
Symposium: The Legacy of Miles Little
Journal of Bioethical Inquiry, Volume 19, Issue 1, 2022
Guest Editors: Claire Hooker, Ian Kerridge, Wendy Lipworth, and Kathryn MacKay
The full texts of all the symposium articles are available to read using the links below**.

Editorial : Liminality: The Not-So-New Normal?, Free Access, Michael Ashby Extract
One of the central concepts that his work badged and explored is that of liminality: a sort of unstable state between states of relatively greater certainly, being perhaps best seen as the interval (for non-sudden deaths) between “normal” life, due, for example, to a cancer diagnosis, and death. Normal in the sense of an “illusion” of settlement, where finitude is managed by aversion of the gaze as a result of good health, together with varying degrees of financial, social, and emotional security. Security but not necessarily safety, as we can never be completely safe, risks surround us every step of the way. But the relatively low risks throughout long western lives generate an emotional state of provisional reality that makes it very hard when there is a real threat of death.

Lead essay: A Discursive Exploration of Values and Ethics in Medicine: The Scholarship of Miles Little, Free Access, Claire Hooker, Ian Kerridge, Wendy Lipworth, and Kathryn MacKay Extract
Introducing the Symposium
This symposium seeks to do two things. The first is to introduce and to re-acquaint academics, researchers, and students in bioethics with the work of Miles Little. It is our view that his work is salient not just to the issues bioethics concerns itself with but also, and perhaps more importantly, to the way that bioethics can be done. The second goal is to identify and honour Miles Little’s contributions to bioethics and the medical humanities. To achieve this, we have republished five of Little’s papers (selected by Little himself, who was asked to nominate his “favourites”) along with new commentaries on each of these papers. The idea behind this structure was not simply to provide contemporary reflections on contributions but to replicate, in some small way, the kind of dialogue that Little established at VELiM and that he and we continue to value so highly; to open up new conversations. The observations of Little’s work offered up in these commentaries are not, therefore, uncritical or sycophantic but reflect new ideas and new thought fomented by Little’s original offerings.

Vascular Amputees: A Study in Disappointment, J. M. Little, Dora Petritsi-Jones, Charles Kerr Summary
Response—Forty-Seven Years Later: Further Studies in Disappointment?, Michael Loughlin Abstract
Response—The Road Less Travelled: Why did Miles Little Turn to Qualitative Research and Where Did This Lead?, Christopher F.C. Jordens Abstract

Liminality: A major category of the experience of cancer illness, Miles Little, Christopher F. C. Jordens, Kim Paul, Kathleen Montgomery & Bertil Philipson Abstract
Response—A Commentary on Miles Little et al. 1998. Liminality: A major category of the experience of cancer illness, Jackie Leach Scully Abstract
Response—Liminality and the Mirage of Settlement, Open Access, Claire Hooker, Ian Kerridge Abstract

Discourse Communities and the Discourse of Experience
Miles Little, Christopher F. C. Jordens, Emma-Jane Sayers Abstract
Response—A Critical Response to “Discourse Communities and the Discourse of Experience”, Open Access, Paul Macneill Abstract
Response—Belonging, Interdisciplinarity, and Fragmentation: On the Conditions for a Bioethical Discourse Community, Christopher Mayes Abstract

Pragmatic pluralism: Mutual tolerance of contested understandings between orthodox and alternative practitioners in autologous stem cell transplantation, Miles Little, Christopher F. C. Jordens, Catherine McGrath, Kathleen Montgomery, Ian Kerridge & Stacy M. Carter Abstract
The present study, conducted in Sydney, Australia, examines narrative-style interviews with 10 sequentially recruited ASCT patients and nine of their carers conducted at the time of transplant and three months later. Transcripts were read for instances of mention of alternative advice, and for instances of contested understanding of information relevant to the transplant.
Patients and carer pairs expressed closely concordant views about alternative advice. Five pairs were consulting alternative practitioners. Contested understanding was expressed in four domains—understandings of the transplant itself and its underlying theory, of the relationship between the components of the ‘transplant’, of the nature and role of stem cells, and of beliefs about bodily function and life-style. Contested understandings of the transplant treatment were expressed as predominantly personal interpretations of orthodox information
Patients and carers seemed to recognise that alternative and conventional systems were discordant, yet they were able to separate the two, and adhere to each practice without prejudicing their medical treatment. A single case of late, post-transplant repudiation of Western medicine is discussed to emphasise some of the possible determinants of dissonance when it does occur.
Response—The Multiple Understandings in the Clinic Do Not Always Need to be Resolved, Paul A. Komesaroff Abstract
Response—An Extreme Ordeal: Writing Emotion in Qualitative Research, Siun Gallagher Abstract

An Archeology of Corruption in Medicine, Miles Little, Wendy Lipworth & Ian Kerridge Abstract
Response—The Corruption of Character in Medicine, Carl Elliott Abstract
Some people change dramatically over time, and often those changes result partly from what they have chosen to do for a living. Drawing on the work of Richard Sennett and Sandeep Jauhar, I explore how practicing in a market-driven medical system can corrupt the character of doctors.
Rules and Resistance: A Commentary on “An Archeology of Corruption in Medicine”, Kathryn MacKay Abstract
Response—Corruption, Trust, and Professional Regulation, Open Access, Kathleen Montgomery Abstract
The Legacy of Miles Little symposium appears in the 19(1) issue of the Journal of Bioethical Inquiry, the full details of which can be viewed here.
**Some symposium papers are Open Access or Free Access, giving readers the ability to read and/or download and print. Others are available to read-only under “SharedIt” publishing options.
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