Pastoral Power and the Confessing Subject in Patient-Centred Communication

This paper examines the power relations in “patient-centred communication”. Drawing on the work of Michel Foucault I argue that while patient-centred communication frees the patient from particular aspects of medical power, it also introduces the patient to new power relations. The paper uses a Foucauldian analysis of power to argue that patient-centred communication introduces a new dynamic of power relations to the medical encounter, entangling and producing the patient to participate in the medical encounter in a particular manner. Keywords: Pastoral power, Patient-centred, Confession, Michel Foucaul

The Harm of Bioethics: A Critique of Singer and Callahan on Obesity

Debate concerning the social impact of obesity has been ongoing since at least the 1980s. Bioethicists, however, have been relatively silent. If obesity is addressed it tends to be in the context of resource allocation or clinical procedures such as bariatric surgery. However, prominent bioethicists Peter Singer and Dan Callahan have recently entered the obesity debate to argue that obesity is not simply a clinical or personal issue but an ethical issue with social and political consequences. This article critically examines two problematic aspects of Singer and Callahan's respective approaches. First, there is an uncritical assumption that individuals are autonomous agents responsible for health-related effects associated with food choices. In their view, individuals are obese because they choose certain foods or refrain from physical activity. However, this view alone does not justify intervention. Both Singer and Callahan recognize that individuals are free to make foolish choices so long as they do not harm others. It is at this point that the second problematic aspect arises. To interfere legitimately in the liberty of individuals, they invoke the harm principle. I contend, however, that in making this move both Singer and Callahan rely on superficial readings of public health research to amplify the harm caused by obese individuals and ignore pertinent epidemiological research on the social determinants of obesity. I argue that the mobilization of the harm principle and corresponding focus on individual behaviours without careful consideration of the empirical research is itself a form of harm that needs to be taken seriously. Keywords: obesity; Peter Singer; Dan Callahan; harm principle; public healt

An Agrarian Imaginary in Urban Life: Cultivating Virtues and Vices Through a Conflicted History.

This paper explores the influence and use of agrarian thought on collective understandings of food practices as sources of ethical and communal value in urban contexts. A primary proponent of agrarian thought that this paper engages is Paul Thompson and his exceptional book, The Agrarian Vision. Thompson aims to use agrarian ideals of agriculture and communal life to rethink current issues of sustainability and environmental ethics. However, Thompson perceives the current cultural mood as hostile to agrarian virtue. There are two related claims of this paper. The first argues that contrary to Thompson’s perception of hostility, agrarian thought is popularly and commercially mobilized among urban populations. To establish this claim I extend Charles Taylor’s notion of a social imaginary and suggest that urban agriculture can be theorized as an agrarian imaginary. Entwined with the first claim is the second, that proponents selectively use agrarian history to overemphasis a narrative of virtue while ignoring or marginalizing historical practices of agrarian violence, exclusion and dispossession. I do not discount or deny the significance of agrarian virtue. By situating agrarian thought within a clearer virtue ethics framework and acknowledging potential manifestation of agrarian vice, I suggest that the idea of agrarian virtue is strengthened. Keywords: Agrarian, Social imaginary, Urban agriculture, Virtue, Vice, Charles Taylo

Slurs aside, let’s talk about the ethics of public health measures

Predictable positions followed the recent announcement of an increase in tobacco tax by 12.5% a year for four years. Public health advocates praised the tax, labelling those questioning it as “tobacco industry apologists”. Libertarians, on the other hand, decried it as further evidence of the “nanny state” and The Australian’s Adam Creighton went as far as to compare the measure to Nazis. Apart from incensing readers, the noise from these well-worn positions drowns out significant public health concerns. The uncritical acceptance from public health and knee-jerk rejection from libertarians leaves little room to ask whether increasing the tobacco tax is unquestionably good. It’s time for a new conversation

Should the food industry resign from the health department too?

Furore over links between Assistant Minister for Health Fiona Nash’s office and industry continues today with revelations that her former chief of staff is connected to the alcohol, as well as the food industry. Alastair Furnival resigned last Friday over his role in shutting down a website about the health star rating food labelling system and it’s now been revealed that he played a key role in cancelling the funding of the Alcohol and other Drugs Council of Australia. Furnival is co-owner of a lobbying firm that has represented major food companies opposed to the new front-of-pack labelling system. According to Fairfax, he and his wife also co-own a company, which, in turn, owns another that lobbied for the alcohol industry in 2012. Such conflicts of interest place question marks over an individual’s capacity to judge a situation, perform a duty or make a decision in a fair and impartial manner. But what if a public institution, such as the Department of Health itself, has conflicted interests? Furnival’s conflict of interest is worrying and should be thoroughly scrutinised. But the influence of the food and alcohol industries at the institutional-level precedes Furnival and will continue despite his resignation.Rock Ethics Institute at the Pennsylvania State University and the Edmond J. Safra Center for Ethics at Harvard University

On the Importance of the Institution and Social Self in a Sociology of Conflicts of Interest

Comment on “Toward a Sociology of Conflict of Interest in Medical Research” by Sarah Winch and Michael Sinnott, published in Journal of Bioethical Inquiry, 8(4): 389–391. In calling for a sociological analysis of conflicts of interest through a postmodern lens, Sarah Winch and Michael Sinnott open multiple avenues of inquiry. As suggested, a postmodern perspective may serve to disrupt modernist notions of objective science, pure knowledge, and human progress implied by COI policies and regulation. However, rather than following this path, I contend that modernist notions of the individual implied by COI governance require critical attention. In this brief response to the case presented, I examine the individual–institution relation in COI governance. Keywords: Primary interests, Secondary interests, Institutional interests, Social sel

Because we can, does it mean we should? The ethics of GM foods

Food is cultural, social and deeply personal, so it’s no surprise that modifications to the way food is produced, distributed and consumed often lead to ethical debates. Developments in the genetic modification (GM) of foods and crops has resulted in a raft of controversies. Ethics can help here. While science determines whether we can safely modify the genetic makeup of certain organisms, ethics asks whether we should. Ethics tries to move beyond factual statements about what is, to evaluative statements about the way we should act towards ourselves, each other and the environment we inhabit. But things are not always so clear-cut. Three areas of ethics can help frame some of the concerns with GM food and crops: virtue, moral status and consequences

The limit of labels: ethical food is more than consumer choice

Over the past hundred years, industrial agriculture and the globalised food system have produced cheaper, longer lasting and more diverse food items. We can now enjoy tropical fruits in winter, purchase whole chickens at the price of a cup of coffee, and eat fresh bread long after it was baked. Once celebrated as the benevolent results of food science and ingenuity of farmers, these cheap and safe foods are dismissed by critics as the tainted fruits of “Big Food” – the culinary version of Big Tobacco and Big Oil. Food is no longer simply a matter of taste or convenience. Our food choices have become ethical and political issues. An innocuous but central strategy in these debates is the food label. In recent years there has been an explosion of ethico-political food labels to address concerns such as slavery, nutrition, environmental degradation, fair trade and animal cruelty. These disparate concerns are unified by their connection to the amorphous culprit “Big Food”. The idea is that by knowing what is in our food and how it was produced, we will reject unethical food corporations, buy from ethical producers and thereby promote justice. But is this necessarily so

Photoionized Neon Plasma Experiments at Z: Data Processing and Analysis Development

Photoionized plasmas are a special class of plasma common in astrophysical environments, such as x-ray binaries and active galactic nuclei, but they are a relatively unexplored regime of laboratory plasmas. This thesis discusses an experimental effort using the Z-Machine at Sandia National Laboratories to study the atomic kinetics in photoionized plasmas via K-shell line absorption spectroscopy. The experiment employs the intense x-ray flux emitted by the collapse of a Z-pinch to heat and backlight a neon photoionized plasma contained within a cm-scale gas cell placed at various distances from the Z-pinch and filled with neon gas with pressures in the range from 3 torr to 30 torr. High-resolution spectra show absorption by several ionization stages of neon, including Be-, Li-, He-, and H-like ions. A suite of IDL programs have been developed to process the experimental data to produce transmission spectra. Analysis of these spectra yields ion areal-densities and charge state distributions, which can be used to benchmark atomic kinetics codes. In addition, the electron temperature is extracted from level population ratios of Li- and Be-like ions, which can be used to test heating models of photoionized plasmas. Multiple aspects of the processing and analysis methods are tested to identify areas that show improvement or must be improved upon. These include the method of zero-level of absorption estimation, correspondence between known gas filling pressure and measurements totals, temperature extraction from Li-like and Be-like level populations, and the use of Voigt line profiles and Stark broadened line profiles to model the absorption spectra. Finally, we discuss trends visible in the analysis results

Practicing what he preached : how Martin Luther lived out his universal priesthood of all believers

When Martin Luther entered the monastery in 1505 as an Augustinian monk, he left the corrupted, inherently less-spiritual world for the religiously-oriented, celibate life in a cloister-the highest, most holy road one could take as a Christian. After a number of years he discovered that he was no more certain about his salvation or God\u27s acceptance of him than the day he had become a monk. The only way to please God came through faith, which a farmer or housewife could have as equally as a monk or a nun. Therefore, he left the monastery to return to the world and championed the cause of the married commoners, whom, he declared, were no less holy or pleasing to God than the thousands of monks, nuns, and priests who filled Europe\u27s churches and cloisters. Luther accomplished this through his writings, his preachings, and especially his lifestyle as he married a former nun, Katherina von Bora, raised children, and managed a home