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Confronting complexities

The Irish health system is confronted by a range of challenges, both emerging and recurring. In order to address these, it is essential that spaces are created for conversations around complex ethical and legal issues. This collection aims to provide a basis for ongoing engagement with selected issues in contemporary Irish health contexts. It includes contributions from scholars and practitioners across a range of disciplines, most particularly, ethics, law and medicine.

The focus of the collection is interdisciplinary and the essays are situated at the intersection between ethics, law and medicine. Important issues addressed include admission to care homes; assisted suicide; adolescent decision-making; allocation of finite resources; conscientious objection; data protection; decision-making at the end of life; mental health; the rights of older people; patient responsibilities; stem cell research; the role of carers; and reproductive rights. From these discussion, the collection draws out the following interlinking themes, addressing difference; context and care; oversight and decision-making; and, regulating research.

The essays are theoretically informed and are grounded in the realities of the Irish health system, by drawing on contributors’ contextual knowledge.

This book makes an informed and balanced contribution to academic and broader public discourse.

Space, identity and power

This volume aims to disclose the political, social and cultural factors that influenced the sanitary measures against epidemics developed in the Mediterranean during the long nineteenth century. The contributions to the book provide new interdisciplinary insights to the booming field of ‘quarantine studies’ through a systematic use of the analytic categories of space, identity and power. The ultimate goal is to show the multidimensional nature of quarantine, the intimate links that sanitary administrations and institutions had with the territorial organization of states, international trade, the construction of national, colonial, religious and professional identities or the configuration of political regimes. The circum-Mediterranean geographical spread of the case studies contained in this volume illuminates the similarities and differences around and across this sea, on the southern and northern shores, in Arabic, Spanish, Portuguese, Greek, Italian, English and French-speaking domains. At the same time, it is highly interested in engaging in the global English-speaking community, offering a wide range of terms, sources, bibliography, interpretative tools and views produced and elaborated in various Mediterranean countries. The historical approach will be useful to recognize the secular tensions that still lie behind present-day issues such as the return of epidemics or the global flows of migrants and refugees.

Bodies and environments in Italy and England

This book explores whether early modern people cared about their health, and what did it mean to lead a healthy life in Italy and England. According to the Galenic-Hippocratic tradition, 'preservative' medicine was one of the three central pillars of the physician's art. Through a range of textual evidence, images and material artefacts, the book documents the profound impact which ideas about healthy living had on daily practices as well as on intellectual life and the material world in Italy and England. Staying healthy and health conservation was understood as depending on the careful management of the six 'Non-Naturals': the air one breathed, food and drink, excretions, sleep, exercise and repose, and the 'passions of the soul'. The book provides fresh evidence about the centrality of the Non-Naturals in relation to groups whose health has not yet been investigated in works about prevention: babies, women and convalescents. Pregnancy constituted a frequent physical state for many women of the early modern European aristocracy. The emphasis on motion and rest, cleansing the body, and improving the mental and spiritual states made a difference for the aristocratic woman's success in the trade of frequent pregnancy and childbirth. Preventive advice was not undifferentiated, nor simply articulated by individual complexion. Examining the roles of the Non-Naturals, the book provides a more holistic view of convalescent care. It also deals with the paradoxical nature of perceptions about the Neapolitan environment and the way in which its airs were seen to affect human bodies and health.

Hogarth’s bodies
Frédéric Ogée

Figure 12.1  William Hogarth, frontispiece to Laurence Sterne’s Tristram Shandy (1759) (detail) 253 Burlesque bellies belief that life – and character – could be faithfully rendered only if they were shown ‘in progress’, the bodies in his pictures are always represented in action,4 physiologically registering and displaying (as in the painting of Schutz) the consequences of the characters’ modes of life. One of the most eloquent exercises in the genre – and also, interestingly, one of Hogarth’s most famous pictures – is A Midnight Modern Conversation (1733), in

in Bellies, bowels and entrails in the eighteenth century
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Mary Donnelly and Claire Murray

this approach can be assessed. It is also positive that, although the Irish courts have sometimes been slow to provide written judgments in cases of ethical complexity, a body of jurisprudence is gradually growing and this helps to provide a context for informed, critical engagement with the legal positions adopted. This book contributes to these emerging conversations and reflects our view that reasoned discussion is essential in developing appropriate responses to difficult questions about health ethics and law and that such discussion must be informed by the

in Ethical and legal debates in Irish healthcare
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New Jersey, 1800–70
James Moran

. He, like many other witnesses, also noted that, ‘the business of the farm is carried on by the sons’.53 Most witnesses took pains to explain that Van Auken’s instances of memory loss and repetition in conversation were no impediments to his successful conduct of his farming business. A local cooper, Nelson Crane, noted that he had done a considerable amount of work for Van Auken during which time they both spoke about farming and that there was ‘nothing that appeared loony in the old man’.54 In a telling testimonial Crane noted that: [I]n a conversation with him

in Work, psychiatry and society, c. 1750–2015
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Lunacy investigation law and the asylum reconsidered
James E. Moran

guardians, Robert Thatcher, along with Thatcher's son. They took John B. home in their carriage. On the same evening of his release from the asylum, John B. spent time at the local supply store, a gathering place where the men of the neighbourhood tended to socialise. John B. bought tobacco at the store and joined in the conversation that evening. Some of the questioning of witnesses revolved around who had said what about John B.'s mental state at the Copper Hill store during a several weeks’ period between his release from the asylum and his retrial

in Madness on trial
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Debbie Palmer

industrial psychology to structure their management of nurses. Psychological research supported the notion that the ideal nurse was a combination of feminine and masculine qualities, largely because psychologists now considered leadership and an ability to tolerate harrowing sights as masculine.18 Nurse leaders began to promote qualities associated with masculinity in order to gain higher status.19 At the same time notions of femininity lost some of their potency in conversations about nurses’ risk to illness. Commentators continued to draw on gendered vulnerability when

in Who cared for the carers?
Localising madness in New Jersey
James E. Moran

conversation about various subjects, past and present. On the subject of her impending inheritance, she appeared to Marshall to know exactly what she was about to acquire, and was not overly kind about the opinions of her family on the subject. In Marshall's recounting of their conversation, ‘she said further[,] “confound them they will not let me enjoy it [the inheritance] in peace in my old days”. She said there was not one who had a better right to a share of [her son's] property than she had … that she had furnished him in clothing and washed for him … and took care of

in Madness on trial
Medical practitioners, birth control clinics and contraceptive efficacy
Claire L. Jones

WL, SA/FPA/A7/71, 8 April 1937. 95 WL, SA/FPA/A7/71, letter by Holland to Pyke, 26 March 1941. 96 WL, SA/FPA/A7/101, memo, ‘Confidential. London Rubber Company’, 14 June 1938. 97 WL, SA/FPA/A7/101, letter by Prentif to Holland, 31 May 1940; ‘Confidential report on telephone conversation with Mr Harrison of Prentif’s re tests made by them of condoms manufactured by LRC (ivory and transparent – latex)’, Spring 1940. 98 WL, SA/FPA/A7/101, letter by Prentif to Holland, 2 August 1940. 99 WL, SA/FPA/A4/1, letter by British Drug Houses Ltd to FPA, 3

in The business of birth control