Researchers have identified the phenomena of moral distress through many studies in Western countries. This research reports the first study of moral distress in Iran. Because of the differences in cultural values and nursing education, nurses working in intensive care units may experience moral distress differently than reported in previous studies. This research used a qualitative method involving semistructured and in-depth interviews of a purposive sample of 31 (28 clinical nurses and 3 nurse educators) individuals to identify the types of (...) moral distress among clinical nurses and nurse educators working in 12 cities in Iran. A content analysis of the data produced four themes to describe the nurses’ moral distress. The four themes were as follows: (a) institutional barriers and constraints; (b) communication problems; (c) futile actions, malpractice, and medical/care errors; (d) inappropriate responsibilities, resources, and competencies. The results demonstrate that moral distress for intensive care unit nurses is different and that the nursing leaders must reduce moral distress among nursing in intensive care. (shrink)

Decades of research conducted in Western, Educated, Industrialized, Rich, & Democratic (WEIRD) societies have led many scholars to conclude that the use of mental states in moral judgment is a human cognitive universal, perhaps an adaptive strategy for selecting optimal social partners from a large pool of candidates. However, recent work from a more diverse array of societies suggests there may be important variation in how much people rely on mental states, with people in some societies judging accidental harms just (...) as harshly as intentional ones. To explain this variation, we develop and test a novel cultural evolutionary theory proposing that the intensity of kin-based institutions will favor less attention to mental states when judging moral violations. First, to better illuminate the historical distribution of the use of intentions in moral judgment, we code and analyze anthropological observations from the Human Area Relations Files. This analysis shows that notions of strict liability—wherein the role for mental states is reduced—were common across diverse societies around the globe. Then, by expanding an existing vignette-based experimental dataset containing observations from 321 people in a diverse sample of 10 societies, we show that the intensity of a society's kin-based institutions can explain a substantial portion of the population-level variation in people's reliance on intentions in three different kinds of moral judgments. Together, these lines of evidence suggest that people's use of mental states has coevolved culturally to fit their local kin-based institutions. We suggest that although reliance on mental states has likely been a feature of moral judgment in human communities over historical and evolutionary time, the relational fluidity and weak kin ties of today's WEIRD societies position these populations' psychology at the extreme end of the global and historical spectrum. (shrink)

Intensive Science and Virtual Philosophy cuts to the heart of the philosophy of Gilles Deleuze and of today's science wars.At the start of the 21st Century, ...

Previous work suggests that moral intensity and the perceived importance of an ethical issue can influence individual ethical decision making. However, prior research has not explored how the various dimensions of moral intensity might differentially affect PIE, or how moral intensity might function together with (or in the presence of) PIE to influence ethical decision making. In addition, prior work has also not adequately investigated how the operational context of an organization, which may embody conditions or practices that create barriers (...) to ethical decision making, may differ from other functional areas of an organization. Consequently, this study investigated the relationships among moral intensity, perceived ethical issue importance, and three stages of the ethical reasoning process: recognition of an ethical issue, ethical judgment, and ethical intention. Using an internet-based, self-report survey containing two operations management scenarios and various ethics measures, information was collected from business professionals working for a Midwestern financial services organization. The hierarchical regression results indicated that some dimensions of moral intensity were positively related to PIE, ethical issue recognition, and ethical judgment, and that PIE was associated with increased ethical issue recognition and ethical judgment. The steps of ethical reasoning were also positively interrelated. (shrink)

By 2050, global livestock production is expected to double—growing faster than any other agricultural sub-sector—with most of this increase taking place in the developing world. As the United Nation’s four-hundred-page report, Livestock’s Long Shadow: Environmental Issues and Options , documents, livestock production is now one of three most significant contributors to environmental problems, leading to increased greenhouse gas emissions, land degradation, water pollution, and increased health problems. The paper draws on the UN report as well as a flurry of other (...) recently published studies in order to demonstrate the effect of intensive livestock production on global warming and on people’s health. The paper’s goal is to outline the problems caused by intensive livestock farming and analyze a number of possible solutions, including legislative changes and stricter regulations, community mobilizing, and consumers choosing to decrease their demand for animal products. (shrink)

There is an increasing interest in how managers describe and respond to what they regard as moral versus nonmoral problems in organizations. In this study, forty managers described a moral problem and a nonmoral problem that they had encountered in their organization, each of which had been resolved. Analyses indicated that: (1) the two types of problems could be significantly differentiated using four of Jones' (1991) components of moral intensity; (2) the labels managers used to describe problems varied systematically between (...) the two types of problems and according to the problem's moral intensity; and (3) problem management processes varied according to the problem's type and moral intensity. (shrink)

In his 'Why We Need A-Intensions', Frank Jackson argues that "representational content [is] how things are represented to be by a sentence in the communicative role it possesses in virtue of what it means," a type of content Jackson takes to be broadly descriptive. I think Jackson overstates his case. Even if we agree that such representational properties play a crucial reference-fixing role, it is much harder to argue the case for a crucial communicative role. I articulate my doubts (...) about Jackson's views on this point by contrasting them with the views of John Stuart Mill, usually regarded as an early believer in something like a direct reference account of content for names, but someone who, on my reading, teaches us a salutary lesson about the importance of separating the question of how reference is determined from the question of how we succeed in communicating. (shrink)

_the a priori role_ (for word T). For instance, perhaps anyone who understands the word _water_ is able to know, without appeal to any further a posteriori information, that _water_ refers to the clear, drinkable natural kind whose instances are predominant in our oceans and lakes (if _water_ refers at all.

Intensive care units are not always able to admit all patients who would benefit from intensive care. Pressure on ICU beds is likely to be particularly high during times of epidemics such as might arise in the case of swine influenza. In making choices as to which patients to admit, the key US guidelines state that significant priority should be given to the interests of patients who are already in the ICU over the interests of patients who would benefit from (...) intensive care but who have not been admitted. We examine four reasons that in principle might justify such a prioritization rule and conclude that none is convincing. We argue that the current location of patients should not, in principle, affect their priority for intensive care. We show, however, that under some but not all circumstances, maximizing lives saved by intensive care might require continuing to treat in the ICU a patient already admitted rather than transferring that patient out of the unit in order to admit a sicker patient who would also benefit more from intensive care. We conclude that further modelling is required in order to clarify what practical policies would maximize lives saved by intensive care. (shrink)

An experimental survey was undertakento explore the links between thecharacteristics of a moral issue, the degree ofmoral intensity/moral imperative associatedwith the issue, and people'sstated willingness to pay for policy toaddress the issue. Two farm animal welfareissues were chosen for comparison and thecontingent valuation method was used to elicitpeople's wtp. The findings of the surveysuggest that increases in moral characteristicsdo appear to result in an increase in moralintensity and the degree of moral imperativeassociated with an issue. Moreover, there was apositive link (...) between moral intensity/moralimperative associated with an issue andpeople's stated wtp for policy to address theissue. The paper discusses the relevance of thefindings of the survey in the context of thedebate concerning the relationship betweenmoral and economic values and the use of thecontingent valuation method to estimatepeople's wtp of policy options with moraldimensions. (shrink)

Suffering repeated experiences of moral distress in intensive care units due to applications of futility reflects on nurses’ patient care negatively, increases their burnout, and reduces their job satisfaction. This study was carried out to investigate the levels of job satisfaction and exhaustion suffered by intensive care nurses and the relationship between them through the futility dimension of the issue. The study included 138 intensive care nurses. The data were obtained with the futility questionnaire developed by the researchers, Maslach Burnout (...) Inventory and Minnesota Satisfaction Questionnaire. It was determined that nurses who agreed to the proposition that the application of futility demoralizes health-care professionals had low levels of job satisfaction but high levels of depersonalization. It was determined that nurses had moderate levels of job satisfaction, emotional exhaustion, and personal achievements but high levels of sensitivity. Nurses’ job satisfaction and sensitivities are positively affected when they consider that futility does not contradict the purposes of medicine. (shrink)

A full understanding of emotions and emotion characteristics can only be reached when their dynamic nature is taken into account. As such, a primary objective of the present study is to describe and account for variability in temporal profiles of experienced emotional intensity. Participants were asked to make detailed drawings of intensity profiles of recently experienced episodes of anger, sadness, joy and affection. Functional data analysis revealed three features that together accounted for 84% of the total variability: (i) steepness at (...) onset; (ii) skewness; and (iii) the number of peaks. Emotions differed with regard to the first two features, with the rise at onset being steeper for sadness and joy and affection being the most negatively skewed emotion under study. Individual differences regarding each of the three features were found, however, they did not strongly generalise across emotions. (shrink)

Non-compensatory aggregation rules are applied in a variety of problems such as voting theory, multi-criteria analysis, composite indicators, web ranking algorithms and so on. A major open problem is the fact that non-compensability implies the analytical cost of loosing all available information about intensity of preference, i.e. if some variables are measured on interval or ratio scales, they have to be treated as measured on an ordinal scale. Here this problem has been tackled in its most general formulation, that is (...) when mixed measurement scales (interval, ratio and ordinal) are used and both stochastic and fuzzy uncertainties are present. Objectives of this article are first to present a comprehensive review of useful solutions already proposed in the literature and second to advance the state of the art mainly in the theoretical guarantee that weights have the meaning of importance coefficients and they can be summarized in a voting matrix. This is a key result for using non-compensatory Condorcet consistent rules. A proof on the probability of existence of ties in the voting matrix is also developed. (shrink)

This paper responds to Kevin Krein’s claim in that the particular value of nature sports over traditional ones is that they offer intensity of sport experience in dynamic interaction between an athlete and natural features. He denies that this intensity is derived from competitive conflict of individuals and denies that nature sport derives its value from internal conflict within the athlete who carries out the activity. This paper responds directly to Krein by analysing ‘intensity’ in sport in terms of the (...) relationship between attention and reflection and the interaction between self and environment. I reply directly to Krein’s rejection of self-competition as based on a mischaracterisation of internal struggle and argue that the weighing of incompatible desires does not involve a fragmented self. I argue that the unique intensity to which Krein refers is strongly comparable to the Kantian conception of the sublime and explore how sublime experience fits Krein’s account and outline some serious problems that such an ideal of experience poses for nature sport. (shrink)

Background Patient dignity is sometimes neglected in intensive care unit (ICU) settings, which may potentially cause psychological harm to critically ill patients. However, no instrument has been specifically developed to evaluate the behaviors of dignified care among critical care nurses. Aim This study aimed to develop and evaluate ICU Dignified Care Questionnaire (IDCQ) for measurement of self-assessed dignity-conserving behaviors of critical care nurses during care. Methods The instrument was developed in 3 phases. Phase 1: item generation; phase 2: a two-round (...) Delphi survey and a readability pilot study; phase 3: cross-sectional survey with model estimation. The questionnaire was evaluated by item analysis, exploratory and confirmatory factor analysis, assessment of internal consistency reliability, and test-retest reliability. The investigation was conducted using a convenience sample of 392 critical care nurses from 6 cities in Zhejiang Province, China, of which 30 participated in the test-retest reliability survey 2 weeks later. Ethical considerations The study was approved by ethics committee. All participants provided written informed consent before the survey. The questionnaire survey was anonymous. Results The results showed acceptable reliability and validity of the IDCQ. The 17-item final version questionnaire was divided into 2 dimensions: absolute dignity and relative dignity. These two factors accounted for 62.804% of the total variance, and model fitting results were acceptable. The Cronbach’s alpha coefficient of the questionnaire was 0.94, and the test-retest intraclass correlation coefficient (ICC) was 0.88 after 2 weeks. Conclusions This study developed a brief and reliable instrument (IDCQ) to assess dignified care in ICU nursing. It can help critical care nurses identify their behaviors in maintaining patient dignity and discover their deficiencies. It may also serve as a clinical nursing management tool to help reduce patient disrespect experience in ICU. (shrink)

Between 1940 and 1945, while still a student of theoretical physics and without any contact with the history of science, Thomas S. Kuhn developed a general outline of a theory of the role of belief in science. This theory was well rooted in the philosophical tradition of Emerson Hall, Harvard, and particularly in H. M. Sheffer’s and C. I. Lewis’s logico-philosophical works—Kuhn was, actually, a graduate student of the former in 1945. In this paper I reconstruct the development of that (...) general outline after Kuhn’s first years at Harvard. I examine his works on moral and aesthetic issues—where he displayed an already ‘anti-Whig’ stance concerning historiography—as well as his first ‘Humean’ approach to science and realism, where his earliest concern with belief is evident. Then I scrutinise his graduate work to show how his first account of the role of belief was developed. The main aim of this paper is to show that the history of science illustrated for Kuhn the epistemic role and effects of belief he had already been theorising about since around 1941.Keywords: Intension; Belief; Causality; Thomas Kuhn; Clarence Irving Lewis; Henry Sheffer. (shrink)

This paper develops a response to the ethical conception of the human Other formulated by Gilles Deleuze in his review of Michel Tournier’s 1967 novel Friday. The central contention here is that although Deleuze develops a compelling notion of intensive ethics in response to Tournier’s novel, that ethics also remains deeply problematic in refusing to ascribe a positive role to the human Other. My wager is that some of these problems can be brought to light by placing Deleuze’s philosophy in (...) dialogue with that of Emmanuel Levinas. As I seek to show, Levinas’s philosophy of alterity not only reveals that Deleuze is mistaken in failing to ascribe a positive ethical role to the human Other, but also begins to point the way toward a more positive conception of ethics that does not oppose the Other to the intensive realm that Deleuze so much values. (shrink)

Since the days of classical Montague Grammar, formal semantics is frequently characterised as intensional, type-logical and model-theoretic. This paper takes a closer look of some less obvious changes these three key concepts have undergone since the appearance of English as a Formal Language. While intensions used to be crucial for resolving substitution puzzles, they are now giving way to more general constructions of index-dependant denotations. Types, on the other hand, were promoted from handy taxonomic devices to driving forces in (...) meaning composition. Finally, the rôle of models was overestimated in the early days of formal semantics, but appears to have lost its importance. (shrink)

Background Moral distress has negative effects on physical and mental health. However, there is little information about nurses’ coping strategies reducing moral distress. Aim The purpose of this study was to investigate the coping strategies of intensive care unit nurses reducing moral distress in Iran. Study design This is a qualitative study with a content analysis approach. Participants and research context The research sample consisted of nurses working in intensive care units of teaching hospitals affiliated to Tehran University of Medical (...) Sciences. Samples were selected among eligible nurses by purposive sampling. Data were obtained through 17 in-depth, individual, and semi-structured interviews with 17 nurses. Graneheim and Lundman’s (2004) 6-step content analysis method was used to analyze the data. Data management was also performed by MAXQDA software version 20. The COREQ checklist was used to report the study. Ethical considerations This project was approved by the Ethics Committee of Tehran University of Medical Sciences. All ethical guidelines in research were followed. Finding The data analysis resulted in the formation of two main categories of desirable coping strategies (with two subcategories of compensation and rejuvenation) and less desirable coping strategies (with three subclasses of indifference over time, escape and concealment). Discussion The intensive care unit nurses in dealing with ethical problems first try to solve the problem through discussion, but when they fail to resolve it peacefully, they resort to several coping strategies. Factors, such as increasing experience, lack of support from hospital managers and officials, poor communication between colleagues, the need to maintain hierarchy, fear of reprimand, and a sense of powerlessness, changed the nurses’ preferred strategies. It is important for managers to provide a blame/punishment-free atmosphere for expression of ethical experiences; a supportive atmosphere in which staff can engage in ethical discussions without fear of punishment. They should also provide opportunities for rest, rejuvenation, and adequate training for their employees. (shrink)

Introduction Intensive care units are contexts in which, due to the remarkable existence of particularly technological resources, interventions are promoted to extend the life of people who experience highly complex health situations. This ability can lead to a culture of death denial where the possibility of implementing futile care and treatment cannot be excluded. Objective To describe nurses’ perceptions of adult intensive care units regarding the therapeutic futility of interventions implemented to persons in critical health conditions. Method Review of the (...) literature following the Scoping Review protocol of the Joanna Briggs Institute. The Population, Concept, and Context mnemonic was used to elaborate the research question and the research was performed using the EBSCOHost search engine in the CINAHL Complete databases, MEDLINE Complete, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews to identify studies published between 1990 and 2019. Seven studies were selected. Results Nurses consider that therapeutic futility, a current problem in adult intensive care units, may have a negative impact on persons in critical health conditions and that contributes directly to resource expenditure and moral conflicts and consequently leads to emotional exhaustion. Conclusion Due to the complexity of this concept, knowing and understanding people’s and families’ perceptions is crucial to the decision-making process, for which reason nurses can play a key role in managing these situations. (shrink)

Maher proposed in 1974 that schizophrenic delusions are hypotheses formed to explain anomalous experiences. He stated that they are “rational, given the intensity of the experiences that they are developed to explain.” Two-factor theorists of delusion criticized Maher’s theory because 1) it does not explain why some patients with anomalous experiences do not develop delusions, and 2) adopting and adhering to delusional hypotheses is irrational, considering the totality of experiences and patients’ other beliefs. In this paper, the notion of the (...) intensity of experience is reappraised to uphold Maher’s basic conception. Regarding 1), I propose that differences in the intensity of anomalous experience are vital to whether the patient forms delusions, while partially reforming his rationality claim regarding 2). Although adopting delusions is irrational, it is inevitable and excusable, given the intensity of the patient’s anomalous experience. With the aid of this notion, it is maintained that anomalous experience is sufficient for the development of delusions, at least in some cases of schizophrenia. Compared to other theories of schizophrenic delusion, Maher’s theory, which embraces the notion of intensity of experience, better explains why such irrational mental states as delusions develop from anomalous experiences, and why delusional patients persist in believing specific thematic content. (shrink)

This article examines whether the likelihood and amount of firm charitable giving in response to catastrophic events are related to firm advertising intensity, and whether industry competition level moderates this relationship. Using data on Chinese firms’ philanthropic response to the 2008 Sichuan earthquake, we find that firm advertising intensity is positively associated with both the probability and the amount of corporate giving. The results also indicate that this positive advertising intensity-philanthropic giving relationship is stronger in competitive industries, and firms in (...) competitive industries are more likely to donate. This study thus provides evidence suggesting that even in the wake of catastrophic events, corporate philanthropic giving is strategic. (shrink)

The new mode of knowledge production is seen as a distinct form of economic organisation used for exchanging and creating knowledge. The emphasis is laid on the role of business services in innovative networks as carriers of knowledge and intermediates between science (knowledge creator) and their customers (knowledge user). The empirical analysis shows that knowledge-intensive business services are able to make existing knowledge useful for, their customers, improving the customer's performance and productivity and contributing to technological and structural change.

Suffering repeated experiences of moral distress in intensive care units due to applications of futility reflects on nurses’ patient care negatively, increases their burnout, and reduces their job satisfaction. This study was carried out to investigate the levels of job satisfaction and exhaustion suffered by intensive care nurses and the relationship between them through the futility dimension of the issue. The study included 138 intensive care nurses. The data were obtained with the futility questionnaire developed by the researchers, Maslach Burnout (...) Inventory and Minnesota Satisfaction Questionnaire. It was determined that nurses who agreed to the proposition that the application of futility demoralizes health-care professionals had low levels of job satisfaction but high levels of depersonalization. It was determined that nurses had moderate levels of job satisfaction, emotional exhaustion, and personal achievements but high levels of sensitivity. Nurses’ job satisfaction and sensitivities are positively affected when they consider that futility does not contradict the purposes of medicine. (shrink)

This research aims to identify the ethical issues perceived by intensive care nurses in their everyday practice. It also aims to understand why these situations were considered an ethical issue and what interventions/strategies have been or are expected to be developed so as to minimize them. Data were collected using a semi-structured interview with 15 nurses working at polyvalent intensive care units in 4 Portuguese hospitals, who were selected by the homogenization of multiple samples. The qualitative content analysis identified end-of-life (...) decisions, privacy, interaction, team work, and health-care access as emerging ethical issues. Personal, team, and institutional aspects emerge as reasons behind the experience of these issues. Personal and team resources are used in and for solving these issues. Moral development and training are the most significant strategies. (shrink)

The measurement of sensory intensity has had a long history, attracting the attention of investigators from many disciplines including physiology, psychology, physics, mathematics, philosophy, and even chemistry. While there has been a continuing doubt by some that sensation has the properties necessary for measurement, experiments designed to obtain estimates of sensory intensity have found that a general rule applies: Equal stimulus ratios produce equal sensory ratios. Theories concerning the basis for this simple psychophysical rule are discussed, with emphasis given to (...) the physical correlate theory, which considers judgments of subjective magnitudes to be based upon estimates of physical dimensions that vary regularly with changes in degree of stimulation. For the most thoroughly investigated sensory scales, brightness and loudness, the physical correlate is considered to be distance. Our “tacit knowledge” of the sensory effects of changing distance plays an essential role in matching motor activities to environmental conditions and in ensuring accurate perceptual evaluations through brightness and loudness constancies. In psychophysical experiments, subjects apparently use this same tacit knowledge when required to estimate relative subjective magnitudes. The evidence related to the physical correlate theory is summarized, and it is concluded that, while under appropriate conditions we demonstrate considerable skill in evaluating environmental relationships, we are quite unable to estimate the neurophysiological nature or quantity of sensory response. A psychophysics devoted to studying conditions required for accuracy and conditions producing errors in the perception of environmental relationships would seem to be more valuable than one devoted to subjective magnitudes. (shrink)

Researchers have considered individual and organizational factors of ethical decision making. However, they have little interest in situational factors :101–125, 2013) which is surprising given the many situations sales persons face. We address this issue using two pilot qualitative studies successively and a 2 by 2 within-subject experiment with sales scenarios. Qualitative and quantitative data are obtained from front-line employees of the main French retail banks that serve low-income customers. We show that the recognition of an ethical issue differs depending (...) on the role behavior salespersons are engaged in and the nature of the conflict of interest they face. Moreover, the combined effect of these two situational characteristics is mediated by moral intensity. This study not only adds evidence on situational factors affecting ethical decision but also extends empirical research on sales ethics by revealing sales situations that are not considered in the empirical literature. The research implications of the findings are discussed along with the study’s limitations and suggestions for future research. (shrink)

In Difference and Repetition, Deleuze claims that it is in virtue of a relation of expression which holds between intensive processes of individuation and virtual Ideas that the former determines the latter to be actualised in concrete entities. He is, however, less than forthcoming in this book about exactly how we should understand the relation of expression. This article addresses itself to this lacuna. It clarifies five characteristic features of the expressive relation, partly by drawing on Deleuze's discussion of the (...) relation of expression in Expressionism in Philosophy, party by examining familiar examples of expressive relations. It then maps these characteristic features of expression onto Deleuze's discussion of the relation between Ideas and intensity in Difference and Repetition, showing that virtual Ideas are ontologically inseparable from the intensive processes that both constitute and actualise them in the production of actual entities. By way of conclusion, this expressive account of the relation between the virtual, the actual and the intensive will be compared and contrasted with several leading accounts to be found in the secondary literature. (shrink)

Faster R-CNN architecture is used to solve the problems of moving path uncertainty, changeable coverage, and high complexity in cold-air induced large-scale intensive temperature-reduction detection and classification, since those problems usually lead to path identification biases as well as low accuracy and generalization ability of recognition algorithm. In this paper, an improved recognition method of national ITR path in China based on faster R-CNN in complicated meteorological systems is proposed. Firstly, quality control of the original dataset of strong cooling processes (...) is carried out by means of data filtering. Then, according to the NITR standard and the characteristics of NITR, the NITR dataset in China is established by the intensive temperature-reduction areas located through spatial transformation. Meanwhile, considering that the selection of regularization parameters of Softmax classification method will cause the problem of probability calculation, support vector machine is used for path classification to enhance the confidence of classification. Finally, the improved faster R-CNN model is used to identify, classify, and locate the path of NITR events. The experimental results show that, compared to other models, the improved faster R-CNN algorithm greatly improves the performance of NITR’s path recognition, especially for the mixed NITR paths and single NITR paths. Therefore, the improved faster R-CNN model has fast calculation speed, high recognition accuracy, good robustness, and generalization ability of NITR path recognition. (shrink)

Background: Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered (...) by nurses nor a study conducted on the issue. Aim/objective: The study aims to (a) validate the Turkish version of the Moral Distress Scale–Revised to be used in intensive care units and to examine the validity and reliability of the Turkish version of the scale, and (b) explore Turkish intensive care nurses’ moral distress level. Method: The sample of this methodological, descriptive, and cross-sectional design study comprises 200 nurses working in the intensive care units of internal medicine and surgical departments of four hospitals in three cities in Turkey. The data were collected with the Socio-Demographic Characteristics Form and The Turkish Version of Moral Distress Scale–Revised. Ethical considerations: The study proposal was approved by the ethics committee of the Faculty of Medicine, Cumhuriyet University. All participating nurses provided informed consent and were assured of data confidentiality. Results: In parallel with the original scale, Turkish version of Moral Distress Scale–Revised consists of 21 items, and shows a one-factor structure. It was determined that the moral distress total and item mean scores of the nurses participating in the study were 70.81 ± 48.23 and 3.36 ± 4.50, respectively. Conclusion: Turkish version of Moral Distress Scale–Revised can be used as a reliable and valid measurement tool for the evaluation of moral distress experienced by nurses working in intensive care units in Turkey. In line with our findings, it can be said that nurses suffered low level of moral distress. However, factors which caused the nurses in our study to experience higher levels of moral distress are inadequate communication within the team, working with professionals they considered as incompetent, and futile care. (shrink)

This paper argues that the difference between contemporary software intensive scientific practice and more traditional non-software intensive varieties results from the characteristically high conditionality of software. We explain why the path complexity of programs with high conditionality imposes limits on standard error correction techniques and why this matters. While it is possible, in general, to characterize the error distribution in inquiry that does not involve high conditionality, we cannot characterize the error distribution in inquiry that depends on software. Software intensive (...) science presents distinctive error and uncertainty modalities that pose new challenges for the epistemology of science. (shrink)

Deleuze's interpretation of Spinozan philosophy is intrinsically related to the concept of intensity. Attributes are defined as intensive qualities, modal essences as intensive quantities or degrees of power; the life of affects corresponds to continuous variations in intensity. This essay will show why Deleuze needs the concept of intensity for his reading of Spinozan philosophy as a philosophy of expressive immanence. It will also discuss the problems that spring from this reading: in what way, if any, are modal essences modified (...) by the intensive variations of affects? How can the Spinozan conception of eternal modal essences be reconciled with the idea of affections of essence? What is the ethical import of the life of existing modes, when modal essences are considered as eternal? While these questions, in particular the last two, confront each commentator on Spinoza and demand a solution in one way or another, the essay will conclude with a question which is posed from an exclusively Deleuzian perspective: why is the concept of the virtual, which takes centre stage in Deleuze's own philosophy of immanence, missing in his account of Spinoza? (shrink)

Significant scientific and technological advances in intensive care have been made. However, patients in the intensive care unit may experience discomfort, loss of control, and surreal experiences. This has generated relevant debates about how to humanize the intensive care units and whether humanization is necessary at all. This paper aimed to explore how humanizing intensive care is described in the literature. A scoping review was performed. Studies published between 01.01.1999 and 02.03.2020 were identified in the CINAHL, Embase, PubMed, and Scopus (...) databases. After removing 185 duplicates, 363 papers were screened by title and abstract. Full-text screening of 116 papers led to the inclusion of 68 papers in the review based on the inclusion criteria; these papers mentioned humanizing or dehumanizing intensive care in the title or abstract. Humanizing care was defined as holistic care, as a general attitude of professionals toward patients and relatives and an organizational ideal encompassing all subjects of the healthcare system. Technology was considered an integral component of intensive care that must be balanced with caring for the patient as a whole and autonomous person. This holistic view of patients and relatives could ameliorate the negative effects of technology. There were geographical differences and the large number of studies from Spain and Brazil reflect the growing interest in humanizing intensive care in these particular countries. In conclusion, a more holistic approach with a greater emphasis on the individual patient, relatives, and social context is the foundation for humanizing intensive care, as reflected in the attitudes of nurses and other healthcare professionals. Demands for mastering technology may dominate nurses’ attention toward patients and relatives; therefore, humanized intensive care requires a holistic attitude from health professionals and organizations toward patients and relatives. Healthcare organizations, society, and regulatory frameworks demanding humanized intensive care may enforce humanized intensive care. (shrink)

The purpose of this study was to determine whether accounting students’ perception of moral intensity could be enhanced through a limited ethics intervention in an Advanced Accounting course. Ethical decisions are heavily influenced by the intensity of the moral problem: the more egregious the act, the more the people view it as unethical. This controlled experiment measures the change in perceptions of moral intensity with the pre- and post-test instruments using five accounting specific vignettes containing moral dilemmas which are progressively (...) more intense. While other studies have shown that perceived moral intensity directly influences a persons’ moral decision-making process, as far as we are aware, this is the first study that assesses and tests whether the coverage of specific ethics content integrated into an accounting class can positively influence the students’ perception of moral intensity, moral sensitivity/awareness, moral judgment, and moral intentions. Positively influencing students’ moral sensitivity/awareness, moral judgment, and moral intentions is a critical first step to ensuring that our courses and curricula provide the learning environment in which students can develop knowledge and competencies required to become the ethical leaders of tomorrow. (shrink)

Within the theoretical framework of the moral intensity model of ethical decision making (Jones, 1991), two studies ascertained the contention that ethicality judgements are contingent upon the perceived intensity of the moral issue. In addition, Study 1 extended the validity of the moral intensity notion to whistle-blowing behaviour; Study 2 addressed the effect of the individual difference variable, need-for-cognition, on differential utilization of intensity dimensions in the ethical decision process. A scenario approach was used in both studies. Results have provided (...) convergent support for the issue-contingency nature of ethical decisions. Study 1 also showed that felt empathy for potential victims predicted the likelihood of whistle-blowing behaviour, and that the perceived overall ethicality of a wrongdoing predicted felt empathy when potential victims are psychologically and physically close. Results of Study 2 further suggested a greater utilization of issue-relevant information by high need-for-cognition individuals in ethical decision making. (shrink)

This study was conducted to gain opinions about euthanasia from nurses who work in intensive care units. The research was planned as a descriptive study and conducted with 186 nurses who worked in intensive care units in a university hospital, a public hospital, and a private not-for-profit hospital in Adana, Turkey, and who agreed to complete a questionnaire. Euthanasia is not legal in Turkey. One third (33.9%) of the nurses supported the legalization of euthanasia, whereas 39.8% did not. In some (...) specific circumstances, 44.1% of the nurses thought that euthanasia was being practiced in our country. The most significant finding was that these Turkish intensive care unit nurses did not overwhelmingly support the legalization of euthanasia. Those who did support it were inclined to agree with passive rather than active euthanasia (P = 0.011). (shrink)