Zinacantec Family Homesign is a new sign language emerging spontaneously over the past three decades in a single family in a remote Mayan Indian village. Three deaf siblings, their Tzotzil-speaking age-mates, and now their children, who have had contact with no other deaf people, represent the first generation of Z signers. I postulate an augmented grammaticalization path, beginning with the adoption of a Tzotzil cospeech holophrastic gesture—meaning “come!”—into Z, and then its apparent stylization as an attention-getting sign, followed by grammatical (...) regimentation and pragmatic generalization as an utterance initial change of speaker or turn marker. (shrink)

This contribution to the Common Knowledge symposium on enmity argues that there is more to the problem of enmity than understanding, preventing, and resolving it: one must also recover from it and from its effects. Drawing on a psychoanalytic theory of shame that discriminates between narcissistic injuries that are enduring and those that can be overcome, this essay proposes a reading of Hester Prynne's transformation in The Scarlet Letter as a series of recognitions informed by her emotional relations to her (...) estranged husband, her lover, their daughter, and her fellow women. Nathaniel Hawthorne's heroine is condemned by her community for her adultery and suffers in silence for seven years before her shame erupts as anger at the men she had idealized and now recognizes as having betrayed her long before she deceived one of them. Only when she understands that the marriage arranged by her father to a man of his own age took advantage of her youth and legal powerlessness does she begin to redistribute blame for this sexual abuse. Refusing to serve the interests of her hated husband, she is able to forgive herself and eventually becomes a source of healing for other injured women. (shrink)

In this introduction to part 4 of the Common Knowledge symposium “Peace by Other Means,” the journal's editor assesses the argument made by Peace, the spokesperson of Erasmus in his Querela Pacis, that the desire to impute and avenge wrongs against oneself is insatiable and at the root of both individual and social enmities. He notes that, in a symposium about how to resolve and prevent enmity, most contributions have to date expressed caveats about how justice and truth must take (...) precedence over peace, how recovery from ill treatment may be impossible, how quietism is not a moral option, and how realism demands a national policy and a personal strategy of, at best, contingent forgiveness. He concedes that the attitudes of those opposed to quietism are healthy but suggests that there may be goods worthier than health of human devotion. This essay concludes that the main differences between what it terms “judgmental” and “irenic” regimes are disagreements over anthropology and metaphysics. The presumptions that truths are objectively knowable and that human beings are moral and rational agents characterize judgmental regimes; irenic regimes are characterized by disillusionment with those assumptions. (shrink)

BackgroundHigh levels of moral distress in nursing professionals, of which oncology nurses are particularly prone, can negatively impact patient care, job satisfaction, and retention.Aim“Positive Attitudes Striving to Rejuvenate You: PASTRY” was developed at a tertiary cancer center to reduce the burden of moral distress among oncology nurses.Research DesignA Quality Improvement (QI) initiative was conducted using a pre- and post-intervention design, to launch PASTRY and measure its impact on moral distress of the nursing unit, using Hamric’s Moral Distress Scale–Revised (MDS-R.) This (...) program consisted of monthly 60-minute sessions allowing nurses to address morally distressing events and themes, such as clinicians giving “false hope” to patients or families. The PASTRY program sessions were led by certified clinicians utilizing strategies of discussion and mind-body practices.ParticipantsClinical nurses working on an adult leukemia/lymphoma unit.Ethical considerationsThis was a QI initiative, participation was voluntary, MDS-R responses were collected anonymously, and the institution’s Ethics Committee oversaw PASTRY’s implementation.FindingsWhile improvement in moral distress findings were not statistically significant, the qualitative and quantitative findings demonstrated consistent themes. The PASTRY program received strong support from nurses and institutional leaders, lowered the nursing unit’s moral distress, led to enhanced camaraderie, and improved nurses’ coping skills.DiscussionMeasurement of moral distress is innately challenging due to its complexity. This study reinforces oncology nurses have measurable moral distress. Interventions should be implemented for a safe and healing environment to explore morally distressing clinical experiences. Poor communication among multidisciplinary team members is associated with moral distress among nurses. Programs like PASTRY may empower nurses to build support networks for change within themselves and institutions.ConclusionThis QI initiative shows further research on moral distress reduction should be conducted to verify findings for statistical significance and so that institutional programs, like PASTRY, can be created. (shrink)