Background and Objectives Primary care providers (PCPs) report decreased job satisfaction and high levels of burnout, yet little is known about their experience of moral distress. The aim of this study was to gain insight into the experiences of PCPs regarding moral distress including causative factors and proposed mitigation strategies. Methods This qualitative pilot study used semi-structured interviews to identify causes of moral distress in PCPs in an academic family medicine department. Interviews were analyzed using conventional content analysis. Results Of (...) 35 eligible participants, 12 completed the study (34% participation rate). Most were white, female, and had practiced for less than 10 years. Four PCPs had considered leaving their position due to moral distress. Participants identified five causes of moral distress: policies and procedures that conflict with patient needs, the unpredictable nature of primary care, need to “bend the rules,” lack of accountability, and lack of support staff. Six internal conflicts made resolving morally distressing situations difficult: perceived powerlessness, sense of responsibility, socialization to follow orders, emotional toll of the job, competing obligations, and fear of mistakes. Conclusions These findings matched themes in the current literature and identified an unbending infrastructure. This, coupled with the chaotic nature of primary care, resulted in frequent moral distress. Participants offered solutions to reduce and mitigate moral distress (also similar with current literature) and suggested moral distress and burnout are closely linked. (shrink)

Kolbe and de Melo-Martin’s (2023) arguments draw attention to what is most useful about moral distress—identifying its causes is at least as important as measuring its severity. Jameton’s original...

How can we talk meaningfully about the past if it does not exist to be talked about? What gives time its direction? Is time travel possible? This defence of presentism - the view that only the present exists - makes an original contribution to a fast growing and exciting debate.

Is there any difference between playing video games in which the player’s character commits murder and video games in which the player’s character commits pedophilic acts? Morgan Luck’s “Gamer’s Dilemma” has established this question as a puzzle concerning notions of permissibility and harm. We propose that a fruitful alternative way to approach the question is through an account of aesthetic engagement. We develop an alternative to the dominant account of the relationship between players and the actions of their characters, and (...) argue that the ethical difference between so-called “virtual murder” and “virtual pedophilia” is to be understood in terms of the fiction-making resources available to players. We propose that the relevant considerations for potential players to navigate concern (1) attempting to make certain characters intelligible, and (2) using aspects of oneself as resources for homomorphic representation. (shrink)

Most of us would want to say that it is true that Socrates taught Plato. According to realists about past facts,1 this is made true by the fact that there is, located in the past, i.e., earlier than now, at least one real event that is the teaching of Plato by Socrates. Presentists, however, in denying that past events and facts exist2 cannot appeal to such facts to make their past-tensed statements true. So what is a presentist to do?

Most of us would want to say that it is true that Socrates taught Plato. According to realists about past facts, this is made true by the fact that there is, located in the past, i.e., earlier than now, at least one real event that is the teaching of Plato by Socrates. Presentists, however, in denying that past events and facts exist cannot appeal to such facts to make their past-tensed Statements true. So what is a presentist to do?There are (...) at least three conditions that would ideally be met in a satisfactory solution to this problem:a) It must preserve our views about which Statements are true and which falseb) It must be transparent what the truthmakers are for those Statementsc) It must accommodate the truth-value links between various times. (shrink)

Kathleen Stock’s engaging and careful book demonstrates that ‘extreme intentionalism’ – the view that a fiction’s content is determined by what its author actually intended – has for too long been held back by a set of familiar objections.1 1 It is often thought to have implausible consequences involving disregarding conventional meaning, permitting undetectable fictional content, denying that authorial intentions can be unsuccessful, or giving too much importance to extraneous indications of intention and too little to the work itself. All (...) these objections, Stock argues, are overplayed, all are answerable, and several ultimately favour extreme intentionalism over its rivals. Stock’s defence of extreme intentionalism grounds a view of imaginative resistance, an account of the fiction/non-fiction distinction and of what an individual fiction is, and a characterization of propositional imagining and of the nature of supposition. (shrink)

In the probing interviews in this vibrant new book, eminent scholars struggle with some of the most crucial issues facing contemporary intellectuals. Poststructuralist philosopher Judith Butler discusses the “pain” of rigorous intellectual work, saying that it is “necessarily extremely hard labor,” as she examines the intersection of discourse and political action. Award-winning filmmaker, philosopher, and social theorist David Theo Goldberg reviews his life’s work, especially on issues of racism. Literary critic and feminist philosopher Avital Ronell sets out to disrupt the (...) standard logic of signification, to force readers into fresh ways of perceiving a subject at hand. Postcolonial theorist Homi Bhabha discusses how critical literacy is intimately connected to the question of democratic representation, and he elaborates on how cultural difference can lead to a politics of discrimination. And neo-Marxist cultural critic Slavoj Žižek takes readers on an exhilarating journey through a wide range of critical subjects. (shrink)

Hospital-based professionals who manage cases of family violence are often unclear about the benefits and costs of particular interventions to their clients. Operating under conditions of potential lethality, both to them and family members, clinicians often experience conflict between legal and ethical recommendations or between strategies intended to provide safety to victims of domestic (spousal) violence and those meant to protect children from abuse. This article presents a situation of family violence and the dilemmas of decision-making confronting both social worker (...) and lawyer. It discusses such issues as professional role, reporting requirements, and duties to warn, emphasizing the difficulty of implementing a plan and of predicting its consequences. It recommends substantive and procedural guidelines that may help protect victims while allowing professionals to emotionally sustain themselves during the management ordeal. (shrink)

Hospital-based professionals who manage cases of family violence are often unclear about the benefits and costs of particular interventions to their clients. Operating under conditions of potential lethality, both to them and family members, clinicians often experience conflict between legal and ethical recommendations or between strategies intended to provide safety to victims of domestic (spousal) violence and those meant to protect children from abuse. This article presents a situation of family violence and the dilemmas of decision-making confronting both social worker (...) and lawyer. It discusses such issues as professional role, reporting requirements, and duties to warn, emphasizing the difficulty of implementing a plan and of predicting its consequences. It recommends substantive and procedural guidelines that may help protect victims while allowing professionals to emotionally sustain themselves during the management ordeal. (shrink)

Some photographs show determinate features of a scene because the photographed scene had those features. This dependency relation is, rightly, a consensus in philosophy of photography. I seek to refute many long-established theories of photography by arguing that they are incompatible with this commitment. In Section II, I classify accounts of photography as either single-stage or multi-stage. In Section III, I analyze the historical basis for single-stage accounts. In Section IV, I explain why the single-stage view led scientists to postulate (...) “latent” photographic images as a technical phenomenon in early chemical photography. In Section V, I discredit the notion of an invisible latent image in chemical photography and, in Section VI, extend this objection to the legacy of the latent image in digital photography. In Section VII, I appeal to the dependency relation to explain why the notion of a latent image makes the single-stage account untenable. Finally, I use the multi-stage account to advance debate about “new” versus “orthodox” theories of photography. (shrink)

According to Roger Scruton, it is not possible for photographs to be representational art. Most responses to Scruton’s scepticism are versions of the claim that Scruton disregards the extent to which intentionality features in photography; but these cannot force him to give up his notion of the ideal photograph. My approach is to argue that Scruton has misconstrued the role of causation in his discussion of photography. I claim that although Scruton insists that the ideal photograph is defined by its (...) ‘merely causal’ provenance, in fact he fails to take the causal provenance of photographs seriously enough. To replace Scruton’s notion of the ideal photograph, I offer a substantive account of the causal provenance of photographs, centred on the distinctive role of ‘the photographic event’. I conclude that, with a proper understanding of the photographic process, we have good reason to re-open the question of photography as a representational art. (shrink)

How can we talk meaningfully about the past if it does not exist to be talked about? What gives time its direction? Is time travel possible? This defence of presentism - the view that only the present exists - makes an original contribution to a fast growing and exciting debate.

Drawing from our interdisciplinary qualitative study of LGBTI conservative Christians and their allies, we name an especially toxic form of shame—what we call sacramental shame—that affects the lives of LGBTI and other conservative Christians. Sacramental shame results from conservative Christianity's allegiance to the doctrine of gender complementarity, which elevates heteronormativity to the level of the sacred and renders those who violate it as not persons, but monsters. In dispensing shame as a sacrament, nonaffirming Christians require constant displays of shame as (...) proof that LGBTI church members love God and belong in the community. Part of what makes this shame so harmful is that parents and pastors often dispense it with sincere expressions of care and affection, compounding the sense that one's capacity to give and receive love is damaged. We foreground LGBTI Christian movements to overcome sacramental shame by cultivating nonhubristic pride, and conclude by discussing briefly their new understandings of love and justice that could have far‐reaching benefits. (shrink)

Photography is valued as a medium for recording and visually reproducing features of the world. I seek to challenge the view that photography is fundamentally a recording process and that every photograph is a record—a view that I claim is based on a ‘single-stage’ misconception of the process. I propose an alternative, ‘multi-stage’ account in which I argue that causal registration of light is not equivalent to recording and reproducing an image. Intervention or non-intervention by photographers is more sophisticated than (...) the traditional view allows. Using the multi-stage account, I describe four models for producing photographic images and pictures. (shrink)

Event summary: The conference focuses on metafiction, taken to cover any fiction which represents itself as a fiction. Because metafictions acknowledge their own status as fictions, they are sometimes known as ‘reflexive’ or ‘self-conscious’ fictions, and sometimes generate apparently paradoxical results. The conference will explore what this reflexivity amounts to, how it distinguishes the metafictional from the non-metafictional works, and what impact this has on questions about the nature of fiction in general. Metafiction amounts to a significant – but not (...) uncommon – distortion of the standard relationship between a fiction and what it represents. This two-day interdisciplinary conference will explore how metafictional representation works by bringing together research on the nature of fiction within philosophy and research on metafiction in literary criticism, film studies and art theory. Questions to Explore Understanding how metafiction works is important to understanding how fiction works. For it raises interesting questions about what fictional representation is, what distinguishes it from non-fictional representation, how fictions represent, how we engage with fiction, and what relations the representation bears to its contents. How should we accommodate metafictions within an account of truth in fiction? Are there any peculiarities of audience engagement with metafictions – do our emotional reactions to a scenario change if we are told by the work that it is ‘just fictional’? What are the different metafictional narrative techniques, and do they all have the same impact on the content of the fiction? What constraints, if any, do metafictions place on the ontology of fiction and the nature of fictional objects? (shrink)

Event synopsis: -What does it mean to claim that the future is open? -Are future contingent statements like "There will be a sea battle tomorrow" now true or false? -Is the claim that future contingents are now true or false compatible with the claim that the future is open? -What is the relation between future contingents and future ontology? -What metaphysical picture is required in order to make sense of the claim that the future is open? Multiple, branching futures? A (...) ‘thin red line’? Metaphysical indeterminacy? Presentism? (shrink)

The author explores how the discursive practices of social texts relate to the subjectivities of readers. Employing Dorothy Smith's notion of femininity as textually mediated discourse, the author analyzes how teenage girls read the depictions of femininity in the glossy advertisements of fashion magazines. Through interviews with 48 girls aged 13 to 17 years, she explores both why and how young girls negotiate “what it means to be a woman.” Most young girls in her study draw on stereotypical meanings of (...) adult femininity. By giving these stereotypes truth status, these readers valorize not only patriarchal meanings of womanhood but also naturalize associations between femininity and the commodities through which this femininity is expressed as the everyday doing of gender. The author concludes by discussing implications of this study for both a feminist theory and a feminist politics of culture. (shrink)

Bridging disciplines have much to teach us about how to combine analytical tools to tackle problems and questions that cross traditional disciplinary boundaries. This article uses examples from the older bridging disciplines of geography and anthropology in order to consider what the relatively young undertaking labeled “interdisciplinary studies” can learn from their long existence. It explains what is meant by the fallacy of nomothetic claim and considers the fruitful production of answers and solutions by viewing process (methodology) not domain (academic (...) turf), as the key to interdisciplinary success. Staking claim to interdisciplinarity is shown to be unproductive while finding the need for interdisciplinary approaches and following the mandates of that need in the pursuit of solutions to problems and questions strengthens both the disciplines and the development of interdisciplinary studies. (shrink)

In neocolonial contexts of globalization, the epistemological terrain of radical diversity poses significant ethical challenges to transnational feminisms. In view of historical associations between knowledge and discourses of love which were conditioned by imperialist brands of humanism and benevolence under colonialism, this paper argues for a deconstructionist approach to conceptualizing love in relation to knowledge and for an ethics that severs the association with benevolence, instead making alterity the basis for its account.

Concerns regarding corporate ethics have grown steadily throughout the past decade. In order to remain competitive, many organizational leaders are faced with the challenge of creating an ethical environment within their organization. A model is presented showing the process and elements necessary for the institutionalization of organizational ethics. The transformational leadership style lends itself well to the creation of an ethical environment and is suggested as a means to facilitate the institutionalization of corporate ethics. Finally, the benefits of using transformational (...) leadership are demonstrated through the components of a psychological contract, organizational commitment, and ethical culture to institutionalize organizational ethics. (shrink)

German philosopher Martin Heidegger stirred educators when in 1951 he claimed teaching is more difficult than learning because teachers must ‘learn to let learn’. However in the main he left the aphorism unexplained as part of a brief four-paragraph, less than two-page set of observations concerning the relationship of teaching to learning; and concluded at the end of those observations that to become a teacher is an ‘exalted matter’. This paper investigates both of Heidegger's claims, interpreting letting learn in the (...) context of Heidegger's larger philosophical project, and suggesting why in light of that project to become a teacher is an exalted concern. The methodology guiding the inquiry is largely hermeneutic, the purpose of the essay to interpret teaching from a Heideggerian perspective: its nature and general method. (shrink)

This article is concerned with the use of correspondence as research data. It focuses on the author's own experience of this method and considers the methodological implications of correspondence as a research method for research in general and feminist research in particular. We argue that at present this method is not often used, even though it provides rich data and is a potential powerful tool for feminist research.

This paper develops an inventory and conceptual map of espoused organizational values. We suggest that espoused values are fundamentally different to other value forms as they are collective value statements that need to coexist as a basis for organizational activity and performance. The inventory is built from an analysis of 3112 value items espoused by 554 organizations in the UK and USA in both profit and not-for-profit sectors. We distil these value items into 85 espoused value labels, and these are (...) assessed in terms of their similarity and difference through judgements made by 53 experienced individuals. The resulting conceptual map facilitates the evaluation of values which are espoused at the organizational level, as opposed to aggregations of personal values, an important distinction that is often ignored in the literature. This analysis identifies a number of distinct areas of emphasis occupied by espoused values. In particular, the richness of value labels that relates to broader ethical issues may be aimed at external stakeholder management, but also may have an increasing influence on organizational behaviour as they are embedded into organizational practices. By advancing our understanding of espoused values, through an analysis of those being used in practice, we provide a means by which future research into organizational values and ethical issues can progress. (shrink)

In this article, we will consider how the regulation of populations is not just a feature of prisons, but of all institutions and organisations that control members though hierarchies, divisions and norms. While nurses and other allied health professionals are considered to be predominantly self‐regulatory, practice is guided by a code of conduct and codes of ethics that act as rules that serve to uphold the safety of the patient, whether they are a sick person in a hospital bed or (...) an inmate in a prison. The codes of conduct espouse a number of rules that to a certain extent govern the behaviour of individual and groups of practitioners through reciprocal rewards and punishments. Supervision is one method of monitoring the effectiveness of the codes of conduct and ethics while regulating both the minimum standard of individual practice and of training organisations. It is posited that one of the possible effects of clinical supervision is to make the person effectively self‐regulatory as, an autonomous practitioner. We take the view that professional autonomy is a highly problematic concept requiring closer examination. (shrink)

In this article, we contribute to sociological literatures on morality, professional and institutional contexts, and morally stigmatized ‘dirty work’ by emphasizing and exploring how they mutually inform one another in lawyers’ work activities. Drawing on interview data with 58 practitioners in the commercial legal industry in Singapore, we analyze how they experience professional and institutional constraints on the expressions of morality in their work. Our findings illustrate how a dominant managerial and economic focus maintains and reproduces a constrained form of (...) morality, limited to instrumental, utilitarian and commercial ends, and subordinated to lucrative client and firm interests. We discuss our findings in terms of the need to research and reform professions in ways that support more rounded and unconstrained moral reflexivity and autonomy in how work is undertaken and valued. This in turn has implications for how organizations and professions might achieve alternative moral institutional orders, and for legal work to avoid the moral and social taints of dirty work. (shrink)

We are told by philosophers that photographs are a distinct category of image because the photographic process is mind-independent. Furthermore, that the experience of viewing a photograph has a special status, justified by a viewer’s knowledge that the photographic process is mind-independent. Versions of these ideas are central to discussions of photography in both the philosophy of art and epistemology and have far-reaching implications for science, forensics and documentary journalism. Mind-independence (sometimes ‘belief independence’) is a term employed to highlight what (...) is important in the idea that photographs can be produced naturally, mechanically, accidentally or automatically. Insofar as the process is physical, natural, mechanical or causal it can occur without human agency or intervention, entirely in the absence of intentional states. Presented innocuously, the idea is that although photographs are dependent on natural or mechanical processes, they can be produced independently of human agency – particularly human beliefs. Presented in a stronger form, the claim is that even if human agency is heavily involved in the production process, the definitive features that make the photograph a photograph and determine its salient properties are nonetheless independent of human minds. In epistemic debates, mind-independence is viewed as essential for explaining why photographs occupy a distinct category among images and justifying a variety of claims about their privileged epistemic and affective status in science, forensics, popular culture and journalism. But, in the philosophy of art, claims about mind-. (shrink)

The Principle of Procreative Beneficence (PB) holds that when a couple plans to have a child, they have significant moral reason to select, of the possible children they could have, the child who is most likely to experience the greatest wellbeing – that is, the most advantaged child, the child with the best chance at the best life.1 PB captures the common sense intuitions of many about reproductive decisions. PB does not posit an absolute moral obligation – it does not (...) dictate what people must do. Instead it holds that there is a significant moral reason to select the best child, but one that must be weighed against other reasons.Recent research suggests that it may become possible to derive gametes (eggs and sperm) from human stem cells in vitro, a process which we will term in vitro gametogenesis (IVG). The ability to create large numbers of eggs or sperm through IVG greatly increases our capacity to select the best child possible. (shrink)