorship has biased the results of clinical drug trials, two different strategies to mitigate this problem are identified and assessed: a regulatory approach, which focuses on managing risks associated with industry funding of university research, and a more radical approach, the sequestration thesis, which counsels the outright elimination of corporate sponsorship. The reformist approach is criticised and the radical approach defended. (shrink)

The purpose of this paper is to present the theoretical and philosophical assumptions of the Nursing Manifesto , written by three activist scholars whose objective was to promote emancipatory nursing research, practice, and education within the dialogue and praxis of social justice. Inspired by discussions with a number of nurse philosophers at the 2008 Knowledge Conference in Boston, two of the original Manifesto authors and two colleagues discussed the need to explicate emancipatory knowing as it emerged from the Manifesto . (...) Our analysis yielded an epistemological framework based on liberation principles to advance praxis in the discipline of nursing. This paper adds to what is already known on this topic, as there is not an explicit contribution to the literature of this specific Manifesto , its significance, and utility for the discipline. While each of us have written on emancipatory knowing and social justice in a variety of works, it is in this article that we identify, as a unit of knowledge production and as a direction towards praxis, a set of critical values that arose from the emancipatory conscience-ness and intention seen in the framework of the Nursing Manifesto. (shrink)

Background There are numerous ethical challenges that can impact patients and families in the health care setting. This paper reports on the results of a study conducted with a panel of clinical bioethicists in Toronto, Ontario, Canada, the purpose of which was to identify the top ethical challenges facing patients and their families in health care. A modified Delphi study was conducted with twelve clinical bioethicist members of the Clinical Ethics Group of the University of Toronto Joint Centre for Bioethics. (...) The panel was asked the question, what do you think are the top ten ethical challenges that Canadians may face in health care? The panel was asked to rank the top ten ethical challenges throughout the Delphi process and consensus was reached after three rounds. Discussion The top challenge ranked by the group was disagreement between patients/families and health care professionals about treatment decisions. The second highest ranked challenge was waiting lists. The third ranked challenge was access to needed resources for the aged, chronically ill, and mentally ill. Summary Although many of the challenges listed by the panel have received significant public attention, there has been very little attention paid to the top ranked challenge. We propose several steps that can be taken to help address this key challenge. (shrink)

"Clare O'Farrell is to be congratulated on producing a truly magnificent book on the work of Michel Foucault. There are details, insights and observations that will engage the specialist and there is an extensive documentation of Foucault's output. If there is a more comprehensive book on Foucault's work I have yet to see it. I anticipate those teaching and taking courses on Foucault's work will find Clare O'Farrell's book to be an invaluable resource'" - Barry Smart, University of Portsmouth "Dr. (...) Clare O'Farrell has written a marvelous introduction to this Foucault for that ever growing number of readers who are working in what has come to be designated as cultural studies. This volume captures the penetrating interdisciplinary concerns that have made Foucault a guide to so many beyond the frontiers of philosophy and history, beyond the borders of the academic community itself. O'Farrell is an excellent guide to Foucault's exploration of culture, highlighting, as she does, the characteristic insights of his learning: the instability of cultural forms of order, the subversive potential of historical analyses, the variety of true discourses within history, and his commitment to social justice. O'Farrell reveals Foucault as he is: the engaged moralist who survived the twentieth century's systems of total explanation. This is an excellent introduction for the general reader to a passionate mind that continues to spread its influence'" - James Bernauer, Boston College Michel Foucault's work is one of the most influential sources of ideas in the humanities and social sciences today. Clare O'Farrell offers a comprehensive and accessible introduction to Foucault's enormous, diverse and challenging output. Her book provides a range of practical tools and a reference work for readers who wish to understand and apply his ideas at both introductory and advanced levels. This volume includes: - a discussion of Foucault's situation in the contemporary context exploring his role as an iconic thinker, with clear explanations as to why his work is so difficult to come to grips with, and also importantly, why it is of interest to so many people. - the location of Foucault's work within its own historical, social and political setting. - brief summaries in chronological order of all of Foucault's major works, including the more recently published volumes of lectures. - the organization of Foucault's work around five distinct but interrelated series of assumptions which underpin his world view: namely order, history, truth, power and ethics. Ideas for which he is well-known, such as archaeology, genealogy, discourse, discipline, governmentality, the subject and others are defined and discussed within the framework of these five assumptions. - a chronology of Foucault's life, work and times. - a very extensive list of key concepts in Foucault's work with detailed references pointing to where the relevant material can be found in his writings. - a wide-ranging list of resources and a bibliography of Foucault's work for easy consultation. (shrink)

The purpose of this paper is to present the theoretical and philosophical assumptions of the Nursing Manifesto, written by three activist scholars whose objective was to promote emancipatory nursing research, practice, and education within the dialogue and praxis of social justice. Inspired by discussions with a number of nurse philosophers at the 2008 Knowledge Conference in Boston, two of the original Manifesto authors and two colleagues discussed the need to explicate emancipatory knowing as it emerged from the Manifesto. Our analysis (...) yielded an epistemological framework based on liberation principles to advance praxis in the discipline of nursing. This paper adds to what is already known on this topic, as there is not an explicit contribution to the literature of this specific Manifesto, its significance, and utility for the discipline. While each of us have written on emancipatory knowing and social justice in a variety of works, it is in this article that we identify, as a unit of knowledge production and as a direction towards praxis, a set of critical values that arose from the emancipatory conscience-ness and intention seen in the framework of the Nursing Manifesto. (shrink)

Although we theorize that nurses ‘make a difference’ to patient outcomes and speculate that this happens because nurses ‘care’, there is so far little evidence to support this nebulous claim. Efforts to promote care as the defining characteristic of nursing, and an ‘ethic of care’ as the ethical basis of nursing, have sparked debate within the discipline. This debate has resulted in a polarization that has effectively stalled productive discourse on the issues. Moreover, the focus on care has been at (...) the expense of understanding the true nature of the relationship between caring and the broader base of ethical knowledge that underpins nursing and that must underpin nursing if it is a viable practice profession. This paper used the framework of philosophical argument to explore the moral and ethical foundations of nursing from the perspective of personal and public morals, and responsive nurse–patient relationships as the reflection of ethical nursing knowledge. The foundation of ethical nursing knowledge is the personal moral sense that resides within the individual and that nurses hold in common with others. Personal moral knowledge is transformed into disciplinary ethical knowledge specific to nursing through disciplinary consensus. Responsive relationships are conceptualized in the nursing literature as founded on three essential elements: respect, trust, and mutuality. These three elements are grounded in ethical nursing knowledge; therefore responsive nurse–patient relationships reflect both personal moral knowledge and disciplinary ethical knowledge. By facilitating the articulation of ethical nursing knowledge in practice, responsive relationships connect theory, ethical knowledge, and clinical outcomes. (shrink)

The social production of an enterprise clinic: nurses, clinical pathway guidelines and contemporary healthcare practicesIn this paper I critically engage with the forming of contemporary nursing practice with/in an ‘enterprise clinic’ in order to discuss the practical potential of developing a mode of reflective practice that is a critical ontology of self. Critical engagement in the paper is secured through a ‘troubling’ of the relationship between the contemporary practices of both the self and governance, without the reduction of one to (...) the other. The paper draws on my doctoral study in which I combined the techniques of ethnography and discourse analysis in order to critically examine registered nurses’ employment of clinical pathway guidelines through an analysis of the political technologies through which that engagement was constituted. This critical purchase was applied because of the influence of the contemporary ‘problematisation’ of healthcare provision in western society on the formation and deployment of the professional identities of nurses. (shrink)

The aim of a previous study was to describe nursing in Slovenia generally, and to identify the most appropriate nursing model for that country. One specific finding was the issue of partner-like relationships; this article deals with that issue only. An interpretive paradigm and qualitative research design were used with a modified grounded theory approach. Interviews were carried out with selected nursing leaders ( n = 24) and other professionals (n = 6) in order to draw on their knowledge and (...) experience to describe the reality of nursing phenomena. The results of this research suggest that participants wish to use a theory that emphasizes clients and treats them as equal partners in nursing, promotes health, and rests on interpersonal relationships. The participants described the missing or obscure parts in nursing and their own beliefs and values about human beings and nursing. Descriptions of and the need for partner-like relationships, and the specific elements of such relationships, were of main concern. The participants argued that nurses need high quality and continuing education to ensure competent nursing practice. The indication is that Slovenia should move to graduate and undergraduate nurse education to foster expert reflective practice in order to abolish routinized care carried out in a hierarchical system. (shrink)

Much attention has been focused in recent years on the ethical acceptability of physicians receiving gifts from drug companies. Professional guidelines recognize industry gifts as a conflict of interest and establish thresholds prohibiting the exchange of large gifts while expressly allowing for the exchange of small gifts such as pens, note pads, and coffee. Considerable evidence from the social sciences suggests that gifts of negligible value can influence the behavior of the recipient in ways the recipient does not always realize. (...) Policies and guidelines that rely on arbitrary value limits for gift-giving or receipt should be reevaluated. (shrink)

Abstract This paper presents an evaluation of the role and function of discourse analysis in relation to claims that it promotes critical interventions within psychology. Discourse analysis challenges the function, truth claims and methodological adequacy of psychological practices, through attending to difference, resistance, relativism and reflexivity. However, these features pose theoretical and conceptual difficulties, particularly if a theoretically motivated position is attributed to the framework itself, rather than the ways it has been taken up and used. I explore how these (...) issues are played out in the arenas of (a) research practice, (b) teaching discourse analysis, and (c) everyday discursive clashes. As with other approaches that have generated methodological innovations, discourse analysis can work to support, rather than challenge, mainstream psychological practices. In order to maintain the fruitful dynamic of discourse analysis, therefore, we should acknowledge the political concerns that motivate our analysis, rather than regard them as a property of the approach itself. (shrink)