Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need (...) to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent. (shrink)
Controlled Human Infection Model research involves the infection of otherwise healthy participants with disease often for the sake of vaccine development. The COVID-19 pandemic has emphasised the urgency of enhancing CHIM research capability and the importance of having clear ethical guidance for their conduct. The payment of CHIM participants is a controversial issue involving stakeholders across ethics, medicine and policymaking with allegations circulating suggesting exploitation, coercion and other violations of ethical principles. There are multiple approaches to payment: reimbursement, wage payment (...) and unlimited payment. We introduce a new Payment for Risk Model, which involves paying for time, pain and inconvenience and for risk associated with participation. We give philosophical arguments based on utility, fairness and avoidance of exploitation to support this. We also examine a cross-section of the UK public and CHIM experts. We found that CHIM participants are currently paid variable amounts. A representative sample of the UK public believes CHIM participants should be paid approximately triple the UK minimum wage and should be paid for the risk they endure throughout participation. CHIM experts believe CHIM participants should be paid more than double the UK minimum wage but are divided on the payment for risk. The Payment for Risk Model allows risk and pain to be accounted for in payment and could be used to determine ethically justifiable payment for CHIM participants.Although many research guidelines warn against paying large amounts or paying for risk, our empirical findings provide empirical support to the growing number of ethical arguments challenging this status quo. We close by suggesting two ways by which payment for risk could be calculated. (shrink)
The Disinterested Witness is a detailed, contextual, and interpretive study of the concept of saksin (or that which directly or immediately perceives) in Advaita Vedanta, and a fascinating and significant comparison of the philosophies of ...
This article discusses the triage response to the COVID-19 delta variant surge of 2021. One issue that distinguishes the delta wave from earlier surges is that by the time it became the predominant strain in the USA in July 2021, safe and effective vaccines against COVID-19 had been available for all US adults for several months. We consider whether healthcare professionals and triage committees would have been justified in prioritising patients with COVID-19 who are vaccinated above those who are unvaccinated (...) in first-order or second-order triage. Given that lack of evidence for a correlation between short-term survival and vaccination, we argue that using vaccination status during first-order triage would be inconsistent with accepted triage standards. We then turn to notions of procedural fairness, equity and desert to argue that that there is also a lack of justification for using vaccination status in second-order triage. In planning for future surges, we recommend that medical institutions base their triage decisions on principles meant to save the most lives, minimise inequity and protect the public’s trust, which for the time being would not be served by the inclusion of vaccination status. (shrink)
Although the topic of value congruence has attracted considerable attention from researchers and practitioners, evidence for the link between person–supervisor value congruence and followers’ reactions is less robust than often assumed. This study addresses three central issues in our understanding of person–supervisor value congruence by assessing the impact of objective person–supervisor value congruence rather than subjective value congruence, by examining the differential effects of value congruence in strongly versus moderately held values, and by exploring perceived empowerment as a central mediating (...) mechanism. Results of a multi-source study comprising 116 person–supervisor dyads reveal that objective value congruence relates to followers’ job satisfaction and affective commitment and that this link can be explained by followers’ perceived empowerment. Moreover, polynomial regression and response surface analyses reveal that congruence effects vary with the importance that leaders and followers ascribe to a certain value: Congruency in strongly held values have more robust relations with followers’ outcomes than congruence in moderately held values. (shrink)
Background:In the past two decades, interest in the concept of ethical climate and in its research has increased in healthcare. Ethical climate is viewed as a type of organizational work climate, and defined as the shared perception of ethically correct behavior, and how ethical issues should be handled in the organization. Ethical climate as an important element of nursing environment has been the focus of several studies. However, scoping reviews of ethical climate research in nursing have not been conducted to (...) guide further research in this area.Objective:The purpose of this scoping review is to describe and analyze studies focusing on ethical climate in nursing environment to elicit an overall picture of the research in this field.Methods:A scoping review methodology guided by Arksey and O’Malley and Levac et al. was used. Studies were identified by conducting electronic searches on PubMed/MEDLINE, CINAHL, Web of Science Core Collection, PsycINFO, and Scopus and Philosophers’ Index databases. Of 1051 citations, 56 articles matched the inclusion criteria.Ethical considerations:This study was conducted according to good scientific guidelines.Findings:Ethical climate is a topical research area which has been explored with different methods and outcomes, in different environments, and has mainly been perceived positively. The focus of the studies was on finding associations between ethical climate and work-related factors such as job satisfaction, moral distress, and turnover intentions. Methodologically, research was rather homogeneous using quantitative, descriptive, and correlative research designs.Conclusion:Novel perspectives and more diverse methodological approaches paying attentions to issues affecting generalizability of the findings could expand our knowledge in this area. (shrink)
Are there limits to what it is morally okay to imagine? More particularly, is imaginatively inhabiting morally suspect perspectives something that is off-limits for truly virtuous people? In this paper, I investigate the surprisingly fraught relation between virtue and a familiar form of imaginative perspective taking I call empathy. I draw out a puzzle about the relation between empathy and virtuousness. First, I present an argument to the effect that empathy with vicious attitudes is not, in fact, something that the (...) fully virtuous person can indulge in. At least one prominent way of thinking about the psychology of the virtuous person excludes the possibility that the virtuous could emotionally apprehend the world in a less than virtuous way, and empathizing with vicious outlooks does seem to run afoul of that restriction. Then, I develop an argument that runs in the contrary direction: virtue in fact requires empathy with vicious outlooks, at least in some situations. There is reason to think that a crucial part of being virtuous is ministering effectively to others’ needs, and there is also reason to think that other people may need to be empathized with, even if their emotional outlooks are at least minorly vicious. Finally, I outline two different solutions to this puzzle. Both solutions hold some promise, but they also bring new challenges in their train. (shrink)
According to the sceptic Saul Kripke envisages in his celebrated book on Wittgenstein on rules and private language, there are no facts about an individual that determine what she means by any given expression. If there are no such facts, the question then is, what justifies the claim that she does use expressions meaningfully? Kripke’s answer, in a nutshell, is that she by and large uses her expressions in conformity with the linguistic standards of the community she belongs to. While (...) Kripke’s sceptical problem has gripped philosophers for over three decades, few, if any, have been satisfied by his proposed solution, and many have struggled to come up with one of their own. The purpose of this paper is to show that a more satisfactory answer to Kripke’s challenge can be developed on the basis of Donald Davidson’s writings on triangulation, the idea of two individuals interacting simultaneously with each other and the world they share. It follows from the triangulation argument that the facts that can be regarded as determining meaning are irreducible. Yet, contra Kripke, they are not mysterious, for the argument does spell out what is needed for an individual’s expressions to be meaningful. (shrink)
In Wittgenstein on Rules and Private Language, Saul Kripke articulates a form of scepticism about meaning. Even though there is considerable disagreement among critics about the reasoning in which the sceptic engages, there is little doubt that he seeks to offer constraints for an adequate account of the facts that constitute the meaningfulness of expressions. Many of the sceptic's remarks concern the nature of the guidance involved in a speaker's meaningful uses of expressions. I propose that we understand those remarks (...) as seeking to give shape to the idea that to use an expression under the guidance of one's understanding is to have a reason for that use, which one's understanding allows one to discern and act on. Any philosophical elucidation of meaning must adequately capture the rational nature of our linguistic acts. (shrink)
Background:Nursing as an ethical practice requires courage to be moral, taking tough stands for what is right, and living by one’s moral values. Nurses need moral courage in all areas and at all levels of nursing. Along with new interest in virtue ethics in healthcare, interest in moral courage as a virtue and a valued element of human morality has increased. Nevertheless, what the concept of moral courage means in nursing contexts remains ambiguous.Objective:This article is an analysis of the concept (...) of moral courage in nursing.Design:Rodgers’ evolutionary method of concept analysis provided the framework to conduct the analysis.Data sources:The literature search was carried out in September 2015 in six databases: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and The Philosopher’s Index. The following key words were used: “moral” OR “ethical” AND “courage” OR “strength” AND “nurs*” with no time limit. After applying inclusion and exclusion criteria, 31 studies were included in the final analysis.Ethical considerations:This study was conducted according to good scientific guidelines.Results:Seven core attributes of moral courage were identified: true presence, moral integrity, responsibility, honesty, advocacy, commitment and perseverance, and personal risk. Antecedents were ethical sensitivity, conscience, and experience. Consequences included personal and professional development and empowerment.Discussion and conclusion:This preliminary clarification warrants further exploring through theoretical and philosophical literature, expert opinions, and empirical research to gain validity and reliability for its application in nursing practice. (shrink)
_An Introduction to Indian Philosophy_ offers a profound yet accessible survey of the development of India’s philosophical tradition. Beginning with the formation of Brahmanical, Jaina, Materialist, and Buddhist traditions, Bina Gupta guides the reader through the classical schools of Indian thought, culminating in a look at how these traditions inform Indian philosophy and society in modern times. Offering translations from source texts and clear explanations of philosophical terms, this text provides a rigorous overview of Indian philosophical contributions to epistemology, (...) metaphysics, philosophy of language, and ethics. This is a must-read for anyone seeking a reliable and illuminating introduction to Indian philosophy. (shrink)
The paper examines the ethical conception of the most well-known and much discussed Hindu text, the "Bhagavad Gītā", in the context of the Western distinction between duty ethics and virtue ethics. Most of the materials published on the "Gītā" make much of its conception of duty; however, there is no systematic investigation of the notion of virtue in the "Gītā". The paper begins with a discussion of the fundamental characteristics of virtue ethics, before undertaking a discussion of the conceptions of (...) duty and virtue in the "Gītā". The paper clearly demonstrates that both duty and virtue coexist in the "Gītā", and the "Gītā" accords virtue an important place. (shrink)
Our collective enthusiasm for empathy reflects a sense that it is deeply valuable. I show that empathy bears a complex and surprisingly problematic relation to another social epistemic phenomenon that we have reason to value, namely testimonial trust. My discussion focuses on empathy with and trust in people who are members of one or more oppressed groups. Empathy for oppressed people can be a powerful tool for engendering a certain form of testimonial trust, because there is a tight connection between (...) empathy and a approval of another's outlook. I then argue that the qualities of empathy that make it such a powerful tool for bridging differences and building trust also have a problematic upshot: they make it the case that reliance on empathy will sometimes have a distorting effect upon the ways we extend testimonial trust. (shrink)
In this paper, I examine Hannah Ginsborg's attempt to address the challenge raised by Saul Kripke's meaning sceptic. I start by identifying the two constraints that the sceptic claims must be met by a satisfactory answer. Then I try to show that Ginsborg's proposal faces a dilemma. In the first instance, I argue that it is able to meet the second constraint, but not the first. I then amend the proposal in order to make room for the first constraint. I (...) go on to argue that, under this new interpretation, it cannot meet the second constraint. (shrink)
Eastern Philosophy represents one of the most ancient intellectual traditions of human culture, yet it is generally ignored by Western philosophers. Today more than ever, the need for understanding in a global community should be stressed as the scope, scale, and complexity of social changes increase. Bina Gupta strives to obtain a harmonious balance between the two traditions in her book Ethical Questions: East and West. Both ancient and modern sources such as the Buddha, Aristotle, the Upanishads, Simone de (...) Beauvoir, Kant, and Alasdair MacIntyre are used to illustrate the varying traditions. (shrink)
We thank the authors of the five commentaries for their careful and highly constructive consideration of our paper,1 which has enabled us to develop our proposal. Participation in research has traditionally been viewed as altruistic. Over time, payments for inconvenience and lost wages have been allowed, as have small incentives, usually in kind. The problem, particularly with controlled human infection model research or ‘challenge studies’, is that they are unpleasant and time-consuming. Researchers want to offer carrots to incentivise participation. We (...) are proposing that research participation be viewed as a job with the full suite of financial entitlements of fairly remunerated work, including payment for risk and labour law protections. This would be a significant shift from current practice and standards. Ambuehl, Ockenfels and Roth have grasped this basic point and have beautifully elaborated how a fair price could be arrived at using economic theory. They build on our proposal helpfully and suggest ‘ salary for time involvement that is adjusted to account for the amount of discomfort experienced during participation, insurance against ex post adverse outcomes and ex ante compensation for risks that cannot be compensated ex post.’3 This effectively addresses Fernandez Lynch and Largent’s2 concern that compensation for risk is inappropriate for harms which do not eventuate. However, because death cannot be compensated for, there must be payment for risk of death, as Ambuehl, Ockenfels and Roth convincingly argue.3 Indeed, the three-part model suggested by Ambuehl, Ockenfels and Roth makes us realise that job model would be a better title for our model than a payment for risk model. The alternative to a properly remunerated job model is the original altruistic model. However, this …. (shrink)
A considerable body of evidence now documents, beyond reasonable doubt, biological and health risk factors for crime and violence. Nevertheless, intervention and prevention efforts with offenders have avoided biological interventions, in part due to past misuses of biological research and the challenges that biological predispositions to crime raise. This article reviews the empirical literature on two biological intervention approaches, omega-3 supplementation and transcranial direct current stimulation. Emerging research on these relatively benign interventions suggests that increased omega-3 intake through dietary intervention (...) and prefrontal upregulation using non-invasive brain stimulation may show some initial promise in reducing antisocial behavior. The ethical issues related to mandated and offered biological interventions within the criminal justice system are discussed. (shrink)
This paper is concerned with the early documented history of featherwork in China, as described in historical texts and literature up until the end of the Tang dynasty in 907 CE. Although featherwork from several Pacific islands and Latin America has recently been the subject of academic attention, the important Chinese tradition has been neglected. Drawing on studies of featherwork from other cultures, this paper divides these accounts by technical criterion into flexible base featherwork ; rigid base featherwork ; and (...) most remarkably of all, deconstructionist featherwork, whereby the barbs of individual feathers were peeled apart and then spun with a silk core to create a feather thread, which was then woven into cloth. Featherwork was produced in vast quantities in early and medieval China to satisfy demand for these luxurious and brightly colored items, and exotic birds—kingfishers, parrots, pheasants, and so on—were traded across the empire to create these wonderful works of art. (shrink)
Against the background of a deeply uneven package of work–family reconciliation measures and an increasing focus on engaging men in unpaid care work, in this article I discuss the extension of the Irish discrimination law framework to provide protection against family status discrimination to workers who are engaged in certain care relationships. While this development of the law to recognize a relational understanding of inequality is welcome, its confined definition of family status fails to capture the range of workers’ caring (...) relationships and networks. Adopting a contextualized assessment of 12 years of litigation generated under the ‘family status’ ground, with reference to complainants’ gender and work status, the study considers the types of experiences being litigated as ‘family status’ discrimination. The study show how much of the nature and forms of inequality presented before the tribunals are beyond the conceptual boundaries of the principle of equal treatment that depends upon a sameness of treatment model with the ‘care-less’ comparator. Despite its potential to question the neutrality of workplace structures predicated upon the division between paid work and unpaid care, the principle of indirect family status discrimination has been under utilised as a litigation strategy. The most successful dimension of family status discrimination protection has been in respect of its ability to capture the negative stereotyping of worker–carers who continue to perform as ideal workers. I suggest that this extension of a limited negative rights framework, when considered alongside the state’s extremely poor support for workcare reconciliation more broadly, places negligible obligations on employers, and that the gender neutrality implicit in its provisions have yet to impact on gender equality as regards work–care reconciliation. (shrink)
Thinking about Reasons collects fourteen new essays on ethics and the philosophy of action, inspired by the work of Jonathan Dancy—one of his generation's most influential moral philosophers.
The reality-virtuality continuum encompasses a multitude of objects, events and environments ranging from real-world multisensory inputs to interactive multisensory virtual simulators, in which sensory integration can involve very different combinations of both physical and digital inputs. These different ways of stimulating the senses can affect the consumer’s consciousness, potentially altering their judgements and behaviours. In this perspective paper, we explore how technologies such as Augmented Reality and Virtual Reality can, by generating and modifying the human sensorium, act on consumer consciousness. (...) We discuss the potential impact of this altered consciousness for consumer behaviour while, at the same time, considering how it may pave the way for further research. (shrink)
Background: Moral courage is required at all levels of nursing. However, there is a need for development of instruments to measure nurses’ moral courage. Objectives: The objective of this study is to develop a scale to measure nurses’ self-assessed moral courage, to evaluate the scale’s psychometric properties, and to briefly describe the current level of nurses’ self-assessed moral courage and associated socio-demographic factors. Research design: In this methodological study, non-experimental, cross-sectional exploratory design was applied. The data were collected using Nurses’ (...) Moral Courage Scale and analysed statistically. Participants and research context: The data were collected from a convenience sample of 482 nurses from four different clinical fields in a major university hospital in Finland for the final testing of the scale. The pilot comprised a convenience sample of 129 nurses. Ethical considerations: The study followed good scientific inquiry guidelines. Ethical approval was obtained from the university ethics committee and permission to conduct the study from the participating hospital. Findings: Psychometric evaluation showed that the 4-sub-scale, 21-item Nurses’ Moral Courage Scale demonstrates good reliability and validity at its current state of development showing a good level of internal consistency for a new scale, the internal consistency values ranging from 0.73 to 0.82 for sub-scales and 0.93 for the total scale, thus well exceeding the recommended Cronbach’s alpha value of >0.7. Principal component analysis and confirmatory factor analysis supported the theoretical construct of Nurses’ Moral Courage Scale. Face validity and expert panel assessments markedly contributed to the relevance of items in establishing content validity. Discussion and conclusion: Nurses’ Moral Courage Scale provides a new generic instrument intended for measuring nurses’ self-assessed moral courage. Recognizing the importance of moral courage as a part of nurses’ moral competence and its assessment offers possibilities to develop interventions and educational programs for enhancement of moral courage. Research should focus on further validation measures of Nurses’ Moral Courage Scale in international contexts. (shrink)
Philosophical Questions: East and West is an anthology of source material for use in comparative courses in philosophy, religion, and the humanities. The readings—derived from the great works of the Indian, Chinese, Japanese, Islamic, and Western intellectual traditions—are presented as answers to some of the most enduring questions in philosophy.
Varro's Hebdomades vel de imaginibus contained 700 pictures of illustres accompanied by short descriptions in verse and prose, all arranged by the number seven: Gellius provides a detailed excerpt from the first book on the significance of this number. Speculation on the arrangement and content of the fifteen books abounds. On the other hand explicit attestation of personages included in Varro's list is relatively scarce: the discussions in the passage of Gellius on the ages of Homer and Hesiod, and of (...) the former's birthplace in the epigram attached to his portrait certify the rather obvious choice of the two oldest Greek poets, presumably part of a canon of seven. (shrink)
The first English translation of the "First Section" --the "Section on Inquiry" --of the Pañacapadikavivaranam, a Sanskrit commentary offering a systematic exposition of Advaita Vedanta from the Vivarana perspective. The central question concerns the nature of ignorance, or not-knowing, and its relation to knowing. It discusses how ignorance obstructs the nature of reality; the locus and support of ignorance; and whether ignorance is a positive entity. Includes a detailed introduction, transliterated text, translation, and explanatory notes. Published by American Institute of (...) Buddhist Studies. (shrink)
A timely and penetrating investigation, this book seeks to transform moral philosophy. In the face of continuing disagreement about which general moral principles are correct, there has been a resurgence of interest in the idea that correct moral judgements can be only about particular cases. This view--moral particularism --forecasts a revolution in ordinary moral practice that has until now consisted largely of appeals to general moral principles. Moral particularism also opposes the primary aim of most contemporary normative moral theory that (...) attempts to show that either one general principle, or a set of general principles, is superior to all its rivals. (shrink)
Nasr Hamid Abu Zayd, the contentious Egyptian thinker, has proposed different ideas about the revelation and the Qur’an and encountered with different reactions. He made endeavor to provide some natural and non metaphysical explanations for the Islamic phenomena. In this regard he went through the miraculous feature of the Qur’an differently and reduced it to a cultural-literary phenomenon that everyone who knows Arabic takes it as a fundamental cultural text. Analyzing the literature and the linguistic mechanism of the Qur’an from (...) the viewpoint of the current literary criticism will show its role in the creation of history and culture. This view is radically different from the viewpoint of faithful people because it reduces the religious attitude to a cultural atmosphere in which the Qur’an is like the other masterpieces which may be literary criticized. The content of the Qur’an, in this kind of criticism, is ignored while in the current literary criticism the content is heeded too. (shrink)
The feeling of shame has a longstanding role in the relations between individual and society. In this article we shall distinguish between shame and shaming and try to understand the social and cultural function of shame. Even though shame is a feeling that has a physiological basis, the way in which we experience emotions differs from culture to culture since it is the meaning that we attach to an event that evokes the emotion rather than the event itself. In order (...) to understand the phenomenon of social shaming in the present we must examine the social origins of this phenomenon in Western culture. The methodology most fitting to examine this cultural construct is the genealogical method, by way of which we shall come to see that shaming is not an essentially new phenomenon in Western culture, but only a new mode of expressing old patterns. (shrink)
This volume, a part of the Foundations of Philosophy in India series, is an examination of the myriad conceptions of consciousness in classical Indian philosophy.
In this work, a distinguished international group of philosophers offers critical assessments of eminent philosopher J. N. Mohanty's work on phenomenology and Indian philosophy. The concluding chapter by Mohanty responds to the critics and contains his assessment of his own philosophical position.
This article aims to make an analysis of the cultural and anthropological issues raised by synthetic biology. The novelty of the field makes it relatively difficult to compose a comprehensive analysis, even for philosophers with experience, but who are not familiar with the specifics of the field. The article will follow the synthesis of the models of ethical decision applicable in the field of ethical evaluation of technologies from a cultural and anthropological perspective, their critical analysis and will highlight the (...) limitations of each model, as well as a possible synthesis of a model of ethical evaluation of technologies. Afterwords, it can be decided whether a particular technology - such as those involved in synthetic biology - poses risks to the environment, to those involved in research, to future generations, to humanity as a whole or to present or future ecosystems. (shrink)
The ethics of technology has primarily focused on what values are and how they can be embedded in technologies through design. In this context, some work has been done to show the efficacy of a number of design approaches. However, existing studies have not clearly pointed out the ways in which design-for-values approaches can be used by design team managers to properly organize and use technologies in practice. This chapter attempts to fill this gap by discussing the value sensitive design (...) (VSD) approach as a useful means of co-designing technologies as a toolkit for existing workflow management, in this case, Agile. It will be demonstrated that VSD shows promise as a way of democratically designing technologies as well as fostering democratic technology policy innovation. (shrink)
In the case of synthetic biology, the responsibility of humanity for the creation of new technologies that interfere with the processes of natural selection and evolution of species can be invoked, thus annihilating the complex ecological balances and possibly leading to uncontrollable genetic mutations. The big ethical questions are raised by the fact that viral genetic material is hybridized with synthetic genetic material, as well as with the genetic material that underlies the DNA of various living cells, that might interfere (...) with synthetic genetic material - either due to errors in the handling of genetic content or the inability to predict the evolution of synthetic biological systems, an evolution beyond any mathematical modeling that would allow the estimation of biological risks given by the appearance of new species - partially or totally synthetic - and especially by their spread in ecosystems. In this article we will plead for an ethical modeling of technology and a wider communication between ethicist and bio-engineers in order to estimate the directions of technological evolution, especially in the case of synthetic biology. (shrink)
Professional codes of ethics are regarded as elements of nurses' ethical knowledge base and consequently part of their ethics education. However, research focusing on these codes from an educational viewpoint is scarce. This study explored the need and applicability of nursing codes of ethics in modern health care, their importance in the nursing ethics curriculum, and the need for development of their teaching. A total of 183 Finnish nurse educators and 212 nursing students answered three structured questions, with an opportunity (...) to justify their responses, and one open-ended question. Descriptive statistics and content analysis were used to analyse the data. The results suggest that the existence of the codes was seen as important and their applicability mainly as appropriate, despite new challenges posed by modern health care. The codes were regarded as an important part of nurses' ethics education, but current integrated teaching methods require development. (shrink)