The aim of this article is to describe the synthesis of the concept of moral stress and to attempt to identify its preconditions. Qualitative data from two independent studies on professional issues in nursing were analysed from a hypothetical-deductive approach. The findings indicate that moral stress is independent of context-given specific preconditions: (1) nurses are morally sensitive to the patient’s vulnerability; (2) nurses experience external factors preventing them from doing what is best for the patient; and (3) nurses feel that (...) they have no control over the specific situation. The findings from this analysis are supported by recent research on stress in the workplace but differ in that the imperatives directing work are moral in nature. Stress researchers have found that persons who experience that they have no control over their work situation and at the same time experience high demands may be prone to cardiovascular diseases. An important question raised by this study is whether moral stress should be recognized as a health risk in nursing. Further research is required in order to generate intervention models to prevent or deal with moral stress. (shrink)

This is a review of contemporary philosophical discussions of population policies. The focus is on normative justification, and the main question is whether population policies can be ethically justified. Although few analytical philosophers have directly addressed this question – it has been discussed more in other academic fields – many arguments and considerations can be placed in the analytical philosophical discourse. This article offers a comprehensive review and analysis of ethically relevant aspects of population policies evaluated on the basis of (...) the main ethical theories. This analysis is preceded by a brief historical contextualisation of when and how population policies became ethically contentious and how this relates to philosophical debates in environmental ethics, population ethics and political philosophy. The article also includes a conceptual analysis of population policies in which the empirical intricacies around individual fertility decisions are sorted out and the different ways in which they can be affected are categorised in a taxonomy which highlight the most relevant ethical aspects of population policies. The ethical analysis shows that while population policies can be justified on the basis of most ethical theories, it all depends on what prior assumptions are made about what is at stake. (shrink)

The aim of this study was to illuminate the meaning of professional carers’ experiences in caring situations when a conflict of interest arises with the older person receiving care. The findings reveal the complexity of the carers’ ambivalence when facing a conflict of interest, weighing up between the older persons’ right to self-determination and external demands. The carers are alone in their ambivalence, and the conclusion is that they need help and support to be more present in the encounter. The (...) implication for this study is to focus on care as a person-centered practice and to focus on people as interdependent on support carers to maintain older people’s right to self-determination in the relationship. (shrink)

The aim of this study was to analyse experiences of moral concerns in intensive care nursing. The theoretical perspective of the study is based on relational ethics, also referred to as ethics of care. The participants were 36 intensive care nurses from 10 general, neonatal and thoracic intensive care units. The structural characteristics of the units were similar: a high working pace, advanced technology, budget restrictions, recent reorganization, and shortage of experienced nurses. The data consisted of the participants’ examples of (...) ethical situations they had experienced in their intensive care unit. A qualitative content analysis identified five themes: believing in a good death; knowing the course of events; feelings of distress; reasoning about physicians’ ‘doings’ and tensions in expressing moral awareness. A main theme was formulated as caring about - caring for: moral obligations and work responsibilities. Moral obligations and work responsibilities are assumed to be complementary dimensions in nursing, yet they were found not to be in balance for intensive care nurses. In conclusion there is a need to support nurses in difficult intensive care situations, for example, by mentoring, as a step towards developing moral action knowledge in the context of intensive care nursing. (shrink)

We offer a functional perspective on hate, showing that hate has a unique pattern of appraisals and action tendencies. Hate is based on perceptions of a stable, negative disposition of persons or groups. We hate persons and groups more because of who they are, than because of what they do. Hate has the goal to eliminate its target. Hate is especially significant at the intergroup level, where it turns already devalued groups into victims of hate. When shared among group members, (...) hate can spread fast in conflict zones where people are exposed to hate-based violence, which further feeds their hate. Hate can be reassuring and self-protective, because its message is simple and helps confirming people’s belief in a just world. (shrink)

In constructivist contractualist theories, such as Rawls’, principles of justice should mirror beliefs that we all, in some sense, share. One would then arrive at principles that everybody could, in that sense, accept. These principles should specify, among other things, to whom to distribute the relevant benefits and burdens and to whom to assign responsibility for the distribution. In addition to this classical assignment problem, however, constructivist contractualism must also deal with a new, and quite different, assignment problem sincewhat to (...) count as beliefs that weall share depends on how the set of people that make up the “we” is delimited. Thus, for constructivist contractualism, the questions of whom to assign a part in the justification procedure and whom to exclude, and how to justify these inclusions and exclusions, are of crucial importance. In this chapter we consider the inclusion or exclusion of future generations, and how this case illuminates a general problem for constructivist contractualism. (shrink)

This paper considers the view that the basis of equality is the range property of being a moral person. This view, suggested by John Rawls in his A Theory of Justice (1971), is commonly dismissed in the literature. By defending the view against the criticism levelled against it, I aim to show that this dismissal has been too quick. The critics have generally failed to fully appreciate the fact that Rawls's account is restricted to the domain of distributive justice. On (...) Rawls's view distributive justice is a matter of the fair terms of cooperation among the participants of a system of social cooperation. I argue that this understanding of distributive justice can provide a compelling rationale for considering moral personality as the basis of equality for this domain of morality. That moral persons are indeed equal is further supported by an intuitive argument concerning the irrelevance of morally arbitrary factors, giving us reasons to believe that varying capacities among moral persons does not result in an unequal moral status. The dismissal of Rawls's account of equality has thus been premature, and it remains an important view to consider. (shrink)

While philosophers have discussed the emotion of contempt from antiquity to the present day, contempt has received less attention in psychological research. We review the defining features of contempt, both as a short-term emotion and as a more long-lasting sentiment. Contempt is similar to anger in that it may occur after social or moral transgressions, but it differs from anger in its appraisals, actions, and emotivational goals. Unlike anger, contempt arises when a person’s or group’s character is appraised as bad (...) and unresponsive to change, leading to attempts to socially exclude the target. We discuss associative, self-regulatory, and social distancing functions of contempt and present a dynamic social model of contempt versus anger. (shrink)

In the present article we argue that emotional interactions are not appropriately captured in present emotion research and theorizing. Emotional stimuli or antecedents are dynamic and change over time because they often interact and have a specific relationship with the subject. Earlier emotional interactions may, for example, intensify later emotional reactions to a specific person, or our anger reactions towards powerful or powerless others may differ considerably. Thus, we suggest that such social factors not only affect the intensity, but also (...) the nature of emotional experiences and expressions, and specifically the nature of the social movement (e.g., moving towards, away, or against). We discuss different processes that are implicated in the relation between the social environment and our emotions, describe how emotional expressions shape social behavior, and provide suggestions for incorporating the social dimension of emotion in future research. (shrink)

In this reply, I discuss some important issues raised in two commentaries. One relates to the distinction between hate and revenge, which also touches upon the more general problem of the usefulness of distinguishing between various related emotions. I argue that emotion researchers need to define specific emotions carefully in order to be able to examine such emotions without necessarily using emotion words. A second comment focusses on the factors influencing the development of hate over time. The question is whether (...) there is an intrapersonal mechanism leading to an increase or decrease of hate over time. I think it is the social environment that is essential in the maintenance of hate. (shrink)

As its title suggests, this anthology is a collection of papers presented at a conference on feelings and emotions held in Amsterdam in 2001. One of the symposium’s main goals was to draw some of the most prominent researchers in emotion research together and provide a multi-disciplinary ‘snap shot’ of the state of the art at the turn of the century. In that respect it is truly a cognitive science success story. There are articles from a wide range of fields, (...) encompassing, e.g., philosophy, neuroscience, anthropology, sociology, and psychology. Another.. (shrink)

If the condemnation and crucifixion of Christ is interpreted in the key of Lutheran divine omniscience and absence of alternative possibilities, an apparent contradiction regarding the moral responsibility and duties of the Israelite executioners of Christ would arise. This contradiction would be the following: How can we sustain the moral responsibility of the executioners if they did not have alternative possibilities and, according to Christ’s first Saying on the cross, they did not know what they were doing? How could it (...) be possible to attribute duties to the executioners if they were not able to fulfill them? These problems can be addressed from a semicompatibilistic perspective of moral responsibility. It could be argued that: 1) the absence of alternative possibilities does not exclude the fact that the executioners could be considered morally responsible for Christ’s crucifixion, and that 2) the impossibility of fulfilling certain duties does not imply that the executioners would not have had these duties and cannot be considered morally responsible for their breach. (shrink)

The goal of this article is to discuss theoretical arguments concerning the idea that emotional mimicry is an intrinsic part of our social being and thus can be considered a social act. For this, we will first present the theoretical assumptions underlying the Emotional Mimicry as Social Regulator view. We then provide a brief overview of recent developments in emotional mimicry research and specifically discuss new developments regarding the role of emotional mimicry in actual interactions and relationships, and individual differences (...) in emotional mimicry. We conclude with open questions for future research. (shrink)

In this article we examine gender differences in nonverbal expressiveness, with a particular focus on crying and smiling. We show that women cry and smile more as well as show more facial expressiveness in general, but that the size of this gender difference varies with the social and emotional context. We interpret this variation within a contextual framework (see also Brody & Hall, 2008; Deaux & Major, 1987; LaFrance, Hecht, & Paluck, 2003). More specifically, we distinguish three factors that predict (...) the size of gender differences in emotional expressiveness: gender-specific norms, social role and situational constraints, and emotional intensity. These factors interact in different ways for smiling and crying. (shrink)

It seems odd that in such a densely theological text that Augustine would bring up something like the KK-thesis, which is so epistemological. Yet, as one progresses through the book it does begin to make sense. In this paper, I aim to try to come to some understanding of how and why Augustine uses something like the KK-thesis in Book 11 of The City of God. The paper will progress in the following way: First, I discuss Jaakko Hintikka's work on (...) the KK-thesis in order to have a clear idea of what the KK-thesis is, and some associated problems with it. Next, since Augustine most explicitly deals with the KK-thesis in De Trinitate, with the help of Gareth Matthews work, I discuss Augustine's use of the KK-thesis there. Finally, I return to The City of God, in order come to an understanding of Augustine's use of the KK-thesis there. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:How Fool Is a "Holy Fool"?Agneta Schreurs (bio)The editors asked me to write a short response to your commentaries. They asked me to do that as a set; therefore, I respond to your texts as a whole.First, I thank you for your comments. I appreciate very much that you took the time to read and reflect on my article. I am really very happy with your positive evaluation (...) of my article, particularly because my choice for this subject has much to do with my own biography. I have been raised by nonreligious parents and grandparents. My mother being a classical scholar and my father a scientist, I knew more about antiquity and chemistry than about the Bible, which in fact did not figure at all in my education. However, when I was forty years old, I took on theology at the University of Utrecht as an extra study in my free time, mainly because I felt embarrassed whenever my students or clients brought the subject up and I did not know the first thing about it. Right from the beginning I became absolutely excited about this study, not only about the broad range of fascinating subjects, but also because quite a number churches had merged the academic part of their seminaries with the theological faculty of the University of Utrecht into an academically very high-standard curriculum. Students and teachers were a mix of Dutch Reformed, Roman Catholic, Old Catholic, Baptist, and several other denominations, in my time even a Jewish rabbi and a Winti (an indigenous religion in the former Dutch West Indies). Outsider as I was, this offered me a unique opportunity to become acquainted in a personal and natural way with their various faiths. Nevertheless, it took me three years before I realized what all those fascinating things had to do with my life and with my work! This realization was the reason why, after getting my master's degree in theology, I decided to choose a combination of philosophy of religion and psychology of religion for my doctoral dissertation and to change my group practice into work that explicitly dealt with the interconnections between spirituality and psychotherapy.I also want to thank you for sharing your thoughts on the larger contexts of my subject. From my biographical sketch, you can see that I agree with both of you in that it is high time that psychiatry and psychotherapy pay more attention to—and become more knowledgeable about—their religious patients' religion and spirituality. Not because I think the "talking cures" may have much in common with "faith healing" (in fact, I agree with Gibson [2000] that they have much more in common with the gentle craft of taking confession), but because it is unprofessional not to do so. When a person consults a priest or minister with regard to a religious problem, it often appears that there are also psychological problems involved. That is why theological curricula include pastoral psychology and clinical training courses. This is also true the other way round: psychological problems treated in psychotherapy and counseling may involve a patient's religious mindset. However [End Page 205], most psychotherapists are generally neither religious themselves nor trained in assessing and understanding the great variety of ways in which people may be religious and how these may be intertwined with the problems for which they have sought therapeutic help. In particular, they are mostly not trained in discovering how their patients' religiousness may be a cause of therapeutic failure or, alternatively, a source of support and as such a help toward therapeutic progress. In addition to such lack in information and training, and in contrast with most clergy, clients in therapy may easily have very different religious backgrounds. As a result of this professional situation, many psychotherapists feel uncomfortable in this area and unprofessionally tend to ignore, avoid, or reinterpret in psychological terms their patients' spiritual expressions.The point I tried to make is this: to successfully discover and assess how a patients' religiousness may be a cause of psychological problems or conversely, be a source of support and as such a help toward therapeutic progress, you need at least some basic... (shrink)

This article offers a relational approach for understanding and dealing with a patient's spiritual concerns. Insight into the relational structure of a particular patient's spirituality may help to (1) analyze in what way psychological and spiritual factors are interconnected and in what way the patient's "spiritual relationship" influences his mental health problems either positively or negatively, and (2) identify the latent opportunities for therapeutic and spiritual healing that are present within their spiritually minded patients' own religious frame of reference.

The aim of this study was to describe the experiences of undergoing a presymptomatic genetic test for the hereditary and fatal Huntington’s disease, using a case study approach. The study was based on 18 interviews with a young woman and her husband from the decision to undergo the test, to receiving the results and trying to adapt to them, which were analysed using a life history approach. The findings show that the process of undergoing a presymptomatic test involves several closely (...) connected ethical and medical questions, such as the reason for the test, the consequences of the test results and how health-care services can be developed to support people in this situation. (shrink)

I focus on some differences between negative emotional states and how they are coped with in explaining different cardiac risks. The different cognitive, motivational, and physiological characteristics of emotions imply different appraisals of the negative event, and different resources to cope with the event. Cardiovascular activity depends on these different appraisals and coping strategies. For example, cortisol levels have shown to be differently associated with anger and fear responses to social stress. In addition, different ways to regulate one’s emotions are (...) also associated with different bodily responses that may increase or decrease cardiac risks. Future research should not only examine different emotions to stressors, but also more long-term regulation strategies and coping resources, such as self-esteem. (shrink)

Vigil's socio-relational framework of sex differences in emotional expressiveness emphasizes general sex differences in emotional responding, but largely ignores the social context in which emotions are expressed. There is much empirical evidence showing that sex differences in emotion displays are flexible and a function of specific social roles and demands, rather than a reflection of evolutionary-based social adjustments.

We report the results of an investigation of nurses’ and physicians’ sensitivity to ethical dimensions of clinical practice. The sample consisted of 113 physicians working in general medical settings, 665 psychiatrists, 150 nurses working in general medical settings, and 145 nurses working in psychiatry. The instrument used was the Moral Sensitivity Questionnaire (MSQ), a self-reporting Likert-type questionnaire consisting of 30 assumptions related to moral sensitivity in health care practice. Each of these assumptions was categorized into a theoretical dimension of moral (...) sensitivity: relational orientation, structuring moral meaning, expressing benevolence, modifying autonomy, experiencing moral conflict, and following the rules. Significant differences in responses were found between health care professionals from general medical settings and those working in psychiatry. The former agreed to a greater extent with the assumptions in the categories ‘meaning’ and ‘autonomy’ and to a lesser degree with the categories ‘benevolence’ and ‘conflict’. Moreover, those from the psychiatric sector agreed to a greater extent to the use of coercion if necessary. Significant differences were also found for some of the MSQ categories, between physicians and nurses, and between males and females. (shrink)

Six case studies on nursing home staff attitudes to patient autonomy have been analysed. The case studies are based on six polarities within autonomy, as developed by Collopy. In total, 189 professional caregivers, comprising the staff of 13 nursing homes in the county of Stockholm, Sweden, responded to questions based on the case studies. Results show that the attitudes within each professional category had a high level of internal correspondence. Nurses consistently supported patient preferences to the highest degree, followed by (...) assistant nurses and auxiliary staff. Nurses' aides ranked lowest in supporting patient preferences. In only one of the cases were background variables of significance. (shrink)

How should one understand comparisons in which neither of two alternatives is at least as good as the other? Much recent literature on comparability problems focuses on what the appropriate explanation of the phenomenon is. Is it due to vagueness or the possibility of non-conventional comparative relations such as parity? This paper argues that the discussions on how to best explain comparability problems has reached an impasse at which it is hard to make any progress. To advance the discussion we (...) suggest a new classification of comparability problems that focuses on the problems they cause for practical reasoning. (shrink)

Asking whether transhumanist hopes of overcoming ageing and cognitive and other shortcomings are realistic, this paper pitches a Christian anthropology against a transhumanist anthropology. It is shown that on critical examination many of the technologies proposed by transhumanists in order to better or extend human life raise questions about dualism and materialism, about our nature as relational beings, and indeed even about what it means to be alive.

ABSTRACTPosed stimuli dominate the study of nonverbal communication of emotion, but concerns have been raised that the use of posed stimuli may inflate recognition accuracy relative to spontaneous expressions. Here, we compare recognition of emotions from spontaneous expressions with that of matched posed stimuli. Participants made forced-choice judgments about the expressed emotion and whether the expression was spontaneous, and rated expressions on intensity and prototypicality. Listeners were able to accurately infer emotions from both posed and spontaneous expressions, from auditory, visual, (...) and audiovisual cues. Furthermore, perceived intensity and prototypicality were found to play a role in the accurate recognition of emotion, particularly from spontaneous expressions. Our findings demonstrate that perceivers can reliably recognise emotions from spontaneous expressions, and that depending on the comparison set, recognition levels can even be equivalent to that o... (shrink)

The purpose of this article is to contribute to the dialogue on spirituality in mental health care. Spirituality is still an uncomfortable theme in mental health care despite a burgeoning literature and research. We will introduce a conceptual model on spiritual and interpersonal relationships based on love in relatedness. The model will enable the therapist to assess the interconnectedness of spiritual and interpersonal relationships, to analyse positive or negative effects of spirituality on interpersonal functioning and vice versa, and to look (...) for possibilities for spiritual and therapeutic change. Based on the model, the next step is to reflect on the relationship between psychiatry and spirituality with a view to dialogue instead of unfruitful discussion and controversy. We will propose a dialogue about the alternative DSM-5™ model for personality disorders. Although preliminary, we will show the usefulness of such an interdisciplinary dialogue. (shrink)

Evolutionary Transitions in Individuality have been responsible for the major transitions in levels of selection and individuality in natural history, such as the origins of prokaryotic and eukaryotic cells, multicellular organisms, and eusocial insects. The integrated hierarchical organization of life thereby emerged as groups of individuals repeatedly evolved into new and more complex kinds of individuals. The Social Protocell Hypothesis proposes that the integrated hierarchical organization of human culture can also be understood as the outcome of an ETI—one that produced (...) a “cultural organism” from a substrate of socially learned traditions that were contained in growing and dividing social communities. The SPH predicts that a threshold degree of evolutionary individuality would have been achieved by 2.0–2.5 Mya, followed by an increasing degree of evolutionary individuality as the ETI unfolded. We here assess the SPH by applying a battery of criteria—developed to assess evolutionary individuality in biological units—to cultural units across the evolutionary history of Homo. We find an increasing agreement with these criteria, which buttresses the claim that an ETI occurred in the cultural realm. (shrink)

In the present research we investigated gender-specific beliefs about emotional behaviour. In Study 1, 180 respondents rated the extent to which they agreed with different types of beliefs (prescriptive, descriptive, stereotypical, and contra-stereotypical) regarding the emotional behaviour of men and women. As anticipated, respondents agreed more with descriptive than with prescriptive beliefs, and more with stereotypical than with contra-stereotypical beliefs. However, respondents agreed more with stereotypical beliefs about the emotional behaviour of women than with those about men. These results were (...) replicated in Study 2 with a sample of 75 students and 80 nonstudents. In Study 3, a sample of 279 respondents rated the extent of agreement with the same items, this time with respect to then own emotional behaviour. A similar pattern of results was obtained, although agreement rates were higher than in Study 1 and 2. (shrink)

This paper examines a struggle over the future use of Nordic forests, which took place from 2009 to 2012 within a major research program, Future Forests—Sustainable Strategies under Uncertainty and Risk, organized and funded by Mistra, The Swedish Foundation for Strategic Environmental Research. We explore the role of strategic environmental research in societal constructions of long-term challenges and future risks. Specifically, we draw attention to the role played by environmental research in the creation of future images that become dominant for (...) how societies structure action for the long term. We also show that this process is on several accounts problematic. Research labeled “strategic” or “relevant” is intended to manage long-term risks and challenges in a sustainable way, by taking into account the “open” and “plural” nature of the future. The case of Future Forests suggests, rather, that by contributing to the emergence of dominant future images, environmental research is entangled with a process of gradual consensus creation around what may be highly selective or biased narratives of the long term, which may conceal or postpone key forms of future conflict. (shrink)

The repugnant conclusion can be formulated as follows: For any population consisting of people with very high positive welfare, there is a better population in which everyone has a very low positive welfare, other things being equal. As the name indicates, this conclusion appears unacceptable. Yet it has proven to be surprisingly difficult to find a theory that avoids it without implying other very counterintuitive conclusions. Moreover, the conclusion is a problem not just for total utilitarians or those committed to (...) welfarism but for all moral theories according to which welfare matters at least when all other things are equal, which arguably is a minimal adequacy condition for any moral theory. And, not the least, how to deal with it has implications for the present generations’ duties to future generations and intergenerational justice. The question as to how the repugnant conclusion should be dealt with has thus become one of the cardinal challenges of modern ethics, and the inquiry into what it shows about the nature of ethics has opened up many new avenues for research. This chapter covers the different suggestions in the literature on how to do deal with the conclusion, both on the axiological and on the normative levels. Moreover, the conclusion and different ways of deriving it are explained in detail. (shrink)

In 1997 John Broome presented the Collapsing Argument that was meant to establish that non-conventional comparative relations cannot exist. Broome's argument has faced a lot of scrutiny and a certain type of counterexample has been used to undermine it. Most of the counterexamples focus on the Collapsing Principle which plays a central role in Broome's argument. In this article we will take a closer look at the most common type of counterexample and propose how to adjust the Collapsing Principle in (...) order to avoid objections based on these counterexamples. We argue that a weaker version of the Collapsing Principle is not susceptible to the classical counterexamples. Furthermore, after an explorative discussion about the intuitions behind the original principle, we show that this weaker formulation is at least as intuitive as the principle suggested by Broome. (shrink)