What counts as a voiceable concern in decisions about speaking out in hospitals: A qualitative study

Objectives Those who work in health care organisations are a potentially valuable source of information about safety concerns, yet failures of voice are persistent. We propose the concept of ‘voiceable concern’ and offer an empirical exploration. Methods We conducted a qualitative study involving 165 semi-structured interviews with a range of staff (clinical, non-clinical and at different hierarchical levels) in three hospitals in two countries. Analysis was based on the constant comparative method. Results Our analysis shows that identifying what counts as a concern, and what counts as a occasion for voice by a given individual, is not a straightforward matter of applying objective criteria. It instead often involves discretionary judgement, exercised in highly specific organisational and cultural contexts. We identified four influences that shape whether incidents, events and patterns were classified as voiceable concerns: certainty that something is wrong and is an occasion for voice; system versus conduct concerns, forgivability and normalisation. Determining what counted as a voiceable concern is not a simple function of the features of the concern; also important is whether the person who noticed the concern felt it was voiceable by them. Conclusions Understanding how those who work in health care organisations come to recognise what counts as a voiceable concern is critical to understanding decisions and actions about speaking out. The concept of a voiceable concern may help to explain aspects of voice behaviour in organisations as well as informing interventions to improve voice.

The Costs and Labour of Whistleblowing: Bodily Vulnerability and Post-disclosure Survival

Whistleblowers are a vital means of protecting society because they provide information about serious wrongdoing. And yet, people who speak up can suffer. Even so, debates on whistleblowing focus on compelling employees to come forward, often overlooking the risk involved. Theoretical understanding of whistleblowers’ post-disclosure experience is weak because tangible and material impacts are poorly understood due partly to a lack of empirical detail on the financial costs of speaking out. To address this, we present findings from a novel empirical study surveying whistleblowers. We demonstrate how whistleblowers who leave their role as a result of speaking out can lose both the financial and temporal resources necessary to redevelop their livelihoods post-disclosure. We also show how associated costs involving significant legal and health expenditure can rise. Based on these insights, our first contribution is to present a new conceptual framing of post-disclosure experiences, drawing on feminist theory, that emphasizes the bodily vulnerability of whistleblowers and their families. Our second contribution repositions whistleblowing as a form of labour defending against precarity, which involves new expenses, takes significant time, and often must be carried out with depleted income. Bringing forth the intersubjective aspect of the whistleblowing experience, our study shows how both the post-disclosure survival of whistleblowers, and their capacity to speak, depend on institutional supports or, in their absence, on personal networks. By reconceptualizing post-disclosure experiences in this way—as material, embodied and intersubjective—practical implications for whistleblower advocacy and policy emerge, alongside contributions to theoretical debates. Reversing typical formulations in business ethics, we turn extant debates on the ethical duty of employees to speak up against wrongdoing on their heads. We argue instead for a responsibility to protect whistleblowers exposed to vulnerability, a duty owed by those upon whose behalf they speak.

Informal Accountability, Distrust, and Speaking Out

Accountability did not operate solely through formal audits, institutions or legal processes; informal and public forms of accountability were also particularly important, not least as a pressure on Parliament, the East India Company and other institutions (often themselves seen as corrupt), to increase their oversight of officers. Such public accountability could take many forms but the chapter focuses on people (often officials themselves) who made public revelations when they felt that formal accountability mechanisms had failed. These men might now be called ‘whistle-blowers’ but in the pre-modern period their behaviour struggled to achieve legitimacy. The chapter surveys the variety of their motives and shows how they fought to expose and remedy corruption, often using print to do so, before sketching the negative ways in which their institutions reacted to their complaints and publicity.

Feminism in song of jineman kenya ndesa laras slendro pathet sanga

Feminism in Sukesi Rahayu's Jineman Kenya Ndesa laras slendro pathet sanga is a study that reviews feminist discourses on the creation of gamelan music based on the issues of gender equality between women and men. The purpose of this research is to prove and show that the creation of Javanese karawitan is not only based on male paradigm domination, but women also have a role in speaking out about feminism through karawitan works. The research methodology used is descriptive qualitative by positioning the object of study as the primary focus and writings on feminism as supporting sources. The results of this study indicate that in Sukesi Rahayu's Jineman Kenya Ndesa Slendro Sanga, there is feminist content, namely an attempt to elevate the dignity of women, which in this case is sindhen, within the scope of Javanese art culture as well as women in general.Keywords: Feminism; Sindhenan; Javanese culture

Drug Use, Public Debate and Increasing Pressures for a Drug Policy Reform in Finland

The situation in Finland is marked by a redistribution of labour between social and health care and criminal control policy. Attitudes are changing especially among the young, authorities are speaking out against the zero-tolerance policy, but there is also resistance to change. The situation is open.

Bridge to the Beloved Community: John Lewis's Interracial and Jewish Community Outreach

This article captures my personal relationship with Congressman John Lewis, his wife, Lillian, and their son, John-Miles. Readers will discover Congressman Lewis's unique ties with the Jewish community and his lifelong commitment to strengthening Black-Jewish relations. It notes the issues he championed—from voting rights to Israel's security—and includes his own words marching in solidarity with the Jewish community and speaking out for freedom for Soviet Jews.

The Dangers of Minimizing Obstetric Violence

This commentary is a response to the article by Lappaman and Swartz, “How gentle must violence against women be in order not to be violent?” in which the term “obstetric violence” is critiqued. The authors argue that the term is harmful and does violence (to health care workers and even birthers themselves) and is not helpful to efforts to improve or reform maternity care. They suggest that we abandon the term and use less inflammatory descriptions (i.e., such as “mistreatment”) instead. While recognizing the inevitable risks involved in naming and writing about obstetric violence, I argue that these risks are necessary in the interests of struggling against unjust systems. I unpack the authors' critique and argue that it ultimately works to minimize experiences of obstetric violence, silence the voices of those that have been speaking out on this issue for a very long time, and casts doubt on the legitimacy of a concept that has only recently received global recognition (after a long and transnational struggle). These harms and dangers are not necessarily the direct intentions of the authors but are embedded in wider structures of power that are often incredulous, disbelieving, and dismissive in the face of testimonies and evidence of gendered and racialized pain/violence.