This work describes the perceptions that Industrial Engineering students have regarding Colombian firms’ corporate social responsibility (CSR) practices. It also explores the incidence of gender, academic level, work experience and entrepreneurial intention on students’ vision. A survey with 70 CSR practices was designed based on previous research. Practices were grouped in ten dimensions: shareholders, customers, employees, suppliers, stakeholders, ethics, environment, legal, human rights and society. A representative sample of 142 students was used. Results show that students perceive a higher commitment (...) of Colombian companies with the shareholders dimension, while a lower with the society, ethics and environmental CSR practices. Work experience and entrepreneurial intention are the only variables affecting the identified perceptions. Thus, as they gain experience, their perceptions become more favorable. On the other hand, potential entrepreneurs have a more critical view on the companies’ commitment. Additionally, the fact that the academic level does not impact students’ perceptions constitutes a challenge for the academic program, since it is expected that this will affect the vision of future engineers. This is the first study that evaluates perceptions of Industrial Engineering students, who, given their object of study, will be responsible for designing and managing production processes in organizations of the future. Results respond to a specific context (students at a Colombian public university), therefore further research to explore the subject is recommended. (shrink)

Desde la publicación de la encíclica Laudato si ‘(LS) del Papa Francisco en 2015, se han llevado a cabo múltiples acciones para fomentar una visión integral de la ecología en la Iglesia Católica. El objetivo fue el desarrollo de una propuesta curricular que incluye el desarrollo sostenible e integral en la enseñanza de la religión católica. El curso CHANCES ofrece un nuevo paradigma de la enseñanza de la religión católica, mostrando cómo desde ella se pueden descubrir motivaciones profundas, y potenciar (...) actitudes y virtudes, que pueden contribuir al desarrollo de competencias en sostenibilidad. (shrink)

This article presents a summary of the key aspects of the Biocentric theory of psychology proposed and developed by Nathaniel Branden. The themes of the conscious and nonconscious aspects of the mind and their interplay in healthy and psychopathological human functioning are highlighted, with the development and maintenance of self-esteem as the centerpiece of this schema. Branden's cogent, in-depth analysis and synthesis of these issues, presented for the first time over fifty years ago, is discussed in relation to issues that (...) are being actively researched today. (shrink)

Antecedentes: El uso de la tecnología médica amplía las posibilidades de vida, pero plantea responsabilidades y problemas filosóficos, legales o políticos. Objetivo: Realizar una revisión sistemática sobre la evolución de las publicaciones científicas del uso bioético de las tecnologías de salud en los últimos 20 años. Metodología: Se realizó una revisión bibliográfica usando la base de datos Scopus. Resultados: La aplicabilidad de las tecnologías de salud, desde un punto de vista bioético, ha aumentado en los últimos años. Conclusión. Existe un (...) aumento en el número de publicaciones del uso bioético de la tecnología médica en los últimos 20 años. (shrink)

Este estudio presenta las evidencias psicométricas de la Escala de Aprendizajes Percibidos, basada en los elementos didácticos y pedagógicos del proceso de enseñanza-aprendizaje de una Experiencia Curricular en formulación y ejecución de «Programas de Intervención en Psicología». Investigación instrumental-psicométrica, de enfoque cuantitativo-transversal, con recolección de datos post-EC, en 117 estudiantes universitarios. Su contraste estadístico se realizó en el entorno R para Análisis Factorial Confirmatorio y Análisis Factorial de Componentes Principales, entre otros. Los resultados indican un adecuado ajuste orientado a 5 (...) factores, ratificado en análisis paralelos. Se concluye en la conformación de un constructo robusto, fiable y válido, que explora la conciencia de los aprendizajes en materia de promoción prevención en salud, y susceptible de adaptación. (shrink)

Background: In Hospital Emergency Department and Emergency Medical Services professionals experience situations in which they face difficulties or barriers to know patient’s advance directives and implement them. Objectives: To analyse the barriers, facilitators, and ethical conflicts perceived by health professionals derived from the management of advance directives in emergency services. Research design, participants, and context: This is a qualitative phenomenological study conducted with purposive sampling including a population of nursing and medical professionals linked to Hospital Emergency Department and Emergency Medical (...) Services. Three focus groups were formed, totalling 24 participants. We performed an inductive-type thematic discourse analysis. Ethical considerations: This study was approved by ethical committees of Ethical Commitee of Clínic Hospital (Barcelona) and Comittee of Emergency Medical Services (Barcelona). The participants received information about the purpose of the study. Patients’ anonymity and willingness to participate in the study were guaranteed. Findings: There were four types of barriers that hindered the proper management of patients’ advance directives in Hospital Emergency Department and Emergency Medical Services: personal and professional, family members, organisational and structural, and those derived from the health system. These barriers caused ethical conflicts and hindered professionals’ decision-making. Discussion: These results are in line with those of previous studies and indicate that factors such as gender, professional category, and years of experience, in addition to professionals’ beliefs and the opinions of colleagues and family members, can also influence the professionals’ final decisions. Conclusion: The different strategies described in this study can contribute to the development of health policies and action protocols to help reduce both the barriers that hinder the correct management and implementation of advance directives and the ethical conflicts generated. (shrink)

Gaze plays a fundamental role in the processing of facial expressions from birth. Gaze direction is a crucial part of the social signal encoded in and decoded from faces. The ability to discriminate gaze direction, already evident early in life, is essential for the development of more complex socially relevant tasks, such as joint and shared attention. At the same time, facial expressions play a fundamental role in the encoding of gaze direction and, when combined, expression and gaze communicate behavioural (...) motivation to approach or avoid. However, the investigation of how gaze direction and emotional expression interact during the processing of a face has been relatively neglected, and is the key question of this review. (shrink)

El confinamiento vivido durante la pandemia de Covid 19 nos obligó a afrontar la vida con un ritmo más tranquilo. En este contexto, desde el Grupo de Estudios Interdisciplinares de Literatura y Arte (LyA) (UCLM) se planteó desarrollar un proyecto donde abordar nuestra docencia desde una perspectiva más pausada siguiendo la filosofía del Slow Movement. El objetivo de este texto es dar a conocer el trabajo que se viene desarrollando en asignaturas de Historia del Arte en los Grados de Humanidades (...) y Estudios Sociales de la Facultad de Humanidades de Albacete y de Historia del Arte de la Facultad de Letras de Ciudad Real (UCLM). (shrink)

The aim of this study was to carry out a psychosocial analysis of child-to-parent violence (CPV) in a sample of school adolescents, considering a set of individual variables (psychological distress, problematic use of social networking sites, and perceived non-conformist social reputation) and family variables (open and problematic communication with parents) according to sex. The sample consisted of 3,731 adolescents (54% boys), aged between 14 and 16 years (M = 14.6 years, SD = 0.567), from the state of Nuevo León, Mexico. (...) The scores of the boys and girls were analyzed to check for differences. Also, correlations between all the study variables were calculated. Finally, a multiple stepwise regression analysis was carried out for the total sample and also for boys and girls separately. Results confirmed the important role of individual variables as predictors of CPV in boys and girls. The main difference between boys and girls was observed in the predictive weight of problematic use of social networking sites, which was higher in girls than in boys. Open communication with the father was a significant factor for predicting the decrease of CPV levels in the case of boys, while open communication with the mother predicted the decrease of CPV in girls. Problematic communication with the mother showed similar values in boys and girls when predicting CPV, however, the predictive weight of problematic communication with the father was higher in girls than in boys. These results are interesting and have important implications for the prevention of CPV. (shrink)

Among the possible ways of gaining moral knowledge, moral perception figures as a controversial yet fruitful option. If moral perception is possible, moral disagreement is addressed not by appealing to principles but to the process and the objects of perception, and moral progress occurs not through deliberation but by refining one’s perceptual faculties. The possibility of “seeing clearly and justly” is at the heart of Iris Murdoch’s thought, but Murdoch herself does not put forth a systematic argument for this view. (...) In this paper I propose an argument for moral perception based on Murdoch’s philosophy, while engaging with contemporary debates in moral perception. The key idea I take from Murdoch is that perception is conceptually laden, where concepts are understood as ways of grasping the world according to human concerns. Murdoch’s position enables us to solve a difficult tension: explaining the motivating force of perception while maintaining objectivity in ethics. This view of moral perception also constitutes a radical position in the debate, where even the most optimistic defenses appeal to the supervenience of values on facts. If Murdoch is right, however, we perceive complex properties, including values, directly, so that appeal to supervenience becomes unnecessary and some of the grounds for the very distinction between fact and value are put into question. (shrink)

The existence of fundamental moral disagreements is a central problem for moral realism and has often been contrasted with an alleged absence of disagreement in mathematics. However, mathematicians do in fact disagree on fundamental questions, for example on which set-theoretic axioms are true, and some philosophers have argued that this increases the plausibility of moral vis-à-vis mathematical realism. I argue that the analogy between mathematical and moral disagreement is not as straightforward as those arguments present it. In particular, I argue (...) that pluralist accounts of mathematics render fundamental mathematical disagreements compatible with mathematical realism in a way in which moral disagreements and moral realism are not. 11. (shrink)

An important yet often unacknowledged aspect of moral discourse is the phenomenon of moral impossibility, which challenges more widely accepted models of moral discussion and deliberation as a choice among possible options. Starting from observations of the new possibilities of anti immigrant attitudes and hate crimes which have been described by the press as something being “unleashed,” the paper asks what it means for something to enter or not the sphere of possibility in the moral sense, and whether it is (...) ever desirable for something to remain or be pushed back outside the realm of the morally possible. Three forms of moral impossibility are identified: the unconceived, the unthinkable, and moral incapacity. Through the discussion of a stark fictional example of moral impossibility, the paper concludes that while the category of moral impossibility cannot settle disagreement, it sheds light on some of the most fundamental aspects of moral life. (shrink)

Attempting to steer moral philosophy away from abstract theorizing, Moral Disquiet and Human Life argues that moral philosophy should be a practical, rational, and argumentative engagement with reality, and that moral reflection should have direct effects on our lives and the world in which we live. Illustrating her discussion with vivid examples from literature, music, drama, and current events, the noted French philosopher Monique Canto-Sperber resumes the most ancient pursuit of philosophy: the examination of human life itself. What did Socrates (...) mean when he said that the unexamined life is not worth living? How can reflecting on one's existence incorporate human singularity, the contingency of events, the certainty of death, the presence of the past, or the irreversibility of time? Carefully analyzing and proposing answers to such questions, Moral Disquiet and Human Life eloquently calls for a redefinition of the task of moral philosophy and of its limits. (shrink)

Morality is one of the fundamental structures of any society, enabling complex groups to form, negotiate their internal differences and persist through time. In the first book-length study of Roman popular morality, Dr Morgan argues that we can recover much of the moral thinking of people across the Empire. Her study draws on proverbs, fables, exemplary stories and gnomic quotations, to explore how morality worked as a system for Roman society as a whole and in individual lives. She examines the (...) range of ideas and practices and their relative importance, as well as questions of authority and the relationship with high philosophy and the ethical vocabulary of documents and inscriptions. The Roman Empire incorporated numerous overlapping groups, whose ideas varied according to social status, geography, gender and many other factors. Nevertheless it could and did hold together as an ethical community, which was a significant factor in its socio-political success. (shrink)

In their daily practices, many ethical vegans choose what to eat, wear, and buy among a range that is limited to the exclusion of animal products. Rather than considering and then rejecting the idea of using such products, doing so often does not occur to them as a possibility at all. In other cases, when confronted with the possibility of consuming animal products, vegans have claimed to reject it by saying that it would be impossible for them to do so. (...) I refer to this phenomenon as ‘moral impossibility’. An analysis of moral impossibility in animal ethics shows that it arises when one’s conception of ‘what animals are’ shifts—say through encounter with other animals. It also arises when individuals learn more about animals and what happens to them in production facilities. This establishes a link between increased knowledge, understanding, and imaginative exploration on the one hand, and the exclusion of the possibility of using animals as resources on the other. Taking moral impossibility in veganism seriously has two important consequences: one is that the debate around veganism needs to shift from choice and decision, to a prior analysis of concepts and moral framing; the other is that moral psychology is no longer seen as empirical psychology plus ethical analysis, but the contents of psychological findings are understood as being influenced and framed by moral reflection. (shrink)

BackgroundImplementing the routine consultation of patient advance directives in hospital emergency departments and emergency medical services has become essential, given that advance directives constitute the frame of reference for care personalisation and respect for patients’ values and preferences related to healthcare. The aim of this study was to assess the levels and relationship of knowledge and attitudes of nursing and medical professionals towards advance directives in hospital emergency departments and emergency medical services, and to determine the correlated and predictor variables (...) of favourable attitudes towards advance directives.MethodsObservational, descriptive, and cross-sectional study. The study was conducted in the emergency department of a second-level hospital and in the emergency medical service. Data collection was performed from January 2019 to February 2020. The STROBE guidelines were followed for the preparation of the study.ResultsA total of 173 healthcare professionals responded to the questionnaire. Among them, 91.3% considered that they were not sufficiently informed about advance directives, and 74% acknowledged not having incorporated them into their usual practice. Multinomial analysis indicated a statistically significant relationship between the variable emergency medical service and having more favourable attitudes towards consulting the advance directives in their practical application (OR 2.49 [95% CI 1.06–5.88]; p = 0.037) and compliance in complex scenarios (OR 3.65 [95% CI 1.58 − 8.41]; p = 0.002). Working the afternoon and night shift was a predictor variable for obtaining a higher score with respect to attitudes in complex scenarios.ConclusionThere is an association between the level of knowledge that nursing and medical professionals have about advance directives and the scores obtained on the attitude scales at the time of practical implementation and in complex scenarios. This shows that the more knowledge professionals have, the more likely they are to consult patients' advance directives and to respect their wishes and preferences for care and/or treatment. (shrink)

The phenomenon of moral transformation, though important, has received little attention in virtue ethics. In this paper we propose a virtue-ethical model of moral transformation as character transformation by tracking the development of new identity-defining (‘core’) character traits, their expressions, and their priority structure, through the change in what appears as possible or impossible to the moral agent. We propose that character transformation culminates when what previously appeared as morally possible to the agent now appears impossible, i.e. unconceived and unthinkable, (...) moving through stages of transformation where some possibilities gradually disappear while others open up. While we show an example of moral transformation towards virtue, we allow that such transformation can occur in the opposite direction, hence we make claims about ‘character traits’ rather than virtues of vices. Through the example of former slave-trader Rodrigo’s transformation in the film The Mission, we follow the parallel development of new objects of value and ways of valuing (with respect to a group of indigenous people of South America) with the closing down of the possibility of disrespecting and harming them, to the end-point of transformation, where allowing their capture is for Rodrigo both unconceived and, when conceived, unthinkable. (shrink)

: This paper explores vicarious responsibility and circumstantial luck from a first-person perspective, drawing on ethnographic research on parenting in Reform Era China. The paper focuses on how informants drew boundaries between what they could and could not control in raising a child who might thrive in a hypercompetitive society. In doing so, the paper engages the question, “What kind of moral agent do we want?” by proposing that we also ask, “What kind of moral agent do we find?” In (...) contrast to the hypothetical figure of a walled-off agent who must be convinced of the duty to take on responsibilities in a circumstance of moral luck, empirical research finds instead a vulnerable agent who has taken on ‘too much’. (shrink)

Drawing on Bourdieu’s theory of habitus and incorporating insights from feminist and critical race and legal scholarship on the creation of “subjugated knowledge,” this article investigates the dispositional production of perceptions of injustice, politics, and morality among differently situated members of a subordinated population. Based on ethnographic fieldwork within and across the West Bank and the Israeli city of Lod, I track how the political rhetoric that Lod Palestinians use to describe key issues in their lives—for example, drug use and (...) dealing, and poor formal education—differs from the moral judgments through which West Bank Palestinians, who have moved to the city and remain there precariously, interpret the same issues. This article traces this interpretive divergence to two dispositional formations: one that has emerged under protracted conditions of denigration, criminalization, and surveillance in Lod and the other that has been produced over time by military rule in the West Bank and imported to Lod by West Bank Palestinians who moved there. It concludes by calling attention to the role of dispositions in studies of identity-formation and boundary-work as well as issues of submission and resistance in contexts of subordination. (shrink)

Despite the lower levels of psychopathy in women than in men, the scientific interest in studying psychopathy in female participants is increasing. Nevertheless, the number of studies investigating psychopathy in women and associated phenomena remains low. The influence of psychopathy in women inmates on experimental tasks of emotional recognition and moral judgment was evaluated, aiming to contribute to this field of research. Utilitarian moral judgment was predicted by psychopathy, specifically by primary and secondary psychopathy, while primary psychopathy predicted a worse (...) performance on the emotional recognition task. There was no significant influence of general intellectual abilities on either task. Contrarily to what was expected, emotional recognition did not prove to be a significant mediator of the relationship between psychopathy and utilitarian moral judgment. These results emphasize that the tendency to utilitarian moral judgment and worse recognition of facial expressions of emotion are associated to higher psychopathy scores in female inmates (especially primary psychopathy), but more studies are necessary to address the role of the emotional component in the process of moral judgment. (shrink)

The attempts to make moral and evolution compatible have assimilated moral capacity either with complex self-control in favour of one’s own goals or with spontaneous altruism. Those attempts face an easy problem, since those two senses of moral are adaptively advantageous resources. But let us focus on the decisions made in favour of another person which the subject, when making them, feels are contrary to his own goals: Could a base for this capacity arise in evolution, however poor and weak? (...) I propose that such base, while it is not an adaptive advantage but quite the opposite, arises from the convergence between two abilities which in their respective origins were adaptively very advantageous: the advanced mode of ‘theory-of-mind’ (ToM) and inner speech. (shrink)

En 1966, Jean Orcibal advirtió la influencia directa del Maestro Eckhart en San Juan de la Cruz, y podemos preguntarnos si sucedió lo mismo con Santa Teresa de Jesús. De ser así, tendrían que haber llegado a España los escritos del Dominico alemán. A través de estas líneas mostraremos, en primer lugar, las vías de transmisión de los textos eckhartianos y cómo estuvieron a disposición de los místicos españoles en el siglo XVI: se hallaban presentes en las ediciones latinas (...) de Tauler y de Ruysbroeck, y en la traducción castellana de las Instituciones. En un segundo momento abordaremos la influencia de Eckhart en San Juan de la Cruz (1542-1591) y en Santa Teresa de Jesús (1515-1582), teniendo en cuenta el estado de la investigación. Por último, señalaremos los grandes temas en los que aparece una ‘confluencia’ de perspectivas y seguramente también una ‘influencia’ del Maestro Eckhart y su escuela en estos grandes escritores y místicos carmelitas del siglo XVI. (shrink)

The phenomenon of moral transformation, though important, has received little attention in virtue ethics. In this paper we propose a virtue-ethical model of moral transformation as character transformation by tracking the development of new identity-defining (‘core’) character traits, their expressions, and their priority structure, through the change in what appears as possible or impossible to the moral agent. We propose that character transformation culminates when what previously appeared as morally possible to the agent now appears impossible, i.e. unconceived and unthinkable, (...) moving through stages of transformation where some possibilities gradually disappear while others open up. While we show an example of moral transformation towards virtue, we allow that such transformation can occur in the opposite direction, hence we make claims about ‘character traits’ rather than virtues of vices. Through the example of former slave-trader Rodrigo’s transformation in the film The Mission, we follow the parallel development of new objects of value and ways of valuing (with respect to a group of indigenous people of South America) with the closing down of the possibility of disrespecting and harming them, to the end-point of transformation, where allowing their capture is for Rodrigo both unconceived and, when conceived, unthinkable. (shrink)

In this paper, I examine the role played by the emotion of admiration in formulating moral judgments. First, I discuss whether and when admiration is a reliable source of moral knowledge, or, on the contrary, it misleads the subject, leaving her prey to forms of uncritical devotion to unworthy objects of admiration. To do so, I try to elucidate which underlying theory of emotions best allows one to characterize admiration as a reliable source of moral knowledge. Second, I introduce the (...) notion of transformative moral experience, understood as a subclass of transformative experiences, and I argue that it is precisely admiration that ensures the rationality of the choices made in such experiences. Finally, in light of this analysis, I show how admiration—together with the constellation of positive and negative emotions connected to the perception of moral exemplarity—acts as a central element for the maintenance of moral integrity. I defend, in particular, the idea that integrity should not be understood as mere coherence, nor as a static maintenance of the moral status quo, but as being firmly rooted in one’s own identity yet open to novelty and especially to the novelty represented by transformative moral experiences. (shrink)

This paper demonstrates an implicit connection between narrativity and recognition in the work of Paul Ricœur. This view is developed in three steps. First, it shows that the subject who calls for recognition demands that his or her own narrative be recognized. In order to be recognized, a story must be measured with history , particularly that of the victims. Second, from this perspective, the role of collective narratives is fundamental, because they represent the possibility to connect the intrinsic teleology (...) of every human being to the collective attribution of significance. Finally, with the help of a little known essay by Ricœur, the metaphorical power of narrativity to configure meaning will be compared to the power of architecture to construct and to organize space. Both these fields give stories visibility and an ability to be recognized.  . (shrink)

This paper focuses on negative exemplarity-related emotions (NEREs) and on their educational implications. In this paper, we will first argue for the nonexpendability of negative emotions broadly conceived (section 2) by defending their instrumental and intrinsic role in a good and flourishing life. In section 3, we will make the claim more specific by focusing on the narrower domain of NEREs and argue for their moral and educational significance by evaluating whether they fit the arguments provided in the previous section. (...) In section 4, we will propose three educational strategies to foster NEREs’ positive moral role. In conclusion, we will point out that an exemplarist approach to character education would greatly benefit from a more fine-grained account of the emotions involved in the educational process and from a broader perspective on which of these emotions should be taken as valuable for educational purposes. (shrink)

This book draws on Iris Murdoch's philosophy to explore questions related to the importance of attention in ethics. In doing so, it also engages with Murdoch's ideas about the existence of a moral reality, the importance of love, and the necessity but also the difficulty, for most of us, of fighting against our natural self-centred tendencies. Why is attention important to morality? This book argues that many moral failures and moral achievements can be explained by attention. Not only our actions (...) and choices, but the possibilities we choose among, and even the meaning what we perceive, are to a large extent determined by whether we pay attention, and what we attend do. In this way, the book argues that attention is fundamental, though often overlooked, in morality. While the book's discussion of attention revolves primarily around Murdoch's thought, it also engages significantly with Simone Weil, who introduced the concept of attention in a spiritual context. The book also engages with contemporary debates concerning moral perception and motivation, empirical psychology, animal ethics, and Buddhist philosophy. The Ethics of Attention will be of interest to researchers and advanced students working on Iris Murdoch, Simone Weil, ethics and moral psychology, and the philosophy of attention. (shrink)

In a time marked by the development of innovative treatments in healthcare and the need for health professionals to deal with resulting ethical dilemmas in clinical practice, this study was developed to determine the influence of the bioethics teaching on the moral competence of medical and nursing students. The authors conduct a longitudinal study using the Moral Competence Test extended version before and after attending the ethics curricular unit, in three nursing schools and three medical schools of Portugal. In this (...) questionnaire the participant is confronted with three ethical dilemmas and asked to evaluate arguments for and against the attitude of the main character. For both nursing and medical students, C-score was lower after the attendance of the ethics curricular units, with a statistically significant decrease in the total score for nursing students and a decrease not statistically significant for medical students. A multivariate analysis did not find any association between this decrease and gender, course, or age. The phenomenon of moral segmentation was observed, with better performance in the worker and judge dilemma, than in the doctor dilemma. These results highlight the need to reflect on the curricular strategies that can be implemented for health professionals to better develop moral competence and decision-making, allowing for the provision of humanized health care. (shrink)

I argue that recent attempts to deflect Access Problems for realism about a priori domains such as mathematics, logic, morality, and modality using arguments from evolution result in two kinds of explanatory overkill: the Access Problem is eliminated for contentious domains, and realist belief becomes viciously immune to arguments from dispensability, and to non-rebutting counter-arguments more generally.

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)

Words change meaning, usually in unpredictable ways. But some words’ meanings are revised intentionally. Revisionary projects are normally put forward in the service of some purpose – some serve specific goals of inquiry, and others serve ethical, political or social aims. Revisionist projects can ameliorate meanings, but they can also pervert. In this paper, I want to draw attention to the dangers of meaning perversions, and argue that the self-declared goodness of a revisionist project doesn’t suffice to avoid meaning perversions. (...) The road to Hell, or to horrors on Earth, is paved with good intentions. Finally and more importantly, I want to demarcate what meaning perversions are. This, I hope, can help us assess the moral and political legitimacy of revisionary projects. (shrink)

We report here an emerging dispute in Italy concerning triage criteria for critically ill covid-19 patients, and how best to support doctors having to make difficult decisions in a context of insufficient life saving resources. The dispute we present is particularly significant as it juxtaposes two opposite views of who should make triage decisions, and how doctors should best be supported. There are both empirical and normative questions at stake here. The empirical questions pertain to the available level of evidence (...) that healthcare professionals would rather not be left alone with their ‘clinical judgments’ to make triage decisions, and to the accounts of distributive justice that doctors and healthcare professionals rely on, when making triage decisions. The normative questions pertain to how this empirical evidence should inform guidelines on how prioritisation decisions are made in a context of emergency, and who gets to have the authority to do so. This debate goes beyond the discussion of the care of critically ill patients with COVID-19 and has broader implications beyond the national context for the discussion of how to relieve moral distress in contexts of imbalances between healthcare resources and clinical needs of a population. (shrink)