Moral distress is now being recognized as a frequent experience for many health care providers, and there's good evidence that it has a negative impact on the health care work environment. However, contemporary discussions of moral distress have several problems. First, they tend to rely on inadequate characterizations of moral distress. As a result, subsequent investigations regarding the frequency and consequences of moral distress often proceed without a clear understanding of the phenomenon being discussed, and thereby risk substantially misrepresenting the (...) nature, frequency, and possible consequences of moral distress. These discussions also minimize the intrinsically harmful aspects of moral distress. This is a serious omission. Moral distress doesn't just have a negative impact on the health care work environment; it also directly harms the one who experiences it. In this paper, I claim that these problems can be addressed by first clarifying our understanding of moral distress, and then identifying what makes moral distress intrinsically harmful. I begin by identifying three common mistakes that characterizations of moral distress tend to make, and explaining why these mistakes are problematic. Next, I offer an account of moral distress that avoids these mistakes. Then, I defend the claim that moral distress is intrinsically harmful to the subject who experiences it. I conclude by explaining how acknowledging this aspect of moral distress should reshape our discussions about how best to deal with this phenomenon. (shrink)

In Welfare, Happiness, and Ethics, L.W. Sumner defends two significant constraints on one’s theory of welfare: formality and generality. An adequate theory of welfare, claims Sumner, must give a constitutive account of the “good-for” relation. This constitutive account must be sufficiently general that any entity whose status as a welfare subject is uncontroversial falls within its scope. This paper will argue that Sumner’s proposed constraints are particularly significant to utilitarian arguments for the equal moral considerability of non-human animals. In the (...) absence of these constraints, the inconsistency that is alleged to follow from denying moral considerability to non-human animals, while affirming it for humans, fails to obtain. I will focus on Peter Singer’s argument for the equal moral considerability of non-human animals, in order to support the conclusion that questions about the formality and generality of welfare are significant areas of further research for philosophers of animal welfare. (shrink)

Harrowing stories reported in the media describe Covid‐19 ravaging through families. This essay reports professional experiences of this phenomenon, family clustering, as encountered during the pandemic's spread across Southern California. We identify three ethical challenges following from it: Family clustering impedes shared decision‐making by reducing available surrogate decision‐makers for incapacitated patients, increases the emotional burdens of surrogate decision‐makers, and exacerbates health disparities for and the suffering of people of color at increased likelihood of experiencing family clustering. We propose that, in (...) response to these challenges, efforts in advance care planning be expanded, emotional support offered to surrogates and family members be increased, more robust state guidance be issued on ethical decision‐making for unrepresented patients, ethics consultation be increased in the setting of conflict following from family clustering dynamics, and health care professionals pay more attention to systemic and personal racial biases and inequities that affect patient care and the surrogate experience. (shrink)

John Searle claims that social-scientific laws are impossible because social phenomena are physically open-ended. William Butchard and Robert D’Amico have recently argued that, by Searle’s own lights, money is a social phenomena that is physically closed. However, Butchard and D’Amico rely on a limited set of data in order to draw this conclusion, and fail to appreciate the implications of Searle’s theory of social ontology with regard to the physical open-endedness of money. Money is not physically open-ended in the strong (...) sense that Butchard and D’Amico require, and their argument for the possibility of social-scientific laws fails as a result. (shrink)

The prevalence of antibiotic resistant microbes has led to a call for new antibiotics development. Due to the irresponsible practices of the medical community in prescribing antibiotics, much of the demand for new antibiotics is suspect. I argue that the social contract, which properly includes human relationships with laboratory animals, requires a conservative attitude toward new antibiotics development. This attitude places limits on the justificatory role of demand in determining whether a particular research project meets the conditions for morally justified (...) research, as defined by Rollin’s utilitarian principle. (shrink)