This paper makes the case for a pluralist, contextualist view of nursing ethics. In defending this view, I briefly outline two current perspectives of nursing ethics – the Traditional View and the Theory View. I argue that the Traditional View, which casts nursing ethics as a subcategory of healthcare ethics, is problematic because it (1) fails to sufficiently acknowledge the unique nature of nursing practice; and (2) applies standard ethical frameworks such as principlism to moral problems which tend to alienate (...) or undermine nursing ethical concerns. Alternatively, the Theory View, which aims to build an independent and comprehensive theory of nursing ethics, is also found wanting because it (1) fails to sufficiently acknowledge the heterogeneous nature of nursing practices; (2) overemphasizes the differences and undervalues the similarities between nurses and other health professionals; and (3) assumes that one ethical framework can be meaningfully applied across diverse moral problems and contexts.My alternative, is to argue that nursing ethics inquiry should take a pluralist and critical stance towards available ethical frameworks and the negotiation of the ethical realm. On this view, the search for moral consensus or a unique ethical framework for nursing is replaced by the task of working strategically with multiple frameworks in order to expand the moral agency of nurses and empower them to positively engage with moral uncertainty as an inevitable feature of living a moral life. I conclude by indicating some of the implications that this has for the teaching of nursing ethics. (shrink)

Moral distress has received much attention in the international nursing literature in recent years. In this article, we describe the evolution of the concept of moral distress among nursing theorists from its initial delineation by the philosopher Jameton to its subsequent deployment as an umbrella concept describing the impact of moral constraints on health professionals and the patients for whom they care. The article raises worries about the way in which the concept of moral distress has been portrayed in some (...) nursing research and expresses concern about the fact that research, so far, has been largely confined to determining the prevalence of experiences of moral distress among nurses. We conclude by proposing a reconsideration, possible reconstruction and multidisciplinary approach to understanding the experiences of all health professionals who have to make difficult moral judgements and decisions in complex situations. (shrink)

In the last three decades, considerable theoretical and empirical research has been undertaken on the topic of moral distress among health professionals. Understood as a psychological and emotional response to the experience of moral wrongdoing, there is evidence to suggest that—if unaddressed—it contributes to staff demoralization, desensitization and burnout and, ultimately, to lower standards of patient safety and quality of care. However, more recently, the concept of moral distress has been subjected to important criticisms. Specifically, some authors argue that the (...) standard account of moral distress elucidated by Jameton :542–551, 1984) does not refer to a discrete phenomenon and/or that it is not sufficiently broad and that this makes measuring its prevalence among health professionals, and other groups of workers, difficult if not impossible. In this paper, we defend the standard account of moral distress. We understand it as a concept that draws attention to the social, political and contextual determinants of moral agency and brings the emotional landscape of the moral realm to the fore. Given the increasing pressure on health professionals worldwide to meet efficiency, financial and corporate targets and reported adverse effects of these for the quality and safety of patient care, we believe that further empirical research that deploys the standard account moral distress is timely and important. (shrink)

The Covid‐19 pandemic has highlighted many of the difficult ethical issues that health care professionals confront in caring for patients and families. The decisions such workers face on the front lines are fraught with uncertainty for all stakeholders. Our focus is on the implications for nurses, who are the largest global health care workforce but whose perspectives are not always fully considered. This essay discusses three overarching ethical issues that create a myriad of concerns and will likely affect nurses globally (...) in unique ways: the safety of nurses, patients, colleagues, and families; the allocation of scarce resources; and the changing nature of nurses’ relationships with patients and families. We urge policy‐makers to ensure that nurses’ voices and perspectives are integrated into both local and global decision‐making so as to minimize the structural injustices many nurses have faced to date. Finally, we urge nurses to seek sources of support throughout this pandemic. (shrink)

This article briefly outlines some of the key problems with the way in which the moral realm has traditionally been understood and analysed. I propose two alternative views of what is morally interesting and applicable to nursing practice and I indicate that instability has its upsides. I begin with a moral tale – a 'Good Samaritan' story – which raises fairly usual questions about the nature of morality but also the more philosophically fundamental question about the relationship between subjectivity and (...) moral agency. I then consider this relationship from the perspectives of two twentieth century philosophers: Emmanuel Levinas and Michel Foucault. Levinas' basic point is that the experience of ethical subjectivity is made possible through others: the demand to respond to the existence of others is the basic social structure that precedes individual freedom. If Levinas posits intersubjectivity as a fundamental or primitive feature of the moral realm, Foucault poses an even more basic question: how have moral subjects and relations of obligation been constituted? The aim of ethical inquiry, for Foucault, is to describe the network of discourses, institutions, relations, and practices through which certain kinds of subjects are constituted and constitute themselves, e.g. as a kind of person who can act morally. Finally, I consider some recent research in philosophy of nursing which illustrates how Levinasian and/or Foucauldian perspectives can deepen understanding of nurses' moral practices, specifically, the work of Norwegian public health nurses, Canadian pediatric nurses, and Irish midwives. I suggest that in spite of the instability of morality in general and the particular ethical challenges that face nurses, there are grounds for hope and possible strategies for living in unstable times. (shrink)

Why the narrative self? -- Contemporary interest in narrative theory -- Is the self real or illusory? -- Dennett's brand of naturalism -- The heterophenomenological method (HM) -- Consciousness and the self -- The naturalist narrative self -- Puzzle cases -- The HM and the narrative self -- The limitations of Dennett's account -- The limits of language -- Epistemological fragility -- Ontological fragility -- Naturalism and phenomenology -- Confronting naturalism -- Phenomenology and hermeneutics -- The detour of interpretation -- (...) Reflexivity -- The problem of personal identity -- The number of selves, identity relations and truth -- The capable self and its narrative identity -- Narrative identity and aristotelian muthos -- Narrative recounting of human lives -- LPSE-identity and literary puzzle cases -- Certainty, knowledge and attestation -- Narrative attestation -- Fact and fiction -- Narrative attestation -- The limitations of Ricoeur's account -- Selective appeals to literary and psychoanalytic discourses -- Focus on the self-examining self -- The ontological status of the narrative self -- The epistemological status of the narrative self -- The practical self -- Why the narrative self? (shrink)

In April 2004 the Irish Government commissioned Judge Maureen Harding Clark to compile a report to ascertain the rate of caesarean hysterectomies at Our Lady of Lourdes Hospital in Drogheda, Republic of Ireland. The report came about as a result of complaints by midwives into questionable practices that were mainly (but not solely) attributed to one particular obstetrician. In this article we examine the findings of this Report through a feminist lens in order to explore what a feminist reading of (...) the Report and the events that led to the inquiry will bring to light. We consider how sex and gender feature in the Lourdes case, draw attention to the deeply gendered asymmetries of power and privilege that existed between the men and women at the centre of this inquiry, and explore the impact such asymmetries had on this particular situation. (shrink)

The Republic of Ireland has some of the most restrictive abortion legislation in the world which grants to the ‘unborn’ an equal right to life to that of the pregnant woman. This article outlines recent developments in the public discourse on abortion in Ireland and explains the particular cultural and religious context that informs the ethical case for access to abortion services. Our perspective rests on respect for two very familiar moral principles – autonomy and justice – which are at (...) the centre of social and democratic societies around the world. This article explains the context for the deployment of these concepts in order to support the claim that the current legislation and its operationalisation in clinical practice poses serious risks to the health, lives and well-being of pregnant women, tramples on their autonomy rights and requires of them a self-sacrifice that is unreasonable and unjust. (shrink)

This title offers an ethical framework for end-of-life decision making in healthcare settings. Its objective is to foster and support ethically and legally sound clinical practice in end-of-life treatment and care in Ireland.

BackgroundThe impact of healthcare ethics educational interventions on participants’ ethical development is rarely reported on and assessed; even less attention is paid to educational interventions that focus on end-of-life ethical issues.AimTo evaluate the impact of the Ethical Framework for End-of-Life Care Study Sessions Programme ( EOLCSS) on the moral development of healthcare staff who are delivering end-of-life care.MethodsThe EOLCSS was delivered to 20 multi-disciplinary health care staff in Ireland in May 2013. Effect on moral reasoning was measured pre and post (...) education using the Defining Issues Test 2 (DIT2). Inferential statistics were used to examine the relationships between change in DIT2 scores and demographic variables.ResultsParticipants experienced moral reasoning development following receipt of EOLCSS. Age and previous ethics education contributed to the observed changes in moral reasoning.ConclusionsReceipt of the EOLCSS may contribute to moral reasoning development in practicing healthcare professionals. (shrink)

Although clinical ethics support services are becoming increasingly prevalent in Europe and North America, they remain an uncommon feature of the Irish healthcare system and Irish health professionals lack formal support when faced with ethically challenging cases. We have developed a variant on existing clinical ethics decision-making tools which is designed to build capacity and confidence amongst Irish practitioners and enable them to confront challenging situations in the absence of any dedicated support structure. The tool provided below follows a transparent (...) stepwise procedure which avoids an overcomplicated analysis while remaining sensitive to the complexity of the issues addressed. The novelty of the tool lies in the explicit association it makes between each step in the process and one or more responsibilities based on established norms of ethical decision-making in the public domain. (shrink)

Background:A high prevalence of cognitive impairment and frailty complicates the feasibility of advance care planning in the long-term-care population.Research aim:To identify challenges in implementing the ‘Let Me Decide’ advance care planning programme in long-term-care.Research design:This feasibility study had two phases: (1) staff education on advance care planning and (2) structured advance care planning by staff with residents and families.Participants and research context:long-term-care residents in two nursing homes and one community hospital.Ethical considerations:The local research ethics committee granted ethical approval.Findings:Following implementation, over (...) 50% of all residents had completed some form of end-of-life care plan. Of the 70 residents who died in the post-implementation period, 14% had no care plan, 10% (with capacity) completed an advance care directive and lacking such capacity, 76% had an end-of-life care plan completed for them by the medical team, following discussions with the resident (if able) and family. The considerable logistical challenge of releasing staff for training triggered development of an e-learning programme to facilitate training.Discussion:The challenges encountered were largely concerned with preserving resident’s autonomy, avoiding harm and suboptimal or crisis decision-making, and ensuring residents were treated fairly through optimisation of finite resources.Conclusions:Although it may be too late for many long-term-care residents to complete their own advance care directive, the ‘ Let Me Decide’ programme includes a feasible and acceptable option for structured end-of-life care planning for residents with variable capacity to complete an advance care directive, involving discussion with the resident (to the extent they were able) and their family. While end-of-life care planning was time-consuming to deliver, nursing staff were willing to overcome this and take ownership of the programme, once the benefits in improved communication and enhanced peace of mind among all parties involved became apparent in practice. (shrink)

Moral distress has been covered extensively in the nursing literature and increasingly in the literature of other health professions. Cases that cause nurses’ moral distress that are mentioned most frequently are those concerned with prolonging the dying process. Given the standard of aggressive treatment that is typical in intensive care units (ICUs), much of the existing moral distress research focuses on the experiences of critical care nurses. However, moral distress does not automatically occur in all end-of-life circumstances, nor does every (...) critical care nurse suffer its damaging effects. What are the practices of these nurses? What specifically do they do to navigate around or through the distressing situations? The nursing literature is lacking an answer to these questions. This article reports a study that used narrative analysis to explore the reported practices of experienced critical care nurses who are skilled at and comfortable working with families and physicians regarding the withdrawal of aggressive treatment. A major finding was that these nurses did not report experiencing the dam-Moral Agency, Moral Imagination, and Moral Community: Antidotes to Moral Distress Terri Traudt, Joan Liaschenko, and Cynthia Peden-McAlpine Terri Traudt, MBC, MA, is a Communications Consultant specializing in bioethics at the Center for Bioethics at the University of Minnesota, in Minneapolis. [email protected] Joan Liaschenko, PhD, RN, FAAN, is a Professor at the Center for Bioethics and Nursing at the University of Minnesota. Cynthia Peden-McAlpine, PhD, ACNS, BC, is an Associate Professor in the School of Nursing at the University of Minnesota. © 2016 by The Journal of Clinical Ethics. All rights reserved. aging effects of moral distress as described in the nursing literature. The verbal communication and stated practices relevant to this finding are organized under three major themes: (1) moral agency, (2) moral imagination, and (3) moral community. Further, a total of eight subthemes are identified. The practices that constitute these themes and subthemes are further detailed and discussed in this article. Understanding these practices can help mitigate critical care nurses’ moral distress. (shrink)

The basic computer components are universal. Whatever can be built from transistors can also be built from vacuum tubes, relays, fluidic elements, McCulloch-Pitts neurons, connectionist neurons, or from any of the other kinds of neuron Marvin Minsky proved universal in his 1954 Princeton PhD dissertation.

"Speciesism: 'A failure, in attitude or practice, to accord any nonhuman being equal consideration and respect'"--From the book's cover.

_A new, definitive translation of Heidegger's most important work._.

Plagiarism is increasingly evident in business and academia. Though links between demographic, personality, and situational factors have been found, previous research has not used actual plagiarism behavior as a criterion variable. Previous research on academic dishonesty has consistently used self-report measures to establish prevalence of dishonest behavior. In this study we use actual plagiarism behavior to establish its prevalence, as well as relationships between integrity-related personal selection and workplace deviance measures. This research covers new ground in two respects: (a) That (...) the academic dishonesty literature is subject to revision using criterion variables to avoid self bias and social desirability issues and (b) we establish the relationship between actual academic dishonesty and potential workplace deviance/white-collar crime. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Feminist Studies 44, no. 2. © 2018 by Feminist Studies, Inc. 379 Amy Bhatt The Butterfly Effect of Women’s Studies My entry into women’s studies began over two decades ago when I was an undergraduate at Emory University. I took Introduction to Women’s Studies in 1998, the same year that Feminist Studies published a formative issue on the evolution of women’s studies in the academy. I turned to doctoral (...) programs in women’s studies after graduation, all the while growing aware of the heated debates over the future (and the past) of the field, the challenges of crafting interdisciplinary graduate programs, the relationship between academic and activist feminisms, and the ramifications of institutionalization. By the time I entered the University of Washington’s PhD program in 2004, these conversations were further enlivened by the expansion of graduate degrees and certificates across the country and internationally. In 2017, I was promoted to associate professor after being hired as the first women’s studies tenure-track faculty member at my current institution, the University of Maryland, Baltimore County. Having been a part of three differently situated women’s studies programs/departments, I have experienced both the advantages that the field offers for engaged scholarship and teaching, but also the conceptual, resourcing, and workload problems that arise from doing interdisciplinary work. While not engaging the longer history of the scholarly and institutional evolution of women’s studies, my perspective as a relatively recently minted PhD student considers two areas: the promises and pitfalls of 380 Amy Bhatt graduate training (particularly in light of a constricted academic job market) and the impact of integrating women’s studies into the academy. Impossibilities and Promises In her introduction to a special forum on the paradoxes and challenges of women’s studies in graduate education in a 2003 issue of Feminist Studies (which took up the themes raised in the 1998 issue), Pamela Caughie points out that tension is at the core of women’s studies: “Interdisciplinary work depends on disciplinary knowledges; professional training may thwart social activism; theory cannot always be applied.”1 While women ’s studies programs have proliferated across higher education, even ardent feminist academics have levied forceful arguments against institutionalizing women’s studies as stand-alone units. In the same Feminist Studies article, Caughie argues that women’s studies should avoid “disciplining interdisciplinarity,” in part, because such attempts presume a (false) coherence in traditional disciplines that is oppositional to the interstitial nature of interdisciplinarity. While she advocates for graduate training in the field, she expresses concern that by hiring faculty in women’s studies and advocating for a shared research agenda, “we risk reproducing rather than critiquing disciplinary structures.”2 Likewise, in her introduction to Women’s Studies on the Edge, Joan Wallach Scott argues that, because of its formalization within the academy, women’s studies has lost its connection to activism and institutional critique.3 And perhaps most famously, Wendy Brown argues that the work of feminist, queer, critical race, and postcolonial theory ought to be returned to the disciplines, rather than remain within the separate, 1. Pamela L. Caughie, “Graduate Education in Women’s Studies: Paradoxes and Challenges (Introduction to Forum),” Feminist Studies 29, no. 2 (Summer 2003): 406. 2. Pamela L. Caughie, “Professional Identity Politics,” Feminist Studies 29, no. 2 (2003): 430. See also Robyn R. Warhol, “Nice Work, If You Can Get It— And If You Can’t? Building Women’s Studies Without Tenure Lines,” in Women’s Studies on Its Own, ed. Robyn Wiegman (Durham, NC: Duke University Press, 2002), 224–32. 3. Joan Wallach Scott, “Introduction: Feminism’s Critical Edge,” in Women’s Studies on the Edge, ed. Joan Wallach Scott (Durham, NC: Duke University Press, 2008), 1–16. Amy Bhatt 381 often marginalized, domain of women’s studies.4 Such critics caution against the formalization of and, in some cases, expansion of women’s studies across academe. On the other hand, advocates of women’s studies point out that the disciplines themselves are a taxonomy that reflects particular power/content /methodologicalinterventionsandthattheyarenotself-evidentspaces of knowledge production. They argue that formalization ought to be celebrated and that the debate over interdisciplinarity versus traditional disciplines has... (shrink)

A psychoanalytic and philosophical exploration of sublimation as a key term in Jacques Lacan's theories of ethics and feminine sexuality.

This collection of John Mackie's papers on personal identity and topics in moral and political philosophy, some of which have not previously been published, deal with such issues as: multiple personality; the transcendental "I"; responsibility and language; aesthetic judgements; Sidgwick's pessimism; act-utiliarianism; right-based moral theories; cooperation, competition, and moral philosophy; universalization; rights, utility, and external costs; norms and dilemmas; Parfit's population paradox; and the combination of partially-ordered preferences.

_A revised translation of Heidegger's most important work._.

This article analyses the forms of dividuation workers undergo when they are linked to technologies, such as algorithms or artificial intelligence. It examines functionalities and operations deployed by certain types of Talent Management software and apps—UKG, Tribepad, Afiniti, RetailNext and Textio. Specifically, it analyses how talented workers materialise in relation to the profiles and the statistical models generated by such artificial intelligence machines. It argues that these operate as a nooscope that allows the transindividual plane to be quantified through a (...) process known as dividuation. Finally, by way of conclusion, the notion of the dividual is presented as the logic that characterises the human–machine relationship in the case of artificial intelligence and as the horizon of what Felix Guattari called “machinic capitalism”. (shrink)

At least since the seventeenth century, the strange combination of epistemological certainty and ontological power that characterizes mathematics has made it a major focus of philosophical, social, and cultural negotiation. In the eighteenth century, all of these factors were at play as mathematical thinkers struggled to assimilate and extend the analysis they had inherited from the seventeenth century. A combination of educational convictions and historical assumptions supported a humanistic mathematics essentially defined by its flexibility and breadth. This mathematics was an (...) expression of l’esprit humain, which was unfolding in a progressive historical narrative. The French Revolution dramatically altered the historical and educational landscapes that had supported this eighteenth‐century approach, and within thirty years Augustin Louis Cauchy had radically reconceptualized and restructured mathematics to be rigorous rather than narrative. (shrink)

Angelaki, Volume 17, Issue 2, Page 31-48, June 2012.