A historical understanding of the virtue of consolation, as contrasted to empathy, compassion, or sympathy, is developed. Recent findings from neuroscience are presented which support and affirm this understanding. These findings are related to palliative care and its current practice in bioethics.

This paper focuses on how online health forums may benefit the wellbeing of caregivers. An online questionnaire of caregivers assessed caregiver strain, forum use, and mental and physical wellbeing. Results show a positive relation between caregiver strain and using online health forums to seek emotional support. Furthermore, we find that caregivers with higher levels of caregiver strain report lower mental and physical wellbeing. This relation is however moderated by using online health forums. While the amount of time spent on the (...) online forums did not moderate the relation between caregiver strain and wellbeing, the amount of activity did: Active participation in online health forums attenuates the negative effect of caregiver strain on wellbeing.These findings suggest that online forums are valuable for caregivers and that it is active contribution that matters, rather than simply visiting the online health groups. (shrink)

A peer commentary on an AJOB article by Kyle Fritz called "Unjustified Asymmetry: Positive Claims of Conscience and Heartbeat Bills.".

The belief in miracle, as a modality of spiritual/religious coping strategy in the face of stress and psychic suffering, has been discussed in psychological literature with regard to its positive or negative role on the health and well-being of patients and family members. In contemporary times, where pseudo-conflicts between religion and science should have been long overcome, there is still some tendency of interpreting belief in miracle – as the possibility of a cure granted by divine intervention, modifying the (...) normal course of events in a bleak medical diagnosis – as having unhealthy impacts in the care and treatment of health. This position seeks to find a base in the three characteristics of hoping in a miracle, frequently pointed out by psychological literature: it would imply a negation of reality instead of its confrontation; it would be a coping strategy focused on emotion instead of the problem; it would imply seeking to modify the supposed desire of God by extra-natural facts. In this study, we shall critically discuss this position and the dangers of its crystallization by the use of SRC scales in which the act of praying for a miracle is previously classified as a negative strategy. We revisit some tendencies in psychological literature about the subject, taking into consideration the various facets of miracle, sociocultural facts, elements of idiographic nature, and their profound outcomes in the lives of people especially in health contexts. We illustrate the dangers of a hasty generalization of the results of nomothetic studies about the role of belief in miracle with two examples of research in the Brazilian context: one carried out with pregnant women with fetal malformation and the other with family members caring for children and adolescents with cancer under chemotherapeutic treatment. In both studies, the results do not confirm the predominance of the negative aspects associated with the act of praying for a miracle, which we discuss and analyze in light of the phenomenological perspective. In this perspective, “pray for a miracle”, as experienced by patients and caregivers, can be recognized as an act of openness to life, bolstering hope, and the resignification of reality in the psyche. (shrink)

Employees’ felt neglect by their employer signals to them that their employer violates ethics of care, and thus, it diminishes employee perceptions of work meaning. Drawing upon work meaning theory, we adopt a relationship-based perspective of felt neglect and its downstream outcome— reduction in organizational citizenship behaviors (OCB) amid the COVID-19 pandemic. We propose and test a core relational mechanism— relatedness need frustration (RNF)—that transmits the effect of felt neglect onto work meaning. A four-wave survey study of 111 working (...) employees in the USA demonstrated that employees’ felt neglect had negative implications for their work meaning and subsequent OCB due to their RNF. Our findings contribute to research on ethics of care and work meaning theory and stress the importance of work meaning amid crises. In addition, our findings suggest steps that employers can take to mitigate employees’ felt neglect (a violation of ethics of care) and its negative ramifications. (shrink)

Using data from China, where the identity of engagement auditors is disclosed, we find significant relationships between engagement auditors’ negative experiences and the costs of corporate bonds. Further tests differentiate field and review auditors’ experiences, and we find that both field and review auditors’ negative experiences are significantly related to higher costs of corporate bonds. In addition, we find that the above results are significant only when the engagement auditors are affiliated with non-Big10 audit firms. Using path analysis, (...) we find that credit rating is a possible channel through which information on engagement auditors’ negative experiences can transfer to bond investors. Regarding non-price terms, we conclude that engagement auditors with negative experiences are associated with smaller bond sizes, shorter bond maturities, a higher likelihood of requiring collateral, and more restrictive covenants. Further analyses also show that the effects of engagement auditors’ negative experiences on the costs of corporate bonds are less pronounced for well-governed firms. To show that our results obtained from China’s corporate bond market are relevant to loan markets, we replicate the above tests using a Chinese sample, and the results from the loan market are consistent with those from the corporate bond market. Overall, our empirical results suggest that investors are indeed concerned with engagement auditors’ negative experiences. (shrink)

Negative prognostic communication is often delayed in intensive care units, which limits time for families to prepare for end‐of‐life. This descriptive study, informed by ethnographic methods, was focused on exploring critical care physician communication of negative prognoses to families and identifying timing influences. Prognostic communication of critical care physicians to nurses and family members was observed and physicians and family members were interviewed. Physician perception of prognostic certainty, based on an accumulation of empirical data, and (...) the perceived need for decision‐making, drove the timing of prognostic communication, rather than family needs. Although prognoses were initially identified using intuitive knowledge for patients in one of the six identified prognostic categories, utilizing decision‐making to drive prognostic communication resulted in delayed prognostic communication to families until end‐of‐life (EOL) decisions could be justified with empirical data. Providers will better meet the needs of families who desire earlier prognostic information by separating prognostic communication from decision‐making and communicating the possibility of a poor prognosis based on intuitive knowledge, while acknowledging the uncertainty inherent in prognostication. This sets the stage for later prognostic discussions focused on EOL decisions, including limiting or withdrawing treatment, which can be timed when empirical data substantiate intuitive prognoses. This allows additional time for families to anticipate and prepare for end‐of‐life decision‐making. (shrink)

Background Moral distress has negative effects on physical and mental health. However, there is little information about nurses’ coping strategies reducing moral distress. Aim The purpose of this study was to investigate the coping strategies of intensive care unit nurses reducing moral distress in Iran. Study design This is a qualitative study with a content analysis approach. Participants and research context The research sample consisted of nurses working in intensive care units of teaching hospitals affiliated to Tehran (...) University of Medical Sciences. Samples were selected among eligible nurses by purposive sampling. Data were obtained through 17 in-depth, individual, and semi-structured interviews with 17 nurses. Graneheim and Lundman’s (2004) 6-step content analysis method was used to analyze the data. Data management was also performed by MAXQDA software version 20. The COREQ checklist was used to report the study. Ethical considerations This project was approved by the Ethics Committee of Tehran University of Medical Sciences. All ethical guidelines in research were followed. Finding The data analysis resulted in the formation of two main categories of desirable coping strategies (with two subcategories of compensation and rejuvenation) and less desirable coping strategies (with three subclasses of indifference over time, escape and concealment). Discussion The intensive care unit nurses in dealing with ethical problems first try to solve the problem through discussion, but when they fail to resolve it peacefully, they resort to several coping strategies. Factors, such as increasing experience, lack of support from hospital managers and officials, poor communication between colleagues, the need to maintain hierarchy, fear of reprimand, and a sense of powerlessness, changed the nurses’ preferred strategies. It is important for managers to provide a blame/punishment-free atmosphere for expression of ethical experiences; a supportive atmosphere in which staff can engage in ethical discussions without fear of punishment. They should also provide opportunities for rest, rejuvenation, and adequate training for their employees. (shrink)

Bernard Stiegler works systematically through the current crisis in education and family relations resulting from the mesmerizing power of marketing technologies. He contends that the greatest threat to social and cultural development is the destruction of young people's ability to pay critical attention to the world around them. This phenomenon, prevalent throughout the first world, is the calculated result of technical industries and their need to capture the attention of the young, making them into a target audience and reversing the (...) relationship between adults and children. _Taking Care_ exposes the carelessness of these industries and urges the reader to re-enter the "battle for intelligence" against the drive-oriented culture of short-term attention characteristic of the negative aspects of the new technologies. Long-term attention, Stiegler shows, produces retentions of cultural memory mandatory for social development—and for the counteracting of ADD and ADHD. Examining the history of education from Plato to the current quagmires in France and the United States, he tracks the notion of critical thinking from its Enlightenment apotheosis to its current eradication. Stiegler is unique in combining the most radical of theoretical constructs—such as "grammatization"—with quite traditional values, values he proposes we re-address in our not-so-brave new world. (shrink)

These are strange and unprecedented times in the wake of the COVID-19 pandemic. Most frontline healthcare professionals have never witnessed anything like this before. As a result, staff may experience numerous and continuous traumatic events, which in many instances, will negatively affect their psychological well-being. Particularly, nurses face extraordinary challenges in response to shifting protocols, triage, shortages of resources, and the astonishing numbers of patients who require care in expedited time constraints. As most healthcare workers are passionate nursing professionals, (...) frustration and often a sense of powerlessness occur when they find themselves unable to provide needed care to their patients. The overwhelming number of deaths, patients isolated and dying alone, and the ever-present fear of being infected and then infecting colleagues, family, friends due to the lack of protective gear or known protocols takes its toll on emotional and psychological well-being. For nurses, the experience of this significant (hopefully once-in-a-lifetime) event can inflict on-going moral injury. Nurses affected by this trauma require education, coping tools, and therapy to help avoid or alleviate the adverse effects on their well-being. Institutions must provide these resources to tend to the well-being of their healthcare staff, during and beyond the pandemic. This article aims to investigate moral distress—considering it as a moral injury—and offer tools and recommendations to support healthcare nurses as they respond to this crisis and its aftermath. (shrink)

The ArgumentSome have claimed that negative genetic interventions are morally permissible while positive ones are not, but the distinction cannot be used to draw this moral boundary. Underlying the negative/positive distinction is a distinction between treatment and enhancement. The treatment/enhancement distinction at best provides an imperfect guide to which health care services we are obliged to provide and which we are not. It offers only some “warning flags” to help us think about what is permissible or not.

Studies of creative industries typically contend that creative work is profoundly precarious, taking place on a freelance basis in highly competitive, individualized and contingent labour markets. Such studies depict creative workers as correspondingly self-enterprising, self-reliant, self-interested and calculative agents who valorise care-free independence. In contrast, we adopt the ‘ethics of care’ approach to explore, recognize and appreciate the communitarian, relational and moral considerations as well as interpersonal connectedness and interdependencies that underpin creative work. Drawing on in-depth interviews with (...) creative workers in a range of marginal socio-cultural contexts, we argue that creative workers cultivate and sustain a diverse array of practices of care arising from an affective concern with the well-being of others. Far from being merely individualistic and crudely competitive actors, creative workers enact practical ethical responsibilities and affectivities towards a range of human and non-human others, including families, local communities and neighbourhoods, colleagues, artistic scenes and their adjacent genres, and surrounding national and linguistic cultures. In emphasizing the fundamental and structuring role of care in contingent labour markets our approach accords with recent trends in the social sciences that ‘affirmatively’—as opposed to ‘negatively’ and ‘suspiciously’—recognize that mutuality, solidarity and affectivity are powerful drivers of action on a par with or even exceeding market-driven self-centredness. (shrink)

""This book contains a careful, thorough, and where necessary skeptical as regards doubtful evidence (especially in the case of Plato and the Old Academy) of the beginnings in European thought of the negative or apophatic way of thinking and its relations to more positive or kataphatic ways of thinking about God. One of its greatest strengths, perhaps the greatest, is that the author makes clear that none of the persons concerned, Hellenic, Jewish or Christian, was engaged in the pursuit (...) of a philosophical abstraction, or the heaping of rhetorical superlatives on God. They were rather concerned to present the origin of the universe as an intimately present living reality which infinitely transcends our thought and speech. This, combined with careful attention to the varieties of negative theology and its relations with positive, and the particular difficulties experienced by the members of the various traditions involved, makes the book the best introduction to the negative theology available."" -A. H. Armstrong, Emeritus Professor of Greek, University of Liverpool, England. Emeritus Professor of Classics, Dalhousie University, Halifax, Nova Scotia, Canada. Senior Fellow of the British Academy. Irish academic Deirdre Carabine has lived and taught in Uganda for more than twenty years. She has recently been founder Vice-Chancellor at the Virtual University of Uganda (VUU), the first fully online university in Sub-Saharan Africa. Prior to that she set up International Health Sciences University in Kampala. She has taught at Queen's Belfast, University College Dublin, and Uganda Martyrs University. Currently, she is Director of Programmes at VUU. She attended the Queen's University of Belfast where she graduated with a PhD in philosophy, and University College Dublin where, as one of the first Newman Scholars, she gained a second PhD in Classics. She is also author of John Scottus Eriugena in the Great Medieval Thinkers Series (2000). (shrink)

Suffering repeated experiences of moral distress in intensive care units due to applications of futility reflects on nurses’ patient care negatively, increases their burnout, and reduces their job satisfaction. This study was carried out to investigate the levels of job satisfaction and exhaustion suffered by intensive care nurses and the relationship between them through the futility dimension of the issue. The study included 138 intensive care nurses. The data were obtained with the futility questionnaire developed by (...) the researchers, Maslach Burnout Inventory and Minnesota Satisfaction Questionnaire. It was determined that nurses who agreed to the proposition that the application of futility demoralizes health-care professionals had low levels of job satisfaction but high levels of depersonalization. It was determined that nurses had moderate levels of job satisfaction, emotional exhaustion, and personal achievements but high levels of sensitivity. Nurses’ job satisfaction and sensitivities are positively affected when they consider that futility does not contradict the purposes of medicine. (shrink)

When Carol Gilligan (1982) first introduced the ethic of care she did so from the discipline of psychology using empirical data that questioned Kohlberg's (1981) negative assumptions about the mora...

Most behavioral decision research takes place in carefully controlled laboratory settings, and examination of relationships between performance and specific real-world decision outcomes is rare. One prior study shows that people who perform better on hypothetical decision tasks, assessed using the Adult Decision-Making Competence (A-DMC) measure, also tend to experience better real-world decision outcomes, as reported on the Decision Outcomes Inventory (DOI). The DOI score reflects avoidance of outcomes that could result from poor decisions, ranging from serious (e.g., bankruptcy) to minor (...) (e.g., blisters from sunburn). The present analyses go beyond the initial work, which focused on the overall DOI score, by analyzing the relationships between specific decision outcomes and A-DMC performance. Most outcomes are significantly more likely among people with lower A-DMC scores, even after taking into account two variables expected to produce worse real-world decision outcomes: younger age and lower socio-economic status. We discuss the usefulness of DOI as a measure of successful real-world decision making. (shrink)

Research on emotion and health has tended to focus on the negative consequences of “negative” emotions. An emerging literature has begun to explore the positive aspects of negative affect, suggesting that emotion be treated in a more differentiated way by recognising the components and intensity that can promote or harm health. For example, short bursts of emotion-associated sympathetic activation can stimulate parts of the immune system, whereas more chronic activation can cause “wear and tear” on the cardiovascular (...) system. Anxiety and guilt have been associated with preventive health behaviours and care-seeking, whereas distress and depression increase symptom sensitivity, accuracy of illness perception, and can facilitate care-seeking and receipt of support. However, intense and chronic negative affects may lead individuals to engage in risky health behaviours, such as substance abuse, overeating, and high risk sex, as a coping mechanism to regulate negative emotion. They may also undermine social support systems, leading to a self-perpetuating cycle of conflict and isolation. Future research must address the parameters defining “healthy” and “unhealthy” negative emotion. (shrink)

Background: Not all patients are considered equal. For patients who are considered to be “very important persons,” care can be different from that of other patients with advantages of greater access to resources, special attention from staff, and options for luxurious hospital amenities. While very important person care is common and widely accepted by healthcare administration, it has negative implications for both very important person and non-very important person patients, supports care disparities and inequities, and can (...) create serious ethical dilemmas for healthcare professionals. Very important person care can also result in negative care outcomes for its recipients. Objective: This article sought to explore the implications and ethical considerations of very important person care within the context of United States healthcare system, and integrate bioethical principles and American Nurses Association Code of Ethics for Nurses to influence recommendations for managing ethical dilemmas associated with very important person care. Method: A synthesis of the literature on very important person care was undertaken for this article. Ethical considerations: Ethical conduct was considered and respected when performing the literature review, referencing sources, and establishing authorship. Findings: According to the published literature, very important person care bares both positive and negative implications for patients, and negative implications for nurses. Nurses are the most affected by the demands from their administrators to provide special care and attention to patients in the “very important person” category and their families. Very important person care can be disruptive, disorienting, challenging, and stressful to nurses. Conclusion: While physicians and other healthcare professionals have commented on very important person care, limited work has been done in nursing. There have not been any empirical studies on very important person care. Therefore, in order to minimize the negative implications of very important person care, studies of this phenomenon are warranted. Exposing very important person care is important in the development of an ethical healthcare system. Moreover, understanding the ethical principles surrounding the concept of very important person care will empower nurses to effectively manage conflicts and ethical dilemmas that arise with very important person care. (shrink)

In this paper, the establishment of "modern" features, as subjectivity, representation and rational, and thus a concise statement of the post-modern critique of modernity, questioned and denied, in order to outline the negative characteristics of post-modern micro. However, more importantly, this will be more committed to master the modern mark out exactly what is very different from the new vision of modernity, made ​​any new way of life and ethical principles. This claim, post-modern addition to the challenge of modernity, (...) critical and negative, but also made ​​a positive value and vision. In other words, the "postmodern" will not just be a negative concept, puts a positive concept, can provide a positive value and ethical life. Which were open to him, to him who care for him who, for his generous and selfless person, and in which the pottery into the self, will be a future source of ethical principles and values ​​of life. Moreover, the rise of art from the post-modern sense of the sublime, it will be innovative and more importantly, aesthetic value, or is linked religious, ethical and artistic value of the key. Finally, out for the post-modern dualistic thinking, while offering more serious plight of relativism, we are trying to address the use of comparative philosophy, the problem of dualism, and advocated the micro-world and multi-cultural world, the ongoing language extrapolated to take and mutual learning, as a solution to relativism, to promote mutual understanding and a wealth of positive way. (shrink)

Background:Psychological abuse of older people is difficult to recognise; specifically, nursing home residents have been documented to be at higher risk of psychological abuse during daily care, such as during feeding. Healthcare professionals adopt positive and negative verbal prompts to maintain residents’ eating independence; however, negative prompts’ purposes and implications have never been discussed to date.Research aims:To critically analyse negative verbal prompts given during mealtimes as forms of abuse of older individuals and violation of ethical principles.Research (...) design:This is a secondary analysis of three cases of negative prompts that emerged in a large descriptive study based upon focus group methodology and involving 13 nursing homes and 54 healthcare professionals.Participants and research context:This study included 3 out of 13 nursing homes caring for residents with moderate/severe functional dependence in self-feeding mainly due to dementia; in these nursing homes, we conducted three focus groups and 13 healthcare professionals participated.Ethical considerations:This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines after being approved by the Review Board of the Trust.Findings:With the intent of maintaining self-feeding independence, negative verbal prompts have been reported as being used by nursing home teams. By critically analysing these negative prompts, it turned out they could trigger intimidation, depression and anxiety and thus could be considered as forms of abuse; moreover, negative prompts can threaten the ethical principles of autonomy using a paternalist approach, beneficence and non-maleficence as with the intent to act in the best interests of residents they are harmed in their dignity and justice, given that residents who received negative prompts are treated differently from those who received positive prompts.Discussion:Eating should be a pleasant experience with a positive impact on physiological, psychological and social well-being. However, negative prompting can lead to abuse and violation of basic ethical principles, destroying the healthcare professional resident and relative relationships strongly dependent on trust.Conclusion:Negative verbal prompting must be avoided. (shrink)

Abstractabstract:This study examines the origin and religious roots of taegyo, Korean traditional prenatal education, and raises concerns about potential negative impacts of contemporary taegyo practice from feminist and disability perspectives. Taegyo has been accepted without much criticism due to its deep integration into prenatal care culture, and most existing literature focuses on taegyo's positive impacts on fetal health and development from scientific or nursing perspectives. This article analyzes a 19th-century taegyo manual, Taegyo Singi, and Seon and Won Buddhist (...) literatures on taegyo in order to understand the religio-cultural concepts and contexts of taegyo. The article then discusses the potential downsides of taegyo practice today, considering its patriarchal, mother-blaming, ablest roots in Korean history and culture. The author raises concerns about social oppression, the control of women's bodily autonomy, and the disproportionate responsibility burden that taegyo places on Korean women. The article concludes with suggestions for future research and for well-balanced taegyo practice. (shrink)

BackgroundThe nursing profession requires ethical and legal regulations to guide nurses’ performance. Ethical climate plays a part in shaping nurses’ ethical practice. Therefore, ethico-legal aspects and ethical climate contribute to improving nurses’ ethical practice and competencies with reducing medical errors in hospital settings.ObjectiveThis study examined the effect of ethico-legal aspects and ethical climate on managing safe patient care and medical errors among nurses.Materials and methodsA cross-sectional correlational study was carried out on 548 nurses. Data were collected through self-administered questionnaires (...) about nurses’ knowledge in both ethical and legal aspects, ethical practice, competencies, ethical climate and experience with medical error.ResultsThe main sources of nurses’ knowledge of ethical and legal aspects were undergraduate lectures, job experience and colleagues. Nurses’ knowledge in both ethical and legal aspects, nurses’ ethical practice and competencies were insufficient. Nurses fairly perceived their ethical climate. Also, nurses experienced medical errors about 22.6% in their units. Nurses’ knowledge of ethical and legal aspects, as well as the ethical climate were positive predictors of inadequate nurses’ ethical practice and competencies. Additionally, nurses’ knowledge in both ethical and legal aspects, ethical climate and practice had a negative influence on the occurrence of medical errors.ConclusionEnhancing nurses’ knowledge in both ethical and legal aspects as well as ethical climate could significantly influence improving nurses’ ethical practice, competencies and reducing medical errors in the study units. Therefore, planning for enhancing the nurses’ ethico-legal learning and ethical climate seems to be mandatory. (shrink)

There have been a variety of arguments over the decades both for and against syntactic Neg Raising. Two recent papers :559–576, 2018; Crowley in Nat Lang Semant 27, 1–17, 2019) focus on the interaction of NR effects with ellipsis. These papers examine similar types of data, but come to opposite conclusion: Jacobson shows that the ellipsis facts provide evidence against syntactic NR, whereas Crowley argues in favor of syntactic NR. The present paper revisits the evidence, showing that the key case (...) in Crowley that he uses to argue for syntactic NR contains a confound, while the broader set of evidence in Jacobson continues to support the non-syntactic account. In addition, I reply here to an argument for syntactic NR due originally to Prince and Smaby and elaborated on by Crowley. The key generalization can be shown to disappear once contexts are carefully controlled for. Moreover, Crowley extends the Prince/Smaby argument to show that no inference-based account of NR can survive, but this conclusion rests on the claim that there are cases where ever is vacuous; I show that this is not the case. I also consider the question—discussed in much previous literature—of why under the syntactic approach to NR the class of predicates allowing NR is limited to just those which easily support an Excluded Middle inference. Crowley attempts to provide a principled explanation, speculating that NR is allowed just in case it is ‘semantically vacuous’. I argue that this proposal is problematic and so the challenge to syntactic approaches remains. Finally, I provide a new argument against syntactic NR which centers on the behavior of guess. (shrink)

Background:It is stated that high ethical sensitivity positively affects the quality of nursing care. However, the relationship between nursing care quality and ethical sensitivity has not been clearly demonstrated in researches.Aim:This study was carried out to determine the relationship between surgical nurses’ care behaviors and their ethical sensitivity.Method:The sample of this cross-sectional, descriptive-correlational study consists of 308 nurses who worked at the surgical departments in four Turkish hospitals. The data were collected using the “Nurse Description Form” developed (...) by the researcher, “Caring Behaviours Inventory-24” and “Ethical Sensitivity Questionnaire.” Data were evaluated by the Mann Whitney U test, Kruskal Wallis one-way analysis of variance and Spearman correlation analysis.Ethical considerations:The study was approved by the ethics committee. Verbal and written consent was received from the nurses.Results:It was found in the study that nurses’ Caring Behaviours Inventory-24 total score median was 5.25 (4.83–5.58), nurses’ perception level of caring quality was high, median of Ethical Sensitivity Questionnaire total score was 89.00 (75.00–101.00) and nurses’ ethical sensitivity was moderate. A negative significant relation was found between nurses’ Caring Behaviours Inventory-24 total score and Ethical Sensitivity Questionnaire total score (r = -0.162; p = 0.009). A negative relation was also detected between nurses’ working period at the current clinic and providing benefit (r = -0.147; p = 0.012), holistic approach (r = -0.139; p = 0.018) and orientation (r = -0.175; p = 0.003) scores of Ethical Sensitivity Questionnaire sub-scales.Conclusion:Nurses’ perception levels of caring quality were high and their ethical sensitivity levels were moderate. It was found out that nurses’ ethical sensitivity increased together with their perception of caring quality, and as their working period at the current clinic increased, the ethical sensitivity also increased in terms of the sub-scales of providing benefit, holistic approach, and orientation. The factors that adversely affect the quality of nursing care and ethical sensitivity should be examined and attempts should be made to improve the working environment. (shrink)

The current U.S. health care system, with both rising costs and demands, is unsustainable. The combination of a sense of individual entitlement to health care and limited acceptance of individual responsibility with respect to personal health has contributed to a system which overspends and underperforms. This sense of entitlement has its roots in a perceived right to health care. Beginning with the so-called moral right to health care, the issue of who provides health care has (...) evolved as individual rights have trumped societal rights. The concept of government providing some level of health care ranges from limited government intervention, a ‘negative right to health care’, to various forms of a ‘positive right to health care’. The latter ranges from a decent minimum level of care to the best possible health care with access for all. We clarify the concept of legal rights as an entitlement to health care and present distributive and social justice counter arguments to present health care as a privilege that can be provided/earned/altered/revoked by governments. We propose that unlike a ‘right’, which is unconditional, a ‘privilege’ has limitations. Going forward, expectations about what will be made available should be lowered while taking personal responsibility for one’s health must for elevated. To have access to health care in the future will mean some loss of personal rights and an increase in personal responsibility for gaining or maintaining one’s health. (shrink)

A negative image of community care prevails. This method of care is perceived to be a relatively novel phenomenon and has received mixed media coverage. The negative image of community care has led to the growing belief that this care method has failed. This failure has largely been ascribed to the lack of powers available to control patients in the community and to the method's relative novelty. However, this paper contends that there are two (...) flaws to the above assertion: first, community care is far from new, and second, the inherent problem is not the lack of powers available to control patients in the community, but, essentially, the absence of a secure and stable environment within the community. (shrink)

The law has therefore had two conflicting impacts on medical ethics: the positive effect of eroding paternalism and replacing it with a patient-centered ethic; and the negative effect of encouraging physicians to be more concerned with avoiding litigation than doing the "right" thing.

In almost all cultures, intriguingly, care has both positive and negative connotations as in taking care of something or somebody and, at the same time, carrying the burden of something or somebody...

: Although there are important aspects of ecofeminist valuations of women's caring, a greater degree of skepticism than is now found in ecofeminist scholarship is in order. In this article I argue that there are political risks in celebrating women's association with caring, as both an ethic and a practice, and in reducing women's ethico-political life to care. I support this position by drawing on the work of feminist theorists who argue that the positive identification of women with caring (...) ought to be treated cautiously for it obscures some of the negative implications of feminized care and narrows our understanding of women as political actors. I explain why I think ecofeminists would be better served by using feminist theories of citizenship to understand and interpret women's engagement in politics. (shrink)

Although there are important aspects of ecofeminist valuations of women's caring, a greater degree of skepticism than is now found in ecofeminist scholarship is in order. In this article I argue that there are political risks in celebrating women's association with caring, as both an ethic and a practice, and in reducing women's ethico-political life to care. I support this position by drawing on the work of feminist theorists who argue that the positive identification of women with caring ought (...) to be treated cautiously for it obscures some of the negative implications of feminized care and narrows our understanding of women as political actors. I explain why I think ecofeminists would be better served by using feminist theories of citizenship to understand and interpret women's engagement in politics. (shrink)

In their paper, Romanis and Adkins delve into the potential impact of artificial amnion and placenta technology (AAPT) on cases of pregnancy loss1 that do not involve procreative loss. First, they call for more recognition of the negative feelings a person might have due to the premature end of their pregnant state. They claim that, should AAPT minimise concerns about prematurity as anticipated, individuals might feel pressured to opt for partial ectogestation to preserve their or their fetus’ well-being; moreover, (...) they point out that the feelings of loss in the context of AAPT are likely to be worse than the ones reported in neonatal intensive care units cases. Finally, they advocate for care pathways focusing on how the transfer of a fetus to the AAPT could affect the pregnant person, with particular attention to managing the grief potentially caused by the pregnancy loss. I praise the authors for such a call to action—especially since partial ectogestation is expected to become a reality in the short-term future—and I share their demands for additional and more attentive care of (formerly) pregnant patients. However, I am concerned that their approach is so focused on negative feelings towards pregnancy loss that it risks becoming …. (shrink)

Moral distress has been the subject of extensive research and debate in the nursing ethics literature since the mid-1980s, but the concept has received comparatively little attention from those working outside of applied ethics. In this article, I defend a care ethical account of moral distress, according to which the phenomenon is the product of an agent’s inability to live up to one of her caring commitments. This account has a number of attractions. First, it places a greater emphasis (...) on the importance of the relationship between the caregiver and her cared-for than that found in previous accounts. Second, it does not make problematic assumptions about the correctness of a caregiver’s moral judgments, as has been claimed in relation to previous accounts of moral distress. Finally, my account allows for a clear conceptual distinction to be drawn between moral distress and other forms of negative moral emotion such as guilt and regret. Earlier accounts draw this distinction by appealing to the causal aetiology of moral distress, but as I show here, such appeals are ultimately unsuccessful unless they are made from an explicitly care ethical starting point. One of the implications of my account is that moral distress has the potential to occur in the context of any caregiving relationship. This claim is explored in the final section of the paper, in relation to student-teacher and parent-child caregiving. (shrink)

The dramatic appearance of managed care organizations (MCOs) on the U.S. health scene has generated tremendous anxiety among health care providers and patients. These fears are based on the belief that managed care techniques pose greater risks of under treatment than do fee-for-service modes of payment. In addition, many physicians and patients resent the limits placed on clinical autonomy by the MCO model and the stresses that it places on the traditional physician-patient relationship. These misgivings have been (...) exacerbated by the mostly negative response to MCOs in the media and academia. Legislatures have responded to these claims and public fears with a wave of regulatory initiatives. Some of these regulations are attempts to protect patients. Others, however, are motivated primarily by antipathy toward the concept of managed care itself. This essay is an attempt to develop a social ethic of regulation and argues that the sole reason that private enterprise may be justifiably limited is when it presents a risk of harm to others or society. While some regulation and proposed regulation of MCOs meet this standard, much legislation represents an unjustified attempt to limit or handicap otherwise legal behavior merely because a segment of the population and medical profession find it aesthetically unpleasing and oppose its approach to the delivery of health services. (shrink)

This paper explores citizens’ views about the welfare of farmed fish and the mental abilities of fish with a large survey data sample from Finland (n = 1,890). Although studies on attitudes towards animal welfare have been increasing, fish welfare has received only limited empirical attention, despite the rapid expansion of aquaculture sector. The results show that the welfare of farmed fish is not any great concern in the Finnish society. The analysis confirms the distinct character given to farmed fish (...) compared to traditional farmed animals. Salmon are rated low in their mental abilities, including the capacity to feel pain, which may weaken ethical concerns for fish welfare. When analyzing the social determinants surrounding the rating of the welfare of farmed fish, it was shown that fish welfare attitudes follow general animal welfare attitudes regarding age and place of residence as fish welfare tends to be rated more negatively among younger age groups and among urban residents. However, no clear connection could be identified between gender and the rating of fish welfare, which may suggest that the distinct cultural categorization of fish diminishes the typical gender difference identified in animal attitudes. It is concluded that in order to improve awareness about fish welfare, there is a need to increase dissemination of scientific knowledge about fish and their welfare. Moreover, further research should be directed toward studying the moral positioning of fish and the distinct moral categorization they receive. (shrink)

Kant's obscure essay entitled An Attempt to Introduce the Concept of Negative Quantities into Philosophy has received virtually no attention in the Kant literature. The essay has been in English translation for over twenty years, though not widely available. In his original 1983 translation, Gordon Treash argues that the Negative Quantities essay should be understood as part of an ongoing response to the philosophy of Christian Wolff. Like Hoffmann and Crusius before him, the Kant of 1763 is at (...) odds with the Leibnizian-Wolffian tradition of deductive metaphysics. He joins his predecessors in rejecting the assumption that the law of contradiction alone can provide proof of the principle of sufficient reason: -/- In his rejection of the possibility of deducing all philosophic truth from the law of contradiction, however, and in the clear recognition that this impossibility has immediate consequences for defense of the law of sufficient reason, Kant's work most definitely and positively constitutes a line of succession from Hoffmann and Crusius (Treash, 1983, p. 25). -/- The recognition that Kant's Negative Quantities essay is part of a response to the tradition of deductive metaphysics is, without a doubt, an important contribution to the Kant literature. However, there is still more to be said about this neglected essay. The full significance of the paper becomes known through its ties to a second, empiricist line of succession. Clues to this second line of succession can be found in Kant's prefatory remarks concerning Euler's 1748 Reflections on Space and Time and Crusius' 1749 Guidance in the Orderly and Careful Consideration of Natural Events. As I will show, these prefatory remarks suggest a reading of Kant's Negative Quantities paper that reaches beyond German deductive metaphysics to engage a debate regarding the application of mathematics in philosophy initiated by George Berkeley. (shrink)

Cases of poor care have been documented across the world. Contrary to professional requirements, evidence indicates that these sometimes go unaddressed. For patients, the outcomes of this inaction are invariably negative. Previous work has either focused on why poor care occurs and what might be done to prevent it, or on the reasons why those who are witness to it find it difficult to raise their concerns. Here, we build on this work but specifically foreground the responsibilities (...) of registrants and students who witness poor care. Acknowledging the challenges associated with raising concerns, we make the case that failure to address poor care is a breach of moral expectation, professional requirement and, sometimes, legal frameworks. We argue that reporting will be more likely to take place if those who wish to enter the profession have a realistic view of the challenges they may encounter. When nurses are provided with robust and applied education on ethics, when “real‐world” cases and exemplars are used in practice and when steps are taken to develop and encourage individual moral courage, we may begin to see positive change. Ultimately however, significant change is only likely to take place where practice cultures invite and welcome feedback, promote critical reflection, and where strong, clear leadership support is shown by those in positions of influence across organisations. (shrink)

The object of this essay is to explore the central role played by the ‘ethic of care’ in debates within and beyond feminist legal theory. The author claims that the ethic of care has attracted feminist legal scholars in particular, as a means of resolving the theoretical, political and strategic difficulties to which the perceived ‘crisis of subjectivity’ in feminist theory has given rise. She argues that feminist legal scholars are peculiarly placed in relation to this crisis because (...) of their reliance on the social ‘woman’ whose interests are the predominant concern of feminist legal engagement. With the problematisation of subjectivity, the object of feminist legal attention disappears and it is in attempts to deflect the negative political consequences of this that the ethic of care has been invoked, the author argues, unsuccessfully. The essay concludes with suggestions as to how the feminist project in law might proceed in the wake of the crisis of subjectivity and the failure of the ethic of care to resolve it. (shrink)

Abstractabstract:Being a parent is hard, particularly parenting adolescents, who need to be given choices and allowed the space to learn how to make choices for themselves, even when those choices result in negative consequences. This essay explores how Steven Sondheim and James Lapine's 1987 musical Into the Woods provides relatable stories of the challenges of being a parent, the challenges of parenting adolescents, and just how messy parents and families can be despite everyone trying their best. The stories of (...) Little Red Riding Hood, Rapunzel, Jack, and Cinderella show us various stages, trajectories, and occasional tragedies of adolescents' emerging autonomy, while the Baker's and the Witch's struggles becoming and being parents encapsulate how disorderly and untidy parenting often is. Pediatricians and clinical bioethicists, who are often in a position to scrutinize the choices of parents and teens, should remember that parents and adolescents are almost always motivated by good intentions and doing the best that they can. Perhaps the best we can do is accompany them on their journey "into the woods.". (shrink)

Background Ethical conflict is a problem with negative consequences, which can compromise the quality and ethical standards of the nursing profession and it is a source of stress for health care practitioners’, especially for nurses. Objectives The main aim of this study was to analyze Spanish critical care nurses’ level of exposure to ethical conflict and its association with sociodemographic, occupational, and COVID-19–related variables. Research Design, Participants, and Research context: This was a quantitative cross-sectional descriptive study conducted (...) among 117 nurses working in critical care units. Data collection tools were sociodemographic, occupational, and COVID-19–related questionnaires and previously validated Spanish version of Ethical Conflict in Nursing Questionnaire-Critical Care Version. Ethical Considerations We obtained permission from the Ethics Committee and participants' informed consent. Findings Data indicates a moderate level of exposure to ethical conflicts. The most frequent ethical conflicts were related to situations about "treatment and clinical procedures." The most intensity of ethical conflicts was related to situations about "treatment and clinical procedures" and "dynamics of the service and working environment." No statistical significance was identified between the socio-demographic variables and level of exposure to ethical conflicts. However, for critical care nurses working in ICU, nurses with perceived worked stress had a higher level of exposure to ethical conflicts. Likewise, critical care nurses whose family/friends were infected with COVID-19 had a higher level of exposure. Conclusions Critical care nurses experience a moderate level of exposure to ethical conflicts which is consistent with the results of previous studies. A deeper understanding of ethical conflicts in conflictive situations allows recognition of the situations that occur in everyday clinical practice, identification of the ethical conflicts, and facilitation of the nurses working in the challenging clinical situation. (shrink)

The aim of this study was to investigate relationships between care and justice reasoning, dispositional empathy variables and meta‐ethical thinking among 128 students from a university of applied sciences. The measures were Skoe’s Ethic of Care Interview, the Defining Issues Test, Davis’s Interpersonal Reactivity Index and Meta‐Ethical Questionnaire. The results showed that levels of care reasoning were positively related to the post‐conventional schema and negatively related to the personal interest schema in justice reasoning. Age, meta‐ethical thinking, the (...) post‐conventional schema and perspective taking predicted care reasoning. Sympathy was positively related to both modes of moral reasoning among men and predicted their care reasoning. The results point out common elements for care and justice reasoning, underscore the importance of perspective taking for moral reasoning and indicate that the relationship between affective‐based empathy and moral reasoning is gender‐specific and far more complex than previous theories suggest. (shrink)

Organizational restructuring involving mass layoffs is an integral part of the corporate strategic landscape. While aimed at increasing a company’s efficiency and profitability, it often falls short of desired objectives, partly due to negative consequences for remaining employees, the so-called “survivors”. As workforce reductions may jeopardize a company’s legitimacy, we develop a model that links the change in post-restructuring employee productivity to the factors that help mitigate legitimacy issues. By using a comprehensive and innovative dataset of restructuring announcements reported (...) by European companies over the post-crisis period, we analyze the moderating effect of the restructuring extent on the role of corporate social responsibility (CSR) and economic justification as legitimacy tools in counterbalancing the negative effects of job reduction measures. Our findings reveal that in reactive layoffs, induced by financial difficulties, initially high levels of CSR help lessen negative effects of restructuring on employee productivity in low-extent restructuring events; while in high-extent restructuring events employee productivity is supported by continuing investments in CSR. We provide evidence that both the level and dynamics of CSR practices play a significant role, and their effect on employee performance is conditional on the restructuring context. (shrink)

Background: The transition to child care is a challenging time in a child’s life and leads to elevated levels of cortisol. These elevations may be influenced by the quality of the mother-child-relationship. However, remarkably little is known about cortisol production in response to the beginning of child care among children-at-risk such as children with an immigrant background. However, attending kindergarten or any other child day-care institution can for example have a compensating effect on potential language deficits thus (...) improving the educational opportunities of these children. Method: Data of a subsample of N = 24 “hard-to-reach” mother-child dyads was collected in the context of the psychoanalytic early prevention project “First Steps”. The project focuses on the earliest integration of children with an immigrant background by supporting parenting capacities in the critical phase of migration and early parenthood. Children’s hair cortisol concentration (HCC) was assessed one week before (mean age = 38.77 months) and three months after kindergarten entry (mean age = 42.26 months). Hair analysis was conducted for both times of measurement, reflecting the first 3 months after kindergarten entry and 3 months prior. Furthermore, the emotional quality of the mother-child-relationship was assessed with the help of the Emotional Availability Scales (EAS) shortly before kindergarten entry when the children were about three years old (mean age = 37.2). Results and Conclusion: Children’s mean cumulated HCC was higher after kindergarten entry than before. The increase correlated negatively with several dimensions of the EAS. Repeated measures ANCOVA revealed that particularly responsive children and children who had experienced less intrusive mother-child-relationships demonstrated lower elevations in HCC after kindergarten entry. Furthermore, a decreased EA score was found in all EA dimensions, besides the dimension “mother’s non-hostility”, indicating problematic EA within the mother-child-relationships of the sample. The results suggest that children with an immigrant background who experience more emotional available mother-child-relationships seem to regulate stress induced by kindergarten entry more effectively, indicated by lower cortisol elevations after entry. This implicates that supporting early mother-child-relationships by intervention may have a positive effect on the children’s ability to regulate stress induced by kindergarten entry thus promoting child development. (shrink)

IntroductionThe 2019–2020 pandemic COVID-19 has become a global health crisis. While many recent studies on COVID-19 pandemic have focused on disease epidemiology and psychological status of patients, few have explored the multi-facet influential factors or combined perspectives from both the patients and healthcare workers. The purposes of this study were to: analyze the influencing factors of psychological distress of COVID-19 patients; and describe the experience of healthcare workers relieving psychological distress.Materials and MethodsThis study uses a mixed-method cross-sectional design, including a (...) quantitative study and a qualitative study, targeting two populations: COVID-19 patient and health workers, respectively. In the quantitative part, we recruited a convenience sample of patients with COVID-19 from five hospitals in Wuhan, Hubei Province from 10 to 15 April, 2020. Besides, we collected data by using participants’ socio-demographic information sheet, the Connor-Davidson Resilience Scale-10, the Herth Hope Index, the Distress Thermometer, the Revised Chinese Version of Mishel Uncertainty in Illness Scale, and the Chinese Version of Wake Forest Physician Trust Scale. In the qualitative part, the participants were healthcare workers involved in medical aid missions in Hubei Province, China. Meanwhile, we used sampling with convenient and purposive, data collection with a semi-structured online video interview, and text transcription with Colaizzi’s phenomenological method.ResultsThe results reveal that 25.7% of patients reported higher level of psychological distress. After controlling the sociodemographic variables, only severity of COVID-19 and uncertainty in illness shown significant effect on psychological distress in the regression model. The experience of healthcare workers emerged five themes: Particularly needed psychological care, Manifestation of negative emotion, Manifestation of proactive adaptation, Strategies relieving psychological distress, and gains of healthcare workers after delivering effective psychological care.ConclusionThe 25.7% of patients with COVID-19 still suffered from psychological distress, which should receive timely attention from healthcare workers. And the severity of the disease and disease uncertainty have a significant impact on distress. It is critical to train the healthcare workers on detecting the different manifestation of psychological distress, offering timely disease related information, and applying communication strategies. (shrink)

The practical aspect of ancient philosophy has been recently made a focus of renewed metaphilosophical investigation. After a brief presentation of three accounts of this kind developed by Martha Nussbaum, Pierre Hadot, and Michel Foucault, the model of the therapeutic argument developed by Nussbaum is called into question from the perspectives offered by her French colleagues, who emphasize spiritual exercise (Hadot) or the care of the self (Foucault). The ways in which the account of Nussbaum can be defended are (...) then discussed, including both a ‘negative’ defense, i.e. the indication of the weaknesses of Hadot and Foucault’s proposals, and a ‘positive’ one focused on the points in which Nussbaum can convincingly address doubts about her metaphilosophical account. In response to these analyses, some further remarks made by Hadot and Foucault are discussed in order to demonstrate that their accounts are not as distant from Nussbaum after all. Finally, a recent metaphilosophical study by John Sellars together with a therapeutic (medical) model developed by the author of the present article are suggested as providing a framework for potential reconciliation between all three accounts discussed and a resource for further metaphilosophical studies. (shrink)