IntroductionThe objectives of this study are to assess and compare differences in the intensity, frequency, and overall severity of moral distress among a diverse group of healthcare professionals.MethodsParticipants from within Baylor Health Care System completed an online seven-point Likert scale (range, 0 to 6) moral distress survey containing nine core clinical scenarios and additional scenarios specific to each participant’s discipline. Higher scores reflected greater intensity and/or frequency of moral distress.ResultsMore than 2,700 healthcare professionals responded to the survey (response rate 18.14 (...) percent); survey respondents represented multiple healthcare disciplines across a variety of settings in a single healthcare system. Intensity of moral distress was high in all disciplines, although the causes of highest intensity varied by discipline. Mean moral distress intensity for the nine core scenarios was higher among physicians than nurses, but the mean moral distress frequency was higher among nurses. Taking into account both intensity and frequency, the difference in mean moral distress score was statistically significant among the various disciplines. Using post hoc analysis, differences were greatest between nurses and therapists.ConclusionsMoral distress has previously been described as a phenomenon predominantly among nursing professionals. This first-of-its-kind multidisciplinary study of moral distress suggests the phenomenon is significant across multiple professional healthcare disciplines. Healthcare professionals should be sensitive to situations that create moral distress for colleagues from other disciplines. Policy makers and administrators should explore options to lessen moral distress and professional burnout that frequently accompanies it. (shrink)

When animal ethicists deal with welfare they seem to face a dilemma: On the one hand, they recognize the necessity of welfare concepts for their ethical approaches. On the other hand, many animal ethicists do not want to be considered reformist welfarists. Moreover, animal welfare scientists may feel pressed by moral demands for a fundamental change in our attitude towards animals. The analysis of this conflict from the perspective of animal ethics shows that animal welfare science and animal ethics highly (...) depend on each other. Welfare concepts are indispensable in the whole field of animal ethics. Evidence for this can be found by analyzing the structure of theories of animal ethics and the different ways in which these theories employ welfare concepts. Furthermore, the background of values underneath every welfare theory is essential to pursue animal welfare science. Animal ethics can make important contributions to the clarification of underlying normative assumptions with regard to the value of the animal, with regard to ideas about what is valuable for the animal, and with regard to the actions that should follow from the results of animal welfare science. (shrink)

Whereas in the first half of the 20th century, proclamation was the focal point of pastoral care in Germany, the 1970s witnessed an embracing of the American pastoral care movement. From then on, pastoral care was increasingly understood as accompanying patients whilst adopting the spiritual dimension. Nowadays, Christian chaplains are encountering an increasing number of patients from different religious communities. Various models have been proposed to help Protestant chaplains find an authentic form of pastoral care suitable for all religions. Until (...) a clear position is assumed with regard to Christianity's demands of absolutism, however, none of these approaches can be satisfactory. (shrink)

In general parlance the term sin has lost its existential meaning. Originally a Jewish-Christian term within a purely religious context, referring to a wrongdoing with regard to God, sin has slowly become reduced to guilt in the course of the secularization process. Guilt refers to a wrongdoing, especially with regard to fellow human beings. It also refers to errors of judgement with what can be tragic consequences. These errors can occur whenever human beings are called upon to act, including the (...) hospital environment. A Christian hospital has to address the issue of how to deal not only with guilt-ridden misdemeanors, but also with wrongdoing unto God, which overshadows every instance of guilt-ridden human behavior. Here, as in every parish, the Church Service is the place to acknowledge sin, confess sin, and forgive sin, beyond the boundaries of the parish itself. Article translated by Sarah L. Kirkby, B.A. Hons. (shrink)

Movies tell stories. Thrilling are especially those situations, when people have to make ethical decisions. Issues of medical ethics crop up not only in hospital series, but often in genres where this subject is hardly to be supposed: comedies, westerns, love stories and gangster movies. Enacting these conflicts means offering a solution, and in doing so films refer to moral values and – at the same time – function as seismographs for the social relevance of bioethical topics. But it is (...) possible that ethical principles of good decision-making fall victims to the drama of the story. Analysis of the portrayed conflict is similar to a case discussion in bioethics and represents a helpful adjunct to the procurement of analytical and communicative competences. (shrink)

Somek’s Knowing What the Law Is makes for an unusually diverting read. Containing both skilful syntheses of complex texts and novel takes on contentious matters, it re-awakened my interest in legal...

In den letzten 100 Jahren hat der Buddhismus zusammen mit anderen asiatischen und indischen Traditionen in steigendem Masse in Europa und Amerika an Prasenz gewonnen. Begriffe wie Nirvana, Karma oder Vorstellungen uber Wiedergeburt haben langst Eingang gefunden in den Formenbestand westlicher Welt- und Daseinserschliessung, werden allerdings oft nicht angemessen verstanden oder bleiben reduziert auf Klischees, was eine fruchtbare Auseinandersetzung und damit die Moglichkeit einer wirklichen Bereicherung des eigenen Denkens erschwert. Der Schwerpunkt der Darstellung liegt daher auf dem Verstehen des Buddhismus (...) und - in entsprechend systematischer Perspektive - auf den damit verbundenen hermeneutischen Grundlagen sowie auf einer Explikation relevanter Faktoren interkulturellen Verstehens. (shrink)

Die Tierethik der letzten Jahrzehnte war über weite Strecken geprägt von einer pathozentrischen Sicht. In der aktuellen tierethischen Diskussion wird jedoch zunehmend bezweifelt, ob die Fokussierung auf die Vermeidung unnötiger oder unzumutbarer tierlicher Schmerzen und Leiden den immer komplexeren Mensch-Tier-Interaktionen angemessen Rechnung tragen kann. Besonders im Hinblick auf genetische Veränderungen von Tieren, die zu einer Reduktion wesentlicher tierlicher Fähigkeiten führen, ohne dabei zugleich negative Empfindungen hervorzurufen, tritt die Frage auf, ob es tierethisch relevante Aspekte gibt, die über das subjektive Wohlergehen (...) hinausgehen.Anhand des Beispiels der gezielten Zucht blinder Hühner wird im Folgenden gezeigt, dass neben den Empfindungen eines Tieres zumindest sein objektives Wohl und die tierliche Integrität als zusätzliche normative Kriterien herangezogen werden müssen, sofern dem Tier ein normativer Eigenwert zugeschrieben wird. Dazu ist weder die Einnahme eines biozentrischen noch eines egalitaristischen Standpunktes erforderlich, sondern allein eine konsequente Trennung der unterschiedlichen Ebenen der tierethischen Argumentation. (shrink)

Excerpt from Beitrage zur Entwicklung der Kant'schen Ethik About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, (...) however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.". (shrink)

Aristotle axiomatically divides the 28 syllogisms of necessity of Anal, prior. I 9-11 into two classes: those with a necessary conclusion and those with a non-necessary conclusion. The fact that Aristotle axiomatically comprehends only 24 syllogisms of necessity, however, raises two questions: 1. What method does he use to decide about the remaining four syllogisms? 2. Is this method consistent with the initial one? This essay pursues the answers to these questions first by means of semantic analysis, showing that Aristotle (...) ultimately considers assertoric propositions to be possible and therewith non-necessary propositions. Aristotle employs this approach, developed within the axiomatic, to the four syllogisms in question, thereby integrating them into the axiomatic. Finally, this essay answers the question of consistency by way of a formalization of the syllogisms of necessity. (shrink)

Aristotle axiomatically divides the 28 syllogisms of necessity of Anal, prior. I 9-11 into two classes: those with a necessary conclusion and those with a non-necessary conclusion. The fact that Aristotle axiomatically comprehends only 24 syllogisms of necessity, however, raises two questions: 1. What method does he use to decide about the remaining four syllogisms? 2. Is this method consistent with the initial one? This essay pursues the answers to these questions first by means of semantic analysis, showing that Aristotle (...) ultimately considers assertoric propositions to be possible and therewith non-necessary propositions. Aristotle employs this approach, developed within the axiomatic, to the four syllogisms in question, thereby integrating them into the axiomatic. Finally, this essay answers the question of consistency by way of a formalization of the syllogisms of necessity. (shrink)

Von Mitarbeitenden im Gesundheitswesen wird ein professioneller Umgang mit PatientInnen und Zugehörigen verlangt. Die Begleitung in Lebenskrisen, bei Erkrankung, Sterben und Tod stellt hohe Anforderungen. Als besonders belastend kann erlebt werden, wenn Mitarbeitende bei der Entscheidungsfindung in Gewissenskonflikte geraten oder sich in einer Dilemmasituation wiederfinden. Das Spektrum reicht von außergewöhnlichen Triage-Entscheidungen bis hin zu einem – vergleichsweise häufigeren – Beteiligtsein an einem (mutmaßlichen oder Beinahe‑) Behandlungsfehler. Angesichts der teilweise tragischen Auswirkungen auf die Patienten und Zugehörigen, die ihr Vertrauen in die (...) Institution gesetzt haben, wird der Umgang für die Mitarbeitenden vor allem dann zusätzlich belastend, wenn innerhalb der Organisation kein glaubwürdiges Konzept für einen strukturierten Umgang mit derartigen Ereignissen etabliert und unter den Kolleginnen und Kollegen sowie Vorgesetzten wenig Wissen über hilfreiche Unterstützungsmöglichkeiten vorhanden ist. (shrink)

Von Mitarbeitenden im Gesundheitswesen wird ein professioneller Umgang mit PatientInnen und Zugehörigen verlangt. Die Begleitung in Lebenskrisen, bei Erkrankung, Sterben und Tod stellt hohe Anforderungen. Als besonders belastend kann erlebt werden, wenn Mitarbeitende bei der Entscheidungsfindung in Gewissenskonflikte geraten oder sich in einer Dilemmasituation wiederfinden. Das Spektrum reicht von außergewöhnlichen Triage-Entscheidungen bis hin zu einem – vergleichsweise häufigeren – Beteiligtsein an einem Behandlungsfehler. Angesichts der teilweise tragischen Auswirkungen auf die Patienten und Zugehörigen, die ihr Vertrauen in die Institution gesetzt haben, (...) wird der Umgang für die Mitarbeitenden vor allem dann zusätzlich belastend, wenn innerhalb der Organisation kein glaubwürdiges Konzept für einen strukturierten Umgang mit derartigen Ereignissen etabliert und unter den Kolleginnen und Kollegen sowie Vorgesetzten wenig Wissen über hilfreiche Unterstützungsmöglichkeiten vorhanden ist. (shrink)

This study gives an arithmetic calculus to determine tautologies, contradictions and satisfiable formulas of the first order logic. The presented calculus may easily be extended on modal and deontic logic. The mathematical foundation of this arithmetic calculus is a Boolean ring.

Summary This study continues in calculating formulas of the first order logic. Whereas the preceding part delt with monadic predicates, the present part treats polyadic predicates. The presumptions were supplied analogously.