Background Encounters of moral distress have long-term consequences on healthcare workers’ physical and mental health, leading to job dissatisfaction, reduced patient care, and high levels of burnout, exhaustion, and intentions to quit. Yet, research on approaches to ameliorate moral distress across the health workforce is limited. Research Objective The aim of our study was to qualitatively explore multi-professional perspectives of healthcare social workers, chaplains, and patient liaisons on ways to reduce moral distress and heighten well-being at a southern U.S. academic (...) medical center. Participants & Research Context Purposive sampling and chain-referral methods assisted with recruitment through hospital listservs, staff meetings, and newsletters. Interested participants contacted the principal investigator and all interviews were conducted in-person. Consent was attained prior to interviews. All interviews were recorded and transcribed verbatim. Research Design Directed content analysis was used to deductively organize codes and to develop themes in conjunction with the National Academy of Medicine’s National Plan for Health Workforce Well-Being. Rigor was attained through peer-debriefing, data triangulation methods, and frequent research team meetings. Ethical Considerations Ethics approval was obtained from the university and medical center institutional review boards. Findings Themes demonstrate that rather than offering interventions in the aftermath of moral distress, multilevel daily practices ought to be considered that pre-emptively identify and reduce morally distressing encounters through (1) the care team, (2) management and leadership, and (3) the health care industry. Strategies include interdisciplinary decision-making, trusting managerial relationships, and organizational policies and practices that explicitly invest in mental health promotion and diverse leadership opportunities. Conclusion Moral distress interventions ought to target short-term stress reactions while also addressing the long-term impacts of moral residue. Health systems must financially commit to an ethical workplace culture that explicitly values mental health and well-being. (shrink)

The ability to understand the mental states of others has sometimes been attributed to a domain‐specific mechanism which privileges the processing of these states over similar but nonmental representations. If correct, then others’ beliefs should be processed more efficiently than similar information contained within nonmental states. We tested this by examining whether adults would be faster to process others’ false beliefs than equivalent “false” photos. Additionally, we tested whether they would be faster to process others’ true beliefs about something than (...) their own (matched) personal knowledge about the same event. Across four experiments, we found a small but reliable effect in favor of the first prediction, but no evidence for the second. Results are consistent with accounts positing specialized processes for (false) mental states. The size of the effect does, however, suggest that alternative explanations such as practice effects cannot be ruled out. (shrink)

A barrier to the development and refinement of ethics education in and across health professional schools is that there is not an agreed upon instrument or method for assessment in ethics education. The most widely used ethics education assessment instrument is the Defining Issues Test (DIT) I & II. This instrument is not specific to the health professions. But it has been modified for use in, and influenced the development of other instruments in, the health professions. The DIT contains certain (...) philosophical assumptions (“Kohlbergian” or “neo-Kohlbergian”) that have been criticized in recent years. It is also expensive for large institutions to use. The purpose of this article is to offer a rubric—which the authors have named the Health Professional Ethics Rubric—for the assessment of several learning outcomes related to ethics education in health science centers. This rubric is not open to the same philosophical critiques as the DIT and other such instruments. This rubric is also practical to use. This article includes the rubric being advocated, which was developed by faculty and administrators at a large academic health science center as a part of a campus-wide ethics education initiative. The process of developing the rubric is described, as well as certain limitations and plans for revision. (shrink)

The early modern period is arguably the most pivotal of all in the study of the mind, teeming with a variety of conceptions of mind. Some of these posed serious questions for assumptions about the nature of the mind, many of which still depended on notions of the soul and God. It is an era that witnessed the emergence of theories and arguments that continue to animate the study of philosophy of mind, such as dualism, vitalism, materialism, and idealism. -/- (...) Covering pivotal figures in philosophy such as Descartes, Hobbes, Kant, Leibniz, Cavendish, and Spinoza, Philosophy of Mind in the Early Modern and Modern Ages provides an outstanding survey of philosophy of mind of the period. Following an introduction by Rebecca Copenhaver, sixteen specially commissioned chapters by an international team of contributors discuss key topics, thinkers, and debates, including: -/- Hobbes, Descartes’ philosophy of mind and its early critics, consciousness, the later Cartesians, Malebranche, Cavendish, Locke, Spinoza, Descartes and Leibniz, perception and sensation, desires, mental substance and mental activity, Hume, and Kant. Essential reading for students and researchers in philosophy of mind, enlightenment philosophy, and the history of philosophy, Philosophy of Mind in the Early Modern and Modern Ages is also a valuable resource for those in related disciplines such as religion, history of psychology, and history of science. (shrink)

"Patient advocates can help make research more ethical, but advocacy raises ethical issues of its own.

The French writer, philosopher, and mystic Simone Weil (1909-1943) was one of the most original spiritual personalities of the 20th century. Now Coles presents a brilliant portrait of the beloved and controversial figure who was a spiritual influence on T.S. Eliot, Flannery O'Connor, Adrienne Rich, and Albert Camus.

Traditionally, social entities (i.e., social properties, facts, kinds, groups, institutions, and structures) have not fallen within the purview of mainstream metaphysics. In this chapter, we consider whether the exclusion of social entities from mainstream metaphysics is philosophically warranted or if it instead rests on historical accident or bias. We examine three ways one might attempt to justify excluding social metaphysics from the domain of metaphysical inquiry and argue that each fails. Thus, we conclude that social entities are not justifiably excluded (...) from metaphysical inquiry. Finally, we ask how focusing on social entities could change the character of metaphysical inquiry. We suggest that starting from examples of social entities might lead metaphysicians to rethink the assumption that describing reality in terms of intrinsic, independent, and individualistic features is preferable to describing it in terms of relational, dependent, and non-individualistic features. (shrink)

I explore how gender can shape the pragmatics of speech. In some circumstances, when a woman deploys standard discursive conventions in order to produce a speech act with a specific performative force, her utterance can turn out, in virtue of its uptake, to have a quite different force—a less empowering force—than it would have if performed by a man. When members of a disadvantaged group face a systematic inability to produce a specific kind of speech act that they are entitled (...) to perform—and in particular when their attempts result in their actually producing a different kind of speech act that further compromises their social position and agency—then they are victims of what I call discursive injustice. I examine three examples of discursive injustice. I contrast my account with Langton and Hornsby's account of illocutionary silencing. I argue that lack of complete control over the performative force of our speech acts is universal, and not a special marker of social disadvantage. However, women and other relatively disempowered speakers are sometimes subject to a distinctive distortion of the path from speaking to uptake, which undercuts their social agency in ways that track and enhance existing social disadvantages. (shrink)

Former NAACP chapter head Rachel Dolezal's attempted transition from the white to the black race occasioned heated controversy. Her story gained notoriety at the same time that Caitlyn Jenner graced the cover of Vanity Fair, signaling a growing acceptance of transgender identity. Yet criticisms of Dolezal for misrepresenting her birth race indicate a widespread social perception that it is neither possible nor acceptable to change one's race in the way it might be to change one's sex. Considerations that support transgenderism (...) seem to apply equally to transracialism. Although Dolezal herself may or may not represent a genuine case of a transracial person, her story and the public reaction to it serve helpful illustrative purposes. (shrink)

Miranda Fricker claims that a “gap” in collective hermeneutical resources with respect to the social experiences of marginalized groups prevents members of those groups from understanding their own experiences (Fricker 2007). I argue that because Fricker misdescribes dominant hermeneutical resources as collective, she fails to locate the ethically bad epistemic practices that maintain gaps in dominant hermeneutical resources even while alternative interpretations are in fact offered by non-dominant discourses. Fricker's analysis of hermeneutical injustice does not account for the possibility that (...) marginalized groups can be silenced relative to dominant discourses without being prevented from understanding or expressing their own social experiences. I suggest that a gap in dominant hermeneutical resources is ambiguous between two kinds of unknowing: hermeneutical injustice suffered by members of marginalized groups, and epistemically and ethically blameworthy ignorance perpetrated by members of dominant groups. (shrink)

Undergraduate students with no prior classroom instruction in mathematical logic will benefit from this evenhanded multipart text by one of the centuries greatest authorities on the subject. Part I offers an elementary but thorough overview of mathematical logic of first order. The treatment does not stop with a single method of formulating logic; students receive instruction in a variety of techniques, first learning model theory (truth tables), then Hilbert-type proof theory, and proof theory handled through derived rules. Part II supplements (...) the material covered in Part I and introduces some of the newer ideas and the more profound results of logical research in the twentieth century. Subsequent chapters introduce the study of formal number theory, with surveys of the famous incompleteness and undecidability results of Godel, Church, Turing, and others. The emphasis in the final chapter reverts to logic, with examinations of Godel's completeness theorem, Gentzen's theorem, Skolem's paradox and nonstandard models of arithmetic, and other theorems. Unabridged republication of the edition published by John Wiley & Sons, Inc. New York, 1967. Preface. Bibliography. Theorem and Lemma Numbers: Pages. List of Postulates. Symbols and Notations. Index. (shrink)

In Making Science, Cole shows how social variables and cognitive variables interact in the evaluation of frontier knowledge.

Proofs are central, and unique, to mathematics. They establish the truth of theorems and provide us with the most secure knowledge we can possess. It is thus perhaps unsurprising that philosophers once thought that the only value proofs have lies in establishing the truth of theorems. However, such a view is inconsistent with mathematical practice. If a proof’s only value is to show a theorem is true, then mathematicians would have no reason to reprove the same theorem in different ways, (...) yet this is a practice they frequently engage in. This suggests that proofs can have a wide variety of values. My purpose in this chapter is to provide a survey of some of them. I will discuss how proofs can have practical value, for example, by helping mathematicians to make new discoveries or learn new mathematical tools, and how they can have abstract value, for example, by being beautiful or explanatory. I will also explore the relationships between different proof values. (shrink)

Emerging from the internationally recognised Theorising Normalcy and the Mundane conference series, the chapters in this book offer wide-ranging critiques of that most pervasive of ideas, 'normal'. In particular, they explore the precarious positions we are presented with and, more often than not, forced into by 'normal', and its operating system, 'normalcy' (Davis, 2010). They are written by activists, students, practitioners and academics and offer related but diverse approaches. Importantly, however, the chapters also ask, what if increasingly precarious encounters with, (...) and positions of, marginality and non-normativity offers us a chance (perhaps the chance) to critically explore the possibilities of 'imagining otherwise'? The book questions the privileged position of 'non-normativity'; in youth and unpacks the expectation of the 'normal' student in both higher and primary education. It uses the position of transable people to push the boundaries of 'disability', interrogates the psycho-emotional disablism of box-ticking bureaucracy and spotlights the 'urge to know' impairment. It draws on cross-movement and cross-disciplinary work around disability to explore topics as diverse as drug use, The Bible and relational autonomy. Finally, and perhaps most controversially, it explores the benefits of (re)instating 'normal'. By paying attention to the opportunities presented amongst the fissures of critique and defiance, this book offers new applications and perspectives for thinking through the most ordinary of ideas, 'normal'. (shrink)

A mass problem is a set of Turing oracles. If P and Q are mass problems, we say that P is weakly reducible to Q if for all Y ∈ Q there exists X ∈ P such that X is Turing reducible to Y. A weak degree is an equivalence class of mass problems under mutual weak reducibility. Let [Formula: see text] be the lattice of weak degrees of mass problems associated with nonempty [Formula: see text] subsets of the Cantor (...) space. The lattice [Formula: see text] has been studied in previous publications. The purpose of this paper is to show that [Formula: see text] partakes of hyperarithmeticity. We exhibit a family of specific, natural degrees in [Formula: see text] which are indexed by the ordinal numbers less than [Formula: see text] and which correspond to the hyperarithmetical hierarchy. Namely, for each [Formula: see text], let hα be the weak degree of 0, the αth Turing jump of 0. If p is the weak degree of any mass problem P, let p* be the weak degree of the mass problem P* = {Y | ∃X ⊆ BLR )} where BLR is the set of functions which are boundedly limit recursive in X. Let 1 be the top degree in [Formula: see text]. We prove that all of the weak degrees [Formula: see text], [Formula: see text], are distinct and belong to [Formula: see text]. In addition, we prove that certain index sets associated with [Formula: see text] are [Formula: see text] complete. (shrink)

I argue that God’s holiness as conceived in Hebrew Scripture grounds human obligations to obey divine commands. To disobey the commands of a holy God would disrespect a basic good, which we have decisive reason to avoid doing. God’s holiness may be a somewhat obscure property––though I propose transcendence and perfect morality as necessary conditions––but His omniscience and perfect morality guarantee that He would not command human beings to do things that His holiness would not ground His authority to command. (...) I conclude by replying to objections. (shrink)

I discuss a puzzle that shows there is a need to develop a new metaphysical interpretation of mathematical theories, because all well-known interpretations conflict with important aspects of mathematical activities. The new interpretation, I argue, must authenticate the ontological commitments of mathematical theories without curtailing mathematicians' freedom and authority to creatively introduce mathematical ontology during mathematical problem-solving. Further, I argue that these two constraints are best met by a metaphysical interpretation of mathematics that takes mathematical entities to be constitutively constructed (...) by human activity in a manner similar to the constitutive construction of the US Supreme Court by certain legal and political activities. Finally, I outline some of the philosophical merits of metaphysical interpretations of mathematical theories of this type. (shrink)

(No abstract is available for this citation).

This chapter explores two kinds of testimonial trust, what we call ‘evidential trust’ and ‘non-evidential trust’ with the aim of asking how testimonial trust could provide epistemic reasons for belief. We argue that neither evidential nor non-evidential trust can play a distinctive role in providing evidential reasons for belief, but we tentatively propose that non-evidential trust can in some circumstances provide a novel kind of epistemic reason for belief, a reason of epistemic facilitation. The chapter begins with an extensive discussion (...) of standard accounts of both kinds of trust and criticises especially the standard accounts of non-evidential trust. A new account of non-evidential trust is offered that avoids a number of difficulties that plague the standard accounts by rejecting what we call ‘attitude-liability assumptions’. (shrink)

Thomas Aquinas, one of the "founding fathers" of just war theory, offers an account of virtuous warfare in practice. The author argues that Aquinas's approach to warfare, with its emphasis on justice and charity, is helpful in providing a coherent moral account of war to which Christians can subscribe. Particular attention is given to the role of charity, since this virtue is the distinguishing characteristic of the Christian soldier. Charity compels him to soldier justly, and by fighting justly, he is (...) elevated by God to friendship with God. Notable features of this approach are its emphasis on the criteria for judging whether a war is just and its relativizing of the criteria for proper combat behavior. (shrink)

: Aanerud's project is to develop an account of white antiracist mothering, using a model of maternal duty to raise antiracist white children. The author sets this project in the context of historic constructions of white mothering in the twentieth century and then contrasts the need for an exploration of white mothers raising white children against the literature of white mothers' raising children of color and mothers of color raising their own children, Once this distinction is made, Aanerud uses Collins's (...) account of racial ethnic mothering as a springboard into her discussion of antiracist white mothering of white children. (shrink)

Aanerud's project is to develop an account of white antiracist mothering, using a model of maternal duty to raise antiracist white children. The author sets this project in the context of historic constructions of white mothering in the twentieth century and then contrasts the need for an exploration of white mothers raising white children against the literature of white mothers’ raising children of color and mothers of color raising their own children, Once this distinction is made, Aanerud uses Collins's account (...) of racial ethnic mothering as a springboard into her discussion of antiracist white mothering of white children. (shrink)

Aanerud's project is to develop an account of white antiracist mothering, using a model of maternal duty to raise antiracist white children. The author sets this project in the context of historic constructions of white mothering in the twentieth century and then contrasts the need for an exploration of white mothers raising white children against the literature of white mothers’ raising children of color and mothers of color raising their own children, Once this distinction is made, Aanerud uses Collins's account (...) of racial ethnic mothering as a springboard into her discussion of antiracist white mothering of white children. (shrink)

The 'Gamer's Dilemma' is the problem of why some actions occurring in video game contexts seem to have similar, albeit attenuated, kinds of moral significance to their real-world equivalents, while others do not. In this paper, I argue that much of the confusion in the literature on this problem is not ethical but metaphysical. The Gamer's Dilemma depends on a particular theory of the virtual, which I call 'inflationary', according to which virtual worlds are a metaphysical novelty generated almost exclusively (...) by video games. Actions performed in virtual worlds really belong to the kinds of action they appear to—'virtual murder' is a kind of murder. Inflationary theories are contrasted with 'deflationary' theories which, in effect, consider video games purely as systems for generating images, and thus the gamer as a consumer of media images. Inflationary theories struggle to explain why video games produce this unique metaphysical novelty; deflationary theories fail to do justice to the intuition that there is some significant difference between the gamer and the consumer of other media forms. In place of either, I sketch a theory of the gamer as performer, primarily by analogy with stage and cinema actors, which I suggest captures more of the moral complexity of the gamer's action. (shrink)

The UK government has recently taken steps to exclude certain groups of migrants from free treatment under the National Health Service, most controversially from treatment for HIV. Whether this discrimination can have any coherent ethical basis is questioned in this paper. The exclusion of migrants of any status from any welfare system cannot be ethically justified because the distinction between citizens and migrants cannot be an ethical one.

This book puts forward a radical, unorthodox thesis with respect to the Anthropocene, the philosophy of Deleuze/Guattari and education. This book analyses the Anthropocene for its unconscious drives and develops a parallel mode of education and social change.

In this article, we outline a novel approach to understanding the role of responsibility in health promotion. Efforts to tackle chronic disease have led to an emphasis on personal responsibility and the identification of ways in which people can ‘take responsibility’ for their health by avoiding risk factors such as smoking and over-eating. We argue that the extent to which agents can be considered responsible for their health-related behaviour is limited, and as such, state health promotion which assumes certain forms (...) of moral responsibility should be avoided. This indicates that some approaches to health promotion ought not to be employed. We suggest, however, that another form of responsibility might be more appropriately identified. This is based on the claim that agents have prudential reasons to maintain their health, in order to pursue those things which make their lives go well—i.e. that maintenance of a certain level of health is rational for many agents, given their pleasures and plans. On this basis, we propose that agents have a self-regarding prudential responsibility to maintain their health. We outline the implications of a prudential responsibility approach to health promotion. (shrink)

In Working Virtue: Virtue Ethics and Contemporary Moral Problems, leading figures in the fields of virtue ethics and ethics come together to present the first ...

Human Rights Education (HRE) has traditionally been articulated in terms of cultivating better citizens or world citizens. The main preoccupation in this strand of HRE has been that of bridging a gap between universal notions of a human rights subject and the actual locality and particular narratives in which students are enmeshed. This preoccupation has focused on ‘learning about the other’ in order to improve relations between plural ‘others’ and ‘us’ and reflects educational aims of national identity politics in citizenship (...) education. The article explores the learning of human rights through narratives in relations, drawing on Hannah Arendt and Sharon Todd. For this re-thinking of relations in learning human rights, the article argues that HRE needs to address both competing historical narratives on the drafting of the Universal Declaration on Human Rights (UDHR) as well as unique life narratives of learners. (shrink)

This paper applies Karl Jaspers’ and Martin Heidegger’s accounts of transcendence to their descriptions of Van Gogh’s art. I will contrast Jaspers’ more vertical account of immanent transcendence to Heidegger’s horizontal one. This difference between their separate understandings of transcendence manifests itself in their estimations of the significance of Van Gogh’s art. Using phenomenology to understand Van Gogh’s art in light of immanent transcendence, moreover, illuminates a new understanding of transcendence as the ‘beyond’ that is always already here in the (...) immanent and reveals the ability of an object to point beyond itself. Both of these concepts are at work in Van Gogh’s art as well as modern art in general as the expansion of reality through new sight. Immanent transcendence and Van Gogh’s art are different but interconnected ways of rethinking experience beyond the limits of positivism and the myth of the given. Van Gogh’s art thus embodies a sensible world transformed. In particular, Van Gogh’s landscapes and still life series suggest the inexhaustibility of the things we so often overlook in our everyday experience. (shrink)

This chapter talks about the war between the Formics, a seemingly malevolent species of aliens, and humans in the Ender's Game. The great tragedy of the violence that erupted from the Human/Formic war was the result of two deep misunderstandings. The Formics not only failed to grasp the capabilities of humanity, but humanity also deeply misunderstood the creatures that they would come to nickname “buggers.” These misunderstandings may have resulted from what is sometimes called “cultural incommensurability.” The chapter relates that (...) what is most important about Ender is not merely his ability to understand his “enemy,” but his ability to love them. He is able to harness the sympathies of the humans and change their minds about the buggers. Along with the Formic hive‐ queen, Ender now occupies the space in between the two conceptual schemes—a space he can never retreat from—and has begun translating their meanings. (shrink)