Biomedical Ethics

Chapter 9 addresses the duties of medical practitioners such as doctors and nurses, mostly in relation to patients, but also in respect of each other and their society. It argues that the relational moral theory is at least no worse than, and is often to be preferred over, more Western principles when it comes to how to understand several biomedical obligations. For example, the chapter maintains that the communal ethic makes good sense of whom a medical professional has moral reason to treat and for which purposes. It further contends that rightness as friendliness grounds moderate positions on abortion and euthanasia that many will find convincing but that utilitarianism and Kantianism have difficulty entailing and explaining. For example, if utilitarianism and Kantianism permit abortion, it is hard for them to avoid also permitting infanticide, but the relational ethic can more easily avoid that implication.

A Relational Approach to Transforming Power in a Community-University Partnership

We use a relational understanding of power to analyze power dynamics at the institutional and interpersonal levels in our multi-year Co-Education/Co-Research (CORE) partnership between Tufts University Department of Urban and Environmental Policy and Planning (UEP) and Dudley Street Neighborhood Initiative (DSNI). Power in community-university partnerships is often examined only at the institutional level, conceiving of power as a resource to be balanced and shared. Indeed, CORE has advanced institutional shifts through co-governance, equitable funding, co-production of curriculum and cross-flow of people. While institutional policies and practices are critical, they alone do not transform deep-seated hierarchies that value university knowledge, practices and people over community. To understand how intertwined interpersonal and institutional practices can reproduce or transform these cultural and ideological dynamics, we use a relational approach, understanding that power flows in and through all relations. As community members, students and faculty, we reflect on the contradictions we have encountered in CORE. We examine how we reinforce the dominance of academic over community knowledge, even as we leverage institutional power to further community goals. These tensions can be opportunities for shifting, disrupting and transforming towards more equitable relations, but they can also reproduce and reinforce the status quo. Through reflective practice and a relational ethic of care, we can try to recognize when we might be shifting power relations and when we might be reproducing them. This is messy work that requires a lot of communication, trust, reflection and time. A relational approach to power provides hope that we can be part of the change we seek in all of our relations, every day. And it reminds us that no matter what we have institutionalised or encoded, our individual beings, organizations and communities are always in a process of becoming.

Developing post-ableist music therapy: An autoethnography exploring the counterpoint of a therapist experiencing illness/disability

<p>This PhD examined a therapist’s experience of illness/disability to see if any new light could be shed on music therapy whilst also finding ways to navigate disability as a practitioner. There has not been adequate research attention given to the experiences of music therapists who have an illness/disability. The position is often negotiated in isolation with minimal tools and resources. An arts-based autoethnography was used to determine how the close examination of one’s personal experience with illness/disability can impact on practice, how the work can be negotiated, and to uncover any new practical or theoretical meanings. Furthermore, it looked to determine what arts-based autoethnography could offer one’s practice. A poststructural lens was used that drew on social constructionism, feminism, and the work of Michel Foucault. Data generated from a music therapist’s practice, experiences of illness/disability, literature, and professional documents were analysed using Foucault’s “critical ontology of ourselves” (Foucault, 1984b, p. 47). Hidden processes of problematic ableism were found within the practice examined as well as in some educational and professional encounters. These regimes of ableism were supported by universalising and dichotomising discourses, namely humanism, western normativity, limited observable understandings of disability, and the enforcement of able/disabled divide through many binaries. The methodology provided the tools to reposition the practice to politicise disability and address ableism. Addressing ableism was found to be more complex than simply incorporating disability issues into existing contemporary frameworks. The analysis led to the development of Post-Ableist Music Therapy (PAMT). PAMT extended the relational ethic beyond what was present in the prior practice by drawing on aspects of posthumanism, agonistic plurality, and increasing the visibility of disability studies and crip theory. Therefore, PAMT offers a different lens to the critical orientations’ apparatus: a social justice practice not based on empowerment and humanism but on agonism and posthumanism instead. As there is a lag in the theorisation of ableism, PAMT provides an alternative framework that can be applied to current approaches to increase our professional consciousness of ableism. By repositioning the practice and exploring alternative subjectivities, the professional and personal narratives of a therapist experiencing illness/disability became more integrated, working with–not against–each other in a shared activism. The methodology fostered an increased ethical care of the self; offered tools that critiqued what we are; experimented with going beyond the limits imposed on us. The use of such tools could have wider application in the everyday practices of therapists. The findings have significant implications for practice and training, as the challenges people and societies face cannot be adequately dealt with without tools to explicitly uncover and address normalisation and ableism.</p>

Developing post-ableist music therapy: An autoethnography exploring the counterpoint of a therapist experiencing illness/disability

<p>This PhD examined a therapist’s experience of illness/disability to see if any new light could be shed on music therapy whilst also finding ways to navigate disability as a practitioner. There has not been adequate research attention given to the experiences of music therapists who have an illness/disability. The position is often negotiated in isolation with minimal tools and resources. An arts-based autoethnography was used to determine how the close examination of one’s personal experience with illness/disability can impact on practice, how the work can be negotiated, and to uncover any new practical or theoretical meanings. Furthermore, it looked to determine what arts-based autoethnography could offer one’s practice. A poststructural lens was used that drew on social constructionism, feminism, and the work of Michel Foucault. Data generated from a music therapist’s practice, experiences of illness/disability, literature, and professional documents were analysed using Foucault’s “critical ontology of ourselves” (Foucault, 1984b, p. 47). Hidden processes of problematic ableism were found within the practice examined as well as in some educational and professional encounters. These regimes of ableism were supported by universalising and dichotomising discourses, namely humanism, western normativity, limited observable understandings of disability, and the enforcement of able/disabled divide through many binaries. The methodology provided the tools to reposition the practice to politicise disability and address ableism. Addressing ableism was found to be more complex than simply incorporating disability issues into existing contemporary frameworks. The analysis led to the development of Post-Ableist Music Therapy (PAMT). PAMT extended the relational ethic beyond what was present in the prior practice by drawing on aspects of posthumanism, agonistic plurality, and increasing the visibility of disability studies and crip theory. Therefore, PAMT offers a different lens to the critical orientations’ apparatus: a social justice practice not based on empowerment and humanism but on agonism and posthumanism instead. As there is a lag in the theorisation of ableism, PAMT provides an alternative framework that can be applied to current approaches to increase our professional consciousness of ableism. By repositioning the practice and exploring alternative subjectivities, the professional and personal narratives of a therapist experiencing illness/disability became more integrated, working with–not against–each other in a shared activism. The methodology fostered an increased ethical care of the self; offered tools that critiqued what we are; experimented with going beyond the limits imposed on us. The use of such tools could have wider application in the everyday practices of therapists. The findings have significant implications for practice and training, as the challenges people and societies face cannot be adequately dealt with without tools to explicitly uncover and address normalisation and ableism.</p>

Ethical Autoethnography: Is it Possible?

Autoethnography is a widely applied qualitative research method to examine self-experience in relation to life events, and also situated experiences in cultural and institutional contexts. In this paper the ethical challenges arising in conducting and presenting autoethnographic research are presented and explored, first through reflection on personal experience of being described and identified in an autoethnographic presentation without my permission, then through the challenges of my own experiences undertaking autoethnographic work. Following Ellis’ relational ethic as a third dimension along with procedural and situation ethics, a fourth dimension of the ethic of the self is presented. Ways we can enhance the ethic of respect in autoethnography is further elaborated.

Ethics of Care: Readings and Perspecives

The article examines the main emphasis in the evolution of the concept of care. It, on the one hand, builds a different ethics (C. Gilligan) and, on the other, is an attempt to justify a new political philosophy (J. Tronto) and new forms of solidarity arising from the understanding of vulnerability as universally shared situation. Particular attention has been paid to the French ethical voices – Sandra Logier and Patricia Paperman, who contribute to the enrichment of care readings: it is a leading relational ethic and political weapon that valorizes all that remains beyond the reach of ethics of justice. Possible political projections range it between the reduction of the feminist charge of the concept in case of over-reduction in favor of a particular political context (J.-M. Chahsiche) and the promising future of this “holistic” concept, bearing resources to enrich the political (S. Logier). Further arguments in favor of ethics of care have been sought in Hunyadi’s theory of the role of context as a combination of factuality and counter-factuality, and the opportunity for ethics of care to formulate its own normativity (St. Collins). The ethics of care is a contribution to feminist theories of difference and an example of a moderate deconstructionist approach: it practically realizes the calls of the deconstruction to “retain aporia” (Fr. Laruelle), but without reaching its possible extremes.

Makeovers Made Over: Ubuntu and Decolonization in Reality TV

Narratives about Africa are often shaped by deficit discourses that frame “development” as an instrument for advancing the interests of global capitalism. From within this neoliberal view, Africa has to “catch up” to and “be taught” how to emulate and achieve the standards promulgated in mainstream media. Through the lens of an alternative realism, however, such narratives can be reshaped. The African philosophy of ubuntu is one example of a deeply relational ethic from within which development can be reconceptualized as “freedom” in terms of democratic ideals and which can be used as a guiding principle for media work and the refashioning of (reality television) images.