This paper completes an argument that the problem of moral distress offers philosophical counselors an opportunity to do work that is both socially useful and philosophically interesting in its own right. A previous Philosophical Practice article answered the question, What's Philosophical About Moral Distress? by conceptualizing it as a phenomenon that arises within a moral worldview (Matchett 2018). The present paper investigates ways in which a philosophical counseling response to moral distress might differ from the strategies deployed by the (...) nursing profession to date. Though they are often quite subtle, the presence of some differences opens the possibility that philosophical counseling might be more effective than those strategies; in addition to helping individual nurses feel better, this could strengthen the nursing profession's efforts to mitigate nursing shortages and enhance quality of patient care. Though case studies are necessary to support these claims, there are reasons to think they are warranted. (shrink)

Moral distress is a well-documented phenomenon in the nursing profession, and increasingly thought to be implicated in a nation-wide nursing shortage in the US. First identified by the philosopher Andrew Jameton in 1984, moral distress has also proven resistant to various attempts to prevent its occurrence or at least mitigate its effects. While this would seem to be bad news for nurses and their patients, it is potentially good news for philosophical counselors, for whom there is both socially important and (...) philosophically interesting work to be done. In an effort to encourage such work, this paper explicates the philosophical (as opposed to more purely psychological or institutional) contours of the problem. A subsequent paper, titled 'A Philosophical Counseling Approach to Moral Distress,' will highlight ways in which such a response would differ from the strategies so far deployed within the nursing profession. (shrink)

This commentary shows how philosophical counseling offers an alternative way for consultants to facilitate "closure" in bioethical disputes.

An application of Aristotle's conception of happiness.

Robert Sparrow has recently claimed that unless there are reasons to think the sexed nature of human beings is normatively significant, current trends in bioethical reasoning force the conclusion that “we may do well to move toward a ‘post sex’ humanity” (American Journal of Bioethics 10: 7 (2010)). This commentary uses basic methodological principles from feminist ethics to argue that he has, in fact, given no reasons to think that a 'post sex' humanity is any more valuable than gender diverse (...) one, and no reason to think that sexual dimorphism has normative significance as a brute biological fact. (shrink)

In "The Virtues of Sharing" I defend two central theses: that sharing is our most overarching ethical ideal, and that virtue ethics is able to serve as a comprehensive and free-standing approach to moral theory. My arguments for these theses are intertwined, because they are also designed to show how a virtue-ethical theory that treats the "Will to Share" as the basis of moral agency helps to resolve the contemporary Justice/Care Debate.

Introduction/Background: Moral distress and related concepts surrounding morality and ethical decision-making have been given much attention in nursing. Despite the general consensus that moral distress is an affective response to being unable to act morally, the literature attests to the need for increased clarity regarding theoretical and conceptual constructs used to describe precisely what the experience of moral distress involves. The purpose of this study is to understand how student nurses experience morally distressing situations when caring for patients with different (...) values and beliefs than their own in the clinical environment -/- Methods: This study is based on secondary analysis of participant data. The stories of eight student nurses who completed the original study were reviewed following Yin’s multiple-case study design. -/- Results: Findings suggest there is a subtle form of moral distress that has been under appreciated in the literature and differs from Jameton’s classic definition. While traditional institutional triggers to moral distress are pervasive, personal conflict as a result of differing value systems may be a moral challenge faced by nursing students working with culturally diverse patients. -/- Conclusion: Ethics education is needed in nursing school to reduce moral distress in the clinical environment. Nursing students need opportunities to develop moral reasoning skills in addition to their clinical skills. A philosophical approach to ethics education may be needed to prevent and alleviate moral distress. (shrink)

Researchers developed and tested an online training module with both experienced public relations professionals and newcomers to the field with the hopes of helping them sharpen and refine their ethical decision-making skills. The study found that although most testers reported the Web site was difficult to navigate and/or found the ethical content to be complex, the majority believed their ethical decision-making abilities were improved.

Review of Steven Sverdlik (2011) Motive and Rightness, Oxford University Press.

Feminist scholars have been remaking the landscape in political theory, and in this important book some of the most important feminist political theorists provide reconstructions of those concepts most central to the tradition of political philosophy. The goal is nothing less than the construction of a blueprint for a positive feminist theory.Many of these papers are completely new; others are extensions of important earlier work; two are reprints of classic papers. The result is a progress report on the continuing feminist (...) project to re-envision traditional political theory. As such, it constitutes essential reading not only for feminist thinkers but also for traditional philosophers and political theorists, who will need to come to terms with these contemporary critiques and re-readings. (shrink)

Cognition in work teams has been predominantly understood and explained in terms of shared cognition with a focus on the similarity of static knowledge structures across individual team members. Inspired by the current zeitgeist in cognitive science, as well as by empirical data and pragmatic concerns, we offer an alternative theory of team cognition. Interactive Team Cognition (ITC) theory posits that (1) team cognition is an activity, not a property or a product; (2) team cognition should be measured and studied (...) at the team level; and (3) team cognition is inextricably tied to context. There are implications of ITC for theory building, modeling, measurement, and applications that make teams more effective performers. (shrink)

How do novel scientific concepts arise? In Creating Scientific Concepts, Nancy Nersessian seeks to answer this central but virtually unasked question in the problem of conceptual change. She argues that the popular image of novel concepts and profound insight bursting forth in a blinding flash of inspiration is mistaken. Instead, novel concepts are shown to arise out of the interplay of three factors: an attempt to solve specific problems; the use of conceptual, analytical, and material resources provided by the (...) cognitive-social-cultural context of the problem; and dynamic processes of reasoning that extend ordinary cognition. Focusing on the third factor, Nersessian draws on cognitive science research and historical accounts of scientific practices to show how scientific and ordinary cognition lie on a continuum, and how problem-solving practices in one illuminate practices in the other. (shrink)

Ault, Nancy J Spiritual direction is at risk in a society which is turning increasingly to personal feelings to validate experience and justify decision making. An appeal to feelings and emotions enables marketers to sell religion and spirituality as consumer products. As a product among many, the wider contexts of religion and spirituality may fade from consciousness and be lost. In such a 'pick and mix' culture, as well as losing sight of the embodied nature of understanding, what may (...) happen is a slow drifting apart of thinking, feelings and action. The cost of such a separation is high. Feelings may disintegrate into sentimentalism, thinking sink into legalism and action become uninformed reaction. Hence, practices which facilitate the intentional integration of mind, heart and behaviour can provide an essential counterbalance to the contemporary forces engendering separation. (shrink)

Approximately 20% of adult cancer patients are eligible to participate in a clinical trial, but only 2.5-9% do so. Accrual is even less for minority and medically underserved populations. As a result, critical life-saving treatments and quality of life services developed from research studies may not address their needs. This study questions the utility of the bioethical concern with therapeutic misconception (TM), a misconception that occurs when research subjects fail to distinguish between clinical research and ordinary treatment, and therefore attribute (...) therapeutic intent to research procedures in the safety net setting. This paper provides ethnographic insight into the ways in which research is discussed and related to standard treatment. (shrink)

PARTI The Philosophical Situation: A Critical Appraisal We must begin with the mistake and find out the truth in it. That is, we must uncover the source of ...

Efforts to decrease errors in health care are directed at prevention rather than at managing a situation when a mistake has occurred. Consequently, nurses and other health care providers may not know how to respond properly and may lack sufficient support to make a healthy recovery from the mental anguish and emotional suffering that often accompany making mistakes. This article explores the conceptualization of mistakes and the ethical response to making a mistake. There are three parts to an ethical response (...) to error: disclosure, apology and amends. Honesty and humility are discussed as important virtues that facilitate coping and personal growth for the health care provider who is involved in mistakes. In conclusion, a healthy view of nursing practice and mistake making is one that prevents error but, when prevention is not possible, accepts fallibility as part of the human condition and achieves the best possible outcome for all. (shrink)

Most incidences of dishonesty in research, financial investments that promote personal financial gain, and kickback scandals begin as conflicts of interest (COI). Research indicates that healthcare professionals who maintain COI relationships make less optimal and more expensive patient care choices. The discovery of COI relationships also negatively impact patient and public trust. Many disciplines are addressing this professional issue, but little work has been done towards understanding and applying this moral category within a nursing context. Do COIs occur in nursing (...) and are they problematic? What are the morally appropriate responses to COI for our discipline and for individual practicing nurses? In this paper I examine the nature of 'conflict of interest' as a general ethical category, its characteristics and its application to our discipline. Conflict of interest is an odd moral category that may actually or potentially result in immoral decisions. The moral justification for COI is grounded prime facie by the moral value of respect for persons and principle of fidelity from which trust is developed and maintained. In review of the historical development, there appears to be consensus on some qualities of COI that are presented. I conclude that making judgements about COI are challenging and often difficult to determine from a nursing perspective. Improving nurses' and professional organizations' awareness of COI and sharpening our ability to respond appropriately when COI arise can reduce potential harm and promote trust in those whom we serve. (shrink)

Under patriarchy, the rationally autonomous agent engages in contractual relations in a marketplace society. The contractual model reinforces a negative conception of the vulnerable as weak and as susceptible to injury and exploitation. Recent feminist writing has a positive notion of vulnerability that is in conflict with contractualism. Positive notions of vulnerability, the paper argues, are found in Virginia Held’s conception of mothering, Nel Noddings’ analysis of teaching, and Annette Baier’s development of trust as essential for social relationships.

A growing number of nurse researchers travel globally to conduct research in poor and underserved populations in developing nations. These researchers, while well versed in research ethics, often find it difficult to apply traditional ethical standards to populations in developing countries. The problem of applying ethical standards across cultures is explained by a long-standing debate about the nature of ethical principles. Fundamentalism is the philosophical stance that ethical principles are universal, while the anthropologically-based ‘multicultural’ model claims the philosophical position that (...) principles are culturally bound. The authors explicate the two philosophical stances and advocate a morally sensitive but moderate position of ‘ethical multiculturalism’ rather than favouring either of the above philosophical positions. The final section suggests ways to promote ethical multiculturalism while planning and conducting nursing research. (shrink)

Globalization, an outgrowth of technology, while informing us about people throughout the world, also raises our awareness of the extreme economic and social disparities that exist among nations. As part of a global discipline, nurses are vitally interested in reducing and eliminating disparities so that better health is achieved for all people. Recent literature in nursing encourages our discipline to engage more actively with social justice issues. Justice in health care is a major commitment of nursing; thus questions in the (...) larger sphere of globalization, justice and ethics, are our discipline's questions also. Global justice, or fairness, is not an issue for some groups or institutions, but a deeper human rights issue that is a responsibility for everyone. What can we do to help reduce or eliminate the social and economic disparities that are so evident? What kind of ethical milieu is needed to address the threat that globalization imposes on justice and fairness? This article enriches the conceptualization of globalization by investigating recent work by Schweiker and Twiss. In addition, I discuss five qualities or characteristics that will facilitate the development of a viable and just global ethic. A global ethic guides all people in their response to human rights and poverty. Technology and business, two major forces in globalization that are generally considered beneficial, are critiqued as barriers to social justice and the common good. To turn human nature into humanity and righteousness is like turning the willow into cups and bowls.The book of Mencius. (shrink)

We lay groundwork for applying ethnographic methods in philosophy of science. We frame our analysis in terms of two tasks: to identify the benefits of an ethnographic approach in philosophy of science and to structure an ethnographic approach for philosophical investigation best adapted to provide information relevant to philosophical interests and epistemic values. To this end, we advocate for a purpose-guided form of cognitive ethnography that mediates between the explanatory and normative interests of philosophy of science, while maintaining openness and (...) independence when framing such an investigation to achieve robust unbiased results. (shrink)

The book examines the emerging approach of using qualitative methods, such as interviews and field observations, in the philosophy of science. Qualitative methods are gaining popularity among philosophers of science as more and more scholars are resorting to empirical work in their study of scientific practices. At the same time, the results produced through empirical work are quite different from those gained through the kind of introspective conceptual analysis more typical of philosophy. This volume explores the benefits and challenges of (...) an empirical philosophy of science and addresses questions such as: What do philosophers gain from empirical work? How can empirical research help to develop philosophical concepts? How do we integrate philosophical frameworks and empirical research? What constraints do we accept when choosing an empirical approach? What constraints does a pronounced theoretical focus impose on empirical work? Nine experts discuss their thoughts and empirical results in the chapters of this book with the aim of providing readers with an answer to these questions. (shrink)

Trust in the nurse—patient relationship is maintained not by how professionals perceive their actions but rather by how the public perceives them. However, little is known about the public's view of nurses and other health care professionals who participate in pharmaceutical marketing. Our study describes public perceptions of health care providers' role in pharmaceutical marketing and compares their responses with those of a random sample of licensed family nurse practitioners. The family nurse practitioners perceived their participation in marketing activities as (...) significantly more ethically appropriate than did the public responders. Further research is warranted before conclusions can be drawn, but these early findings suggest that nurse practitioners should consider a conservative approach to participating in pharmaceutical marketing. (shrink)

Thought experiments have played a prominent role in numerous cases of conceptual change in science. I propose that research in cognitive psychology into the role of mental modeling in narrative comprehension can illuminate how and why thought experiments work. In thought experimenting a scientist constructs and manipulates a mental simulation of the experimental situation. During this process, she makes use of inferencing mechanisms, existing representations, and general world knowledge to make realistic transformations from one possible physical state to the next. (...) The simulation reveals the impossibility of integrating multiple constraints drawn from existing representations and the world and pinpoints the locus of the required conceptual reform. (shrink)

Building computational models of engineered exemplars, or prototypes, is a common practice in the bioengineering sciences. Computational models in this domain are often built in a patchwork fashion, drawing on data and bits of theory from many different domains, and in tandem with actual physical models, as the key objective is to engineer these prototypes of natural phenomena. Interestingly, such patchy model building, often combined with visualizations, whose format is open to a wide range of choice, leads to the discovery (...) of new concepts and control structures. Two key questions are raised by this practice: how could discoveries arise from building external representations for which there is wide latitude in choice of the components from which they are built, and thus can be considered significantly arbitrary, and how could such discoveries allow engineering a real-world prototype system. To examine these questions, we present two case studies of discoveries that emerged from the building of such computational models in the bioengineering sciences. We then develop a process model that accounts for the discovery and transfer problems raised by both these cases, focusing on the process of building the model. Specifically, to account for the discovery problem, we propose that the process of building such models gradually leads to a close coupling between the modeler’s internal processes and the external dynamic model. To account for the transfer problem, we propose that the process of building the model leads to the creation of an enactive model that is generic, which closely enacts, and thus reveals, the way the system-level behavior of the engineered prototype emerges in time through the interaction of its parts. This enactive replication process leads to the model and the prototype forming a new class, which allows concepts and control structures developed for the computational model to be transfered to the real-world prototype. We argue that this account requires rethinking correspondence in engineering sciences as a plastic and enactive relation. A closer focus on the process of building models is required to develop a general account of this emerging approach to discovery. (shrink)

The import of Petrarch's description of Laura extends well beyond the confines of his own poetic age; in subsequent times, his portrayal of feminine beauty became authoritative. As a primary canonical text, the Rime sparse consolidated and disseminated a Renaissance mode. Petrarch absorbed a complex network of descriptive strategies and then presented a single, transformed model. In this sense his role in the history of the interpretation and the internalization of woman's "image" by both men and women can scarcely be (...) overemphasized. When late-Renaissance theorists, poets, and painters represented woman's body, Petrarch's verse justified their aesthetic choices. His authority, moreover, extended beyond scholarly consideration to courtly conversation, beyond the treatise on beauty to the after-dinner game in celebration of it. The descriptive codes of others, both ancients and contemporaries, were, of course, not ignored, but the "scattered rhymes" undeniably enjoyed a privileged status: they informed the Renaissance norm of a beautiful woman.1· 1. On this "thoroughly self-conscious fashion," see. Elizabeth Cropper, "On Beautiful Women, Parmigianino, Petrarchismo, and the Vernacular Style," Art Bulletin 58 1976): 374-94.Nancy Vickers is an assistant professor of French and Italian at Dartmouth College. She has published articles on Dante and Petrarch and has recently completed a book, The Anatomy of Beauty: Woman's Body and Renaissance Blazon. (shrink)

In Gender, Class, and Freedom in Modern Political Theory, Nancy Hirschmann demonstrates not merely that modern theories of freedom are susceptible to gender and class analysis but that they must be analyzed in terms of gender and class in order to be understood at all. Through rigorous close readings of major and minor works of Hobbes, Locke, Rousseau, Kant, and Mill, Hirschmann establishes and examines the gender and class foundations of the modern understanding of freedom. Building on a social (...) constructivist model of freedom that she developed in her award-winning book The Subject of Liberty: Toward a Feminist Theory of Freedom, she makes in her new book another original and important contribution to political and feminist theory. Despite the prominence of "state of nature" ideas in modern political theory, Hirschmann argues, theories of freedom actually advance a social constructivist understanding of humanity. By rereading "human nature" in light of this insight, Hirschmann uncovers theories of freedom that are both more historically accurate and more relevant to contemporary politics. Pigeonholing canonical theorists as proponents of either "positive" or "negative" liberty is historically inaccurate, she demonstrates, because theorists deploy both conceptions of freedom simultaneously throughout their work. (shrink)

There is substantial evidence that traditional instructional methods have not been successful in helping students to restructure their commonsense conceptions and learn the conceptual structures of scientific theories. This paper argues that the nature of the changes and the kinds of reasoning required in a major conceptual restructuring of a representation of a domain are fundamentally the same in the discovery and in the learning processes. Understanding conceptual change as it occurs in science and in learning science will require the (...) development of a common cognitive model of conceptual change. The historical construction of an inertial representation of motion is examined and the potential instructional implications of the case are explored. (shrink)

The paper argues that the practice of thought experintenting enables scientists to follow through the implications of a way of representing nature by simulating an exemplary or representative situation that is feasible within that representation. What distinguishes thought experimenting from logical argument and other forms of propositional reasoning is that reasoning by means of a thought experiment involves constructing and simulating a mental model of a representative situation. Although thought experimenting is a creative part of scientific practice, it is a (...) highly refined extension of a mundane form of reasoning. It is not a mystery why scientific thought experiments are a reliable source of empirical insights. Thought experimenting uses and manipulates representations that derive from real-world experiences and our conceptualizations of them. (shrink)

Excitation at widely dispersed loci in the cerebral cortex may represent a neural correlate of consciousness. Accordingly, each unique combination of excited neurons would determine the content of a conscious moment. This conceptualization would be strengthened if we could identify what orchestrates the various combinations of excited neurons. In the present paper, cholinergic afferents to the cerebral cortex are hypothesized to enhance activity at specific cortical circuits and determine the content of a conscious moment by activating certain combinations of postsynaptic (...) sites in select cortical modules. It is proposed that these selections are enabled by learning-related restructuring that simultaneously adjusts the cytoskeletal matrix at specific constellations of postsynaptic sites giving all a similar geometry. The underlying mechanism of conscious awareness hypothetically involves cholinergic mediation of linkages between microtubules and microtubule-associated protein-2 . The first reason for proposing this mechanism is that previous studies indicate cognitive-related changes in MAP-2 occur in cholinoceptive cells within discrete cortical modules. These cortical modules are found throughout the cerebral cortex, measure 1–2 mm2, and contain approximately 103–104cholinoceptive cells that are enriched with MAP-2. The subsectors of the hippocampus may function similarly to cortical modules. The second reason for proposing the current mechanism is that the MAP-2 rich cells throughout the cerebral cortex correspond almost exactly with the cortical cells containing muscarinic receptors. Many of these cholinoceptive, MAP-2 rich cells are large pyramidal cell types, but some are also small pyramidal cells and nonpyramidal types. The third reason for proposing the current mechanism is that cholinergic afferents are module-specific; cholinergic axons terminate wholly within individual cortical modules. The cholinergic afferents may be unique in this regard. Finally, the tapering apical dendrites of pyramidal cells are proposed as primary sites for cholinergic mediation of linkages between MAP-2 and microtubules because especially high amounts of MAP-2 are found here. Also, the possibility is raised that muscarinic actions on MAP-2 could modulate microtubular coherence and self-collapse, phenomena that have been suggested to underlie consciousness. (shrink)

A theoretical approach relying on quantum computation in microtubules within neurons can potentially resolve the enigmatic features of visual consciousness, but raises other questions. For example, how can delicate quantum states, which in the technological realm demand extreme cold and isolation to avoid environmental ‘decoherence’, manage to survive in the warm, wet brain? And if such states could survive within neuronal cell interiors, how could quantum states grow to encompass the whole brain? We present a physiological model for visual consciousness (...) that can accommodate brain-wide quantum computation according to the Penrose–Hameroff ‘Orch OR’ model. In this view, visual consciousness occurs as a series of several-hundred-millisecond epochs, each comprising ‘crescendo sequences’ of quantum computations occurring at ∼40 Hz. (shrink)

<I>Conducting Hermeneutic Research: From Philosophy to Practice is the only textbook that teaches the reader ways to conduct research from a philosophical hermeneutic perspective. It is an invaluable resource for graduate students about to embark in hermeneutic research and for academics or other researchers who are novice to this research method or who wish to extend their knowledge. In 2009, the lead author of this proposed text was one of three co-founders of the Canadian Hermeneutic Institute. The institute was created (...) as a means of bringing together scholars of hermeneutics and hermeneutic research across disciplines in creative dialogue and conversations of philosophy, research, and practice. An outcome of this was the launch of the <I>Journal of Applied Hermeneutics, with Nancy J. Moules serving as Editor. The work of the institute and the journal make clear that people (both students and professors) seek practical guidance on how to conduct hermeneutic research. This book is a must read for this audience. (shrink)