Thinking through critical posthumanism: Nursing as political and affirmative becoming.

As a rejection and continuous reframing of theoretical humanism, critical posthumanism questions and imagines the human condition in the current context, aligning it with nonhuman and more than human entities, past and future. While this philosophical approach has been referenced in many academic disciplines since the 1990s, it has been gradually garnering interest among nursing scholars, leading to questions such as what it means to be human and what it means to be a nurse in the here and now. As a deeply ethical and political project, posthumanism, which we associate with poststructuralist concepts of power and resistance, questions the formation of posthuman subjects who more accurately reflect complex times, characterized by capitalistic commodification of life-human and nonhuman. In this article, we aim to explore how the ontological and epistemological underpinnings of critical posthumanism, specifically through Rosi Braidotti's works, can be useful to understand a posthuman subjectivity that favors affirmative actions aimed at actualizing our world in becoming. Through examples in nursing practice, education, and research, we will explore not only how critical posthumanism allows us to frame transformations in the current situation that we are embedded in as nurses and more generally as beings but also how these examples allow us to move beyond critique to the actualization of affirmative actions that correspond to the creation of new worlds.

Notes on [post]human nursing: What It MIGHT Be, What it is Not.

With this paper, we walk out some central ideas about posthumanisms and the ways in which nursing is already deeply entangled with them. At the same time, we point to ways in which nursing might benefit from further entanglement with other ideas emerging from posthumanisms. We first offer up a brief history of posthumanisms, following multiple roots to several points of formation. We then turn to key flavors of posthuman thought to differentiate between them and clarify our collective understanding and use of the terms. This includes considerations of the threads of transhumanism, critical posthumanism, feminist new materialism, and the speculative, affirmative ethics that arise from critical posthumanism and feminist new materialism. These ideas are fruitful for nursing, and already in action in many cases, which is the matter we occupy ourselves with in the final third of the paper. We consider the ways nursing is already posthuman-sometimes even critically so-and the speculative worldbuilding of nursing as praxis. We conclude with visions for a critical posthumanist nursing that attends to humans and other/more/nonhumans, situated and material and embodied and connected, in relation.

Toward an ontology of the mutant in the health sciences: Re/defining the person from Cronenberg's perspective.

Traditional health sciences (including nursing) paradigms, conceptual models, and theories have relied heavily upon notions of the 'person' or 'patient' that are deeply rooted in humanistic principles. Our intention here, as a collective academic assemblage, is to question taken-for-granted definitions and assumptions of the 'person' from a critical posthumanist perspective. To do so, the cinematic works of filmmaker David Cronenberg offer a radical perspective to revisit our understanding of the 'person' in nursing and beyond. Cronenberg's work explores bodily transformation and mutation, with the body as a fragile and malleable vessel. Cronenberg's work allows us to interrogate the body in all its complexity, contingency, and hybridity and provides avenues of rupture within current understandings of 'the person'. Reinventing the definition of what it means to be human, critical posthumanism offers opportunities to both critique humanist theories and build affirmative futurities. Also drawing on the work of Deleuze and Guattari, specifically, their concept of becoming, we propose a critical posthumanist alternative to the conceptualization of the person in the health sciences, that of the becoming-mutant, so frequently explored in Cronenberg's films. Such a conceptualization permits the inclusion of various technological interventions of the contemporary subject: The postperson. This position offers the health science disciplines a radical reconceptualization of the conceptual and theoretical approaches, extending beyond those trapped within the quagmire of humanistic principles.

When to err is inhuman: An examination of the influence of artificial intelligence-driven nursing care on patient safety.

Artificial intelligence, as a nonhuman entity, is increasingly used to inform, direct, or supplant nursing care and clinical decision-making. The boundaries between human- and nonhuman-driven nursing care are blurred with the advent of sensors, wearables, camera devices, and humanoid robots at such an accelerated pace that the critical evaluation of its influence on patient safety has not been fully assessed. Since the pivotal release of To Err is Human, patient safety is being challenged by the dynamic healthcare environment like never before, with nursing at a critical juncture to steer the course of artificial intelligence integration in clinical decision-making. This paper presents an overview of artificial intelligence and its application in healthcare and highlights the implications which affect nursing as a profession, including perspectives on nursing education and training recommendations. The legal and policy challenges which emerge when artificial intelligence influences the risk of clinical errors and safety issues are discussed.

Critical ethnography and its others: Entanglement of matter/meaning/madness.

Beginning with a critical examination of the humanist assumptions of critical ethnography, this article interrogates and surfaces problems with the ontological and epistemological orientations of this research methodology. In drawing on exemplar empirical data from an arts-based project, the article demonstrates the limitations in the humanist-based qualitative research approach and advances a postdualist, postrepresentationalist direction for critical ethnography called entangled ethnography. Using data from a larger study that examined the perspectives of racialized mad artists, what is demonstrated in this inquiry is that the entanglement of bodies, objects, and meaning-making practices is central to working with the ontologically excluded, such as those who find themselves in various states of disembodiment and/or corporeal and psychic distribution. We propose the redevelopment of critical ethnography, extended by entanglement theory (a critical posthuman theory), and suggest that for it to be an inclusive methodology, critical ethnography must be conceptualized as in the process of becoming and always in regeneration, open to critique, extension, and redevelopment.

Critical posthumanism: A double-edged sword for advancing nursing knowledge in planetary health.

In this article, we aimed to evaluate the utility of critical posthumanism for nurses interested in planetary health-a growing area of study that requires a decentering of the human, and environmental justice considerations. We used Chinn and colleagues' method to describe and critically reflect on critical posthumanism, extending the theory analysis method to include a wide range of academic and video sources. We found that critical posthumanism is like a double-edged sword: It provides a lens through which to transcend human-centric approaches to healthcare but is marred by its lack of clarity and inaccessibility. We argue critical posthumanism can be adapted to enhance its potential at the intersection of nursing and planetary health. An analysis of critical posthumanism is followed by a discussion framed by five ways of knowing in nursing, highlighting real-world examples of how critical posthumanism can aid nurses in dealing with planetary health concerns. By exploring the intersections of critical posthumanism with nursing knowledge, we demonstrate how critical posthumanism can enable nurses to comprehend and tackle environmental issues intricately linked to human health.

Extending the methodology of critical discourse analysis using Haraway's figurations: The example of The Monstrous Perpetrator within contemporary responses to child neglect and abuse.

Critical discursive analyses offer possibilities for equity-oriented research, and are a resource for addressing resistant social problems, such as child neglect and abuse (CN&A). A key challenge for discourse analysts in health disciplines is the tensions between materiality and social constructions, particularly at the site of the body. This paper describes how Donna Haraway's ideas of figuration and technobiopower can augment critical discourse analysis to address this tension. Technobiopower, an intensification of biopower in the context of technoscience, is seen as underpinning the melding of material and semiotic practices. The subject is no longer a material body, but a hybrid body that exists in tropic figuration between the real and unreal. This paper uses an analysis of the figuration of The Monstrous Perpetrator from a study of nursing responses to CN&A to illustrate how Haraway's figuration aligns with and provides an analytical tool to extend critical discursive analyses. Specifically, this methodology offers new ways to identify the discursive qualities of bodies, and how material aspects of bodies are exaggerated, concealing their hegemonic ideologies and discriminatory effects. By identifying discourses within or inscribed upon the body, they can be disrupted, opening new possibilities for social change.

From 'if-then' to 'what if?' Rethinking healthcare algorithmics with posthuman speculative ethics.

This article discusses the role that algorithmic thinking and management play in health care and the kind of exclusions this might create. We argue that evidence-based medicine relies on research and data to create pathways for patient journeys. Coupled with data-based algorithmic prediction tools in health care, they establish what could be called health care algorithmics-a mode of management of healthcare that produces forms of algorithmic governmentality. Relying on a critical posthumanist perspective, we show how healthcare algorithmics is contingent on the way authority over bodies is produced and how predictive health care algorithms can reproduce inequalities of the worlds from which they are made, centreing possible futures on existing normativities regulated through algorithmic biopower. In contrast to that, we explore posthuman speculative ethics as a way to challenge understanding of 'ethics' and 'care' in healthcare algorithmics. We suggest some possible avenues towards working speculative ethics into health care while still being critically attentive to algorithmic modes of management and prediction in health care.

Nursing for the Chthulucene: Abolition, affirmation, antifascism.

Critical posthumanism as a philosophical, antifascist nonhierarchical imagination for nursing offers a liberatory passageway forward amidst environmental collapse, an epic pandemic, global authoritarianism, extreme health and wealth disparities, over-reliance on technology and empirics, and unjust societal systems based in whiteness. Drawing upon philosophical and theoretical works from Black and Indigenous scholars, Haraway's idea of the Chthulucene, Deleuze and Guattari's rhizomatic thought, and Kaba's abolitionist organizing among others, we as activist nurse scholars continue the speculative discussion outlined in prior papers. Here we further imagine how we can engage a radical philosophical mission of care for all beings human and non, walking and working alongside the people and communities nurses accompany, connected as we are on this dystopian celestial orb. Discussion is centred on critical analyses of traditional justice framing in nursing, and on the praxis possibilities found within rhizomatic thought, making kin, and just episteme while knitting filaments of nursing theory and history, humming song lyrics from collective memory, and critically dismantling received wisdoms to stumble toward a more emancipatory present future.

Mattering: Per/forming nursing philosophy in the Chthulucene.

This paper presents an overview of the process of entanglement at the 25th International Philosophy of Nursing Conference (IPNC) at University of California at Irvine held on August 18, 2022. Representing collective work from the US, Canada, UK and Germany, our panel entitled 'What can critical posthuman philosophies do for nursing?' examined critical posthumanism and its operations and potential in nursing. Critical posthumanism offers an antifascist, feminist, material, affective, and ecologically entangled approach to nursing and healthcare. Rather than focusing on the arguments of each of the three distinct but interrelated panel presentation pieces, this paper instead focuses on process and performance (per/formance) and performativity as relational, connected and situated, with connections to nursing philosophy. Building upon critical feminist and new materialist philosophies, we describe intra-activity and performativity as ways to dehierarchise knowledge making practices within traditional academic conference spaces. Creating critical cartographies of thinking and being are actions of possibility for building more just and equitable futures for nursing, nurses, and those they accompany-including all humans, nonhumans, and more than human matter.

The Vitruvian nurse and burnout: New materialist approaches to impossible ideals.

The Vitruvian Man is a metaphor for the "ideal man" by feminist posthuman philosopher Rosi Braidotti (2013) as a proxy for eurocentric humanist ideals. The first half of this paper extends Braidotti's concept by thinking about the metaphor of the "ideal nurse" (Vitruvian nurse) and how this metaphor contributes to racism, oppression, and burnout in nursing and might restrict the professionalization of nursing. The Vitruvian nurse is an idealized and perfected form of a nurse with self-sacrificial language (re)producing self-sacrificing expectations. The second half of this paper looks at how regulatory frameworks (using the example of UK's Nursing and Midwifery Council Code of Conduct) institutionalize the conditions of possibility through collective imaginations. The domineering expectations found within the Vitruvian nurse metaphor and further codified by regulatory frameworks give rise to boredom and burnout. The paper ends by suggesting possible ways to diffract regulatory frameworks to practice with affirmative ethics and reduce feelings of self-sacrifice and exhaustion among nurses.

What does person-centred care mean, if you weren't considered a person anyway: An engagement with person-centred care and Black, queer, feminist, and posthuman approaches.

Despite the prominence of person-centred care (PCC) in nursing, there is no general agreement on the assumptions and the meaning of PCC. We sympathize with the work of others who rethink PCC towards relational, embedded, and temporal selfhood rather than individual personhood. Our perspective addresses criticism of humanist assumptions in PCC using critical posthumanism as a diffraction from dominant values  We highlight the problematic realities that might be produced in healthcare, leading to some people being more likely to be disenfranchised from healthcare than others. We point to the colonial, homo- and transphobic, racist, ableist, and ageist consequences of humanist traditions that have influenced the development of PCC. We describe the deep rooted conditions that structurally uphold inequality and undermine nursing practice that PCC reproduces. We advocate for the self-determination of patients and emphasize that we support the fundamental mechanisms of PCC enabling patients' choice; however, without critical introspection, these are limited to a portion of humans. Last, we present limitations of our perspective based on our white*-cisheteropatriarchy** positionality. We point to the fact that any reimagining of models such as PCC should be carefully done by listening, following, and ceding power to people with diversity dimensions*** and the lived experience or expertise that exists from diverse perspectives. We point towards Black, queer feminism, and critical disabilities studies to contextualize our point of critique with humanism and PCC to amplify equity for all people and communities. Theory and philosophy are useful to understand restrictive factors in healthcare delivery and to inform systematic strategies to improve the quality of care so as not to perpetuate the oppression of groups of people with diversity dimensions. * We purposely capitalize Black and use lower case for white to decentre whiteness and as an intentional act of antiracism (see White Homework a podcast series by Tori W. Douglas). ** Cisheteropatriarchy describes people with intersecting identities of dominant social groups; cisgender is the gender identity that aligns with the gender you were assigned at birth, hetero means heterosexual, and patriarchy refers to structural systems of power based on maleness where women are often excluded and hold less power. *** With diversity dimensions, we refer to subjective lived experience and material realities of people that exist outside the 'dominant minorities' of white-cisheteropatriarchy, meaning groups of people in society who historically and currently hold more power and through this, structurally dominate the norms and possibilities of living for other people.

Why Should We Become Posthuman? The Beneficence Argument Questioned.

Why should we become posthuman? There is only one morally compelling answer to this question: because posthumanity will be a more beneficial state, better than present humanity. This is the Posthuman Beneficence Argument (PBA), the centerpiece of the liberal transhumanist defense of "directed evolution." In this article, I examine PBA and find it deficient on a number of lethal counts. My argument focuses on the writings of transhumanist philosopher Nick Bostrom, who has developed the most articulate defense of PBA and disclosed its metaethical framework. I begin by locating PBA in the context of wider transhumanist claims for the desirability of posthumanity. I identify two crucial components: (1) a model of deliberative rationality, requiring reasons to endorse claims; and (2) the reasons themselves (i.e., the greater beneficence that posthumanity represents). I examine these two conditions, in turn, specifying the claims that they ask us to accept. Following Bostrom, I argue that there is a need for a foundationalist approach that assures us of some universality in the process of valuation. This is required to appropriately ground the moral continuity and appeal to universality that PBA demands. I examine the reasons why this approach ultimately fails, leaving posthumanity as an unintelligible concept with no moral force. I conclude by identifying (and endorsing) a more mature approach to the debate on human enhancement, one that forfeits the grandiose but baseless claims too often found in transhumanist defenses of directed evolution. In short, posthumanity may be a good science fiction trope, but it has no normative force in the moral philosophy of human enhancement.

Techno-species in the Becoming Towards a Relational Ontology of Multi-species Assemblages (ROMA).

Robots equipped with artificial intelligence pose a huge challenge to traditional ontological differentiations between the spheres of the human and the non-human. Drawing mainly from neo-animistic and perspectivist approaches in anthropology and science and technology studies, the paper explores the potential of new forms of interconnectedness and rhizomatic entanglements between humans and a world transcending the boundaries between species and material spheres. We argue that intelligent robots meet virtually all criteria Western biology came up with to define 'life' and that it ultimately makes sense to recognize them as a new species that is part of our social universe. Contrasting dualistic concepts of man and nature with a monistic approach, we show that traditional properties of life (agency, self-replication, etc.) may apply to artefacts and that, once we accept the idea that social relationships are ultimately open connections to matter of any kind, the seemingly strict boundaries between species and material spheres can no longer be sustained. Instead, we propose to include 'matter' and ideas into the sphere of the social as agents in their own right to form a relational ontology of multi-species assemblages (ROMA).

Uncivilizing "Mental Illness": Contextualizing Diverse Mental States and Posthuman Emotional Ecologies within The Icarus Project.

This article argues humans should not be defined strictly at their physical boundaries with clear distinctions between anatomical bodies, mental states, and the rest of the world. Rather, diverse mental states, which are often diagnosed as "mental illness," take shape within greater environmental forces and flows, including those that are constructed online. Drawing from a multi-sited ethnography of The Icarus Project, a radical mental health community, the author situates online narratives written by two of its members within posthuman emotional ecologies in which the exchange of ideas online affects mental states in a profound way. These narratives can be seen as a new type of psychiatric resistance based in new technologies, one that "uncivilizes" mental illness by searching for alternative frameworks and metaphors to understand lived experiences with mental distress. This ethnographic perspective differs significantly from traditional bio-psychiatric models and interventions and can offer both patients and mental healthcare providers with an alternative language to frame mental health.