Background Speech understanding may rely not only on auditory, but also on visual information. Non-invasive functional neuroimaging techniques can expose the neural processes underlying the integration of multisensory processes required for speech understanding in humans. Nevertheless, noise (from fMRI) limits the usefulness in auditory experiments, and electromagnetic artefacts caused by electronic implants worn by subjects can severely distort the scans (EEG, fMRI). Therefore, we assessed audio-visual activation of temporal cortex with a silent, optical neuroimaging technique: functional near-infrared spectroscopy (fNIRS). Methods (...) We studied temporal cortical activation as represented by concentration changes of oxy- and deoxy-hemoglobin in four, easy-to-apply fNIRS optical channels of 33 normal-hearing adult subjects and 5 post-lingually deaf cochlear implant (CI) users in response to supra-threshold unisensory auditory and visual, as well as to congruent auditory-visual speech stimuli. Results Activation effects were not visible from single fNIRS channels. However, by discounting physiological noise through reference channel subtraction, auditory, visual and audiovisual speech stimuli evoked concentration changes for all sensory modalities in both cohorts (p<0.001). Auditory stimulation evoked larger concentration changes than visual stimuli (p<0.001). A saturation effect was observed for the audiovisual condition. Conclusions Physiological, systemic noise can be removed from fNIRS signals by reference channel subtraction. The observed multisensory enhancement of an auditory cortical channel can be plausibly described by a simple addition of the auditory and visual signals with saturation. (shrink)

Using multisource data and multilevel analysis, we propose that the ethical stance of supervisors influences subordinates’ perceptions of corporate social responsibility which in turn influences subordinates’ trust in the organization resulting in their taking increased personal social responsibility and engagement in organizational citizenship behaviors oriented toward both the organization and other individuals. Using a multilevel model, we assessed the extent to which ethical leadership and CSR at the work unit level impacts subordinates’ behaviors mediated by organizational trust at the individual (...) level. We employed a sample of 71 work unit supervisors and 308 subordinates from five businesses of a conglomerate company located in mainland China. Subordinates were asked to rate supervisory ethical leadership practices, CSR, and their extent of organizational trust. Supervisors were asked to rate the personal social responsibility taking and OCB of their respective subordinates. A multilevel path analysis revealed that ethical leadership has a positive effect on CSR at the work unit level and that CSR has a positive cross-level effect on organizational trust at the individual level, which in turn significantly and positively impacts OCB through the mediating effect of taking personal social responsibility. Results are discussed in the context of China’s manufacturing sector. (shrink)

This chapter discusses fundamental problems and prospects for ethical naturalism. Section 1 explains what is meant by “ethical naturalism” and surveys different versions of the view. Section 2 discusses the central philosophical challenge to ethical naturalism, viz., the “Normativity Objection.” Section 3 offers a battery of responses to it on behalf of the ethical naturalist. Section 4 explores a promising and novel approach to ethical naturalism, viz., a moral nativist theory that that combines a Chomskian approach to moral competence with (...) a structuralist metaphysics. (shrink)

I understand feminist epistemology to be epistemology put at the service of feminist politics. That is, a feminist epistemology is dedicated to answering the many questions about knowledge that arise in the course of feminist efforts to understand and transform patriarchal structures, questions such as: Why have so many intellectual traditions denigrated the cognitive capacities of women? Are there gender differences in epistemic capacities or strategies, and what would be the implications for epistemology if there were? I argue here that (...) such questions situate feminist epistemology much more in mainstream epistemological discussion than probably most feminists would admit, finding that, at least for issues in these areas, the naturalistic approach to the study of knowledge advocated by W. V. Quine has been extremely useful. (shrink)

This paper provides a brief explanation and illustration of the phenomenon of semiotics. It then describes the conceptual tools of semiotics and how lawyers can use semiotics in law to create compelling arguments. Last, the paper applies the tools of semiotics to the Pennsylvania Supreme Court case Ferguson v. McKiernan, 940 A.2d 1236 (Pa. 2008), to reveal the shift in social context that made the lines of legal reasoning behind the outcome appear “self-evident.”.

For decades, aged care facility residents at risk of pressure ulcers (PUs) have been repositioned at two-hour intervals, twenty-four-hours-a-day, seven-days-a-week (24/7). Yet, PUs still develop. We used a cross-sectional survey of eighty randomly selected medical records of residents aged ≥ 65 years from eight Australian Residential Aged Care Facilities (RACFs) to determine the number of residents at risk of PUs, the use of two-hourly repositioning, and the presence of PUs in the last week of life. Despite 91 per cent (73/80) (...) of residents identified as being at risk of PUs and repositioned two-hourly 24/7, 34 per cent (25/73) died with one or more PUs. Behaviours of concern were noted in 72 per cent (58/80) of residents of whom 38 per cent (22/58) were restrained. Dementia was diagnosed in 70 per cent (56/80) of residents. The prevalence of behaviours of concern displayed by residents with dementia was significantly greater than by residents without dementia (82 per cent v 50 per cent, p = 0.028). The rate of restraining residents with dementia was similar to the rate in residents without dementia. Two-hourly repositioning failed to prevent PUs in a third of at-risk residents and may breach the rights of all residents who were repositioned two-hourly. Repositioning and restraining may be unlawful. Rather than only repositioning residents two-hourly, we recommend every resident be provided with an alternating pressure air mattress. (shrink)

This paper provides a brief explanation and illustration of the phenomenon of semiotics. It then describes the conceptual tools of semiotics and how lawyers can use semiotics in law to create compelling arguments. Last, the paper applies the tools of semiotics to the Pennsylvania Supreme Court case Ferguson v. McKiernan, 940 A.2d 1236, to reveal the shift in social context that made the lines of legal reasoning behind the outcome appear “self-evident.”.

Animal data suggest that jet fuels such as JP-8 are associated with hearing deficits when combined with noise and that the effect is more pronounced than with noise exposure alone. Some studies suggest peripheral dysfunction while others suggest central auditory dysfunction. Human data are limited in this regard. The aim of this study was to investigate the possible chronic adverse effects of JP-8 combined with noise exposure on the peripheral and central auditory systems in humans. Fifty-seven participants who were current (...) personnel from the Royal Australian Air Force were selected. Based on their levels of exposure to jet fuels, participants were divided into three exposure groups. Groups were also categorised based on their noise exposure levels. All participants were evaluated by tympanometry, pure-tone audiometry, distortion product otoacoustic emissions, auditory brainstem response, words-in-noise, compressed speech, dichotic digit test, pitch pattern sequence test, duration pattern sequence test and adaptive test of temporal resolution. All auditory tests were carried out after the participants were away from the Air Force base for a minimum of two weeks, thus two weeks without jet fuel and noise exposure. Jet fuel exposure was significantly associated with hearing thresholds at 4 and 8 kHz; average hearing thresholds across frequencies in the better ear; DPOAEs at 2.8, 4 and 6 kHz; ABR wave V latency in the right ear; compressed speech and words-in-noise. Further analyses revealed that participants with low exposure level to jet fuels showed significantly better results for the aforementioned procedures than participants with moderate and high exposure levels. All results were controlled for the covariates of age and noise exposure levels. The results suggest that jet fuel exposure, when combined with noise exposure, has an adverse effect on audibility in humans. Taking all the test results into consideration, jet fuel exposure combined with noise exposure specifically seems to affect the peripheral hearing system in humans. (shrink)

To commemorate 40 years since the founding of the Journal of Business Ethics, the editors in chief of the journal have invited the editors to provide commentaries on the future of business ethics. This essay comprises a selection of commentaries aimed at creating dialogue around the theme Ethics at the centre of global and local challenges. For much of the history of the Journal of Business Ethics, ethics was seen within the academy as a peripheral aspect of business. However, in (...) recent years, the stakes have risen dramatically, with global and local worlds destabilized by financial crisis, climate change, internet technologies and artificial intelligence, and global health crises. The authors of these commentaries address these grand challenges by placing business ethics at their centre. What if all grand challenges were framed as grand ethical challenges? Tanusree Jain, Arno Kourula and Suhaib Riaz posit that an ethical lens allows for a humble response, in which those with greater capacity take greater responsibility but remain inclusive and cognizant of different voices and experiences. Focussing on business ethics in connection to the grand challenge of environmental emergencies, Steffen Böhm introduces the deceptively simple yet radical position that business is nature, and nature is business. His quick but profound side-step from arguments against human–nature dualism to an ontological undoing of the business–nature dichotomy should have all business ethics scholars rethinking their “business and society” assumptions. Also, singularly concerned with the climate emergency, Boudewijn de Bruin posits a scenario where, 40 years from now, our field will be evaluated by its ability to have helped humanity emerge from this emergency. He contends that Milieudefensie v. Royal Dutch Shell illustrates how human rights take centre stage in climate change litigation, and how business ethics enters the courtroom. From a consumer ethics perspective, Deirdre Shaw, Michal Carrington and Louise Hassan argue that ecologically sustainable and socially just marketplace systems demand cultural change, a reconsideration of future interpretations of “consumer society”, a challenge to the dominant “growth logic” and stimulation of alternative ways to address our consumption needs. Still concerned with global issues, but turning attention to social inequalities, Nelarine Cornelius links the capability approach to global and corporate governance, arguing that CA will continue to lie at the foundation of human development policy, and, increasingly, CSR and corporate governance. Continuing debate on the grand challenges associated with justice and equality, Laurence Romani identifies a significant shift in the centrality of business ethics in debates on managing differences, positing that dialogue between diversity management and international management can ground future debate in business ethics. Finally, the essay concludes with a commentary by Charlotte Karam and Michelle Greenwood on the possibilities of feminist-inspired theories, methods, and positionality for many spheres of business ethics, not least stakeholder theory, to broaden and deepen its capacity for nuance, responsiveness, and transformation. In the words of our commentators, grand challenges must be addressed urgently, and the Journal of Business Ethics should be at the forefront of tackling them. (shrink)

Residency selection is a challenging process for medical students, one further complicated in the USA by the recentDobbs v Jackson Women’s Health Organization(Dobbs) decision over-ruling the federal right to abortion. We surveyed medical students to examine howDobbsis influencing the ideological, personal and professional factors they must reconcile when choosing where and how to complete residency.Between 6 August and 22 October 2022, third-year and fourth-year US medical students applying to US residency programmes were surveyed through social media and direct outreach to (...) medical schools. Analysis of quantitative and qualitative data from 494 responses was performed to assess downstream effects ofDobbson residency applicants’ family, health and career choices.Most respondents said changes in abortion access would likely or very likely influence their decision regarding location of considered residency programme (76.9%), where to start a family (72.2%) and contraceptive planning for them or their partner (57.9%). Cis-gender females were more influenced byDobbsregarding where (5 (4, 5) p<0.001) and when (3 (3, 5) p<0.001) to start a family. In qualitative responses, medical trainees highlighted the importance of abortion access for their patients, themselves and their loved ones.Medical trainees are incorporating state abortion access into their residency programme choices. Future physicians care about both the quality of care they will be able to provide and their own health. For personal and professional reasons, reproductive healthcare access is now a key factor in residency match decisions. (shrink)

As one of the preeminent philosophers of the twentieth century, W. V. Quine made groundbreaking contributions to the philosophy of science, mathematical logic, and the philosophy of language. This collection of essays examines Quine's views, particularly his holism and naturalism, for their value to feminist theorizing today. Some contributors to this volume see Quine as severely challenging basic tenets of the logico-empiricist tradition in the philosophy of science—the analytic/synthetic distinction, verificationism, foundationalism—and accept various of his positions as potential resources for (...) feminist critique. Other contributors regard Quine as an unrepentant empiricist and, unlike feminists who seek to use or extend his arguments, they interpret his positions as far less radical and more problematic. In particular, critics and advocates of Quine's arguments that the philosophy of science should be "naturalized"—understood and pursued as an enterprise continuous with the sciences proper—disagree deeply about whether such a naturalized philosophy is "philosophy enough." Central issues at stake in these disagreements reflect current questions of special interest to feminists and also bridge the analytic and postmodern traditions. They include questions about whether and how the philosophy of science, as a form of practice, is or can be normative as well as questions concerning the implications of Quine's philosophy of language for the transparency and stability of meaning. In representing feminist philosophy centrally engaged with the analytic tradition, this volume is important not only for what it contributes to the understanding of Quine and naturalized epistemology but also for what it accomplishes in working against restrictive conceptions of the place of feminism within the discipline. Aside from the editors, the contributors are Kathryn Pyne Addelson, Louise M. Antony, Richmond Campbell, Lorraine Code, Jane Duran, Maureen Linker, Phyllis Rooney, and Paul A. Roth. (shrink)

When a chimpanzee stockpiles rocks as weapons or when a frog sends out mating calls, we might easily assume these animals know their own motivations--that they use the same psychological mechanisms that we do. But as Beyond the Brain indicates, this is a dangerous assumption because animals have different evolutionary trajectories, ecological niches, and physical attributes. How do these differences influence animal thinking and behavior? Removing our human-centered spectacles, Louise Barrett investigates the mind and brain and offers an alternative (...) approach for understanding animal and human cognition. Drawing on examples from animal behavior, comparative psychology, robotics, artificial life, developmental psychology, and cognitive science, Barrett provides remarkable new insights into how animals and humans depend on their bodies and environment--not just their brains--to behave intelligently. Barrett begins with an overview of human cognitive adaptations and how these color our views of other species, brains, and minds. Considering when it is worth having a big brain--or indeed having a brain at all--she investigates exactly what brains are good at. Showing that the brain's evolutionary function guides action in the world, she looks at how physical structure contributes to cognitive processes, and she demonstrates how these processes employ materials and resources in specific environments. Arguing that thinking and behavior constitute a property of the whole organism, not just the brain, Beyond the Brain illustrates how the body, brain, and cognition are tied to the wider world. (shrink)

Many children and adults experience significant breakdown in the use of language. The resulting pragmatic disorders present a considerable barrier to effective communication. This book is the first critical examination of the current state of our knowledge of pragmatic disorders and provides a comprehensive overview of the main concepts and theories in pragmatics. It examines the full range of pragmatic disorders that occur in children and adults and discusses how they are assessed and treated by clinicians. Louise Cummings attempts (...) to integrate the fields of pragmatics, language pathology and cognitive science by examining the ways in which pragmatics can make a useful contribution to debates about cognitive theories of autism. The reader is encouraged to think in a critical fashion about how clinicians, experimentalists and theorists deal with pragmatic issues. (shrink)

This paper considers the question of whether predictions of wrongdoing are relevant to our moral obligations. After giving an analysis of 'won't' claims, the question is separated into two different issues: firstly, whether predictions of wrongdoing affect our objective moral obligations, and secondly, whether self-prediction of wrongdoing can be legitimately used in moral deliberation. I argue for an affirmative answer to both questions, although there are conditions that must be met for self-prediction to be appropriate in deliberation. The discussion illuminates (...) an interesting and significant tension between agency and prediction. (shrink)

ABSTRACTThis article addresses the question of whether certain experiences that originate in causes other than bereavement are properly termed ‘grief’. To do so, we focus on widespread experiences of grief that have been reported during the Covid-19 pandemic. We consider two potential objections to a more permissive use of the term: grief is, by definition, a response to a death; grief is subject to certain norms that apply only to the case of bereavement. Having shown that these objections are unconvincing, (...) we sketch a positive case for a conception of grief that is not specific to bereavement, by noting some features that grief following bereavement shares with other experiences of loss. (shrink)

The first truly multidisciplinary text of its kind, this book offers an original analysis of the current state of linguistic pragmatics. Cummings argues that no study of pragmatics can reasonably neglect the historical and contemporary influences on this.

In this paper, I consider the implications of grief for philosophical theorising about absence experience. I argue that whilst some absence experiences that occur in grief might be explained by extant philosophical accounts of absence experience, others need different treatment. I propose that grieving subjects' descriptions of feeling as if the world seems empty or a part of them seems missing can be understood as referring to a distinctive type of absence experience. In these profound absence experiences, I will argue, (...) the absence of a person as a condition on various possibilities is made manifest in the structure of experience over time. Thus, by paying close attention to grief, we can see that even accounts of absence experience that are presented as in competition with one another may not be so, and that to explain all kinds of absence experience we sometimes need to appeal to something overlooked in other accounts, and which is neither straightforwardly perceptual or cognitive. I also suggest that we would have good reason to take such experiences to be part of and not merely psychological effects of grief. (shrink)

This paper discusses the relationship between internationalisation, mobility, quality and equality in the context of recent developments in research policy in the European Research Area (ERA). Although these developments are specifically concerned with the growth of research capacity at European level, the issues raised have much broader relevance to those concerned with research policy and highly skilled mobility. The paper draws on a wealth of recent research examining the relationship between mobility and career progression with particular reference to a recently (...) completed empirical study of doctoral mobility in the social sciences (Ackers et al. Doctoral Mobility in the Social Sciences. Report to the NORFACE ERA-Network, 2007). The paper is structured as follows. The first section introduces recent policy developments including the European Charter for Researchers and Code of Conduct for the Recruitment of Researchers and the European Commission’s Green Paper on the ERA. The discussion focuses on concerns around the definition of ‘mobility’ and the tendency (in both policy circles and academic research) to conflate different forms of mobility and to equate these with notions of excellence or quality. Scientific mobility is shaped as much by ‘push’ factors (limited opportunity) as it is by the ‘draw’ of excellence. Scientists are exercising a degree of ‘choice’ within a specific and individualised framework of constraints. The following sections consider some of the ‘professional’ and ‘personal’ factors shaping scientific mobility and the influence that these have on the relationship between mobility, internationalisation and excellence. The paper concludes that mobility is not an outcome in its own right and must not be treated as such (as an implicit indicator of internationalisation). To do so contributes to differential opportunity in scientific labour markets reducing both efficiency and equality. (shrink)

This book is a translation into English of La religion grecque by Louise Bruit Zaidman and Pauline Schmitt Pantel, described by Dr Simon Price as 'an excellent book, by far the best introduction to the subject in any language'. It is the purpose of the book to consider how religious beliefs and cultic rituals were given expression in the world of the Greek citizen - the functions performed by the religious personnel, and the place that religion occupied in individual, (...) social and political life. The chapters cover first ritual and then myth, rooting the account in the practices of the classical city while also taking seriously the world of the imagination. For this edition the bibliography has been substantially revised to meet the needs of a mainly student, English-speaking readership. The book is enriched throughout by illustrations, and by quotations from original sources. (shrink)

In this paper I argue that olfactory experience, like visual experience, is exteroceptive: it seems to one that odours, when one smells them, are external to the body, as it seems to one that objects are external to the body when one sees them. Where the sense of smell has been discussed by philosophers, it has often been supposed to be non-exteroceptive. The strangeness of this philosophical orthodoxy makes it natural to ask what would lead to its widespread acceptance. I (...) argue that philosophers have been misled by a visuocentric model of what exteroceptivity involves. Since olfaction lacks the spatial features that make vision exteroceptive the conclusion that olfaction is nonexteroceptive can appear quite compelling, particularly in the absence of an alternative model of exteroceptivity appropriate to olfaction. I offer a model according to which odours seem to be external to the body because they seem to be brought into the nose from without by sniffing and breathing through the nostrils. I argue that some natural-seeming objections to this model rely on substantive assumptions about how the senses are distinguished from one another, and how perceptual experience is put together out of its modality-specific parts, that require defence. (shrink)

Among semanticists and philosophers of language, there has been a recent outburst of interest in predicates such as delicious, called predicates of personal taste (PPTs, e.g. Lasersohn 2005). Somewhat surprisingly, the question of whether or how we can distinguish aesthetic predicates from PPTs has hardly been addressed at all in this recent work. It is precisely this question that we address. We investigate linguistic criteria that we argue can be used to delineate the class of specifically aesthetic adjectives. We show (...) that there are, in fact, good motivations for keeping PPTs and aesthetic predicates apart: the semantic structure of the former, but not the latter, entails an experiencer. There are many adjectives whose semantic structure arguably also entails an experiencer, yet which are readily used in expressing aesthetic judgments. Adjectives such as provocative or moving are a case in point, since as adjectives they arguably maintain the experiencer argument from the verb they are derived from. Nevertheless, when we describe, say, a sculpture as provocative, or a theater performance as moving, we clearly make aesthetic judgments. The difficult question, then, is to articulate the relationship between an aesthetic predicate (of which beautiful and ugly are paradigms) and other predicates that just happen to be used in making an aesthetic judgment. Tightly related to this point is the more general question of the relationship between an evaluative predicate and a predicate that occurs in an evaluative judgment. One of our aims is to make some progress in addressing these questions. (shrink)

t. 1. Dialog s V. V. Davydovym -- t. 2. Nereshennye problemy razvivai︠u︡shchego obrazovanii︠a︡.

As a gynecologic surgeon with a focus on infertility, I frequently hold complex discussions with patients, exploring with them the risks and benefits of surgical options. In the past, we physicians may have expected our patients to simply defer to our expertise and choose from the options we presented. In our contemporary era, however, patients frequently request options not favored by their physicians and even some they've found themselves online. In reproductive endocrinology and infertility, the range of options that may (...) be offered or that patients may themselves seek out is continuously widening. Physicians certainly seek to find the option that will result in the best outcome for their patients, but the information to guide us in achieving the best outcome can be vague or conflicting. Add to this the financial and emotional pressures bearing on patients seeking assisted reproduction. In this essay, I explore the extent to which clinicians in reproductive medicine should follow patient requests with which they disagree or instead try to persuade the patient to do something else or simply refuse outright to meet the request. And if persuasion is to be used, what would be legitimate methods? Clearly, coercion is unacceptable, but the line between persuasion and coercion can be elusive. At what point can or should clinicians resist such requests—and to what degree? (shrink)

BackgroundDealing with end of life is challenging for patients and health professionals alike. The situation becomes even more challenging when a patient requests a legally permitted medical service that a health professional is unable to provide due to a conflict of conscience. Such a scenario arises when Victorian health professionals, with a conscientious objection (CO) to voluntary assisted dying (VAD), are presented with patients who request VAD or merely ask about VAD. The Voluntary Assisted Dying Act 2017 (Vic) recognizes the (...) inherent conflict of conscience that may arise for some health professionals when asked to provide VAD and responds by affording broad protection to conscientious objectors who wish to refuse to take part in the VAD process.MethodsSeventeen semi-structured qualitative interviews were conducted with Victorian health professionals with a self-identified CO to VAD in the lead-up to the implementation of VAD in Victoria. Interviews explored how participants anticipated they would manage their CO in practice. Interviews were transcribed verbatim and analyzed thematically.ResultsOur results reveal that the way in which health professionals claimed they would approach CO conversations is variable and was dependant on the strength of their opposition to VAD. We categorized conscientious objectors according to their approach as either dissuasive non-referrers, passive non-referrers, facilitators or negotiators. Our study also explores the perceived difficulties of exercising one’s CO as identified by our participants.ConclusionThe broad protection offered by the Voluntary Assisted Dying Act 2017 (Vic) encourages a range of behaviors from conscientious objectors, due to the minimal obligations imposed. In order to assist conscientious objectors, more policy, institutional guidance, and education needs to be available to conscientious objectors explicitly addressing how to effectively manage one’s CO. Such guidance is imperative to ensuring that their moral integrity is preserved and that they are exercising their CO appropriately. (shrink)

Abstract: In this paper I offer an account of a particular variety of perception of absence, namely, visual perception of empty space. In so doing, I aim to make explicit the role that seeing empty space has, implicitly, in Mike Martin's account of the visual field. I suggest we should make sense of the claim that vision has a field—in Martin's sense—in terms of our being aware of its limitations or boundaries. I argue that the limits of the visual field (...) are our own sensory limitations, and that we are aware of them as such. Seeing empty space, I argue, involves a structural feature of experience that constitutes our awareness of our visual sensory limitations, and thus, in virtue of which vision has a field. (shrink)

Many people accept, at least implicitly, what I call the asymmetry claim: the view that moral realism is more defensible than aesthetic realism. This article challenges the asymmetry claim. I argue that it is surprisingly hard to find points of contrast between the two domains that could justify their very different treatment with respect to realism. I consider five potentially promising ways to do this, and I argue that all of them fail. If I am right, those who accept the (...) asymmetry claim have a significant burden of proof. (shrink)

Background Ethical challenges constitute an inseparable part of daily decision-making processes in all areas of healthcare. Ethical challenges are associated with moral distress that can lead to burnout. Clinical ethics support has proven useful to address and manage such challenges. This paper explores how prehospital emergency personnel manage ethical challenges. The study is part of a larger action research project to develop and test an approach to clinical ethics support that is sensitive to the context of emergency medicine. Methods We (...) explored ethical challenges and management strategies in three focus groups, with 15 participants in total, each attended by emergency medical technicians, paramedics, and prehospital anaesthesiologists. Focus groups were audio-recorded and transcribed verbatim. The approach to data analysis was systematic text condensation approach. Results We stratified the management of ethical challenges into actions before, during, and after incidents. Before incidents, participants stressed the importance of mutual understandings, shared worldviews, and a supportive approach to managing emotions. During an incident, the participants employed moral perception, moral judgments, and moral actions. After an incident, the participants described sharing ethical challenges only to a limited extent as sharing was emotionally challenging, and not actively supported by workplace culture, or organisational procedures. The participants primarily managed ethical challenges informally, often using humour to cope. Conclusion Our analysis supports and clarifies that confidence, trust, and safety in relation to colleagues, management, and the wider organisation are essential for prehospital emergency personnel to share ethical challenges and preventing moral distress turning into burnout. (shrink)