Background Unit-based critical care nurse leaders (UBCCNL) play a role in exemplifying ethical leadership, addressing moral distress, and mitigating contributing factors to moral distress on their units. Despite several studies examining the experience of moral distress by bedside nurses, knowledge is limited regarding the UBCCNL’s experience. Research aim The aim of this study was to gain a deeper understanding of the lived experiences of Alabama UBCCNLs regarding how they experience, cope with, and address moral distress. Research design A qualitative descriptive (...) design and inductive thematic analysis guided the investigation. A screening and demographics questionnaire and a semi-structured interview protocol were the tools of data collection. Participant and research context Data were collected from 10 UBCCNLs from seven hospitals across the state of Alabama from February to July 2023. Ethical considerations This study was approved by the Institutional Review Board at the University of Alabama in Huntsville. Informed consent was obtained from participants prior to data collection. Findings UBCCNLs experience moral distress frequently due to a variety of systemic and organizational barriers. Feelings of powerlessness tended to precipitate moral distress among UBCCNLs. Despite moral distress resulting in increased advocacy and empathy, UBCCNLs may experience a variety of negative responses resulting from moral distress. UBCCNLs may utilize internal and external mechanisms to cope with and address moral distress. Conclusions The UBCCNL’s experience of moral distress is not dissimilar from bedside staff; albeit, moral distress does occur as a result of the responsibilities of leadership and the associated systemic barriers that UBCCNLs are privier to. When organizations allocate resources for addressing moral distress, they should be convenient to leaders and staff. The UBCCNL perspective should be considered in the development of future moral distress measurement tools and interventions. Future research exploring the relationship between empathy and moral distress among nurse leaders is needed. (shrink)

To better understand the available publications addressing ethical issues in rural health care we sought to identify the ethics literature that specifically focuses on rural America. We wanted to determine the extent to which the rural ethics literature was distributed between general commentaries, descriptive summaries of research, and original research publications. We identified 55 publications that specifically and substantively addressed rural health care ethics, published between 1966 and 2004. Only 7 (13%) of these publications were original research articles while (12) (...) 22% were descriptive summaries of research and 36 (65%) were general commentaries. The majority of publications examined (55%) were clinically focused while 27% addressed organizational ethics and 18% addressed ethical ramifications of rural health care policy at a national or community level. Our findings indicate that there are a limited number of publications focusing on rural health care ethics, suggesting a need for scholars and researchers to more rigorously address rural ethics issues. (shrink)

Integration of music in an academic university teaching setting is an example of how artistic practice and competences have potentials to resonate beyond the immediate discipline. The article explo...

Research shows that a culture of consumerism and materialism has a dramatic and negative impact on children's physical and psychological health. Psychologists have a duty to act to reverse this trend. Information on why and how to act is the key. This article explores the use of psychology to improve the effectiveness of advertising to youth and details the harm suffered by children as a result of some of this advertising. A discussion of ethical considerations related to specific guiding principles (...) and ethical standards of the 2002 American Psychological Association (APA) Ethics Code frames why action is imperative. Actions for psychologists to take in applying the 2002 APA Ethics Code are suggested herein. (shrink)

In this paper we describe the objectives of teaching medical ethics to undergraduates and the teaching methods used. We describe a workshop used in the University of Liverpool Department of Psychiatry, designed to enhance ethical sensitivity in psychiatry. The workshop reviews significant historical and current errors in the ethical practice of psychiatry and doctors' defence mechanisms against accepting responsibility for deficiencies in ethical practice. The workshop explores the student doctors' own group ethos in response to ethical dilemmas, and demonstrates how (...) the individual contributes to and is responsible for the group ethos through participation and also through nonparticipation. The student feedback about the workshop is reviewed. The Toronto Ethical Sensitivity Instrument was used to assess whether or not the workshop altered sensitivity. Compared to a control group the attenders' sensitivity was significantly increased (on Student's t-test p equals or is less than 0.002). (shrink)

Psychologists and neuroscientists often struggle to integrate findings in their respective domains, a problem due partly to implicitly and explicitly held philosophical positions on issues of reduction and autonomy across these domains. The present article reviews how reduction and autonomy have been used in philosophical arguments regarding how macro-scale findings relate to micro-scale findings across various scientific disciplines. The present article demonstrates how macro findings are indispensable to explanations of phenomena of interest by (a) providing information regarding higher levels of (...) organization in mechanisms, (b) including information not contained within certain micro explanations that (c) provides more general and stable causal explanations relative to micro explanations in certain situations. The purpose of presenting these analyses and recommendations is to disabuse psychologists and neuroscientists of pervasive assumptions that psychology is reducible to biology and that lower level phenomena (molecular) should be prioritized as somehow more explanatory than higher level phenomena (behavioral). The article concludes with 3 hypothetical scenarios from clinical psychology and psychiatry illustrating this critique and providing a pragmatic approach to clarify the relative roles, and importance, of biological and psychological data in service of general and stable explanations that are tailored to the kind of intervention desired. (shrink)

In 1988, the control of the American Psychological Association shifted to those advocating the interests of professional practice and a substantial segment of the scientific community in psychology seceded to form the American Psychological Society, devoted to scientific psychology and scientific-based practice. In this climate, it has become increasingly difficult for scientists and practitioners to maintain analytical discussions of the philosophical and methodological issues that divide these two groups. For over 25 years, the authors have been fortunate to have the (...) professional and intellectual luxury of just such a discussion, and present here a dialogue that attempts to capture their initial stark differences in perspective and the process by which differences have been clarified, and areas of agreement established. 2012 APA, all rights reserved). (shrink)

Recent events at Enron, K-Mart, Adelphia, and Tyson would seem to suggest that managers are still experiencing ethical lapses. These lapses are somewhat surprising and disappointing given the heightened focus on ethical considerations within business contexts during the past decade. This study is designed, therefore, to increase our understanding of the forces that shape ethical perceptions by considering the effects of business school education as well as a number of other individual-level factors (such as intra-national culture, area of specialization within (...) business, and gender) that may exert an influence on ethical perceptions. We found significant effects for business education, self-reported intra-national culture, area of specialization within business, and gender for some and/or all areas of ethics examined (i.e., deceit, fraud, self-interest, influence dealing, and coercion). One of our most encouraging findings is that tolerance for unethical behavior appears to decrease with formal business education. Despite the prevalent stereotype that business students are only interested in the bottom line or that business schools transform idealistic freshman into self-serving business graduates, our results suggest otherwise. Given the heightened criticism of the ethicality of contemporary managerial behavior, it is heartening to note that, even as adults, individuals can be positively affected by integration of ethics training. (shrink)

The Patient Self Determination Act of 1991 brought much needed attention to the importance of advance care planning and surrogate decision-making. The purpose of this law is to ensure that a patient’s preferences for medical care are recognized and promoted, even if the patient loses decision-making capacity. In general, patients are presumed to have DMC. A patient’s DMC may come under question when distortions in thinking and understanding due to illness, delirium, depression or other psychiatric symptoms are identified or suspected. (...) Physicians and other healthcare professionals working in hospital settings where medical illness is frequently comorbid with depression, adjustment disorders, demoralization and suicidal ideation, can expect to encounter ethical tension when medically sick patients who are also depressed or suicidal request do not resuscitate orders. (shrink)

We like to think of ourselves, our friends, and our families as decent people. We may not be saints, but we are still honest, relatively kind, and mostly trustworthy. Miller argues here that we are badly mistaken in thinking this. Hundreds of recent studies in psychology tell a different story: that we all have serious character flaws that prevent us from being as good as we think we are - and that we do not even recognize that these flaws (...) exist. But neither are most of us cruel or dishonest. Instead, Miller argues, we are a mixed bag. On the one hand, most of us in a group of bystanders will do nothing as someone cries out for help in an emergency. Yet it is also true that there will be many times when we will selflessly come to the aid of a complete stranger - and resist the urge to lie, cheat, or steal even if we could get away with it. Much depends on cues in our social environment. Miller uses this recent psychological literature to explain what the notion of "character" really means today, and how we can use this new understanding to develop a character better in sync with the kind of people we want to be. (shrink)

Franklin G. Miller and colleagues have stimulated renewed interest in research ethics through their work criticizing clinical equipoise. Over three years and some twenty articles, they have also worked to articulate a positive alternative view on norms governing the conduct of clinical research. Shared presuppositions underlie the positive and critical dimensions of Miller and colleagues' work. However, recognizing that constructive contributions to the field ought to enjoy priority, we presently scrutinize the constructive dimension of their work. We argue (...) that it is wanting in several respects. (shrink)

The central virtue at issue in recent philosophical discussions of the empirical adequacy of virtue ethics has been the virtue of compassion. Opponents of virtue ethics such as Gilbert Harman and John Doris argue that experimental results from social psychology concerning helping behavior are best explained not by appealing to so-called ‘global’ character traits like compassion, but rather by appealing to external situational forces or, at best, to highly individualized ‘local’ character traits. In response, a number of philosophers have argued (...) that virtue ethics can accommodate the empirical results in question. My own view is that neither side of this debate is looking in the right direction. For there is an impressive array of evidence from the social psychology literature which suggests that many people do possess one or more robust global character traits pertaining to helping others in need. But at the same time, such traits are noticeably different from a traditional virtue like compassion. (shrink)

This book first reviews Miller's theory of Mixed Traits, as developed in his 2013 book Moral Character: An Empirical Theory. It then engages extensively with situations, the CAPS model in social psychology, and the Big Five Model in personality psychology. It ends by taking up implications for his view in meta-ethics (a modified error theory) and normative ethics (a challenge for virtue ethics).

Integrity, honesty, and truth seeking are important virtues that most people care about and want to see promoted in society. Yet surprisingly, there has been relatively little work among scholars today aimed at helping us better understand this cluster of virtues related to truth. This volume incorporates the insights and perspectives of experts working in a variety of disciplines, including philosophy, law, communication and rhetorical studies, theology, psychology, history, and education. For each virtue, there is a conceptual chapter, an application (...) chapter, and a developmental chapter. The resulting volume significantly deepens our knowledge about and appreciation for these central virtues. (shrink)

As work on practical wisdom and medicine accelerates, now is a good time to outline some important challenges that any approach to developing an account of this virtue faces. More specifically, I develop five challenges having to do with the existence and nature of practical wisdom, and whether it connects with objective and general normative truths. The main goal is to provide a guide to the challenges themselves and some of the options available for tackling them, rather than trying to (...) resolve them here. (shrink)

There have only been three articles in mainstream philosophy journals going back at least to the 1970s on generosity. In this paper, I hope to draw attention to this neglected virtue. By building on what work has already been done, and trying to advance that discussion along several different dimensions, I hope that others will take a closer look at this important and surprisingly complex virtue. More specifically, I formulate three important necessary conditions for what is involved in possessing the (...) virtue of generosity, and consider other contenders as well. (shrink)

The focus of this special issue is on moral psychology and the goals of moral education. My focus will be considerably narrower in addressing the following question: In light of the situationist movement in psychology and philosophy, what should be the goal(s) of character education? The main conclusion will be that the central goal of character education should be modified in a certain way to make it more empirically informed. But not to worry, as this modification should be amenable to (...) most contemporary supporters of character education. (shrink)

"Honesty is clearly an important virtue. Parents want to develop it in their children. Close relationships typically depend upon it. Employers value it in their employees. Yet philosophers have said almost nothing about the virtue of honesty in the past fifty years. This book aims to draw attention to this surprisingly neglected virtue. Part One looks at the concept of honesty. It takes up questions such as what does honesty involve, what are the motives of an honest person, how does (...) practical wisdom relate to honesty, and is there anything that connects all the different sides of honesty, including not lying, not stealing, not breaking promises, not misleading others, and not cheating. A central idea is that the honest person reliably does not intentionally distort the facts as she takes them to be. Part Two looks at the empirical psychology of honesty. It takes up the question of whether most people are honest, dishonest, or somewhere in-between. Drawing extensively on recent studies of cheating and lying in particular, the emerging model ends up implying that most of us have a long way to go to reach an honest character"--. (shrink)

This Element provides an overview of some of the central issues in contemporary moral psychology. It explores what moral psychology is, whether we are always motivated by self-interest, what good character looks like and whether anyone has it, whether moral judgments always motivate us to act, whether what motivates action is always a desire of some kind, and what the role is of reasoning and deliberation in moral judgment and action. This Element is aimed at a general audience including undergraduate (...) students without an extensive background in philosophy. (shrink)

The goal of this book is to develop a new framework for thinking about what moral character looks like today. My central claim will be that most people have moral character traits, but at the same time they do not have either the traditional  ...

There has been almost nothing written in philosophy on honesty in the past fifty years. This paper contributes one piece to a larger project of trying to change this unfortunate state of affairs. In section one, I outline an original account of the behavioural component of honesty as involving being disposed to not intentionally distort the facts as the person sees them. Section two turns to the vice of deficiency, namely dishonesty, which I suggest is the only vice corresponding to (...) honesty. It has at least five different dimensions, and a person’s character needs to be assessed along all of them before an overall judgment as to her dishonesty can justifiably be made. (shrink)

Systems-oriented social epistemology, studies epistemic systems in which individuals work together to determine the epistemic status (true, justified, true beyond a reasonable doubt, e...

This essay argues that the affective component inherent in the enthymeme is the essence of aristotle's concept of the enthymeme as practical reasoning. 'affective component' refers to emotions and feelings. The three proofs of the thesis are the etymology of 'enthymeme', Aristotle's works on human action and practical wisdom, And aristotle's rhetoric. These sources show the inherent relation between enthymemes and phronesis, Or practical reasoning, Not nous, Or abstract intellect.

: The authors respond to objections Fred Gifford has raised against their paper "Rehabilitating Equipoise." They situate this exchange in the wider context of recent debate over equipoise, highlighting substantial points of agreement between themselves and Gifford. The authors offer a brief restatement of "Rehabilitating Equipoise" in which they amplify some of its core arguments. They then assess Gifford's objections. Finding each to be unfounded, they argue that there is no justification for "pulling the plug" on clinical equipoise.

What views are the primary target of Moore’s fallacy and his open question argument? A common answer, I suspect, would be naturalistic approaches to morality. It is the naturalistic fallacy, after all. But in fact both his fallacy and his argument apply just as straightforwardly to supernatural approaches to morality as well. In this chapter, I focus specifically on how philosophers of religion have tried to grounds morality in God in ways that are clearly relevant to Moore’s project.

As the Society for Theoretical and Philosophical Psychology works to encourage greater genuine dialogue among proponents of disparate philosophical positions and traditions related to psychology, I am pleased for the second time in three years to have the opportunity to publish another set of commentaries on a paper previously published in Journal of Theoretical and Philosophical Psychology , together with the author's reply. I am also delighted to know that the future of the Journal has been placed in the wise (...) and energetic care of Thomas Teo, but more of that in the announcement to follow. 2012 APA, all rights reserved). (shrink)