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)

There is disagreement in the literature about the exact nature of the phenomenon of empathy. There are emotional, cognitive, and conditioning views, applying in varying degrees across species. An adequate description of the ultimate and proximate mechanism can integrate these views. Proximately, the perception of an object's state activates the subject's corresponding representations, which in turn activate somatic and autonomic responses. This mechanism supports basic behaviors that are crucial for the reproductive success of animals living in groups. The Perception-Action Model, (...) together with an understanding of how representations change with experience, can explain the major empirical effects in the literature. It can also predict a variety of empathy disorders. The interaction between the PAM and prefrontal functioning can also explain different levels of empathy across species and age groups. This view can advance our evolutionary understanding of empathy beyond inclusive fitness and reciprocal altruism and can explain different levels of empathy across individuals, species, stages of development, and situations. Key Words: altruism; cognitive empathy ; comparative; emotion; emotional contagion; empathy ; evolution; human; perception-action; perspective taking. (shrink)

This article demonstrates how researchers from both the sciences and the humanities can learn from Charles Darwin’s mixed methodology. We identify two basic challenges that face emotion research in the sciences, namely a mismatch between experiment design and the complexity of life that we aim to explain, and problematic efforts to bridge the gap, including invalid inferences from constrained study designs, and equivocal use of terms like “sympathy” and “empathy” that poorly reflect such methodological constraints. We argue that Darwin’s mixed (...) methodology is a model for addressing these challenges even in laboratory work on emotion, because it shows how close observation of emotional phenomena makes sense only within broader historical contexts. The article concludes with 5 practical research recommendations. (shrink)

When leading spectroscopists in Europe and America were engaged, during 1897, in exploring the recently-discovered Zeeman Effect, they were overtaken by a relatively obscure phsicist working in Dublin. Thomas Preston had previously been known only for his excellent textbooks. His achievement in discovering the Anomalous Zeeman Effect was immediately recognized, but his untimely death has deprived posterity until now of a full account of his life and qualities.

Power consists in the capacity of A to command B, even against B's wishes, whether directly or indirectly. Questions to do with who possesses it and in what degree are obscured by inflationary shifts of definition (as where power encompasses action as such, or right action, or co?operation). These misjudged moves are generally marked by the assumption that democracy displaces power. But if democracy ultimately persists as a voting procedure, its object is to create power?holders. Democracy may endorse three electoral (...) principles: (a) majority rule, or (b) enhanced majority rule, or (c) unanimity. Its commonest electoral device is (a), but its strongest moral defence for (a) implicitly is (c), which legitimates forms of (d) veto and forms of minority rule. If (d) is fair, this need not follow from (a). Nor is (a) right in virtue of superior power. Democracy is commonly a combination of (a) plus (e) defence of individual and corporate rights. But this combination, while apt and convenient, is not incontestably coherent. Despite growing support for deliberation over election, if democracy must be impelled by (a), thus far does it sustain, not topple, power. If power persists more stably under democracies than elsewhere, sustained caution in regard to its supposed ?circularization? is fully warranted. (shrink)

This essay treats Private Management and Public Policy not only as one of the key building blocks of theory in the business and society field, but as a work of theoretical social science in the structural-functional tradition. As a work in the "s-f" tradition, it shares the weaknesses inherent in that mode of theorizing and introduces some of its own in the attempt to translate structural-functionalism into terms relevant for management. These problems are discussed in the context of detailed analysis (...) of the work's theoretical structure. (shrink)

Martin Hollis (d.1998) was arguably the most incisive, eloquent and witty philosopher of the social sciences of his time. His work is appreciated and contested here by some of the most eminent of contemporary social theorists. Hollis's philosophy of social action, routinely distinguished between understanding (rational) and explanation (causal). He argued that the aptest account of human interaction was to be made in terms of the first. Thus he focused upon the human reasons, for, rather than upon the natural causes (...) of, action. This volume, for the first time, brings together important essays on the work of Hollis, from many different perspectives. These include politics, sociology and economics in general; international relations, rational choice theory, constitutionalism and the rule of law as well as current concerns with relativism, Rousseauist contractarianism, "dirty hands" and "buck-passing". (shrink)

This article discusses Ronald Preston's understanding of William Temple and the relationships between the two thinkers. It shows how both develop a theology of Christian realism which places great emphasis on the autonomy of the social sciences and the importance of economic expertise. Questions are raised about the appropriateness of this method, as well as their understanding of the state as an order of creation: these can easily lead to the reduction of the sphere of political morality and its (...) substitution with a form of technical rationality. After a brief discussion of the cult of the expert and the manager in contemporary British politics, and the limitation of political action through the rhetoric of ‘there is no alternative', the article concludes by calling for a remoralisation of political life against an economic reductionism which threatens to remove ethics from politics altogether. (shrink)

Geoffrey Rose’s prevention paradox points to a tension between two prima facie plausible moral principles: that we should save the greater number and that weshould save the most at risk. This paper argues that a novel moral theory, ex-ante contractualism, captures our intuitions in many prevention paradox cases, regardless of our interpretation of probability claims. However, it goes on to show that it might be impossible to square ex-ante contractualism with all of our moral intuitions. It concludes that even if (...) ex-ante contractualism cannot furnish an entire ethics of risk, it does identify important considerations for any such theory. (shrink)

Eupolis’ fragmentary Demes has traditionally been placed in 412 bc, after the failure of the Sicilian Expedition but before the oligarchic coup of 411. Ian Storey has recently argued that the play belongs instead in 417 or perhaps 416 bc, while Mario Telò and Leone Porciani put it in 410 bc. This article demonstrates that both alternative dates face decisive objections, and suggests that Demes is better kept in 412 bc. I then briefly consider the role of late 5th-century Athenian (...) “political” comedy generally, and in particular the sort of popular sentiment that Eupolis’ comedy must have been exploiting or echoing when it was conceived in the first half of 413. (shrink)

Since the middle of the 20th century there has been a significant debate about the attribution of capacities of living systems, particularly humans, to technological artefacts, especially computers—from Turing’s opening gambit, to subsequent considerations of artificial intelligence, to recent claims about artificial life. Some now argue that the capacities of future technologies will ultimately make it impossible to draw any meaningful distinctions between humans and machines. Such issues center on what sense, if any, it makes to claim that gadgets can (...) actually think, feel, act, live, etc. I outline this debate and offer a critique of its persistent polarization. I characterize two of the debate’s major camps (associated roughly with Turing and Searle); argue that the debate’s structure (including key assumptions inherent to each camp) precludes resolution; and, contend that some central clashes within the debate actually stem from an inadequately drawn distinction between claims about the capacities of artifacts and claims about the proper criteria for assessing such attributions. I offer a different perspective in which I: challenge some central elements of the debate that contribute to its perennially irresolvable state; hold that the debate needs to be placed more squarely in sync with how we in fact treat the attribution of such capacities to humans themselves; and, offer (unlike the other two camps) a foothold for making moral assessments of such proposed technologies. (shrink)

The current Medicare prospective payment system has many positive incentives for hospitals to control costs. Hospitals are increasing outpatient surgery, decreasing admissions, decreasing length of stay, and decreasing use of ancillary services. These are just the effects that Congress and the Health Care Financing Administration hoped for to save the Medicare trust fund. However, there has been evidence of some adverse outcomes including premature discharge, “dumping” sicker patients and patients without insurance, and adverse impact on hospitals with specialty centers. We (...) examine these issues and present a possible solution based on a new Computerized Severity Index. (shrink)

This article begins from the assumption that what was once an integral dimension of progress—the development of literature and of art more generally—now lies outside its scope. The essay falls into three parts that juxtapose French with German intellectual history. The first part examines the notion of literary progress developed by Charles Perrault and Fontenelle, as well as the opposition to it by Boileau and other antiquarians, during the querelle des Anciens et des Modernes in the later seventeenth century. The (...) second part treats the reception of those arguments during the eighteenth century by J. C. Gottsched, J. J. Bodmer, and J. J. Breitinger. Special attention is given to the paradox that Gottsched, the leader of the German antiquarians, and Bodmer, the leader of the German progressives, were equally devoted to the Leibnizian-Wolffian philosophical system and thus that German Romanticism, heavily indebted to Bodmer's poetics, had roots in rationalist philosophy. The essay's third part discusses ideas of literary progress in the writings of the early Romantics J. G. Herder and Friedrich Schlegel. As these discussions show, the conception of general progress was formed in a field that has since dissociated itself from progress's march. (shrink)

While there is significant consensus that undergraduate medical education should include bioethics training, there is widespread debate about how to teach bioethics to medical students. Educators disagree about course methods and approaches, the topics that should be covered, and the effectiveness and metrics for UME ethics training. One issue that has received scant attention is the timing of bioethics education during medical training. The existing literature suggests that most medical ethics education occurs in the pre-clinical years. Follow-up studies indicate that (...) medical students in their clinical rotations have little recall or ability to apply ethics concepts that were learned in their pre-clinical training. Trainees also report a desire for medical ethics to be taught in the context of practical application, which would suggest that the timing of pre-clinical ethics education is flawed. However, moving bioethics training to the clinical years should not be assumed to be the solution to the problems of recall and theory application. We argue that the effectiveness of timing bioethics education will depend on when medical students witness or experience particular categories of ethical dilemmas during their training. Our overarching hypothesis is that ethics education will be most effective when the bioethics training on a particular topic correlates to experiential exposure to that ethical issue. The purpose of our current study was to describe medical students exposure to particular categories of ethical conflicts, dilemmas, or issues. Our results may help bioethics educators better strategize about the most effective timing of medical ethics training in UME. (shrink)

Joseph C. Pitt, based on his understanding of trust and of technology, makes the provocative argument that trusting technology is actually a matter of trusting people. I agree with Pitt’s conclusion but differ with him on the nature of trust. I contend, nonetheless, that my understanding of trust actually reinforces Pitt’s characterization of technology as “humanity at work.”.