Unable to answer the call of our patients: mental health nurses’ experience of moral distress When health practitioners’ moral choices and actions are thwarted by constraints, they may respond with feelings of moral distress. In a Canadian hermeneutic phenomenological study, physicians, nurses, psychologists and non‐professional aides were asked to identify care situations that they found morally distressing, and to elaborate on how moral concerns regarding the care of patients were raised and resolved. In this paper, we describe the experience of (...) moral distress related by nurses working in mental healthcare settings who believed that lack of resources (such as time and staff) leads to dispiritedness, lack of respect, and absence of recognition (for both patients and staff) which severely diminished their ability to provide quality care. The metaphors of flashlight and hammer are used to elaborate nurses’ possible responses to intolerable situations. (shrink)

According to the proponents of Developmental Systems Theory and the Causal Parity Thesis, the privileging of the genome as “first among equals” with respect to the development of phenotypic traits is more a reflection of our own heuristic prejudice than of ontology - the underlying causal structures responsible for that specified development no more single out the genome as primary than they do other broadly “environmental” factors. Parting with the methodology of the popular responses to the Thesis, this paper offers (...) a novel criterion for ‘causal primacy’, one that is grounded in the ontology of the unique causal role of dispositional properties. This paper argues that, if the genome is conceptualised as realising dispositional properties that are “directed toward” phenotypic traits, the parity of ‘causal roles’ between genetic and extra-genetic factors is no longer apparent, and further, that the causal primacy of the genome is both plausible and defensible. (shrink)

Corporate and commercial values are inducing some healthcare organizations to prescribe a customer service model that reframes the provision of nursing care. In this paper it is argued that such a model is incommensurable with nursing conceived as a moral practice and ultimately places nurses at risk. Based upon understanding from ongoing research on compassion fatigue, it is proposed that compassion fatigue as currently experienced by nurses may not arise predominantly from too great a demand for compassion, but rather from (...) barriers to enacting compassionate care. These barriers are often systemic. The paradigm shift in which healthcare environments are viewed as marketplaces rather than moral communities has the potential to radically affect the evolution of nursing as a discipline. (shrink)

The moral distress of psychologists working in psychiatric and mental health care settings was explored in an interdisciplinary, hermeneutic phenomenological study situated at the University of Alberta, Canada. Moral distress is the state experienced when moral choices and actions are thwarted by constraints. Psychologists described specific incidents in which they felt their integrity had been compromised by such factors as institutional and interinstitutional demands, team conflicts, and interdisciplinary disputes. They described dealing with the resulting moral distress by such means as (...) silence, taking a stance, acting secretively, sustaining themselves through work with clients, seeking support from colleagues, and exiting. Recognizing moral distress can lead to a significant shift in the way we perceive moral choices and understand the moral context of practice. (shrink)

According to dispositionalism, de re modality is grounded in the intrinsic natures of dispositional properties. Those properties are able to serve as the ground of de re modal truths, it is said, because they bear a special relation to counterfactual conditionals, one of truthmaking. However, because dispositionalism purports to ground de re modality only on the intrinsic natures of dispositional properties, it had better be the case that they do not play that truthmaking role merely in virtue of their being (...) embedded in some particular, extrinsic causal context. This paper examines a recent argument against dispositionalism that purports to show that the intrinsicality of that relation cannot be maintained, due to the ceteris paribus nature of the counterfactuals that dispositions make-true. When two prominent responses are examined, both are found wanting: at best, they require unjustified special pleading, and at worst, they amount to little more than ad hoc conceptual trickery. (shrink)

There are many ethical issues arising for practitioners in what are termed the boundaries of professional helping relationships. In this article, the authors argue that the boundary metaphor is not sufficient for conceptualizing these ethical issues and propose that alternative metaphors be considered. The use of a different metaphor might allow practitioners to re-vision the relationship issues in a more realistic, richer, and holistic way. Those explored here include highway, bridge, and territory. For the authors, it is territory that seems (...) to hold the greatest promise. (shrink)

Human rights may be the most globalized political value of our times. The rights paradigm has been criticized, however, for being theoretically unsound, legalistic, individualistic and based on the assumption that there is a given and universal humanness. Its use in the area of health is relatively new. Proponents point to its power to frame health as an entitlement rather than a commodity. The problems and the possibilities of a rights approach in addressing health ethics issues are explored in this (...) article. (shrink)

This paper is an aesthetic analysis of the practice of serpent handling by Christians in the Appalachian region of the United States. The purpose of this analysis is to understand serpent handling's aesthetic relationship to the Pentecostal tradition and exposit the implications of this relationship for the practice's legal status. The first section examines the history and defining characteristics of serpent handling and introduces the controversial problem of whether the practice can be categorized within the Pentecostal movement. The second section (...) argues that serpent handling can be understood as belonging within the broader global Pentecostal tradition through engagement with the Pentecostal aesthetics of Nimi Wariboko. The final section concludes that if serpent handling is legible according to the aesthetic norms of Pentecostalism, a now broadly tolerated religious tradition in the United States, then this necessitates a wholesale reconsideration of antiserpent handling legislation. (shrink)

The movie, The terminal, is used to illustrate Mac Intyre's description of virtue ethics. The terminal is a mythical tale about a traveler, Viktor Navorski, who is stranded by circumstances in a New York airport. Viktor is a person who, without a strict reliance on duty or rules, has developed the disposition to act well despite variation in his circumstances. His character is revealed in contrast to that of three other characters: a cleaner, a flight attendant and the airport manager. (...) Stories like this one may be a good way to open dialogue among clinicians about being virtuous as a practitioner. Such dialogue may make striving to be virtuous an acceptable goal for practitioners and less like an idealistic, pseudo-goal for those aiming for sainthood. (shrink)

The doctrine of theosis is receiving increased attention from contemporary evangelicals. In this paper, I explore theosis and its importance for our understanding and practice of the Christian moral and spiritual life. I discuss the connection between theosis and how we understand the work of the Holy Spirit in the life of the believer, and conclude with some practical applications related to this doctrine.

Historically, Judeo-Christian doctrine has been used to justify the mistreatment of nonhuman animals through the “dominion” view of human superiority. Linzey and others have questioned this perspective, suggesting that critical tenets of religion, and particularly Christianity, support the ethical treatment of other animals by defining dominion as stewardship. This article considers how framing and networks help explain the complex relationship between religion and support for animal rights. We offer ways in which social networks and framing might inform the beliefs and (...) behaviors of religious individuals who support animal rights as well as the strategies of the animal rights movement intended to appeal to such individuals. (shrink)

Excerpt from The Samkhya Karikas of Is'vara Krishna: With the Commentary of Gaudapada; Abstract of Thesis In a concise and comprehensive way, these sixty-nine me morial verses, each in turn, explain the several doctrines of the earlier and pure Samkhya school, as yet untouched by Vedantic colorings, and in their brevity and terseness they resemble, in every particular, except their metrical structure, the sutras of the remaining five orthodox systems of Hindu philosophy. About the Publisher Forgotten Books publishes hundreds of (...) thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Influence of Anxiety and Literature's Panglossian NoseMichael AustinIScheherazade may be the protagonist of The Thousand and One Nights, but her stories are the heroes. Her audience for these stories consists only of her sister and her husband, the great sultan Shahryar, who three years earlier had vowed to avenge his wife's infidelity by marrying a new woman each night and executing her the following morning. With the supply (...) of virgins in the kingdom running short, Scheherazade forces her father, the royal vizier, to allow her to marry the Sultan, assuring him that she has a plan to end his bloody practice. Her plan is simple: every night, Scheherazade tells Shahryar a piece of a story. Many of these stories are overtly didactic, and some are even thinly veiled allegories of Shahryar's own situation, but Scheherazade aims to do more than simply rehabilitate the sultan with pedagogically sound morality tales. She weaves her stories together, often using multiple frames and levels of embedded narrative, to make sure that the night always ends in the middle of at least one story, and, each morning, the Sultan postpones his sentence of death one day so he can hear the conclusion.Scheherazade's gambit succeeds—with the Sultan and with readers everywhere—because it taps into a very deep human need for literature, which, broadly defined, includes folk tales, songs, oral epics, and other forms of narrative expression. Stories have been a source of pleasure for human beings for a long time—much longer than there have been writing systems to record them. And, during all this time, as Paul Hernadi writes, "the pleasure of succumbing to literary seduction has long served as a psychological reward for what was once and perhaps still is [End Page 215] a biologically advantageous thing to do."1 Scheherazade's stories give Shahryar pleasure—more pleasure, arguably, than the sexual encounters that precede them. In more than a thousand marriages (assuming three full years since he began the practice), sexual pleasure never entices the sultan to suspend his vow. With an entire kingdom full of potential wives, of course, he need never fear an end to such pleasures. The pool of wives who can bring the pleasure of narrative to the marriage bed is much smaller indeed.But pleasure alone cannot explain Scheherazade's success; if it could, she would not have to end each night in the middle of a story. By doing so, she combines the pleasure of narrative with the anxiety of incompleteness. Scheherazade's cliffhangers work on Shahryar for the same reason that they work on us today: we expect to find out what happens in a story, and we experience anxiety when this expectation is frustrated. This anxiety is just as deeply rooted in biology and natural selection as the "pleasure of succumbing to literary seduction." Most of the things that produce great anxiety in people—such as snakes, spiders, fire, high places, large bodies of water, contaminated surfaces, and unknown social situations—constitute very real threats to our survival. Anxiety is nature's way of telling us to pay extra attention around potentially dangerous things or to take steps to avoid such things whenever possible. Pleasure and anxiety work hand in hand, as carrot and stick, to encourage, or discourage, the same fitness-enhancing behaviors. Eating when we are hungry gives us pleasure; wondering where our next meal is coming from gives us anxiety.The pleasure and anxiety that we experience in literature are neurologically indistinguishable from the same responses that we experience in the life-or-death situations for which they were designed. According to John Tooby and Leda Cosmides, "fictional worlds engage emotion systems while disengaging action systems.... An absorbing series of fictional events will draw out of our mental mechanisms a rich array of emotional responses—the same responses that would be appropriate to those same events and persons if they were real."2 The ability to respond in this way appears to be unique to human beings, but it also appears to be a universal element of human nature. People everywhere tell and respond to stories, and many people devote considerable... (shrink)

If the Bucolics as a whole ‘ look on us with dark enigmatical eyes,’ for long no more impenetrable darkness and no more compelling enigma could be found than that of the fourth poem in the collection. But Skutsch, the authors of Virgil's Messianic Eclogue, and more recently Mr. Royds in his Virgil and Isaiah, have done much to solve its many mysteries. Their efforts, however, were mainly directed towards the problems of fact contained in the Eclogue, and so far (...) little attention seems to have been given to an equally interesting point, that of its metrical arrangement. It is plain that we must consult the Sibyll for help: if it is not plain, that is not Virgil's fault. I hope to be able to show here that Virgil himself has left in this poem certain unmistakeable signs for those who have eyes to see and ears to hear, besides his own rather casual reference to the Cumaeum carmen, and incidentally to dispose anew of the theory which reads in that expression an allusion not to the Sibyl but to Hesiod. (shrink)

The transparency of visual experience is a widely held and important thesis in the philosophy of perception. Critical discussion of transparency has focused on visual experiences, such as the experience of visual blur that are taken to be counter examples to transparency. Here, I consider a novel objection to transparency that does not depend on intuitions about examples. The objection is that if transparency is true then we cannot explain our ability to think about our visual experiences as such. In (...) response to this objection, I develop an account of how we are able to think about our own visual experiences as such that is compatible with transparency. (shrink)

In this paper, I examine two contemporary models of sport, the Martial/Commercial Model and the Aesthetic/Recreational Model, from the perspective of Stoic philosophy. Drawing on the writ...

A Guide to the Threefold Lotus Sutra. Nikkyo Niwano. Translated and adapted by Eugene Langston. Kosei Publishing Co., Tokyo 1981. Distributed by Prentice/Hall International, Hemel Hempstead. 168pp. £2.10.

Human awareness of natural beauty stimulates the formation of environmental ethics. I build from the insights of Jonathan Edwards, the American Puritan theologian. The experience of beauty creates and sustains relationships. Natural beauty is an aspect of that which holds things together, supporting life and individuation. Beauty joins experience to ethics. We experience beauty intuitively: it is an affecting experience which motivates thought and action. The experience of beauty gives us a stake in the existence of the beautiful. Ecology can (...) explore the relationships of natural beauty scientifically: it may be a science of the beauty of the Earth. The beauty of the world is necessary to its survival. Beauty is manifest in the interplay of interdependence with individuality, yielding diversity. The most beautiful relationships are those which recognize diversity, support individuality, and empathetically span the distinctions between beings. The sense of beauty is not a luxury, but a distinctive human vocation. (shrink)

Singapore's strategic play to secure international wealth management market share has been very successful. Serious questions, however, were raised in relation to this ascendency as the Global Financial Crisis drove the European Union and the United States of America to become proactive in clamping down on tax evasion and other areas deemed by them to be undesirable within the international financial system. This paper will examine the Singapore government's decade-long growth policy of its wealth management sector, and how it has (...) been impacted upon by international regulatory responses. Further, it examines how in stark contrast to the EU and the US, Indonesia has been far less successful in its diplomatic efforts to have Singapore address financial diplomacy issues in relation to Indonesian citizens residing in Singapore. This article will argue, however, that Singapore's less than robust response to Indonesia's constant requests for action maybe to the long-term detriment of Singapore itself. (shrink)

The Christ and the Bodhisattva. Ed. by Donald Lopez and Steven Rockefeller. State University of New York Press, Albany 1987. viii, 274pp. Hbk $44.50, pbk $14.95.