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

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

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

This case study explored how a teacher, Mr. Smith, and his students experienced a mandated performance assessment while simultaneously preparing for an end of the year high-stakes, multiple-choice assessment. We employed qualitative research methods to examine how the teacher enacted a mandated performance assessment during a unit on Byzantium and how students described their learning and classroom experiences from the unit. Drawing on Grant's idea of ambitious teaching and learning of history and Ball's work on policy realization, analysis of these (...) data indicated that Mr. Smith interpreted and enacted a performance assessment in ways that differed from how district and state policy makers intended. Despite an assessment that the district designed to promote historical thinking skills, students learned primarily factual knowledge. (shrink)

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

Several recent studies indicate that cheating has become both more prevalent and more socially acceptable. In this article I draw parallels between market values and student attitudes about cheating. They include: (1) reduction of a broad range of goods to their economic value, (2) use of non-reciprocity as a guiding principle, (3) valuing the appearance of virtue over real virtue, and (4) reframing dishonesty in a positive light. I posit two ways that market culture influences the willingness to cheat, and (...) discuss the media's role in transmitting this influence. The article concludes with the suggestion that attempts to curtail cheating by further policing students may only exacerbate the problem in the long run. The same contextual factors that help mitigate undesirable market behavior, when cultivated in the classroom, can help to curb student cheating. (shrink)

In this work, Colleen Clements presents her case for the need to subject the field of bioethics to a critical external analysis apart from the current postmodern assumptions. Clements argues that, since the 1970s, bioethics has refuted human values in favour of political consensus building. This failure to recognize basic human values in the ethical critique of modern medicine has lead to a dehumanization of the medical system by the field. Clements proceeds to advocate a naturalistic theory of bioethics (...) that reinstates primary human values. (shrink)

The Flint water crisis demonstrates the importance of adequate legal preparedness in dealing with complicated legal arrangements and multiple statutory responsibilities. It also demonstrates the need for alternative accountability measures when public officials fail to protect the public's health and explores mechanisms for restoring community trust in governmental public health.

While the focus examines multiple levels and perspectives on care, it will go beyond description and analysis to discuss ethical, intersectional, and life-sustaining ways in which care may be enhanced.

It is easy to call for public engagement (or dialogue) around difficult, morally fraught policy topics such as synthetic biology, but it is quite another thing to make sure that the deliberation is meaningful, as Kaebnick, Gusmano, and Murray aptly insist it should be. The surveys, focus groups, and public dialogues that have been held about synthetic biology to date show a very low level of public knowledge about it. Focus group findings also suggest that the in­herent uncertainty and complexity (...) surrounding synthetic biology give rise to greater ambivalence moving forward. The Science and Technology Innovation Program at the Woodrow Wilson International Center for Scholars and Hart Research Associates presented respondents with a “balanced description” of synthetic biology in nation­wide phone surveys and eight sessions of focus groups and found that, after respondents received information, the percentage saying that the risks outweighed the ben­efits consistently increased.In my view, the Hart research suggests three very im­portant conclusions about how best to structure public deliberation. First, information about uncertainty may not inform the public in any meaningful way. Second, the purpose of assessing public opinion and conduct­ing public deliberation is crucially important. Third, as Kaebnick, Gusmano, and Murray point out, the type and framing of the information given and the timing of the discussion matters a great deal for shaping the content. (shrink)

Hegemonic masculinity, a framework where stereotypically masculine traits are over-emphasized, plays a central role in sport, partly due to an excessive focus on winning. This type of masculinity marginalizes those that do not possess specific traits, including many women and men. I argue sport reform focused on mitigating hypercompetitive attitudes can reduce this harmful and marginalizing hegemonic masculinity in sport. I make this argument first by challenging the dichotomous nature of sport, especially in recognizing that all outcomes are a blend (...) of winning and losing, that ties are relevant and informative outcomes to contests, and that winning and losing do not always tell accurate stories of the outcome. Secondly, I contend that expanding the potential outcomes in sport can help broaden the emphasis of competitive sport to take into account playing well and improving, in terms of both the test and the contest. I conclude that these reforms decrease hegemonic masculinity, making sport better for all. (shrink)

In this paper, we present a Capabilities -based Approach to the acceptability and the tolerability of risks posed by natural and man-made hazards. We argue that judgments about the acceptability and/or tolerability of such risks should be based on an evaluation of the likely societal impact of potential hazards, defined in terms of the expected changes in the capabilities of individuals. Capabilities refer to the functionings, or valuable doings and beings, individuals are able to achieve given available personal, material, and (...) social resources. The likely impact of a hazard on individuals’ capabilities should, we argue, be compared against two separate thresholds. The first threshold specifies the minimum level of capabilities attainment that is acceptable in principle for individuals to have in the aftermath of a hazard over any period of time. This threshold captures the level that individuals’ capabilities ideally should not fall below. A risk is acceptable if the probability that the attained capabilities will be less than the acceptable level is sufficiently small. In practice, it can be tolerable for some individuals to temporarily fall below the acceptable threshold, provided this situation of lower capabilities attainment is temporary, reversible, and the probability that capabilities will fall below a tolerability threshold is sufficiently small. This second, tolerable threshold delimits an absolute minimum level of capabilities attainment below which no individual in a society should ever fall, regardless of whether that level of capabilities attainment is temporary or reversible. In this paper, we describe and justify this Capabilities -based Approach to the acceptability and tolerability of risks. We argue that the proposed theoretical framework avoids the limitations in current approaches to acceptable risk. The proposed approach focuses the attention of risk analysts directly on what should be our primary concern when judging the acceptability and the tolerability of risks, namely, how risks impact the well-being of individuals in a society. Also, our Capabilities -based Approach offers a transparent, easily communicable way for determining the acceptability and the tolerability of risks. (shrink)

The development of the curriculum for engineering education should be based on a comprehensive understanding of engineers’ responsibilities. The responsibilities that are constitutive of being an engineer include striving to fulfill the standards of excellence set by technical codes; to improve the idealized models that engineers use to predict, for example, the behavior of alternative designs; and to achieve the internal goods such as safety and sustainability as they are reflected in the design codes. Globalization has implications for these responsibilities (...) and, in turn, for engineering education, by, for example, modifying the collection of possible solutions recognized for existing problems. In addition, international internships can play an important role in fostering the requisite moral imagination of engineering students. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 39.4 (2001) 491-533 [Access article in PDF] Worthy Constraints in Albertus Magnus's Theory of Action Colleen McCluskey Many medieval accounts of action focus upon the interaction between intellect and will in order to explain how human action comes about. What moves agents to act are their desires for certain goals, their deliberations about their goals, and what it will take to accomplish (...) those goals and satisfy their desires. Thus, many medieval philosophers explain human action by referring to the operations of intellect or reason, which accounts for the deliberative aspect, and the will, which accounts for the desiderative aspect. This is not to say that medieval accounts ignored other influences on action such as passions or sensory desires, but that they tended to focus on the intellect and the will. The account of action developed by Albert the Great early in his career is a notable variation on this basic model. 1 Albert examined the nature of action in a number of texts written over the course of his long career, including De homine, De anima, and his commentaries on the Sentences and Nicomachean Ethics. In De homine, which is an early work, he agrees that intellect and will play important roles in the execution of action, but he argues that both the performance of an action and its freedom involve a third capacity that he calls "liberum arbitrium." Albert modified his views of action significantly in his later works, but I shall argue that this early view retains something of philosophical interest and importance.In the medieval philosophical tradition of the Latin West, beginning with Augustine in the fourth and fifth centuries and continuing well into the thirteenth century, philosophers used the term "liberum arbitrium," often translated [End Page 491] as "free choice" or "free decision," as a technical term for that power or capacity in virtue of which human beings act freely. 2 In the first half of the thirteenth century, many philosophers identified liberum arbitrium either with the will, or with both intellect and will. In De homine, Albert insists that it is a separate capacity. According to his account, liberum arbitrium is the human capacity for choice and also helps to explain the freedom of those choices. Although Albert ultimately characterizes an act of choosing as an inclination in favor of a particular course of action, a certain cognitive ability plays an important role in his account. Part of what makes human freedom possible is the ability to judge secundum rationem honesti. Literally this phrase means "in accordance with the concept of what has worth." I shall argue that this capacity consists of the ability to evaluate choices in light of one's immediate, intermediate, or ultimate objectives and to forgo lesser goods for the sake of a greater good. It would appear that an ability of this sort is a function of the intellect, since judgments about how to accomplish one's goals and which goods are the better ones require the exercise of certain abstract cognitive skills. But Albert holds that the intellect is determined and concludes that while the intellect is a necessary condition for free action, the constraints placed upon it prevent it from contributing substantially to the freedom of an action. Since the ability to judge secundum rationem honesti plays an integral role in bringing about a free action, Albert cannot argue that this ability is a function of the intellect. Although the will has the requisite freedom, it is an appetitive capacity, not a cognitive one. Therefore, it too is unable to fulfill this role. Given these commitments, it would seem natural for Albert to locate this ability in an independent power.As natural as it may appear, this position is bound to strike many philosophers as implausible and unnecessary. One could argue that the constraints placed upon the intellect need not restrict it in any significant way. I do not plan to defend Albert's account against this objection. Rather, first, I shall [End Page 492] examine Albert's view of... (shrink)

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

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

It is often argued that the rule of law is only instrumentally morally valuable, valuable when and to the extent that a legal system is used to purse morally valuable ends. In this paper, I defend Lon Fuller’s view that the rule of law has conditional non-instrumental as well as instrumental moral value. I argue, along Fullerian lines, that the rule of law is conditionally non-instrumentally valuable in virtue of the way a legal system structures political relationships. The rule of (...) law specifies a set of requirements which lawmakers must respect if they are to govern legally. As such, the rule of law restricts the illegal or extra-legal use of power. When a society rules by law, there are clear rules articulating the behavior appropriate for citizens and officials. Such rules ideally determine the particular contours political relationships will take. When the requirements of the rule of law are respected, the political relationships structured by the legal system constitutively express the moral values of reciprocity and respect for autonomy. The rule of law is instrumentally valuable, I argue, because in practice the rule of law limits the kind of injustice which governments pursue. There is in practice a deeper connection between ruling by law and the pursuit of moral ends than advocates of the standard view recognize. The next part of this paper outlines Lon Fuller’s conception of the rule of law and his explanation of its moral value. The third.. (shrink)

Cognitive control constrains retrieval processing and so restricts what comes to mind as input to the attribution system. We review evidence that older adults, patients with Alzheimer's disease, and people with traumatic brain injury exert less cognitive control during retrieval, and so are susceptible to memory misattributions in the form of dramatic levels of false remembering.

Thomism is a philosophical movement based on the writings of Thomas Aquinas. This chapter begins by explaining the historical context within which Thomism originated and some of the general issues arising in Thomistic discussions, and then considers the two main approaches to Thomistic ethics: eudaimonism and natural law. It concludes with an application of Thomistic ideas to a current discussion of justice and practical rationality, specifically Alasdair MacIntyre's treatment of Aquinas in his book, Whose Justice? Which Rationality?

One of the central moral challenges facing numerous political communities today is political reconciliation. In the aftermath of repression, conflict, and injustice, communities confront the task of repairing damaged relationships among citizens and between citizens and officials. In A Moral Theory of Political Reconciliation, I develop a theory of what this process entails and of its moral significance. My central claim is that political relationships are damaged when and to the extent that they fail to express reciprocity and respect for (...) agency. Failures of reciprocity and respect for agency are how relationships go wrong during extended periods of repression and conflict, and it is in cultivating these two values in relations among citizens and officials that relationships are repaired. I am very grateful for the thoughtful, incisive, and stimulating comments provided by Cindy Holder, Tracy Isaacs, and Alice MacLachlan. In this reply to their commentaries, I first provide a brief background of the motivation for my project and an overview of the main theses that I defend over the course of my book. I then turn to three kinds of concerns raised by Holder, Isaacs, and MacLachlan. The first urges me to rethink the restriction of my analysis of political reconciliation to contexts of transition. The second challenges the particular way that I conceptualize the demands of reciprocity and respect for agency in political relationships. The final set turns to my analysis of the processes that can facilitate reconciliation. (shrink)

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

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

This purpose of this qualitative study was to gather detailed information about student perceptions of self-plagiarism and the perceived effectiveness of a brief self-plagiarism video tutorial. Semi-structured interviews were conducted and health sciences doctoral students were queried regarding their knowledge and perceptions of self- plagiarism. The population for this study was new doctoral students, as well as students who had committed self-plagiarism during the semester. Overall, participants reported a specific self-plagiarism intervention was more helpful in preventing self- plagiarism than a (...) traditional plagiarism intervention and that the intervention should be included in initial program orientation. Overwhelmingly, students did not believe self- plagiarism was a serious academic offense and think they own their intellectual property and unpublished works. (shrink)

I argue that international criminal trials can contribute to political reconciliation by fostering the social conditions required for law’s efficacy.