Background:Moral distress, moral sensitivity, and moral courage among healthcare professionals have been explored considerably in recent years. However, there is a paucity of studies exploring these topics among baccalaureate nursing students.Aim/objective:The purpose of this study was to explore the relationship between and among moral distress, moral sensitivity, and moral courage of undergraduate baccalaureate nursing students.Research design:The research employed a descriptive-correlational design to explore the relationships between and among moral distress, moral sensitivity, and moral courage of undergraduate nursing students.Participants and research (...) context:A total of 293 baccalaureate Filipino nursing students who have been exposed to various clinical areas participated in the study.Ethical considerations:Institutional review board approval was sought prior to the conduct of the study. Self-determination was assured and anonymity and confidentiality were guaranteed to all participants.Findings:Results indicate that a majority of the nursing students in the clinical areas encounter morally distressing situations that compromise quality patient care. However, despite the fact that they want to do what is in the best interest of their patients, their perception of being the inexperienced among the healthcare team drives the majority of them to ignore morally distressing situations to avoid conflict and confrontation. Another interesting finding is that 79.20% of the respondents hardly consider quitting the nursing profession even if they frequently encounter morally distressing situations. Analysis also shows associations between moral distress intensity and frequency ( r = 0.13, p < 0.05) and moral distress intensity and moral sensitivity ( r = 0.25, p < 0.05). The dimensions of moral courage are also related to both moral distress and moral sensitivity.Conclusion:Results of the study imply that moral distress is a reality among all healthcare professionals including nursing students and requires more consideration by nurse educators. (shrink)

After a decade of intense debate about mechanisms, there is still no consensus characterization. In this paper we argue for a characterization that applies widely to mechanisms across the sciences. We examine and defend our disagreements with the major current contenders for characterizations of mechanisms. Ultimately, we indicate that the major contenders can all sign up to our characterization.

The past decade has seen a burgeoning of scholarly interest in conscientious objection in healthcare. While the literature to date has focused primarily on individual healthcare practitioners who object to participation in morally controversial procedures, in this article we consider a different albeit related issue, namely, whether publicly funded healthcare institutions should be required to provide morally controversial services such as abortions, emergency contraception, voluntary sterilizations, and voluntary euthanasia. Substantive debates about institutional responsibility have remained largely at the level of (...) first-order ethical debate over medical practices which institutions have refused to offer; in this article, we argue that more fundamental questions about the metaphysics of institutions provide a neglected avenue for understanding the basis of institutional conscientious objection. To do so, we articulate a metaphysical model of institutional conscience, and consider three well-known arguments for undermining institutional conscientious objection in light of this model. We show how our metaphysical analysis of institutions creates difficulties for justifying sanctions on institutions that conscientiously object. Thus, we argue, questions about the metaphysics of institutions are deserving of serious attention from both critics and defenders of institutional conscientious objection. (shrink)

Ethics and professionalism -- Ethical theory and philosophy -- Ethical principles and values -- Social responsibility -- Codes of ethics -- Ethical decision making in dental hygiene and dentistry -- Society and the State Dental Practice Act -- Dental hygienist/patient relationship -- Dental hygienist/dentist-employer relationship -- Risk management -- Case studies, activities, and testlets -- Appendix A : American Dental Association Principles of Ethics and Code of Professional Conduct.

Strong non-maximalism holds that some truths require no ontological ground of any sort. Strong non-maximalism allows one to accept that some propositions are true without being forced to endorse any corresponding ontological commitments. We show that there is a version of truthmaker theory available—anti-aboutness truthmaking—that enjoys the dialectical benefits of the strong non-maximalist’s position. According to anti-aboutness truthmaking, all truths require grounds, but a proposition need not be grounded in the very thing(s) that the proposition is about. We argue that (...) if strong non-maximalism can be defended, then so can anti-aboutness truthmaking on the very same basis; one can enjoy the benefits of strong non-maximalism without giving up on the idea that truth is always grounded in being. (shrink)

Scientific and philosophical literature on causality has become highly specialised. It is hard to find suitable access points for students, young researchers, or professionals outside this domain. This book provides a guide to the complex literature, explains the scientific problems of causality and the philosophical tools needed to address them.

Mechanisms have become much-discussed, yet there is still no consensus on how to characterise them. In this paper, we start with something everyone is agreed on – that mechanisms explain – and investigate what constraints this imposes on our metaphysics of mechanisms. We examine two widely shared premises about how to understand mechanistic explanation: (1) that mechanistic explanation offers a welcome alternative to traditional laws-based explanation and (2) that there are two senses of mechanistic explanation that we call ‘epistemic explanation’ (...) and ‘physical explanation’. We argue that mechanistic explanation requires that mechanisms are both real and local. We then go on to argue that real, local mechanisms require a broadly active metaphysics for mechanisms, such as a capacities metaphysics. (shrink)

Background:Nurses exposed to community health nursing commonly encounter situations that can be morally distressing. However, most research on moral distress has focused on acute care settings and very little research has explored moral distress in a community health nursing setting especially among nursing students.Aim:To explore the moral distress experiences encountered by undergraduate baccalaureate nursing students in community health nursing.Research design:A descriptive qualitative design was employed to explore the community health nursing experiences of the nursing students that led them to have (...) moral distress.Participants and research context:The study included 14 senior nursing students who had their course in Community Health Nursing in their sophomore year and stayed in the partner communities in their junior year for 6 and 3 weeks during their senior year.Ethical considerations:Institutional review board approval was sought prior to the conduct of the study. Self-determination was assured and anonymity and confidentiality were guaranteed to all participants.Findings:Nursing students are vulnerable and likely to experience moral distress when faced with ethical dilemmas. They encounter numerous situations which make them question their own values and ideals and those of that around them. Findings of the study surfaced three central themes which included moral distress emanating from the unprofessional behavior of some healthcare workers, the resulting sense of powerlessness, and the differing values and mindsets of the people they serve in the community.Conclusion:This study provides educators a glimpse of the morally distressing situations that often occurs in the community setting. It suggests the importance of raising awareness and understanding of these situations to assist nursing students to prepare themselves to the “real world,” where the ideals they have will be constantly challenged and tested. (shrink)

Taking the formal analogies between black holes and classical thermodynamics seriously seems to first require that classical thermodynamics applies in relativistic regimes. Yet, by scrutinizing how classical temperature is extended into special relativity, I argue that the concept falls apart. I examine four consilient procedures for establishing the classical temperature: the Carnot process, the thermometer, kinetic theory, and black-body radiation. I argue that their relativistic counterparts demonstrate no such consilience in defining the relativistic temperature. As such, classical temperature doesn’t appear (...) to survive a relativistic extension. I suggest two interpretations for this situation: eliminativism akin to simultaneity, or pluralism akin to rotation. (shrink)

Through essays, Mount Mary College professors from various disciplines analyze several pieces of literature from a variety of genres and authors to show how ...

Emphasizing the importance of etiquette and ethics in promoting success in American business, this helpful handbook describes how values reveal a company's relationships with customers, stockholders, and employees, covering such topics as listening skills, making a positive impression, dealing with allies and enemies, technology etiquette, presentation skills, and political skills.

Although we all learn differently, we all need to be able to engage certain fundamental reasoning skills if we are to manoeuvre successfully through life—however we define success. Peirce's philosophy provides us with a framework for helping students develop and hone the ability for making deliberate and well‐considered choices. For, embedded within Peirce's complete body of work is a design for thinking that provides a sturdy foundation for the development of three important learning capabilities. These capabilities are 1) the ability (...) to identify, compare, and contrast qualities, 2) the ability to perform analyses, and 3) the ability to interpret the meaning of signs. Although these capabilities may seem like the sort of skills that only older and academically inclined students can master, even young children and the intellectually challenged can learn to use them as well. Once teachers learn to develop their own intellectual potential by expanding these capabilities within themselves, they will be able to begin bringing about the development of these capabilities in their students. Once identified, developed, and applied to the mastery of educational skills and subject matter, these three fundamental learning capabilities , can form the foundation of a common‐sense approach to educational reform. Peirce asserts that good reasoning must be informed by ethical considerations, which in turn has been informed by the highest of aesthetic impulses. From this, we can extrapolate the importance that an educational model based upon Peirce's philosophy must place upon aesthetic and ethical considerations, as well as logical ones. Once fully understood, the philosophy of education embedded within Peirce's epistemology can revolutionize educational practices at all levels of learning. (shrink)

Russo and Williamson claim that establishing causal claims requires mechanistic and difference-making evidence. In this article, I will argue that Russo and Williamson's formulation of their thesis is multiply ambiguous. I will make three distinctions: mechanistic evidence as type vs object of evidence; what mechanism or mechanisms we want evidence of; and how much evidence of a mechanism we require. I will feed these more precise meanings back into the Russo–Williamson thesis and argue that it is both true and false: (...) two weaker versions of the thesis are worth supporting, while the stronger versions are not. Further, my distinctions are of wider concern because they allow us to make more precise claims about what kinds of evidence are required in particular cases. (shrink)

Craver claims that mechanistic explanation is ontic, while Bechtel claims that it is epistemic. While this distinction between ontic and epistemic explanation originates with Salmon, the ideas have changed in the modern debate on mechanistic explanation, where the frame of the debate is changing. I will explore what Bechtel and Craver’s claims mean, and argue that good mechanistic explanations must satisfy both ontic and epistemic normative constraints on what is a good explanation. I will argue for ontic constraints by drawing (...) on Craver’s work in Sect. 2.1, and argue for epistemic constraints by drawing on Bechtel’s work in Sect. 2.2. Along the way, I will argue that Bechtel and Craver actually agree with this claim. I argue that we should not take either kind of constraints to be fundamental, in Sect. 3, and close in Sect. 4 by considering what remains at stake in making a distinction between ontic and epistemic constraints on mechanistic explanation. I suggest that we should not concentrate on either kind of constraint, to the neglect of the other, arguing for the importance of seeing the relationship as one of integration. (shrink)

Xunzi's philosophy provides a rich resource for understanding how ethical relationships between humans and nature can be articulated in terms of harmony. In this paper, I build on his ideas to develop the concept of reciprocal harmony, which requires us to reciprocate those who make our lives liveable. In the context of the environment, I argue that reciprocal harmony generates moral obligations towards nature, in return for the existential debt that humanity owes towards heaven and earth. This can be used (...) as a normative basis for an environmental ethic that enables humanity and nature to flourish together. (shrink)

Although we all learn differently, we all need to be able to engage certain fundamental reasoning skills if we are to manoeuvre successfully through life—however we define success. Peirce's philosophy provides us with a framework for helping students (and ourselves) develop and hone the ability for making deliberate and well‐considered choices. For, embedded within Peirce's complete body of work is a design for thinking that provides a sturdy foundation for the development of three important learning capabilities. These capabilities are 1) (...) the ability to identify, compare, and contrast qualities, 2) the ability to perform analyses, and 3) the ability to interpret the meaning of signs. Although these capabilities may seem like the sort of skills that only older and academically inclined students can master, even young children and the intellectually challenged can learn to use them as well. Once teachers learn to develop their own intellectual potential by expanding these capabilities within themselves, they will be able to begin bringing about the development of these capabilities in their students. Once identified, developed, and applied to the mastery of educational skills and subject matter, these three fundamental learning capabilities (qualification, analysis, and interpretation), can form the foundation of a common‐sense approach to educational reform. Peirce asserts that good reasoning must be informed by ethical considerations, which in turn has been informed by the highest of aesthetic impulses. From this, we can extrapolate the importance that an educational model based upon Peirce's philosophy must place upon aesthetic and ethical considerations, as well as logical ones. Once fully understood, the philosophy of education embedded within Peirce's epistemology can revolutionize educational practices at all levels of learning. (shrink)

Why do ideas of how mechanisms relate to causality and probability differ so much across the sciences? Can progress in understanding the tools of causal inference in some sciences lead to progress in others? This book tackles these questions and others concerning the use of causality in the sciences.

In this paper, we compare the mechanisms of protein synthesis and natural selection. We identify three core elements of mechanistic explanation: functional individuation, hierarchical nestedness or decomposition, and organization. These are now well understood elements of mechanistic explanation in fields such as protein synthesis, and widely accepted in the mechanisms literature. But Skipper and Millstein have argued that natural selection is neither decomposable nor organized. This would mean that much of the current mechanisms literature does not apply to the mechanism (...) of natural selection.We take each element of mechanistic explanation in turn. Having appreciated the importance of functional individuation, we show how decomposition and organization should be better understood in these terms. We thereby show that mechanistic explanation by protein synthesis and natural selection are more closely analogous than they appear—both possess all three of these core elements of a mechanism widely recognized in the mechanisms literature. (shrink)

The Employee Retirement Income Security Act of 1974 , a federal law regulating private employer-sponsored employee benefit plans, was primarily designed for pension plans, but has had a profound impact on state health care reform efforts. ERISA's broad preemption language has been judicially interpreted to preclude states from most forms of regulation of employer health plans, including benefit design and incorporating employer expenditure requirements in state health reform financing. But since 1974, Congress has never seriously returned to reexamine several fundamental (...) questions: Should employers be required to offer or contribute to employee health coverage? Should ERISA preempt state efforts to take such actions? Or should ERISA incorporate more comprehensive regulation of health plans in these areas? Although the politics of ERISA preemption have thus far blocked federal reform, while allowing state reform activity to be simultaneously curtailed, new health reform efforts may force Congress to address these questions. (shrink)

Hrotsvit wrote stories, plays, and histories during the reign of Emperor Otto the Great. Twelve original essays survey her work, showing historical roots and contexts, Christian values, and a surprisingly modern grappling with questions of identity and female self-realization.

The purpose of this essay is to explore, and clarify, some key features in Aquinas’ account of the virtue of temperance, with an eye to answering some common objections raised against a positive evaluation of temperance. In particular, I consider three features of Aquinas’ understanding of temperance: First, the role of the rational mean in temperance; second, the role of rightly ordered passions in temperance; and third, the ‘despotic’ control of reason over the passions in temperance. Along the way I (...) consider three common objections to Aquinas’ account of temperance: the objection that temperance can be misused for evil, the objection that temperance devalues effort, and the objection that temperance devalues strong passions and thereby implicitly devalues the goodness of sexuality. In responding to these objections on behalf of Aquinas, I take the opportunity to clarify and slightly extend Aquinas’ account of temperance. (shrink)

Conventional wisdom holds that the von Neumann entropy corresponds to thermodynamic entropy, but Hemmo and Shenker (2006) have recently argued against this view by attacking von Neumann's (1955) argument. I argue that Hemmo and Shenker's arguments fail due to several misunderstandings: about statistical-mechanical and thermodynamic domains of applicability, about the nature of mixed states, and about the role of approximations in physics. As a result, their arguments fail in all cases: in the single-particle case, the finite particles case, and the (...) infinite particles case. (shrink)

Philosophy’s adversarial argumentation style is often noted as a factor contributing to the low numbers of women in philosophy. I argue that there is a level of adversariality peculiar to philosophy that merits specific feminist examination, yet doesn’t assume controversial gender differences claims. The dominance of the argument-as-war metaphor is not warranted, since this metaphor misconstrues the epistemic role of good argument as a tool of rational persuasion. This metaphor is entangled with the persisting narrative of embattled reason, which, in (...) turn, is linked to the sexism-informed narrative of the “man of reason” continually warding off or battling “feminine” unreason. (shrink)

Qualitative research poses ethical issues and challenges unique to the study of human beings. In developing the interpersonal relationship that is critical to qualitative research, investigator and participant engage in a dialogic process that often evokes stories and memories that are remembered and reconstituted in ways that otherwise would not occur. Ethical issues are raised when this relationship not only provides qualitative research data, but also leads to some degree of therapeutic interaction for the participant. The purpose of this article (...) is to examine some of the controversies inherent in the researcher's dilemma when this occurs, set within the context of a nursing caring theory (Swanson), and the International Council of Nurses Code of ethics for nurses, which provides guidance on global nursing practice. (shrink)

This book cuts through the complex writing style of the seminal philosopher, Charles Sanders Peirce. It disentangles his ideas, explains them one by one, and then puts the pieces back together for application to educational issues. Accessible to a general readership, this study provides useful insights into Peirce's pragmatism for educators and philosophers.

In this paper, we examine what is to be said in defence of Machamer, Darden and Craver’s (MDC) controversial dualism about activities and entities (Machamer, Darden and Craver’s in Philos Sci 67:1–25, 2000). We explain why we believe the notion of an activity to be a novel, valuable one, and set about clearing away some initial objections that can lead to its being brushed aside unexamined. We argue that substantive debate about ontology can only be effective when desiderata for an (...) ontology are explicitly articulated. We distinguish three such desiderata. The first is a more permissive descriptive ontology of science, the second a more reductive ontology prioritising understanding, and the third a more reductive ontology prioritising minimalism. We compare MDC’s entities-activities ontology to its closest rival, the entities-capacities ontology, and argue that the entities-activities ontology does better on all three desiderata. (shrink)

Women are underrepresented in managerial positions and company international assignments, in part due to gender discrimination. There is a lack of fair and just treatment of women in selection, assignment and promotion processes, as well as a lack of virtue shown by business leaders in not upholding the principle of assigning comparable women and men equally to positions in management and postings abroad. Female professionals, however, initiate their own expatriation more often than they are assigned abroad by their company, and (...) usually as often as men self-expatriate. What causes women to self-initiate expatriation? Women's proactivity, in part an attempt to redress the disadvantage they face in managerial career advancement, appears influential, as are career and family motivations. Indeed, during expatriation, women fare well in their career and they repatriate only at the same rate as men. Compared with men, however, women repatriate less often for career than for family reasons. On their return, despite their international experience, women do not gain as much of a financial return on their investment in self-expatriation as do men, suggesting that women may suffer unfair, non-meritorious treatment at home. Overall, self-initiated expatriation provides a new, gendered, social context for researching women's career advancement. The ethical issues associated with women's self-expatriation — a lack of fairness and justice in selection, assignment and promotion decisions, and a lack of virtue shown by business leaders in upholding fair and just human resource decisions by gender -suggest practical avenues to resolve these issues. (shrink)

Women are underrepresented in managerial positions and company international assignments, in part due to gender discrimination. There is a lack of fair and just treatment of women in selection, assignment and promotion processes, as well as a lack of virtue shown by business leaders in not upholding the principle of assigning comparable women and men equally to positions in management and postings abroad. Female professionals, however, initiate their own expatriation more often than they are assigned abroad by their company, and (...) usually as often as men self-expatriate. What causes women to self-initiate expatriation? Women’s proactivity, in part an attempt to redress the disadvantage they face in managerial career advancement, appears influential, as are career and family motivations. Indeed, during expatriation, women fare well in their career and they repatriate only at the same rate as men. Compared with men, however, women repatriate less often for career than for family reasons. On their return, despite their international experience, women do not gain as much of a financial return on their investment in self-expatriation as do men, suggesting that women may suffer unfair, non-meritorious treatment at home. Overall, self-initiated expatriation provides a new, gendered, social context for researching women’s career advancement. The ethical issues associated with women’s self-expatriation – a lack of fairness and justice in selection, assignment and promotion decisions, and a lack of virtue shown by business leaders in upholding fair and just human resource decisions by gender – suggest practical avenues to resolve these issues. (shrink)

The debate about the rational and the social in science has sometimes been developed in the context of a distinction between epistemic and non-epistemic values. Paying particular attention to two important discussion in the last decade, by Longino and by McMullin, I argue that a fuller understanding of values in science ultimately requires abandoning the distinction itself. This is argued directly in terms of an analysis of the lack of clarity concerning what epistemic values are. I also argue that the (...) philosophical import of much of the feminist work in philosophy of science is restricted by any kind of strict adherence to the distinction. (shrink)

The Recursive Bayesian Net formalism was originally developed for modelling nested causal relationships. In this paper we argue that the formalism can also be applied to modelling the hierarchical structure of mechanisms. The resulting network contains quantitative information about probabilities, as well as qualitative information about mechanistic structure and causal relations. Since information about probabilities, mechanisms and causal relations is vital for prediction, explanation and control respectively, an RBN can be applied to all these tasks. We show in particular how (...) a simple two-level RBN can be used to model a mechanism in cancer science. The higher level of our model contains variables at the clinical level, while the lower level maps the structure of the cell's mechanism for apoptosis. (shrink)