Research on moral distress has paid limited attention to nurses’ responses and actions. In a survey of nurses’ perceptions of moral distress and ethical climate, 292 nurses answered three open-ended questions about situations that they considered morally distressing. Participants identified a range of situations as morally distressing, including witnessing unnecessary suffering, being forced to provide care that compromised values, and negative judgments about patients. They linked these situations to contextual constraints such as workload and described responses, including feeling incompetent and (...) distancing themselves from patients. Participants described considerable effort to effect change, calling into question the utility of defining moral distress as an “inability to act due to institutional constraints” or a “failure to pursue a right course of action.” Various understandings of moral distress operated, and action was integral to their responses. The findings suggest further conceptual work on moral distress and effort to support system-level change. (shrink)

In this paper, I will argue that there is a version of possibilism—inspired by the modal analogue of Kit Fine’s fragmentalism—that can be combined with a weakening of actualism. The reasons for analysing this view, which I call Modal Fragmentalism, are twofold. Firstly, it can enrich our understanding of the actualism/possibilism divide, by showing that, at least in principle, the adoption of possibilia does not correspond to an outright rejection of the actualist intuitions. Secondly, and more specifically, it can enrich (...) our understanding of concretism, by proving that, at least in principle, the idea that objects have properties in an absolute manner is compatible with transworld identity. (shrink)

Colleen Glenney Boggs puts animal representation at the center of the making of the liberal American subject. Concentrating on the formative and disruptive presence of animals in the writings of Frederick Douglass, Edgar Allan Poe, and Emily Dickinson, Boggs argues that animals are critical to the ways in which Americans enact their humanity and regulate subjects in the biopolitical state. Biopower, or a politics that extends its reach to life, thrives on the strategic ambivalence between who is considered human (...) and what is judged as animal. It generates a space of indeterminacy in which animal representations intervene to define and challenge the parameters of subjectivity. The renegotiation of the species line produces a tension that is never fully regulated. Therefore, as both figures of radical alterity and the embodiment of biopolitics, animals are simultaneously exceptional and exemplary to the biopolitical state. An original contribution to animal studies, American studies, critical race theory, and posthumanist inquiry, Boggs thrillingly reinterprets a long and highly contentious human-animal history. (shrink)

In this work, Colleen Clements presents her case for the need to subject the field of bioethics to a critical external analysis apart from the current postmodern assumptions. Clements argues that, since the 1970s, bioethics has refuted human values in favour of political consensus building. This failure to recognize basic human values in the ethical critique of modern medicine has lead to a dehumanization of the medical system by the field. Clements proceeds to advocate a naturalistic theory of bioethics (...) that reinstates primary human values. (shrink)

Many countries have attempted to transition to democracy following conflict or repression, but the basic meaning of transitional justice remains hotly contested. In this book, Colleen Murphy analyses transitional justice - showing how it is distinguished from retributive, corrective, and distributive justice - and outlines the ethical standards which societies attempting to democratize should follow. She argues that transitional justice involves the just pursuit of societal transformation. Such transformation requires political reconciliation, which in turn has a complex set of (...) institutional and interpersonal requirements including the rule of law. She shows how societal transformation is also influenced by the moral claims of victims and the demands of perpetrators, and how justice processes can fail to be just by failing to foster this transformation or by not treating victims and perpetrators fairly. Her book will be accessible and enlightening for philosophers, political and social scientists, policy analysts, and legal and human rights scholars and activists. (shrink)

In evidence-based medicine (EBM), methodology has become the central means of determining the quality of the evidence base. The “gold standard” method, the randomised, controlled trial (RCT), imbues medical research with an ethos of disinterestedness; yet, as this essay argues, the RCT is itself a rhetorically interested construct essential to medical-professional boundary work. Using the example of debates about methodology in EBM-oriented research on complementary and alternative medicine (CAM), practices not easily tested by RCTs, I frame the problem of method (...) as a fundamentally rhetorical problem, situated within a boundary drama, and deeply rooted in the discursive practices of science and medicine. The genre of the RCT report, for example, idealises the research process and can tilt the course of arguments about CAM, while the notion of efficacy can function as a rhetorically mobile boundary object that can redefine the very terms of debate. I suggest herein that arguments about method in CAM debates can productively be read, metonymically, as expressions of more general anxieties in medicine about knowledge and evidence, community values, and professional boundaries; as such, these debates can illuminate some of the rhetorical dimensions of EBM. (shrink)

The category of jus post bellum is a welcome addition to discussions of the justice of war. But, despite its handy Latin label, we will argue that it cannot be properly understood merely as a set of corollaries from jus ad bellum and jus in bello. Instead, an acceptable theory of justice in the postwar period will have to draw on a broader set of normative ideas than those that have been the focus of the just war tradition. In this (...) paper, we will argue that norms of political reconciliation provide some of the resources we need to address postwar justice. (shrink)

In their article “Racial Justice Requires Ending the War on Drugs,” Earp, Lewis, and Hart argue for the end of our War on Drugs in order to alleviate our reliance on mass incarceration, harm...

The purpose of this study was to assess student perceptions of self-plagiarism. Students at three university campuses offering graduate and undergraduate classes in a residential and online format were queried; 284 students responded. Overwhelmingly, students perceived they owned their own previous published works and over half reported they believed self-plagiarism should not be considered an academic honesty offense. Most faculty members did not provide information about self-plagiarism to their students. Only about one-fourth of the students reported recycling parts of an (...) assignment in the past. Students who took online courses were more likely to have been educated about self-plagiarism than those who took residential courses. Understanding students’ perceptions about academic honesty offenses such as plagiarism can help institutions develop effective policies and interventions. (shrink)

Gils-Schmidt and Salloch recognise that human and climate health are inextricably linked, and that mitigating healthcare-associated climate harms is essential for protecting human health.1 They argue that physicians have a duty to consider how their own practices contribute to climate change, including during their interactions with patients. Acknowledging the potential for conflicts between this duty and the provision of individual patient care, they propose the application of Korsgaard’s neo-Kantian account of practical identities to help navigate such scenarios. In this commentary, (...) we argue that by focusing attention on this physician–patient level, the authors overlook the complexity of climate change, both within the healthcare sector and beyond. We recognise the importance of individual agency in tackling this issue, and we also recognise that the authors do briefly acknowledge the importance of considering these broader complexities; however, we emphasise the need for climate and health discussions/action to be situated in a wider framework of systemic change. Our concern is that overemphasis on patient-level interactions risks normalising the prioritisation of individual-level approaches to addressing climate change, detracting from such a broader approach. Physician training emphasises the need for trust, confidentiality and shared decision-making in the doctor–patient relationship. …. (shrink)

The Flint water crisis demonstrates the importance of adequate legal preparedness in dealing with complicated legal arrangements and multiple statutory responsibilities. It also demonstrates the need for alternative accountability measures when public officials fail to protect the public's health and explores mechanisms for restoring community trust in governmental public health.

This edited collection recalls the events that led up to the Fitzgerald Inquiry and examines the extraordinary influence the ‘watershed' inquiry has had on police and public sector reform at the state, national and international levels.

We sometimes fail unwittingly to do things that we ought to do. And we are, from time to time, culpable for these unwitting omissions. We provide an outline of a theory of responsibility for unwitting omissions. We emphasize two distinctive ideas: (i) many unwitting omissions can be understood as failures of appropriate vigilance, and; (ii) the sort of self-control implicated in these failures of appropriate vigilance is valuable. We argue that the norms that govern vigilance and the value of self-control (...) explain culpability for unwitting omissions. (shrink)

Several recent studies indicate that cheating has become both more prevalent and more socially acceptable. In this article I draw parallels between market values and student attitudes about cheating. They include: (1) reduction of a broad range of goods to their economic value, (2) use of non-reciprocity as a guiding principle, (3) valuing the appearance of virtue over real virtue, and (4) reframing dishonesty in a positive light. I posit two ways that market culture influences the willingness to cheat, and (...) discuss the media's role in transmitting this influence. The article concludes with the suggestion that attempts to curtail cheating by further policing students may only exacerbate the problem in the long run. The same contextual factors that help mitigate undesirable market behavior, when cultivated in the classroom, can help to curb student cheating. (shrink)

Each volume of this series of companions to major philosophers contains specially commissioned essays by an international team of scholars and will serve as a reference work for students and nonspecialists. John Rawls is the most significant and influential philosopher and moral philosopher of the twentieth century. His work has profoundly shaped contemporary discussions of social, political and economic justice in philosophy, law, political science, economics and other social disciplines. In this exciting collection of new essays, many of the world's (...) leading political and moral theorists discuss the full range of Rawls's contribution to the concepts of political and economic justice, democracy, liberalism, constitutionalism, and international justice. There are also assessments of Rawls's controversial relationships with feminism, utilitarianism and communitarianism. New readers will find this the most accessible guide to Rawls currently available. Advanced students and specialists will find a conspectus of recent developments in the interpretation of Rawls. (shrink)

During his long and continuing scholarly career, Patrick Suppes contributed significantly both to the sciences and to their philosophies. The volume consists of papers by an international group of Suppes colleagues, collaborators, and students in many of the areas of his expertise, building on or adding to his insights. Michael Friedman offers an overview of Suppes accomplishments and of his unique perspective on the relation between science and philosophy. Paul Humphreys, Stephen Hartmann, and Tom Ryckman present essays in the philosophy (...) of physics. Jens-Erik Fenstad, Harvey Friedman, and Jaako Hintikka consider problems in the foundations of mathematics, while the late Duncan Luce, Jean-Claude Falmagne, Brian Skyrms, and Hannes Leitgeb have contributed essays in theory of measurement, decision theory and probability. Foundations of economics and political theory are addressed by Adolfo Garcia de la Sienra, Russell Hardin, and Kenneth Arrow. Psychology, language, and philosophy of language are addressed by Elizabeth Loftus, Anne Fagot-Largeault, Willem Levelt, Dagfinn Follesdal, and Marcos Perreau-Guimares and some of Suppes most recent research in neurobiology is addressed in essays by Colleen Crangle, Acadio de Barros and Claudio Carvalhes. Finally Nancy Cartwright and Alexandre Marcelles consider the alignment (or misalignment) of method and policy. Each of the essays is accompanied by a response from Suppes.". (shrink)

Volume 20, Issue 7, July 2020, Page 185-187.

"Center for the Study of Language and Information, Leland Stanford Junior University.".

Abstract Medical futility is commonly understood as treatment that would not provide for any meaningful benefit for the patient. While the medical facts will help to determine what is medically appropriate, it is often difficult for patients, families, surrogate decision-makers and healthcare providers to navigate these difficult situations. Often communication breaks down between those involved or reaches an impasse. This paper presents a set of practical strategies for dealing with cases of perceived medical futility at a major cancer center. Content (...) Type Journal Article Pages 1-8 DOI 10.1007/s10730-011-9168-3 Authors Colleen M. Gallagher, Section for Integrated Ethics in Cancer Care, Unit 1430, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX 77230-1402, USA Ryan F. Holmes, St. Louis University, St. Louis, MO, USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737. (shrink)

The Direction of Medical Ethics The direction bioethics, and specifically medical ethics, will take in the next few years will be crucial. It is an emerging specialty that has attempted a great deal, that has many differing agendas, and that has its own identity crisis. Is it a subspecialty of clinical medicine? Is it a medical reform movement? Is it a consumer pro tection movement? Is it a branch of professional ethics? Is it a ra tionale for legal decisions and (...) agency regulations? Is it something physicians and ethical theorists do constructively together? Or is it a morally concentrated attack on high technology, with the prac titioners of scientific medicine and the medical ethicists in an adversarial role? Is it a conservative endeavor, exhibiting a Frankenstein syn drome in Medical Genetics ("this time, they have gone too far"), or a Clockwork Orange syndrome in Psychotherapy ("we have met hods to make you talk-walk-cry-kill")? Or does it suffer the afflic tion of overdependency on the informal fallacy of the Slippery Slope ("one step down this hill and we will never be able to stop") that remains an informal fallacy no matter how frequently it's used? Is it a restricted endeavor of analytic philosophy: what is the meaning of "disease," how is "justice" used in the allocation of medical resources, what constitutes "informed" or "consent?" Is it applied ethics, leading in clinical practice to some recommenda tion for therapeutic or preventive action? This incomplete list of questions indicates just how complex. (shrink)

The Theology of Hathor of Dendera: Aural and Visual Scribal Techniques in the Per-Wer Sanctuary. By Barbara A. Richter. Brown University Department of Egyptology and Assyriology, Wilbour Studies, vol. 4. Atlanta: Lockwood Press, 2016. Pp. xxix + 543, illus. $145. [Distributed by ISD, Bristol, CT].

In this paper, we present a Capabilities -based Approach to the acceptability and the tolerability of risks posed by natural and man-made hazards. We argue that judgments about the acceptability and/or tolerability of such risks should be based on an evaluation of the likely societal impact of potential hazards, defined in terms of the expected changes in the capabilities of individuals. Capabilities refer to the functionings, or valuable doings and beings, individuals are able to achieve given available personal, material, and (...) social resources. The likely impact of a hazard on individuals’ capabilities should, we argue, be compared against two separate thresholds. The first threshold specifies the minimum level of capabilities attainment that is acceptable in principle for individuals to have in the aftermath of a hazard over any period of time. This threshold captures the level that individuals’ capabilities ideally should not fall below. A risk is acceptable if the probability that the attained capabilities will be less than the acceptable level is sufficiently small. In practice, it can be tolerable for some individuals to temporarily fall below the acceptable threshold, provided this situation of lower capabilities attainment is temporary, reversible, and the probability that capabilities will fall below a tolerability threshold is sufficiently small. This second, tolerable threshold delimits an absolute minimum level of capabilities attainment below which no individual in a society should ever fall, regardless of whether that level of capabilities attainment is temporary or reversible. In this paper, we describe and justify this Capabilities -based Approach to the acceptability and tolerability of risks. We argue that the proposed theoretical framework avoids the limitations in current approaches to acceptable risk. The proposed approach focuses the attention of risk analysts directly on what should be our primary concern when judging the acceptability and the tolerability of risks, namely, how risks impact the well-being of individuals in a society. Also, our Capabilities -based Approach offers a transparent, easily communicable way for determining the acceptability and the tolerability of risks. (shrink)

Following extended periods of conflict or repression, political reconciliation is indispensable to the establishment or restoration of democratic relationships and critical to the pursuit of peacemaking globally. In this book, Colleen Murphy offers an innovative analysis of the moral problems plaguing political relationships under the strain of civil conflict and repression. Focusing on the unique moral damage that attends the deterioration of political relationships, Murphy identifies the precise kinds of repair and transformation that processes of political reconciliation ought to (...) promote. Building on this analysis, she proposes a normative model of political relationships. A Moral Theory of Political Reconciliation delivers an original account of the failure and restoration of political relationships, which will be of interest to philosophers, social scientists, legal scholars, policy analysts, and all those who are interested in transitional justice, global politics, and democracy. (shrink)

In contemporary philosophy, substantive moral theories are typically classified as either consequentialist or deontological. Standard consequentialist theories insist, roughly, that agents must always act so as to produce the best available outcomes overall. Standard deontological theories, by contrast, maintain that there are some circumstances where one is permitted but not required to produce the best overall results, and still other circumstances in which one is positively forbidden to to do. Classical utilitarianism is the most familiar consequentialist view, but it is (...) widely regarded as an inadequate account of morality. Although Professor Scheffler agrees with this assessment, he also believes that consequentialism seems initially plausible, and that there is a persistent air of paradox surrounding typical deontological views. In this book, therefore, he undertakes to reconsider the rejection of consequentialism. He argues that it is possible to provide a rationale for the view that agents need not always produce the best possible overall outcomes, and this motivates one departure from consequentialism; but he shows that it is surprisingly difficult to provide a satisfactory rationale for the view that there are times when agents must not produce the best possible overall outcomes. He goes on to argue for a hitherto neglected type of moral conception, according to which agents are always permitted, but not always required, to produce the best outcomes. (shrink)

Hegemonic masculinity, a framework where stereotypically masculine traits are over-emphasized, plays a central role in sport, partly due to an excessive focus on winning. This type of masculinity marginalizes those that do not possess specific traits, including many women and men. I argue sport reform focused on mitigating hypercompetitive attitudes can reduce this harmful and marginalizing hegemonic masculinity in sport. I make this argument first by challenging the dichotomous nature of sport, especially in recognizing that all outcomes are a blend (...) of winning and losing, that ties are relevant and informative outcomes to contests, and that winning and losing do not always tell accurate stories of the outcome. Secondly, I contend that expanding the potential outcomes in sport can help broaden the emphasis of competitive sport to take into account playing well and improving, in terms of both the test and the contest. I conclude that these reforms decrease hegemonic masculinity, making sport better for all. (shrink)

The development of the curriculum for engineering education should be based on a comprehensive understanding of engineers’ responsibilities. The responsibilities that are constitutive of being an engineer include striving to fulfill the standards of excellence set by technical codes; to improve the idealized models that engineers use to predict, for example, the behavior of alternative designs; and to achieve the internal goods such as safety and sustainability as they are reflected in the design codes. Globalization has implications for these responsibilities (...) and, in turn, for engineering education, by, for example, modifying the collection of possible solutions recognized for existing problems. In addition, international internships can play an important role in fostering the requisite moral imagination of engineering students. (shrink)

This article challenges the association between realist methodology and ideals of legitimacy. Many who seek a more “realistic” or “political” approach to political theory replace the familiar orientation towards a state of justice with a structurally similar orientation towards a state of legitimacy. As a result, they fail to provide more reliable practical guidance, and wrongly displace radical demands. Rather than orienting action towards any state of affairs, I suggest that a more practically useful approach to political theory would directly (...) address judgments, by comparing the concrete possibilities for action faced by real political actors. (shrink)

P. Kyle Stanford defends the problem of unconceived alternatives, which maintains that scientists are unlikely to conceive of all the scientifically plausible alternatives to the theories they accept. Stanford’s argument has been criticized on the grounds that the failure of individual scientists to conceive of relevant alternatives does not entail the failure of science as a corporate body to do so. I consider two replies to this criticism and find both lacking. In the process, I argue that Stanford does not (...) provide evidence that there are likely scientifically plausible unconceived alternatives to scientific theories accepted now and in the future. (shrink)

Mintz examines seventeenth-century reactions to the political philosophy of Thomas Hobbes.

The controversy over the equivalence of continuous sedation until death (CSD) and physician-assisted suicide/euthanasia (PAS/E) provides an opportunity to focus on a significant extended use of CSD. This extension, suggested by the equivalence of PAS/E and CSD, is designed to promote additional patient autonomy at the end-of-life. Samuel LiPuma, in his article, “Continuous Sedation Until Death as Physician-Assisted Suicide/Euthanasia: A Conceptual Analysis” claims equivalence between CSD and death; his paper is seminal in the equivalency debate. Critics contend that sedation (...) follows proportionality protocols for which LiPuma’s thesis does not adequately account. Furthermore, sedation may not eliminate consciousness, and as such LiPuma’s contention that CSD is equivalent to neocortical death is suspect. We not only defend the equivalence thesis, but also expand it to include additional moral considerations. First, we explain the equivalence thesis. This is followed by a defense of the thesis against five criticisms. The third section critiques the current use of CSD. Finally, we offer two proposals that, if adopted, would broaden the use of PAS/E and CSD and thereby expand options at the end-of-life. (shrink)