Increased technological and pharmacological interventions in patient care when patient outcomes are uncertain have been linked to the escalation in moral and ethical dilemmas experienced by health care providers in acute care settings. Health care research has shown that facilities that are able to attract and retain nursing staff in a competitive environment and provide high quality care have the capacity for nurses to process and resolve moral and ethical dilemmas. This article reports on the findings of a systematic review (...) of the empirical literature (1980 — February 2007) on the effects of unresolved moral distress and poor ethical climate on nurse turnover. Articles were sought to answer the review question: Does unresolved moral distress and a poor organizational ethical climate increase nurse turnover? Nine articles met the criteria of the review process. Although the prevailing sentiment was that poor ethical climate and moral distress caused staff turnover, definitive answers to the review question remain elusive because there are limited data that confidently support this statement. (shrink)

The number of children with chronic critical illness (CCI) is a growing population in the United States. A defining characteristic of this population is a prolonged hospital stay. Our study assessed the proportion of pediatric patients with chronic critical illness in U.S. hospitals at a specific point in time, and identified a subset of children whose hospital stay lasted for months to years. The potential harms of a prolonged hospitalization for children with CCI, which include over treatment, infection, disruption of (...) family life, and the intensive utilization of resources—combined with the moral distress experienced by the clinicians who care for the children, suggest the need for ethical analysis of this growing issue to identify actions that could be taken at the clinical and health systems levels to reduce the harms associated with prolonged hospital stay.In this article we present three real cases from our study that involved a very long hospital stay. We applied a framework developed by Mackenzie, Rogers, and Dodds to analyze inherent, situational, and pathogenic vulnerabilities to examine the ways that interventions intended to remedy one source of harm for the children in our cohort inadvertently created other harms. We examined the complex ways that children with protracted hospitalization are vulnerable to the choices made by their family and clinicians, as well as by healthcare systems and communities. Finally, we used this analysis to summarize actions and ethical responses to this growing patient population. Such an understanding is essential to making clinical and ethical decisions that arise for children who are at risk for a very long stay in the hospital. (shrink)

Resumen. La congregación fundada por Vicente de Paúl y Luisa de Marillac ha estado ligada al cuidado y, por su formación y método de trabajo, pueden ser consideradas como pioneras de los cuidados de enfermería, ya que su objetivo ha sido y es cubrir las necesidades básicas de la persona, teoría que postularía en 1960 Virginia Henderson. En este trabajo se pretende dar a conocer cómo las Hijas de la Caridad han estado ligadas al cuidado de la salud desde (...) sus inicios y la labor socio sanitaria que durante casi 150 años lleva prestando en Zaragoza la Casa de Amparo. Desde su inauguración el 5 de marzo de 1871, y gracias al apoyo económico del Ayuntamiento de Zaragoza, esta Institución proporciona asilo y cuidados a toda persona mayor que carece de recursos necesarios. Desde el primer momento se encargaron de ello las Hijas de la Caridad que, sin apenas recursos ni conocimientos, cuidaron de los asilados. Con el paso del tiempo, estos cuidados han ido evolucionando y profesionalizándose hasta que, en la actualidad, están siendo procurados por personal sanitario especializado; a pesar de ello, las hermanas siguen presentes en la vida de la residencia prestando su ayuda aquellos que lo necesitan. Palabras clave: Hijas de la Caridad, beneficencia, salud, enfermería, Casa de Amparo, Zaragoza, siglos XIX-XXI.. The congregation founded by Vicente de Paul and Luisa de Marillac has been linked to care and, because of their training and working method, they can be considered as pioneers of nursing care, since their objective has been and is to cover the basic needs of the person, a theory that Virginia Henderson would postulate in 1960. This paper aims to make known how the daughters of charity have been linked to health care since its inception and the social and health work that the Casa de Amparo has been providing in Zaragoza for almost 150 years. Since its inauguration on March 5, 1871, and thanks to the economic support of the City Council of Zaragoza, this Institution provides asylum and care for all older people who lack the necessary resources. From the first moment the daughters of the charity took care of it, who, without scarce resources or knowledge, took care of the asylees. With the passage of time, these cares have been evolving and professionalizing until, at present, they are being procured by specialized health personnel; In spite of this, the sisters are still present in the life of the residence, helping those who need it. Key words: Daughters of Charity, charity, health, nursing, Casa de Amparo, Zaragoza, 19th-21th centuries. (shrink)

Epistemic Evaluation aims to explore and apply a particular methodology in epistemology. The methodology is to consider the point or purpose of our epistemic evaluations, and to pursue epistemological theory in light of such matters. Call this purposeful epistemology. The idea is that considerations about the point and purpose of epistemic evaluation might fruitfully constrain epistemological theory and yield insights for epistemological reflection. Several contributions to this volume explicitly address this general methodology, or some version of it. Others focus on (...) advancing some application of the methodology rather than on theorizing about it. The papers go on to explore the idea that purposes allow one to understand the conceptual demands on knowing, examine how purposeful epistemology might shed light on the debate between internalist and externalist epistemologies, and further develop the idea of purposeful epistemology. (shrink)

The chapter rehearses the main outlines of gatekeeping contextualism—the view that it is central to the concept of knowledge that attributions of knowledge function in a kind of epistemic gatekeeping for contextually salient communities. The case for gatekeeping contextualism is clarified within an extended discussion of the character of philosophical reflection. The chapter argues that normatively valenced, evaluative concepts constitute a broad class of concepts for which a sociolinguistic point or purpose may be readily sensed—and for which the intimate connection (...) between point/purpose and the concept itself is readily understandable. Commonly at the inception of philosophical reflection one’s sense for the point or purpose of a specific concept is seldom highly articulate. The chapter argues that this does not prevent one’s grasp of point/purpose from doing real work in philosophical reflection. (shrink)

Pt. I. The apparent good. Evaluative cognition -- Perceiving the good -- Phantasia and the apparent good -- pt. II. The apparent good and non-rational motivation. Passions and the apparent good -- Akrasia and the apparent good -- pt. III. The apparent good and rational motivation. Phantasia and deliberation -- Happiness, virtue, and the apparent good -- Practical induction -- Conclusion : Aristotle's practical empiricism.

Plato's Epistemology presents an original interpretation of one of the central topics in Plato's work: epistemology. Moss argues, against the grain of much modern scholarship, that Plato's epistemology is radically different from our own.

Is there a need for a distinctively diachronic conception of metaphysical emergence? Here I argue to the contrary. In the main, my strategy consists in considering a representative sample of accounts of purportedly diachronic metaphysical emergence, and arguing that in each case, the purportedly diachronic emergence at issue either can (and should) be subsumed under a broadly synchronic account of metaphysical emergence, or else is better seen as simply a case of causation. In addition, I consider and argue against the (...) suggestion that 'in-principle unpredictability' accounts of diachronic emergence support there being distinctively diachronic metaphysical emergence. (shrink)

La réflexion sur la guerre de Montesquieu est amorcée dans l’ouvrage qu’il consacre à l’histoire de Rome : les Considérations sur les causes de la grandeur des Romains et de leur décadence. C’est pour le baron de la Brède un moyen de prendre position contre les arguments machiavélistes qui soutiennent les entreprises de conquêtes de son époque. Il s’agit alors de retracer la généalogie de cette prise de position depuis les thèses de Machiavel, dont Montesquieu hérite, jusqu’aux usages politiques qu’il (...) dénonce. (shrink)

Fallibilists claim that one can know a proposition on the basis of evidence that supports it even if the evidence doesn't guarantee its truth. Jessica Brown offers a compelling defence of this view against infallibilists, who claim that it is contradictory to claim to know and yet to admit the possibility of error.

This introductory chapter proceeds in three parts. The first section characterizes the general approach to epistemology around which the volume revolves—purposeful epistemology—and examines the general motivation for that approach. The guiding idea is that considerations about the point and purpose of epistemic evaluation might fruitfully constrain epistemological theory and yield insights for epistemological reflection. The second section explores the approach by characterizing some important versions of it. Several themes and issues that we see running through the volume are here articulated (...) and highlighted. The third section provides a brief summary of each contribution to the collection. (shrink)

After characterizing the general outlines of Davidson's criticism of the idea of conceptual schemes, the specifics of his argument are examined and evaluated. It is argued that his argument against radically different conceptual schemes does mark out plausible limits to what might be thought of as differences against conceptual schemes, but it is doubtful that those he mentioned as proponents of the idea envisions such differences. It is argued that the stylized character of Davidson's arguments against the less radical variants (...) of the idea fail to foreclose the possibility of differences that many would find interesting. (shrink)

did plato and aristotle have anything to say about belief? The answer to this question might seem blindingly obvious: of course they did. Plato distinguishes belief from knowledge in the Meno, Republic, and Theaetetus, and Aristotle does so in the Posterior Analytics. Plato distinguishes belief from perception in the Theaetetus, and Aristotle does so in the De anima. They talk about the distinction between true and false beliefs, and the ways in which belief can mislead and the ways in which (...) it can steer us aright. Indeed, they make belief a central component of their epistemologies.The view underlying these claims—one so widespread these days as to remain largely unquestioned—is that when Plato and Aristotle talk... (shrink)

According to a number of contemporary theorists, aesthetic reasons can invite or entice us but never compel us. In this paper, I develop a Kantian account of the normative force of aesthetic reasons. While Kant would likely agree that aesthetic reasons do not give rise to obligations, his account nevertheless gives us the resources for explaining how aesthetic reasons can still have more force than merely enticing reasons. This account appeals to the distinct normativity of aesthetic judgments on Kant's theory (...) and the way in which this kind of normativity structures aesthetic exchanges with other judging subjects. I argue that, in addition to the moral reasons we have for appreciating and preserving beauty, Kant’s account can accommodate distinctly aesthetic reasons for doing so that stem from our membership in aesthetic communities. (shrink)

I argue that the best explanation of the multiplicity of available frameworks for treating any given philosophical topic is that philosophy currently (though not insuperably) lacks fixed standards; I then go on to identify three barriers to philosophical progress associated with our present epistemic situation. First is that the lack of fixed standards encourages what I call “intra‐disciplinary siloing,” and associated dialectical and argumentative failings; second is that the lack of fixed standards makes room for sociological factors (including elite influence (...) and disciplinary inertia) to be determinative of which philosophical frameworks are embraced; third is that the lack of fixed standards encourages (implicit and/or explicit) bias. I close by offering some suggestions about how to move beyond these barriers, even in the absence of fixed standards. (shrink)

This book is a collection of essays written by Bob Hale (three co-authored), with a critical introduction from Kit Fine. They comprise Hale’s final years of work, adding to and extending beyond his landmark monograph Necessary Beings: An Essay on Ontology, Modality, and the Relations Between Them (OUP, 2013, 2nd edition 2015). The essays develop and consolidate several key themes in Hale’s work, most notably the notion of definition, especially as it extends beyond definition of a word to definition of (...) a thing more generally, and its relations to essence and existence; how the recently influential notion of truthmaking relates to and illuminates some of these issues; and ontological questions connected with Hale’s metaphysical commitments on the one hand, and his commitments in the foundations of mathematics on the other. Several of the essays engage with and respond to work by Kit Fine, and contributions to Being Necessary: Themes of Ontology and Modality from the Work of Bob Hale (OUP 2018). As such, these essays also demonstrate a rich and fruitful philosophical dialogue between Hale and his critics and friends. (shrink)

What are rules? -- Why are rules important? -- Rules for the classroom -- Rules at school -- Rules in the community -- Follow the law! -- Rules and laws must be fair -- All together now -- It's good to have rules.

Rosenberg argues that intentional generalizations in the human sciences cannot be law-like because they are not amenable to significant empirical refinement. This irrefinability is said to result from the principle that supposedly controls in intentional explanation also serving as the standard for successful interpretation. The only credible evidence bearing on such a principle would then need conform to it. I argue that psychological generalizations are refinable and can be nomic. I show how empirical refinement of psychological generalizations is possible by (...) considering concrete cases. A sufficiently detailed view of the role of psychological generalizations in interpretation allows us to find in psychological investigations instances of bootstrap testing. (shrink)

Horgan (1993) proposed that "superdupervenience" - supervenience preserving physicalistic acceptability - is a matter of robust explanation. I argued against him (1999) that (as nearly all physicalist and emergentist accounts reflect) superdupervenience is a matter of Condition on Causal Powers (CCP): every causal power bestowed by the supervenient property is identical with a causal power bestowed by its base property. Here I show that CCP is, as it stands, unsatisfactory,for on the usual understandings of causal power bestowal, it is trivially (...) satisfied or falsified. I offer a revision of CCP which incorporates the evident fact that causal powers are grounded in fundamental forces. (shrink)

Here I compare two accounts of metaphysical indeterminacy (MI): first, the 'meta-level' approach described by Elizabeth Barnes and Ross Cameron in the companion to this paper, on which every state of affairs (SOA) is itself precise/determinate, and MI is a matter of its being indeterminate which determinate SOA obtains; second, my preferred 'object-level' determinable-based approach, on which MI is a matter of its being determinate---or just plain true---that an indeterminate SOA obtains, where an indeterminate SOA is one whose constitutive object (...) has a determinable property, but no unique determinate of that determinable. In S1, I first note an important difference between our accounts, concerning whether MI is taken to induce propositional indeterminacy; in S2, I highlight and defend certain advantages of my account; in S3, I address certain of Barnes and Cameron's objections to my account. (shrink)

O povo Kaingang é o mais populoso do Sul do Brasil e está entre os mais numerosos povos indígenas do país. Neste trabalho faz-se uma relação entre as informações encontradas na literatura e a atualidade na Terra Indígena Kaingang em relação ao conhecimento que possuem sobre o uso de plantas para a cura de doenças e como interpretam a ação da erva no organismo. Para isto, realizou-se uma pesquisa de campo em uma Terra Indígena Kaingang no Paraná, cujo entrevistas forneceram (...) confirmações históricas em relação aos etnoconhecimentos da etnia, da evolução dos aspectos químicos e das atitudes perante a química e os remédios de origem farmacêutica e natural. (shrink)

de Anima III.10 characterizes akrasia as a conflict between phantasia (“imagination”) on one side and rational cognition on the other: the akratic agent is torn between an appetite for what appears good to her phantasia and a rational desire for what her intellect believes good. This entails that akrasia is parallel to certain cases of perceptual illusion. Drawing on Aristotle's discussion of such cases in the de Anima and de Insomniis , I use this parallel to illuminate the difficult discussion (...) of akrasia in Nicomachean Ethics VII.3, arguing that its account of akrasia as involving ignorance is compatible with, and in fact crucially supplements, the more straightforward account we find elsewhere in the corpus of akrasia as a struggle between desires. (shrink)

Foreword -- Preface -- Acknowledgments -- Introduction to corporate social responsibility and ethics -- Business ethics and the meetings and events industry -- Strategies for sustainable meetings -- Social responsibility and culture -- Meetings, events, and environmental science -- Shared value and strategic corporate responsibility -- Communication, marketing, and public relations -- Sustainable supply chains for meetings and events -- Sustainability measurement and evaluation -- Sustainability reporting for meetings and events -- Risk management and legal considerations -- Backcasting and scenario (...) planning for a sustainable meetings and events industry -- Glossary -- Index. (shrink)

Drawing on the moving story of the last year of the life of her own treasured dog, Ody, she presents an in-depth exploration of the practical, medical, and moral issues that trouble pet owners confronted with the decline and death of their ...

This is a comprehensive discussion of determinables, determinates, and their relation ('determination', for short), covering the historical development of these notions, the theoretical options for understanding them, and certain of their contemporary applications.

Contemporary Bioethics: A Reader with Cases is the most cutting-edge bioethics anthology/casebook available. Incorporating introductions, readings, and cases that span the breadth of the discipline, this exceptional volume captures the spirit of bioethics as a rich, exciting, and continuously evolving field. Addressing all of the essential topics--including abortion, reproductive ethics, end-of-life care, research ethics, and the allocation of resources--it also moves beyond the "classic" approach of other books by extending into timely and provocative issues like terrorism, cosmetic surgery, immigration, genetic (...) manipulations, links between first- and third-world health, and--unique to this book--environmental sustainability and climate change. In addition, Contemporary Bioethics is the only book of its kind that includes both philosophical and religious perspectives.The text opens with a substantial introduction that presents key ethical principles, theories, and methods and shows students how to use these tools to frame and address ethical dilemmas in medicine. Covering the brief yet captivating history of the field, the introduction also considers the role of religion in the development of bioethics and examines differences between secular and religious modes of argumentation. Each of the seven topical chapters contains an in-depth introduction, a selection of concise readings representing a diverse range of moral perspectives, discussion questions, and a collection of full-length and provocative case studies that enable students to further explore the issues.Ideal for introductory courses in bioethics and biomedical ethics, Contemporary Bioethics is supplemented by a Instructor's Manual on CD and a Companion Website containing resources for both students and professors, including chapter summaries, additional cases with discussion questions, ideas for further reading, vocabulary flashcards, self-quizzes, and more. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Editor’s NoteJessica HeybachThis issue of education and culture offers readers theoretical in-sights and clarifications to social dilemmas as well as the concerns of the classroom. The authors contained in this issue take up questions of political literacy, moral judgment, the mathematics curriculum and classroom, and the social studies curriculum and classroom. If I had to offer a throughline within these articles, it is the pragmatist conception of judgment that (...) should be cultivated through social relations and classroom practices. These authors are concerned with citizens’ capacity for intelligent judgment within communities and society at large. Pushing back against prevailing logics, these authors offer corrective arguments by positioning Dewey’s thought and pragmatism in contrast to the current logics operating in classrooms and society.Charles Lowery takes up the consequences of modern society’s “conflation of an associated way of living with government, and government with politics, and politics with partisanship” on conceptions of community in his article, “The Role of Education in The Public and Its Problems: A Deweyan Perspective on Political Literacy.” Building on key authors that have previously advanced this line of inquiry central to Dewey’s The Public and Its Problems, Lowery attends to how contemporary education and the development of a politically literate citizenry through democratic habits rather than knowledge accumulation should be centered as the central task of schooling. Lowery highlights current obstacles to cultivating political literacy in the schools such as dogma, disinformation, divisiveness, and de-democratization, and concludes by underscoring the work of school leaders as central to the task of political literacy.Davin Carr-Chellman puts forth a provocative argument which attends to the consequences of instrumental rationality and identity thinking on moral judgment in his article, “Education for Moral Judgment: Situational Creativity and Dewey’s Aesthetics.” Drawing from critical theory, Carr-Chellman emphasizes how dehumanization, moral indifference, and alienation are byproducts of instrumental rationality, measurability, and identity thinking. He then engages Dewey’s aesthetics and Joas’s concept of situational creativity as possible resources to reconstruct human experience and renew the human capacity for moral judgment. According to Carr-Chellman, small acts of creativity and relationship-building become essential to resisting human relations that have become “abstract, impersonal, vague, and competitive.” Thus, an education for moral judgment must humanize through authentic relationships and meaning-making learning opportunities that resist the alienation now culturally rampant. [End Page 1]Marshall Gordon argues that mathematics curriculum and classroom should be understood as a site for developing habits of mind that foster democracy in his article, “Teaching Mathematics with Democracy in Mind.” Gordon elaborates on the problematic persistence of abstracted, procedural mathematics which valorizes memorization and calls for mathematics to capitalize on the unrealized democratic potentials in the mathematics classroom. Drawing on Dewey’s claim in Democracy and Education that “Education is not an affair of ‘telling’ and being told, but an active and constructive process,” Gordon describes a mathematics for democracy. Gordon describes mathematics as a powerful force in the development of students’ reflective intelligence and their capacity for problem-solving by problem-clarifying strategies rather than problem-solving procedures (for example, “take things apart, make the problem simpler, reason by analogy, and tinker”) and collaboration through “multiple-centers” which capitalizes on shared-interest investigations.Dave Powell explores the relationship between inquiry and Dewey’s pragmatic epistemology to advance democratic citizenship education in the social studies classroom in his article, “Has Anybody Here Seen My Old Friend John? Making the Case for a More Pragmatic Social Studies.” In particular, Powell attends to educators’ stance on truth and how “reframing their epistemological orientations” opens up possibilities for different future actions. He begins by describing how pragmatist thinking and Dewey’s philosophical commitments of child-centeredness could shape conceptions of inquiry and allow a reflective practitioner to ask different kinds of questions associated with social studies. Through a rich discussion of what Deweyan thought makes possible in social studies, Powell advances the promise of a citizenry able to think pragmatically in a democracy. He argues that social studies can reject fixed notions of truth, foster trust among students as they exchange ideas, reject opportunities for reverse indoctrination, and cultivate intelligence, as practical... (shrink)

Stoics and Sceptics distinguish belief (doxa) from a representationally and functionally similar but sub-doxastic state: passive yielding to appearance. Belief requires active assent to appearances, that is, affirmation of the appearances as true. I trace the roots of this view to Plato's accounts of doxa in the Republic and Theaetetus. In the Republic, eikasia and pistis (imaging and conviction) are distinguished by their objects, appearances versus ordinary objects; in the Theaetetus, perception and doxa are distinguished by their objects, proper perceptibles (...) versus ‘commons’, including being. But underlying these ontological distinctions is a psychological one: the lower mental states are confined to their lower objects because they are passive; the higher mental states have access to higher objects because they result from questioning appearances and making active affirmations about how things are. This doctrine of doxa anticipates both the Hellenistic one and modern accounts of belief as ‘aiming at truth’; it also shows Plato's views of doxa to have more in their favour philosophically and to cohere better with one another than generally thought. (shrink)