The concept of moral distress comes from nursing ethics, and was initially defined as ‘…when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action’. There is a large body of literature associated with moral distress, yet multiple definitions now exist, significantly limiting its usefulness. We undertook a systematic review of the argument-based bioethics literature on this topic as the basis for a critical appraisal, identifying 55 papers for analysis. (...) We found that moral distress is most frequently framed around individual experiences of distress in relation to local practices and constraints, and understood in terms of power relations and workplace hierarchies. This understanding is directly derived from, and often still seen as specific to, nursing. Frequently the perspective of the morally distressed individual is privileged. Understandings of moral distress have evolved towards an ‘occupational health approach’, with the assumption that moral distress should be measured and prevented. Counter-perspectives were identified, highlighting conceptual problems. Based on our review, we propose a redefinition of moral distress: ‘Ethical unease or disquiet resulting from a situation where a clinician believes they have contributed to avoidable patient or community harm through their involvement in an action, inaction or decision that conflicts with their own values’. This definition is specific enough for research use, anchored in clinicians’ professional responsibilities and concerns about harms to patients, framed relationally rather than hierarchically, and amenable to multiple perspectives on any given morally distressing situation. (shrink)

The Open Corporation, originally published in 2002, set out a blueprint for effective corporate self-regulation, offering practical strategies for managers, stakeholders and regulators to build successful self-regulation management systems. Christine Parker examined the conditions under which corporate self-regulation of social and legal responsibilities were likely to be effective, covering a wide range of areas - from consumer protection to sexual harassment to environmental compliance. Focusing on the features that make self-regulation or compliance management systems effective, Parker argued (...) that law and regulators needed to focus much more on 'meta-regulating' corporate self-regulation if democratic control over corporate action was to be established. (shrink)

This Article examines normative arguments for legal pluralism in regulation. First I briefly set out what we know in fact about how plural regulatory orderings interact and compete with state agency regulatory action. Second, I sketch, and reject, a simple legal pluralist response to regulatory pluralism. In the third part of the Article I show that "responsive" and "reflexive" approaches to intentional pluralization in the design of law should be seen as providing different but complementary pictures of pluralized law. Finally (...) I argue that this pluralized view of law might provide us with the conceptual tools to identify a type of emergent, pluralistic law, without or beyond the state, which would be relevant to thinking about both transnational regulation and multiculturalism. (shrink)

This paper investigates what “free-range” eggs are available for sale in supermarkets in Australia, what “free-range” means on product labelling, and what alternative “free-range” offers to cage production. The paper concludes that most of the “free-range” eggs currently available in supermarkets do not address animal welfare, environmental sustainability, and public health concerns but, rather, seek to drive down consumer expectations of what these issues mean by balancing them against commercial interests. This suits both supermarkets and egg producers because it does (...) not challenge dominant industrial-scale egg production and the profits associated with it. A serious approach to free-range would confront these arrangements, and this means it may be impossible to truthfully label many of the “free-range” eggs currently available in the dominant supermarkets as free-range. (shrink)

This paper provides a systematic account of how artificial intelligence (AI) technologies could harm nonhuman animals and explains why animal harms, often neglected in AI ethics, should be better recognised. After giving reasons for caring about animals and outlining the nature of animal harm, interests, and wellbeing, the paper develops a comprehensive ‘harms framework’ which draws on scientist David Fraser’s influential mapping of human activities that impact on sentient animals. The harms framework is fleshed out with examples inspired by both (...) scholarly literature and media reports. This systematic account and framework should help inform ethical analyses of AI’s impact on animals and serve as a comprehensive and clear basis for the development and regulation of AI technologies to prevent and mitigate harm to nonhumans. (shrink)

Practice guidelines are an increasingly relevant feature of health insurance. One hundred and seventy-eight million people in the United States have some form of private health insurance coverage; coverage for 150 million of them is employment-related. Traditionally, this coverage was provided by employers purchasing a group contract under which an insurance carrier provided indemnity coverage for employees—that is, the insurance company paid all usual, customary, and reasonable charges incurred by an employee for medical care, subject in some cases to an (...) annual deductible and to a percentage of covered expenses, co-paid by the employee, for each service. In recent years, however, employers in greater numbers have switched to so-called self-insurance plans in which employees’ health care claims are paid directly by the employer. (shrink)

Many are calling for transformative food systems changes to promote population and planetary health. Yet there is a lack of research that considers whether current food policy frameworks and regulatory approaches are suited to tackle whole of food systems challenges. One such challenge is responding to the rise of ultra-processed foods (UPF) in human diets, and the related harms to population and planetary health. This paper presents a narrative review and synthesis of academic articles and international reports to critically examine (...) whether current food policy frameworks and regulatory approaches are sufficiently equipped to drive the transformative food systems changes needed to halt the rise of UPFs, reduce consumption and minimise harm. We draw on systems science approaches to conceptualise the UPF problem as an emergent property of complex adaptive food systems shaped by capitalist values and logics. Our findings reveal that current food policy frameworks often adjust or reform isolated aspects of food systems (e.g., prices, labels, food composition), but under-emphasise the deeper paradigms, goals and structures that underlie the rise of UPFs as a systems phenomenon, and its socio-ecological implications. We propose that a ‘leverage points’ framework illuminates where to intervene in food systems to generate multi-level changes, while the theory of ecological regulation highlights how to respond to complex multi-factorial problems, like the rise of UPFs, in diverse ways that respect planetary boundaries. More research is needed to better understand the transformative potential of ecological regulation to advance food systems transformation and attenuate whole of food systems challenges. (shrink)

At the International Legal Ethics Conference IV held at Stanford Law School between 15 and 17 July 2010, one of the two opening plenary sessions consisted of a panel who debated the proposition that legal ethics should be mandatory in legal education. The panel included leading legal ethics academics from jurisdictions around the world—both those where legal ethics is a compulsory part of the law degree and those where it is not. It comprised Professors Andrew Boon, Brent Cotter, Christine (...) Parker, Stephen L Pepper and Richard Wu, and was organised and chaired by Professor Kim Economides. This is an edited version of the panel's discussion. It provides a useful summary of the state of legal ethics teaching in the jurisdictions represented as well as a marshalling of the arguments for and against legal ethics as a required course in the university law degree. (shrink)

Since the 1990s there have been a number of government and market led initiatives to improve the welfare of layer hens in the United Kingdom, Australia and the USA. The focus of these regulatory and market initiatives has been a shift away from the dominant battery-cage system to enriched cages, barn/aviary and free-range production systems. Government regulations have played an important role in setting some minimum welfare standards and the banning of battery cages in the UK and in some US (...) states. However the commodification and market segmentation of higher welfare standards has also seen the growth in production and demand of cage-free and free-range eggs in all three countries. This paper maps and compares the developments in government regulation and market segmentation of layer-hen welfare in the UK, Australia and the USA. The role of labelling and certification in facilitating commodification and market segmentation will be examined, including the public controversies and legal conflicts over egg labelling. The key state, market and civil society actors in each country will also be identified, and their role in driving or resisting higher standards examined, including the increasingly influential role of animal welfare organizations and food corporations. (shrink)

Practice guidelines are an increasingly relevant feature of health insurance. One hundred and seventy-eight million people in the United States have some form of private health insurance coverage; coverage for 150 million of them is employment-related. Traditionally, this coverage was provided by employers purchasing a group contract under which an insurance carrier provided indemnity coverage for employees—that is, the insurance company paid all usual, customary, and reasonable charges incurred by an employee for medical care, subject in some cases to an (...) annual deductible and to a percentage of covered expenses, co-paid by the employee, for each service. In recent years, however, employers in greater numbers have switched to so-called self-insurance plans in which employees’ health care claims are paid directly by the employer. (shrink)

IntroductionResponsible investment, in which environmental, social and governance considerations are incorporated into investment decision making, is a potentially powerful tool for increasing corporate accountability and improving corporate practices to address broad societal challenges. Whilst the RI sector is growing, there is limited understanding of the extent to which pressing social issues, such as obesity and unhealthy population diets, are incorporated within RI decision making. This study aimed to investigate the extent to which obesity prevention and population nutrition are considered by (...) Australian institutional investors engaged in responsible investment.MethodsA desk-based review was conducted of investment approaches of prominent Australian asset managers and superannuation funds identified as engaged in responsible investment. Relevant information on the incorporation of ESG issues related to obesity and population nutrition was extracted for each investor, drawing on websites, published policy documents and annual reports. Strategies were categorized as: negative/exclusionary screening; positive/best-in-class screening; norms-based screening; ESG integration; sustainability-themed investing; impact/community investing; and corporate engagement and shareholder action. These strategies were compared across investors and by themes related to obesity and population nutrition.ResultsEighteen of the 35 investors indicated that they applied investment strategies that considered issues related to obesity and population nutrition. The most commonly identified strategy was ESG integration, followed by sustainability-themed investing, and positive screening. The ways in which obesity and population nutrition were considered as part of these approaches included relatively high-level general health considerations, considerations around the healthiness of food company product portfolios, and consideration of specific company nutrition policies and practices. The specificity and depth to which RI strategies were disclosed varied.ConclusionThere is significant potential for investment decisions to contribute to efforts to address key social issues, such as obesity and unhealthy diets. Some institutional investors in Australia have recognized the potential importance of incorporating obesity- and population nutrition-related issues into decision-making processes. However, the extent to which these considerations translate into investment decisions and their impact on companies in the food sector warrant further exploration. (shrink)

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Many companies are now implementing ethics and regulatory compliance programs. The growth of employment of both lawyers and specialist "compliance professionals" to advise on and facilitate implementation of these programs has expanded concomitantly. This paper examines the ethical role that should be played by these advisors. Traditional ways of conceptualising corporate lawyers' ethics are shown to be inadequate because they see the legal advisor as an autonomous adversarial advocate or an independent and aloof counsellor. Instead interviews with compliance practitioners are (...) used to show that a superior conceptualisation of the compliance advisor's role is emerging. Compliance practitioners identify explicitly with business and, at the same time, identify with a broader ethical community of other compliance professionals, regulators and stakeholders in order to play a transformative role within the organisation. This conception recognises the interdependence between compliance advisor and corporate client. (shrink)

Ethical discussions about Artificial Intelligence (AI) often overlook its potentially large impact on nonhuman animals. In a recent commentary on our paper about AI’s possible harms, Leonie Bossert argues for a focus not just on the possible negative impacts but also the possible beneficial outcomes of AI for animals. We welcome this call to increase awareness of AI that helps animals: developing and using AI to improve animal wellbeing and promote positive dimensions in animal lives should be a vital ethical (...) goal. Nonetheless, we argue that there is some value in focusing on technology-based harms in the context of AI ethics and policy discourses. A harms framework for AI can inform some of our strongest duties to animals and inform regulation and risk assessment impacts designed to prevent serious harms to humans, the environment, and animals. (shrink)

Alternative proteins, including plant-based and cell-based meat and dairy analogues, are discursively positioned as a new form of meat and dairy and as a solution to the myriad of issues associated with conventional animal agriculture. Animal agricultural industries across various nations have resisted this positioning in regulatory spaces by advocating for laws that restrict the use of meat and dairy terms on the labels of alternative proteins products. Underlying this contestation are differing understandings of, and vested interests in, desirable futures (...) for animal agriculture. In Australia, this broader contestation led to a national-level inquiry by a Senate parliamentary committee entitled _Definitions of meat and other animal products_ (the Inquiry). This paper reports findings from a study of the problematizations developed through the Inquiry using a framework for policy discourse analysis referred to as Bacchi’s ‘What’s the Problem Represented to be’ methodology. It shows how the dominant discourse throughout the Inquiry moved away from the initial problematization of alternative proteins as a threat to animal agriculture. Instead, both industries were ultimately positioned as not in competition and only labelling laws were problematized with the solution being amendments to ensure ‘consumer clarity’. This outcome ignored a range of alternative problematizations related to the ethical, environmental, health, social and economic issues raised by animal agriculture and by alternative proteins. This lack of scrutiny benefits both industries, by closing off the policy discourse to consideration of a range of alternative interests, voices, and potential solutions, such as stricter health and welfare regulation. (shrink)

The aim of this paper is twofold: first, it seeks to provide a better understanding of lawyers’ ethics in practice in the field of publicly funded asylum law. It does so by examining Dutch asylum legal aid lawyers’ moral reasoning in respect of the ethically challenging issue of ‘the hopeless case’, employing a version of Christine Parker’s four approaches to moral reasoning in legal practice: adversarial advocacy, responsible lawyering, moral activism and relational lawyering. Second, it aims to demonstrate (...) the applicability of Parker’s taxonomy, developed in a common law country (Australia), to a civil law country (The Netherlands). This paper shows, in line with what Parker argued, that lawyers may apply a combination of approaches – different ethical considerations carry different in weight in different circumstances. It provides illustrations of situations in which approaches coexist and compete and the circumstances in which one prevails over the other in the area under review. (shrink)

Julian Savulescu argues for two principles of reproductive ethics: reproductive autonomy and procreative beneficence, where the principle of procreative beneficence is conceptualised in terms of a duty to have the child, of the possible children that could be had, who will have the best opportunity of the best life. Were it to be accepted, this principle would have significant implications for the ethics of reproductive choice and, in particular, for the use of prenatal testing and other reproductive technologies for the (...) avoidance of disability, and for enhancement. In this paper, it is argued that this principle should be rejected, and it is concluded that while potential parents do have important obligations in relation to the foreseeable lives of their future children, these obligations are not best captured in terms of a duty to have the child with the best opportunity of the best life. (shrink)

Clinical geneticists are increasingly confronted with ethical tensions between their responsibilities to individual patients and to other family members. This paper considers the ethical implications of a “familial” conception of the clinical genetics role. It argues that dogmatic adherence to either the familial or to the individualistic conception of clinical genetics has the potential to lead to significant harms and to fail to take important obligations seriously.Geneticists are likely to continue to be required to make moral judgments in the resolution (...) of such tensions and may find it useful to have access to ethics training and support. (shrink)

The development of human genetics raises a wide range of important ethical questions for us all. The interpersonal dimension of genetic information in particular means that genetics also poses important challenges to the idea of patient-centredness and autonomy in medicine. How ought practical ethical decisions about the new genetics be made given that we appear, moreover, no longer to be able to appeal to unquestioned traditions and widely shared communitarian values? This paper argues that any coherent ethical approach to these (...) questions must be able both to uphold the moral status of the individual and at the same time recognise the communitarian, interpersonal dimensions both of the world in which we live and of personal autonomy itself. The paper then goes on to propose an approach to the resolution of the ethical questions raised by the use of the new genetics in reproductive choice through the development of a coherent and principled process of public reason and justification oriented towards the support and development of personal autonomy. (shrink)

The internet is becoming increasingly important in health care practice. The number of health-related web sites is rising exponentially as people seek health-related information and services to supplement traditional sources, such as their local doctor, friends, or family. The development of e-medicine poses important ethical challenges, both for health professionals and for those who provide clinical ethics support for them. This paper describes some of these challenges and explores some of the ways in which those who provide clinical ethics support (...) might respond creatively to them. By offering ways of responding to such challenges, both electronically and face-to-face, the providers of clinical ethics support can show themselves to be an indispensable part of good quality health care provision. (shrink)

_Feminism and Ecological Communities_ presents a bold and passionate rethinking of the ecofeminist movement. It is one of the first books to acknowledge the importance of postmodern feminist arguments against ecofeminism whilst persuasively preseenting a strong new case for econolocal feminism. Chris J.Cuomo first traces the emergence of ecofeminism from the ecological and feminist movements before clearly discussing the weaknesses of some ecofeminist positions. Exploring the dualisms of nature/culture and masculing/feminine that are the bulwark of many contemporary ecofeminist positions and (...) questioning traditional traditional feminist analyses of gender and caring, _Feminism and Ecological Communities_ asks whether women are essentially closer to nature than men and how we ought to link the oppression of women, people of colour, and other subjugated groups to the degradation of nature. Chris J.Cuomo addresses these key issues by drawing on recent work in feminist ethics as well as teh work of diverse figures such as Aristotle, John Dewey, Donna Haraway adn Maria Lugones. A fascinating feature of the book is the use of the metaphor of the cyborg to highlight the fluidity of the nature/culture distinction and how this can enrich econfeminist ethics and politics. An outstanding new argument for an ecological feminism that links both theory and practice, _Feminism and Ecological Communities_ bravely redraws the ecofeminist map. It will be essential reading for all those interested in gender studies, environmental studies and philosophy. (shrink)

Background: Little is known about what factors may contribute to the growth of a consultation service or how a practice may change or evolve across time. Methods: This study examines data collected from a busy ethics consultation service over a period of more than two decades. Results: We report a number of longitudinal findings that represent significant growth in the volume of ethics consultation requests from 19 in 1990 to 551 in 2013, as well as important changes in the patient (...) population for which ethics help is requested. The findings include (1) a steady growth in requests from primary care providers (e.g., physicians and nurses), as well as increases in ancillary services (e.g., social workers); (2) a decrease in length of stay (days) before ethics help is requested; (3) an increase in the reasons that individuals ask for help from ethics; (4) an upsurge in consults requests from areas outside the intensive care unit (ICU); (5) a decrease in patients that died during hospitalization (e.g., live discharges); and (6) growth in the numbers of patients lacking decision-making capacity. Conclusions: We believe the increases in consult requests reflect appropriate and necessary growth because recent consultations have also been associated with consultations requiring (7) additional interventions and (8) reasonably high time intensity scores. (shrink)

We clarify aspects of our Dynamic Functional Model of Jealousy in response to D’Arms and Stets. Our model proposes that jealousy is an evolved motivational state that arises over threat by a rival to one’s relationship or some aspect of one’s relationship. The formation or loss of relationships rarely occurs instantaneously. Therefore, we argue that jealousy, whose goal is to remove or reduce the rival threat, can occur over a longer time course than is often assumed in theories of specific (...) emotions. We further suggest that other emotions such as grief and fear also can occur over extended periods. This raises challenges for emotion theories that assume that emotions must be short-lived. (shrink)

Organizations have long struggled to find ways to reduce the occurrence of unethical behaviors by employees. Unfortunately, time theft, a common and costly form of ethical misconduct at work, has been understudied by ethics researchers. In order to remedy this gap in the literature, we used the theory of planned behavior (TPB) to investigate the antecedents of time theft, which includes behaviors such as arriving later to or leaving earlier from work than scheduled, taking additional or longer breaks than is (...) acceptable, and on-the-job daydreaming. We surveyed 135 employed undergraduate business students regarding the TPB variables at Time 1. Two months later, participants reported the frequency they engaged in time theft since Time 1. Results indicate that behavioral, normative, and control beliefs significantly predicted attitudes, subjective norms, and perceived behavioral control, respectively. Attitudes, subjective norms, and perceived behavioral control, in turn, were significantly related to time theft intentions, which predicted later enactment of time theft. Thus, employers can decrease time theft by primarily focusing on altering employees’ attitudes toward time theft, followed by reducing social pressures to engage in it, and lastly, by implementing organizational practices that make it difficult to commit time theft. (shrink)

... View (i) The Thesis of Essential Contestedness The view that freedom and other ideals such as justice are essentially contested is important, ...

In this paper, I set an aspect of what it is to live a flourishing life against the backdrop of neo liberal trends that continue to influence educational policy across the globe. The view I set out is in sharp contrast to any narrow assumption that education’s main task is the measurement of high performing individuals who will thus contribute to an economically viable society. Instead, I explore and argue for a conception of what constitutes a flourishing life that is (...) embedded in a more pragmatist analysis of what education may be. The argument begins with developing the centrality of embodiment to aesthetic sensibility and goes on to suggest how collective understanding of this within a community could constitute a sense of performance and thus contribute to the educational aim of developing a full and flourishing life. The argument is that this way of seeing life could have implications for educational practice, the role of the teacher and could help to reconfigure how education is experienced by the young. (shrink)

Biomedical research is an increasingly multidisciplinary activity bringing together a range of different academic fields and forms of expertise to investigate diseases that are increasingly understood to be complex and multifactorial. Recently the discipline of ethics has been starting to find a place in large-scale biomedical collaborations. In this article we draw from our experience of working with the Malaria Genomic Epidemiology Network and other research projects to reflect upon the integration of ethics into biomedical research. We examine the way (...) in which ethics input may be valuable to research, the forms it tends to take, and also the problems and limitations of such collaborations. (shrink)

The way in which one understands information and concepts, and the way a student works to develop this, is an individual aspect of learning that cannot be universally defined as (at least manifested) the same for everyone. ‘Understanding’ is a broad term, and the way one achieves understanding is dependent on the way that material is presented. In this article, we argue that the philosophy of science can be important to nursing education—in particular, by showing that the way we imbue (...) understanding might depend on the meaning of ‘understanding’. Diagrams and concept maps are meant to guide newly formed knowledge and connections to develop proper thinking (e.g., the order in which nursing students must prioritize data) that a student requires in the field. We argue that whether or not an image/diagram/concept map confers understanding will depend on both what the object is and what we mean by ‘understanding’. (shrink)

One of the most‐exciting and controversial discoveries of the last decade has been the isolation of embryonic stem cells from human embryos. The capacity of these cells to form all somatic cell types in the human body has captured the imagination of researcher and clinician alike, the perspectives that they represent for cell replacement therapies in multiple chronic disorders being used to justify the use of embryos for this purpose. However, there is a gradual realization that cell therapies are in (...) the far future and some find that the other, more immediately applicable, types of research give less justification for the use of embryos. Here, cardiomyocytes derived from human embryonic stem cells are discussed. The research opportunities created by having human heart cells available routinely in the laboratory are explored and the types of questions that can be addressed are placed in the context of alternative cell and animal models. BioEssays 29:572–579, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Stem cell research is the product of cumulative, integrated effort between and within laboratories and disciplines. The many collaborative steps that lead to that special “Eureka moment”, when something that has been a puzzle perhaps for years suddenly become clear, is among the greatest pleasures of a scientific career. In this essay, the serendipitous pathway from first acquaintance with pluripotent stem cells to advanced cardiovascular models that emerged from studying development and disease will be described. Perhaps inspiration for later generations (...) of stem cell researchers simply to follow whatever they find interesting. (shrink)