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)

This long-awaited book replaces Hughes and Cresswell's two classic studies of modal logic: _An Introduction to Modal Logic_ and _A Companion to Modal Logic_. _A New Introduction to Modal Logic_ is an entirely new work, completely re-written by the authors. They have incorporated all the new developments that have taken place since 1968 in both modal propositional logic and modal predicate logic, without sacrificing tha clarity of exposition and approachability that were essential features of their earlier works. The book takes (...) readers from the most basic systems of modal propositional logic right up to systems of modal predicate with identity. It covers both technical developments such as completeness and incompleteness, and finite and infinite models, and their philosophical applications, especially in the area of modal predicate logic. (shrink)

Adverbial modification is probably one of the least understood areas of linguistics. The essays in this volume all address the problem of how to give an analysis of adverbial modifiers within truth-conditional semantics. Chapters I-VI provide analyses of particular modifiers within a possible worlds framework, and were written between 1974 and 1981. Original publication details of these chapters may be found on p. vi. Of these, all but Chapter I make essential use of the idea that the time reference involved (...) in tensed sentences should be a time interval rather than a single instant. The final chapter (Chapter VII) was written especially for this volume and investigates the question of how the 'situation semantics' recently devised by Jon Barwise and John Perry, as a rival to possible-worlds semantics, might deal with adverbs. In addition I have included an appendix to Chapter III and an introduction which links all the chapters together. (shrink)

Neuroethics has developed rapidly, driven in large part by developments in neuroscience. This article reviews neuroethics from the standpoint of its growing real-world relevance. It opens up with an analysis of the history of neuroscience that suggests the reason for the emergence of neuroethics now, in the early twenty-first century. It proceeds to survey current applications of neuroscience to diverse real-world problems. Published research in the field of neuromarketing is more focused on academic issues, such as the nature of the (...) brain activity underlying consumer behavior and the accuracy of brain-behavior predictions, than it is on the real-world utility of neuromarketing for improving business. Finally, this article concludes with a discussion of the ethical issues raised by these developments, and outlines three general challenges for society in the age of neuroscience. (shrink)

The paper investigates interpretations of propositional and firstorder logic in which validity is defined in terms of partial indices; sometimes called possibilities but here understood as non-empty subsets of a set W of possible worlds. Truth at a set of worlds is understood to be truth at every world in the set. If all subsets of W are permitted the logic so determined is classical first-order predicate logic. Restricting allowable subsets and then imposing certain closure conditions provides a modelling for (...) intuitionistic predicate logic. The same semantic interpretation rules are used in both logics for all the operators. (shrink)

The most common way of proving decidability in propositional modal logic is to shew that the system in question has the finite model property. This is not however the only way. Gabbay in [4] proves the decidability of many modal systems using Rabin's result in [8] on the decidability of the second-order theory of successor functions. In particular [4, pp. 258-265] he is able to prove the decidability of a system which lacks the finite model property. Gabbay's system is however (...) complete, in the sense of being characterized by a class of frames, and the question arises whether there is a decidable modal logic which is not complete. Since no incomplete modal logic has the finite model property [9, p. 33], any proof of decidability must employ some such method as Gabbay's. In this paper I use the Gabbay/Rabin technique to prove the decidability of a finitely axiomatized normal modal propositional logic which is not characterized by any class of frames. I am grateful to the referee for suggesting improvements in substance and presentation.The terminology I am using is standard in modal logic. By aframeis understood a pair 〈W, R〉 in whichWis a class (of “possible worlds”) andR⊆W2. To avoid confusion in what follows, a frame will henceforth be referred to as aKripkeframe. By contrast, ageneral frameis a pair 〈,Π〉 in whichis a Kripke frame andΠis a collection of subsets ofWclosed under the Boolean operations and satisfying the condition that ifAis inΠthen so isR−1“A. A model on a frame (of either kind) is obtained by adding a functionVwhich assigns sets of worlds to propositional variables. In the case of a general frame we require thatV(p) ∈Π. (shrink)

The second of these lines seems to be the result of an interpolation designed to spell out the implicit sense of the first. In 241–6 Ion has expressed amazement that Creusa should be weeping at the sight of Apollo's sanctuary, a sight which brings other visitors joy. She prefaces her explanation of this with an assurance which in its transmitted form is elegantly translated by Grégoire: ‘Il n'est point discourtois de ta part, étranger, de marquer ta surprise au sujet de (...) mes pleurs.’ But there are reasons for doubting I the authenticity of line 248: Line 247 is self-sufficient, as is shown by IA 1402: τ μν σόν, νενι, γενναίως χει. This also gives the closest parallel for the use of τ σόν in reference to the attitude which a previous speaker's words have just expressed. Other instances of τ σόν, tout court, are helpfully grouped in Allen and Italie's Concordance to Euripides, s.v. σός. τ σόν…[adverbial phrase] χει occurs also in Hek. 1195 and Med. 312; cf. HF 165, Hel. 893, Pho. 995 with τομόν. These make it unlikely that τ χόν in our passage is to be taken adverbially, as perhaps Grégoire intended with ‘de ta part’, rather than as subject of χει. Tro. 82 might be adduced for the alternative , but there is no reason for Creusa to be saying emphatically ‘as far as you are concerned’. (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)

Expressions in a language, whether words, phrases, or sentences, have meanings. So it seems reasonable to suppose that there are meanings that expressions have. Of course, it is fashionable in some philosophical circles to deny this.

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

' I heartily recommend it to any philosopher of language interested in the issues. [] Logicians, of course, will want to savour the whole thing.' Australian Journal of Philosophy, 71:3 (1993).

M. J. Woods; XI*—Substance and Essence in Aristotle, Proceedings of the Aristotelian Society, Volume 75, Issue 1, 1 June 1975, Pages 167–180, https://doi.org/10.

Various claims have been made, recently, that Darwin's argumentation in the Origin instantiates and so supports some general philosophical proposal about scientific theorizing, for example, the "semantic view". But these claims are grounded in various incorrect analyses of that argumentation. A summary is given here of an analysis defended at greater length in several papers by the present author. The historical and philosophical advantages of this analysis are explained briefly. Darwin's argument comprises three distinct evidential cases on behalf of natural (...) selection, cases, that is, for its existence, its adequacy and its responsibility. Theorizing, today, about evolution by natural selection involves a similar structure of evidential and explanatory concerns. (shrink)