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)

As a result of recent corporate scandals, several rules have focused on the role played by Boards of Directors on the planning and monitoring of corporate codes of ethics. In theory, outside directors are in a better position than insiders to protect and further the interests of all stakeholders because of their experience and their sense of moral and legal obligations. Female directors also tend to be more sensitive to ethics according to several past studies which explain this affirmation by (...) early gender socialization, the fact that women are thought to place a greater emphasis on harmonious relations and the fact that men and women use different ethical frameworks in their judgments. The goal of this paper is to determine the influence of these characteristics of the Board in terms of promoting and hindering the creation of a code of ethics. Our findings show that a greater number of female directors does not necessarily lead to more ethical companies. Moreover, within Europe as a continent, board ownership leads to an entrenchment of upper-level management, generating a divergence between the ethical interests of owners and managers. In light of this situation, the presence of independent directors is necessary to reduce such conflicts. (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)

In 1991, Jones developed an issue-contingent model of ethical decision making in which moral intensity is posited to affect the four stages of Rest's 1986 model. Jones claimed that moral intensity, which is "the extent of issue-related moral imperative in a situation", consists of six characteristics: magnitude of consequences, social consensus, probability of effect, temporal immediacy, proximity, and concentration of effect. This article reports the findings of two studies that analyzed the factor structure of moral intensity, operationalized by a 12-item (...) Perceived Moral Intensity Scale adapted from the work of Sing-hapakdi et al. [1996, Journal of Business Research, 36, 245-255] and Frey [2000, Journal of Business Ethics, 26, 181-195]. The two items that were purported to measure CE were dropped due to their inability to effectively tap into the characteristic proposed by Jones. Factor analyses of the remaining 10 items supported a 3-factor structure, with the MC, PE, and TI items loading on the first factor, the PX items loading on the second factor, and the SC items loading on the third factor. These factors were labeled: Probable Magnitude of Consequences, Proximity, and Social Consensus. The authors conclude that moral intensity consists of three characteristics, rather than the six posited by Jones. (shrink)

Following an extensive review of the moral intensity literature, this article reports the findings of two studies (one between-subjects, the other within-subject) that examined the effect of manipulated and perceived moral intensity on ethical judgment. In the between-subjects study participants judged actions taken in manipulated high moral intensity scenarios to be more unethical than the same actions taken in manipulated low moral intensity scenarios. Findings were mixed for the effect of perceived moral intensity. Both probable magnitude of consequences (a factor (...) consisting of magnitude of consequences, probability of effect, and temporal immediacy) and social consensus had a significant effect; proximity did not. In the within-subject study manipulated moral intensity had a significant effect on ethical judgment, but perceived moral intensity did not. Regression of ethical judgment on age, gender, major, and the three perceived moral intensity factors was significant between-subjects, but not within-subject. Ethical judgment was found to be a more robust predictor of intention than perceived moral intensity using a within-subject design. (shrink)

Fanny Bré was a volunteer nurse in the International Brigades, who fought in the Spanish Civil War (1936–1939) on the side of the democratically elected Republican government. The objective of this study is to understand the relationship between Bré's antifascist ideas, her conception of care and the activities she carried out in the Spanish hospitals of Casa Roja (Murcia), Villa Paz (Selices, Cuenca) and Vic (Barcelona). We use narrative biography to describe Bré's personal, political and professional trajectory. To do so, (...) we conducted a content analysis of primary sources archived in Spain, Russia and France and secondary sources that emerged from a thorough literature review. We identified three thematic axes: (1) a concept of nursing in the service of the antifascist struggle, (2) nursing activity for high‐quality care and (3) political action for improving hospital organisation and care. The interest of Bré's texts transcends the war in Spain because, in them, Bré questions the neutrality of care by revealing that care can itself be a political act. (shrink)

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

The factor structure of the Multidimensional Ethics Scale (MES; Reidenbach and Robin: 1988, Journal of Business Ethics 7, 871–879; 1990, Journal of Business Ethics 9, 639–653) was examined for the 8-item short form (N = 328) and the original 30-item pool (N = 260). The objectives of the study were: to verify the dimensionality of the MES; to increase the amount of true cross-scenario variance through the use of 18 scenarios varying in moral intensity (Jones: 1991, Academy of Management Review (...) 16, 366–395); and, to examine the items for measurement precision using item-response theory (IRT) methods. Results of confirmatory and exploratory factor analysis failed to conclusively support the hypothesized 3- (short form) or 5-factor (long form) structure; both instruments were instead dominated by a general factor. Item response theory analyses using Samejima’s (1969, Psychometrika Monograph Supplement 34, (4, Pt. 2)) graded response model revealed that many items in the 30-item pool performed very well, and suggested that a different collection of items be used to form a short-form version of the MES. Our proposed 10-item instrument includes more discriminating items than the 8-item version, and has the added advantage of including two items from each of the five ethical philosophies represented in the original 30-item pool. (shrink)

The purpose of this study was to determine the applicability of Buddhist practices in today’s workplaces. The findings were supported by interviews with Buddhist masters and Buddhist business practitioners, as well as literature review, through phenomenological analysis. As a means of presenting the main reasons why Buddhist practices should be considered in contemporary workplaces, a SWOT analysis is presented. In this analysis, a number of strengths for using Buddhist practices in workplaces are listed such as pro-scientific, greater personal responsibility, and (...) healthy detachment, while potential weaknesses such as non-harming, equanimity, and no competition are also reviewed. Both the strengths and the weaknesses could be listed in reverse if applied to a different extent. Among the opportunities were issues such as re-educating the world of business, enhancing personal ownership and a healthier society, while the threats comprised issues such as creating different imbalances, disinterest, and stationary development. (shrink)

In this paper, the author questions whether the research ethics guidelines and procedures are robust enough to protect groups when conducting genetics research with socially identifiable populations, particularly with Native American groups. The author argues for a change in the federal guidelines in substance and procedures of conducting genetic research with socially identifiable groups.

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)

Does the “free market” foster more freedom for individuals generally and less coercion? Libertarians and other market advocates argue that the unfettered market maximizes freedom and hence has less coercion than any feasible alternative. Welfare liberals, Socialist, and Marxists, in different ways, argue against the claim that the unrestricted market maximizes freedom generally. Both supporters and critics agree that coercion undermines freedom and that that is what is ultimately prima facie wrong with it. Further, they agree that the extent to (...) which an economic system includes coercion provides a serious strike against it. The problem is that there is little consensus on the necessary conditions for coercion. In this paper I will be concerned with the nature of coercive relationships in the market. Market interactions have a particular character and occur within a specific institutional framework. Other accounts of coercion have failed to capture the unique character of coercion in the market because they have failed to take into account certain nontrivial facts about the market which are essential to the analysis of coercive market relations. (shrink)

Does the “free market” foster more freedom for individuals generally and less coercion? Libertarians and other market advocates argue that the unfettered market maximizes freedom and hence has less coercion than any feasible alternative. Welfare liberals, Socialist, and Marxists, in different ways, argue against the claim that the unrestricted market maximizes freedom generally. Both supporters and critics agree that coercion undermines freedom and that that is what is ultimately prima facie wrong with it. Further, they agree that the extent to (...) which an economic system includes coercion provides a serious strike against it. The problem is that there is little consensus on the necessary conditions for coercion. In this paper I will be concerned with the nature of coercive relationships in the market. Market interactions have a particular character and occur within a specific institutional framework. Other accounts of coercion have failed to capture the unique character of coercion in the market because they have failed to take into account certain nontrivial facts about the market which are essential to the analysis of coercive market relations. (shrink)

The genetic revolution is well underway, with genetic research and knowledge expanding at an exponential rate. Much of the new genetics research is focused on population groups, and proponents of “population genomics” argue that such studies are necessary since genetic “variation” among human populations holds the most promise for technological innovations that can improve human health and lead to increased understanding of the origin of human populations. Population genomic research thus targets specific groups to discover variation that could lead to (...) knowledge about genetic disorders, possible cures, and the origin and migration patterns of distinctive peoples. Research on genetic differences among groups or populations, however, raises many pressing ethical and legal questions. For example, focus on biological differences of racial and ethnic groups has in the past lead to assumptions about superiority and inferiority between groups, and in practice resulted in stigmatization and discrimination. Consequently, attention on groups should raise legal and moral red flags and compel us to move cautiously in this area. Pragmatically, targeting population groups as the object of study requires the determination of the nature and scope of “population groups” for purposes of genetics research. (shrink)

Artificial persons are those who speak and act for others. Nurses speak and act for patients as well as for physicians and institutions, or, more aptly, institutionalized medicine. Yet, acting for institutionalized medicine can be harmful to nurses, due to the psychological experience of moral distress and the loss of integrity of their practice. This paper illustrates the harm to nurses as expressed in narratives of their practice, and suggests some initial steps we might take in resisting the artificial personhood (...) imposed by institutionalized medicine. (shrink)

Natalie Davis is a quintessential storyteller in the way theorized by Walter Benjamin, Hannah Arendt, and Michel de Certeau. Her work decenters history not simply because it grants agency and so historical visibility to those who have been hidden from history or left on its margins, but also because her stories reveal the complexities of human experience and so challenge the received categories with which we are accustomed to thinking about the world.

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

Scholars have advocated for the inclusion of metacognition in our understanding of the ethical decision making process and in support of moral learning. An instrument to measure metacognition as a domain-specific capacity related to ethical decision making is not found in the current literature. This research describes the development and validation of the 20-item Moral Metacognition Scale. Psychometric properties of the scale were assessed by exploration and confirmation of the factor structure, and the demonstration of convergent, discriminant, and predictive validity. (...) Moral metacognition, as measured by the MMS, was significantly correlated with ethical awareness and ethical judgment. Limitations of our research, suggestions for future exploration, and practical implications are discussed. (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)

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)

The paper argues for the importance to Kant's critique of judgment of epistemological reflections upon the problematics of experimentation on organic processes. It examines the investigations of generation by Wolff and Blumenbach, demonstrating how their experimental practices mediated reflectively between organic phenomena and their conceptualisation, acting as instruments of their judgments of these processes. It then reads Kant's ‘Kritik der teleologischen Urteilskraft’ in light of these experimental investigations, arguing that Kant highlights how the problematic relation between organic phenomena and their (...) conceptualisation manifested in such investigations is opened up as a space for reflection, thus making this act of judgment conscious. The relation between Kant's critiques of judgment in his first and third critiques are then discussed, and it is argued that the reflective character of judgment highlighted in the judgment of organic processes draws into focus the problematic aspects of all judgments of natural phenomena, by making conscious the synthetic process of judgment effected by unconscious acts of the imagination in the first critique. Finally, the paper examines Humboldt's galvanic experiments, showing how they were informed by Kant's critical philosophy, but also how they contributed to the blurring of the boundaries between the judgment of organic and inorganic processes. Thus it is claimed that the reflections upon judgment in the Kritik der Urteilskraft problematized rather than clarified Kant's treatment of judgment in the first critique. (shrink)

The. Metamorphosis. of. Motherhood. Patricia. Smith. Motherhood, as traditionally understood, is obsolete. It is not yet as obsolete as, say, knighthood, but it is moving just as inevitably in the same direction. No one wants to admit that, but it is ...

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)

Early Christian writers defined idolatry around the monotheistic distinction between proper worship of the creator and vain worship of the creature, which they had inherited from Hellenistic Judaism. Despite the remarkable consensus about the validity of this theological analysis, the medieval synthesis was under severe strain throughout the early modern period, mainly because of the concept's extended range of application in the new contexts of religious controversy. In all these cases, deciding what practices constituted idolatry was open to debate. By (...) the eighteenth century, libertine writers could retain the concept of superstition at the expense of that of idolatry, which Voltaire (himself an anti-Christian deist) denounced as meaningless. (shrink)

This paper reports results from a longitudinal study on the impact of the lockdown on daily self-reported life satisfaction levels during the first wave of the COVID-19 pandemic in Spain. A stable panel (N= 1,131) of adult subjects were surveyed during 84 consecutive days (March 29–June 20, 2020). They were asked to report daily life satisfaction and health state levels. Interestingly, daily life satisfaction increased during the lockdown. At the beginning of the experiment, subjects were asked to guess the end-week (...) of the lockdown, against a possible monetary reward for accurate forecasts. Subjects predicting a longer lockdown period reported a higher average level of daily life satisfaction. Females reported on average lower levels of daily life satisfaction, but exhibited a stronger tendency to report higher levels of life satisfaction, the longer their lockdown forecast. Individual heterogeneity in life satisfaction levels can be partly attributed to personality traits, with neuroticism having a negative effect, while extraversion and agreeableness having a positive effect on daily life satisfaction. (shrink)

Changing paradigms about moving forward -- The notion of progress in the past -- The notion of progress today -- Self-leadership and progress -- Toward a moral compass -- The right thing in pre-millennial context -- The right thing in current context -- Defining and polishing our moral compass -- Moving forward while doing the right thing -- About choice and reality -- Five moral pitfalls to avoid -- Moral theories : some pros and cons -- Five moral handles for (...) every type of decision-making. (shrink)

Long run success in watershed management requires understanding of how economic stratification and social values affect water quality protection. Feedback effects on water quality are produced by three aspects of economic well-being: income levels, quality of life and inequality, including the effects of gender based inequality. In the US emphasis on individualistic values leads to reliance on local and private policy solutions to social problems. Analysis of the context of New York City's internationally famous watershed agreement with communities 120 miles (...) distant provides a case study of these relationships. The nature of economic stratification in these upstate communities and the insufficient response of social policies were an impediment to achieving New York City's water quality goals. As a consequence the City's watershed agreement contains direct economic aid to Watershed communities. The Agreement does not address all stratification issues. Some call for solutions beyond the local level and an approach that benefits from the European emphasis on community. It is in the interest of watershed managers to broaden the scope of their concerns to understand and support state and national programs which address problems created by economic stratification. The expansion of the European Union increases the relevance of these lessons for Europe. (shrink)

Historically, academic freedom is a concept aimed at resolving conflicts about the relationship between power and knowledge, politics and truth, action and thought by positing a sharp distinction between them, a distinction that has been difficult to maintain. This paper analyzes those tensions by looking at early statements of the founders of the American Association of University Professors , by exploring the paradoxes of disciplinary authority which at once guarantees and limits professorial autonomy, and by examining several cases in which (...) the question of the meaning of academic responsibility was in dispute. It argues that because the tensions are not susceptible to final resolution, the principle of academic freedom must be preserved in order to mediate them. (shrink)

The review argues that, while Fish's book is undoubtedly a corrective to the most extreme examples of polemical teaching, it oversimplifies the difficulties academics face in trying to create sharp distinctions between politics and scholarship. The radical disconnection he advocates does not address the most difficult situations in which lines cannot be clearly drawn between the substance of academic research and teaching and the politics of the process of knowledge production itself.