Background Intensive Care Unit (ICU) nurses face ethical challenges during decision-making in terms of the sophisticated nature of in-patients. Moral comfort is known as a phenomenon with a positive effect on moral decision-making and moral actions of nurses. Aim This study investigated ICU nurses’ level of moral comfort and factors affecting it. Research Design This study used a cross-sectional descriptive design. Participants and research context A total of 350 ICU nurses were selected with the (...) convenience sampling method. The data collection tool included the Demographic Characteristics Questionnaire and the Moral Comfort Questionnaire. The data were analyzed with SPSS19 using descriptive and inferential statistics. Ethical Considerations Upon the Committee of Ethics in Human Research’s acceptance of the research concept, approvals were secured, and informed written consent was acquired from all participants. They were assured of the information confidentiality of participation. Findings The mean moral comfort score was 112.75 ± 13.18. The mean score of personal factors related to ethics was higher than the external factors pertaining to the environment/organization. The mean scores of “moral comfort in a specific situation” and “moral comfort in general” were 50.52 ± 5.08 and 62.32 ± 9.31, respectively. The mean moral comfort score of nurses was significantly correlated with age, clinical work experience, ICU work experience, marital status, education, and employment status ( p <.05). Regression analysis revealed that ICU work experience as the strongest predictor variable predicted 17.7% of moral comfort variance. Conclusion Although moral comfort score was at a favorable level, ICU nurses did not feel comfortable when making decisions in moral situations, and nursing managers did not support the decisions of nursing staff. Consequently, this issue warrants the attention of nursing managers and policy-makers. They need to enhance the quality of healthcare by offering more support and addressing the variables influencing the moral comfort of nurses. (shrink)

The recent debate over Intelligent Design provides an opportunity to examine the pervasiveness and the meaning of Darwinian thinking in modern culture. The latest incarnation of a century-old critique of evolution, ID infuriated critics as a disease of scientific illiteracy. However, examining the debate as cultural history of science suggests that the IDers were not ignorant or stupid, but rather shrewd and disingenuous. They wielded scientific data as a rhetorical weapon, not as truth but as text, to be bent to (...) one's moral purpose—which in their case was an attack on science itself. In contrast to the scientific critics, I view ID as a symptom, a boil on the neck of a social body infected with anxiety over cultural Darwinism. Though the courts seem to have effectively lanced ID, the infection remains. In an age of Darwinian psychiatry, Darwinian business, Darwinian literature criticism, and even Darwinian anti-Darwinism, some boundary checks on cultural Darwinism would be salutary—not for advancing a conservative political agenda as the ID folks seek to do, but simply for reconciling a faith in reason with a rejection of biological determinism. (shrink)

Background:Moving into the last phase of life comprises a developmental transition with specific needs and risks. Facilitating transitions is an important component of the work of nurses. When curative interventions are no longer helpful, nurses enact key roles in caring for patients and families.Aim:The aim of this study was to examine the experiences of registered nurses in acute care settings as they worked with patients and families to facilitate transition to comfort-focused care.Research design:Sampling, data collection, and data analysis were (...) guided by constructivist grounded theory, chosen because of its strength in identifying and explicating social processes.Participants and context:A purposeful sample of 26 registered nurses working in acute care hospitals in one community in the northeastern United States participated in this study through semi-structured interviews.Ethical considerations:The study received approval from the university’s Institutional Review Board for the Protection of Human Subjects. Participants provided informed consent.Findings:Nurses facilitated transition to comfort-focused care by enacting their moral commitments to patients and families. They focused on building relationships, honoring patient self-determination, and maintaining respect for personhood. In this context, they discerned a need for transition, opened a discussion, and used diverse strategies to facilitate achieving consensus on the part of patients, family members, and care providers. Regardless of how the process unfolded, nurses offered support throughout.Discussion:Achievement of consensus by all stakeholders is critical in the transition to comfort-focused care. This study deepens our understanding of how nurses as moral agents utilize specific strategies to assist progress toward consensus. It also offers an example of recognizing the moral agency of nurses through listening to their voices.Conclusion:Increased understanding of effective nursing strategies for facilitating transition to comfort-focused care is essential for developing needed evidence for excellent care and strengthening end-of-life nursing education. (shrink)

An increasingly popular view in scholarly literature and public debate on implicit biases holds that there is progressive moral potential in the discomfort that liberals and egalitarians feel when they realize they harbor implicit biases. The strong voices among such discomfort advocates believe we have a moral and political duty to confront people with their biases even though we risk making them uncomfortable. Only a few voices have called attention to the aversive effects of discomfort. Such discomfort skeptics (...) warn that, because people often react negatively to feeling blamed or called-out, the result of confrontational approaches is often counterproductive. To deepen this critique, I distinguish between awareness discomfort and interaction discomfort, developing a contextual approach that draws on recent research on negative affect and emotions to chart a more complete picture of the moral limits of discomfort. I argue that discomfort advocates risk overrating the moral potential of discomfort if they underestimate the extent to which context shapes the interpretation of affect and simple, raw feelings. (shrink)

Immanuel Kant’s work on the sublimity of aesthetic experience lends itself to puzzlement, if not misclassification. Complicating matters, Kant distinguishes between two kinds of sublimity: respectively, the “mathematical” and “dynamical” sublime. More mystifying is that the sublime is ineffable, beyond the ken of human comprehension. These perplexities notwithstanding, Kant argues that sublime sentiment produces a feeling of supersensible comfort. Commentators identify this comfort emanating most strongly from the dynamical sublime. However, in this paper I draw from the unity (...) of reason thesis to offer a plausible account of how the mathematical sublime is equally capable of providing the same feeling of supersensible comfort. (shrink)

Boethius’ “Consolation of Philosophy” combines a philosophical dialogue with the use of prosimetrum. This mixture of prose and poetry in several meters originally served a satirical criticism of high culture literature and/or philosophy. With regard to the “Consolation”, however, the interpretation of the prosimetrum is a matter of controversy. This article uses insights from modern genre theory to understand the processes of genre transformation active in the “Consolation”, and highlights Martianus Capella as an important mediator between earlier prosimetric satires and (...) Boethius’ “Consolation”. Then, the article analyses how philosophical dialogue and prosimetric satire are evoked throughout the “Consolation” to create a generic hybrid in which both genres are assigned a proper function in relation to the aim of the “Consolation”: to assure the reader of the existence of a cosmic moral order. (shrink)

On elective students may not always be clear about safeguarding themselves and others. It is important that placements are safe, and ethically grounded. A concern for medical schools is equipping their students for exposure to and response to uncomfortable and/or unfamiliar requests in locations away from home, where their comfort and safety, or that of the patient, may be compromised. This can require legal, ethical, and/or moral reasoning on the part of the student. The goal of this article (...) is to establish what students actually encounter on elective, to inform better preparing students for safe and ethical medical placements. We discuss the implications of our findings, which are arguably applicable to other areas of graduate training, e.g. first medical roles post-qualification. An anonymised survey exploring clinical and ethical dilemmas on elective was issued across 3 years of returning final year elective medical students. Questions included the prevalence and type of potentially unsafe scenarios encountered, barriers to saying ‘no’ in unsafe situations, perceived differences between resource poor and developed world settings and the degree to which students refused or consented to participation in events outside of the ‘norms’ of their own training experience. Three hundred seventy-nine students participated. 45% were asked to do something “not permissible” at home. 27% were asked to do something they felt “uncomfortable” with, often an invasive clinical task. Half asked to do something not usually permissible were “comfortable”. 48% felt it more acceptable to bypass guidelines in developing settings. 27% refused an offer outside their experience. Of interest are reasons for “going along with” uncomfortable invitations, e.g. “emergency”, self-belief in ‘capability’ and being ‘more qualified’ than host-personnel. This “best pair of hands available” merits scrutiny. Adverse scenarios were not exclusive to developing settings. We discuss preparing students for decision-making in new contexts, and address whether ‘home’ processes are too inflexible to prepare students for ‘real’ medical life? Ethical decision-making and communicating reluctance should be included in elective preparation. (shrink)

The COVID-19 pandemic and the quarantine undergone by children in many countries is a stressful situation about which little is known to date. Children and adolescents' behaviors to cope with home confinement may be associated with their emotional welfare. The objectives of this study were: to examine the coping strategies used out by children and adolescents during the COVID-19 health crisis, to analyze the differences in these behaviors in three countries, and to examine the relationship between different coping modalities and (...) adaptation. Participants were 1,480 parents of children aged 3–18 years from three European countries. The children's mean age was 9.15 years. Parents completed an online survey providing information on symptoms and coping behaviors observed in their children. The most frequent coping strategies were accepting what is happening, collaborating with quarantine social activities, acting as if nothing is happening, highlighting the advantages of being at home, and not appearing to be worried about what is happening. Compared to Italian and Spanish children, Portuguese children used a sense of humor more frequently when their parents talked about the situation. Acting as if nothing was happening, collaborating with social activities, and seeking comfort from others were more likely in Spanish children than in children from the other countries. Compared to Portuguese and Spanish children, Italian children did not seem worried about what was happening. Overall, an emotional-oriented coping style was directly correlated with a greater presence of anxious symptoms, as well as to mood, sleep, behavioral, and cognitive alterations. Task-oriented and avoidance-oriented styles were related to better psychological adaptation. Results also show that unaffected children or children with a lower level of impact were more likely to use strategies based on a positive focus on the situation. This study provides interesting data on the strategies to be promoted by parents to cope with the COVID-19 health crisis in children. (shrink)

Norman Bowie wrote an article on the moral obligations of multinational corporations in 1987. This paper is a response to Bowie, but more importantly, it is designed to articulate the force and substance of the pragmatist philosophy developed by Richard Rorty. In his article, Bowie suggested that moral universalism (which he endorses) is the only credible method of doing business ethics across cultures and that cultural relativism and ethnocentrism are not. Bowie, in a manner surprisingly common among contemporary (...) philosophers, lumps Rorty into a bad guy category without careful analysis of his philosophy and ascribes to him views which clearly do not fit. I attempt to provide both a more careful articulation of Rorty's views, and to use his pragmatism to illustrate an approach to business ethics which is more fruitful than Bowie's. This brand of philosophy follows the Enlightenment spirit of toleration and attempts to set aside questions of Truth, whether religious or philosophical, and have ethics centered around what James called that which is good in the way of belief. Rather than looking for metaphysical foundations or some type of external justification, ethicists perform their craft from within the cultural traditions, narratives and practices of their society. (shrink)

Background: Moral distress, which is especially high in critical care nurses, has significant negative implications for nurses, patients, organizations, and healthcare as a whole. Aim: A moral distress workshop and follow-up activities were implemented in an intensive care unit in order to decrease levels of moral distress and increase nurses’ perceived comfort and confidence in ethical decision-making. Design: A quality improvement (QI) initiative was conducted using a pre- and post-intervention design. The program consisted of a four-hour (...) interactive workshop, followed by two individual self-reflection activities at 2–3 weeks and 5–6 weeks after the workshop. Participants: Critical care nurses working in a heart and vascular intensive care unit at a large academic medical center. Ethical Considerations: This study was deemed to be a QI project by the institution’s Institutional Review Board. Participation was voluntary. Findings: Nurses experienced a significant decrease in moral distress. The participants’ average ethical confidence increased in four areas (ability to identify the conflicting values at stake, knowing role expectations, feeling prepared to resolved ethical conflict, and being able to do the right thing), with knowledge of role expectations and feeling prepared to resolve ethical conflict yielding statistically significant increases. Qualitative findings resulted in consistent themes related to causes of moral distress and ways nurses approached addressing moral distress. Discussion: This study reinforces previous evidence on moral distress and its causes in critical care nurses, and provides a mechanism for improving moral distress and ethical confidence. Conclusions: This QI study demonstrates the effectiveness of an evidence-based program for decreasing critical care nurses’ moral distress and increasing their ethical confidence. The strategies described in this paper can replicated by nursing leaders who wish to effect change at their local level, or adapted and expanded to other professions and clinical care units. (shrink)

Moral distress has been covered extensively in the nursing literature and increasingly in the literature of other health professions. Cases that cause nurses’ moral distress that are mentioned most frequently are those concerned with prolonging the dying process. Given the standard of aggressive treatment that is typical in intensive care units (ICUs), much of the existing moral distress research focuses on the experiences of critical care nurses. However, moral distress does not automatically occur in all end-of-life (...) circumstances, nor does every critical care nurse suffer its damaging effects. What are the practices of these nurses? What specifically do they do to navigate around or through the distressing situations? The nursing literature is lacking an answer to these questions. This article reports a study that used narrative analysis to explore the reported practices of experienced critical care nurses who are skilled at and comfortable working with families and physicians regarding the withdrawal of aggressive treatment. A major finding was that these nurses did not report experiencing the dam-Moral Agency, Moral Imagination, and Moral Community: Antidotes to Moral Distress Terri Traudt, Joan Liaschenko, and Cynthia Peden-McAlpine Terri Traudt, MBC, MA, is a Communications Consultant specializing in bioethics at the Center for Bioethics at the University of Minnesota, in Minneapolis. trau0116@umn.edu Joan Liaschenko, PhD, RN, FAAN, is a Professor at the Center for Bioethics and Nursing at the University of Minnesota. Cynthia Peden-McAlpine, PhD, ACNS, BC, is an Associate Professor in the School of Nursing at the University of Minnesota. © 2016 by The Journal of Clinical Ethics. All rights reserved. aging effects of moral distress as described in the nursing literature. The verbal communication and stated practices relevant to this finding are organized under three major themes: (1) moral agency, (2) moral imagination, and (3) moral community. Further, a total of eight subthemes are identified. The practices that constitute these themes and subthemes are further detailed and discussed in this article. Understanding these practices can help mitigate critical care nurses’ moral distress. (shrink)

The impact moral judgments have on our deliberations and actions seems to vary a great deal. Moral judgments play a large part in the lives of some people, who are apt not only to make them, but also to be guided by them in the sense that they tend to pursue what they judge to be of moral value, and shun what they judge to be of moral disvalue. But it seems unrealistic to claim that (...) class='Hi'>moral judgments play a pervasive role in the lives of all or even most people. There are considerable variations in how strong a tendency people have to think in moral terms, and in how such thoughts affect their decisions and actions. For every moral hero who single- mindedly pursues moral values, there are thousands of less com- mitted people who only do so when it does not cost them too much in material comfort, personal relations, or social standing. And of course, what counts as too much varies from person to person. On top of such variations, there are those who consistently display mor- al indifference-people who concede, for example, that certain investment policies have morally problematic consequences, but who can readily and without compunction ignore that in their busi- ness decisions. There even seem to be moral subversives, people who intentionally and knowingly pursue what they acknourledge to be morally u~ong or bad, and do so for that very reason. (shrink)

Moral philosophers are, among other things, in the business of constructing moral theories. And moral theories are, among other things, supposed to explain moral phenomena. Consequently, one’s views about the nature of moral explanation will influence the kinds of moral theories one is willing to countenance. Many moral philosophers are (explicitly or implicitly) committed to a deductive model of explanation. As I see it, this commitment lies at the heart of the current debate (...) between moral particularists and moral generalists. In this paper I argue that we have good reasons to give up this commitment. In fact, I show that an examination of the literature on scientific explanation reveals that we are used to, and comfortable with, non-deductive explanations in almost all areas of inquiry. As a result, I argue that we have reason to believe that moral explanations need not be grounded in exceptionless moral principles. (shrink)

There is an increased focus on fostering integrity in research by through creating an open culture where research integrity dilemmas can be discussed. We describe a pilot intervention study that used Moral Case Deliberation (MCD), a method that originated in clinical ethics support, to discuss research integrity dilemmas with researchers. Our research question was: can moral case deliberation in research groups help to navigate research integrity dilemmas? We performed 10 MCDs with 19 researchers who worked in three different (...) research groups from three different disciplinary fields at a university in the Netherlands. We analyzed the dilemmas and values discussed, sent out a survey questionnaire to assess self-perceived moral competencies, and conducted in-depth interviews. We found research integrity dilemmas pertained to authorship disputes, supervision of junior co-workers, and questionable handling of data. Participants perceived the majority of moral competencies to a higher degree during the MCD when compared to perceiving them in daily practice afterward. Interviewees told us that they felt most comfortable discussing dilemmas among peers with whom they were not closely affiliated. We conclude that MCD sessions could be relevant in navigating research integrity dilemmas, but that revisions to ensure commitment and safety are required. (shrink)

PurposeMedical assistance in dying (MAiD) in Canada places the medical provider at the centre of the process. The MAiD provider holds primary responsibility for determining eligibility and becomes acquainted with patients’ inner desires and expressions of suffering. This is followed by the MAiD procedure of administering the lethal agent and being present at the death of eligible patients. We report participants’ perceptions of the emotional and moral impacts of this role.MethodologyTwo years after MAiD was legalised in Canada, 22 early-adopting (...) physician providers were interviewed. Data were examined using both phenomenological analysis and a novel ChatGPT-enhanced analysis of an anonymised subset of interview excerpts.FindingsParticipants described MAiD as emotionally provocative with both challenges and rewards. Providers expressed a positive moral impact when helping to optimise a patient’s autonomy and moral comfort with their role in relieving suffering. Providers experienced tensions around professional duty and balancing self with service to others. Personal choice and patient gratitude enhanced the provider experience, while uncertainty and conflict added difficulty.ConclusionsParticipants described MAiD provision as strongly aligned with a patient-centred ethos of practice. This study suggests that, despite challenges, providing MAiD can be a meaningful and satisfying practice for physicians. Understanding the emotional and moral impact and factors that enhance or detract from the providers’ experience allows future stakeholders to design and regulate assisted dying in ways congruent with the interests of patients, providers, families and society. (shrink)

Constructing Moral Concepts of God in a Global Age sets aside arguments about God's existence and focuses on what people say and think about God. It offers a theological method, or step-by-step approach to exploring and, if warranted, reframing personal convictions about God and the worldviews shaped by those convictions. Since a moral God is more likely to foster a moral life, this method integrates an ethical check to ensure that conceptions of God and their associated worldviews (...) are validly moral. The proposed method builds on the work of 20th Century theologian Gordon Kaufman during the Kantian phase of his work. It anticipates a person-like God who hears prayers, loves without end, and comforts in times of hardship. To accommodate today's pluralistic and globalized world, the moral check integrated in the method is a widely-collaborative and vetted global ethic, the Parliament of the World's Religions "Declaration Towards a Global Ethic." This volume of constructive philosophical theology is written for seminary students, educators, clergy, study groups, and anyone interested in delving more deeply and systematically into understandings of God, whether their own or other understandings. (shrink)

In this essay, moral anti-theodicy is characterized as opposition to the trivialization of suffering, defined as the reinterpretation of horrendous evils in a way the sufferer cannot accept. Ambitious theodicy (which claim goods emerge from specific evils) is deemed always to trivialize horrendous evils and, because there is no specific theoretical context, also harm sufferers. Moral anti-theodicy is susceptible to two main criticisms. First, it is over-demanding as a moral position. Second, anti-theodicist opposition to least ambitious theodicies, (...) which portray God's decision to create as an scenario, requires a moral commitment to philosophical pessimism. Thus anti-theodicists should not be quick to take the moral high ground. However, this should not encourage theodicists, since theodicies may well be self-defeating in so far as they attempt to provide comfort. (shrink)

Thus declares Francis Hutcheson, expressing a view widespread during the Enlightenment, and throughout the history of philosophy. According to this tradition, we are by nature moral, and ourS concern for good and evil is as natural to us as our capacity to feel pleasure and pain. The link between morality and human nature has been a common theme since ancient times, and, with the rise of modern empirical moral psychology, it remains equally popular today. Evolutionary ethicists, ethologists, developmental (...) psychologists, social neuroscientists, and even some cultural anthropologists tend to agree that morality is part of the bioprogram (e.g., Cosmides & Tooby, 1992; de Waal, 1996; Haidt & Joseph, 2004; Hauser, 2006; Ruse, 1991; Sober & Wilson, 1998; Turiel, 2002). Recently, researchers have begun to look for moral modules in the brain, and they have been increasingly tempted to speculate about the moral acquisition device, and innate faculty for norm acquisition akin to celebrated language acquisition device, promulgated by Chomsky (Dwyer, 1999; Mikhail, 2000; Hauser, this volume). All this talk of modules and mechanism may make some shudder, especially if they recall that eugenics emerged out of an effort to find the biological sources of evil. Yet the tendency to postulate an innate moral faculty is almost irresistible. For one thing, it makes us appear nobler as a species, and for another, it offers an explanation of the fact that people in every corner of the globe seem to have moral rules. Moral nativism is, in this respect, an optimistic doctrine—one that makes our great big world seem comfortingly smaller. I want to combat this alluring idea. I do not deny that morality is ecumenical, but I think it is not innate—at least that the current state of evidence is unpersuasive. Morality, like all human capacities, depends on having particular biological predispositions, but none of these, I submit, deserves to be called a moral faculty. Morality is a byproduct—accidental or invented—of faculties that evolved for other purposes.. (shrink)

This paper defends pro-realism, the view that it is better if moral realism is true rather than any of its rivals. After offering an account of philosophical angst, I make three general arguments. The first targets nihilism: in securing the possibility of moral justification and vindication in objecting to certain harms, moral realism secures something that is non-morally valuable and even essential to the meaning and intelligibility of our lives. The second argument targets antirealism: moral realism (...) secures a desirable independence for moral justification that is qualitatively different from the anti-realistic construal of independence that is only explicable in terms of degrees of distance from our subjective responses and attitudes. Finally, I argue that while the pan-expressivist semantic program of quasi-realism has significant effects on what can be appropriately said in meta-ethical discourse, it provides no comfort to the pro-realist who is already angsty about anti-realism. (shrink)

This paper concerns what I take to be the primary epistemological motivation for defending moral perception. Offering a plausible account of how we gain moral knowledge is one of the central challenges of metaethics. It seems moral perception might help us meet this challenge. The possibility that we know about the instantiation of moral properties in something like the way we know that there is a bus passing in front of us raises the alluring prospect of (...) subsuming moral epistemology under the comfortable umbrella of perceptual or, more broadly, empirical knowledge. The good news on this front is that various combinations of metaethical positions and theories of perception arguably have the potential to vindicate moral perception. The bad news, I’ll argue, is that moral perception would be dependent for its epistemic merit on background knowledge of bridge principles linking moral and non-moral properties. Thus, in order to defend a purely perceptual moral epistemology, one would have to argue that knowledge of those principles is likewise perceptual. I further argue it is not. (shrink)

A popular accusation against moral relativism is that it goes too far in its vindication of tolerance. The idea behind accusations like this can be summarized in the slogan, frequently attributed to relativism, that “anything goes”. The aim of this paper is to defend moral relativism from the accusation that it is an “anything goes” view; from the accusation that it forces us to suspend our judgment in cases in which we do not think we should even be (...) allowed to. In the end, relativism is not an “anything goes” view because it is not a view about what goes, but about the way things go—about what goes on when we say that something is morally right or wrong. There is indeed a view, sometimes called “relativism”, that forces us to suspend our judgment about practices that do not allow for such comfort, but it is not so much moral relativism as moral contextualism. Apparently, though, the most salient alternative to “anything goes” views such as contextualism is not moral relativism. It is moral objectivism, according to which there is a fact of the matter about moral issues. However, I show that moral objectivism too ends up being an “anything goes” view unless the objectivist takes herself to be endowed with “God’s point of view”, which I prove troublesome. (shrink)

The question of corporate moral responsibility – whether corporate bodies can be held morally responsible for their actions – has been debated by a number of writers since the 1970s. This discussion is intended to add to that debate, and focuses for that purpose on our understanding of the organisation. Though the integrity of the organisation has been called into question by the postmodern view of organisations, that view does not necessarily rule out the attribution of corporate agency, any (...) more than the postmodern view of the person rules out the attribution of individual agency. The postmodern view is opposed to a reifying, metaphysical view of corporate agency, but a semantic view of corporate agency would seem to sit more comfortably with it. A bigger problem for the idea of corporate moral responsibility arises from the fact that in Kantian terms organisations are not ends in themselves. In that sense they are not like persons, and this must limit their autonomy, and their responsibility. This aspect of organisations also limits their punishability. For these reasons corporate moral responsibility must be seen as more limited than the responsibility of persons. (shrink)

Both moral practice and moral theory need a sense of proportion. If it matters whether people have virtues or vices, we are justified in praising virtues and the actions that proceed from them, and justified in criticizing, blaming, and condemning vices and vicious actions. Moral judgment is connected with judgments about responsibility and blameworthiness, because the positive and negative sanctions that belong to morality are serious, and we do not want to apply them to people who do (...) not deserve them. We suppose that acceptance of morality is something that we are entitled to demand (under the appropriate conditions) of other people. These features of moral requirements also encourage us to limit the scope of morality. We do not want to confuse moral judgments with judgments about how we would like people to behave, or what makes us comfortable or uncomfortable, or what we regard as good or bad manners. (shrink)

It is an undeniable empirical fact that a human fetus is a member of the species homo sapiens from the moment of conception. There is thus an important sense in which it is a human being in itself, and not simply part of a pregnant woman’s body, despite what defenders of abortion on demand might want us to think. It is also reasonable to suppose that all human beings, and thus human fetuses, are persons, with all that entails, but this (...) is a metaphysical presupposition as opposed to an empirical fact, and is thus contentious. It is argued, however, that this should be of little comfort to the defenders of abortion, because the mere fact that human fetuses have an inherent tendency to become persons is sufficient reason to confer a moral status upon them, which renders abortion morally problematic at best. (shrink)

Many authors have argued that emotions serve an epistemic role in our moral practice. Some argue that this epistemic connection is so strong that creatures who do not share our affective nature will be unable to grasp our moral concepts. I argue that even if this sort of incommensurability does result from the role of affect in morality, incommensurability does not in itself entail relativism. In any case, there is no reason to suppose that one must share our (...) emotions and concerns to be able to apply our moral concept successfully. Finally, I briefly investigate whether the moral realist can seek aid and comfort from Davidsonian arguments to the effect that incommensurability in ethics is in principle impossible, and decide that these arguments are not successful. I conclude that the epistemic role our emotions play in moral discourse does not relativize morality. (shrink)

The likelihood of nurse reflection is examined from the theoretical perspectives of Habermas' Theory of Communicative Action and Moral Action and Sumner's Moral Construct of Caring in Nursing as Communicative Action, through a critical social theory lens. The argument is made that until the nurse reaches the developmental level of post-conventional moral maturity and/or Benner's Stage 5: expert, he or she is not capable of being inwardly directed reflective on self. The three developmental levels of moral (...) maturity and Benner's stages are presented with discussion on whether or not there can be self-reflection because of an innate vulnerability that leads to self-protective behaviours. It is only when the confidence from mastery of practice has been achieved can the nurse be comfortable with reflection that enables him or her to become enlightened, emancipated, and empowered. The influences and constraints of the knowledge power between nurse and patient are acknowledged. The power hierarchy of the institution is recognized as constraining. (shrink)

The aim of this study was to explore the obligations of nurses and physicians in providing end-of-life care. Nineteen nurses and 11 physicians from a single newborn intensive care unit participated. Using content analysis, an overarching obligation of creating the best possible experience for infants and parents was identified, within which two categories of obligations (decision making and the end of life itself) emerged. Obligations in decision making included talking to parents and timing withdrawal. End-of-life obligations included providing options, preparing (...) parents, being with, advocating, creating peace and normalcy, and providing comfort. Nurses and physicians perceived obligations in both categories, although nurse obligations centered on the end of life while physician obligations focused on decision making. The findings demonstrate that, although the ultimate goal is shared by both disciplines, the paths to achieving that goal are often different. This has important implications for collaboration, communication, and improving the end of life. (shrink)

Masahito Mori hypothesised that robots that look somewhat but not quite enough like humans are likely to arouse a sense of unease and discomfort. This hugely influential design hypothesis about robot appearance has been dubbed the ‘Uncanny Valley.’ I argue that there is a more general formulation of this principle that can be extended beyond the aesthetic domain of robot appearance. Specifically, I propose that there exists a _Moral Uncanny Valley_, which occurs when the behaviour of artificial agents mimics somewhat (...) but not quite enough the moral behaviour of humans.The question then is: what should we do about the Moral Uncanny Valley? The solution Mori proposed for the appearance of robots is to _avoid_ the Uncanny Valley and, given the inevitability of failing to reach the second peak, advised designers to design machines specifically to aim for the first peak: that is, to look _less_ like humans. Instead of making a parallel recommendation in the moral case, I explore the dangers of being too comfortable around machines and thus the advantages of _embracing_ the Moral Uncanny Valley. The sense of the uncanny brought about through what I call ‘discomfort by design’ can be useful for helping us to avoid making moral mistakes, like over-ascribing moral agency, patiency and responsibility. (shrink)

The ambiguity regarding whether a given intervention is perceived as enhancement or as therapy might contribute to the angst that the public expresses with respect to endorsement of enhancement. We set out to develop empirical data that explored this. We used Amazon Mechanical Turk to recruit participants from Canada and the United States. Each individual was randomly assigned to read one vignette describing the use of a pill to enhance one of 12 cognitive, affective or social domains. The vignettes described (...) a situation in which an individual was using a pill to enhance the relevant domain under one of two possible enhancement conditions, one perceived as enhancing above the norm, what most people recognize as a clear case of enhancement, whereas the other perceived as enhancing towards the norm, with the individual using the enhancement having a modest, but subclinical deficit. Participants were asked how comfortable they were with the individual using the enhancement and about the impact the enhancement might have had in the individuals’ success in life. We found that irrespective of the domain to be enhanced, participants felt significantly more comfortable with ETN than with EAN, and they regarded the enhancement intervention as contributing to greater success in life with ETN rather than EAN. These data demonstrate that the therapy enhancement distinction is morally salient to the public, and that this distinction contributes to the angst that people feel when considering the propriety of CAS enhancement. (shrink)

Background In February, 2015, the Supreme Court of Canada struck down the ban on medical assistance in dying. In June, 2016, the federal government passed Bill C-14, permitting MAiD. Current medical students will be the first physician cohort to enter a system permissive of MAiD, and may help to ensure equitable access to care. This study assessed medical student views on MAiD, factors influencing these views, and opportunities for medical education. Methods An exploratory cross-sectional survey was developed and distributed to (...) medical students across all years of a three-year Canadian undergraduate medical program. The investigators administered the survey to participants during academic sessions from November to December, 2015. Analysis of the results included summary descriptive statistics, Pearson’s chi-square test of independence to identify differences between participants by year of study, logistic regression to identify factors that influence students’ stances on MAiD, and Wilcoxon signed rank test to measure changes in student support for MAiD and comfort discussing MAiD. Results There were 405 participants for a response rate of 87%. The majority of students supported the Supreme Court’s decision, 61% would provide the means for a patient to end their life, and 38% would personally administer a lethal medication. Students who were more willing to provide the means for MAiD found medical education/clinical experience and patient autonomy to be important contributors to their stances on MAiD. Those students who were less willing to provide the means for MAiD found religious/spiritual beliefs and teachings, as well as concern about potential negative consequences, to be important contributors to their stances on MAiD. Educational training desired by participants included medicolegal, communication skills, technical skills, and religious. Conclusions Medical students generally supported and would provide the means for MAiD to patients. They also indicated a desire for directed medical education on MAiD. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Moral Distress for the Physician AssistantSharyn L. KurtzMy morning rounds as an inpatient medical oncology physician assistant began as usual. I arrived at the hospital early to receive 7 a.m. sign out from the covering resident. The overnight report began favorably. All patients remained stable. Even my patient, whom I will call Mrs. Walker,* had a quiet night. However, given her tenuous admission presentation, including altered mental status, (...) hypercalcemia (high levels of calcium in the blood), atrial fibrillation with rapid ventricular response (irregular, rapid heart function), widespread metastatic lung cancer, and recent neurosurgery to stabilize her spine, I decided to prioritize Mrs. Walker’s morning evaluation.Examining her medical chart proved reassuring. Her tachycardia (rapid heart rate) had been better controlled over the past two days. Her hypercalcemia had been treated, such that she was no longer somnolent. In fact, she was now arousable, conversant, and able to offer some input regarding her healthcare wishes. However, because she was experiencing intermittent delirium, her husband continued to act as her primary medical decision–maker.As her health care proxy, Mr. Walker had experienced conflict with the medical team during his wife’s prior hospital admission. However, even though Mr. Walker lived greater than 45 minutes from the hospital and was not able to visit regularly, he and I spoke daily by phone, which allowed me the opportunity to offer regular medical updates. Mr. Walker felt overwhelmed with his wife’s condition, but he was comfortable with the care the medical team had provided thus far. He was encouraged by the small improvements we had noted since her hospital admission five days prior.Mr. Walker stated on hospital admission that he wished for DNR/I orders to be placed, since this cohered with his wife’s previously stated wishes. However, he still wanted “everything else done” in terms of treating his wife’s medical conditions, including treatment of her atrial fibrillation, pain, and electrolyte anomalies. Most of all, he hoped Mrs. Walker would soon have increased mobility, which he felt would grant his wife the best quality of life possible. He was adamant that “being active” was what Mrs. Walker wished for, and that she had never wanted to be confined to bed.Mr. Walker’s requests seemed reasonable. Although Mrs. Walker’s lung cancer was widespread, and although many on the medical team felt she would not improve to the point where palliative chemotherapy could be considered, [End Page E13] she had stabilized. Her recent spine surgery had been successful, and she was healing adequately. The neurosurgeons had cleared Mrs. Walker for increased activity out of bed as soon as she could be fitted with a lumbar brace. The pain and palliative care specialists felt that Mrs. Walker’s residual back pain and delirium could be well managed with oral medications.Prior to my entering Mrs. Walker’s room to begin her physical evaluation, I was met by her seasoned nurse, whom I will call Amy. “Sharyn,” Amy warned, “Mrs. Walker’s heart rate is 150 and she is complaining of chest pain.” I entered Mrs. Walker’s room, and she was notably uncomfortable, grasping her chest. The monitor showed that Mrs. Walker’s heart rate was in fact in the 150’s. She was pale, short of breath, and wheezing. “Mrs. Walker,” I asked, “how severe is your chest pain on a scale from 1 to 10?” Mrs. Walker replied, “Nine.” I asked Amy to obtain an EKG, to provide oxygen, and to administer an IV medication that would slow Mrs. Walker’s heart rate. I stepped out of the room to place the computer orders, and I paged my attending physician to let him know about Mrs. Walker’s change in status. After hearing the update, my attending physician, whom I will call Dr. Clark, stated that he agreed with all of my treatment decisions thus far. He was on his way into the hospital. I planned out my next steps with him on the phone and returned to the patient’s room.The monitor gave evidence that Mrs. Walker’s heart rate was improving. Mrs. Walker reported that her pain was now “4 out of... (shrink)

How can an individual’s Moral Compass address the question of whether or not to help a patient to shorten and end his or her life? Moral Compass has been defined as that set of values and experiences that guides each individual’s decisions and conduct in relation to others and to society. Can a robot be programmed to have a moral compass? If we were only considering rules of conduct, then perhaps yes, that would be possible. We could (...) establish a series of rules and sanctions that a computer assisted robot could rigorously apply for any violation. The state and many religions already do that, and many individuals are quite comfortable with rigorous, unbendable rules. Most rules, however, have exceptions, so perhaps the robots of the future can be designed to be flexible, that is, human. (shrink)

This contribution has two main goals which might be labelled for convenience as apars construensandpars denstruensreversing the usual order of these terms. The first aim is to offer an overview of the main tenets of the book, while the second aim is to raise some critical concerns while remaining sympathetic to the author’s overall project. With regard to the first point, I present the context of intellectual debate where Buchanan’s contribution fits comfortably: Darwin’s evolutionary theory, anthropology, psychology, moral analysis (...) etc. The target here is to show the internal complexity and different layers of analysis of the book. These initial reconstructions are, next, used to formulate some thoughts on what I consider possible problematic points in need of clarification. In particular, first, I hold that Buchanan presents too narrow oppositional views between intergroup relations whereupon the notion of “tribalism” is constructed. Such strong identitarian conception does not seem to depict adequately the sociological dynamics of intergroup relations. Second, I consider the terms in which it can be addressed the notion of the rise of the moral mind in evolutionary terms. The suggestion is to consider in a milder form the author’s key concept of a “Great Uncoupling” for the moral reason. (shrink)

In healthcare practice, care providers are confronted with decisions they have to make, directly affecting patients and inevitably harmful. These decisions are tragic by nature. This study investigates the role of Moral Case Deliberation in dealing with tragic situations. In MCD, caregivers reflect on real-life dilemmas, involving a choice between two ethical claims, both resulting in moral damage and harm. One element of the reflection process is making explicit the harm involved in the choice. How harmful are our (...) decisions? We investigated how facilitators of MCD experience the importance of addressing harm in MCD and what participants learn from reflecting on harm. The study was qualitative, focusing on the views and experiences of the facilitators of MCD. Semi-structured interviews were conducted with facilitators of MCD. The research focuses on the subjective experiences of facilitators. Grounded Theory was used for analysis. The results show two main categories. The first concerns the awareness of tragedy. Within this category, five themes were discerned: making explicit that there is no solution, visualizing consequences, uncovering pain, focusing on emotion, and exploring perspectives on harm. The second category concerns the support for healthcare professionals in dealing with the tragedy of the choices they face. In this category, five themes came forward: acknowledging, offering comfort, managing harm, consideration through dialogue and repairing harm. Our study shows that addressing harm in MCD in tragic situations provides an important moral learning opportunity for participants. By formulating and becoming aware of harm, MCD aids healthcare professionals in the task they are faced with, namely making difficult and painful choices. MCD helps healthcare professionals to repair moral damage, making clear at the same time that harm cannot be undone. (shrink)

In Morality, Bernard Gert argues that the fundamental demands of morality are well articulated by ten distinct, and relatively simple, rules. These rules, he holds, are such that any person, no matter what her circumstances or interests, would be rational in accepting, and guiding her choices by, them. The rules themselves are comfortably familiar (e.g. “Do not kill,” “Do not deceive,” “Keep your promises”) and sit well as intuitively plausible. Yet the rules are not, Gert argues, to be accepted merely (...) because they are intuitively attractive, nor because they are already widely recognized, but because they stand as the only set of rules that can qualify as appropriately acceptable to all rational beings. (shrink)

Even though morally competent artificial agents have yet to emerge in society, we need insights from empirical science into how people will respond to such agents and how these responses should inform agent design. Three survey studies presented participants with an artificial intelligence agent, an autonomous drone, or a human drone pilot facing a moral dilemma in a military context: to either launch a missile strike on a terrorist compound but risk the life of a child, or to cancel (...) the strike to protect the child but risk a terrorist attack. Seventy-two percent of respondents were comfortable making moral judgments about the AI in this scenario and fifty-one percent were comfortable making moral judgments about the autonomous drone. These participants applied the same norms to the two artificial agents and the human drone pilot. However, people ascribed different patterns of blame to humans and machines as a function of the agent’s decision of how to solve the dilemma. These differences in blame seem to stem from different assumptions about the agents’ embeddedness in social structures and the moral justifications those structures afford. Specifically, people less readily see artificial agents as embedded in social structures and, as a result, they explained and justified their actions differently. As artificial agents will perform many actions with moral significance, we must heed such differences in justifications and blame and probe how they affect our interactions with those agents. (shrink)

Workers can be fired from jobs, citizens sent to jail, and adolescents more likely to experience depression, all because of algorithms. Algorithms have considerable impacts on our lives. To increase user satisfaction and trust, the most common proposal from academics and developers is to increase the transparency of algorithmic design. While there is a large body of literature on algorithmic transparency, the impact of unethical data collection practices is less well understood. Currently, there is limited research on the factors that (...) affect users’ trust in data collection practices and algorithmic transparency. In this research, we explore the relative impact of both factors as they relate to important outcome measures such as user’s trust, comfort level, and moral acceptability. We conducted two pilot studies to learn what real users consider to be ethical and unethical data collection practices, as well as high and low transparency for algorithms. We then used these findings in a 2 × 2 design to examine how transparency and the acceptability of data collection practices impact users’ acceptance, comfort, and trust in algorithms. Our results suggest that the singular emphasis on algorithmic transparency may be misplaced. Given the difference in their impact to increase acceptance, trust, and user satisfaction, a more effective strategy would be to also understand and abide by users’ views of ethical data collection practices. (shrink)

Objective: To explore the ways in which health care practitioners working within the morally contested area of prenatal screening balance their professional and private moral values.Design: Qualitative study incorporating semistructured interviews with health practitioners followed by multidisciplinary discussion groups led by a health care ethicist.Setting: Inner city teaching hospital and district general hospital situated in South East England.Participants: Seventy practitioners whose work relates directly or indirectly to perinatal care.Results: Practitioners managed the interface between their professional and private moral (...) values in a variety of ways. Two key categories emerged: “tolerators”, and “facilitators”. The majority of practitioners fell into the “facilitator” category. Many “facilitators” felt comfortable with the prevailing ethos within their unit, and appeared unlikely to feel challenged unless the ethos was radically challenged. For others, the separation of personal and professional moral values was a daily struggle. In the “tolerator” group, some practitioners sought to influence the service offered directly, whereas others placed limits on how they themselves would contribute to practices they considered immoral.Conclusions: The “official” commitment to non-directiveness does not encourage open debate between professionals working in morally contested fields. It is important that practical means can be found to support practitioners and encourage debate. Otherwise, it is argued, these fields may come to be staffed by people with homogeneous moral views. This lack of diversity could lead to a lack of critical analysis and debate among staff about the ethos and standards of care within their unit. (shrink)

"In the United States, we try to comfort ourselves with the belief that this country, as the leading world power and industrial democracy, is different from the rest of the world--that we have solved our day-to-day problems. Such optimism--undergirded with the best of intentions--obscures the reality of the social problems that remain among us. To name only a few, these include violence, drugs, and other crime illiteracy, homelessness, and poverty and the rising rate of illegitimacy in our society. "A (...) vigorous debate over these issues, which are of such pressing concern, is taking place now in our country. It largely concerns the means we should use to address them: What is the proper role of the government in solving these problems without depriving individuals of their right to shape their own destinies?" --from the Introduction by Andrew R. Cecil. (shrink)

Quand tu es seul, debout au milieu de la haute plaine d'Asie,sous la coupole insondable où parfois un piloteou un ange sème dans l'azur une coulée d'amidon;quand tu tressailles sentant ta petitesse,apprends-le: l'espace auquel semble-t-il il ne fautrien, a grandement besoin en réalitéd'un regard extérieur, de distance, de vide.Tu es seid à pouvoir lui rendre ce service.Joseph BrodskyIn the course of this century, a number of authors have asserted that geographic knowledge is useful for the development of programs to parcel (...) out land. Hoping to foster this link between insight and action, applied geography saw the light of day. In order to be genuinely effective, the practice of this kind of planning, so it was thought, needed to rely on the expertise of the geographer who studied forms of human settlement. More fundamentally, the utilitarian claim of applied geography rested on the conviction according to which the spatial organization of human societies brought into play the question of justice and commonweal. As Jean Gottmann wrote, our epoch is particularly sensitive to the fact that everyone, whoever or from wherever they may be, consider themselves “to be entitled to live just as well as all others.” In this way a “popular will” was affirmed “that the necessary measures be taken to envisage, prepare, and provide for an improvement of life's comforts …, for a better life.” Inspired by the “modern idea of planning,” applied geography set itself the goal of “establishing justice […] by a more even distribution of people, of their means of subsistence, [and] of their living standard.”. (shrink)

Technologies are being developed for significantly altering the traits of existing persons (or fetuses or embryos) and of future persons via germ line modification. The availability of such technologies may affect our philosophical, legal, and everyday understandings of several important concepts, including that of personal identity. I consider whether the idea of personal identity requires reconstruction, revision or abandonment in the face of such possibilities of technological intervention into the nature and form of an individual's attributes. This requires an account (...) of the work done by the concept of personal identity, and an explanation of what “conceptual impacts of technology” and “conceptual reconstruction” might mean. Our existing notions of personal identity and related ideas such as personhood and autonomy may seem unable to comfortably accommodate the possibilities of technologically directed trait formation and development. This is a matter of moral and legal importance because the idea of personal identity embeds major values and reflects value-laden beliefs and attitudes. The assumed endurance of identity underlies interpersonal relationships, the assignment of rewards and punishments, and the very idea of what constitutes an autonomous person. Perhaps radical restructuring or even abandonment of concepts are sometimes called for when the world changes drastically, but I suggest that conceptual modification is not “compelled” for personal identity except under extreme circumstances—the remote possibility of rapid human “shape shifting” where physical and mentational attributes can be transformed quickly and continuously. Efforts to enhance human traits, including merit attributes and other resource-attractive characteristics (e.g., intellectual and athletic aptitudes, physical size and appearance), may generate legal problems wherever the persistence of identity is presupposed. Some advance speculation is thus warranted on how trait change generally will be managed within our legal and socioeconomic systems, and more particularly on rights of access to trait-altering technologies. I mention the possible distributive effects of enhancing highly-resource attractive traits, including the strengthening individual powers to acquire still more increments in such traits in a self-reinforcing cycle. A brief review of some constitutional issues bearing on trait change completes the discussion. I conclude that existing and projected technologies do not impel the abandonment or remodeling of the idea of personal identity. We may, however, have to reconsider some uses of this concept in different settings, to rethink our understandings of ideas of merit and desert, and to deal with the distribution of resources that may enlarge and entrench the “distances” between social and economic groups. (shrink)

The gap between the affluent and the global poor has increased during the past few decades, whether it is measured in terms of private consumption, income, or wealth. One would expect that severe poverty in a world of abundance would constitute a moral challenge to the affluent, but in fact it hardly seems a serious ethical concern. Affluent citizens seem so little morally concerned with global poverty. However, the most promising approach seems to be to explore and divulge factually (...) and conceptually the numerous ways in which the affluent are implicated in a wholly unjust world of growing inequality. Changing people's moral perception is an arduous task and it is to be expected that affluent people will only gradually come to morally question their comfortable lives, at least in the absence of environmental or political disasters that might occur in the future. The immense human suffering at stake makes it a duty for moral philosophers to continue to work at and even increase their efforts towards this task. (shrink)

Through examining the respective roles of "pride" and "sympathy" in Hume's natural sublime experience and through comparing that analysis with the roles played by those concepts in his discussion of "heroic virtue," I demonstrate both that there is an element of the moral in natural sublimity and that Hume evokes a conception of sublimity as sometimes _distinctly<D> moral. Moral sublime experience entails the _un<D>-comfortably _un-<D>Humean possibility of sublimity inhering in the uniquely human object which makes that experience (...) "moral." I detail how this radical claim is so and demonstrate how Hume's moral sublime deepens the pre-Kantian strain in his aesthetics. (shrink)

BackgroundIn childhood cancer care, healthcare professionals must deal with several difficult moral situations in clinical practice. Previous studies show that morally difficult challenges are related to decisions on treatment limitations, infringing on the child's integrity and growing autonomy, and interprofessional conflicts. Research also shows that healthcare professionals have expressed a need for clinical ethics support to help them deal with morally difficult situations. Moral case deliberations (MCDs) are one example of ethics support. The aim of this study was (...) to describe the MCD-related outcomes that healthcare professionals in childhood cancer care considered important, before MCDs were implemented, in order to facilitate the implementation of MCDs in childhood cancer care in Sweden.MethodsThis study is based on qualitative data. Healthcare professionals, mostly representing registered nurses, nursing assistants and physicians, working at childhood cancer care centres in Sweden, were invited to respond to the translated and content validated European MCD Outcomes Instrument, before participating in regular MCDs. Answers to the main open-ended question, included in the questionnaire, was analysed according to systematic text condensation.ResultsData was collected from 161 responses from the healthcare professionals. The responses included healthcare professionals’ perceptions of which MCD-related outcomes they found important for handling moral challenges. Three different themes of important outcomes from the analysis of the data are presented as follows:Interprofessional well-being in team interactionson a team level;Professional comfort when dealing with moral challengeson a personal level; andImproved quality of care for the child and the familyon a care level.ConclusionsHealthcare professionals in childhood cancer care considered it important that ethics support could enhance the well-being of interprofessional teams, support healthcare professionals on an individual level and improve quality of care. The results of this study can be used in current and future training for MCD-facilitators. When knowing the context specific important MCD-outcomes, the sessions could be adapted. Managers in childhood cancer care would benefit from knowing about the specific important outcomes for their target group because they could then create relevant working conditions for clinical ethics support. (shrink)

Recent research has highlighted the application of moral foundations theory in counseling settings as it can provide a complex framework to understand the concept of morality, moral diversity, values, and decision-making processes. The emergence and development of social justice and multicultural counseling competencies has particularly raised important concerns regarding the application of values in counseling. The present study examined moral foundations as predictors of counseling students’ universality – diversity orientation. Three hundred and fifty-six counseling students at the (...) undergraduate level participated in the research (Mage = 21.86, SD = 2.26, 77.1% female). The results of a series of multiple regression analyses indicated that individualizing foundations were stronger predictors of universality – diversity orientation. Fairness was the only significant predictor of the behavioral aspect of universality – diversity orientation (diversity of contact), while fairness and care robustly predicted the cognitive aspect of universality – diversity orientation (relativistic appreciation). Care, authority, and loyalty significantly predicted the emotional aspect (comfort with differences). Overall, these results suggest that the participating counselor candidates were more likely to rely on individualizing foundations for cultural competence. (shrink)

In this article, caring, remembering and sharing memory are presented as moral responses, the case study being Alzheimer’s disease (AD). Memory connects memories and images, while care connects individuals, which is an ethical issue. When a person’s memory is lost, the care of others becomes the only thread connecting them to the world. AD deprives a person of memories, body control, makes it impossible to remember, communicate, move, recognize the environment, and disrupts consciousness. Caring for a patient with a (...) neurodegenerative brain disease requires constant reminding and reiteration; the presence of a caring person reminds of what the patient themselves can no longer remember. Lost memories do not mean that life or relational values have also lost their meaning. The description of the memory movement emphasizes the importance of repetition in the moral act. Highlighting the matter of care, also in scientific work, is the aim of this text. To care is to remember, on behalf of the AD patient, about the patient’s life. Within bioethical research, moral responses are an important point for projects which seek to improve the condition of patients—not only the condition of health but also the comfort of life. This improvement will not be possible without attentive, committed caregivers and their responsible attitude in the face of the phenomenon of memory loss. (shrink)

Ralph Waldo Emerson once wrote: “In the tranquil landscape, and especially in the distant line of the horizon, man beholds somewhat as beautiful as his own nature” (2003. 39). Th e poet captures nicely an idea, dominant in the contemporary environmental aesthetics, namely, that aesthetic appreciation of nature is intimately connected with the moral nature within us. Many of us have experienced when in contact with nature that its beauty moves us in a way that goes deeper than its (...) initial appeal; it elicits in us a feeling of comfort, hope, a sense of well-being and belonging to the world. My aim in this paper is to propose an explanation of the connection between our aesthetic experience of natural beauty and our moral ideas. I approach this problem in light of Kant’s aesthetic theory put forward in the Critique of the Power of Judgment. (shrink)