As professionals, nurses are engaged in a moral endeavour, and thus confront many challenges in making the right decision and taking the right action. When nurses cannot do what they think is right, they experience moral distress that leaves a moral residue. This article proposes a theory of moral distress and a research agenda to develop a better understanding of moral distress, how to prevent it, and, when it cannot be prevented, how to manage it.

Technological advances are making devices that functionally replace body parts—artificial organs and limbs—more widely used, and more capable of providing patients with lives that are close to “normal.” Some of the ethical issues this is likely to raise relate to how such prostheses are conceptualized. Prostheses are ambiguous between being inanimate objects and sharing in the status of human bodies—which already have an ambiguous status, as both objects and subjects. At the same time, the possibility of replacing body parts with (...) artificial objects puts pressure on the normative status typically accorded to human bodies, seemingly confirming that body parts are replaceable objects. The paper argues that bodies’ normative status relies on the relation of a body to a person and shows that persons could have similar relations to prostheses. This suggests that in approaching ethical issues surrounding prostheses, it is appropriate to regard them as more like body parts than like objects. (shrink)

The part anger plays in motivating political action is frequently noted, but less is said about ways in which anger continues to be a part of how people do politics. This article critically assesses approaches to emotions that emphasize managing anger in accordance with ‘feeling rules’. It reflects on the utility of Marxist notions of conflict as the engine of change for the understanding of how anger operates in political life. This involves understanding the ambivalence of anger and its operation (...) within particular power relations. Shifting sets of conventions have had some continuity in discouraging women in Western nations (particularly white and middle-class women) from showing anger. But clearly, women do get angry and feminists have drawn on anger in acting politically. New Zealand feminist writings from the ‘second wave’ are taken as illustrative of the common difficulties Western feminists faced in dealing with anger. These difficulties were due to trying to juggle social conventions about femininity, the political ideal of sisterhood, and the realities of dealing with other women in often new and experimental political processes. Anger could be personalized and hurtful, but in certain cases its expression was constructive in producing more respectful relations. Exploring these cases makes it clear how anger produces, and is produced by, relations with others. (shrink)

Fetal tissue transplants have now been successful in primates, raising the possibility of treatment for Parkinson's disease and other chronic illnesses. Whether or not abortion is morally justified, use of human fetal tissue for research or therapy is justified in certain circumstances. The rationale, both for permitting transplantation of fetal tissue and for limitations in exercising the technology, is based on the same set of ethical principles that supported restrictive legislation in the past: respect for autonomy and a balancing of (...) harms and benefits that gives priority to those most affected. (shrink)

This paper shows that species are individuals with respect to evolutionary theory in the sense that the laws of the theory deal with species as irreducible wholes rather than as sets of organisms. 'Species X' is an instantiation of a primitive term of the theory. I present a sketch of a proof that it cannot be defined within the theory as a set of organisms; the proof relies not on details of my axiomatization but rather on a generally accepted property (...) of speciation; hence the same argument should work for any axiomatization which captures this generally accepted property of speciation. (shrink)

Kinship was one of the key areas of research interest among anthropologists in the nineteenth century, one of the most hotly debated areas of theory in the early and mid-twentieth century, and yet an area of waning interest by the end of the twentieth century. Since then, the study of kinship has experienced a revitalization, with concomitant disputes over how best to proceed. This special issue brings together recent studies of kinship by scientific anthropologists employing evolutionary theory and quantitative methods. (...) We argue that the melding of the evolutionary theoretical perspective with quantitative and ethnographic methodologies has strengthened and reinvigorated the study of kinship by synthesizing and extending existing research via rigorous analyses of evidence. (shrink)

This discussion note responds to Mark Colyvan’s claim that there is no easy road to nominalism. While Colyvan is right to note that the existence of mathematical explanations presents a more serious challenge to nominalists than is often thought, it is argued that nominalist accounts do have the resources to account for the existence of mathematical explanations whose explanatory role resides elsewhere than in their nominalistic content.

Background: Clinical investigation is a growing field employing increasing numbers of nurses. This has created a new specialty practice defined by aspects unique to nursing in a clinical research context: the objectives (to implement research protocols and advance science), setting (research facilities), and nature of the nurse–participant relationship. The clinical research nurse role may give rise to feelings of ethical conflict between aspects of protocol implementation and the duty of patient advocacy, a primary nursing responsibility. Little is known about whether (...) research nurses experience unique ethical challenges distinct from those experienced by nurses in traditional patient-care settings. Research objectives: The purpose of the study was to describe the nature of ethical challenges experienced by clinical research nurses within the context of their practice. Research design: The study utilized a qualitative descriptive design with individual interviews. Participants and research context: Participating nurses (N = 12) self-identified as having experienced ethical challenges during screening. The majority were Caucasian (90%), female (83%), and worked in outpatient settings (67%). Approximately 50% had > 10 years of research experience. Ethical considerations: The human subjects review board approved the study. Written informed consent was obtained. Findings: Predominant themes were revealed: (1) the inability to provide a probable good, or/do no harm, and (2) dual obligations (identity as a nurse vs a research nurse). The following patterns and subthemes emerged: conflicted allegiances between protocol implementation, needs of the participant, desire to advance science, and tension between the nurse–patient therapeutic relationship versus the research relationship. Discussion: Participants described ethical challenges specific to the research role. The issues are central to the nurse–participant relationship, patient advocacy, the nurse’s role in implementing protocols, and/or advancing science. Conclusion: Ethical challenges related to the specialized role of clinical research nurses were identified. More research is warranted to fully understand their nature and frequency and to identify support systems for resolution. (shrink)

Medical ethics committees are increasingly called on to assist doctors, patients, and families in resolving difficult ethics issues. Although committees are becoming more sophisticated in the substance of medical ethics, little attention has been given to the processes these committees use to facilitate decision-making. In 1990, the National Institute for Dispute Resolution in Washington, D.C., provided a planning grant from its Innovation Fund to the Institute of Public Law of the University of New Mexico School of Law to look at (...) what ethics committees can learn from facilitation and mediation techniques. The study's thesis was that, if adapted for use by medical ethics committees, facilitation and mediation techniques can be helpful to those bodies in case review consultations and in other internal committee processes. This article reports on that project. (shrink)

Demonstrates the dramatic interplay of elements that comprise the concepts of norm, bisexuality, and development.

Children show increasing control of emotions and behavior during their early years. Our studies suggest a shift in control from the brain’s orienting network in infancy to the executive network by the age of 3—4 years. Our longitudinal study indicates that orienting influences both positive and negative affect, as measured by parent report in infancy. At 3—4 years of age, the dominant control of affect rests in a frontal brain network that involves the anterior cingulate gyrus. Connectivity of brain structures (...) also changes from infancy to toddlerhood. Early connectivity of parietal and frontal areas is important in orienting; later connectivity involves midfrontal and anterior cingulate areas related to executive attention and self-regulation. (shrink)

A collaboration between distinguished physicists and philosophers of physics, this important anthology surveys the deep implications of Bell's nonlocality theorem.

This book provides a comprehensive insight into the ways in which psychoanalysts think and work. Mary Brownescombe Heller and Sheena Pollet bring together internationally known contributors trained at the Institute of Psychoanalysis to explore the broad range of clinical work, thinking, and teaching undertaken with children, families, adults and staff by psychoanalysts in the UK public health sector. Divided into four sections, _The Work of Psychoanalysts in the Public Health Sector_ covers: clinical work with parents and young children clinical (...) work with adults and their families analytic thinking in health service practice analytic support for health service staff. Experienced psychoanalysts discuss work with various client groups including parents with babies, children, adolescents who self harm, and adults with serious mental health conditions and psychosis. The book also explores how psychoanalytically-informed work can be used alongside other treatment methods, and how health service staff can best be trained and supported. _The Work of Psychoanalysts in the Public Health Sector_ offers the reader a broad perspective and a clear understanding of the various analytical concepts used in clinical practice. It will be invaluable reading for anyone interested in, or already using psychoanalytic ideas and techniques in the health sector, as well as students in training. (shrink)

This paper elaborates a theory of ‘unbecoming’ to explore how a queering of the subject might transform oppressive social conditions. In this analysis of the subject’s deconstructive relation to the law I take up the interpellation scenario forwarded by Louis Althusser and Judith Butler’s theory of performativity to argue that being ‘unbecoming’ potentially not only alters subjectivity, it also alters the very law that hails the subject into being. First, I deconstruct both subject and law in their relation to each (...) other as performatives, for it is at this threshold of undecidability that the possibilities for political transformation emerge. Second, I demonstrate the creative and transformative political force of queer performativity to show that our agency as political beings lies not merely in affirmative representations of identity. Political agency also emerges in the creative force of a becoming that is also an unbecoming, where in and through our abjection from the social order we critique and transform it. (shrink)

The fairness of agricultural markets is frequently invoked, especially by farmers. But fairness is difficult to define and measure. In this paper we link fairness and power with the concept of constrained choice to develop a framework for assessing fairness in agricultural markets. We use network exchange theory to define power from the dependencies that exist in agricultural networks. The structure of agricultural networks and the options that agricultural producers have to participate in agricultural networks affect the degree to which (...) they are dependent on others within the network. Dependency, in turn, affects the choices that agricultural producers have. We consider both the number and nature of these choices. We argue that constraining or limiting choices—both in number and type—violates principles of justice. Importantly, network exchange theory provides a method for assessing constraints in choices and, hence, the fairness of agricultural markets. Such an assessment could potentially lead to new policies that safeguard the liberties of marketplace participants. We present a brief case to illustrate how this framework can inform on the fairness of agricultural markets and conclude with considerations of what this means for policy, particularly in the arena of anti-trust. (shrink)

Narrative Science examines the use of narrative in scientific research over the last two centuries. It brings together an international group of scholars who have engaged in intense collaboration to find and develop crucial cases of narrative in science. Motivated and coordinated by the Narrative Science project, funded by the European Research Council, this volume offers integrated and insightful essays examining cases that run the gamut from geology to psychology, chemistry, physics, botany, mathematics, epidemiology, and biological engineering. Taking in shipwrecks, (...) human evolution, military intelligence, and mass extinctions, this landmark study revises our understanding of what science is, and the roles of narrative in scientists' work. This title is also available as Open Access. (shrink)

In this paper we seek to make the case for a teaching and learning strategy that integrates business ethics in the curriculum, whilst not precluding a disciplines based approach to this subject. We do this in the context of specific work experience modules at undergraduate level which are offered by Middlesex University Business School, part of a modern university based in North West London. We firstly outline our educative values and then the modules that form the basis of our research. (...) We then identify and elaborate what we believe are the five dimensions which distinguish an integrated approach based on work experience from a disciplines-based approach, namely: process and content, internal and external, facilitation and teaching, covert and overt, and living wisdom and established wisdom. The last dimension draws on the practical relevance of the Aristotelian notion of phronesis inherent in our approach. We go on to provide two case examples of our practice to illustrate our perspective and in support of our conclusions. These are that reflection integrated into the Business Studies curriculum, using the ASKE typology of learning [Frame, 2001, Proceedings of the 9th Annual Teaching and Learning Conference, p. 80], in respect of personal and group process in a work experience context, provides a useful heuristic for the development of moral sensibility and ethical practice. (shrink)

Explores the teaching and learning of issues relating to the impact of science in society. This title offers practical guidance in devising learning goals and suitable learning and assessment strategies. It helps teachers to provide students with the skills and understanding needed to address these multi-faceted issues.

O cuidado espiritual é considerado um aspecto intrínseco às boas práticas de cuidados paliativos. Contudo, este é um desafio a profissionais de saúde. Há carência de propostas cientificamente embasadas e não religiosas para identificar e atender as necessidades existenciais/espirituais de pacientes e familiares. Este artigo tem como objetivo apresentar uma ferramenta de cuidado espiritual denominada Modelo Diamante ou _Ars Moriendi_, desenvolvida por um pesquisador holandês que a concebeu a partir de elementos extraídos de sua pesquisa empírica. O modelo é teoricamente (...) baseado em estruturas antropológicas não morais e não religiosas e está aberto a pessoas de uma variedade de origens culturais e religiosas. Tanto capelães quanto equipes multidisciplinares podem usar essa ferramenta hermenêutica. Ela ajuda a melhor compreender e atender as necessidades espirituais de pacientes e familiares nas dimensões que envolvem autonomia, sofrimento, relacionamentos, questões pendentes e esperança. A apresentação do Modelo Diamante ao público brasileiro também é um convite para testá-lo e avaliá-lo em estudos futuros que investiguem a espiritualidade em cuidados paliativos no Brasil. (shrink)

This issue of Business & Society contains the transcripts of 12 oral history interviews with founders of and early contributors to the business and society/social issues in management field. The publication of these interviews is the culmination of a very long-term project, with the first interview having been conducted in 1993 with Lee Preston and the most recent interview having been conducted in 2011 with Jim Post. This project has been very much of a team effort with Sandra Waddock, John (...) Steiner, Mary Mallott, Ariane Berthoin Antal, and, of course, our interviewees all playing important roles. (shrink)

The Buddhist Art of Nagarjunakonda. Elizabeth Rosen Stone. Buddhist Tradition Series 25, ed. Alex Wayman. Motilal Banarsidass, Delhi 1994. 143 pp. Rs.600. ISBN 81-208-0828-2.