Research on moral distress has paid limited attention to nurses’ responses and actions. In a survey of nurses’ perceptions of moral distress and ethical climate, 292 nurses answered three open-ended questions about situations that they considered morally distressing. Participants identified a range of situations as morally distressing, including witnessing unnecessary suffering, being forced to provide care that compromised values, and negative judgments about patients. They linked these situations to contextual constraints such as workload and described responses, including feeling incompetent and (...) distancing themselves from patients. Participants described considerable effort to effect change, calling into question the utility of defining moral distress as an “inability to act due to institutional constraints” or a “failure to pursue a right course of action.” Various understandings of moral distress operated, and action was integral to their responses. The findings suggest further conceptual work on moral distress and effort to support system-level change. (shrink)

Effective altruism encourages people to donate their money to the most effective, efficient charities. Some effective altruists believe that taking a longtermist priority—benefitting far-off future, enormous generations—is one of the best ways to use our resources. This paper explains how the longtermist argument as laid out by William MacAskill in his book What We Owe the Future, is unconvincing. MacAskill argues that we should ensure that the future is very well-populated on the assumption that it will be on balance good (...) over bad. This reasoning, however, fails to account for additional moral considerations that most people would endorse. The present critique of pronatalist longtermism advances a critical benefit theory compatible with putting our energy into preventing and alleviating serious harms to actual future generations without intensive pronatalism. (shrink)

Many countries have attempted to transition to democracy following conflict or repression, but the basic meaning of transitional justice remains hotly contested. In this book, Colleen Murphy analyses transitional justice - showing how it is distinguished from retributive, corrective, and distributive justice - and outlines the ethical standards which societies attempting to democratize should follow. She argues that transitional justice involves the just pursuit of societal transformation. Such transformation requires political reconciliation, which in turn has a complex set of (...) institutional and interpersonal requirements including the rule of law. She shows how societal transformation is also influenced by the moral claims of victims and the demands of perpetrators, and how justice processes can fail to be just by failing to foster this transformation or by not treating victims and perpetrators fairly. Her book will be accessible and enlightening for philosophers, political and social scientists, policy analysts, and legal and human rights scholars and activists. (shrink)

Given recent advancements in CRISPR‐Cas9 powered genetic modification of gametes and embryos, both popular media and scientific articles are hailing CRISPR’s life‐saving, curative potential for people with serious monogenic diseases. But claims that CRISPR modification of gametes or embryos, a form of germline engineering, has therapeutic value are deeply mistaken. This article explains why reproductive uses of CRISPR, and germline engineering more generally, do not treat or save lives that would otherwise have a genetic disease. Reproductive uses of CRISPR create (...) healthy people whose existence is not inevitable in the first place. Creating healthy lives has distinct and lesser moral value from saving or curing lives that would otherwise have genetic disease. The real value in reproductive uses of CRISPR is in helping a very limited population of people have healthy, genetically related children. This diminished value cannot compete with the concerns in opposition to germline engineering, nor is it worth the investment of research money. (shrink)

Millions of children worldwide could benefit from adoption. One could argue that prospective parents have a pro tanto duty to adopt rather than create children. For the sake of argument, I assume there is such a duty and focus on a pressing objection to it. Prospective parents may prefer that their children are genetically related to them. I examine eight reasons prospective parents have for preferring genetic children: for parent-child physical resemblance, for family resemblance, for psychological similarity, for the sake (...) of love, to achieve a kind of immortality, for the genetic connection itself, to be a procreator, and to experience pregnancy. I argue that, with the possible exception of the pregnancy desire, these reasons fail to defeat a duty to adopt a child rather than create one, even assuming that we do have some leeway to favor our own interests. (shrink)

THOROUGHLY refreshing is this novel conception of the "romantic isle of philosophy". The author takes Scholasticism from the dry and tedious study of abstract canons, and transports her to the realm of the imaginative. The Editor.

The purpose of this study was to assess student perceptions of self-plagiarism. Students at three university campuses offering graduate and undergraduate classes in a residential and online format were queried; 284 students responded. Overwhelmingly, students perceived they owned their own previous published works and over half reported they believed self-plagiarism should not be considered an academic honesty offense. Most faculty members did not provide information about self-plagiarism to their students. Only about one-fourth of the students reported recycling parts of an (...) assignment in the past. Students who took online courses were more likely to have been educated about self-plagiarism than those who took residential courses. Understanding students’ perceptions about academic honesty offenses such as plagiarism can help institutions develop effective policies and interventions. (shrink)

Gathering thoughts -- Teachers who inspired me -- What am I? : Montessori? Steiner? eclectic? : Is it important? -- Which comes first? : a philosophical framework, theory and research evidence : what do teachers and other practitioners need to bring out their best work -- Working with principles which are interpreted and embedded in articulated practice -- The importance of parent partnership and the development of moral values and self-discipline -- Play : a very complex thing -- Finding how (...) to position myself in relation to play -- Inclusion : commonalities, differences"fragmentation or wholeness?"-- Cultivating creativity -- Remaining a generalist rather than becoming a specialist within one area of early childhood education -- Changing political climates -- How best to train teachers of young children -- Remaining a Froebelian but still exploring why and wondering "will I always be one?". (shrink)

This article argues that two forms of mitochondrial replacement therapy, maternal spindle transfer and pro-nuclear transfer, are not therapies at all because they do not treat children who are coming into existence. Rather, these technologies merely create healthy children where none was inevitable. Even if creating healthy lives has some value, it is not to be confused with the medical value of a cure or therapy. The article addresses a recent Bioethics article, ‘Mitochondrial Replacement: Ethics and Identity,’ by Wrigley, Wilkinson, (...) and Appleby, who argue that PNT is morally favorable to MST due to the Non-Identity Problem. Wrigley et al. claim that PNT, since it occurs post-conception, preserves the identity of the resulting child, whereas MST, since it occurs pre-conception, is an identity-altering technique. As such, a child born with mitochondrial disease could complain that her parents failed to use PNT, but not MST. The present article argues that the authors are mistaken: both MST and PNT are identity-affecting techniques. But this is of little matter, for we should be cautious in drawing any moral conclusions from the application of the Non-Identity Problem to cases. The article then argues that the authors are mistaken in inferring that PNT is a type of embryonic cure or therapy for children with mitochondrial disease. The article cautions against the mistaken life-saving rhetoric that is common in bioethics discussions of MRTs. (shrink)

Based on a creative use of the phenomenological method, we argue that a close examination of the temporality of objects reveals the future as genuinely open. Without aiming to decide the matter of phenomenological realism, we suggest that this method can be used to investigate the mode of being of objects in their own temporality. By bracketing the anticipatory structure of experience, one can get a sense of objects’ temporality as independent of consciousness. This contributes to the current Realism versus (...) Idealism debates, but it does so without taking sides. The starting point is neither an analysis of pure consciousness, nor attempts to describe objects in-themselves, but the idea that things can be phenomenologically grasped through the difference between their temporality and our own. By being methodically “open to the future,” one can become aware of the sui generis temporality of objects as different from the temporality shaped by our anticipation. (shrink)

Following extended periods of conflict or repression, political reconciliation is indispensable to the establishment or restoration of democratic relationships and critical to the pursuit of peacemaking globally. In this book, Colleen Murphy offers an innovative analysis of the moral problems plaguing political relationships under the strain of civil conflict and repression. Focusing on the unique moral damage that attends the deterioration of political relationships, Murphy identifies the precise kinds of repair and transformation that processes of political reconciliation ought to (...) promote. Building on this analysis, she proposes a normative model of political relationships. A Moral Theory of Political Reconciliation delivers an original account of the failure and restoration of political relationships, which will be of interest to philosophers, social scientists, legal scholars, policy analysts, and all those who are interested in transitional justice, global politics, and democracy. (shrink)

The independence of irrelevant alternatives is a popular and important axiom of decision theory. It states, roughly, that one’s choice from a set of options should not be influenced by the addition or removal of further, unchosen options. In recent debates, a number of authors have given putative counterexamples to it, involving intuitively rational agents who violate IIA. Generally speaking, however, these counterexamples do not tend to move IIA’s proponents. Their strategy tends to be to individuate the options that the (...) agent faces differently, so that the case no longer counts as a violation of IIA. In this paper, we examine whether this strategy succeeds. We argue that the ways of individuating options required to save IIA from the most problematic counterexamples—in particular, cases where agents violate IIA due to nonconsequentialist moral beliefs—do so only at the expense of severely compromising its central function within decision theory. (shrink)

Most studies of corporate social responsibility have focused on the organisational level, while the individual level of analysis has been treated as a ‘black box’ when researching antecedents of CSR engagement or disengagement. This article offers insights into a small and medium-sized enterprise that is recognised as a pioneer in CSR. Although the extant literature suggests that the owner-manager is crucial in the implementation of CSR, this study reveals that employees drive CSR. The employees in the focal firm voluntarily joined (...) forces based on their shared perception of moral responsibility for CSR and they developed strict targets to be achieved by 2030. Despite their strong ethical and moral perspective when enacting CSR, they disengaged from their moral responsibility for CSR in various contexts. This paper contributes to the theory of moral decoupling by uncovering a novel context of disengagement—‘visionary procrastination’. Visionary procrastination is suggested to be a particularly relevant context of disengagement when individuals perceive moral responsibility for CSR. Moreover, by delivering insights into the antecedents of employee-initiated CSR on the organisational level, this study adds to the growing body of literature on the micro-foundations of CSR. (shrink)

Abstract Medical futility is commonly understood as treatment that would not provide for any meaningful benefit for the patient. While the medical facts will help to determine what is medically appropriate, it is often difficult for patients, families, surrogate decision-makers and healthcare providers to navigate these difficult situations. Often communication breaks down between those involved or reaches an impasse. This paper presents a set of practical strategies for dealing with cases of perceived medical futility at a major cancer center. Content (...) Type Journal Article Pages 1-8 DOI 10.1007/s10730-011-9168-3 Authors Colleen M. Gallagher, Section for Integrated Ethics in Cancer Care, Unit 1430, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX 77230-1402, USA Ryan F. Holmes, St. Louis University, St. Louis, MO, USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737. (shrink)

_ Source: _Page Count 30 Millions of children worldwide could benefit from adoption. One could argue that prospective parents have a pro tanto duty to adopt rather than create children. For the sake of argument, I assume there is such a duty and focus on a pressing objection to it. Prospective parents may prefer that their children are genetically related to them. I examine eight reasons prospective parents have for preferring genetic children: for parent-child physical resemblance, for family resemblance, for (...) psychological similarity, for the sake of love, to achieve a kind of immortality, for the genetic connection itself, to be a procreator, and to experience pregnancy. I argue that, with the possible exception of the pregnancy desire, these reasons fail to defeat a duty to adopt a child rather than create one, even assuming that we do have some leeway to favor our own interests. (shrink)

This edited collection recalls the events that led up to the Fitzgerald Inquiry and examines the extraordinary influence the ‘watershed' inquiry has had on police and public sector reform at the state, national and international levels.

Colleen Glenney Boggs puts animal representation at the center of the making of the liberal American subject. Concentrating on the formative and disruptive presence of animals in the writings of Frederick Douglass, Edgar Allan Poe, and Emily Dickinson, Boggs argues that animals are critical to the ways in which Americans enact their humanity and regulate subjects in the biopolitical state. Biopower, or a politics that extends its reach to life, thrives on the strategic ambivalence between who is considered human (...) and what is judged as animal. It generates a space of indeterminacy in which animal representations intervene to define and challenge the parameters of subjectivity. The renegotiation of the species line produces a tension that is never fully regulated. Therefore, as both figures of radical alterity and the embodiment of biopolitics, animals are simultaneously exceptional and exemplary to the biopolitical state. An original contribution to animal studies, American studies, critical race theory, and posthumanist inquiry, Boggs thrillingly reinterprets a long and highly contentious human-animal history. (shrink)

This article presents the current legislative and educative measures in place for plagiarism prevention in Kosovo, especially in the case of student work, and provides an analysis of the effectiveness of such measures. Two public universities are used as case studies – the University of Haxhi Zeka and the University of Kadri Zeka – and the research is based on the legal and policy documents enacted by the two universities, as well as many reports, scientific articles on plagiarism and HEI (...) official websites. The issue of plagiarism has only recently become a priority in Kosovo, with many factors hindering advancement and development in this area. (shrink)

The purpose of this inquiry is to explore the experience of Borderline Personality Disorder with the aim of developing a more liberating approach to its diagnosis and treatment. Eight participants diagnosed with Borderline Personality Disorder were recruited from a psychiatric hospital operated by the Surrey and Borders NHS Trust and an outpatient daycentre based in London, United Kingdom. A narrative approach to methodology was employed to collect and analyse the participants’ life-stories. Themes to emerge from the participant’s narratives were found (...) to coincide with R.D. Laing’s concept of ontological insecurity. Ontological insecurity describes a number of aspects of the participant’s distress. To conclude, some general implications of this research for psychotherapy are briefly explored. (shrink)

Better memory, greater motivation and concentration lead to greater productivity, efficiency and performance, all of which are features that are highly valued in a modern society focused on productivity. In the effort for better cognitive abilities, otherwise healthy individuals use cognitive enhancers, medicines for the treatment of cognitive deficits of patients with various disorders and health problems, such as Alzheimer’s disease, schizophrenia, stroke, Attention Deficit Hyperactivity Disorder or ageing. The use of these is more common in professions with emphasised cognitive (...) abilities, or in occupations that require more attention, focus and alertness. Their use is also associated with the general working population, in that they are supposed to use them to alleviate the effects of sleep deprivation and to cope with increasing workloads. In the paper, we are addressing the ethical issue and the dilemmas of the use of pharmaceutical enhancements by healthy people who have no medical reason for taking such substances, in the context of improving their cognitive functions. (shrink)

In the article ‘Testimonial injustice in medical machine learning’, Pozzi argues that the prescription drug monitoring programme (PDMP) leads to testimonial injustice as physicians are more inclined to trust the PDMP’s risk scores over the patient’s own account of their medication history.1 Pozzi further develops this argument by discussing how credibility shifts from patients to machine learning (ML) systems that are supposedly neutral. As a result, a sense of distrust is now formed between patients and physicians. While there are merits (...) to Pozzi’s main argument of epistemic injustice caused by PDMPs, Pozzi mentions but ultimately glosses over the problem of automation bias. In this commentary, I will discuss automation bias and the affect it has on clinical decision making as well as a technical problem exacerbated by the usage of PDMPs that can potentially cause physical harms. It is reiterated in the article that the confidence physicians have in the PDMP’s risk scores over the patient’s testimony leads to misplaced trust in the ML systems. What Pozzi describes here is known as automation bias, which occurs when there is an over-reliance on ML systems. …. (shrink)

In their article “Racial Justice Requires Ending the War on Drugs,” Earp, Lewis, and Hart argue for the end of our War on Drugs in order to alleviate our reliance on mass incarceration, harm...

Clinicians and health researchers frequently encounter opportunities to rescue people. Rescue cases can generate a moral duty to aid those in peril. As such, bioethicists have leveraged a duty to rescue for a variety of purposes. Yet, despite its broad application, the duty to rescue is under-analyzed. In this paper, we assess the state of theorizing about the duty to rescue. There are large gaps in bioethicists’ understanding of the force, scope, and justification of the two most cited duties to (...) rescue—the individual duty of easy rescue and the institutional rule of rescue. We argue that the duty of easy rescue faces unresolved challenges regarding its force and scope, and the rule of rescue is indefensible. If the duty to rescue is to help solve ethical problems, these theoretical gaps must be addressed. We identify two further conceptions of the duty to rescue that have received less attention—an institutional duty of easy rescue and the professional duty to rescue. Both provide guidance in addressing force and scope concerns and, thereby, traction in answering the outstanding problems with the duty to rescue. We conclude by proposing and propose research priorities for developing accounts of duties to rescue in bioethics. (shrink)

Zusammenfassung Heute gilt Muhammad Ali in der öffentlichen Meinung als einer der bekanntesten und beliebtesten Sportler des 20. Jahrhunderts. Der vorliegende Beitrag liefert einen Rückblick auf den US-amerikanischen Sportler, dessen Image in den 1960er Jahren ein Gegenteiliges war. Bei der Darstellung des Wandlungsprozesses werden zwei Perspektiven verfolgt: Zum einen geht es um die Rekonstruktion des öffentlichen Images Muhammad Alis seit den 1960er Jahren, über das eine Analyse der zahlreichen Stellungnahmen von Berichterstattern und Reportern Aufschluss geben kann. Zum anderen geht es (...) um das Verhalten und die Einstellung Muhammad Alis selbst, welche in engem Zusammenhang mit der öffentlichen Rezeption seiner Person stehen. In Anlehnung an diese doppelte Perspektive wird, einem chronologischen Verlauf folgend, erläutert, wie sich das Image dieses Sportlers in den Augen der Öffentlichkeit von dem eines Verräters zu dem eines Märtyrers verändern konnte. (shrink)

In the previous four papers in this series, individual versus structural or contextual factors have informed various understandings of moral distress. In this final paper, we summarize some of the key tensions raised in previous papers and use these tensions as springboards to identify directions for action among practitioners, educators, researchers, policymakers and others. In particular, we recognize the need to more explicitly politicize the concept of moral distress in order to understand how such distress arises from competing values within (...) power dynamics across multiple interrelated contexts from interpersonal to international. We propose that the same socio-political values that tend to individualize and blame people for poor health without regard for social conditions in which health inequities proliferate, hold responsible, individualize and even blame health care providers for the problem of moral distress. Grounded in a critical theoretical perspective of context, definitions of moral distress are re-examined and refined. Finally, recommendations for action that emerge from a re-conceptualized understanding of moral distress are provided. (shrink)

Some obligations are conditional such that act A is morally optional, but if one chooses A, one is required to do act B rather than some other less valuable act C. Such conditional obligations arise frequently in research ethics, in the philosophical literature, and in real life. They are controversial: how does a morally optional act give rise to demanding requirements to do the best? Some think that the fact that a putative obligation has a conditional structure, so defined, is (...) a strike against its being a genuine obligation. I argue that conditional obligations are to be expected in a moral theory that has moral options. (shrink)

In evidence-based medicine (EBM), methodology has become the central means of determining the quality of the evidence base. The “gold standard” method, the randomised, controlled trial (RCT), imbues medical research with an ethos of disinterestedness; yet, as this essay argues, the RCT is itself a rhetorically interested construct essential to medical-professional boundary work. Using the example of debates about methodology in EBM-oriented research on complementary and alternative medicine (CAM), practices not easily tested by RCTs, I frame the problem of method (...) as a fundamentally rhetorical problem, situated within a boundary drama, and deeply rooted in the discursive practices of science and medicine. The genre of the RCT report, for example, idealises the research process and can tilt the course of arguments about CAM, while the notion of efficacy can function as a rhetorically mobile boundary object that can redefine the very terms of debate. I suggest herein that arguments about method in CAM debates can productively be read, metonymically, as expressions of more general anxieties in medicine about knowledge and evidence, community values, and professional boundaries; as such, these debates can illuminate some of the rhetorical dimensions of EBM. (shrink)

Medieval thinkers were both puzzled and fascinated by the capacity of human beings to do what is morally wrong. In this book, Colleen McCluskey offers the first comprehensive examination of Thomas Aquinas' explanation for moral wrongdoing. Her discussion takes in Aquinas' theory of human nature and action, and his explanation of wrong action in terms of defects in human capacities including the intellect, the will, and the passions of the sensory appetite. She also looks at the notion of privation, (...) which underlies Aquinas' account of wrongdoing, as well as his theory of the vices, which intersects with his basic account. The result is a thorough exploration of Aquinas' psychology which is both accessible and illuminating, and will be of interest to a wide range of readers in Aquinas studies, medieval philosophy, the history of theology, and the history of ideas. (shrink)

Most people would agree that adoption is a good thing for children in need of a family. Yet adoption is often considered a second best or even last resort for parents in making their families. Against this assumption, I explore the unique value of adoption for prospective parents. I begin with a criticism of the selective focus on the value of adoption for only those people using assisted reproductive technologies. I focus on the value of adoption for all prospective parents, (...) reflecting on non-relative, non-procreative adoptions. First, adoption can meet the important need that a child has for a family, whereas procreation creates rather than meets needs. Second, adoption provides a morally noble opportunity to extend to a stranger benefits usually withheld for one's genetic kin. As such, adoption offers a unique possibility in which impartial concern for an other can be the starting point for a lifetime of love and care. Finally, adoptions can have transformative power over adoptive parents’ conception of family and self. In highlighting the unique value of adoption, I aim to challenge the widespread assumption that adoption has second best status to procreation. Indeed adoption can exemplify the human potential for moral compassion and impartial concern for the needs of others. (shrink)

During sudden school closures in spring 2020 due to the COVID-19 pandemic, teachers had to move to distance teaching. This unprecedented situation could be expected to influence teacher well-being and schools as organizations. This article reports a qualitative study that aims at understanding how changes in teachers’ professional lives that were related to school closure affected Swiss primary teachers’ professional well-being. In semi-structured online-interviews, 21 teachers from 15 schools sampled by snowball method reported their experiences during school closure and distance (...) teaching and how this situation influenced their professional well-being. Results showed that medium to high levels of teacher well-being could accompany a general negative evaluation of the move to distance teaching. Factors such as high work-load, social distancing and feelings of lack of competence and self-efficacy were among the most aversive aspects of distance teaching and associated with deteriorating professional well-being. Among a plethora of factors that supported teachers in maintaining their well-being, contextual work-related aspects such as school resources, collegial support or leadership support along with individual aspects such as resilience, coping strategies, and clear work structures were important. Additionally, it was found that teacher well-being was nourished by positive experiences with the new forms of distance teaching and feelings of professional mastery. Despite methodological limitations, the findings of this study could inform schools and authorities about what is needed to support teacher well-being and might help to develop organizational strategies that aim at preventing harmful declines in teacher well-being during challenging and difficult times such as a pandemic. (shrink)