Article shows, that the practical philosophy of Władysław Tatarkiewicz – especially from his Analysis of Happiness – can be important for the contemporary acting man, which is living always in the own world of the life. In the introduction, author explains the title, assumptions and character of his ethical analysis. Next part shows the subjective perspective of the author’s statement. This is a statement from the work with students of non-philosophical directions. Students’ postulates and questions to ethics, answers of Tatarkiewicz, (...) generalizations and next questions from author – these are the next parts of article. In the conclusion, author writes about his own philosophy, which can be recommended as a little practical philosophy. It is a philosophy for everyday life, philosophy useful in microscale of the moral experience. Across such philosophy, Tatarkiewicz can be an intimate author for more than one his reader. (shrink)

Background Serious ethical problems have been anecdotally identified in the care of children with osteogenesis imperfecta (OI), which may negatively impact their moral experiences, defined as their sense of fulfillment towards personal values and beliefs. Research aims To explore children’s actual and desired participation in discussions, decisions, and actions in an OI hospital setting and their community using art-making to facilitate their self-expression. Research design A focused ethnography was conducted using the moral experiences framework with data from key (...) informant interviews; participant observations, semi-structured interviews, and practice-based research (art-making) with 10 children with OI; and local documents. Participants and research context The study was conducted at a pediatric, orthopedic hospital. Ethical considerations This study was approved by McGill University Institutional Review Board. Findings/results Children expressed desires to participate in their care, but sometimes lacked the necessary resources and encouragement from healthcare providers. Art-making facilitated children’s voice and participation in health-related discussions. Conclusions Healthcare providers are recommended to consider the benefits of art-making and educational resources to reduce discrepancies between children’s actual and desired participation in care and promote positive moral experiences. (shrink)

Background: Pediatric nursing care involves many significant ethical challenges. Although nurses are broadly recognized as professionals with relevant knowledge about children and families, little is known about how nurses experience ethical concerns in their everyday practice. Objective: The objective of this study was to better understand the moral experiences and related moral distress experiences of nurses working in pediatric settings in Brazil. Design: Interpretative phenomenological study conducted through narrative interviews. Participants and research context: Nine nurses working in (...) three pediatric settings of a teaching hospital in a city of Southern Brazil. Ethical considerations: The study was approved by the Research Ethics Committee of the research site, and research ethics principles were respected throughout the study. Findings: This investigation illuminated a broader dimension of nurses’ moral distress, which was recognized as moral experience. In advancing our understanding of nurses’ moral experiences, engagement was identified as a central phenomenon that is present in the understandings and actions of nurses within their relationships in their daily practice and lived experiences. Three themes were described with regard to nurses’ relationships and their moral experiences: (a) relationship with the healthcare team; (b) relationship with the family; and (c) relationship with the child. Discussion: The findings of this study are congruent with emerging health literature that demonstrated the focus on moral distress as limiting for bioethical inquiry. Moreover, it is important to better understand and recognize nurses’ relational environment and engagements to advance understandings of the ethical dimensions of pediatric nursing practice. Conclusion: This study provides a better understanding on how engagement affects moral experiences, demonstrating how nurses can experience distress but also satisfaction, gratification, rewarding feelings, and a sense of responsibility for the care they provide. (shrink)

Experience machines, popularized in print by Robert Nozick and on the screen by the Wachowskis’ film The Matrix, provide highly or perfectly realistic experiences that are more pleasant and less painful than those generated in real life.1 The recent surge in virtual reality and neuro-prosthetic technologies is making the creation of real-world experience machines seem inevitable and perhaps imminent.2 Given the likelihood of the near-future availability of such machines, it behooves ethicists to consider the moral status of (...) their potential uses. In this chapter, we investigate the use of experience machines in palliative and end-of-life care situations. We pair up various kinds of experience machines with patients in a range of conditions, to illuminate the moral problems and benefits of using experience machines in this way. We argue that the use of Nozickian experience machines to treat patients in most conditions would be morally problematic, most notably for the negative effects on patients’ characters and real-world relationships. Informed by this initial moral analysis, we describe an experience machine that is more closely related to a virtual reality game, and argue that it can avoid the moral problems encountered by Nozickian experience machines. In fact, we argue that this new kind of experience machine could improve some patients’ characters and relationships with real-world people. We conclude that some kinds of experience machines could benefit many patients, especially those in extreme pain and those not in the position to meaningfully interact with their loved ones in reality. We also note that certain kinds of experience machines could be useful for religious people, for whom the range of palliative and end-of-life care options is often thought to be relatively narrow. (shrink)

IntroductionThe value of a short life characterized by disability has been hotly debated in the literature on fetal and neonatal outcomes.MethodsWe conducted a scoping review to summarize the available empirical literature on the experiences of families in the context of trisomy 13 and 18 (T13/18) with subsequent thematic analysis of the 17 included articles.FindingsThemes constructed include (1) Pride as Resistance, (2) Negotiating Normalcy and (3) The Significance of Time.InterpretationOur thematic analysis was guided by the moral experience framework conceived (...) by Hunt and Carnevale (2011) in association with the VOICE (Views On Interdisciplinary Childhood Ethics) collaborative research group.RelevanceThis article will be of interest and value to healthcare professionals and bioethicists who support families navigating the medically and ethically complex landscape of T13/18. (shrink)

In the Critique of Judgment Kant had declared the moral will to be the purpose of the world, thus subordinating teleology to morality. But in his final notes, published in the Opus Posthumum, morality is increasingly emphasized as a source of religious inspiration. Some passages clearly contradict all that Kant wrote on the autonomy of the moral law in the Critique of Practical Reason and anticipate what was to become the moral argument. Thus he maintains that the (...) religious interpretation of all duties is not an addition subsequent to their perception as duties but is immediately and necessarily given with it. This means, as Kemp Smith points out, that “the categorical imperative leads directly to God and affords surety of his reality.” “The categorical imperative of the command of duty is grounded in the idea of an imperantis, who is all-powerful and holds universal sway. This is the Idea of God.”. (shrink)

In light of recent empirical data, many psychologists and philosophers have turned away from rationalism about moral judgment and embraced sentimentalism. In the process, they have rejected the classical “moral signature” as a way of distinguishing moral from conventional norms in favor of a sentimentalist approach to carving out the moral domain. In this paper, we argue that this sentimentalist turn has been made prematurely. Although we agree that the experiments reveal that the classical approach is (...) flawed, we propose to replace it with an alternative, according to which a norm is moral precisely if it is justifiable to all. This does not hold for most norms based on disgust or loyalty to a particular community. We accommodate the fact that such norms are not merely conventional by introducing a third domain, the domain of ethics. Our proposal reveals that (psychological) rationalism is still a viable option, as a lot of the experimental evidence that features emotions concerns the domain of ethics rather than morality. (shrink)

The field of bioethics is calling for a new generation of scholars equipped with the normative, empirical, and practical knowledge and expertise to prioritize equity concerns largely underrepresent...

Background: Legislative changes are resulting in assisted death as an option for people at the end of life. Although nurses’ experiences and perspectives are underrepresented within broader ethical discourses about assisted death, there is a small but significant body of literature examining nurses’ experiences of caring for people who request this option. Aim: To synthesize what has been learned about nurses’ experiences of caring for patients who request assisted death and to highlight what is morally at stake for nurses who (...) undertake this type of care. Design: Qualitative meta-synthesis. Methods: Six databases were searched: CINAHL, Medline, EMBASE, Joanna Briggs Institute, PsycINFO, and Web of Science. The search was completed on 22 October 2014 and updated in February 2016. Of 879 articles identified from the database searches, 16 articles were deemed relevant based on inclusion criteria. Following quality appraisal, 14 studies were retained for analysis and synthesis. Results: The moral experience of the nurse is (1) defined by a profound sense of responsibility, (2) shaped by contextual forces that nurses navigate in everyday end-of-life care practice, and (3) sustained by intra-team moral and emotional support. Discussion: The findings of this synthesis support the view that nurses are moral agents who are deeply invested in the moral integrity of end-of-life care involving assisted death. The findings further demonstrate that to fully appreciate the ethics of assisted death from a nursing standpoint, it is necessary to understand the broader constraints on nurses’ moral agency that operate in everyday end-of-life care. Ethical considerations: Research ethics board approval was not required for this synthesis of previously published literature. Conclusion: In order to understand how to enact ethical practice in the area of assisted death, the moral experiences of nurses should be investigated and foregrounded. (shrink)

Background Moral distress is reported to be a critical force contributing to intensifying rates of anxiety, depression and burnout experienced by healthcare workers. In this paper, we examine the moral dilemmas and ensuing distress personally and collectively experienced by healthcare workers while caring for patients during the pandemic. Methods Data are drawn from free-text responses from a cross-sectional national online survey of Australian healthcare workers about the patient care challenges they faced. Results Three themes were derived from qualitative (...) content analysis that illuminated the ways in which moral dilemmas and distress were relationally experienced by healthcare workers: (1) the moral ambiguity of how to care well for patients amid a rapidly changing work environment; (2) the distress of witnessing suffering shared _between_ healthcare workers and patients; and (3) the distress of performing new forms of invisible work in the absence of institutional recognition. These findings reveal that moral distress was a strongly shared experience. Conclusions Findings advance understandings of moral distress as a relational experience, collectively felt, constituted, and experienced by healthcare workers. Considering how to harness collective solidarity in effectively responding to moral distress experienced across the frontline healthcare workforce is critical. (shrink)

A recurrent issue in the vast amount of literature on reasoning models in ethics is the role and nature of moral intuitions. In this paper, we start from the view that people who work and live in a certain moral practice usually possess specific moral wisdom. If we manage to incorporate their moral intuitions in ethical reasoning, we can arrive at judgements and (modest) theories that grasp a moral experience that generally cannot be found (...) outside the practice. Reflective equilibrium (RE) provides a framework for balancing moral intuitions, ethical principles and general theories. Nevertheless, persisting problems associated with the use of intuitions need to be addressed. One is the objection that moral intuitions lack the credibility necessary to guide moral reasoning. Ethicists have tried to solve this problem by formulating criteria to separate the “bad” intuitions from the “good” ones at the beginning of the reasoning process. We call this the credible input-justified outcome strategy. An example is the appeal to the common morality by Beauchamp and Childress. We think this approach is unsuccessful. As an alternative, we outline the good reasoning-justified outcome strategy. It connects to a variant of RE in which intuitions from different sources are incorporated. We argue that the elements of RE have different levels of justificatory power at the start of reasoning. In our strategy, each element can gain or lose justificatory power when it is tested in a reasoning process that meets several criteria. (shrink)

Background: Moral distress is a kind of suffering that nurses may experience when they act in ways that are considered inconsistent with moral values, leading to a perceived compromise of moral integrity. Consequences are mostly negative and include physical and psychological symptoms, in addition to organizational implications. Objective: To psychometrically test the Moral Distress Risk Scale. Research design: A methodological study was realized. Data were submitted to exploratory factorial analysis through the SPSS statistical program. Participants (...) and research context: In total, 268 nurses from hospitals and primary healthcare settings participated in this research during the period of March to June of 2016. Ethical considerations: This research has ethics committee approval. Findings: The Moral Distress Risk Scale is composed of 7 factors and 30 items; it shows evidence of acceptable reliability and validity with a Cronbach’s α = 0.913, a total variance explained of 59%, a Kaiser–Meyer–Olkin = 0.896, and a significant Bartlett <0.001. Discussion: Concerns about moral distress should be beyond acute care settings, and a tool to help clarify critical points in other healthcare contexts may add value to moral distress speech. Conclusion: Psychometric results reveal that the Moral Distress Risk Scale can be applied in different healthcare contexts. (shrink)

While the movement to ensure patient’s rights to information and informed consent spreads throughout the world, patient rights of this kind have yet to be introduced in mainland China. Nonetheless, China is no different from other parts of the world in that nurses are expected to shoulder the responsibility of safeguarding patients’ best interests and at the same time to uphold their right to information. This paper expounds on the principle of protectiveness grounded in traditional Chinese medical ethics concerning the (...) practice of informed consent. Nurses in China have a moral obligation to treat patients with sincerity. This notion carries a strong sense of parental protectiveness. As far as information-giving is concerned, nurses in China are ambivalent about the notion of truthfulness. The findings of an empirical study undertaken in seven Chinese cities reveal that nurses in China experience similar difficulties related to the disclosure of information as their counterparts in other parts of the world. A nurse’s narrative, the Chan case, is used to illustrate the typical difficult situation that nurses in China often encounter in looking after vulnerable patients who would like to learn more about their therapeutic regimens. The moral tension embedded in nursing practice is analysed. It is found that most nurses would prefer to tell the truth to patients, but their primary ethical justification is not that of respect for patients’ autonomy or safeguarding patients’ right to self-determination. Rather, it is basically beneficent in nature; that is, they base their decision to reveal the truth on whether or not patients will receive more relevant treatment and better nursing care. (shrink)

This chapter contains sections titled: The Concept of a Categorical Imperative The First Formula: FUL and FLN The Second Formula: FH Third Formula: FA (and FRE) The System of Formulas and the “Universal” Formula Conclusion.

MY programme is as follows: I shall draw a general distinction between morals and moral philosophy in order to show that an ethical theory cannot be neutral and autonomous but must have an empirical foundation. Both ethical naturalists and existentialists agree that an adequate moral theory must be based on anthropological considerations. They however differ on one major issue: ethical naturalists maintain that such a theory must be scientifically grounded, existentialists that it must be grounded on experience (...) phenomenologically described. The weakness of the naturalists’ position becomes apparent when some anthropological notion like the concept of action is clarified, since human behaviour of a morally relevant kind cannot be fully understood from a scientific point of view. (shrink)

Much has been written about the need for trustworthy artificial intelligence (AI), but the underlying meaning of trust and trustworthiness can vary or be used in confusing ways. It is not always clear whether individuals are speaking of a technology’s trustworthiness, a developer’s trustworthiness, or simply of gaining the trust of users by any means. In sociotechnical circles, trustworthiness is often used as a proxy for ‘the good’, illustrating the moral heights to which technologies and developers ought to aspire, (...) at times with a multitude of diverse requirements; or at other times, no specification at all. In philosophical circles, there is doubt that the concept of trust should be applied at all to technologies rather than their human creators. Nevertheless, people continue to intuitively reason about trust in technologies in their everyday language. This qualitative study employed an empirical ethics methodology to address how developers and users define and construct requirements for trust throughout development and use, through a series of interviews. We found that different accounts of trust (rational, affective, credentialist, norms based, relational) served as the basis for individual granting of trust in technologies and operators. Ultimately, the most significant requirement for user trust and assessment of trustworthiness was the accountability of AI developers for the outputs of AI systems, hinging on the identification of accountable moral agents and perceived value alignment between the user and developer’s interests. (shrink)

Background “Crisis military deployment” was defined as a situation in which military personnel are suddenly ordered to duty to support an operation away from their home station and in a potentially dangerous environment. As a result of complex changes in the global political and economic landscape, military nurses are assuming an increasing number of crisis military deployment tasks. Moral distress has been widely studied among civilian nurses. However, little is known about the moral distress military nurses experience (...) during military deployments in crisis. Aim This review discussed the current state of research on the phenomenon, unique factors, specific sources, and measurement tools. Methods The scope of the study was defined using a framework developed by Arksey and O’Malley. Following English databases were searched: PubMed, CINAHL, Cochrane Library, Web of Science, and Embase, using MeSH terms and free word combinations; furthermore, Chinese databases: CNKI and CBMDisc, were explored using thematic terms from inception until January 20, 2023. Data were selected and defined by the inclusion and exclusion criteria and independently screened by two researchers. Ethical considerations The scoping review adhered to sound scientific practice and respected authorship and reference sources. Results Finally, 21 articles were included in the review. The moral distress of military nurses in crisis military deployments had unique and specific sources and reported positive aspects. The deployment environment and nature of the mission, responsibilities and obligations of military nurses, and the limited rights of patients were unique factors. Specific sources included third-party intervention, military triage, resource allocation, futile care, care of the enemy, and return to the battlefield. Military nurses in deployment reported positive aspects. They grow in their inner strength, build deep friendships and gain a greater sense of professional value. Conclusion It is important to understand the unique factors and specific sources of moral distress faced by military nurses in crisis military deployments and to identify the positive aspects. This research will help prepare military nurses for future deployments in advance by providing useful information to mitigate and eliminate moral distress. (shrink)

The emotions of guilt and shame have an effect on how individuals feel and behave in relation to environmental crises, yet studies of the moral potential of these emotions remain limited. From a philosophical perspective, some scholars have defended using eco-guilt and eco-shame as morally constructive emotions due to their ability to evoke more pro-environmental behaviour. Meanwhile, others have posited that there are pitfalls to these emotions, claiming that they perpetuate a problematic individualised focus, which diverts attention from the (...) collective and structural conditions considered necessary for pro-environmental change. This paper critically examines these two differing perspectives on eco-guilt and eco-shame, applying insights from moral and political philosophy and the sociology of emotions. Through this exploration, we try to nuance the discussion concerning the moral potential of eco-guilt and eco-shame. We argue that if individuals are able to break their introspective, consumption-based loops of eco-guilt and eco-shame alleviation, the emotions may enforce an individual ethical demand to be more sustainable and foster an ethical and political pro-environmental drive. Furthermore, experiences of eco-guilt and eco-shame have the potential to spread socially and help catalyse emotional shifts within society, sparking a greater political and social pro-environmental movement. Therefore, eco-guilt and eco-shame may indeed transcend the purported introspective and individual-level focus and have the potential to influence broader collective and structural conditions and thus foster environmental change. (shrink)

In this article, I address problems associated with ‘Modernity’ and those encountered at the impasse of post-modernity and the newly named phenomenon of ‘post-secularism’. I consider more specifically what I call ‘moral emotions’ or essentially interpersonal emotions can tell us about who we are as persons, and what they tell us about our experience and concepts of freedom, normativity, power, and critique. The moral emotions, and retrieving the evidence of the ‘heart’, point to the possibility of contributing (...) to the social imaginary of the Modern and its post-modern variants, playing a significant role in shaping civic life and relations of power. (shrink)

The Moral Foundations of Trust seeks to explain why people place their faith in strangers, and why doing so matters. Trust is a moral value that does not depend upon personal experience or on interacting with people in civic groups or informal socializing. Instead, we learn to trust from our parents, and trust is stable over long periods of time. Trust depends on an optimistic world view: the world is a good place and we can make it (...) better. Trusting people are more likely to give through charity and volunteering. Trusting societies are more likely to redistribute resources from the rich to the poor. Trust has been in decline in the United States for over 30 years. The roots of this decline are traceable to declining optimism and increasing economic inequality, which Uslaner supports by aggregate time series in the United States and cross-sectional data across market economies. (shrink)

In this book, Jeanine Grenberg argues that everything important about Kant's moral philosophy emerges from careful reflection upon the common human moral experience of the conflict between happiness and morality. Through careful readings of both the Groundwork and the Critique of Practical Reason, Grenberg shows that Kant, typically thought to be an overly technical moral philosopher, in fact is a vigorous defender of the common person's first-personal encounter with moral demands. Grenberg uncovers a notion of (...) phenomenological experience in Kant's account of the Fact of Reason, develops a new a reading of the Fact, and grants a moral epistemic role for feeling in grounding Kant's a priori morality. The book thus challenges readings which attribute only a motivational role to feeling; and Fichtean readings which violate Kant's commitments to the limits of reason. This study will be valuable to students and scholars engaged in Kant studies. (shrink)

The aim of this qualitative study was to gain an understanding of the meaning that community psychiatric nurses impart to their everyday interactions with patients in depot neuroleptic treatment situations. Nine experienced community psychiatric nurses were interviewed using semistructured, open-ended questions. Data analysis was by the phenomenological descriptive method according to Giorgi. Four themes were identified, highlighting aspects of the moral meaning of treating patients with depot neuroleptics: (1) ‘benevolent justification’ occurs when nurses perceive that the patient’s welfare is (...) at stake; (2) ‘inability to advocate the patients’ best interest’ occurs when nurses feel they are at a disadvantage; (3) ‘accommodative interactions’ occur when nurses are able to respond to a patient’s expressed needs; and (4) ‘acceptable advocacy’ occurs when physicians are sensitive to nurses’ suggestions on patients’ treatment. The findings indicate that treatment care planning involving both patients and nurses is essential to enhance patients’ autonomy, which is a precondition for satisfactory interactions. This phenomenological study describes the meaning that nurses give to administering depot neuroleptic injections to patients in the context of community psychiatric clinics. The phenomenon of concern was identified as the moral aspect in the interactions with individual patients in the treatment situation. (shrink)

Moral injury names how the lived experience of armed conflict can damage an individual's ethical foundations, often with serious consequences. While the term has gained increasing acceptance for the clinical treatment of veterans and as a means of better understanding the impact of war, it is generally applied to individualized trauma. As part of the roundtable, “Moral Injury, Trauma, and War,” this essay argues that moral injury is also a useful means of addressing political violence at (...) a societal level. It explores the term's value within international human rights discourse and practice, particularly in efforts to document and analyze the systematic commission of atrocities to achieve accountability and reconciliation. The essay presents field research among Iraqi human rights investigators as a means of reflecting on the value of rediscovering agency in the aftermath of societal trauma. In this way, moral injury provides guidance on the essential ethical qualities of the lived experience of violent repression, an issue central to a more complete understanding of international affairs. (shrink)

Background: Moral distress is a growing problem for healthcare professionals that may lead to dissatisfaction, resignation, or occupational burnout if left unattended, and nurses experience different levels of this phenomenon. Objectives: This study aims to investigate the factor structure of the Persian version of the Moral Distress Scale–Revised in intensive care and general nurses. Research design: This methodological research was conducted with 771 nurses from eight hospitals in the Mazandaran Province of Iran in 2017. Participants completed the (...) Moral Distress Scale–Revised, data collected, and factor structure assessed using the construct, convergent, and divergent validity methods. The reliability of the scale was assessed using internal consistency (Cronbach’s alpha, Theta, and McDonald’s omega coefficients) and construct reliability. Ethical considerations: This study was approved by the Ethics Committee of Mazandaran University of Medical Sciences. Findings: The exploratory factor analysis ( N = 380) showed that the Moral Distress Scale–Revised has five factors: lack of professional competence at work, ignoring ethical issues and patient conditions, futile care, carrying out the physician’s orders without question and unsafe care, and providing care under personal and organizational pressures, which explained 56.62% of the overall variance. The confirmatory factor analysis ( N = 391) supported the five-factor solution and the second-order latent factor model. The first-order model did not show a favorable convergent and divergent validity. Ultimately, the Moral Distress Scale–Revised was found to have a favorable internal consistency and construct reliability. Discussion and conclusion: The Moral Distress Scale–Revised was found to be a multidimensional construct. The data obtained confirmed the hypothesis of the factor structure model with a latent second-order variable. Since the convergent and divergent validity of the scale were not confirmed in this study, further assessment is necessary in future studies. (shrink)

In this paper, I draw a contrast between two ways of posing the question of moral experience: the episodic and the contemplative. On the first, the episodic outlook, the question of moral experience is the question of specifying the workings of a capacity (or set of capacities) whose exercise may ground claims of moral knowledge. On the contemplative outlook, on the other hand, the question of understanding moral experience is the question of articulating (...) a standpoint: the moral standpoint. On this view, philosophical reflection on moral experience aims to shed light on the human experiences that paradigmatically exemplify and, thus, best reveal the moral standpoint. In the tradition of contemplative accounts, I propose that some of the human experiences that paradigmatically exemplify and reveal the moral standpoint are experiences of “moral growth and change”. Finally, I argue that in “moral growth and change”, one is in view of the world as what is at stake. This leads to a different sense in which moral experience grounds knowledge claims. (shrink)

When we judge an action as morally right or wrong, we rely on our capacity to infer the actor's mental states. Here, we test the hypothesis that the right temporoparietal junction, an area involved in mental state reasoning, is necessary for making moral judgments. In two experiments, we used transcranial magnetic stimulation to disrupt neural activity in the RTPJ transiently before moral judgment and during moral judgment. In both experiments, TMS to the RTPJ led participants to rely (...) less on the actor's mental states. A particularly striking effect occurred for attempted harms : Relative to TMS to a control site, TMS to the RTPJ caused participants to judge attempted harms as less morally forbidden and more morally permissible. Thus, interfering with activity in the RTPJ disrupts the capacity to use mental states in moral judgment, especially in the case of attempted harms. (shrink)

Background Moral distress was first described by Jameton in 1984, and has been defined as distress experienced by an individual when they are unable to carry out what they believe to be the right course of action because of real or perceived constraints on that action. This complex phenomenon has been studied extensively among healthcare providers, and intensive care professionals in particular report high levels of moral distress. This distress has been associated with provider burnout and associated consequences (...) such as job attrition, with potential impacts on patient and family care. There is a paucity of literature exploring how middle and late career healthcare providers experience and cope with moral distress. Objectives We explore the experience of moral distress and the strategies and resources invoked to mitigate that distress in mid- and late-career healthcare providers practicing in paediatric intensive care, in order to identify ways in which the work environment can build a culture of moral resilience. Research design An exploratory, qualitative quality improvement project utilizing focus group and semi-structured interviews with pediatric intensive care front-line providers. Participants Mid-and-later career (10 + years in practice) pediatric intensive care front line providers in a tertiary pediatric hospital. Research context This work focuses on paediatric intensive care providers in a single critical care unit, in order to explore the site-specific perspectives of health care providers in that context with respect to moral distress coping strategies. Ethical considerations The study was approved by the Quality Management Office at the institution; consent was obtained from participants, and no identifying data was included in this project. Findings Participants endorsed perspective-building and described strategies for positive adaptation including; active, reflective and structured supports. Participants articulated interest in enhanced and accessible formal supports. Discussion Findings in this study resonate with the current literature in healthcare provider moral distress, and exposed ways in which the work environment could support a culture of moral resilience. Avenues are described for the management and mitigation of moral distress in this setting. Conclusion This exploratory work lays the groundwork for interventions that facilitate personal growth and meaning in the midst of moral crises in critical care practice. (shrink)

Background: Homeless persons in the United States have disproportionately high rates of illness, injury, and mortality and tend to believe that the quality of their end-of-life care will be poor. No studies were found as to whether nurses or nursing students require moral courage to help homeless persons or members of any other demographic complete advance directives. Research hypothesis: We hypothesized that baccalaureate nursing students require moral courage to help homeless persons complete advance directives. Moral courage was (...) defined as a trait of a person or an action that overcomes fears or other challenges to achieve something of great moral worth. Research design: The hypothesis was investigated through a qualitative descriptive study. Aside from the pre-selection of a single variable to study (i.e. moral courage), our investigation was a naturalistic inquiry with narrative hues insofar as it attended to specific words and phrases in the data that were associated with that variable. Participants and research context: A total of 15 baccalaureate nursing students at a public university in the United States responded to questionnaires that sought to elicit fears and other challenges that they both expected to experience and actually experienced while helping homeless persons complete advance directives at a local, non-profit service agency. Ethical considerations: The study was approved by the Internal Review Board of the authors’ university, and each participant signed an informed consent form, which stated that the study involved no reasonably foreseeable risks and that participation was voluntary. Findings: Before meeting with homeless persons, participants reported that they expected to experience two fears and a challenge: fear of behaving in ways that a homeless person would deem inappropriate, fear of discussing a homeless person’s dying and death, and the challenge of adequately conveying the advance directive’s meaning and accurately recording a homeless person’s end-of-life wishes. In contrast, after their meetings with homeless persons, relatively few participants reported having encountered those obstacles. So, while participants required moral courage to assist homeless persons with advance directives, they required greater moral courage as they anticipated their meetings than during those meetings. Discussion: Our study breaks new ground at the intersection of nursing, moral courage, and advance directives. It might also have important implications for how to improve the training that US nursing students receive before they provide this service. Conclusion: Our results cannot be generalized, but portions of our approach are likely to be transferable to similar social contexts. For example, because homeless persons are misunderstood and marginalized throughout the United States, our design for training nursing students to provide this service is also likely to be useful across the United States. Internationally, however, it is not yet known whether our participants’ fears and the challenge they faced are also experienced by those who assist homeless persons or members of other vulnerable populations in documenting healthcare wishes. (shrink)

: Moral cognition research has in part been taken to be a problem for moral sentimentalists, who claim that emotions are sensitive to moral information. In particular, Joshua Greene can be understood to provide an argument against moral sentimentalism on the basis of neuropsychological evidence. In his argument he claims that emotions are an unreliable source of moral insight. However, the argument boils down to circular claims: Rationalistic factors are assumed to be the only morally (...) relevant factors; Emotions are not sensitive to these factors; Thus, Moral Sentimentalism is false, because only rationalistic factors are justified. While this circularity makes so-called sourcing-arguments fallacious if applied against moral sentimentalism, moral cognition research has much to contribute. Indeed, moral cognition research will be instrumental for clarifying the sentimentalist position, shedding light on the mental mechanics underlying emotional moral processing. After all, evidence from moral cognition points to substantial involvement of affective processes in human moral cognizing and their embodied nature; thus, challenging long held beliefs about morality. Keywords : Moral Cognition; Moral Sentimentalism; Emotions; Embodied Cognition; Moral Brain Emozioni, Esperimenti e il cervello morale. L’errore degli argomenti basati sulla cognizione morale contro il sentimentalismo morale Riassunto: Si è spesso ritenuto che la ricerca nell’ambito della cognizione morale costituisse, almeno in parte, un problema per il sentimentalismo morale, il quale sostiene che le emozioni sono sensibili all’informazione morale. In particolare, si può pensare che Joshua Greene abbia portato un argomento contro il sentimentalismo morale basato su evidenza neuropsicologica. Secondo il suo argomento le emozioni non costituiscono una fonte affidabile di comprensione morale. E tuttavia questo argomento fa leva su una circolarità: gli unici fattori qualificati come moralmente rilevanti sono quelli razionali; le emozioni non sono sensibili a questi fattori; pertanto, considerato che solo i fattori razionali sono giustificati, il sentimentalismo morale è falso. Tale circolarità rende fallaci i cosiddetti argomenti sorgente, laddove questi siano applicati al sentimentalismo morale. Al contempo, la ricerca sulla cognizione morale ha molto da dire su questo argomento perché può contribuire a chiarire la posizione sentimentalista, gettando luce sulla meccanica mentale sottostante i processi morali che fanno leva su emozioni. Anzi questa prospettiva di ricerca evidenzia che i processi di carattere affettivo sono coinvolti in maniera sostanziale nella cognizione morale umana e hanno una natura incarnata; in questo modo essa mette in discussione convinzioni di vecchia data sulla morale. Parole chiave : Cognizione morale; Sentimentalismo morale; Emozioni; Cognizione incarnata; Cervello morale. (shrink)

While philosophers have been debating for decades on whether different entities—including severely disabled human beings, embryos, animals, objects of nature, and even works of art—can legitimately be considered as having moral status, this question has gained a new dimension in the wake of artificial intelligence (AI). One of the more imminent concerns in the context of AI is that of the moral rights and status of social robots, such as robotic caregivers and artificial companions, that are built to (...) interact with human beings. In recent years, some approaches to moral consideration have been proposed that would include social robots as proper objects of moral concern, even though it seems unlikely that these machines are conscious beings. In the present paper, I argue against these approaches by advocating the “consciousness criterion,” which proposes phenomenal consciousness as a necessary condition for accrediting moral status. First, I explain why it is generally supposed that consciousness underlies the morally relevant properties (such as sentience) and then, I respond to some of the common objections against this view. Then, I examine three inclusive alternative approaches to moral consideration that could accommodate social robots and point out why they are ultimately implausible. Finally, I conclude that social robots should not be regarded as proper objects of moral concern unless and until they become capable of having conscious experience. While that does not entail that they should be excluded from our moral reasoning and decision-making altogether, it does suggest that humans do not owe direct moral duties to them. (shrink)

In this paper, we explore the consumer experience of responsibilization, wherein consumers are tasked with addressing social issues via their consumption choices. We study an approach to responsibilization which we label conscious pricing. Conscious pricing asks consumers to place a price on morality: How much would they pay for their lunch to combat the social issue of food insecurity? Conscious pricing stems from the broader movement of conscious capitalism, defined by its chief architects as an approach to business wherein (...) the goal is to create value for all stakeholders: financial, ecological, ethical, and spiritual. Strategies such as conscious capitalism rely on consumers acting responsibly, assuming that consumers, when presented with the opportunity to “do good,” will do so, and that consumers will prefer companies who provide them this opportunity. Using a case study approach and online reviews, in our analysis of Panera Cares, we find that consumers in fact experience discomfort when asked to address social issues via how much they choose to pay for their meal. Because food insecurity is embodied by homeless people eating with them in the café, eating in the café is perceived as unpleasant, and the homeless also feel demoralized. This discomposure leads consumers to resist the subject position of being responsibilized by not supporting the organization that is tasking them to do so. This study is the first empirical examination of the consumer experience of consumer responsibilization and allows us to contribute to a deepened understanding of consumer ethics. (shrink)

This paper proposes to analyse the process that makes paths of action meaningful. It argues that this process is one of ‘figuration’. The term ‘figuration’ intends to outline how the experience of moral meaning is one that already positively marks out a field and to identify and analyse the mechanisms used for such marking and selection. It is my contention that these mechanisms predate the persuasion to a moral path; they are the process through which this path (...) is constructed as meaningful. This thesis is elucidated through an analysis of the tactics of meaning in Kant’s moral theory. Kant turns to aesthetics as a means of corroboration for his moral theory, but he also attempts to limit the scope of the interactions between his aesthetic and moral theory. For instance, when he writes on the topic of form in aesthetic taste or outlines the technical specifications of aesthetic judgment, it is arguably the arcane peculiarities of his system that are met. For this reason, Kant insists on the merely analogical relations between beauty and morality. However, it is also possible to see how certain aspects of Kant’s aesthetic theory execute wider, and potentially more important, functions for his practical philosophy, such as providing meaningful orientation for the ascetic moral attitude of his duty-ethics. In this respect, certain figures of Kant’s aesthetic theory may well be viewed as complementing the dependence in his moral philosophy, in the important sections on moral pedagogy and methodology, on appeals to heroic models and stories as ways of shaping and inculcating the moral disposition. This paper considers these aspects of interaction between Kant’s aesthetic and moral philosophies as both 1) a problem for the consistency of his philosophy given his avowed exclusion of aesthetic and religious elements of meaning in his duty-ethics; and 2) as a case study for the new, schematic analysis of ‘moral figuration’ outlined in the paper. (shrink)

"Written by a well-known and respected author, this book reflects careful scholarship by someone who has extensive experience in the field and creative insights.

Many studies have examined clinical and institutional moral problems in the practice of nurses that have led to the experience of moral distress. The causes and implications of moral distress in nurses, however, have not been understood in terms of their implications from the perspective of virtue ethics. This paper analyzes how nurses reach for the telos of their practice, within a context of moral distress. A qualitative case study was carried out in a private (...) hospital in Brazil. Observation and semi‐semistructured interviews were conducted with 13 nurse participants. With the aid of ATLAS.ti software, the data were analyzed by using thematic content analysis using virtue ethics to theorize the findings. These nurses experienced a loss of their nursing identity as they encountered an ambiguous telos and the domination of institutional values. In their reach for the telos of their practice, nurses found an environment permeated by ethical challenges, which not only created moral distress but also created professional invisibility, a phenomenon referred to as ‘invisibility of the self’. (shrink)

The study of the moral sense was neglected for a long time in psychology until recently when Kohlberg, following the work of Piaget, constructed a scale for studying moral judgments. In this article the more scientific and empirical approach to the moral sense is questioned and an argument is made that a qualitative approach would yield more meaningful results. The work of Coles is cited as one example of a qualitative approach, and this article suggests a phenomenological (...) approach. Five brief descriptions describing learning, resentment, decision-making, and the experience of autonomy were used for both analyses of the moral sense and psychological concomitants. The results indicate that the moral sense is a meaning that refers to an "ought" and that the awakening of the moral sense is frequently associated with negative emotions or feelings. (shrink)

Drawing from the Boulding''s (1956) framework for general systems theory, the need to employ richer paradigm in the study of organizations (Pondy and Mitroff, 1979) is reiterated. It is argued that a better understanding of organizational ethical behavior is contingent upon viewing organizations as symbol processing systems of shared language and meanings. Further, it is proposed that organizations, like individuals, develop into collectivities of shared cognitions and rationale, over a period of time. The study adapts Kohlberg''s (1983) model of (...) class='Hi'>moral development to examine if organizations can be viewed as passing through different stages of moral development depending on the type of moral reasoning employed to explain their behaviors in the face of ethical crises. Several cases raising questions about the ethics of corporate behavior were researched. An instrument entitled Organization Response Analysis was constructed using statements made by various spokespersons representing five of these organizations. The instrument was administered to 246 graduate and undergraduate students of business (N = 246). Results indicated a great degree of concurrence among respondents of differing genders, levels of education and work experience in determining the stages of moral development of organizations. Limitations of the current study and implications for future research and practice are discussed. (shrink)

The purpose of this paper is to elaborate on the notion of clinical medicine as a hermeneutical enterprise and to bridge the gap between the general perspectives of hermeneutics and the particularities of medical practice. The case of a patient with low back pain is analyzed. The discussion centers around the metaphor of the patient as a text and a model of five social discourses about low back pain. The problems addressed are: (1) the nature of a moral (...) class='Hi'>experience, (2) the variety of available texts, (3) the difference between the doctor's and patient's narratives, and (4) the patient's and doctor's responsibility regarding the existential, biographical meaning of an illness. Although many problems are left unsolved, it is argued that from a philosophical point of view the notion of medicine as a hermeneutical enterprise opens up the possibility of gaining insight in the foundations of the clinical encounter. (shrink)

There is extensive literature that indicates animals suffer considerably in the practices of factory farming and animal experimentation. In the light of the evidence of this suffering there is an urgent need to answer the question whether our current use of animals is ever morally justifiable. The aim of this thesis is to provide a critical examination of the moral status of animals and of our treatment of animals in these practices. My objective is to assess whether these practices (...) are ever justifiable and whether we have a moral obligation to revise our attitudes towards our use of animals. Animals are often denied moral standing on the basis that they lack certain capacities, such as rationality, language and the ability to think. Further, it is often thought that animals' supposed lack of such capacities could be used as a defence for our use of them in intensive farming and animal experimentation. Thus, in examining the moral status of animals this thesis also examines animals and their capacities in order to determine whether any of the arguments given against the moral standing of animals are sound. In seeking to discover the extent of our moral obligations towards animals and the necessary conditions for moral standing, I will demonstrate that, although animals used in factory farming and experiments do have moral standing, the only consistent course is to extend moral standing to all living things. I will conclude that although the possession of certain much-prized capacities is not necessary for moral standing, many animals do indeed possess such capacities, including the ability to use language. Centrally this thesis calls for a re-evaluation of our attitudes towards animals, particularly in respect of our beliefs about animals used in factory farms and experiments. (shrink)

Judith Jarvis Thomson famously argued that abortion is permissible even if we accept that a fetus qualifies as a person and possesses a right to life. The current paper presents two arguments that undermine Thomson’s position. First, the paper sketches a contractarian argument that explores Thomson’s violinist thought experiment from behind a veil of ignorance, which suggests that if we had an equal likelihood of being an unwanted fetus and a pregnant woman, it would be rational for us to oppose (...) abortion. Second, the paper discusses the hypothetical self-aborting fetus, a thought experiment that reverses the dependence relationship between a woman and a fetus. It is argued that in this scenario, where fetuses have agency of their own, Thomson’s position would counterintuitively prohibit a woman from temporarily curtailing the freedom of her fetus even to save her own life. (shrink)

This article seeks to describe in general terms what has become the standard way of conceptualizing moral injury in the clinical psychological and psychiatric literature, which is the key source for applications of the concept in other domains. What we call “the standard model” draws on certain assumptions about beliefs, mental states, and emotions as well as an implicit theory of causation about how various forms of harm arise from certain experiences or “events” that violate persons’ moral beliefs (...) and systems. Our analysis makes these assumptions more explicit and subjects them to critical scrutiny. In so doing, we survey the current literature and identify basic features of how moral injuries are defined, how they are thought to occur, and the forms of treatment or repair that appear to be indicated. We caution that it matters how moral experience is characterized and argue that an alternative understanding of what is the moral in moral injury is important for overcoming critical challenges to the standard model. Moreover, recently evolving approaches to moral repair could be more consistent with an alternative model. Our concluding suggestion is that a more robust account of the nature of moral experience and its relations to self-identity and social experience more generally could advance understanding of the etiology of moral injury and promote rehabilitation. (shrink)

The Oregon Basic Health Services Act of 1989 seeks to establish universal access to basic medical care for all currently uninsured Oregon residents. To control the increasing cost of medical care, the Oregon plan will restrict funding according to a priority list of medical interventions. The basic level of medical care provided to residents with incomes below the federal poverty line will vary according to the funds made available by the Oregon legislature. A rationing plan such as Oregon's which potentially (...) excludes medically necessary procedures from the basic level of health care may be just, for the right to publically-sponsored medical care is restricted by opposing rights of private property. However, the moral acceptability of the Oregon plan cannot be determined in the absence of knowing the level of resources to be provided. Finally, Oregon to date has failed to include the individuals being rationed in discussions as to how the scarce resources are to be distributed. (shrink)

Slips of the tongue, unwitting favoritism and stereotyped assumptions are just some examples of microaggression. Nearly all of us commit microaggressions at some point, even if we don’t intend to. Yet over time a pattern of microaggression can cause considerable harm by reminding members of marginalized groups of their precarious position. The Ethics of Microaggression is a much needed and clearly written exploration of this pervasive yet complex problem. What is microaggression and how do we know when it is occurring? (...) Can we be held responsible for microaggressions and if so, how? How has social media affected the problem? What role can philosophy play in understanding microaggression? Regina Rini explores these highly topical and controversial questions in an engaging and fair-minded way, arguing that an event is a microaggression precisely because it causes a marginalized person to experience an ambiguous encounter with oppression. She illustrates her argument with compelling examples from media, politics and psychology and explains the significance of essential concepts, such as media representation, reparative renaming, and safe spaces. The Ethics of Microaggression explains what microaggression is and offers strategies for combating it. Assuming no prior knowledge of the topic or philosophy, it demystifies a controversial and extremely important topic in clear language. It is ideal for anyone coming to the topic for the first time and for students in philosophy, gender studies, race theory, disability theory and social and political philosophy. (shrink)

The main question that we address in this chapter is what to say about reportedly libertarian experiences of free agency – in other words, experiences of options as being open, and up to oneself to decide among, such that, if they are accurate or veridical, then (at a minimum) indeterminism must be true. A great deal rides on this question. If normal experiences of free agency are libertarian, and if compatibilists cannot explain them away, then all of us may be (...) under systematic illusion at almost every moment of our waking lives. That is, our experiences would be illusory if humans do not in fact satisfy libertarian conditions (e.g., if indeterminism does not occur in the right time or place during decision-making, or we lack agent-causal powers). In some sense, more rides on the question of whether we are agents of the sort that we experience ourselves as being than on the question of whether we have the type of control required for moral responsibility. At worst, we are not responsible in only one sense if we lack what libertarians say we need. Yet even then, we would not be under systematic experiential illusion during most of our waking lives, as we are if our experience is libertarian, yet false. (shrink)

Navigating the Moral Maze is a teaching resource to help students understand and critically engage with the most pressing issues in the world today. From the destruction of Gaza to the climate emergency, from the repeal of Roe v Wade to rising inequality, young people are growing up in a world beset with moral concerns and predicaments. With this book teachers can equip students with the critical skills and conceptual clarity needed to navigate through these issues and reach (...) a clear and articulate understanding of their own views. Each chapter features several lesson plans with activities, texts and thought experiments that help refine and enrich students' thoughts on the topics and promote discussion, thought and reflection. Topics covered include: Reproduction Euthanasia Poverty Environment Borders War Applicable to Religious Studies, Philosophy and Ethics, and touching on topics relevant to PSHE, History and Geography, this will be a valuable resource for secondary teachers wanting to enhance their students' critical writing and thinking skills. (shrink)

The objective of this work is to carry out a genetic study on the Husserlian concept of noema based in the givenness of the real body in the passive experience of pain. The development focuses, either, on the delimitation of the painful body given in its physical sphere in attention to its material properties, and in the eventual integration of this passively given body in the so-called noetic-noematic structure regarding the intentional revelation that pain implies. To do this, pain (...) will first be briefly examined in light of "original" passivity. Secondly, the way in which the body is given in its real disposition and its understanding as a bodily ego in experiencing pain will be contemplated. Thirdly, considering the “original” constitution of the body in pain in a broad sense, emphasis will be placed on its correspondence with intentionality, a matter that only confirms that pain is a form of perception. Finally, the deployment of the genetically viewed noema is given on the basis of the determination of the real body as a noematic object. (shrink)