Stephen David Edwards

An exploratory pilot study with a small homogenous sample of Christian English speaking participants provided support for an alternative research hypothesis that a Christ consciousness contemplation with Heart Prayer of HeartMath techniques was significantly associated with increasing psychophysiological coherence, sense of coherence, spirituality and health perceptions. Participants described feelings of a peaceful place in oneness and connection with Christ. Integrative findings point towards Christ consciousness as an ultimately non-dual process of sensing vibrational resonance radiating from the human heart. Implications for further research are discussed.

This integral investigation explored phenomenological and neurophysiologic, individual and collective dimensions of Christian Trinitarian meditation experiences in a volunteer, convenience sample of 10 practicing Christians, 6 men and 4 women, with a mean age of 48 years and an age range from 21 to 85 years. Participants meditated for a minimum period of 15 minutes, during which neurophysiologic data in the form of electroencephalographic (EEG), electromyographic (EMG), blood volume pulse (BVP) and respiratory activity were recorded. A phenomenological analysis indicated that the meditation process generally involved a movement from body to mind to spirit as evident in reports of an increasingly relaxed, contented and focused state of consciousness characterised by Christian Trinitarian imagery, wonder, surrender, peace, bliss, openness and formlessness. The neuropsychological findings indicated significant increases, from baseline to meditation recordings, in the alpha and beta range, accompanied by increasing mean trends in the theta and gamma range, and decreasing mean trends in the delta range, EMG, BVP and respiration. Integrative findings indicated the practical theological value of small doses of Christian Trinity meditation to enhance spiritual life for those forms of waking, thinking, conscious behaviour needed in everyday world involvement and healing. Findings were discussed in relation to further integrative investigations and interventions with practical theological implications

The research was generally motivated by a dearth of studies on joy, and particularly inspired by a book of joy celebrating the inter-spiritual dialogue between the Dalai Lama and Desmond Tutu. Its aim was to investigate whether the direct contemplation of joy would be associated with improvements in psychophysiological coherence, spirituality and various positive emotions and feelings. Integrative quantitative and qualitative findings emerging from a small pilot study, including a convenience sample of six participants with a mean age of 42 years and age range of 25-69 years, supported the research hypothesis. Significant quantitative increases in psychophysiological coherence, spirituality and positive feelings were coherently and consistently supported by participants' individual and collective experiences. Integrative discussion amplified the paradoxical theme of joy through suffering in human emotional and spiritual life.

The ethics of care still appeals to many in spite of penetrating criticisms of it which have been presented over the past 15 years or so. This paper tries to offer an explanation for this, and then to critically engage with three versions of an ethics of care. The explanation consists firstly in the close affinities between nursing and care. The three versions identified below are by Gilligan (1982 ), a second by Tronto (1993 ), and a third by Gastmans (2006 ), see also Little (1998 ). Each version is described and then subjected to criticism. It is concluded that where the ethics of care is presented in a distinctive way, it is at its least plausible; where it is stated in more plausible forms, it is not sufficiently distinct from nor superior to at least one other common approach to nursing ethics, namely the much-maligned 'four principles' approach. What is added by this paper to what is already known: as the article tries to explain, in spite of its being subjected to sustained criticism the ethics of care retains its appeal to many scholars. The paper tries to explain why, partly by distinguishing three different versions of an ethics of care. It is also shown that all three versions are beset with problems the least serious of which is distinctiveness from other approaches to moral problems in health care.

This paper is prompted by the charge that the prevailing Western paradigm of medical knowledge is essentially Cartesian. Hence, illness, disease, disability, etc. are said to be conceived of in Cartesian terms. The paper attempts to make use of the critique of Cartesianism in medicine developed by certain commentators, notably Leder (1992), in order to expose Cartesian commitments in conceptions of disability. The paper also attempts to sketch an alternative conception of disability — one partly inspired by the work of Merleau-Ponty. In particular, three key Cartesian claims are identified and subjected to criticism. These are as follows: (a) The claim that the body is an object, (b) what is termed here ‘the modularity thesis’, and (c) the claim that the body cannot be constitutive of the self (i.e. since the soul/mind/brain is). In opposition to these claims, it is argued that the body is properly viewed as a subject; that there are neither purely mental, nor purely physical disabilities; and that selves are constituted, at least in part, by their bodies

This paper is an attempt to provide a critical evaluation of the theory of disability put forward by Lennart Nordenfelt. The paper is in five sections. The first sets out the main elements of Nordenfelt's theory. The second section elaborates the theory further, identifies a tension in the theory, and three kinds of problems for it. The tension derives from Nordenfelt's attempt to respect two important but conflicting constraints on a theory of health. The problems derive from characterisation of the goals of persons; the difficulty which Nordenfelt has in respecting the plausible view that there is a distinction between illness and disability; and the presence in the theory of other strongly counter-intuitive implications. In section three a defence of Nordenfelt is attempted from within the resources available within his own theory. This defence seeks to exploit his distinctions between a person who is ill and one who is generally disabled and that between first- and second-order disabilities. However, it is concluded that there are insufficient resources within Nordenfelt's theory to fend off the criticisms developed in section two. The fourth section of the paper attempts a defence of Nordenfelt. It is claimed that introduction of the concept of capacity helps to explain differences between problem cases in the theory. Finally, it is shown that at least two important constraints on any theory of disability emerge from the preceding discussion.

This “current controversies” contribution describes the recent case of a severely disabled six year old girl who has been subjected to a range of medical interventions at the request of her parents and with the permission of a hospital clinical ethics committee. The interventions prescribed have become known as “the Ashley treatment” and involve the performance of invasive medical procedures (eg, hysterectomy) and oestrogen treatment. A central aim of the treatment is to restrict the growth of the child and thus make it easier for her parents to care for her at home. The paper below discusses the main objections to the treatment. It concludes that the most serious concern raised by the case is that it may set a worrying precedent if the moral principle employed in justification of the treatment is applied again to endorse it in similar circumstances. Finally, it raises the possibility that that same moral principle may even be invoked to justify more radical interventions than those that were actually performed in the Ashley treatment

This paper recounts the events surrounding the case of Ashley X, a severely disabled young girl whose parents opted for oestrogen therapy, a hysterectomy and breast removal – the so-called ‘Ashley treatment’ – in order to reduce her projected adult weight and improve her quality of life. Following a description of the events leading up to the procedure itself, and the worldwide debate which ensued, the main arguments in favour and against the procedures are presented. The paper also critically engages with a recent defence of the treatments presented by one of those closely involved with the case – Dr D Diekema. Finally, the recommendations of a report which criticizes procedures at the hospital in which the treatments took place are described, and it is argued that the main recommendation regarding the constitution of the Hospital Ethics Committee (HEC) is ill-thought through and is unlikely to have made any difference to the decision taken by the HEC to approve the Ashley treatments

This paper enquires into the nature and the extent of the obligations of nurses. It is argued that nurses appear to be obliged to undertake supererogatory acts if they take clause one of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) Code of Professional Conduct seriously (as, indeed, they are required to do). In the first part of the paper, the nature of nursing obligations is outlined, and then the groups and individuals to whom nurses have obligations are identified. Following a brief discussion of the moral foundation of the nurse's obligations to her/his employer, a common conflict of obligations is identified. Then a distinction is drawn between ordinary and extraordinary moral standards. Appreciation of this is necessary for an understanding of the criterion of what constitutes a supererogatory act. By the definition of supererogatory acts proposed below, it is suggested that actions such as whistleblowing satisfy that definition

Tom Shakespeare’s important new book includes, among other topics, a persuasive critique of the social model of disability. A key component in his case against that model consists in an argument against the impairment/disability distinction as this is understood within the social model. The present paper focuses on the case Shakespeare makes against that distinction. Three arguments mounted by Shakespeare are summarised and responded to. It is argued that the responses adequately rebut Shakespeare’s case on this specific issue. Moreover, as the engagement with Shakespeare’s argument illustrates, his claim to employ a critical realist perspective appears to be in considerable tension with the case he offers against the impairment/disability distinction

This paper discusses the distinction between disability and handicap as it is proposed by the World Health Organization (WHO) in their publication International Classification of Impairments, Disabilities and Handicaps (WHO, 1993 (first published, 1980)). Following criticism of this an attempt to salvage the distinction by Nordenfelt (1993, 1983) is discussed. It is argued that neither the WHO nor Nordenfelt are successful in their attempts to preserve the distinction between disability and handicap in a theoretically wellmotivated manner. Contrary to the WHO, it is argued that what they term ‘disabilities’ and ‘handicaps’ both have external causes. And contrary to Nordenfelt's position it is shown that “basic actions” do not provide a firm theoretical foundation for the concept of disability. Moreover, the criticisms of these two sets of views reveal that attempts to describe the phenomenon of disablement which focus on the individual suffer from a serious methodological shortcoming

The moral status accorded to an individual (or class of individuals) helps to account for the weight of the moral obligations considered due to an individual (or class of individuals). Strong arguments can be given to indicate that the moral status accorded, justly or unjustly, to individuals with intellectual disabilities is less than that accorded to those considered intellectually able. This paper suggests that such a view of the moral status of intellectually disabled individuals derives from individualism. Ontological and normative components of individualism are identified. It is shown that individualistic, ontological criteria for personhood compromise the integrity of “dependent” individuals. And it is shown that the normative component of individualism further compromises the integrity of intellectually disabled individuals. An alternative view of the self is outlined in which dependence features centrally. It is tentatively suggested that such a view of the self may prove more congenial to enhancing the moral status of individuals with intellectual disabilities

It was reported in 2006 that a regime of ‘supervised self harm’ had been implemented at St George’s Hospital, Stafford. This involves patients with a history of self-harming behaviour being offered both emotional and practical support to enable them to do so. This support can extend to the provision of knives or razors to enable them to self-harm while they are being supervised by a nurse. This article discusses, and evaluates from an ethical perspective, three competing responses to self-harming behaviours: to prevent it; to allow it; and to make provision for supervised self-harm. It is argued that of these three options the prevention strategy is the least plausible. A tentative conclusion is offered in support of supervised self-harm

Is it true that an ethics of care offers something distinct from other approaches to ethical problems in nursing, especially principlism? In this article an attempt is made to clarify an ethics of care and then to argue that there need be no substantial difference between principlism and an ethics of care when the latter is considered in the context of nursing. The article begins by considering the question of how one could in fact differentiate moral theories. As is explained, this cannot be done merely in light of the moral judgements they defend, nor their ontological commitments (e.g. their view of the nature of persons). Following these methodological beginnings, care-based ethics is described and critically discussed. It is shown that ontological commitments embraced within care ethics do not themselves show that care ethics is distinct from other approaches. The idea of ‘psychological care’ is also discussed, which stems from the work of Margaret Little. Her claim that the ‘gestalts’ of justice and care cannot be combined is rejected in favour of an approach that does just that and which has been developed by Joan Tronto. It is then claimed that the moral commitments of principlism are certainly not incompatible with those of an ethics of care in the nursing context. A challenge to the idea that principlism and ethics of care might be compatible is anticipated in the work of Eva Feder Kittay. This challenge is responded to and it is concluded that care considered as a moral orientation and the moral values embedded in principlism are best combined in the nursing context. Care provides a moral orientation over which the obligations referred to in principlism can be laid

Depression is ranked as most common type of mental illness by the World Health Organization. Although cognitive behavioural therapy is recommended as the evidence-based psychological treatment of choice, this applies mostly to youthful, attractive, verbal, intelligent and successful persons with medical aid support in high income countries. More holistic counselling that includes holistic, verbal and non-verbal, expressive therapeutic modalities are more suitable for the planetary majority. Consequently, this study describes the process and effectiveness of philophonetics counselling with a sample of ten depressed clients seeking clinical psychological services in Zululand, South Africa, a region and country beset with considerable violence, crime illness and unemployment. Client reports of effectiveness of philophonetics counselling warrants further intervention and evaluative research, with special reference to wider community psychological applications of this expressive therapeutic modality via primary health care facilities, online courses and mobile technology.

HeartMath is a contemporary, scientific, coherent model of heart intelligence. The aim of this paper is to review this coherence model with special reference to its implications for artificial intelligence and robotics. Various conceptual issues, implications and challenges for AI and robotics are discussed. In view of seemingly infinite human capacity for creative, destructive and incoherent behaviour, it is highly recommended that designers and operators be persons of heart intelligence, optimal moral integrity, vision and mission. This implies that AI and robotic design and production should be continuously optimized through vigilant and appropriate human and material quality control procedures. Evidence is provided for some value and effectiveness of the HeartMath coherence model in this context.

Current UK guidelines regarding clinical research on children permit research that is non-therapeutic from the perspective of that particular child. The guidelines permit research interventions that cause temporary pain, bruises or scars. It is argued here that such research conflicts with the Declaration of Helsinki according to which the interests of the research subject outweigh all other interests. Given this, in the context of clinical research, who is best placed to protect the child from this kind of exploitation? Is it the medical researcher, the child’s parents or the nurse advocate? This article describes the problem, possible responses to it, and closes with a consideration of, and rejection of, a defence of current guidelines that claims moral parity between clinical research and clinical education

Sports Medicine as an apparent sub-class of medicine has developed apace over the past 30 years. Its recent trajectory has been evidenced by the emergence of specialist international research journals, standard texts, annual conferences, academic appointments and postgraduate courses. Although this field of enquiry and practice lays claim to the title ‘sports medicine’ this paper queries the legitimacy of that claim. Depending upon how ‘sports medicine’ and ‘medicine’ are defined, a plausible-sounding case can be made to show that sports medicine is not in fact a branch of medicine. Rather, it is sometimes closer to practices such as non-therapeutic cosmetic surgery. The argument of the paper is as follows. It begins with a brief statement concerning methodology. We then identify and subscribe to a plausible defining goal of medicine taken from a recognised authority in the field. Then two representative, authoritative, definitions of sports medicine are discussed. It is then shown that acceptance of these definitions of sports medicine generates a problem in that if they are accepted, no necessary commitment to the defining goal of medicine is present within sports medicine. It seems to follow that sports medicine is not medicine. In the final part of the paper a critical response to that conclusion is presented and rebutted. The response is one which rejects the identification of the defining goal of medicine upon which our argument rests

In this article we examine ethical aspects of the involvement of children in clinical research, specifically those who are incapable of giving informed consent to participate. The topic is, of course, not a new one in medical ethics but there are some tensions in current guidelines that, in our view, need to be made explicit and which need to be responded to by the relevant official bodies. In particular, we focus on tensions between the World Medical Association Declaration of Helsinki, and the guidance offered by the British Medical Association, the Royal College of Paediatrics and Child Health , and the Council for International Organizations of Medical Sciences. We conclude with a call for these organisations to make their guidance explicit in relation to the World Medical Association Declaration

This article discusses the question of whether, as is often claimed, nursing is properly described as an art. Following critical remarks on the claims of Carper, Chinn and Watson, and Johnson, the account of art provided by RG Collingwood is described, with particular reference to his influential distinction between art and craft. The question of whether nursing is best described as an art or a craft is then discussed. The conclusion is advanced that nursing cannot properly be described as an art, given acceptance of Collingwood’s influential definition of art. Moreover, it is shown that, due to difficulties inherent in specifying the ‘ends’ of nursing, nursing is only problematically described as a craft

HeartMath is a contemporary, scientific, coherent model of heart intelligence. The aim of this paper is to review this coherence model with special reference to its implications for artificial intelligence and robotics. Various conceptual issues, implications and challenges for AI and robotics are discussed. In view of seemingly infinite human capacity for creative, destructive and incoherent behaviour, it is highly recommended that designers and operators be persons of heart intelligence, optimal moral integrity, vision and mission. This implies that AI and robotic design and production should be continuously optimized through vigilant and appropriate human and material quality control procedures. Evidence is provided for some value and effectiveness of the HeartMath coherence model in this context.

A number of commentators claim their disability to be a part of their identity. This claim can be labelled ‘the identity claim’. It is the claim that disabling characteristics of persons can be identity-constituting. According to a central constraint on traditional discussions of personal identity over time, only essential properties can count as identity-constituting properties. By this constraint, contingent properties of persons (those they might not have instanced) cannot be identity-constituting. Viewed through the lens of traditional approaches to the problem of personal identity over time, disablement is most likely to be regarded as a contingent property of a person and not an essential one. Hence, on traditional approaches, the identity claim must be false. An alternative account of identity is sketched here. It is one which exploits the idea of narrative identity, and points to five basic features of personal existence. When accounts of identity are structured in relation to these five features, it is argued, disablement can be shown to be identity-constituting, and hence the identity claim can be accepted