Ethics is a foundational competency in healthcare inherent in everyday nursing practice. Therefore, the promotion of qualified nurses’ and nursing students’ moral competence is essential to ensure ethically high-quality and sustainable healthcare. The aim of this integrative literature review is to identify the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence. The review has been registered in PROSPERO (CRD42023386947) and reported according to the PRISMA guideline. Focusing on qualified nurses’ and nursing students’ moral competence, a (...) literature search was undertaken in January 2023 in six scientific databases: CINAHL, Cochrane Library, PsycINFO, PubMed Medline, Scopus and Web of Science. Empirical studies written in English without time limitation were eligible for inclusion. A total of 29 full texts were retrieved and included out of 5233 citations. Quality appraisal was employed using Joanna Briggs Institute checklists and the Mixed Method Appraisal Tool. Data were analysed using inductive content analysis. Research about the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence is limited and mainly explored using descriptive research designs. The contributing factors were identified as comprising two main categories: (1) human factors, consisting of four categories: individual, social, managerial and professional factors, and ten sub-categories; and (2) structural factors, consisting of four categories: educational, environmental, organisational and societal factors, and eight sub-categories. This review provides knowledge about the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence for the use of researchers, nurse educators, managers, organisations and policymakers. More research about the contributing factors is needed using complex intervention, implementation and multiple methods designs to ensure ethically sustainable healthcare. (shrink)

Bullying often results in negative coping in victims, including an increased consumption of alcohol. Recently, however, an increase in alcohol use has also been reported among perpetrators of bullying. The factors triggering this pattern are still unclear. We investigated the role of empathy in the interaction between bullying and alcohol use in an adolescent sample (IMAGEN) at age 13.97 (±0.53) years (baseline (BL), N = 2165, 50.9% female) and age 16.51 (±0.61) years (follow-up 1 (FU1), N = 1185, 54.9% female). (...) General empathic distress served as a significant moderator of alcohol use in perpetrators (F9, 493 = 17.978, p < 0.01), which was specific for males and FU1. Male perpetrators, who are generally less sensitive to distress, might thus be more vulnerable to alcohol abuse. (shrink)

Research ethics committees (RECs) evaluate whether the risk-benefit ratio of a study is acceptable. Decentralized clinical trials (DCTs) are a novel approach for conducting clinical trials that potentially bring important benefits for research, including several collateral benefits. The position of collateral benefits in risk-benefit assessments is currently unclear. DCTs raise therefore questions about how these benefits should be assessed. This paper aims to reconsider the different types of research benefits, and their position in risk-benefit assessments. We first propose a categorization (...) of research benefits, based on the types of benefits that can be distinguished from the literature and ethical guidelines. Secondly, we will reconsider the position of collateral benefits. We argue that these benefits are not fundamentally different from other benefits of research and can therefore be included in risk-benefit assessments of DCTs. (shrink)

Background:Moral courage is defined as courage to act according to one’s own ethical values and principles even at the risk of negative consequences for the individual. In a complex nursing practice, ethical considerations are integral. Moral courage is needed throughout nurses’ career.Aim:To analyse graduating nursing students’ moral courage and the factors associated with it in six European countries.Research design:A cross-sectional design, using a structured questionnaire, as part of a larger international ProCompNurse study. In the questionnaire, moral courage was assessed with (...) a single question (visual analogue scale 0–100), the questionnaire also covered several background variables.Participants and research context:The sample comprised graduating nursing students (n = 1796) from all participating countries. To get a comprehensive view about graduating nursing students’ moral courage, the views of nurse managers (n = 538) and patients (n = 1327) from the same units in which the graduating nursing students practised were also explored, with parallel questionnaires.Ethical considerations:Ethical approvals and research permissions were obtained according to national standards in every country and all participants gave their informed consent.Results:The mean of graduating nursing students’ self-assessed moral courage was 77.8 (standard deviation 17.0; on a 0–100 scale), with statistically significant differences between countries. Higher moral courage was associated with many factors, especially the level of professional competence. The managers assessed the graduating nursing students’ moral courage lower (66.5; standard deviation 18.4) and the patients slightly higher (80.6; standard deviation 19.4) than the graduating nursing students themselves.Discussion and conclusions:In all countries, the graduating nursing students’ moral courage was assessed as rather high, with differences between countries and populations. These differences and associations between moral courage and ethics education require further research. (shrink)

Most donated organs in the United States come from brain dead donors, while a small percentage come from patients who die in “controlled,” or expected, circumstances, typically after the family or surrogate makes a decision to withdraw life support. The number of organs available for transplant could be substantially if donations were permitted in “uncontrolled” circumstances–that is, from people who die unexpectedly, often outside the hospital. According to projections from the Institute of Medicine, establishing programs permitting “uncontrolled donation after circulatory (...) determination of death,” or uDCDD, throughout the United States has the potential to provide 22,000 more donation opportunities annually. In contrast, U.S. controlled donation after circulatory determination of death, or cDCDD, cases have increased progressively over the past decade from 87 to 848 donors, but currently account for only 10.6 percent of all deceased donors. Following the IOM recommendations, several projects exploring the feasibility of uDCDD were funded by the federal government, including a grant from the Health Resources and Services Administration that supported a pilot project in New York City in which the authors of this article participated.A key feature of our protocol, and indeed of many uDCDD protocols, is the initiation of preservation methods such as chest compressions and extracorporeal membrane oxygenation shortly after death in order to perfuse and preserve the donor's organs. Critics of uDCDD argue that the means of determining death deviates from generally ascribed principles. They assert that reinstituting circulation in order to preserve organs has the effect of “undoing” the prior determination of death. The result is that cDCDD is widely accepted and practiced routinely even though it only marginally increases the number of organs available for transplantation, and uDCDD is widely considered unacceptable despite being ethically embraced and proven to significantly increase organ donation opportunities in other countries. This article explores the evolution of this counterintuitive state of affairs and calls for a policy that, in line with the IOM report, allows for both cDCDD and uDCDD protocols. (shrink)

The prospect of using genome technologies to modify the human germline has raised profound moral disagreement but also emphasizes the need for wide-ranging discussion and a well-informed policy response. The Hinxton Group brought together scientists, ethicists, policymakers, and journal editors for an international, interdisciplinary meeting on this subject. This consensus statement formulated by the group calls for support of genome editing research and the development of a scientific roadmap for safety and efficacy; recognizes the ethical challenges involved in clinical reproductive (...) applications of genome editing but, importantly, rejects the idea that human reproductive germline modification is necessarily morally unacceptable; and highlights the importance of meaningful engagement in discussions of genome editing and the development of regulation and oversight mechanisms to govern future uses of such technologies. (shrink)

Research question and aimClinical Ethics Committees (CECs) aim to support healthcare professionals (HPs) and healthcare organizations to deal with the ethical issues of clinical practice. In 2020,...

Biobanks correspond to different situations: research and technological development, medical diagnosis or therapeutic activities. Their status is not clearly defined. We aimed to investigate human biobanking in Europe, particularly in relation to organisational, economic and ethical issues in various national contexts. Data from a survey in six EU countries were collected as part of a European Research Project examining human and non-human biobanking. A total of 147 institutions concerned with biobanking of human samples and data were investigated by questionnaires and (...) interviews. Most institutions surveyed belong to the public or private non-profit-making sectors, which have a key role in biobanking. This activity is increasing in all countries because few samples are discarded and genetic research is proliferating. Collections vary in size, many being small and only a few very large. Their purpose is often research, or research and healthcare, mostly in the context of disease studies. A specific budget is very rarely allocated to biobanking and costs are not often evaluated. Samples are usually provided free of charge and gifts and exchanges are the common rule. Good practice guidelines are generally followed and quality controls are performed but quality procedures are not always clearly explained. Associated data are usually computerised. Biobankers generally favour centralisation of data rather than of samples. Legal and ethical harmonisation within Europe is considered likely to facilitate international collaboration. We propose a series of recommendations and suggestions arising from the EUROGENBANK project. (shrink)

A common understanding of the political function of human rights is as a trigger for international intervention, with states typically understood to be duty bound by these rights claims. The unique character of the human right to health raises some complications for these conventional views. In this paper, I will argue that because of the unique character of the human right to health, intervention on its behalf can be justified not only in response to outright violation, but also due (...) to unmet needs of populations. As a secondary goal of this paper, I will attempt to respond to some of the worries about cultural imperialism in human rights and cross-cultural humanitarian interventions, specifically in the context of global health justice. (shrink)

The consequence argument for the incompatibility of free action and determinism has long been under attack, but two important objections have only recently emerged: Warfield’s modal fallacy objection and Campbell’s no past objection. In this paper, I explain the significance of these objections and defend the consequence argument against them. First, I present a novel formulation of the argument that withstands their force. Next, I argue for the one controversial claim on which this formulation relies: the trans-temporality thesis. This thesis (...) implies that an agent acts freely only if there is one time at which she is able to perform an action and a distinct time at which she actually performs it. I then point out that determinism, too, is a thesis about trans-temporal relations. I conclude that it is precisely because my formulation of the consequence argument emphasizes trans-temporality that it prevails against the modal fallacy and no past objections. (shrink)

Glenn Pearce, labels the identification of the firing of one's pain centres in the brain with feeling pain ‘a naive view,’ the refutation of which cannot much threaten any serious version of materialism. But in fact at least a dozen proponents of contemporary materialism have already hypothesized the identification of feeling pain with activation of a specific neural mechanism, although they picked the wrong mechanism, namely C-fibres. Just to take a recent example, James Cornman and Keith Lehrer, trying to get (...) around the objection to the identity theory that the language of neural processes and the language of feeling pains belong to different linguistic categories, suggest that the materialist could devise a new term to refer to the same entity across categories: ‘fibain.’They write,He would then claim that there are fibains, that is, entities with those properties usually associated with pains, and also with the properties usually associated with firing C-fibers. He can, then, avoid category mistakes by saying that what are thought to be pains and what are thought to be firing C-fibers are really fibains. (shrink)

Glenn Pearce, labels the identification of the firing of one's pain centres in the brain with feeling pain ‘a naive view,’ the refutation of which cannot much threaten any serious version of materialism. But in fact at least a dozen proponents of contemporary materialism have already hypothesized the identification of feeling pain with activation of a specific neural mechanism, although they picked the wrong mechanism, namely C-fibres. Just to take a recent example, James Cornman and Keith Lehrer, trying to get (...) around the objection to the identity theory that the language of neural processes and the language of feeling pains belong to different linguistic categories, suggest that the materialist could devise a new term to refer to the same entity across categories: ‘fibain.’They write,He would then claim that there are fibains, that is, entities with those properties usually associated with pains, and also with the properties usually associated with firing C-fibers. He can, then, avoid category mistakes by saying that what are thought to be pains and what are thought to be firing C-fibers are really fibains. (shrink)

Jung's explanation of the religious tendency of the psyche addresses many sides of the contemporary debate on religion and the role that it has in individual and social life. This book discusses the emergence of a new mythic consciousness and details ways in which this consciousness supersedes traditional concepts of religion to provide a spirituality of more universal inclusion. _On Behalf of the Mystical Fool_ examines Jung's critique of traditional western religion, demonstrating the negative consequences of religious and political (...) collective unconsciousness, and their consequent social irresponsibility in today's culture. The book concludes by suggesting that a new religiosity and spirituality is currently emerging in the West based on the individual’s access to the sense of ultimacy residual in the psyche, and seeking expression in a myth of a much wider compass. This book will be of interest to scholars and students at all levels who are engaged in the expanding field of Jungian studies. It will also be key reading for anyone interested in the theoretical and therapeutic connections between the psyche and religious experience. (shrink)

responses to Sloep and Van der Steen, Biol. Philos. 1987 (2)33.

In this comment I express my puzzlement about Burrell’s employment of “the distinction,” and request further clarification. I also discuss at some length his views concerning free will. I explain the libertarian view as I understand it and point out why his criticisms of it do not succeed. I sketch out his own view of created freedom, and raise certain questions concerning that view.

This paper responds to a previous paper by Gary Matthews and Lynne Rudder Baker. Their paper, in turn, was a response to my reply to an even earlier paper of theirs. (The relevant bibliographical details are in this paper.) They claim to have a new, improved, simple ontological argument. I argue that the new, simple ontological argument is not, in any way, improved.

Suppose we are able to transplant Jones's pain centres into Smith's brain. Half way through the operation we test the pain centres by stimulating them electrically in vitro. Would there be pain? Roland Puccetti argues that there would not be. Because pains must have owners and the only available candidate for that role — the excised tissue — is logically unfit to play it. He concludes that the firing of such centres in a normally functioning brain cannot be pain either (...) and that, therefore, materialism is false.So far as I can see, Puccetti's “refutation” is a series of nonsequiturs from start to finish, and that is what I mainly want to show. It will not follow, of course, that materialism is true. Indeed, I think the view which Puccetti attacks under that name is too naive to be taken seriously by anyone. (shrink)

Chris Kaposy raises an important point about possible interpretations of advances in neuroscience. Specifically, he argues that certain advances may pose a problem for the folk conception of the mind, and he explains that this has crucial implications for our views of what makes a person rational, free, or responsible. In this commentary, I press Kaposy’s position from an eliminativist perspective. Although he may be correct in believing that advances in neuroscience may be difficult to square with our common or (...) folk views, his arguments fall far short of convincing us that these sort of advancements are somehow impossible to adopt, or somehow inconsistent with the possibility of something like epistemic normativity. In fact, I will argue that the most rational course of action may involve adopting radical views about neuroscientific advances. (shrink)

This paper treats a question which first arose in these Proceedings: Can Anselm's ontological argument be inverted so as to yield parallel proofs for the existence (or non-existence) of a least (or worst) conceivable being? Such 'devil parodies' strike some commentators as innocuous curiosities, or redundant challenges which are no more troubling than other parodies found in the literature (e.g., Gaunilo's Island). I take issue with both of these allegations; devil parodies, I argue, have the potential to pose substantive, and (...) novel, challenges to Anselm's ontological argument. (shrink)

Janet Staiger _Perverse Spectators: The Practices of Film Reception_ New York and London: New York University Press, 2000 ISBN 0-8147-8139-X 242 pp.

Cho and Martinez-Martin (2023) provide a compelling critique of the profound influence that data sourcing for artificial intelligence (AI) has on the healthcare sector. They emphasize the need for...

In this essay I discuss two limitations that emerge when considering Tsoukas analysis of the Academy of Management’s initial response to the travel ban issued by President Trump in 2017. First, I suggest that any initial official response on the part of AOM would have required its leaders to “speak on behalf of” all AOM members and thus would have created a number of problems. We therefore need to take better account of others’ perspectives whenever speaking for others. For (...) this reason I emphasize that moral imagination does not constitute a solely individual cognitive act but must be thought of as a deliberative process. Second, while Tsoukas’ analysis suggests that the leadership of AOM should have made an exception to the rule on taking public stands, I show that such exceptions need to be justified communicatively, especially when dealing with moral questions. My analysis outlines the formal and informal communication processes necessary to facilitate such justification and explores ways in which AOM’s current approach to deliberation can be improved. (shrink)

We implemented a user-centered approach to the design of an artificial intelligence (AI) system that provides users with access to information about the workings of the United States federal court system regardless of their technical background. Presently, most of the records associated with the federal judiciary are provided through a federal system that does not support exploration aimed at discovering systematic patterns about court activities. In addition, many users lack the data analytical skills necessary to conduct their own analyses and (...) convert data into information. We conducted interviews, observations, and surveys to uncover the needs of our users and discuss the development of an intuitive platform informed from these needs that makes it possible for legal scholars, lawyers, and journalists to discover answers to more advanced questions about the federal court system. We report on results from usability testing and discuss design implications for AI and law practitioners and researchers. (shrink)

Multimodal communication research focuses on how different means of signalling coordinate to communicate effectively. This line of research is traditionally influenced by fields such as cognitive and neuroscience, human-computer interaction, and linguistics. With new technologies becoming available in fields such as natural language processing and computer vision, the field can increasingly avail itself of new ways of analyzing and understanding multimodal communication. As a result, there is a general hope that multimodal research may be at the “precipice of greatness” due (...) to technological advances in computer science and resulting extended empirical coverage. However, for this to come about there must be sufficient guidance on key (theoretical) needs of innovation in the field of multimodal communication. Absent such guidance, the research focus of computer scientists might increasingly diverge from crucial issues in multimodal communication. With this paper, we want to further promote interaction between these fields, which may enormously benefit both communities. The multimodal research community (represented here by a consortium of researchers from the Visual Communication [ViCom] Priority Programme) can engage in the innovation by clearly stating which technological tools are needed to make progress in the field of multimodal communication. In this article, we try to facilitate the establishment of a much needed common ground on feasible expectations (e.g., in terms of terminology and measures to be able to train machine learning algorithms) and to critically reflect possibly idle hopes for technical advances, informed by recent successes and challenges in computer science, social signal processing, and related domains. (shrink)

Mark Mason, in his ‘A Justification, After the Postmodern Turn, of Universal Ethical Principles and Educational Ideals’ Educational Philosophy and Theory, 37 , attempts to justify transcultural multiculturalism. In this paper I argue that he fails to refute moral relativism, and that multiculturalism as he interprets it is not morally acceptable.

Mark Mason, in his ‘A Justification, After the Postmodern Turn, of Universal Ethical Principles and Educational Ideals’ Educational Philosophy and Theory, 37 (2005), attempts to justify transcultural multiculturalism. In this paper I argue that he fails to refute moral relativism, and that multiculturalism as he interprets it is not morally acceptable.