Although moral distress is now a well-recognized phenomenon among all of the healthcare professions, few evidence-based strategies have been published to address it. In morally distressing situations, the “presenting problem” may be a particular patient situation, but most often signals a deeper unit- or system-centered issue. This article describes one institution’s ongoing effort to address moral distress in its providers. We discuss the development and evaluation of the Moral Distress Consultation Service, an interprofessional, unit/system-oriented approach to addressing and ameliorating moral (...) distress. (shrink)

In their article “A Broader Understanding of Moral Distress,” Campbell, Ulrich, and Grady (2016) correctly assert that moral distress is well established in the nursing literature and is gaining at...

This study surveyed investors to determine the extent to which they preferred ethical behavior to profits and their interest in having information about corporate ethical behavior reported in the corporate annual report. First, investors were asked to determine what penalties should be assessed against employees who engage in profitable, but unethical, behavior. Second, investors were asked about their interest in using the annual report to disclose the ethical performance of the corporation and company officials. Finally, investors were asked if they (...) felt that ethics reports should be audited.The survey results indicate that many shareholders (42%) do not expect a high level of ethical behavior from corporate employees or officers. There is a significant amount of interest in disclosure of ethical issues (72%) and unwillingness to trust management to provide unbiased reports of ethical behavior. If such reports are included with the financial statements, 32 percent of the investors surveyed would prefer to have them audited to provide independent verification. (shrink)

L’ouvrage d’Anne Cova, tiré principalement de la partie inédite de sa thèse doctorale soutenue en 1994, porte sur l’histoire des débats autour d’une question : « la liberté de la maternité », dont les contours s’étendent bien au-delà des discussions entre les féministes et leur opposants, et qui d’une certaine manière reste aussi « brûlante » de nos jours qu’il y a cent ans, soit la période étudiée. Le dépouillement des plus importants périodiques spécialisés publiés entre 1890 et 1939 (...) (Régén... (shrink)

Premier « organe illustré consacré exclusivement à la femme » (p. 23), la revue Femina a longtemps servi de source de renseignements visuels et textuels sur des personnalités et la vie féminines en France pendant une période où les femmes, même connues, n’ont pas laissé tellement de traces dans les archives. La revue reste toutefois méconnue, ignorée comme objet de recherche, selon l’historien américain Leonard Berlanstein, en raison de son apparence luxueuse et des protestations de non-fémin...

Moral distress is a phenomenon increasingly recognized in healthcare that occurs when a clinician is unable to act in a manner consistent with his or her moral requirements due to external constraints. We contend that some experiences of moral distress are self-inflicted due to one’s under-assertion of professional authority, and these are potentially avoidable. In this article we outline causes of self-inflicted moral distress and offer recommendations for mitigation.

Toward a New Socialism offers a critical analysis of capitalism's failings and the imminent need for socialism as an alternative form of government. Dr. Richard Schmitt joins with Dr. Anatole Anton to compile a volume of essays exploring the benefits and consequences of a socialist system as an avenue of increased human solidarity and ethical principle.

Our results support the idea that adults have access to the principles and parameters of Universal Grammar (UG), contrary to Epstein et al.'s misrepresentation of our work as involvingpartial access toUG. For both LI and L2 acquisition, functional projections appear to develop in a gradual fashion, but in L2 acquisition there ispartial transferin that the lowest projection (VP) is transferred from the speaker's LI.

Anne O’Byrne: Natality and finitude Content Type Journal Article Category Book Review Pages 1-7 DOI 10.1007/s11007-011-9203-8 Authors Jeffrey Epstein, SUNY Stony Brook, 213 Harriman Hall, Stony Brook, NY 11794-3750, USA Journal Continental Philosophy Review Online ISSN 1573-1103 Print ISSN 1387-2842.

The aim of this study was to explore the obligations of nurses and physicians in providing end-of-life care. Nineteen nurses and 11 physicians from a single newborn intensive care unit participated. Using content analysis, an overarching obligation of creating the best possible experience for infants and parents was identified, within which two categories of obligations (decision making and the end of life itself) emerged. Obligations in decision making included talking to parents and timing withdrawal. End-of-life obligations included providing options, preparing (...) parents, being with, advocating, creating peace and normalcy, and providing comfort. Nurses and physicians perceived obligations in both categories, although nurse obligations centered on the end of life while physician obligations focused on decision making. The findings demonstrate that, although the ultimate goal is shared by both disciplines, the paths to achieving that goal are often different. This has important implications for collaboration, communication, and improving the end of life. (shrink)

The design of new constitutions is fraught with challenges on both issues of structural design and individual rights. As both a descriptive and normative matter it is exceedingly difficult to believe that one structural solution will fit all cases. The high variation in nation size, economic development, and ethnic division can easily tilt the balance for or against a Presidential or Parliamentary system, and even within these two broad classes the differences in constitutional structure are both large and hard to (...) measure. The only confident claim is that some system of separation of powers coupled with checks and balances is needed. Deciding which system, however, is far harder. In contrast, that same level of doubt does not arise in connection with the correct specification of individual right. Strong systems of negative rights on matters of liberty, property, religion, and speech are preferable across a wide range of social organizations. On the other hand, any effort to create systems of positive entitlements will fail because of the negative effects that they have on wealth creation and the inability to define or limit the scope of the relevant entitlements. (shrink)

Who gets to decide what it means to live a healthy lifestyle, and how important a healthy lifestyle is to a good life? As more governments make preventing obesity and diet-related illness a priority, it's become more important to consider the ethics and acceptability of their efforts. When it comes to laws and policies that promote healthy eating--such as special taxes on sugary drinks and the banning of food deemed unhealthy--critics argue that these policies are paternalistic, and that they limit (...) individual autonomy over food choices. In Healthy Eating Policy and Political Philosophy: A Public Reason Approach, Anne Barnhill and Matteo Bonotti show that both paternalistic justifications for healthy eating efforts and anti-paternalistic arguments against them can be grounded in perfectionist views that overly prioritize some values over others. The authors therefore propose a more inclusive, public reason approach to healthy eating policy that will be appealing to those who take pluralism and cultural diversity seriously, by providing a framework through which different kinds of values, including but not limited to autonomy and health, can be factored into the public justification for healthy eating efforts. Additionally, the book adopts a 'farm to fork' approach to the ethics of healthy eating efforts: it engages with theories and debates in political philosophy, considers the implications of different theoretical positions for healthy eating efforts, and then develops a concrete tool for assessing policies that will be of interest to both scholars and policymakers. As well as offering a novel normative analysis of healthy eating policy, the authors offer a new theoretical framework that will be applicable to a wide range of public policy scenarios. (shrink)

This groundbreaking work by one of the world's foremost theoreticians of culture and scholars of Russian philosophy gives for the first time a systematic examination of the development of Russian philosophy during the late Soviet period. Countering the traditional view of an intellectual wilderness under the Soviet regime, Mikhail Epstein provides a comprehensive account of Russian thought of the second half of the 20th century that is highly sophisticated without losing clarity. It provides new insights into previously mostly ignored (...) areas such as late Soviet Russian nationalism and Eurasianism, religious thought, cosmism and esoterism, and postmodernism and conceptualism. Epstein shows how Russian philosophy has long been trapped in an intellectual prison of its own making as it sought to create its own utopia. However, he demonstrates that it is time to reappraise Russian thought, now freed from the bonds of Soviet totalitarianism and ideocracy but nevertheless dangerously engaged into new nationalist aspirations and metaphysical radicalism. We are left with not only a new and exciting interpretation of recent Russian intellectual history, but also the opportunity to rethink our philosophical heritage. (shrink)

When We Collide is a landmark reassessment of the significance of sex in contemporary Jewish ethics. Rebecca Epstein-Levi offers a fresh and vital exploration of sexual ethics and virtue ethics in conversation with rabbinic texts and feminist and queer theory. Epstein-Levi explores how sex is not a special or particular form of social interaction but one that is entangled with all other forms of social interaction. The activities of sex-doing it, talking about it, thinking about it, regulating it-are (...) sites of ongoing moral formation on individual, interpersonal, and communal levels. When We Collide explores the development of Jewish sexual ethics, and represents an opportunity to move beyond the usual heteronormative accounts that are presented as though they were neutral representations of what "Judaism teaches about sex.". (shrink)

This groundbreaking work by one of the world's foremost theoreticians of Russian literature, culture, and thought gives for the first time an extensive and detailed examination of the development of Russian thought during the late Soviet period. Countering the traditional view of an intellectual wilderness under the Soviet regime, Mikhail Epstein offers a systematic account of Russian thought in the second half of the 20th century. In doing so, he provides new insights into previously ignored areas such as Russian (...) liberalism, personalism, structuralism, neo-rationalism, and culturology. Epstein shows how Russian philosophy and culture has long been trapped in an intellectual prison of its own making as it sought to create its own utopia. However, he demonstrates that it is time to reappraise Russian philosophical thought and cultural theory, now freed from the bonds of totalitarianism. We are left with not only a new and exciting interpretation of Russian thought, but also an opportunity to rethink our own intellectual heritage. (shrink)

Examines how violence has been conceptually and rhetorically put to use in continental social theory.

_Examines how violence has been conceptually and rhetorically put to use in continental social theory._.

This book uses the body to peel back the layers of time and taken-for-granted ideas about the two defining political forms of modernity, the state and the subject of rights. It traces, under the lens of the body, how the state and the subject mutually constituted each other since their original crafting in the seventeenth century. Considering multiple sites of theory and practice, Charlotte Epstein analyses the fundamental rights to security, liberty, and property respectively as the initial knots where (...) the state-subject relation was first sealed. (shrink)

There are countless circumstances under which random individuals COULD act together to prevent something morally bad from happening or to remedy a morally bad situation. But when OUGHT individuals to act together in order to bring about a morally important outcome? Building on Philip Pettit’s and David Schweikard’s account of joint action, I will put forward the notion of joint duties: duties to perform an action together that individuals in so-called random or unstructured groups can jointly hold. I will show (...) how this account of joint duties is preferable to one which defends individual duties to cooperate. I then discuss the limits of joint duties and the ways in which one can fail to comply with them. It will become apparent that the circumstances under which individuals in random collectives acquire such joint duties are rare. (shrink)

A theoretical platform for a much‐needed change in the provision of healthcare based on restoring the autonomy of doctor–patient relationships.

The inner ecology: Buddhist ethics and practice -- A Buddhist perspective on animal rights -- Pollution and the environment: some radically new ancient views -- Animals for dinner: a Karmic tale -- Our relationship with nature: a Buddhist exploration -- Environmental issues: a Buddhist perspective -- Human spiritual potential and the environmental crisi -- The need for ethical guidelines to protect us from the very real dangers of a technological world -- Looking at hi-tech through the lens of the five (...) moral precepts -- Science and Buddhism: a critical comparison -- Genetic engineering: a Buddhist assessment -- Redesigning the world: ethical questions about genetic engineering -- Some ethical challenges posed by the Internet and digital social media: a Buddhist perspective -- Where are we going - digitally? (shrink)

Since the late 1960s, the legal doctrine of consent has occasionally been subject to severe criticism from within the bioethical discourse. The criticism was often based on observations indicating that consents and refusals, which had been considered valid from legal or institutional points of view, had frequently failed to reflect genuinely autonomous decision making, hence genuinely autonomous choices.This has led several critics to conclude that informed consent is a legal fiction. To clarify the concept, a legal fiction is a supposition (...) of fact taken to be true by the courts of law, irrespective of whether it is true or not, and even though it might not be true .1 What these critics probably meant to say was that the law deems any person who has given a legally valid consent to be genuinely task specifically autonomous, regardless of whether this is true or not and even though it might not be true. In other words, informed consent is a legal fiction, since it presupposes—that is, claims to reflect—genuine task specific autonomy, however baselessly.It was precisely this potentially embarrassing conclusion that prompted Faden and Beauchamp to develop a brilliant and remarkably effective argument in defence of the legal doctrine of consent. In their seminal work, AHistory and Theory of Informed Consent, they indeed acknowledged that effective consent often fails to be compatible with autonomous authorisation . Indeed, they recognised that effective consent does not necessarily entail autonomous authorisation. They argued, however, that the former is not a legal fiction, since it does not presuppose the …. (shrink)

In this article, I will consider whether, and in what way, doxastic states can harm. I’ll first consider whether, and in what way, a person’s doxastic state can harm her, before turning to the question of whether, and in what way, it can harm someone else.

In this article we examine the association between national welfare regime and the propensity of middle–aged and older individuals with adult children of their own to provide social support to aged parents. Using data from mature adults (50+) in 26 European countries, we examine whether older and younger generations compete for the time resources of the middle “sandwiched” generation, and whether national policy context shapes this competition. Contrary to expectations, we found that sandwich generation members were less likely to provide (...) support to their parents in Conservative–Mediterranean and East European regimes, but more likely to do so in universalistic Social–Democratic regimes. This evidence supports the hypothesis that well–developed welfare states “crowd–in” family support to older individuals. Middle generation members who provided social support to their adult children tended to provide to their older parents as well. This was particularly true in the two regimes where resources and public benefits tend to be more generous and may be interpreted as state benefits that reduce intergenerational competition. Findings are discussed in terms of the capacity of state policies to shape the allocation of family resources to older adults where extended family lineages have become the norm. (shrink)

Why equality cannot be conditional on a shared human “nature” but has to be for all For centuries, ringing declarations about all men being created equal appealed to a shared human nature as the reason to consider ourselves equals. But appeals to natural equality invited gradations of natural difference, and the ambiguity at the heart of “nature” enabled generations to write of people as equal by nature while barely noticing the exclusion of those marked as inferior by their gender, race, (...) or class. Despite what we commonly tell ourselves, these exclusions and gradations continue today. In Unconditional Equals, political philosopher Anne Phillips challenges attempts to justify equality by reference to a shared human nature, arguing that justification turns into conditions and ends up as exclusion. Rejecting the logic of justification, she calls instead for a genuinely unconditional equality. Drawing on political, feminist, and postcolonial theory, Unconditional Equals argues that we should understand equality not as something grounded in shared characteristics but as something people enact when they refuse to be considered inferiors. At a time when the supposedly shared belief in human equality is so patently not shared, the book makes a powerful case for seeing equality as a commitment we make to ourselves and others, and a claim we make on others when they deny us our status as equals. (shrink)

People hold wildly opposing and very strong views on the question whether mental disorders are brain disorders, and the disagreement is primarily a conceptual one, not one about whether there are,...

Analytic metaphysics has recently discovered biology as a means of grounding metaphysical theories. This has resulted in long-standing metaphysical puzzles, such as the problems of personal identity and material constitution, being increasingly addressed by appeal to a biological understanding of identity. This development within metaphysics is in significant tension with the growing tendency amongst philosophers of biology to regard biological identity as a deep puzzle in its own right, especially following recent advances in our understanding of symbiosis, the evolution of (...) multi-cellular organisms and the inherently dynamical character of living systems. Moreover, and building on these biological insights, the broadly substance ontological framework of metaphysical theories of biological identity appears problematic to a growing number of philosophers of biology who invoke process ontology instead. This volume addresses this tension, exploring to what extent it can be dissolved. For this purpose, the volume presents the first selection of essays exclusively focused on biological identity and written by experts in metaphysics, the philosophy of biology and biology. The resulting cross-disciplinary dialogue paves the way for a convincing account of biological identity that is both metaphysically constructive and scientifically informed, and will be of interest to metaphysicians, philosophers of biology and theoretical biologists. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

The recently published Report of theAHAG on the Operation of NHS Research Ethics Committees advocates major reforms of the NHS research ethics committees system. The main implications of the proposed changes and their probable effects on the major stakeholders are described.The Ad Hoc Advisory Group on the operation of NHS research ethics committees, set up in November 2004 by Lord Warner on behalf of the Department of Health, submitted its report in June 2005.1 The report advocates major reforms of the (...) research ethics committee system. The primary aim of the report is to streamline the processes around the approval of research projects and to pursue conformity of governance across Europe. Implicit in the report is the contention that failure to achieve this objective would be harmful to everyone with vested interests in improving health and social care. Moreover, it is stated that the reforms will enhance the mechanisms that protect the interests of all parties concerned.1Being mindful of two published critiques of the Warner Report, we suggest that its alleged benefits should not be taken at face value.2,3 In fact, the reformed system will give rise to moral failings akin to those of the existing system, but will differ from the existing system in its effect on the stakeholders. Thus, whereas the outgoing system has given each stakeholder a unique mixture of benefit and harm, the incoming system offers benefit only to sponsors and researchers and nothing but detriment to participants in research and consumers of its products.In the light of this conclusion, we finally suggest that the Warner Report be construed not merely as an ill-considered document, but rather as an ideological reflection of a long-established hegemonic contract fine-tuning itself to contemporary global challenges.To avoid …. (shrink)

The standard view of ignorance is that it consists in the mere lack of knowledge or true belief. Duncan Pritchard has recently argued, against the standard view, that ignorance is the lack of knowledge/true belief that is due to an improper inquiry. I shall call, Pritchard’s alternative account the Normative Account. The purpose of this article is to strengthen the Normative Account by providing an independent vargument supporting it.

It is commonly accepted – not only in the philosophical literature but also in daily life – that ignorance is a failure of some sort. As a result, a desideratum of any ontological account of ignorance is that it must be able to explain why there is something wrong with being ignorant of a true proposition. This article shows two things. First, two influential accounts of ignorance – the Knowledge Account and the True Belief Account – do not satisfy this (...) requirement. They fail to provide a satisfying normative account of the badness of ignorance. Second, this article suggests an alternative explanation of what makes ignorance a bad cognitive state. In a nutshell, ignorance is bad because it is the manifestation of a vice, namely, of what Cassam calls “epistemic insouciance”. (shrink)