This paper presents a reflective account of my teaching practice with health practitioners who work as school nurses in the secondary education system in regional Victoria, Australia. It highlights some of the issues and dilemmas that emerged during my experiences, as a social work educator, facilitating workshops about critically reflective learning as a cross-disciplinary enterprise. Using critical reflection, this paper also raises questions regarding how we might respond to some of the challenges to improve future approaches to teaching critical reflection.

The diagnosis of attention-deficit hyperactivity disorder is a subject of controversy, for a host of reasons. This paper seeks to explore the manner in which children's interests may be subsumed to those of parents, teachers, and society as a whole in the course of diagnosis, treatment, and labeling, utilizing a framework for children's citizenship proposed by Elizabeth Cohen. Additionally, the paper explores aspects of discipline associated with the diagnosis, as well as distributional pathologies resulting from the application of the diagnosis (...) in potentially biased ways. (shrink)

Healthcare systems across the globe are struggling with increasing costs and worsening outcomes. This presents those responsible for overseeing healthcare with a challenge. Increasingly, policymakers, politicians, clinical entrepreneurs and computer and data scientists argue that a key part of the solution will be ‘Artificial Intelligence’ (AI) – particularly Machine Learning (ML). This argument stems not from the belief that all healthcare needs will soon be taken care of by “robot doctors.” Instead, it is an argument that rests on the classic (...) counterfactual definition of AI as an umbrella term for a range of techniques that can be used to make machines complete tasks in a way that would be considered intelligent were they to be completed by a human. Automation of this nature could offer great opportunities for the improvement of healthcare services and ultimately patients’ health by significantly improving human clinical capabilities in diagnosis, drug discovery, epidemiology, personalised medicine, and operational efficiency. However, if these AI solutions are to be embedded in clinical practice, then at least three issues need to be considered: the technical possibilities and limitations; the ethical, regulatory and legal framework; and the governance framework. In this article, we report on the results of a systematic analysis designed to provide a clear overview of the second of these elements: the ethical, regulatory and legal framework. We find that ethical issues arise at six levels of abstraction (individual, interpersonal, group, institutional, sectoral, and societal) and can be categorised as epistemic, normative, or overarching. We conclude by stressing how important it is that the ethical challenges raised by implementing AI in healthcare settings are tackled proactively rather than reactively and map the key considerations for policymakers to each of the ethical concerns highlighted. (shrink)

ObjectiveTo evaluate the relationship between recently trained paediatricians' ethics knowledge and exposure to a formal ethics or professionalism curriculum during residency.MethodsWe conducted a cross-sectional survey of recently trained paediatricians which included a validated 23-item instrument called the Test of Residents' Ethics Knowledge for Pediatrics. The sample included paediatricians who completed medical school in 2006–2008, whose primary specialty was paediatrics or a paediatric subspecialty, and who completed paediatric residency training in 2010–2011. This sample was stratified based on residency programme variables: presence (...) of a formal curriculum in ethics or professionalism, programme size and American Board of Pediatrics certifying exam passage rate. Paediatricians were randomly selected from each stratum for survey participation.ResultsAmong the 370 responding paediatricians (55%), the mean knowledge score was 17.3 (SD 2.2) out of a possible 23. Presence of a formal curriculum in ethics and/or professionalism was not significantly associated with knowledge. Knowledge was lowest on items about parental requests for a child to undergo genetic testing (2 items, 44% and 85% incorrect), preserving patient confidentiality over email (55% incorrect), decision-making regarding life-sustaining technologies (61% incorrect), and decision-making principles such as assent and parental permission (2 items, 47% and 49% incorrect).ConclusionsThis study highlights several areas in which paediatricians' knowledge may be low and that are amenable to targeted educational interventions. These findings should prompt discussion and research among ethicists and educators about how ethics and professionalism curricula can more consistently influence paediatricians' knowledge. (shrink)

Health-care professionals in end-of-life care are frequently confronted with patients who seem to be ‘ambivalent’ about treatment decisions, especially if they express a wish to die. This article investigates this phenomenon by analysing two case stories based on narrative interviews with two patients and their caregivers. First, we argue that a respectful approach to patients requires acknowledging that coexistence of opposing wishes can be part of authentic, multi-layered experiences and moral understandings at the end of life. Second, caregivers need to (...) understand when contradictory statements point to tensions in a patient’s moral experience that require support. Third, caregivers should be careful not to negatively label or even pathologize seemingly contradictory patient statements. (shrink)

"Pop'philosophie" : si l'on en croit la morgue méprisante que ce simple mot provoque, il s'agirait du nom d'une étrange maladie. Celle d'une philosophie se prostituant aux industries culturelles ou, pire, aux sirènes du populisme. Avec la pop' philosophie, on assisterait à la ruine de la philosophie tout court, devenue tantôt gadget pédagogique, tantôt tentative pathétique de capitaliser sur le glamour frelaté de la pop culture. Et si c'était faux? Pour Gilles Deleuze, en tout cas, rien n'était plus important que (...) l'invention d'une pop'philosophie qui sauverait la pensée de la correction professorale et de la pontification esthétique. Inventer une pensée véritablement anarchiste, enterrant la philosophie pour l'ouvrir à des devenirs inédits : tel était l'objectif qu'il donna au concept de pop'philosophie. Rien n'était moins simple ni plus ambitieux. Il est temps de comprendre en quoi."--Page 4 of cover. (shrink)

Since 1986 Darwin College, Cambridge has organised a series of annual public lectures built around a single theme approached in a multi-disciplinary way. These essays were developed from the 2008 lectures, which explored the idea of serendipity – the relationship between good fortune and the preparation of the mind to spot and exploit it. Serendipity is an appealing concept, and one which has been surprisingly influential in a great number of areas of human discovery. The essays collected in this volume (...) provide insightful and entertaining accounts of the relationship between serendipity and knowledge, in the human and natural sciences. Written by some of the most eminent thinkers of this generation, Serendipity explores a variety of subjects, including disease, politics, scientific invention and the art of writing. This collection will fascinate and inspire a wide range of readers, highlighting the multifaceted nature of the popular, but elusive, concept of serendipity. -/- Contents: Introduction. Fortune and the prepared mind Iain Morley and Mark de Rond; 1. The stratigraphy of serendipity Susan E. Alcock; 2. Understanding humans - serendipity and anthropology Richard Leakey; 3. HIV and the naked ape Robin Weiss; 4. Cosmological serendipity Simon Singh; 5. Serendipity in astronomy Andrew C. Fabian; 6. Serendipity in physics Richard Friend; 7. Liberalism and uncertainty Oliver Letwin; 8. The unanticipated pleasures of the writing life Simon Winchester. (shrink)

The article explores the underlying reasons for patients’ self‐perception of being a burden (SPB) in family settings, including its impact on relationships when wishes to die (WTD) are expressed. In a prospective, interview‐based study of WTD in patients with advanced cancer and non‐cancer disease (organ failure, degenerative neurological disease, and frailty) SPB was an important emerging theme. In a sub‐analysis we examined (a) the facets of SPB, (b) correlations between SPB and WTD, and (c) SPB as a relational phenomenon. We (...) analyzed 248 interviews with 62 patients, their family caregivers, and professionals using grounded theory and interpretive phenomenological analysis. SPB appeared as important empathic concern in care situations. Patients expressed many sorts of concerns for others, but also perceived an altered self‐understanding that did not meet mutual expectations within relationships. In SPB associated with WTD three constellations were found: (a) WTD to unburden others; (b) patients decided against hastening death to prevent being a further burden to others (in these cases, the SPB counteracted the wish to die); and (c) both wishes for and against dying were sustained by SPB. These patients often felt paralyzed and suffered deeply. Family caregivers felt emotionally touched by SPB and tried to unburden patients by caring and compassion. We concluded that the impact of SPB on a WTD and the various meanings the facets of SPB have in balancing relationships need to be worked out individually. An early palliative and narrative approach is warranted. (shrink)

In light of scientific advances such as genomics, predictive diagnostics, genetically engineered agriculture, nuclear transfer cloning, and the manipulation of stem cells, the idea that genes carry predetermined molecular programs or blueprints is pervasive. Yet new scientific discoveries—such as rna transcripts of single genes that can lead to the production of different compounds from the same pieces of dna—challenge the concept of the gene alone as the dominant factor in biological development. Increasingly aware of the tension between certain empirical results (...) and interpretations of those results based on the orthodox view of genetic determinism, a growing number of scientists urge a rethinking of what a gene is and how it works. In this collection, a group of internationally renowned scientists present some prominent alternative approaches to understanding the role of dna in the construction and function of biological organisms. Contributors discuss alternatives to the programmatic view of dna, including the developmental systems approach, methodical culturalism, the molecular process concept of the gene, the hermeneutic theory of description, and process structuralist biology. None of the approaches cast doubt on the notion that dna is tremendously important to biological life on earth; rather, contributors examine different ideas of how dna should be represented, evaluated, and explained. Just as ideas about genetic codes have reached far beyond the realm of science, the reconceptualizations of genetic theory in this volume have broad implications for ethics, philosophy, and the social sciences. Contributors. Thomas Bürglin, Brian C. Goodwin, James Griesemer, Paul Griffiths, Jesper Hoffmeyer, Evelyn Fox Keller, Gerd B. Müller, Eva M. Neumann-Held, Stuart A. Newman, Susan Oyama, Christoph Rehmann-Sutter, Sahotra Sarkar, Jackie Leach Scully, Gerry Webster, Ulrich Wolf. (shrink)

Experiments with the simple pendulum are easy, but its motion is nevertheless confounded with simple harmonic motion. However, refined theoretical models of the pendulum can, today, be easily taught using software like CALCODE. Similarly, the cycloidal pendulum is isochronous only in simplified theory. But what are theoretically equal intervals of time? Newton accepted Barrow’s even tenor hypothesis, but conceded that ‘equal motions’ did not exist – the refutability of Newtonian physics is independent of time measurement. However, time measurement was the (...) key difficulty in reconciling Newtonian physics with electrodynamics. On Poincaré’s criterion of convenience, equal intervals of time ought be so defined as to make the enunciation of physics simple. Hence he postulated constancy of the speed of light. (The Michelson–Morley experiment was not critical.) The theory of relativity followed. But does there exist a proper clock? (shrink)

We show that if T is a trivial uncountably categorical theory of Morley Rank 1 then T is model complete after naming constants for a model.

Fifty or sixty years ago anyone fluttering the pages of one of the many magazines which then catered for the cultivated and intelligent English reader would have been fairly certain to come upon an article bearing somewhat the same title as that of the present paper. The author would probably be an eminent scientist, such as Huxley or Clifford; a distinguished scholar, such as Frederic Harrison or Edmund Gurney; or a politician of cabinet rank, such as Gladstone or Morley. (...) Whichever side he might take, he would write with the moral fervour of which Englishmen at that time had an inexhaustible supply. Nowadays the so-called “conflict between Religion and Science,” which was then appetizingly hot from the oven, has acquired something of the repulsiveness of half-cold mutton in halfcongealed gravy. There seems to be a widespread opinion that Sir Arthur Eddington and Sir James Jeans, with some highly technical and not readily intelligible assistance from Professor Whitehead, have enabled the lion to lie down with the lamb. Well, I have no wish to pipe a discordant note in this scene of Messianic harmony. But I cannot help reflecting that psychology, anthropology, and psychical research have made considerable advances as well as mathematical physics; and that they seem prima facie much more likely to be relevant to religion. Even the ordinary common sense of the lawyer and the historian may still have something useful to say on such topics. (shrink)

A sequel to Nineteenth Century Studies, this book is a series of well-documented studies of several Victorian religious liberals--among them Tennyson, John Morley, and Francis Newman. Willey's theme is the religious disillusionment suffered by Victorian intellectuals; he sees as its cause the application of the techniques of historical scholarship to religion. Since the book is largely biographical, there is little consideration of the issues involved on their own accounts; but as a gallery of intellectual portraits, it is first-rate--sympathetic, sensitive, (...) perceptive.--A. C. P. (shrink)

Sir—In their editorial, Hall, Carter & Morley [1] present an incorrect interpretation of my central argument. The point of my paper [2] is that there are solid reasons to suspect that the capacity of heroin addicts to consent to heroin therapy is compromised because of their addiction. As one medical commentator on my paper states, if active heroin addicts can give voluntary and competent consent to heroin therapy without any problems, then we need a new conceptualization of addiction: they (...) are not addicted, almost by definition [3]. Yet obviously there are problems and grey zones. The solution is to investigate the issue empirically in order to determine the extent of the problem. (As we have done for consent to research on depression and other mental illnesses.) Ultimately, the question can only be solved on a case by case basis, using standardized assessment tools adapted for this purpose. The MacArthur Competence Assessment Tool (MaCAT‐T) is the particular assessment tool I chose to discuss. [4] It is the most promising candidate available, and it has proved its merits in the areas of depression and schizophrenia. -/- At no point do I condemn heroin therapy and endorse an abstinence model of treatment, as the authors state. On the contrary, I note the success of heroin therapy and make suggestions about how to facilitate the consent process. Ironically, it may be Hall et al . who have oversimplified the issues. What we need here are empirical studies on the decisional capacity of heroin addicts to consent to heroin therapy. Only then will we be able to refute the naive view they have no ‘free will’, or say how much they have; but really my paper is not about ‘free will’ at all. This is a philosophical concept. The topic I chose to discuss is ‘decisional capacity’, also called ‘mental competence’. This is a clinical concept with complex legal and ethical associations that often vary across jurisdictions. My point was that although the Swiss Heroin Trials were approved in Europe, they probably would not be approved in Canada or the United States under existing regulations. Interested readers might want to consider the wide variety of reactions to my paper, published in the same issue [5]. Unfortunately, the editorial by Hall et al . does little to advance this debate. (shrink)

In scientific explanations, the explanans theory is sometimes incommensurable with the explanandum empirical data. How is this possible, especially when the explanation is deductive in nature? This paper attempts to solve the puzzle without relying on any particular theory of reference. For us, it is rather obvious that the geometric idea of projection plays a key role in Keplers explanation of Tycho Brahes empirical data. We discover that a similar mechanism operates in theoretic explanations in general. In short, all theoretic (...) explanations are projective explanations. If so, there should be no logical reason why explanans theories cannot be incommensurable with explanandum data. For illustration, we analyse Einsteins explanation of the results of the Michelson–Morley experiment in some detail. (shrink)

We know quite a lot about the general structure of ω-stable solvable centerless groups of finite Morley rank. Abelian groups of finite Morley rank are also well-understood. By comparison, nonabelian nilpotent groups are a mystery except for the following general results:• An ω1-categorical torsion-free nonabelian nilpotent group is an algebraic group over an algebraically closed field of characteristic 0 [Z3].• A nilpotent group of finite Morley rank is the central product of a definable subgroup of finite exponent (...) and of a definable divisible subgroup [N3].• A divisible nilpotent group of finite Morley rank is the direct product of its torsion part (which is central) and of a torsion-free subgroup [N3].However, we do not understand nilpotent groups of bounded exponent. It seems that the classification of nilpotent (but nonabelian)p-groups of finite Morley rank is impossible. Even the nilpotent groups of Morley rank 2 contain insurmountable difficulties [C], [T]. At first glance, this may seem to be an obstacle to proving the Cherlin-Zil'ber conjecture (“simple groups of finite Morley rank are algebraic groups”). Our purpose in this article is to show that if such a group is a definable subgroup of a nonnilpotent group, then it is possible to obtain a classification within the boundaries of our present knowledge. In this respect, our article may be considered as a relief to those who are trying to classify simple groups of finite Morley rank.Before explicitly stating our result, we need the following definition. (shrink)

The Alperin-Goldschmidt Fusion Theorem [1, 5], when combined with pushing up [7], was a useful tool in the classification of the finite simple groups. Similar theorems are needed in the study of simple groups of finite Morley rank, in the even type case (that is, when the Sylow 2-subgroups are of bounded exponent, as in algebraic groups over fields of characteristic 2). In that context a body of results relating to fusion of 2-elements and the structure of 2-local subgroups (...) is needed: pushing up, and the classification of groups with strongly or weakly embedded subgroups, or have strongly closed abelian subgroups (c.f, [2]). Two theorems of Alperin-Goldschmidt type are proved here. Both are needed in applications.The following is an exact analog of the Alperin-Goldschmidt Fusion Theorem for groups of finite Morley rank, in the case of 2-elements:Theorem 1.1.Let G be a group of finite Morley rank, and P a Sylow2-subgroup of G.If A, B⊆P are conjugate in G, then there are subgroups Hi≤Pand elementsxi∈N(Hi)for1 ≤i≤n,and an elementy∈N(P),such that for all i:1.Hiis a tame intersection of two Sylow2-subgroups;2.CP(Hi) ≤Hi;3.N(Hi)/Hiis2-isolatedand(a)(b). (shrink)

The debate about the ethical implications of Artificial Intelligence dates from the 1960s :741–742, 1960; Wiener in Cybernetics: or control and communication in the animal and the machine, MIT Press, New York, 1961). However, in recent years symbolic AI has been complemented and sometimes replaced by Neural Networks and Machine Learning techniques. This has vastly increased its potential utility and impact on society, with the consequence that the ethical debate has gone mainstream. Such a debate has primarily focused on principles—the (...) ‘what’ of AI ethics —rather than on practices, the ‘how.’ Awareness of the potential issues is increasing at a fast rate, but the AI community’s ability to take action to mitigate the associated risks is still at its infancy. Our intention in presenting this research is to contribute to closing the gap between principles and practices by constructing a typology that may help practically-minded developers apply ethics at each stage of the Machine Learning development pipeline, and to signal to researchers where further work is needed. The focus is exclusively on Machine Learning, but it is hoped that the results of this research may be easily applicable to other branches of AI. The article outlines the research method for creating this typology, the initial findings, and provides a summary of future research needs. (shrink)

De Interpretatione is among Aristotle's most influential and widely read writings; C. W. A. Whitaker presents the first systematic study of this work, and offers a radical new view of its aims, its structure, and its place in Aristotle's system. He shows that De Interpretatione is not a disjointed essay on ill-connected subjects, as traditionally thought, but a highly organized and systematic treatise on logic, argument, and dialectic.

In this essay, I examine Robert Boyle's strategies for making imperceptible entities accessible to the senses. It is well known that, in his natural philosophy, Boyle confronted the challenge of making imperceptible particles of matter into objects of sensory experience. It has never been noted, however, that Boyle confronted a strikingly similar challenge in his natural theology – he needed to make an equally imperceptible God accessible to the senses. Taking this symmetrical difficulty as my starting point, I propose a (...) new approach to thinking about the interconnections between Boyle's natural philosophy and natural theology. For the most part, studies of science and religion in the early modern period work by seeking out the influence of explicitly stated religious beliefs on scientific ideas. I argue, by contrast, that we need to focus on Boyle's representational practices, using his attempts to represent imperceptible entities as a means of uncovering metaphysical and theological presuppositions that he did not always articulate when stating his religious beliefs. With new interpretations of bothA Discourse of Things Above Reason(1681) andSome Physico-Theological Considerations about the Possibility of the Resurrection(1675), I show that there were crucial similarities between Boyle's practices for representing both God and atoms. I go on to show, moreover, that Boyle used these practices to enact an ontological stance at odds with one of his most important professed beliefs. (shrink)

As the technology for ectogenesis continues to advance, the ethical implications of such developments should be thoroughly and proactively explored. The possibility of full ectogenesis remains hypothetical at present, and myriad concerns regarding the safety and efficacy of the technology must be evaluated and addressed, while pressing moral considerations should be fully deliberated. However, it is conceivable that the technology may become sufficiently well established in the future and that eventually full ectogenesis might be deemed ethically acceptable as a reproductive (...) alternative to gestation within a human womb under certain circumstances. If the safety and efficacy of full ectogenesis are established, if ethical dilemmas are sufficiently well addressed, and if the technology is offered as a reproductive option to cisgender heterosexual individuals or couples desiring to become parents, there is a moral obligation grounded in social justice to ensure that full ectogenesis be made available to individuals or couples identifying as members of sexual‐ or gender‐minority groups who likewise seek to pursue parenthood. We examine the history of access to current family‐building options, including assisted reproductive technology, surrogacy and adoption, for these populations and conclude that in the absence of robust empirical evidence suggesting an increased risk of harm to children of individuals and couples who identify as members of sexual‐ or gender‐minority groups, equitable access to ectogenesis as a pathway to parenthood for sexual and gender minorities must be assured as a matter of reproductive justice. (shrink)

As the range of potential uses for Artificial Intelligence, in particular machine learning, has increased, so has awareness of the associated ethical issues. This increased awareness has led to the realisation that existing legislation and regulation provides insufficient protection to individuals, groups, society, and the environment from AI harms. In response to this realisation, there has been a proliferation of principle-based ethics codes, guidelines and frameworks. However, it has become increasingly clear that a significant gap exists between the theory of (...) AI ethics principles and the practical design of AI systems. In previous work, we analysed whether it is possible to close this gap between the ‘what’ and the ‘how’ of AI ethics through the use of tools and methods designed to help AI developers, engineers, and designers translate principles into practice. We concluded that this method of closure is currently ineffective as almost all existing translational tools and methods are either too flexible or too strict. This raised the question: if, even with technical guidance, AI ethics is challenging to embed in the process of algorithmic design, is the entire pro-ethical design endeavour rendered futile? And, if no, then how can AI ethics be made useful for AI practitioners? This is the question we seek to address here by exploring why principles and technical translational tools are still needed even if they are limited, and how these limitations can be potentially overcome by providing theoretical grounding of a concept that has been termed ‘Ethics as a Service.’. (shrink)

Aims:The aim of this narrative synthesis was to explore the necessary and sufficient conditions required to define moral distress.Background:Moral distress is said to occur when one has made a moral judgement but is unable to act upon it. However, problems with this narrow conception have led to multiple redefinitions in the empirical and conceptual literature. As a consequence, much of the research exploring moral distress has lacked conceptual clarity, complicating attempts to study the phenomenon.Design:Systematic literature review and narrative synthesis (November (...) 2015–March 2016).Data sources:Ovid MEDLINE®In-Process & Other Non-Indexed Citations 1946–Present, PsycINFO®1967–Present, CINAHL®Plus 1937–Present, EMBASE 1974–24 February 2016, British Nursing Index 1994–Present, Social Care Online, Social Policy and Practice Database (1890–Present), ERIC (EBSCO) 1966–Present and Education Abstracts.Review methods:Literature relating to moral distress was systematically retrieved and subjected to relevance assessment. Narrative synthesis was the overarching framework that guided quality assessment, data analysis and synthesis.Results:In all, 152 papers underwent initial data extraction and 34 were chosen for inclusion in the narrative synthesis based on both quality and relevance. Analysis revealed different proposed conditions for the occurrence of moral distress: moral judgement, psychological and physical effects, moral dilemmas, moral uncertainty, external and internal constraints and threats to moral integrity.Conclusion:We suggest the combination of (1) the experience of a moral event, (2) the experience of ‘psychological distress’ and (3) a direct causal relation between (1) and (2) together are necessary and sufficient conditions for moral distress. (shrink)

In July 2017, China’s State Council released the country’s strategy for developing artificial intelligence, entitled ‘New Generation Artificial Intelligence Development Plan’. This strategy outlined China’s aims to become the world leader in AI by 2030, to monetise AI into a trillion-yuan industry, and to emerge as the driving force in defining ethical norms and standards for AI. Several reports have analysed specific aspects of China’s AI policies or have assessed the country’s technical capabilities. Instead, in this article, we focus on (...) the socio-political background and policy debates that are shaping China’s AI strategy. In particular, we analyse the main strategic areas in which China is investing in AI and the concurrent ethical debates that are delimiting its use. By focusing on the policy backdrop, we seek to provide a more comprehensive and critical understanding of China’s AI policy by bringing together debates and analyses of a wide array of policy documents. (shrink)

BackgroundThe phenomenon of ‘moral distress’ has continued to be a popular topic for nursing research. However, much of the scholarship has lacked conceptual clarity, and there is debate about what it means to experience moral distress. Moral distress remains an obscure concept to many clinical nurses, especially those outside of North America, and there is a lack of empirical research regarding its impact on nurses in the United Kingdom and its relevance to clinical practice.Research aimTo explore the concept of moral (...) distress in nursing both empirically and conceptually.MethodologyFeminist interpretive phenomenology was used to explore and analyse the experiences of critical care nurses at two acute care trauma hospitals in the United Kingdom. Empirical data were analysed using Van Manen’s six steps for data analysis.Ethical considerationsThe study was approved locally by the university ethics review committee and nationally by the Health Research Authority in the United Kingdom.FindingsThe empirical findings suggest that psychological distress can occur in response to a variety of moral events. The moral events identified as causing psychological distress in the participants’ narratives were moral tension, moral uncertainty, moral constraint, moral conflict and moral dilemmas.DiscussionWe suggest a new definition of moral distress which captures this broader range of moral events as legitimate causes of distress. We also suggest that moral distress can be sub-categroised according to the source of distress, for example, ‘moral-uncertainty distress’. We argue that this could aid in the development of interventions which attempt to address and mitigate moral distress.ConclusionThe empirical findings support the notion that narrow conceptions of moral distress fail to capture the real-life experiences of this group of critical care nurses. If these experiences resonate with other nurses and healthcare professionals, then it is likely that the definition needs to be broadened to recognise these experiences as ‘moral distress’. (shrink)

The present study examined what participants perceive of their hand movements when using a tool. In the experiments different gains for either the x-axis or the y-axis perturbed the relation between hand movements on a digitizer tablet and cursor movements on a display. As a consequence of the perturbation participants drew circles on the display while their covered hand movements followed either vertical or horizontal ellipses on the digitizer tablet. When asked to evaluate their hand movements, participants were extremely uncertain (...) about their trajectories. By varying the amount of visual feedback, findings indicated that the low awareness of one’s own movements originated mainly from an insufficient quality of the humans’ tactile and proprioceptive system or from an insufficient spatial reconstruction of this information in memory. (shrink)

There has been increasing debate in recent years about the conceptualization of moral distress. Broadly speaking, two groups of scholars have emerged: those who agree with Jameton’s ‘narrow definition’ that focuses on constraint and those who argue that Jameton’s definition is insufficient and needs to be broadened. Using feminist empirical bioethics, we interviewed critical care nurses in the United Kingdom about their experiences and conceptualizations of moral distress. We provide our broader definition of moral distress and examples of data that (...) both challenge and support our conceptualization. We pre‐empt and overcome three key challenges that could be levelled at our account and argue that there are good reasons to adopt our broader definition of moral distress when exploring prevalence of, and management strategies for, moral distress. (shrink)