Moral distress is a phenomenon of increasing concern in nursing practice, education and research. Previous research has suggested that moral distress is associated with perceptions of ethical climate, which has implications for nursing practice and patient outcomes. In this study, a randomly selected sample of registered nurses was surveyed using Corley’s Moral Distress Scale and Olson’s Hospital Ethical Climate Survey (HECS). The registered nurses reported moderate levels of moral distress intensity. Moral distress intensity and frequency were found to be inversely (...) correlated with perceptions of ethical climate. Each of the HECS factors (peers, patients, managers, hospitals and physicians) was found to be significantly correlated with moral distress. Based on these findings, we highlight insights for practice and future research that are needed to enhance the development of strategies aimed at improving the ethical climate of nurses’ workplaces for the benefit of both nurses and patients. (shrink)

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)

Background:Attention to ethical leadership in nursing has diminished over the past several decades.Objectives:The aim of our study was to investigate how frontline nurses and formal nurse leaders envision ethical nursing leadership.Research design:Meta-ethnography was used to guide our analysis and synthesis of four studies that explored the notion of ethical nursing leadership.Participants and research context:These four original studies were conducted from 1999-2008 in Canada with 601 participants.Ethical considerations:Ethical approval from the original studies covered future analysis.Findings:Using the analytic strategy of lines-of-argument, we (...) found that 1) ethical nursing leadership must be responsive to practitioners and to the contextual system in which they and formal nurse leaders work, and 2) ethical nursing leadership requires receiving and providing support to increase the capacity to practice and discuss ethics in the day-to-day.Discussion and conclusion:Formal nurse leaders play a critical, yet often neglected role, in providing ethical leadership and supporting ethical nursing practice at the point of patient care. (shrink)

In this paper, I provide an account of epistemic anxiety as an emotional response to epistemic risk: the risk of believing in error. The motivation for this account is threefold. First, it makes epistemic anxiety a species of anxiety, thus rendering psychologically respectable a notion that has heretofore been taken seriously only by epistemologists. Second, it illuminates the relationship between anxiety and risk. It is standard in psychology to conceive of anxiety as a response to risk, but psychologists – very (...) reasonably – have little to say about risk itself, as opposed to risk judgement. In this paper, I specify what risk must be like to be the kind of thing to which anxiety can be a response. Third, my account improves on extant accounts of epistemic anxiety in the literature. It is more fleshed out than Jennifer Nagel’s, which is largely agnostic about the nature of epistemic anxiety, focusing instead on what work it does in our epistemic lives. In offering an account of epistemic anxiety as an emotion, my account explains how it is able to do the epistemological work to which Nagel puts it. My account is also more plausible than Juliette Vazard’s, on which epistemic anxiety is an emotional response to potential threat to one’s practical interests. Vazard’s account cannot distinguish epistemic anxiety from anxiety in general, and also fails to capture all instances of what we want to call epistemic anxiety. My account does better on both counts. (shrink)

Although ethical leadership by formal nurse leaders is critical to enhancing ethical health-care practice, research has shown that many nurses feel unsupported by their leaders. In this article, we consider the limited attention directed toward ethical leadership of formal nurse leaders and how our own research on ethical nurse leadership compares to other research in this field. In searching Nursing Ethics since its inception 20 years ago, we found only a dozen articles that directly addressed this topic. We then reviewed (...) nurses’ professional codes of ethics in Canada and found significant retractions of ethical guidelines for formal nurse leaders’ ethical responsibilities over the past decade. We began to seek explanations of why this is so and offer some recommendations for the study and enhancement of ethics for formal nurse leadership. (shrink)

ABSTRACT:This article reviews four key orientations in environmental ethics that range from an instrumental understanding of sustainability to one that acknowledges the intrinsic value of sustainable behavior. It then shows that the current scholarly discourse around corporate sustainability management—as reflected in environment management, corporate social responsibility, and corporate political activity —mostly favors an instrumental perspective on sustainability. Sustainable business practices are viewed as anthropocentric and are conceptualized as a means to achieve competitive advantage. Based on these observations, we speculate about (...) what corporate sustainability management might look like if it applied ethical orientations that emphasize the intrinsic value of nature. This discussion also includes an introduction to two articles in this special section focused on the role of the environmental manager and sustainability standards, both of which offer paths for incorporating intrinsic valuation of the environment into sustainability management. (shrink)

_Business Ethics and the Natural Environment_ examines the present status of relations between corporate enterprise and the natural environment in the world today. •Discusses such questions as: What obligations does a corporation have toward the environment? To respect entities unprotected by law? To care about future generations? •Argues that environmentally-friendly business practices yield dividends exceeding expectations, and that the competitive firm of the 21st century will follow “green” standards •Provides a background in ethics, a survey of business ethics, an account (...) of environmental philosophy, an overview of environmental legal issues, and an account of the problems associated with globalization. (shrink)

When there are disasters in our society, whether on an individual, organizational or systemic level, individuals or groups of individuals are often singled out for blame, and commonly it is assumed that the alleged culprits engaged in deliberate misdeeds. But sometimes, at least, these disasters occur not because of deliberate malfeasance, but rather because of complex organizational and systemic circumstances that result in these negative outcomes. Using the Boeing Corporation and its 737 MAX aircraft crashes as an example, this ethical (...) analysis will examine some of the organizational problems that led to changes in management in Boeing and ultimately resulted in the fatal accidents. We will examine ethical blind spots within the company that led to the deadly accidents, and we will study the kinds of circumstances that are particularly acute in organizations such as Boeing, and which contributed to the malfunctions in the 737 MAX and the two resulting crashes. The Boeing 737 MAX example is not a singular case, but rather shares similarities with other engineering disasters such as the Challenger and Columbia explosions, and the ignition switch failures at General Motors each of which seem to have been at least partly the result of organizational shortcomings involving a compromise in commitment to safety. These parallels lead us to conclude that organizational malfeasance poses a serious ethical challenge for engineers and their organizations. We will conclude with some tentative suggestions for avoiding such tragic incidents in the future. (shrink)

_Business Ethics and the Natural Environment_ examines the present status of relations between corporate enterprise and the natural environment in the world today. •Discusses such questions as: What obligations does a corporation have toward the environment? To respect entities unprotected by law? To care about future generations? •Argues that environmentally-friendly business practices yield dividends exceeding expectations, and that the competitive firm of the 21st century will follow “green” standards •Provides a background in ethics, a survey of business ethics, an account (...) of environmental philosophy, an overview of environmental legal issues, and an account of the problems associated with globalization. (shrink)

Robert Solomon has usefully set forth the outlines of an ontology of ethics for the employee. I seize upon three of the insights in his paper-specifically, relating to employee role, social nature, and virtue-and develop them along Aristotelean lines, showing along the way how classic "dilemmas" of the business ethics literature can be recast as problems of employee character and virtue.

Late in 1990, the Center for the Study of Ethics in the Professions at Illinois Institute of Technology (lIT) received a grant of more than $200,000 from the National Science Foundation to try a campus-wide approach to integrating professional ethics into its technical curriculum.! Enough has now been accomplished to draw some tentative conclusions. I am the grant's principal investigator. In this paper, I shall describe what we at lIT did, what we learned, and what others, especially philosophers, can learn (...) from us. We set out to develop an approach that others could profitably adopt. I believe that we succeeded. (shrink)

The contributors to this volume cover a wide range of philosophers, from Simplicius to John Wyclif, and philosophical problems, including: the harmony of ...

The eight pieces constituting this Meeting Report are summaries of presentations made during a panel session at the 2011 Association for Practical and Professional Ethics (APPE) annual meeting held between March 3rd and 6th in Cincinnati. Lisa Newton organized the session and served as chair. The panel of eight consisted both of pioneers in the field and more recent arrivals. It covered a range of topics from how the field has developed to where it should be going, from identification of (...) issues needing further study to problems of training the next generation of engineers and engineering-ethics scholars. (shrink)

This chapter contains section titled: Introduction: How Brent Spar Changed the Rules The Brent Spar was not Alone: Two Sentinel Cases What is Going on? The Power Shift Third Sector, Global Civil Society Dealing with Attacks from CSOs Challenges for the CSOs The Ultimate Hope for the CSOs Case 7: Monsanto and the Genetically Modified Organisms Notes.

This paper evaluates whether and to what extent modal constraints on knowledge or the semantics of ‘knows’, which make essential reference to what goes on in other possible worlds, can be considered non-epistemic factors with epistemic significance. This is best understood as the question whether modal factors are non-truth-relevant factors that make the difference between true belief and knowledge, or to whether a true belief falls under the extension of ‘knowledge’ in a context, where a factor is truth-relevant with respect (...) to S’s belief that P iff it bears on the probability that P is true. To the extent that these factors are non-epistemic, epistemologies that endorse them—modal epistemologies—stand in conflict with intellectualism. I focus on three modal epistemologies: safety, sensitivity, and David Lewis’s epistemic contextualism. I argue that prima facie, safety and sensitivity allow that non-epistemic changes in a context can shift the closeness ordering on worlds, and in so doing make a difference to whether S knows P, while Lewis’s contextualism allows that non-epistemic changes in a context can shift the relevant domain of not-P possibilities that must be eliminated for ‘S knows P’ to be true in that context. Then to make her theory compatible with intellectualism, the modal epistemologist must say much more about the notion of probability at play in the definition of ‘truth-relevant’. I suggest that either accepting or rejecting that modal epistemologies are intellectualist has significance consequences for debates between pragmatists and purists, which radiate into wider contemporary epistemology. (shrink)

Is good morality the natural outcome of profitable business practices? The thesis explored here is one version of the recent literature on corporate culture, typified by the bestselling In Search of Excellence — that the corporation that creates a strong culture, one that best serves the customer, the product, and the employee, must also be profitable. The thesis turns out to have an historical parallel in Plato's Republic (subtitled, I suppose, In Search of Justice). Parallel virtues can be worked out (...) for state and corporation. In the end, profitability turns out not to be a necessary consequence of excellence, just as Plato's Ideal state turned out to be mortal. (shrink)

There is increasing emphasis on the need for collaboration between practice and academic leaders in health care research. However, many problems can arise owing to differences between academic and clinical goals and timelines. In order for research to move forward it is important to name and address these issues early in a project. In this article we use an example of a participatory action research study of ethical practice in nursing to highlight some of the issues that are not frequently (...) discussed and we identify the impact of things not-named. Further, we offer our insights to others who wish to be partners in research between academic and practice settings. These findings have wide implications for ameliorating misunderstandings that may develop between nurse leaders in light of collaborative research, as well as for participatory action research. (shrink)

A casebook in environmental ethics that presents the classic cases with adequate detail so the students experience real situations in order to learn how serious and complex the issues are. The authors present a balanced, impartial account of these events that will interest and challenge students.

Accountability is viewed as a civilizing element in society, with professional accountability formalized in most cases as duties dating to the Greeks and Socrates; journalists must find their own way, without formal professional or government regulation or licensing. Three scholars look at the process in a line from the formal professional discipline to suggesting problems the journalism fraternity faces without regulation to suggesting serious internal ethics conferences as 1 solution to the problem.

In a hyper-consuming society, what questions should we ask ourselves as we survey the increasingly crowded planet on which we find ourselves? What are the moral effects of living amid unprecedented material plenty? With David Crocker, Lisa Newton, and Judith Lichtenberg.

In this paper, I examine Scotus’s claim that the categories are the subject of a propter quid science. In order to see the significance of this claim, I first trace the development of the idea that the categories are the subject of a science from Martin of Denmark, Peter of Auvergne, and Simon of Faversham. I then turn toDuns Scotus’s account of the categories as the subject of a propter quid science. Throughout the discussion, I concentrate on the fundamental problems (...) confronting anyone who claims that there is a science of the categories: namely, how they, being ten, can have an appropriate unity. Scotus, as we will see, will answer this problem by claiming that the intellect causes a greater unity in second intentions than the corresponding unity that exists in the world. As a consequence, Scotus contends that the categories are the subject of a propter quid science, one that is radically different from the science of metaphysics. (shrink)

In all the criticisms that have shadowed the financial industry in recent years, the burden seems to be, that the reckless (as opposed to malicious) bankers too often took money of which they were the appointed stewards, and used it for speculation, especially in junk bonds. AsShaheen Borna and James Lowry argue in their "Gambling and Speculation" (the only article on gambling that I was able to raise on my computer) business speculation is probably wrong, since it is very like (...) gambling, which everyone knows is wrong. But why is gambling wrong? Ifwe, as the ethicists of business, are to adopt an uncharacteristically judgmental posture toward the most venerable American institutions, occupying the tallest and closest of American buildings, by calling their residents "gambIers," then surely we ought to be able to provide an account of the blameworthiness of gambling itself. That, at any rate, is the challenge I set myself for this paper. (shrink)

In all the criticisms that have shadowed the financial industry in recent years, the burden seems to be, that the reckless (as opposed to malicious) bankers too often took money of which they were the appointed stewards, and used it for speculation, especially in junk bonds. AsShaheen Borna and James Lowry argue in their "Gambling and Speculation" (the only article on gambling that I was able to raise on my computer) business speculation is probably wrong, since it is very like (...) gambling, which everyone knows is wrong. But why is gambling wrong? Ifwe, as the ethicists of business, are to adopt an uncharacteristically judgmental posture toward the most venerable American institutions, occupying the tallest and closest of American buildings, by calling their residents "gambIers," then surely we ought to be able to provide an account of the blameworthiness of gambling itself. That, at any rate, is the challenge I set myself for this paper. (shrink)

Moral imagination is a central component of moral agency and person‐centred care. Becoming moral agents who can sustain attention on patients and their families through their illness and suffering involves imagining the other, what moral possibilities are available, what choices to make, and how one wants to be. This relationship between moral agency, moral imagination, and personhood can be effaced by a focus on task‐driven technical rationality within the multifaceted challenges of contemporary healthcare. Similarly, facilitating students' moral agency can also (...) be obscured by the task‐driven technical rationality of teaching. The development of moral agency requires deliberate attention across the trajectory of nursing education. To prepare nursing students for one practice challenge, workplace violence, we developed a multimodal education intervention which included a simulated learning experience (SLE). To enhance the realism and consistency of the educational experience, 11 nursing students were trained as simulated participants (SP). As part of a larger study to examine knowledge acquisition and practice confidence of learners who completed the SLE, we explored the experience of being the SP through interviews and a focus group with the SP students. The SP described how their multiple performances contributed to imagining the situation ‘on both sides’ prompting empathy, a reconsideration of their moral agency, and the potential to prevent violence in the workplace beyond technical rational techniques, such as verbal de‐escalation scripts. The empirical findings from the SP prompted a philosophical exploration into moral imagination. We summarise the multimodal educational intervention and relevant findings, and then, using Johnson's conception of moral imagination and relevant nursing literature, we discuss the significance of the SP embodied experiences and their professional formation. We suggest that SLEs offer a unique avenue to create pedagogical spaces which promote moral imagination, thereby teaching for moral agency and person‐centred care. (shrink)

In a hyper-consuming society, what questions should we ask ourselves as we survey the increasingly crowded planet on which we find ourselves? What are the moral effects of living amid unprecedented material plenty? With David Crocker, Lisa Newton, and Judith Lichtenberg.

Does “business ethics,” as we have developed it in the United States, apply without change when business goes abroad? We argue that we cannot assume, in foreign nations (especially in the developing world), that the assumptions of U.S. business practice and business ethics hold without modification. An attempt to find a universally applicable ethic for global business results in the tentative formulation of “ten commandments” to guide the practice of business in the nations of the world.

This chapter contains sections titled: Introduction Toeing the line at the millennium Kyosei: Working together for the common good Crisis: danger and opportunity.

Everyone knows that somehow we must protect the natural environment as part of the ethical imperatives of doing business, especially in the era of globalization of business. But where, actually, do we find the structure of ethical imperatives that will support that “must”? The drawbacks of several candidates, some of them discussed in papers elsewhere in this volume, are considered, then supplemented with the Japanese concept of kyosei as supplying a missing link between ethics and the land. In the end, (...) some questions are raised about the possibility of success of the entire environmental enterprise in face of the provisions of global trade agreements. (shrink)

Everyone knows that somehow we must protect the natural environment as part of the ethical imperatives of doing business, especially in the era of globalization of business. But where, actually, do we find the structure of ethical imperatives that will support that “must”? The drawbacks of several candidates, some of them discussed in papers elsewhere in this volume, are considered, then supplemented with the Japanese concept of kyosei as supplying a missing link between ethics and the land. In the end, (...) some questions are raised about the possibility of success of the entire environmental enterprise in face of the provisions of global trade agreements. (shrink)