Poverty and maternal mortality in Nigeria: towards a more viable ethics of modern medical practice

Poverty is often identified as a major barrier to human development. It is also a powerful brake on accelerated progress toward the Millennium Development Goals. Poverty is also a major cause of maternal mortality, as it prevents many women from getting proper and adequate medical attention due to their inability to afford good antenatal care. This Paper thus examines poverty as a threat to human existence, particularly women's health. It highlights the causes of maternal deaths in Nigeria by questioning the practice of medicine in this country, which falls short of the ethical principle of showing care

Diagnosis by Documentary: Professional Responsibilities in Informal Encounters

Most work addressing clinical workers' professional responsibilities concerns the norms of conduct within established professional-patient relationships, but such responsibilities may extend beyond the clinical context. We explore health workers' professional responsibilities in such "informal" encounters through the example of a doctor witnessing the misdiagnosis and mistreatment of a serious long-term condition in a television documentary, arguing that neither internalist approaches to professional responsibility (such as virtue ethics or care ethics) nor externalist ones (such as the "social contract" model) provide sufficiently clear guidance in such situations. We propose that a mix of both approaches, emphasizing the noncomplacency and practical wisdom of virtue ethics, but grounding the normative authority of virtue in an external source, is able to engage with the health worker's responsibilities in such situations to the individual, the health care system, and the population at large

The Challenge to Care in a Premier League Football Club

Elite men’s football in the UK has previously been portrayed as a harsh and competitive micro-political environment. This environment has been described as ‘uncaring’. Paradoxically, care has been identified as an essential aspect of coaching pedagogy. Thus, this study drew upon the experience of a case-study strength and conditioning coach to explore care in a Premier League Football Club. Specifically, a naturally occurring reflective diary served as a primary data source. Findings revealed that the coach ‘cared for’ an athlete through a ‘rules based’ approach, which thus far has not been described within coaching research. The narrative presented also suggested that care was constrained by the competitive context in which the coach operates. This context requires coaches to ‘care about’ results, and the associated implications for their own careers and other individuals around the club e.g. staff and supporters. Thus, this caring relationship was situated and influenced by wider contextual influences. This study should prompt significant consideration by coaches who might examine how their care is influenced by social, economic and micro-political factors, whilst simultaneously providing novel insights for coaching researchers who may further consider ‘rule based’ approaches to care. Keywords: Care; Elite Football; Coaching; Noddings; Micro-Politic

High attaining students, marketisation and the absence of care: everyday experiences in an urban academy

This article draws on the work of Nel Noddings to suggest that the current neoliberal, marketised system of education is eroding caring relationships in schools. Data are drawn from a small-scale qualitative study of an ethnically diverse group of high attaining sixth form students from a successful urban academy. Based on this data, we argue that two fundamental aspects of care, students’ relationships with their teachers and an attention to their personal and social concerns, were neglected because of the overriding focus on examination success to maintain the school’s position in the education marketplace. The article offers detailed evidence from the students’ perspective to support the claim that the marketisation of the education system leads to students being valued only in as far as they bring value to the school. It also suggests that care is one of the main casualties in such a system

Eudaimonistic Argumentation

Virtue theories have lately enjoyed a modest vogue in the study of argumentation, echoing the success of more far-reaching programmes in ethics and epistemology. Virtue theories of argumentation (VTA) comprise several conceptually distinct projects, including the provision of normative foundations for argument evaluation and a renewed focus on the character of good arguers. Perhaps the boldest of these is the pursuit of the fully satisfying argument, the argument that contributes to human flourishing. This project has an independently developed epistemic analogue: eudaimonistic virtue epistemology. Both projects stress the importance of widening the range of cognitive goals beyond, respectively, cogency and knowledge; both projects emphasize social factors, the right sort of community being indispensable for the cultivation of the intellectual virtues necessary to each project. This paper proposes a unification of the two projects by arguing that the intellectual good life sought by eudaimonistic virtue epistemologists is best realized through the articulation of an account of argumentation that contributes to human flourishing

Foundations of character: methodological aspects of a study of character development in three- to six-year-old children with a focus on sharing behaviours

This article focuses on methodological issues arising in a study of character development, using illustrations of ‘sharing behaviours.’ Based primarily in six early years settings in southeast England the research records naturalistic observations of peer interactions for 55 children aged three to six years. Applying grounded theory to the processes of observing, analysing and interpreting evidence required a cautious and collectively reflective approach. The methodology sought to moderate the influence of the researchers' prior knowledge of ‘grand theories’ of moral development and assumptions about relevance to the observation records. The study's originality lay in the exploration of moral development without reference to any particular grand theory as an explanatory framework; and in the reluctance to be drawn to potentially simplistic rationalisations of the children's intentions on the basis of their observed behaviours. Exploring young children's subjective experiences, this research provides insights into the intricacy of this process, steering away from ‘neat’ findings and attempting to reflect the sophistication of the children's skilful and sometimes surprising negotiations of moral dilemmas. Implications for practice relate to the complexities involved in attempts to unravel the developing moral characters of young children and the practice through which this may be nurtured

Implications of teacher life-work histories for conceptualisations of ‘care’: narratives from rural Zimbabwe

Schools are increasingly seen as key sites for support to HIV-affected and other vulnerable children, and teachers are assigned the critical role of identifying and providing psychosocial support. Drawing on the life-work history narratives of twelve teachers in Zimbabwe, this paper explores the psychosocial processes underpinning teachers’ conceptualisations of these caring roles. The influence of prolonged adversity, formative relationships, and broader patterns of social and institutional change in teacher identity formation processes speak to the complex and embodied nature of understandings of ‘care’. In such extreme settings teachers prioritise the material and disciplinary aspects of ‘care’ that they see as essential for supporting children to overcome hardship. This focus not only means that emotional support as envisaged in international policy is commonly overlooked, but also exposes a wider ideological clash about childrearing. This tension together with an overall ambivalence surrounding teacher identities puts further strain on teacher-student relationships. We propose the current trainings on providing emotional support are insufficient and that more active focus needs to be directed at support to teachers in relation with their students

Care(ful) relationships: supporting children in secure care

Secure children's homes are used to accommodate children aged 10–16 under two main categories; while half are sentenced after committing a serious offence, the other half are placed because there are serious concerns around their safety in the community. Secure children's homes are prized within the secure estate, and they administer complex therapeutic support to ‘the most vulnerable’ young people, however little is known about the experiences of those employed to work in such spaces. This paper shares findings from PhD research conducted in one secure children's home over 1 year. Data presented are drawn from sensitive ethnographic fieldwork and in‐depth interviews with residential staff and residents in the home. Although young people's views are important, we concentrate here on the perspectives of residential staff to share their reflections of delivering ‘care’ and the strategies used to manage successful relationships within a secure setting. We conclude that residential staff tread a fine line between creating emotional closeness while maintaining physical distance and that they are sometimes unable to return the intensity of feeling that residents' direct towards them. We recommend that all residential staff receive regular and detailed supervision to provide opportunity to request support when necessary

Between overt and covert research: concealment and disclosure in an ethnographic study of commercial hospitality

This article examines the ways in which problems of concealment emerged in an ethnographic study of a suburban bar and considers how disclosure of the research aims, the recruitment of informants, and elicitation of information was negotiated throughout the fieldwork. The case study demonstrates how the social context and the relationships with specific informants determined overtness or covertness in the research. It is argued that the existing literature on covert research and covert methods provides an inappropriate frame of reference with which to understand concealment in fieldwork. The article illustrates why concealment is sometimes necessary, and often unavoidable, and concludes that the criticisms leveled against covert methods should not stop the fieldworker from engaging in research that involves covertness