Los textos de este libro, escritos entre 2006 y 2010, están vinculados por un tema común: la conjunción Humanidades-Universidad. Los autores presentan aquí una parte del proceso de investigación –que se realiza en el Instituto de Investigaciones Sociales de la UNAM– cuyo eje ha girado alrededor del problema de la definición contemporánea de Universidad como institución educativa formadora de cultura y su relación intrínseca con las Humanidades, en una dirección más específica, buscan mostrar la continuidad de las palabras que definen (...) lo humano, a través de un léxico que ha perdurado en la definición y quehacer de la institución universitaria, específicamente de la UNAM. Las correspondencias y cruces necesarios entre las evidencias teóricas y empíricas en este trabajo permiten un abanico de lecturas desde las cuales se posibilitan diversas interpretaciones problemáticas de la institución. Los temas y problemas abordados resultan de sumo interés para la comunidad universitaria, en especial para los académicos universitarios en cuyas manos se realiza cotidianamente el fin formativo de la Universidad. De la misma manera, este libro constituye un excelente material de apoyo para la formación de comunicólogos: en el sentido de contrastar las teorías desde la perspectiva de un estudio concreto, y con ello, arrojar luz sobre la investigación de diversos fenómenos comunicativos. (shrink)

Suffering is a ubiquitous yet elusive concept in health care. In a field devoted to the pursuit of objective data, suffering is a phenomenon with deep ties to subjective experience, moral values, and cultural norms. Suffering’s tie to subjective experience makes it challenging to discern and respond to the suffering of others. In particular, the question of whether a child with profound neurocognitive disabilities can suffer has generated a robust discourse, rooted in philosophical conceptualizations of personhood as well as the (...) academic and experiential expertise of practiced health-care professionals. The issue remains unresolved because it is difficult, perhaps impossible, to ever truly know an infant’s lived experience. But what if this is not the best question? What if instead of asking “can this infant suffer?” the discourse is broadened to ask “is there suffering here?” This latter question demands attention to patients’ subjective experiences of suffering, but also to the web of relationships that envelop them. Without losing sight of the importance of patients’ experiences, consideration of their relationships may elucidate the presence of suffering when the patients themselves are unable to provide the same clarity. In this essay, care ethics frames an examination of how suffering manifests in the loving and caring relationships that surround an infant with profound neurocognitive disabilities, changing those relationships and affecting the individuals within them. Exploring suffering through these relationships may offer clarity on the presence and content of suffering for infants with profound cognitive disabilities, in turn offering moral guidance for responding to suffering and supporting flourishing in this context. (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...

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)

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)

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 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)

During the 1780s, as Kant was developing his universalistic moral theory, he published texts in which he defended the superiority of whites over non-whites. Whether commentators see this as evidence of inconsistent universalism or of consistent inegalitarianism, they generally assume that Kant's position on race remained stable during the 1780s and 1790s. Against this standard view, I argue on the basis of his texts that Kant radically changed his mind. I examine his 1780s race theory and his hierarchical conception of (...) the races, and subsequently address the question of the significance of these views, especially in the light of Kant's own ethical theory. I then show that during the 1790s Kant restricts the role of the concept of race, and drops his hierarchical account of the races in favour of a more genuinely egalitarian and cosmopolitan view. (shrink)

Iho/abstractThe idea of the ‘intercultural hyphen’ is likened to a gap or bridge between ethnic groups, created from the ongoing intertwining of sociopolitical and intellectual histories. This ‘gap or bridge’ wording captures the paradoxical nature of the intercultural space, for which the ‘hyphen’ is a shorthand symbol or sign. There are options on either side to engage or disengage across the intercultural space represented by the hyphen—but how, and with what results? In Aotearoa New Zealand, tensions invoked by the indigenous-settler (...) hyphen are worked through every day in a multitudinous range of real-world scenarios. The purpose of this article is to combine critical Māori readings with critical Pākehā readings to discuss the intercultural hyphen as a theoretical concept in education, showing how Māori and Kaupapa Māori benefit from this concept, and arguing for stronger engagement of critical Māori scholarship in the field of philosophy and theory of education. (shrink)

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)

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)

The Montagovian hypothesis of direct model-theoretic interpretation of syntactic surface structures is supported by an account of the semantics of binding that makes no use of variables, syntactic indices, or assignment functions & shows that the interpretation of a large portion of so-called variable-binding phenomena can dispense with the level of logical form without incurring equivalent complexity elsewhere in the system. Variable-free semantics hypothesizes local interpretation of each surface constituent; binding is formalized as a type-shifting operation on expressions that denote (...) functions, & sentences containing a free pronoun are analyzed as a function from individuals to propositions having a meaning of type (e,t). Standard weak crossover effects & binding patterns in sentences with multiple pronouns are shown to submit to straightforward type-theoretic treatments that do not rely on indexation. The variable-free semantics smoothly implements full surface compositionality & requires less machinery than standard accounts to handle functional questions, their answers, sloppy inferences, & across-the-board binding. 73 References. J. Hitchcock. (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)

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)

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)

Alongside clinical practice, medical schools now confront mounting reasons to examine nontraditional approaches to ethics. Increasing awareness of systems of oppression and their effects on the experiences of trainees, patients, professionals, and generally on medical care, is pushing medical curriculum into an unfamiliar territory. While there is room throughout medical school to take up these concerns, ethics curricula are well-positioned to explore new pedagogical approaches. Feminist ethics has long addressed systems of oppression and broader structures of power. Some of its (...) established concepts can offer distinct value as medical climates change and adapt in response to increased awareness of the experiences of marginalized individuals and populations. In this essay, we offer a set of concepts from feminist ethics that have a fundamental role to play in medical school curriculum: relationality, relational autonomy, and epistemic justice. Though these concepts are not exhaustive, they can be taught in tandem with the concepts that have historically grounded ethics education in medical school, such as autonomy and beneficence. Ultimately, we contend that these concepts hold particular value in ethics curriculum insofar as they diversify mainstream ethical approaches, directly address the pervasiveness of systems of oppression in medicine, and recognize the voices and concerns that may be marginalized in standard approaches. (shrink)

Volume 25, Issue 2, February 2025, Page 36-38.

The aim of this paper is to examine the current state of development of Mäori science curriculum policy, and the roles that various discourses have played in shaping these developments. These discussions provide a background for suggestions about a possible future direction, and the presentation of a new concept for Mäori science education.

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)

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)

The BBC is an exemplary institution in the government of culture. In the context of the neo-liberalism of the 1990s it became also a key experimental site for the development of a new culture of government, one in which notions of markets, efficiency, accountability and audit were translated into the public sector. The focus of this paper is an analysis, based on ethnographic research, of the BBC's culture of markets, accountability and audit in the mid to late nineties. Indebted in (...) part to the Foucauldian concern with the relations between forms of political rationality and specific technologies of government, the paper charts the substance and the anti-creative effects of these techniques. But it stresses also their contestability and negotiability, how they evoke ambivalance and coexist with diverse forms of resistance. In particular, through the case of the BBC, the paper sketches the contours of a sociology of reflexivity based on a more differentiated account of reflexivity than is found in the speculative, often normatively-directed writings of Beck, Giddens and Lash. It points to the layering of reflexivities in and around the contemporary BBC, and to the competing and antagonistic reflexivities that may inhabit any social space. (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)

The present study endeavors to give a description of a famous case of sexual harass- ment at the workplace and critique it in terms of its embedment of an intertwined relationship between two pervasive ideologies prevalent in our society: patriarchy and consumerism. By focusing on the favorable conditions, ways of resolution, and outcomes of the lawsuit, this essay approaches the organization- al culture of Mitsubishi Motor Manufacturing of America through the lens of critical theory. Selective literature review on sexual harassment, (...) as well as general coverage of the event by the media and the parties involved demonstrate the validity of the claim that this study has made. (shrink)

The German poet Barbara Köhler's 2007 poem-cycle Niemands Frau [Nobody's Wife] is more than a feminist response to Homer's Odyssey. In shifting the focus from the escapades of the hero Odysseus to the web of women characters that populates Homer's epic poem – Nausicaa, Circe, the Sirens, Helen, Ino Leucothea, the shades of the dead women whom Odysseus meets in Hades, and “Nobody’s wife” Penelope – Köhler also undertakes a grammatical shift: from the masculine singular pronoun “er” to the polyvalent (...) pronoun “sie” that denotes the feminine singular, the gender-unmarked plural and the formal “you.” “Sie” acts as the “quantum linguistic particle” that transports the reader from a world analogous to that conceived by Newtonian physics into a quantum universe of plural probabilities. Köhler's work explores the difference in power dynamics that results from this transformation, generating intriguing ways of reconceiving subjectivity, relationality, rationality, and authorship. Taken at their word, the poems open up a prospect of no longer insisting on the sovereign individual subject and his linear modes of narration, inheritance, calculation and grammatical proposition. (shrink)

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)

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)

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)

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)

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)

Russell articulates compelling reasons that bioethicists and health care professionals should take individual responsibility for deconstructing structural injustices in healthcare through in...

This year’s Waitangi Day, 6 February 2021, saw the revival of a favourite zombie in New Zealand politics when Judith Collins, the leader of the Opposition, complained about not getting a chance to...

This article presents narratives from 13 Indigenous early career academics (ECAs) at one university in Auckland, New Zealand. These experiences are likely to represent those of Indigenous Māori and Pasifika ECAs nationally, given the small, centralised nature of the national academy of Aotearoa New Zealand. The narratives contain testimony, fictionalised vignettes of experience, and poetic expressions. Meeting the demands of an academic role in one’s first years of working at a university is a big deal for anyone; the extra pressures (...) and challenges for Indigenous Māori and Pacific staff are immense, yet little understood by White ‘others.’ A writing workshop was the initial catalyst of this collective writing project. Through these insider narratives, this article presents a collective description of, and response to, the experience of Māori and Pasifika early career academics. (shrink)

In the present book, Pauline Phemister argues against traditional Anglo-American interpretations of Leibniz as an idealist who conceives ultimate reality as a plurality of mind-like immaterial beings and for whom physical bodies are ultimately unreal and our perceptions of them illusory. Re-reading the texts without the prior assumption of idealism allows the more material aspects of Leibniz's metaphysics to emerge. Leibniz is found to advance a synthesis of idealism and materialism. His ontology posits indivisible, living, animal-like corporeal substances as the (...) real metaphysical constituents of the universe; his epistemology combines sense-experience and reason; and his ethics fuses confused perceptions and insensible appetites with distinct perceptions and rational choice. In the light of his sustained commitment to the reality of bodies, Phemister re-examines his dynamics, the doctrine of pre-established harmony and his views on freedom. The image of Leibniz as a rationalist philosopher who values activity and reason over passivity and sense-experience is replaced by the one of a philosopher who recognises that, in the created world, there can only be activity if there is also passivity; minds, souls and forms if there is also matter; good if there is evil; perfection if there is imperfection. (shrink)

Cosmopolitanism is not a single encompassing idea but rather comes in at least six different varieties, which have often been conflated in previous literature. This is shown on the basis of the discussion in late eighteenth-century Germany (roughly, 1780-1800). The six varieties are: (1) moral cosmopolitanism, the view that all humans belong to a single moral community; political cosmopolitanism, which advocates (2) reform of the international political and legal order or (3) a strong notion of human rights; (4) cultural cosmopolitanism, (...) which emphasizes the value of global cultural pluralism; (5) economic cosmopolitanism, which aims at establishing a global free market; and (6) the romantic ideal of humanity as united by faith and love. These six kinds of cosmopolitanism are not mutually exclusive, and the relationships among them are clarified. (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...

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)

Patriotism and cosmopolitanism are often presumed to be mutually exclusive, but Immanuel Kant defends both. Although he is best known for his moral and political cosmopolitanism, in several texts he defends the claim that we have a duty of patriotism, claiming that cosmopolitans ought to be patriotic. In this paper, I examine Kant’s different accounts of the duty of patriotism. I argue that Kant’s defense of nationalist patriotism fails, but that his argument for a duty of civic patriotism succeeds.

One of the most important difficulties facing Kant’s Formula of Universal Law (FUL) is its apparent inability to show that it is always impermissible to kill others for the sake of convenience. This difficulty has led current Kantian ethicists to de-emphasize the FUL or at least complement it with other Kantian principles when dealing with murder. The difficulty stems from the fact that the maxim of convenience killing fails to generate a ‘contradiction in conception’, producing only a ‘contradiction in the (...) will’ when subjected to the two-fold test associated with the FUL. This result is thought to imply that the FUL allows us sometimes to kill for the sake of convenience. In this essay, I argue that the very diagnosis of the problem rests on a mistake, and that if the maxim of convenience killing generates a contradiction in the will, then acting on it is never permissible. (shrink)

In this essay, “The Principle of Autonomy in Kant’s Moral Theory: Its Rise and Fall,” Pauline Kleingeld notes that Kant’s Principle of Autonomy, which played a central role in both the Groundwork for the Metaphysics of Morals and the Critique of Practical Reason, disappeared by the time of the Metaphysics of Morals. She argues that its disappearance is due to significant changes in Kant’s political philosophy. The Principle of Autonomy states that one ought to act as if one were giving (...) universal laws through one’s maxims. The criterion of just legislation that Kant accepted in the mid-1780s does not require any actual consent on the part of the citizens—genuine universality is sufficient for a law to be just. Hence, at that time, Kant could indeed explicate the criterion governing the moral permissibility of one’s maxims by drawing an analogy with the criterion governing the justice of political laws. In the Metaphysics of Morals and in other works in the 1790s, however, he added the further condition that laws must be given with the consent of the citizens. With this further condition, the moral criterion was no longer fully analogous to the criterion for political laws being just. Accordingly, Kleingeld argues, Kant dropped the Principle of Autonomy, which was firmly based on that analogy. (shrink)

Background: Pre-licensure ethics nursing education does not adequately prepare and instill confidence in nurses to address ethical issues, and yet ethics education provides nurses with greater confidence to take moral action, which can mitigate the negative effects of moral distress. Objectives: To assess the feasibility and acceptability of a nursing ethics education program that included simulated case-based ethics competencies as a form of evaluation. The program aimed at building nurses’ ethical knowledge and confidence to respond to ethical challenges in practice. (...) Research design: A prospective, longitudinal, correlational, single-cohort feasibility study using an investigator-developed survey and intervention field data. Participants and research context: Registered nurses were recruited from an academic quaternary-care medical center and 9 small- to mid-sized regional hospitals within one health system in the Midwest United States. Ethical considerations: IRB approval was obtained. Participants could complete the educational program regardless of research process participation. Findings: Of 20 participants, 19 (95%) provided post-program surveys and 18 completed competencies. Median (IQR) scores with quartiles for scheduling, timing, and length of sessions were all 10.0 [9.0, 10.0], and participants perceived that the content was interesting, increased knowledge and confidence in ethics, increased skills in providing ethical care, and would recommend the program to colleagues. Of factors, an increase in ethics knowledge had the highest “always agree” (17, 89.5%) response. Most participants reported that ethics competencies were appropriate 9.0 [9.0, 10.0] and sufficiently challenging 10.0 [9.0, 10.0]. Discussion: The education program developed nurses’ ethics knowledge and confidence. The single-cohort feasibility design provided early-stage intervention outcomes; however, a larger randomized controlled trial would substantiate program value. Conclusion: This novel ethics education program was highly feasible and acceptable to hospital-based nurses who reported increased knowledge and confidence in providing ethical care. Simulated case-based ethics competencies were an appropriate evaluation method. (shrink)

Paulin and Cahill‐Lane explore the origins of event processing and event prediction in animal evolution. They propose that the evolutionary benefit of being able to predict and thus to quickly react to anticipated events may have triggered the evolution of the earliest nervous systems.

This book focusses on conceptual shifts in the successive formulations of natural law theory by Aquinas, Suárez, Grotius, Pufendorf, and Finnis, and reveals the accumulation of problems, inherent in natural law and theory, which ultimately led to its demise.