The Madness of Free Indirect Style

This chapter considers the emergence of moral therapy in early psychiatry in order to argue that the Romantic-era innovation of free indirect style shares an affinity with eighteenth-century psychiatric diagnosis and case records. While the origin of free indirect style is often ascribed to Jane Austen, the chapter finds emergent forms of free indirect style appearing in psychiatric notebooks by mad-doctors practicing moral management, as well as in the political literature of the 1790s and in Romantic-era realist prose fiction. Free indirect style has a monitory function that abetted the psychiatric practice of moral management in the late eighteenth century: as a strategy for mediating the voice of a speaker in a text, free indirect style allowed early psychiatrists, who believed madness was transmitted orally, to regulate their patients’ conditions by moderating their speech. Free indirect style continues to bear the traces of the madhouse in novels by Mary Wollstonecraft and Jane Austen. The chapter thus uncovers pathological traces underlying the representational device that has been called the novel’s most distinctive formal feature. Free indirect style also thus inaugurates the association of the novel with the patient’s narrative, anticipating modern discussions of “psycho-narration” as a medico-literary formal device. Ultimately, free indirect style allows the writer to intimate forms of pathology that the reader is invited to, in effect, diagnose.

Ethical challenges in management of critically ill pregnant patients with coronavirus disease 2019 (COVID-19)

Despite the overwhelming number of coronavirus disease 2019 (COVID-19) cases worldwide, data regarding the optimal clinical guidance in pregnant patients is not uniform or well established. As a result, clinical decisions to optimize maternal and fetal benefit, particularly in patients with critical COVID-19 in the early preterm period, continue to be a challenge for obstetricians. There is often uncertainty in clinical judgment about fetal monitoring, timing of delivery, and mode of delivery because of the challenge in balancing maternal and fetal interests in reducing morbidity and mortality. The obstetrician and critical care team should empower pregnant patients or their surrogate decision maker to make informed decisions in response to the team’s clinical evaluation. A clinically grounded ethical framework, based on the concepts of the moral management of medical uncertainty, beneficence-based obligations, and preventive ethics, should guide the decision-making process.

Dominant Management Logics of Siyasetnamas – A Moral Management Perspective

This article examines the management perspectives in Islamic political history, which can contribute to the contemporary management and organizational knowledge (MOK). It attempts to find out the taken-for-granted assumptions and arguments that shape the Muslim scholars’ management perspective in history. To this end, political treatises in Islamic history (namely, 'siyasetnamas') and their managerial arguments are scrutinized through content analysis. By determining underlying dominant logics -assumptions that most siyasetnamas refer to- this article allows us a mental exercise to step out of the Western mindset, which is thought to be the best, and the only way to understand MOK and tries to introduce a moral management perspective from the history of Islam. Our results indicate that siyasetnamas’ dominant management logics could provide valuable implications to MOK with their emphasis on (i) considering society as the real owner of entities, (ii) having additional societal responsibilities, and (iii) moral competency of organizational actors.