Austerity, by its very nature, imposes constraints by limiting the options for action available to us because certain courses of action are too costly or insufficiently cost effective. In the context of healthcare, the constraints imposed by austerity come in various forms; ranging from the availability of certain treatments being reduced or withdrawn completely, to reductions in staffing that mean healthcare professionals must ration the time they make available to each patient. As austerity has taken hold, across the United Kingdom (...) and Europe, it is important to consider the wider effects of the constraints that it imposes in healthcare. Within this paper, we focus specifically on one theorised effect—moral distress. We differentiate between avoidable and unavoidable ethical challenges within healthcare and argue that austerity creates additional avoidable ethical problems that exacerbate clinicians’ moral distress. We suggest that moral resilience is a suitable response to clinician moral distress caused by unavoidable ethical challenges but additional responses are required to address those that are created due to austerity. We encourage clinicians to engage in critical resilience and activism to address problems created by austerity and we highlight the responsibility of institutions to support healthcare professionals in such challenging times. (shrink)

Contrary to political and philosophical consensus, we argue that the threats posed by climate change justify population engineering, the intentional manipulation of the size and structure of human populations. Specifically, we defend three types of policies aimed at reducing fertility rates: choice enhancement, preference adjustment, and incentivization. While few object to the first type of policy, the latter two are generally rejected because of their potential for coercion or morally objectionable manipulation. We argue that forms of each policy type are (...) pragmatically and morally justified tools for preventing the harms of global climate change. (shrink)

Among the myriad of technical approaches and abstract guidelines proposed to the topic of AI bias, there has been an urgent call to translate the principle of fairness into the operational AI reality with the involvement of social sciences specialists to analyse the context of specific types of bias, since there is not a generalizable solution. This article offers an interdisciplinary contribution to the topic of AI and societal bias, in particular against the poor, providing a conceptual framework of the (...) issue and a tailor-made model from which meaningful data are obtained using Natural Language Processing word vectors in pretrained Google Word2Vec, Twitter and Wikipedia GloVe word embeddings. The results of the study offer the first set of data that evidences the existence of bias against the poor and suggest that Google Word2vec shows a higher degree of bias when the terms are related to beliefs, whereas bias is higher in Twitter GloVe when the terms express behaviour. This article contributes to the body of work on bias, both from and AI and a social sciences perspective, by providing evidence of a transversal aggravating factor for historical types of discrimination. The evidence of bias against the poor also has important consequences in terms of human development, since it often leads to discrimination, which constitutes an obstacle for the effectiveness of poverty reduction policies. (shrink)

This paper examines how young peoples’ lived experiences with personal technologies can be used to teach engineering ethics in a way which facilitates greater engagement with the subject. Engineering ethics can be challenging to teach: as a form of practical ethics, it is framed around future workplace experience in a professional setting which students are assumed to have no prior experience of. Yet the current generations of engineering students, who have been described as ‘digital natives’, do however have immersive personal (...) experience with digital technologies; and experiential learning theory describes how students learn ethics more successfully when they can draw on personal experience which give context and meaning to abstract theories. This paper reviews current teaching practices in engineering ethics; and examines young people’s engagement with technologies including cell phones, social networking sites, digital music and computer games to identify social and ethical elements of these practices which have relevance for the engineering ethics curricula. From this analysis three case studies are developed to illustrate how facets of the use of these technologies can be drawn on to teach topics including group work and communication; risk and safety; and engineering as social experimentation. Means for bridging personal experience and professional ethics when teaching these cases are discussed. The paper contributes to research and curriculum development in engineering ethics education, and to wider education research about methods of teaching ‘the net generation’. (shrink)

o privacy regarding family matters, common law rule, and a general presumption that parents or guardians will act in the best interest of their incompetent child. However, over the years, the courts have gradually recognized that children younger than 18 years who show maturity and competence deserve a voice in determining their course of medical treatment. This article will explore the rights and interests of minors, parents, and the state in medical decision making and will address implications for nursing administrators (...) and leaders.... (shrink)

The complexities of how justice comes to be realized, and by which agents, is a relatively neglected element in contemporary theories of justice. This has left several crucial questions about agency and justice undertheorized, such as why some particular agents are responsible for realizing justice, how their contribution towards realizing justice should be understood, and what role agents such as activists and community leaders play in realizing justice. We aim to contribute towards a better understanding of the landscape of these (...) kinds of questions. First, we argue that theorists should distinguish between (i) agents who are responsible for realizing justice, but not committed to it, (ii) agents who are not responsible for realizing justice, but who are committed to it, and (iii) agents who are both responsible for and committed to realizing justice. Second, we discuss how to incorporate agents of justice more robustly into theorizing about justice. (shrink)

Aims: The aim of this narrative synthesis was to explore the necessary and sufficient conditions required to define moral distress. Background: Moral distress is said to occur when one has made a moral judgement but is unable to act upon it. However, problems with this narrow conception have led to multiple redefinitions in the empirical and conceptual literature. As a consequence, much of the research exploring moral distress has lacked conceptual clarity, complicating attempts to study the phenomenon. Design: Systematic literature (...) review and narrative synthesis (November 2015–March 2016). Data sources: Ovid MEDLINE® In-Process & Other Non-Indexed Citations 1946–Present, PsycINFO® 1967–Present, CINAHL® Plus 1937–Present, EMBASE 1974–24 February 2016, British Nursing Index 1994–Present, Social Care Online, Social Policy and Practice Database (1890–Present), ERIC (EBSCO) 1966–Present and Education Abstracts. Review methods: Literature relating to moral distress was systematically retrieved and subjected to relevance assessment. Narrative synthesis was the overarching framework that guided quality assessment, data analysis and synthesis. Results: In all, 152 papers underwent initial data extraction and 34 were chosen for inclusion in the narrative synthesis based on both quality and relevance. Analysis revealed different proposed conditions for the occurrence of moral distress: moral judgement, psychological and physical effects, moral dilemmas, moral uncertainty, external and internal constraints and threats to moral integrity. Conclusion: We suggest the combination of (1) the experience of a moral event, (2) the experience of ‘psychological distress’ and (3) a direct causal relation between (1) and (2) together are necessary and sufficient conditions for moral distress. (shrink)

Within this paper, we discuss Moral Distress Reflective Debriefs as a promising approach to address and mitigate moral distress experienced by healthcare professionals. We briefly review the empirical and theoretical literature on critical incident stress debriefing and psychological debriefing to highlight the potential benefits of this modality. We then describe the approach that we take to facilitating reflective group discussions in response to morally distressing patient cases (“Moral Distress Reflective Debriefs”). We discuss how the debriefing literature and other clinical ethics (...) activities influenced the development of our approach. In particular, we focus on the role of the clinical ethicist as a facilitator with particular emphasis on encouraging perspective-taking and nurturing ethical attunement in a supportive manner. We suggest that this approach reduces the narrowing effects of frustration and anger that are often reported when individuals experience moral-constraint distress. Finally, we provide an example of Moral Distress Reflective Debriefs, elucidating how this supportive process complements ethics consultation and can mitigate the negative effects of moral distress. (shrink)

In recent years, the phenomenon of moral distress has been critically examined—and for a good reason. There have been a number of different definitions suggested, some that claimed to be consistent with the original definition but in fact referred to different epistemological states. In this paper, we re‐examine moral distress by exploring its relationship with moral agency. We critically examine three conceptions of moral agency and argue that two of these conceptions risk placing nurses' values at the center of moral (...) action when it ought to be the patient's values that shape nurses' obligations. We propose that the conception of moral agency advanced by Aimee Milliken which re‐centers patient values, should be more broadly accepted within nursing. We utilize a case example to demonstrate a situation in which the values of a patient's parents (surrogates) justifiably constrained nurses' moral agency, creating moral distress. Through an examination of constraints on nurse agency in this case, we illustrate the problematic nature of ‘narrow' moral distress and the value of re‐considering moral distress. Finally, we provide an action‐oriented proposal identifying mediating steps that we argue have utility for nurses (and other healthcare professionals) to mediate between experiences of narrow moral distress and the exercise of moral agency. (shrink)

Though many argue over root causes, few dispute the existence of gender disparities across our societal landscape. Patriarchal norms consistently obstruct the flourishing of those who identify themselves as women, those who are identified by others as women, and generally those who gender-identify in ways that challenge the norms of heterosexual cis-gender male privilege. Acknowledging the limits of our analysis, here we focus on some of the disparities faced by women in particular.1 From the persistent wage gap despite women's steadily (...) increasing participation in the workforce, to the perplexing paucity of women occupying C-suite positions in business or tenured professorships in academia despite efforts to... (shrink)

While Jameton’s (1984) definition of moral distress has been embraced by researchers and scholars for recognizing the many constraints that nurses experience on their moral agency, it has also been...

Wittgenstein explores learning through practice in the Philosophical Investigations by means of an extended analogy with games. However, does this concern with learning also necessarily extend to education, in our institutional understanding of the word? While Wittgenstein's examples of language learning and use are always shared or social, he does not discuss formal educational institutions as such. He does not wish to found a ‘school of thought’, and is suspicious of philosophy acting as a theory that can be applied to (...) other areas of life. While Wittgenstein's focus on developing independent thinking was neither individualistic nor anti-institutional, it did, however, focus on developing the thinking of his students rather than theorising about how this could be applied on a large scale. An analysis of Hermann Hesse's novel, The Glass Bead Game will help us to pick up where Wittgenstein deliberately left off—thinking about how (or if) one can institutionalise learning methods that encourage thinking for oneself. These differences in the writers’ treatment of education will become evident in the differences between their game analogies. While language-games combat our ‘craving for generality’ in Philosophical Investigations, the Glass Bead Game represents this craving, and how it manifests itself throughout history in disciplines other than logic and philosophy of language. It also represents the potential for institutions to become insular, exclusive communities. (shrink)

The Covid‐19 pandemic has highlighted many of the difficult ethical issues that health care professionals confront in caring for patients and families. The decisions such workers face on the front lines are fraught with uncertainty for all stakeholders. Our focus is on the implications for nurses, who are the largest global health care workforce but whose perspectives are not always fully considered. This essay discusses three overarching ethical issues that create a myriad of concerns and will likely affect nurses globally (...) in unique ways: the safety of nurses, patients, colleagues, and families; the allocation of scarce resources; and the changing nature of nurses’ relationships with patients and families. We urge policy‐makers to ensure that nurses’ voices and perspectives are integrated into both local and global decision‐making so as to minimize the structural injustices many nurses have faced to date. Finally, we urge nurses to seek sources of support throughout this pandemic. (shrink)

The predominant position in the reproductive rights literature argues that access to assisted reproductive technologies (ART) forms part of an individual’s right to reproduce. On this reasoning, refusal of treatment by clinicians (via provision) violates a hopeful parent’s reproductive right and discriminates against the infertile. I reject these views and suggest they wrongly contort what reproductive freedom entitles individuals to do and demand of others. I suggest these views find their origin, at least in part, in the way we define (...) “reproduction” itself. This paper critically analyses two widely accepted definitions of human reproduction and demonstrates that both are fundamentally flawed. While the process of reproduction includes the biological acts of begetting and bearing a child, I argue that it does not extend to include rearing. This reworked definition has little impact in the realm of sexual reproduction. However, it has significant ethical implications for the formulation and assignment of reproductive rights and responsibilities in the non-sexual realm in two important ways. First, a claim to access ART where one has an intention to rear a child (but does not beget or bear) cannot be grounded in reproductive rights. Second, lacking an intention to rear does not extinguish the reproductive rights and responsibilities for those who collaborate in the process. I conclude that clinicians collaborate in non-sexual reproduction at the point of triggering conception (begetting) and therefore have the right to refuse to be involved in non-sexual reproduction, in some instances, as do all reproductive collaborators. (shrink)

Background There is ongoing debate regarding how moral distress should be defined. Some scholars argue that the standard “narrow” definition overlooks morally relevant causes of distress, while others argue that broadening the definition of moral distress risks making measurement impractical. However, without measurement, the true extent of moral distress remains unknown. Research aims To explore the frequency and intensity of five sub-categorizations of moral distress, resources used, intention to leave, and turnover of nurses using a new survey instrument. Research design (...) A mixed methods embedded design included a longitudinal, descriptive investigator-developed electronic survey with open-ended questions sent twice a week for 6 weeks. Analysis included descriptive and comparative statistics and content analysis of narrative data. Participants Registered nurses from four hospitals within one large healthcare system in Midwest United States. Ethical considerations IRB approval was obtained. Results 246 participants completed the baseline survey, 80 participants provided data longitudinally for a minimum of 3 data points. At baseline, moral-conflict distress occurred with the highest frequency, followed by moral-constraint distress and moral-tension distress. By intensity, the most distressing sub-category was moral-tension distress, followed by “other” distress and moral-constraint distress. Longitudinally, when ranked by frequency, nurses experienced moral-conflict distress, moral-constraint distress, and moral-tension distress; by intensity, scores were highest for moral-tension distress, moral-uncertainty distress, and moral-constraint distress. Of available resources, participants spoke with colleagues and senior colleagues more frequently than using consultative services such as ethics consultation. Conclusions Nurses experienced distress related to a number of moral issues extending beyond the traditional understanding of moral distress (as occurring due to a constraint) suggesting that our understanding and measurement of moral distress should be broadened. Nurses frequently used peer support as their primary resource but it was only moderately helpful. Effective peer support for moral distress could be impactful. Future research on moral distress sub-categories is needed. (shrink)

Background The phenomenon of ‘moral distress’ has continued to be a popular topic for nursing research. However, much of the scholarship has lacked conceptual clarity, and there is debate about what it means to experience moral distress. Moral distress remains an obscure concept to many clinical nurses, especially those outside of North America, and there is a lack of empirical research regarding its impact on nurses in the United Kingdom and its relevance to clinical practice. Research aim To explore the (...) concept of moral distress in nursing both empirically and conceptually. Methodology Feminist interpretive phenomenology was used to explore and analyse the experiences of critical care nurses at two acute care trauma hospitals in the United Kingdom. Empirical data were analysed using Van Manen’s six steps for data analysis. Ethical considerations The study was approved locally by the university ethics review committee and nationally by the Health Research Authority in the United Kingdom. Findings The empirical findings suggest that psychological distress can occur in response to a variety of moral events. The moral events identified as causing psychological distress in the participants’ narratives were moral tension, moral uncertainty, moral constraint, moral conflict and moral dilemmas. Discussion We suggest a new definition of moral distress which captures this broader range of moral events as legitimate causes of distress. We also suggest that moral distress can be sub-categroised according to the source of distress, for example, ‘moral-uncertainty distress’. We argue that this could aid in the development of interventions which attempt to address and mitigate moral distress. Conclusion The empirical findings support the notion that narrow conceptions of moral distress fail to capture the real-life experiences of this group of critical care nurses. If these experiences resonate with other nurses and healthcare professionals, then it is likely that the definition needs to be broadened to recognise these experiences as ‘moral distress’. (shrink)

The paper discusses some aspects of the relationship between Feyerabend and Kuhn. First, some biographical remarks concerning their connections are made. Second, four characteristics of Feyerabend and Kuhn's concept of incommensurability are discussed. Third, Feyerabend's general criticism of Kuhn's Structure of Scientific Revolutions is reconstructed. Fourth and more specifically, Feyerabend's criticism of Kuhn's evaluation of normal science is critically investigated. Finally, Feyerabend's re-evaluation of Kuhn's philosophy towards the end of his life is presented.

The idea of a role in nursing that includes expertise in ethics has been around for more than 30 years. Whether or not one subscribes to the idea that nursing ethics is separate and distinct from bioethics, nursing practice has much to contribute to the ethical practice of healthcare, and with the strong grounding in ethics and aspiration for social justice considerations in nursing, there is no wonder that the specific role of the nurse ethicist has emerged. Nurse ethicists, expert (...) in nursing practice and the application of ethical theories and concepts, are well positioned to guide nurses through complex ethical challenges. However, there is limited discussion within the field regarding the specific job responsibilities that the nurse ethicist ought to have. The recent appearance of job postings with the title “nurse ethicist” suggest that some healthcare institutions have identified the value of a nurse in the practice of ethics and are actively recruiting. Discomfort about the possibility of others defining the role of the nurse ethicist inspired this paper (and special issue). If the nurse ethicist is to be seen as an integral part of addressing ethical dilemmas and ethical conflicts that arise in healthcare, then nurse ethicists ought to be at the forefront of defining this role. In this paper, we draw upon our own experiences as nurse ethicists in large academic healthcare systems to describe the essential elements that ought to be addressed in a job description for a nurse ethicist practicing in a clinical setting linked to academic programs. Drawing upon our experience and the literature, we describe how we perceive the nurse ethicist adds value to healthcare organizations and teams of professional ethicists. (shrink)

This essay considers the ancient antecedents to the “new field” of the ethics of philanthropy, arguing that key questions such as “to whom should we give our money?” have already been explored by ancient authors and that the answers they give to these questions can be quite different to the answers given by contemporary scholars. By analysing the treatment of giving in Aristotle’s Nicomachean Ethics, Cicero’s De Officiis, and Seneca’s De Beneficiis, I argue that the focus of ancient thinkers upon (...) giving within one’s own community can be viewed as a possible response to a number of issues that have been raised by modern scholars, including the “problem of acting at a distance” and the “problem of accountability.” Moreover, these ancient thinkers have additional, positive reasons for thinking that philanthropy should take place within one’s own community, based upon their ideas of man’s natural duty to his political community, and the social benefits that can be derived from local philanthropy. The integration of ancient perspectives, then, into these modern debates, can serve to complement and broaden research in this emerging field. (shrink)

In debates over abortion, the foetus and the woman have been continually positioned as antagonists. Given the stakes involved in such debates about personal integrity, individual responsibility, life and death, it is no wonder that many radical feminist authors have concentrated on refocusing the attention on women and away from the disembodied foetus. Such writers have worked hard to decode and deconstruct the public foetus in our midst and have mobilized interpretative tools such as cultural criticism to contextualize the production (...) and consumption of foetal images. Barbara Duden's book, The Public Foetus, is an important and interesting contribution to this effort, which is still taken up by authors writing in this field. Duden's strategy is to seek to remind us (and in particular those who are involved in reproductive medicine) that pregnancy is concentrated in the embedded pregnant woman rather than the disembodied ‘public foetus’ and she attempts to retrieve the embodied woman as the site of pregnancy through what Michaels has termed a ‘fetal disappearing act’. While this may create as many problems for women as it resolves, I would argue that, while the ‘public foetus’ continues to loom large in the politics of abortion and women's positions in relation to the new reproductive technologies remain contested, Duden's work remains important in the continuing debate about how women's reproductive freedom can be continually re-negotiated and re-established. (shrink)

Este artículo se divide en una parte teórica, que examina las aportaciones de la ética ecológica, la pedagogía socrática –actualizada en la Filosofía para Niñas, Niños y Jóvenes– y el ecofeminismo a la educación ambiental; y una parte narrativa, donde se describe una propuesta de educación ecofeminista llevada a cabo con estudiantes de un bachillerato ubicado en Suchitlán, Colima, México. El objetivo de este trabajo es transitar desde los referentes conceptuales hacia la implementación de diálogos sobre feminismo y crisis ecológica (...) con jóvenes en el contexto de una comunidad en la que sobreviven algunas concepciones indígenas del mundo, pero también la pobreza, la desigualdad de género, los problemas socioambientales y el maltrato animal. La tesis defendida es que el ecofeminismo, en tanto que cuestionamiento del antropocentrismo, el androcentrismo y el colonialismo, representa un nuevo paradigma para la pedagogía ambiental. En las conclusiones se argumenta el valor positivo de las reflexiones dialógicas del estudiantado y la relevancia de sus voces para otra educación posible. (shrink)

A Catholic layman who views himself as uniquely “in the world,” but not “of the world” provides a broader perspective on the “end times.” This book is the first of its kind, a Catholic perspective that is not heavily weighed down in doctrine and dogma.

Worldwide, more parents are opting for immersion pre-schooling for their children in order to benefit from its linguistic, educational, and cultural benefits. This immersion can be either bilingual or monolingual, aimed at early second language learning, or at language maintenance – offering minority language children mother-tongue support and enrichment. This book examines some of the key issues and policy concerns relating to immersion education in the early years. The term itself can be difficult in some political contexts, as can the (...) differing outcomes noted by studies comparing monolingual programmes, and bilingual programmes for minority language children. The importance of training in immersion methodology for educators is discussed, as is the need to adapt preschool pedagogical practices to the immersion context, in order to provide optimal input for young language learners. One of the most pressing discussions surrounds differentiated provision – ensuring that the varying needs of children with language impairment, typical second language learners, and mother-tongue speakers with significant socioeconomic or linguistic disadvantages are all met. Overall, the book explores the challenges currently facing the sector, particularly with regard to training and professional development for practitioners, and the provision of appropriate materials in less widely used languages. Given the documented benefit of high quality immersion pre-schooling, this book fulfils an urgent need to increase the recognition of the sector. This book was published as a special issue of _International Journal of Bilingual Education and Bilingualism. _. (shrink)

Embora a ideia de que os processos orgânicos se equilibrassem entre dois processos opostos, um construtivo e um destrutivo, fosse lugar-comum entre as especulações biológicas do século XIX, a semelhança entre a proposta de um instinto de morte, introduzida por Élie Metchnikoff em sua obra de 1903, Etudes sur la Nature Humaine, e a pulsão de morte, proposta por Freud em 1920, justifica não somente essa breve exposição sobre algumas das reflexões de Metchnikoff, como traz novamente à cena a ideia (...) – detectada por meio do mecanismo da apoptose - de que forças de morte atuam na própria constituição da matéria orgânica. (shrink)

Colonization occurs in many fields, from the scientific to the philosophical, and involves all forms of life including flora, fauna and micro-organisms. All these forms of life can colonize or be c...

There has been increasing debate in recent years about the conceptualization of moral distress. Broadly speaking, two groups of scholars have emerged: those who agree with Jameton’s ‘narrow definition’ that focuses on constraint and those who argue that Jameton’s definition is insufficient and needs to be broadened. Using feminist empirical bioethics, we interviewed critical care nurses in the United Kingdom about their experiences and conceptualizations of moral distress. We provide our broader definition of moral distress and examples of data that (...) both challenge and support our conceptualization. We pre‐empt and overcome three key challenges that could be levelled at our account and argue that there are good reasons to adopt our broader definition of moral distress when exploring prevalence of, and management strategies for, moral distress. (shrink)

After twelve years as the inaugural Director of the Caroline Chisholm Centre for Health Ethics, leading Melbourne bioethicist Dr Norman M Ford has resigned his position. Instead of contemplating retirement however, the tireless septuagenarian, who is also a philosopher, author, Honorary Research Fellow in the School of Philosophy and Bioethics at Monash University and Catholic Salesiah priest, has his sights set on tackling even more controversial biomedical issues as an independent research scholar and author. Georgina Hall gets an insight (...) into his life’s work. (shrink)

Children, the image of the child, and the gendered figures of the girl and the boy are thematics that run through the work of Deleuze and feature prominently in his joint writing with Guattari. However, there are many different children in Deleuze's writings. Various child figures do distinct things in Deleuze's work. In this article, I argue that his work on children can be utilized to rethink popular, teleological notions of childhood and growing up.

Reproduction is broadly recognised as fundamental to human flourishing. The presumptive priority of reproductive freedom forms the predominant position in the literature, translating in the non-sexual reproductive realm as an almost inviolable right to access assisted reproductive technology (ART). This position largely condemns refusal or restriction of ART by clinicians or the state as discriminatory. In this paper, I critically analyse the moral rights individuals assert in reproductive pursuit to explore whether reproductive rights entitle hopeful parents to ART. I demonstrate (...) that none of the protected actions performed, or entitlements generated are sui generis ‘reproductive’ rights, leading to the claim that there is no such thing as a right to reproduce. Under scrutiny, the reproductive right is a far narrower and weaker rights assertion than is recognised in the literature. I argue that the predominant position is grounded in a fundamental misunderstanding of the scope and strength of reproductive claims.I also highlight a significant conceptual inconsistency in the literature. On one hand, there is broad consensus that reproductive rights are predominantly negative, yet access to fertility treatment is framed as a component of the right. This wrongly contorts the negative nature of reproductive rights into a positive claim-right to ART. I conclude that this mistakenly frames ART access as sitting within the scope of reproductive freedom. I offer a revised conceptual paradigm of reproductive rights that has important clinical and policy implications for the provision and regulation of ART. (shrink)

Fertility clinicians participate in non-sexual reproductive projects by providing assisted reproductive technology (ART) to those hoping to reproduce, in support of their reproductive goals. In most countries where ART is available, the state regulates ART as a form of medical treatment. The predominant position in the reproductive rights literature frames the clinician’s role as medical technician, and the state as a third party with limited rights to interfere. These roles broadly align with established functions of clinician and state in Western (...) liberal democracies, where doctors have duties to provide safe, beneficial and legal healthcare to all who seek it. Recognised state responsibilities include safeguarding equitable access to medical services and protecting and promoting reproductive liberty.I argue against this normative moral framing of clinician and state involvement in non-sexual reproduction, suggesting that clinician and state join the non-sexual reproductive project at the point of triggering conception. Begetting a child is more than just the provision and regulation of healthcare; it generates rights and confers responsibilities on all who join this morally significant project. All who collaborate have the right to join or refuse to join the project. I suggest this is intuitively understood in the sexual realm, but not in the non-sexual realm. My key substantive claim is that non-sexual reproduction is a pluralist pursuit that morally implicates more than the genetic and gestational contributors. I find that while the moral basis of a clinician or the state’s right to refuse to join the ART project is the same as for those providing gestational or genetic input, the reasons that morally underpin their refusal differs. (shrink)

Place, practice and status have played significant and interacting roles in the complex history of primatology during the early to mid-twentieth century. This paper demonstrates that, within the emerging discipline of primatology, the field was understood as an essential supplement to laboratory work. Founders argued that only in the field could primates be studied in interaction with their natural social group and environment. Such field studies of primate behavior required the development of existing and new field techniques. The practices and (...) sites developed by American primatologist Clarence Ray Carpenter were used to demonstrate that scientific standards could be successfully applied to the study of primates in the field. In an environment in which many field biologists fought for higher scientific status, Carpenter gradually adopted increasingly interventionist techniques. These techniques raised epistemological problems for studies whose value rested on the naturalness of the behaviors observed. Thus, issues of status shaped field practices and subsequently altered Carpenter's criteria for what constituted natural primate behavior. (shrink)

While the phenomenon of ‘moral distress’ has been of interest to the nursing community since Jameton first described it in 1984, moral distress is now understood to effect healthcare professionals...

Catalysed by conversations amongst a group of colleagues, this article is an initial exploration of what happens to women academics aged 60+ who work in a university in Aotearoa New Zealand. This work is an example of when academic theories, in this case feminism, are called forth by real-world experiences – in this case, increasing academic job insecurity, catalysed by post-pandemic economic shortfalls. We blend together personal anecdotes and feminist analysis to show how women’s academic careers, which are commonly constrained (...) by motherhood in their younger years, are also curtailed at the senior end by processes of voluntary/involuntary retirement, as and when demanded by adverse fiscal conditions. (shrink)

ABSTRACT:Clinical ethics consultants bear witness to the direct harms of intersecting axes of oppression—such as racism and classism—as they impinge on elucidating and resolving ethical dilemmas in health care. Health Care Ethics Consultation (HCEC) professional guidance supports recognizing and analyzing power dynamics and social-structural obstacles to good care. However, the most relied upon bioethical principles in clinical ethics have been criticized for insufficiency in this regard. While individual ethics consultants have found ways to expand their approaches, they do so in (...) an ad hoc way without frameworks to guide consistency. Motivated by the practical expertise of clinical ethicists, this essay offers a new framework to support openness to analyzing power imbalances and respecting marginalized voices and values. This framework is grounded in transformative justice, where the aim is to take responsibility for oppression by centering and responding to moral perspectives and value systems that are all too often silenced. (shrink)

Background: Nurses face ethical issues and experience moral distress in their everyday work. A nursing ethics champion program was developed at a hospital in the United States. Methods: As part of a quality improvement project, pre- and post-training surveys were developed to assess whether the program was feasible and sustainable, enhanced nurse confidence in recognizing and addressing ethical issues and moral distress, and increased nurse knowledge of institutional resources for addressing the same. Qualitative and quantitative analyses were performed. Results: Thirteen (...) nurses from both the critical care and medical/surgical settings participated in the program. The program proved feasible. Attrition after the educational sessions raised concerns about sustainability. Survey results suggest an association between participating in the program’s educational sessions and increased nurse confidence in recognizing and addressing ethical issues and moral distress, as well as identifying institutional resources that can assist nurses with the same. Discussion: Opportunities for future nursing ethics champion programs include increasing the interactivity and duration of educational sessions, making programs multidisciplinary, and creating materials for nurses to more easily share with colleagues. It would be valuable for future research to measure the impact of nursing ethics champion programs on nursing turnover. Implications: A nursing ethics champion program has the potential to help nurses feel better equipped to navigate ethical issues and moral distress in their everyday work. (shrink)

Empathy is sometimes so hard to achieve that one may wonder if it is a virtue for caregivers at all. Perhaps a caregiver cannot always know how a patient feels, and perhaps that knowledge is sometimes too painful to possess. A nuanced understanding of what empathy entails and of the conditions for attaining it can help ground its possibility.

A growing body of literature critical of ethics review boards has drawn attention to the processes used to determine the ethical merit of research. Citing criticism on the bureaucratic nature of ethics review processes, this literature provides a useful provocation for (re)considering how the ethics review might be enacted. Much of this criticism focuses on how ethics review boards _deliberate,_ with particular attention given to the lack of transparency and opportunities for researcher recourse that characterise ethics review processes. Centered specifically (...) on the conduct of ethics review boards convened within university settings, this paper draws on these inherent criticisms to consider the ways that ethics review boards might enact more communicative and deliberative practices. Outlining a set of principles against which ethics review boards might establish strategies for engaging with researchers and research communities, this paper draws attention to how _Deliberative communication_, _Engagement with researchers_ and the _Distribution of responsibility_ for the ethics review might be enacted in the day-to-day practice of the university human ethics review board. This paper develops these themes via a conceptual lens derived from Habermas’ (The theory of communicative action. Volume 1: Reason and the rationalization of society, 1984 ) articulation of ‘communicative action’ and Fraser’s (Social Text, 25(26), 56–80, 1990 ) consideration of ‘strong publics’ to cast consideration of the role that human ethics review boards might play in supporting university research cultures. _Deliberative communication_, _Engagement with researchers_ and the _Distribution of responsibility_ provide useful conceptual prompts for considering how ethics review boards might undertake their work. (shrink)

No organization is absolutely justified even if it promotes the freedom of all its members—but promotes their freedom only. It may do so and yet be inimical to a broader liberty. That is why each partial organization needs the criticism of some higher organization, and why ultimately all other organizations of men must come to the bar of the organization of all men if that can ever come to pass.... We can imagine a perfect liberty only in a world society (...) and a world State. (shrink)