Nurses may, and often do, experience moral distress in their careers. This is related to the complicated work environment and the complex nature of ethical situations in everyday nursing practice. The outcomes of moral distress may include psychological and physical symptoms, reduced job satisfaction and even inadequate or inappropriate nursing care. Moral distress can also impact retention of nurses. Although research has grown considerably over the past few decades, there is still a great deal about this topic that we do (...) not know including how to deal well with moral distress. A critical key step is to develop a deeper understanding of relational practice as it pertains to moral distress. In this article, exploration of the experience of moral distress among nurses is guided by the key elements of relational ethics. This ethical approach was chosen because it recognizes that ethical practice is situated in relationships and it acknowledges the importance of the broader environment on influencing ethical action. The findings from this theoretical exploration will provide a theoretical foundation upon which to advance our knowledge about moral distress. (shrink)

This is the first complete, one-volume English translation of the ancient Chinese text Xunzi, one of the most extensive, sophisticated, and elegant works in the tradition of Confucian thought. Through essays, poetry, dialogues, and anecdotes, the Xunzi articulates a Confucian perspective on ethics, politics, warfare, language, psychology, human nature, ritual, and music, among other topics. Aimed at general readers and students of Chinese thought, Eric Hutton’s translation makes the full text of this important work more accessible in English than ever (...) before. Named for its purported author, the Xunzi has long been neglected compared to works such as the Analects of Confucius and the Mencius. Yet interest in the Xunzi has grown in recent decades, and the text presents a much more systematic vision of the Confucian ideal than the fragmented sayings of Confucius and Mencius. In one famous, explicit contrast to them, the Xunzi argues that human nature is bad. However, it also allows that people can become good through rituals and institutions established by earlier sages. Indeed, the main purpose of the Xunzi is to urge people to become as good as possible, both for their own sakes and for the sake of peace and order in the world. In this edition, key terms are consistently translated to aid understanding and line numbers are provided for easy reference. Other features include a concise introduction, a timeline of early Chinese history, a list of important names and terms, cross-references, brief explanatory notes, a bibliography, and an index. (shrink)

In pediatric critical care, nurses are the primary caregivers for critically ill children and are particularly vulnerable to moral distress. There is limited evidence on what approaches are effective to minimize moral distress among these nurses. To identify intervention attributes that critical care nurses with moral distress histories deem important to develop a moral distress intervention. We used a qualitative description approach. Participants were recruited using purposive sampling between October 2020 to May 2021 from pediatric critical care units in a (...) western Canadian province. We conducted individual semi-structured interviews via Zoom. A total of 10 registered nurses participated in the study. Four main themes were identified: (1) “I’m sorry, there’s nothing else”: increasing supports for patients and families; (2) “someone will commit suicide”: improving supports for nurses: (3) “Everyone needs to be heard”: improving patient care communication; and (4) “I didn’t see it coming”: providing education to mitigate moral distress. Most participants stated they wanted an intervention to improve communication among the healthcare team and noted changes to unit practices that could decrease moral distress. This is the first study that asks nurses what is needed to minimize their moral distress. Although there are multiple strategies in place to help nurses with difficult aspects of their work, additional strategies are needed to help nurses experiencing moral distress. Moving the research focus from identifying moral distress towards developing effective interventions is needed. Identifying what nurses need is critical to develop effective moral distress interventions. (shrink)

Biobanking activities for genetic research purposes have recently undergone nothing short of a small revolution. Many biobanks have left their traditional home of a small refrigerator in a laboratory to reach the unprecedented proportion of large, sophisticated storage centers containing DNA samples from whole populations. As we turn our attention to research on complex diseases and show great interest in human genetic variation and genetic epidemiology, we need to base our research not only on the DNA of small family cohorts, (...) but on larger sample collections, coupled with geographic location, genealogical information, and environmental and medical data. Population genetic research projects are underway around the world. Setting up such large-scale population biobanks is a challenge for any researcher. Population genetic research projects raise legal, ethical, and social issues that need to be addressed properly in order to maintain the trust of the population, an absolute requirement for the success of such research endeavour. (shrink)

Biobanking activities for genetic research purposes have recently undergone nothing short of a small revolution. Many biobanks have left their traditional home of a small refrigerator in a laboratory to reach the unprecedented proportion of large, sophisticated storage centers containing DNA samples from whole populations. As we turn our attention to research on complex diseases and show great interest in human genetic variation and genetic epidemiology, we need to base our research not only on the DNA of small family cohorts, (...) but on larger sample collections, coupled with geographic location, genealogical information, and environmental and medical data. Population genetic research projects are underway around the world. Setting up such large-scale population biobanks is a challenge for any researcher. Population genetic research projects raise legal, ethical, and social issues that need to be addressed properly in order to maintain the trust of the population, an absolute requirement for the success of such research endeavour. (shrink)

The global pandemic has intensified the risk of moral distress due to increased demands on already limited human resources and uncertainty of the pandemic’s trajectory. Nurses commonly experience moral distress: a conflict between the morally correct action and what they are required or capable of doing. Effective moral distress interventions are rare. For this reason, our team conducted a multi-phase research study to develop a moral distress intervention for pediatric critical care nurses. In this article, we discuss our multi-phase approach (...) to develop a moral distress intervention—proactive, interdisciplinary meeting. Our proposed intervention is a sequential compilation of empirical work couched within a relational ethics lens thus should point to enhanced potential for intervention effectiveness. (shrink)

Moral distress is a common phenomenon among nurses and is related to the complicated work environments and complex nature of ethical situations in day-to-day nursing practice. Moral distress impacts nurses as well as patient care and the health care system. Few strategies have been identified for instructors to effectively engage with learners when communicating about moral distress. We discuss two key curricular and pedagogical strategies that should be utilized when learning about moral distress: difficult knowledge’ and ‘terror management theory’. Whether (...) it is with new nursing students or experienced nurses, there is necessary learning that needs to occur on moral distress. Difficult knowledge’ and ‘terror management theory’, when implemented, can provide a starting point for both the learner and the instructor to discuss the emotionally difficult and complex topic of moral distress. Knowledge about moral distress has the potential to mitigate its negative effects, therefore it is vital to consider educational strategies to teach nurses about this complex phenomenon. (shrink)

1. Sae sidae rŭl yŏrŏ gan saramdŭl -- 2. Ŏdum ŭi sidae.

Marjolaine Deschênes | : C’est surtout de Joan C. Tronto que les ambassadrices du care se réclament en France, davantage que de Carol Gilligan. Je montre ici qu’une certaine tendance du discours français sur le care peut être diagnostiquée comme le symptôme d’une culture désenchantée, dépouillant le monde non de ses dieux, mais de ses dimensions esthétique, artistique et imaginative. Le renversement que ce discours tend à opérer, de la figure morale de l’autonomie à celle de la vulnérabilité, illustrerait (...) ce « symptôme ». C’est plus précisément l’idée du care comme « maintien du monde » chez Tronto que je critique, puisque l’auteure exclut de ces activités les domaines esthétique, artistique et intellectuel. Je discute trois auteures ayant déjà critiqué cette notion de care, qui chacune font progresser mon propos vers ce que je considère être un oubli du monde « existentiellement » habitable chez la philosophe. Enfin je contribue à combler ce qui manque dans la théorie de Tronto, soit un horizon esthétique et une réflexion sur le langage qui s’encastre dans une herméneutique du soi. Je me penche alors sur un care qui consiste à veiller sur la « fragilité du langage politique » chez Paul Ricoeur. Je conclus que s’agissant de faire du care une valeur publique à la fois féministe et soucieuse non seulement de la vie, mais aussi du monde, les activités artistiques, intellectuelles et éducationnelles sont de loin les plus efficaces, contrairement à ce que Tronto semble penser. | : In France, the ambassadresses of care ethics mainly align themselves with Joan C. Tronto’s theory—rather more than with Carol Gilligan’s. Here I want to state that a certain tendency of French discourse of “care” might be diagnosed as a symptom of a disenchanted culture, since it strips the world of its aesthetic, artistic, and imaginative dimensions. I contend that we can find the best illustration of this symptom when that discourse tends to shift from the moral figure of autonomy to the moral figure of vulnerability. More precisely, I aim to challenge Tronto’s idea of “care” as a “maintaining of the world”, since she excludes from it the areas of aesthetics, the arts, and intellectual activities. I shall discuss three authors who have already criticized Tronto’s notion of “care”. Each of them presents an opportunity for me to refine my reflection on what I consider to be Tronto’s disregard for an existentially liveable world. Finally, I help to fill in what is lacking from Tronto’s theory —that is to say, an aesthetic horizon and a real reflection on language, a reflection framed by a hermeneutics of the self. To this end, I focus on a “care” consisting in keeping watch over the “political language’s fragility” in Paul Ricoeur. I conclude by stating that if we really want to make “care” a public value, this feminist value should be concerned not only with life, but also with world. Artistic, intellectual, and educational activities are by far the most efficient at making such a value public. (shrink)

Why are we here? What is the meaning of life? How can we feel happy and free? The answers to these and other life questions are gathered in Tiny Buddha, Simple Wisdom for Life's Hard Questions. Tiny Buddha began as a quote-a-day Twitter account, @tinybuddha, in 2008. Lori Deschene's daily wisdom posts about mindfulness, non-attachment, and happiness became so popular that she now has more than 200,000 twitter followers who share quotes and stories about inspiration in their daily lives.Deschene asked (...) her Twitter followers to contribute their thoughts and perspectives on the difficult questions that influence how we live our everyday lives: thoughts about the meaning of life, pain, happiness, fate, and more.Tiny Buddha, Simple Wisdom for Life's Hard Questions is a combination of the amazing responses that she received along with her own insightful essays, and insights from wise teachers around the world and throughout time. Deschene explores how these issues have played out in her own life and offers action-oriented suggestions to help people empower themselves, even in a world with so much uncertainty. The result is a guide that helps readers discover the endless possibilities for a life lived mindfully in the present, and connected to others. (shrink)

Dans Parcours de la reconnaissance, « se reconnaître dans le lignage » est conçu comme la première expérience de reconnaissance de soi paisible. Traitant de filiation, Ricoeur cite deux auteurs peu compatibles entre eux : Françoise Héritier et Pierre Legendre. Cet article élucide ce passage, montrant que ce double appel est motivé chez Ricoeur par un souci de voir l’« ordre des places » filiales rester intact. La référence à Héritier exprime un féminisme en germe chez Ricoeur, différencialiste, plaidant pour (...) un binarisme des sexes sans hiérarchie. Quant à la référence à Legendre, elle sert de propédeutique à la phénoménologie ricoeurienne du don « sans prix », mais dénote aussi l’appréhension de Ricoeur quant à certaines demandes contemporaines de reconnaissance. Dans le parcours ricoeurien de la reconnaissance-identité, où « se reconnaître dans le lignage » paraît essentiel, trouve-t-on la place pour des personnes intersexuées, transsexuelles, transgenres ou issues de familles monoparentales, homoparentales, alloparentales? En plus de répondre à cette question, j’explique pourquoi Ricoeur rejette le lacanisme de Legendre, et comment il critiquerait le structuralisme d’Héritier s’il avait pris le temps de le faire. (shrink)

Both issues of the Journal of Consciousness Studies on ‘Art and the Brain’[ Vol.6, No.6/7; Vol.8, No.8/9] were enlightening yet seriously lacking. As a musician, it was disconcerting to read such a wide-ranging title and discover that there was nothing pertinent about music and hearing, the performing arts and other forms of art. I concur with most of the criticisms made here and there, including those on jcs-online, in particular the contributions by Amy Ione and Donnya Wheelwell in the second (...) issue. The following comments and observations explain why I find the overall treatment of art in these issues completely unsatisfactory. (shrink)

This article indicates a reflective paradigm generally ignored in feminist research regarding the sex/gender debate, as presented in the work of Judith Butler ( Gender Trouble ). First, I address the fact that Butler’s philosophy is inscribed in the hermeneutical tradition of suspicion. Second, I put into relief the implicitly Platonic concept of mimesis , which is central to the anticipated subversion of gender, but uncriticized by Butler and others who follow her line of thought. Third, since Butler’s feminism can’t (...) ward off dualism, nor consider idem and ipse identity , I emphasize Paul Ricoeur ’s concept of triple mimesis and narrative identity, which allows us to depart from dichotomies and hierarchies. Following the path of Ricoeur and Françoise Heritier, I finally defend a feminist hermeneutical point of view, which is differentialist and universal. (shrink)

Sufi Music of India and Pakistan: Sound, Context, and Meaning in Qawwali. Regula Burckhardt Qureshi. Chicago and London: The University of Chicago Press, 1995. $24.95 (paper), xviii. 265 pp. CD with 60 min. of Qawwali music.

AbstractmRNA stability is increasingly recognized as being essential for controlling the expression of a wide variety of transcripts during neuronal development and synaptic plasticity. In this context, the role of AU‐rich elements (ARE) contained within the 3′ untranslated region (UTR) of transcripts has now emerged as key because of their high incidence in a large number of cellular mRNAs. This important regulatory element is known to significantly modulate the longevity of mRNAs by interacting with available stabilizing or destabilizing RNA‐binding proteins (...) (RBP). Thus, in parallel with the emergence of ARE, RBP are also gaining recognition for their pivotal role in regulating expression of a variety of mRNAs. In the nervous system, the member of the Hu family of ARE‐binding proteins known as HuD, has recently been implicated in multiple aspects of neuronal function including the commitment and differentiation of neuronal precursors as well as synaptic remodeling in mature neurons. Through its ability to interact with ARE and stabilize multiple transcripts, HuD has now emerged as an important regulator of mRNA expression in neurons. The present review is designed to provide a comprehensive and updated view of HuD as an RBP in the nervous system. Additionally, we highlight the role of HuD in multiple aspects of a neuron's life from early differentiation to changes in mature neurons during learning paradigms and in response to injury and regeneration. Finally, we describe the current state of knowledge concerning the molecular and cellular events regulating the expression and activity of HuD in neurons. BioEssays 28: 822–833, 2006. © 2006 Wiley Periodicals, Inc. (shrink)

Information can be public among a group. Whether or not information is public matters, for example, for accounts of interdependent rational choice, of communication, and of joint intention. A standard analysis of public information identifies it with (some variant of) common belief. The latter notion is stipulatively defined as an infinite conjunction: for p to be commonly believed is for it to believed by all members of a group, for all members to believe that all members believe it, and so (...) forth. This analysis is often presupposed without much argument in philosophy. Theoretical entrenchment or intuitions about cases might give some traction on the question, but give little insight about why the identification holds, if it does. The strategy of this paper is to characterize a practical-normative role for information being public, and show that the only things that play that role are (variants of) common belief as stipulatively characterized. In more detail: a functional role for “taking a proposition for granted” in non-isolated decision making is characterized. I then present some minimal conditions under which such an attitude is correctly held. The key assumption links this attitude to beliefs about what is public. From minimal a priori principles, we can argue that a proposition being public among a group entails common commitment to believe among that group. Later sections explore partial converses to this result, the factivity of publicity and publicity from the perspective of outsiders to the group, and objections to the aprioricity of the result deriving from a posteriori existential presuppositions. (shrink)

Traditionally, empathy is conceived of as a cognitive function that governs how people think during social interactions, and is considered as largely impervious to change. However, developments in psychology and neuroscience show that empathy is grounded in neural substrates of emotionally communicative behaviour and so is learned through imitation and other forms of cultural learning. This also means that abnormal patterns of empathic function can develop through adverse life experiences, or that empathy may fail to develop in young people with (...) neurodevelopmental disorders. Nevertheless, by focussing on empathy as a quality of social interaction and affective expression in the here and now, and by appreciating that it is as a special form of sensorimotor skill, pathways to training and fostering better development of empathy can be identified. (shrink)

The rapid rise of international collaborative science has enabled access to genomic data. In this article, it is argued that to move beyond mapping genomic variation to understanding its role in complex disease aetiology and treatment will require extending data sharing for the purposes of clinical research translation and implementation.

Bazzocchi disposes the text of the Tractatus in a user-friendly manner, exactly as Wittgenstein's decimals advise. This discloses the logical form of the book by distinct reading units, linked into a fashioned hierarchical tree. The text becomes much clearer and every reader can enjoy, finally, its formal and literary qualities.

The AGI alignment problem has a bimodal distribution of outcomes with most outcomes clustering around the poles of total success and existential, catastrophic failure. Consequently, attempts to solve AGI alignment should, all else equal, prefer false negatives (ignoring research programs that would have been successful) to false positives (pursuing research programs that will unexpectedly fail). Thus, we propose adopting a policy of responding to points of philosophical and practical uncertainty associated with the alignment problem by limiting and choosing necessary assumptions (...) to reduce the risk of false positives. Herein we explore in detail two relevant points of uncertainty that AGI alignment research hinges on---meta-ethical uncertainty and uncertainty about mental phenomena---and show how to reduce false positives in response to them. (shrink)