Kolbe and de Melo-Martin’s (2023) arguments draw attention to what is most useful about moral distress—identifying its causes is at least as important as measuring its severity. Jameton’s original...

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)

Moral distress, is, at its core, an organizational problem. It is experienced on a personal level, but its causes originate within the system itself. In this commentary, we argue that moral distress is not inherently good, that effective interventions must address the external sources of moral distress, and that while there is a place for resilience in the healthcare professions, it cannot be an effective antidote to moral distress.

It is predicted that the rapid acquisition of new genetic knowledge and related applications during the next decade will have significant implications for virtually all members of society. Currently, most people get exposed to information about genes and genetics only through stories publicized in the media. We sought to understand how individuals in the general population used and understood the concepts of ???genetics??? and ???genes.??? During in-depth one-on-one telephone interviews with adults in the United States, we asked questions exploring their (...) basic understanding of these terms, as well as their belief as to the location of genes in the human body. A wide range of responses was received. Despite conversational familiarity with genetic terminology, many noted frustration or were hesitant when trying to answer these questions. In addition, some responses reflected a lack of understanding about basic genetic science that may have significant implications for broader public education measures in genetic literacy, genetic counseling, public health practices, and even routine health care. (shrink)

The article is an attempt to uncover the metaphysical assumptions implicit in the otherwise highly scientific contemporary identity theories. 1) the identity statement, Being a philosophical interpretation of dualistic psychophysical correspondence, Requires for its support a justificatory ontological or linguistic premise. 2) the conception of the mental as the hidden, Unobservable, Subjective and private is a metaphysical distortion with historical roots in an empiricist and positivist interpretation of the cartesian dichotomy of thinking and extended thing. 3) acceptance of an artificial (...) dichotomy and reliance on a narrow conceptual framework lead identity theorists to misrepresent the nature of the mental-Physical relation and to see ontological reductionism as the only solution. 4) alternative explanations are possible which bypass the shortcomings mentioned and propose the irreducibility of mind to body without postulating a dualistic ontology; merleau-Ponty's and wittgenstein's theories are good examples of an ontological monism which allows for the reality and meaningfulness of the mental within the scope of the physical. (edited). (shrink)

This article seeks the origin, in the theories of Ibn al-Haytham (Alhazen), Descartes, and Berkeley, of two-stage theories of spatial perception, which hold that visual perception involves both an immediate representation of the proximal stimulus in a two-dimensional ‘‘sensory core’’ and also a subsequent perception of the three dimensional world. The works of Ibn al-Haytham, Descartes, and Berkeley already frame the major theoretical options that guided visual theory into the twentieth century. The field of visual perception was the first area (...) of what we now call psychology to apply mathematics, through geometrical models as used by Euclid, Ptolemy, Ibn al-Haytham, and Descartes (among others). The article shows that Kepler’s discovery of the retinal image, which revolutionized visual anatomy and entailed fundamental changes in visual physiology, did not alter the basic structure of theories of spatial vision. These changes in visual physiology are advanced especially in Descartes' Dioptrics and his L'Homme. Berkeley develops a radically empirist theory vision, according to which visual perception of depth is learned through associative processes that rely on the sense of touch. But Descartes and Berkeley share the assertion that there is a two-dimensional sensory core that is in principle available to consciousness. They also share the observation that we don't usually perceived this core, but find depth and distance to be phenomenally immediate, a point they struggle to accommodate theoretically. If our interpretation is correct, it was not a change in the theory of the psychology of vision that engendered the idea of a sensory core, but rather the introduction of the theory into a new metaphysical context. (shrink)

In a recent issue of this Bulletin, S. Meskhi cites 7 additional conditions for Heyting algebras with involution and linearly ordered matrix [10, p. 11]. In [2], R. Cignoli indicates 3 additional conditions for P-algebras [5] with normal involution [9]. The equivalence of these conditions is shown.

Epstein and Carnielli's fine textbook on logic and computability is now in its second edition. The readers of this journal might be particularly interested in the timeline `Computability and Undecidability' added in this edition, and the included wall-poster of the same title. The text itself, however, has some aspects which are worth commenting on.

Today’s film scholars draw from a dizzying range of theoretical perspectives—they’re just as likely to cite philosopher Gilles Deleuze as they are to quote classic film theorist André Bazin. To students first encountering them, these theoretical lenses for viewing film can seem exhilarating, but also overwhelming. _Thinking in the Dark _introduces readers to twenty-one key theorists whose work has made a great impact on film scholarship today, including Rudolf Arnheim, Sergei Eisenstein, Michel Foucault, Siegfried Kracauer, and Judith Butler. Rather than (...) just discussing each theorist’s ideas in the abstract, the book shows how those concepts might be applied when interpreting specific films by including an analysis of both a classic film and a contemporary one. It thus demonstrates how theory can help us better appreciate films from all eras and genres: from _Hugo _to_ Vertigo_, from _City Lights _to _Sunset Blvd._, and from _Young Mr. Lincoln_ to _A.I. _and _Wall-E_. The volume’s contributors are all experts on their chosen theorist’s work and, furthermore, are skilled at explaining that thinker’s key ideas and terms to readers who are not yet familiar with them. _Thinking in the Dark _is not only a valuable resource for teachers and students of film, it’s also a fun read, one that teaches us all how to view familiar films through new eyes. Theorists examined in this volume are: Rudolf Arnheim, Béla Balázs, Roland Barthes, André Bazin, Walter Benjamin, Judith Butler, Stanley Cavell, Michel Chion, Gilles Deleuze, Jean Douchet, Sergei Eisenstein, Jean Epstein, Michel Foucault, Siegfried Kracauer, Jacques Lacan, Vachel Lindsay, Christian Metz, Hugo Münsterberg, V. F. Perkins, Jacques Rancière, and Jean Rouch. (shrink)

Adherence to a few basic principles of textbook reading compilation have made this one of the more worthwhile introductory philosophy texts. In the first place, the editors have given lengthy and frequently complete texts. Anselm's Proslogium, Descartes' Meditations, Plato's Phaedo, and Kant's Prolegomena are given complete or nearly complete; there is a ninety-one page extract from Locke's Essay, over fifty pages of James and nearly forty pages from Whitehead. This still leaves room for ample primary material by Leibniz, Hume, and (...) Schopenhauer. The plan of the book is to frame the important primary text with intellectually contemporaneous discussion of the problems treated in the primary text, and then to bracket each section with a prologue and epilogue drawn—except in the final section where Plato has the last word—from twentieth-century literature relevant to the issues under discussion in each section. The authors are thus able to provide an historical and thematic introduction to philosophy, which together cannot help but impress the beginning student with the unity of philosophical experience. Obviously no single textbook will ever escape the need for supplementation; this one in particular will require those who would like their students to be exposed to more phenomenology and existentialism, and, to a lesser degree, analytical philosophy, to introduce additional reading. But Epstein and Kennedy have provided the basic skeleton to which may be added as much flesh as the instructor desires.—E. A. R. (shrink)

In their article “A Broader Understanding of Moral Distress,” Campbell, Ulrich, and Grady (2016) correctly assert that moral distress is well established in the nursing literature and is gaining at...

Premier « organe illustré consacré exclusivement à la femme » (p. 23), la revue Femina a longtemps servi de source de renseignements visuels et textuels sur des personnalités et la vie féminines en France pendant une période où les femmes, même connues, n’ont pas laissé tellement de traces dans les archives. La revue reste toutefois méconnue, ignorée comme objet de recherche, selon l’historien américain Leonard Berlanstein, en raison de son apparence luxueuse et des protestations de non-fémin...

Moral distress (MD) is well-documented within the nursing literature and occurs when constraints prevent a correct course of action from being implemented. The measured frequency of MD has increased among nurses over recent years, especially since the COVID-19 Pandemic. MD is less understood among nurse leaders than other populations of nurses. A qualitative systematic review was conducted with the aim to synthesize the experiences of MD among nurse leaders. This review involved a search of three databases (Medline, CINAHL, and APA (...) PsychINFO) which resulted in the retrieval of 303 articles. PRISMA review criteria guided authors during the article review and selection process. Following the review, six articles were identified meeting review criteria and quality was assessed using the Critical Appraisal Skills Programme (CASP) Checklist for qualitative studies. No ethical review was required for this systematic review. The six studies included in this review originated from the United States, Brazil, Turkey, and Iran. Leadership roles ranged from unit-based leadership to executive leadership. Assigned quality scores based upon CASP criteria ranged from 6 to 9 (moderate to high quality). Three analytical themes emerged from the synthesis: (1) moral distress is consuming; (2) constrained by the system; and (3) adapt to overcome. The unique contributors of MD among nurse leaders include the leadership role itself and challenges navigating moral situations as they arise. The nurse leader perspective should be considered in the development of future MD interventions. (shrink)

In his insightful and challenging paper, Jonathan Schaffer argues against a distinction I make in The Ant Trap (Epstein 2015) and related articles. I argue that in addition to the widely discussed “grounding” relation, there is a different kind of metaphysical determination I name “anchoring.” Grounding and anchoring are distinct, and both need to be a part of full explanations of how facts are metaphysically determined. Schaffer argues instead that anchoring is a species of grounding. The crux of his (...) argument comes in the last sections of his paper, in his discussion of “exportation,” the relations strategy, and the definitions strategy. I am inclined to agree that Schaffer’s interesting strategies offer the best choices for the philosopher who wants to insist that anchoring is a species of grounding. But both, I will argue, are fatally flawed. I do not take the separation of anchors from grounds lightly, but find the evidence in its favor overwhelming. And once the distinction is made, I find anchoring to be a powerful practical tool in metaphysics. Philosophy and Phenomenological Research, Volume 99, Issue 3, Page 768-781, November 2019. (shrink)

The thesis of methodological individualism in social science is commonly divided into two different claims—explanatory individualism and ontological individualism. Ontological individualism is the thesis that facts about individuals exhaustively determine social facts. Initially taken to be a claim about the identity of groups with sets of individuals or their properties, ontological individualism has more recently been understood as a global supervenience claim. While explanatory individualism has remained controversial, ontological individualism thus understood is almost universally accepted. In this paper I argue (...) that ontological individualism is false. Only if the thesis is weakened to the point that it is equivalent to physicalism can it be true, but then it fails to be a thesis about the determination of social facts by facts about individual persons. Even when individualistic facts are expanded to include people’s local environments and practices, I shall argue, those still underdetermine the social facts that obtain. If true, this has implications for explanation as well as ontology. I first consider arguments against the local supervenience of social facts on facts about individuals, correcting some flaws in existing arguments and affirming that local supervenience fails for a broad set of social properties. I subsequently apply a similar approach to defeat a particularly weak form of global supervenience, and consider potential responses. Finally, I explore why it is that people have taken ontological individualism to be true. (shrink)

In an unusual instance of lay participation in biomedical research, U.S. AIDS treatment activists have constituted themselves as credible participants in the process of knowledge construction, thereby bringing about changes in the epistemic practices of biomedical research. This article examines the mechanisms or tactics by which these lay activists have constructed their credibility in the eyes of AIDS researchers and government officials. It considers the inwlications of such interventions for the conduct of medical research; examines some of the ironies, tensions, (...) and limitations in the process; and argues for the importance of studying social movements that engage with expert knowledge. (shrink)

In recent years, theorists have debated how we introduce new social objects and kinds into the world. Searle, for instance, proposes that they are introduced by collective acceptance of a constitutive rule; Millikan and Elder that they are the products of reproduction processes; Thomasson that they result from creator intentions and subsequent intentional reproduction; and so on. In this chapter, I argue against the idea that there is a single generic method or set of requirements for doing so. Instead, there (...) is a variety of what I call “anchoring schemas,” or methods by which new social kinds are generated. Not only are social kinds a diverse lot, but the metaphysical explanation for their being the kinds they are is diverse as well. I explain the idea of anchoring and present examples of social kinds that are similar to one another but that are anchored in different ways. I also respond to Millikan’s argument that there is only one kind of “glue” that is “sticky enough” for holding together kinds. I argue that no anchoring schema will work in all environments. It is a contingent matter which schemas are successful for anchoring new social kinds, and an anchoring schema need only be “sticky enough” for practical purposes in a given environment. (shrink)

A recurring theme dominates recent philosophical debates about the nature of conscious perception: naïve realism’s opponents claim that the view is directly contradicted by empirical science. I argue that, despite their current popularity, empirical arguments against naïve realism are fundamentally flawed. The non-empirical premises needed to get from empirical scientific findings to substantive philosophical conclusions are ones the naïve realist is known to reject. Even granting the contentious premises, the empirical findings do not undermine the theory, given its overall philosophical (...) commitments. Thus, contemporary empirical research fails to supply any new argumentative force against naïve realism. I conclude that, as philosophers of mind, we would be better served spending a bit less time trying to wield empirical science as a cudgel against our opponents, and a bit more time working through the implications of each other’s views – something we can accomplish perfectly well from the comfort of our armchairs. (shrink)

The country's leading libertarian scholar sets forth the essential principles for a legal system that best balances individual liberty versus the common good.

It is often seen as a truism that social objects and facts are the product of human intentions. I argue that the role of intentions in social ontology is commonly overestimated. I introduce a distinction that is implicit in much discussion of social ontology, but is often overlooked: between a social entity’s “grounds” and its “anchors.” For both, I argue that intentions, either individual or collective, are less essential than many theorists have assumed. Instead, I propose a more worldly – (...) and less intellectualist – approach to social ontology. (shrink)

According to Minkoswki, Einstein's special theory of relativity reveals that ‘space by itself, and time by itself are doomed to fade away into mere shadows’. But perceptual experience represents objects as instantiating shapes like squareness — properties of ‘space by itself’. Thus, STR seems to threaten the veridicality of shape experience. In response to this worry, some have argued that we should analyze the contents of our spatial experiences on the model of traditional secondary qualities. On this picture—defended in recent (...) work by Chalmers —an experience of squareness just represents whatever property usually causes such experiences. This view salvages the veridicality of shape experience, but leaves the nature of the properties we perceive outside our ken. I argue that such a move is unwarranted: STR is compatible with the idea that shape experience acquaints us with the spatial character of our world. In defending this claim, I propose a view on which shape experience presents familiar Euclidean spatial properties veridically, while implicitly representing those properties as instantiated in a particular manner — namely, relative to our own frame of reference. (shrink)

Individualists about social ontology hold that social facts are “built out of” facts about individuals. In this paper, I argue that there are two distinct kinds of individualism about social ontology, two different ways individual people might be the metaphysical “builders” of the social world. The familiar kind is ontological individualism. This is the thesis that social facts supervene on, or are exhaustively grounded by, facts about individual people. What I call anchor individualism is the alternative thesis that facts about (...) individuals put in place the conditions for a social entity to exist, or the conditions for something to have a social property. Examples include conventionalist theories of the social world, such as David Hume’s theories of promises, money, and government, and collective acceptance theories, such as John Searle’s theory of institutional facts. Anchor individualism is often conflated with ontological individualism. But in fact, the two theses are in tension with one another: if one of these kinds of individualism is true, then the other is very unlikely to be. My aim in this paper is to clarify both, and argue that they should be sharply distinguished from one another. (shrink)

This groundbreaking work by one of the world's foremost theoreticians of Russian literature, culture, and thought gives for the first time an extensive and detailed examination of the development of Russian thought during the late Soviet period. Countering the traditional view of an intellectual wilderness under the Soviet regime, Mikhail Epstein offers a systematic account of Russian thought in the second half of the 20th century. In doing so, he provides new insights into previously ignored areas such as Russian (...) liberalism, personalism, structuralism, neo-rationalism, and culturology. Epstein shows how Russian philosophy and culture has long been trapped in an intellectual prison of its own making as it sought to create its own utopia. However, he demonstrates that it is time to reappraise Russian philosophical thought and cultural theory, now freed from the bonds of totalitarianism. We are left with not only a new and exciting interpretation of Russian thought, but also an opportunity to rethink our own intellectual heritage. (shrink)

Malice that cannot speak its name, cold-blooded but secret hostility, impotent desire, hidden rancor and spite--all cluster at the center of envy. Envy clouds thought, writes Joseph Epstein, clobbers generosity, precludes any hope of serenity, and ends in shriveling the heart. Of the seven deadly sins, he concludes, only envy is no fun at all. Writing in a conversational, erudite, self-deprecating style that wears its learning lightly, Epstein takes us on a stimulating tour of the many faces of (...) envy. He considers what great thinkers--such as John Rawls, Schopenhauer, and Nietzsche--have written about envy; distinguishes between envy, yearning, jealousy, resentment, and schadenfreude ; and catalogs the many things that are enviable, including wealth, beauty, power, talent, knowledge and wisdom, extraordinary good luck, and youth. He looks at resentment in academia, where envy is mixed with snobbery, stirred by impotence, and played out against a background of cosmic injustice; and he offers a brilliant reading of Othello as a play more driven by Iago's envy than Othello's jealousy. He reveals that envy has a strong touch of malice behind it--the envious want to destroy the happiness of others. He suggests that envy of the astonishing success of Jews in Germany and Austria may have lurked behind the virulent anti-Semitism of the Nazis. As he proved in his best-selling Snobbery, Joseph Epstein has an unmatched ability to highlight our failings in a way that is thoughtful, provocative, and entertaining. If envy is no fun, Epstein's Envy is truly a joy to read. (shrink)

This book is dedicated to a classic presentation of the theory of computable functions in the context of the foundations of mathematics. Part I motivates the study of computability with discussions and readings about the crisis in the foundations of mathematics in the early 20th century, while presenting the basic ideas of whole number, function, proof, and real number. Part II starts with readings from Turing and Post leading to the formal theory of recursive functions. Part III presents sufficient formal (...) logic to give a full development of Gödel's incompleteness theorems. Part IV considers the significance of the technical work with a discussion of Church's Thesis and readings on the foundations of mathematics. This new edition contains the timeline "Computability and Undecidability" as well as the essay "On mathematics". (shrink)

In this article I consider how our experiences of bodily privacy are changing in the contemporary surveillance society. I use biometric technologies as a lens for tracking the changing relationships between the body and privacy. Adopting a broader genealogical perspective, I retrace the role of the body in the constitution of the modern liberal political subject. I consider two different understandings of the subject, the Foucauldian political subject, and the Lacanian psychoanalytic subject. The psychoanalytic perspective serves to appraise the importance (...) of hiding for the subject effects of excessive exposure to the Other’s gaze. I conclude to the importance of the subject’s being able to hide, even when it has nothing to hide. By considering these two facets of subjectivity, political and psychic, I hope to make sense of our enduring and deeply political passionate attachment to privacy. (shrink)

In his novel Remembrance of Things Past, Marcel Proust argues that conventional descriptions of the phenomenology of consciousness are incomplete because they focus too much on the highly-salient sensory information that dominates each moment of awareness and ignore the network of associations that lies in the background. In this paper, I explicate Proust’s theory of conscious experience and show how it leads him directly to a theory of aesthetic perception. Proust’s division of awareness into two components roughly corresponds to William (...) James’ division of the stream of thought into a “nucleus” and “fringe.” Proust argues that the function of art is to evoke the underlying associative network indirectly in the mind of the observer by using carefully chosen sensory surfaces to control the stream of thought. I propose a possible neural basis for this Proustian/Jamesian phenomenology, and argue that the general principles of Proustian aesthetics can be applied to all forms of art. I conclude that a scientific theory of art should follow in a straightforward manner from a scientific theory of consciousness. (shrink)

William M. Epstein charges that most current social welfare programs are not held to credible standards in their design or their results. Rather than spending less on such research and programs, however, Epstein suggests we should spend much more, and do the job right. The American public and policymakers need to rely on social science research for objective, credible information when trying to solve problems of employment, affordable housing, effective health care, and family integrity. But, Epstein contends, (...) politicians treat welfare issues as ideological battlegrounds; they demand immediate results from questionable data and implement policies long before social researchers can complete their analyses. Social scientists often play into the political agenda, supporting poorly conceived programs and doing little to test and revise them. Analyzing Aid to Families with Dependent Children (AFDC) and the recent welfare reform act, Food Stamps, Medicaid, job training, social services, and other programs, Epstein systematically challenges the conservative’s vain hope that neglect is therapeutic for the poor, as well as the liberal’s conceit that a little bit of assistance is sufficient. (shrink)

Bioethical arguments conceal the coercion underlying the choice between poverty and selling ones organsIn mid-May 2006, three Palestinian prisoners detained in Israel applied to the Israeli Prison Service for permission to sell their kidneys in order to send money to their children for food. Whether truly sincere or merely propagandistic, the request was made against the background of Israel’s decision to suspend the transfer of Palestinian tax moneys to the Hamas-led Palestinian Authority, and the subsequent increasing poverty and famine in (...) the Gaza Strip.1An official decision was yet to be made when this paper was written. However, the IPS chief medical officer had already made it clear that the request is likely to be rejected. Aside from emphasising that the cost of the pertinent treatment of the prisoners could not be imposed on the IPS, especially as it would greatly exceed the sum to be obtained by the sellers , he asserted that the IPS “won’t lend a hand to endangering the prisoner”. He also reiterated the official IPS policy, according to which the prisoners’ consent to such transaction could not be valid, since they might have been threatened by people from inside or outside the prison.1This is ironic. While the IPS’ professed concerns for the welfare and best interests of the prisoners are commendable, they conceal and hence reaffirm the real coercion implicit in the dilemma the prisoners face: to sell their kidney or let their children starve. Interestingly, approval of their request would have equally concealed the coercion, this time behind concerns for either their autonomy, or the welfare of their children, or both.At present, it is unlikely that Israel will acknowledge the role of national oppression and poverty in producing this dilemma. Rather, the debate will remain focused on …. (shrink)