Background and Objectives Primary care providers (PCPs) report decreased job satisfaction and high levels of burnout, yet little is known about their experience of moral distress. The aim of this study was to gain insight into the experiences of PCPs regarding moral distress including causative factors and proposed mitigation strategies. Methods This qualitative pilot study used semi-structured interviews to identify causes of moral distress in PCPs in an academic family medicine department. Interviews were analyzed using conventional content analysis. Results Of (...) 35 eligible participants, 12 completed the study (34% participation rate). Most were white, female, and had practiced for less than 10 years. Four PCPs had considered leaving their position due to moral distress. Participants identified five causes of moral distress: policies and procedures that conflict with patient needs, the unpredictable nature of primary care, need to “bend the rules,” lack of accountability, and lack of support staff. Six internal conflicts made resolving morally distressing situations difficult: perceived powerlessness, sense of responsibility, socialization to follow orders, emotional toll of the job, competing obligations, and fear of mistakes. Conclusions These findings matched themes in the current literature and identified an unbending infrastructure. This, coupled with the chaotic nature of primary care, resulted in frequent moral distress. Participants offered solutions to reduce and mitigate moral distress (also similar with current literature) and suggested moral distress and burnout are closely linked. (shrink)

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

CAROLE BOURNE-TAYLOR AND ARIANE MILDENBERG Introduction: Phenomenology, Modernism and Beyond Etat Present It was at the Eleventh Virginia Woolf Conference ...

Kathleen Stock’s engaging and careful book demonstrates that ‘extreme intentionalism’ – the view that a fiction’s content is determined by what its author actually intended – has for too long been held back by a set of familiar objections.1 1 It is often thought to have implausible consequences involving disregarding conventional meaning, permitting undetectable fictional content, denying that authorial intentions can be unsuccessful, or giving too much importance to extraneous indications of intention and too little to the work itself. All (...) these objections, Stock argues, are overplayed, all are answerable, and several ultimately favour extreme intentionalism over its rivals. Stock’s defence of extreme intentionalism grounds a view of imaginative resistance, an account of the fiction/non-fiction distinction and of what an individual fiction is, and a characterization of propositional imagining and of the nature of supposition. (shrink)

From Zen and the Art of Motorcycle Maintenance to The Motorcycle Diaries, to be a biker is to be on the road to the meaning of life. What would the existentialists have to say about facing death on a bike? Can your motorcycle be as much a work of art as a Michelangelo painting? And why is it that bikers are so often political rebels? Philosopher and biker Craig Bourne shows for the first time the thoughtful side of the (...) biker, and takes us on a fun trip through the philosophy of motorcycles. (shrink)

How can we talk meaningfully about the past if it does not exist to be talked about? What gives time its direction? Is time travel possible? This defence of presentism - the view that only the present exists - makes an original contribution to a fast growing and exciting debate.

How can we talk meaningfully about the past if it does not exist to be talked about? What gives time its direction? Is time travel possible? This defence of presentism - the view that only the present exists - makes an original contribution to a fast growing and exciting debate.

Some fictions seem to involve branching time, where one time series ‘splits’ into two or two time series ‘fuse’ into one. We provide a new framework for thinking about these fictional representations: not as representations of branching time series but rather as branching representations of linear time series. We explain how branching at the level of the representation creates a false impression that the story describes a branching of the time series in the fictional world itself. This involves explaining away (...) the illusion of various causal connections which may at first appear essential to understanding the story as a unified whole. This provides a more accurate account of the relationship between the representation and what is represented, which in turn reveals the extent to which it is legitimate to draw conclusions about actual time from fictional representations. (shrink)

Concerns regarding corporate ethics have grown steadily throughout the past decade. In order to remain competitive, many organizational leaders are faced with the challenge of creating an ethical environment within their organization. A model is presented showing the process and elements necessary for the institutionalization of organizational ethics. The transformational leadership style lends itself well to the creation of an ethical environment and is suggested as a means to facilitate the institutionalization of corporate ethics. Finally, the benefits of using transformational (...) leadership are demonstrated through the components of a psychological contract, organizational commitment, and ethical culture to institutionalize organizational ethics. (shrink)

In neocolonial contexts of globalization, the epistemological terrain of radical diversity poses significant ethical challenges to transnational feminisms. In view of historical associations between knowledge and discourses of love which were conditioned by imperialist brands of humanism and benevolence under colonialism, this paper argues for a deconstructionist approach to conceptualizing love in relation to knowledge and for an ethics that severs the association with benevolence, instead making alterity the basis for its account.

Originally published in 1900, this book presents a discussion of the relationship between ethics and education. The text is divided into four main parts: 'Congenital Endowment: its Nature and Treatment'; 'Educative Influences'; 'Sound Judgment'; and 'Self-Development and Self-Control'. This book will be of value to anyone with an interest in philosophy and the history of education.

German philosopher Martin Heidegger stirred educators when in 1951 he claimed teaching is more difficult than learning because teachers must ‘learn to let learn’. However in the main he left the aphorism unexplained as part of a brief four-paragraph, less than two-page set of observations concerning the relationship of teaching to learning; and concluded at the end of those observations that to become a teacher is an ‘exalted matter’. This paper investigates both of Heidegger's claims, interpreting letting learn in the (...) context of Heidegger's larger philosophical project, and suggesting why in light of that project to become a teacher is an exalted concern. The methodology guiding the inquiry is largely hermeneutic, the purpose of the essay to interpret teaching from a Heideggerian perspective: its nature and general method. (shrink)

Event summary: The conference focuses on metafiction, taken to cover any fiction which represents itself as a fiction. Because metafictions acknowledge their own status as fictions, they are sometimes known as ‘reflexive’ or ‘self-conscious’ fictions, and sometimes generate apparently paradoxical results. The conference will explore what this reflexivity amounts to, how it distinguishes the metafictional from the non-metafictional works, and what impact this has on questions about the nature of fiction in general. Metafiction amounts to a significant – but not (...) uncommon – distortion of the standard relationship between a fiction and what it represents. This two-day interdisciplinary conference will explore how metafictional representation works by bringing together research on the nature of fiction within philosophy and research on metafiction in literary criticism, film studies and art theory. Questions to Explore Understanding how metafiction works is important to understanding how fiction works. For it raises interesting questions about what fictional representation is, what distinguishes it from non-fictional representation, how fictions represent, how we engage with fiction, and what relations the representation bears to its contents. How should we accommodate metafictions within an account of truth in fiction? Are there any peculiarities of audience engagement with metafictions – do our emotional reactions to a scenario change if we are told by the work that it is ‘just fictional’? What are the different metafictional narrative techniques, and do they all have the same impact on the content of the fiction? What constraints, if any, do metafictions place on the ontology of fiction and the nature of fictional objects? (shrink)

Event synopsis: -What does it mean to claim that the future is open? -Are future contingent statements like "There will be a sea battle tomorrow" now true or false? -Is the claim that future contingents are now true or false compatible with the claim that the future is open? -What is the relation between future contingents and future ontology? -What metaphysical picture is required in order to make sense of the claim that the future is open? Multiple, branching futures? A (...) ‘thin red line’? Metaphysical indeterminacy? Presentism? (shrink)

The “boomerang thesis” enjoys widespread currency in contemporary scholarship: that the means and ends of colonial domination would “spin back” to the metropole is an idea with intuitive grip. This article extrapolates the depth of meaning this metaphor contains, as well as what it conceals. It first considers the “boomerang” as it appears in Aimé Césaire’s Discourse on Colonialism, a poetic work that captures the moral and experiential return-effects of imperial violence. Turning to Hannah Arendt’s The Origins of Totalitarianism—the only (...) articulation of the thesis that uses the word “boomerang”—the article disaggregates the teleological, ideological, and institutional elements that spun back from European colonies in the imperial era. Finally, it traces the development of the thesis in Michel Foucault’s “Society Must Be Defended,” where it is transformed into a more general explanatory mechanism. Each theorist indicates how distance operates to transform dubious, even hateful ideas into acceptable practices. (shrink)

What can we learn about the world from engaging with fictional time-series--stories involving time travellers, recurring and rewinding time, and foreknowledge of the future? Do they show us radical alternative possibilities concerning the nature of time, or do they show that even the impossible can be represented in fiction? Neither, so this book argues. Defending the view that a fiction represents a single possible world, the authors show how apparent representations of radically different time-series can be explained in terms of (...) how worlds are represented without there being any fictional world which has such a time-series. In this way, the book uses the complexities of fictional time to get to the core of the relation between truth in fiction and possibility. It provides a logic and metaphysics to deal with the fact that fictions can leave certain features of their fictional worlds indefinite, and draws comparisons and connections between fictional and scientific representations and hypotheses. (shrink)

As nursing moves towards a holistic approach to care, its publications on sexuality have proliferated. 'Sexuality' and 'Gender' are concepts which are extremely difficult to define. While sex refers to the physical differences of the body, gender concerns the psychological and sociocultural differences between females and males. This distinction between sex and gender is fundamental, since many differences between females and males are not biological in origin. And, when a person's gender and sex fall together in accordance with social norms, (...) it may not necessarily be a similar correlation for every individual. The nature of these similarities is essentially threefold. First, Thomas, Savage and Webb accept that there should be a nursing definition of sexuality. In different ways they acknowledge and refer to it as an integral part of a person's being and self concept. Secondly, the authors underline some of the complexities and difficulties nurses have defining and dealing with it in professional relationships as well as on the level of self reflection, knowledge, attitudes and beliefs. Thirdly, all three surveys show why such difficulties prevail, and go on to make suggestions for change in nursing interventions and training. This article summarizes these contributions and discusses the ethical problems which nurses face in dealing with the sexuality of their patients. Pendant que les soins deviennent plus complet, les publications sur la sexualité se sont multipliés. Sexualité et genre sont des idées qui sont difficiles à définir. Pendant que 'sexualité' fait allusion aux différences entre les corps, 'genre' regarde les différences psychologiques et socioculturelles entre femmes et hommes. Cette distinction entre sexualité et genre est fondamentale, puisque beaucoup des différences entre femmes et hommes ne sont pas d'origine biologique. Et quand le genre et la sexualité d'une personne sont en accord avec les normes sociaux, il n'y a toujours pas une même correlation pour chaque individu. La nature de ces ressemblances est triple: premièrement, Thomas, Savage et Webb acceptent qu'une définition pour infirmiers/ères de las sexualité devrait exister. De plusières manières ils l'acceptent, et en réfèrent comme à un part total de l'être et idée de soi de la personne. Deuxièmement, les auteurs soulignent quelques-unes des difficultés et complexités que les infirmier/ères rencontrent dans leurs relations professionnelles aussi bien que dans leurs reflexions, compréhensions, attitudes et convictions personelles. Troisièmement, les trois études montrent pourquoi ces difficultès continuent encore, et suggèrent des changements en interventions et formation professionnelle. L'article-ci résume ces contributions et discute les problèmes éthiques des infirmier/ères vis-à-vis de la sexualité de leurs malades. Weil sich die ganzheitliche Pflege vermehrt, vermehren sich auch die Veröffentli chungen über Sexualität. Sexualität und Geschlecht sind Begriffe, die sehr schwierig zu beschreiben sind. Sexualität bezieht sich auf die physikalischen, und Geschlecht auf die psychologischen und kulturellen Unterschiede zwischen Frauen und Männern. Diese Unterschiede zwischen Sexualität und Geschlecht sind grundsätzlich, denn viele Verschiedenheiten zwischen Frauen und Männern haben keinen biologischen Ursprung. Wenn die Sexualität und das Geschlecht einer Person zusammen fallen mit den gesellschaftlichen Normen, bedeutet es noch nicht, dass es sich für alle solche Leute auf das selbe hinbezieht. Das bedeutende dieser Aehnlichkeiten ist dreifach: erstens, Thomas, Savage und Webb akzeptieren dass es eine Definition der Sexualität für die Krankenpflege geben sollte. Auf verschiedene Arten bestätigen sie sie, und weisen auf das Wesen der Person und deren Selbst-Vorstellung als etwas Vollständiges hin. Zweitens, diese Autoren betonen die Verwicklungen und Schwierigkeiten, die das Krankenpflegepersonal hat mit der Sexualität in beruflichen Beziehungen wie auch in persönlichem Nachdenken, Einstellungen und Ueberzeugungen. Drittens, alle drei Ueberblicke zeigen warum solche Schwierigkeiten weiterhin bestehen, und machen Vorschläge für Aenderungen in Pflegeeingriffen und Unterricht. Dieser Artikel fasst diese Beiträge zusammen und diskutiert die ethischen Probleme die das Krankenpflegepersonal hat mit der Sexualität der Patienten. (shrink)

This study addresses the nature of the contribution made by Christian feminist thinkers who claim that mutuality is a necessary part of a Christian social ethical framework. The theological method employed is analytical and comparative toward the end of illuminating, testing, and demonstrating the thesis: mutuality is a formal norm for Christian social ethics that functions along with love and justice to promote a balance of power that is required for optimum human flourishing, a flourishing set within the interdependent context (...) of the whole of creation. ;Chapter One analyzes selected primary sources of Rosemary Radford Ruether, Carter Heyward, Beverly Wildung Harrison, and Elizabeth A. Johnson isolating their definition and treatment of the term, "mutuality." A consensus definition of mutuality drawn from definitions by the four feminists. It is concluded that, similar to the tripartite nature of justice, mutuality has four forms--cosmic, gender, generative, and social. ;Chapters Two and Three illustrate several moments in the history of Christian thought wherein antecedents of the feminists' notion of mutuality are found. Selected primary works of Thomas Aquinas, John Duns Scotus, Martin Buber, and H. Richard Niebuhr are examined. ;Chapter Four compares the four feminists' definition of mutuality with definitions of formal norm by Josef Fuchs, Lisa Sowle Cahill, and Timothy E. O'Connell, determining that mutuality is a formal norm for Christian social ethics. Chapter Five is a case study. Utilizing our definition, it is shown how consideration of mutuality and its four forms influences the ethical analyses of George Weigel, Jean Bethke Elshtain, and Stanley Hauerwas in determining if the Persian Gulf War was a just war. It is concluded that the probative value of the formal norm, mutuality, is multifaceted. First and foremost, it requires the moral agent to deal concretely in moral reflection and moral decision-making. Specific and careful attention needs to be given to the reality revealing questions in the concrete, as well as in the abstract. Second, mutuality requires the moral agent to probe the dynamics of power in an ethical dilemma and to seek out ways to shape those dynamics to serve power-with. It is a complement to and corrective of love and justice. Third, engaging the norm of mutuality presses the moral agent toward inclusivity drawing into the process of moral reflection concern for the thriving and flourishing of all involved. More than the norms of love and justice, mutuality places humans in a perspective within the whole of creation. (shrink)

In this article, we contribute to sociological literatures on morality, professional and institutional contexts, and morally stigmatized ‘dirty work’ by emphasizing and exploring how they mutually inform one another in lawyers’ work activities. Drawing on interview data with 58 practitioners in the commercial legal industry in Singapore, we analyze how they experience professional and institutional constraints on the expressions of morality in their work. Our findings illustrate how a dominant managerial and economic focus maintains and reproduces a constrained form of (...) morality, limited to instrumental, utilitarian and commercial ends, and subordinated to lucrative client and firm interests. We discuss our findings in terms of the need to research and reform professions in ways that support more rounded and unconstrained moral reflexivity and autonomy in how work is undertaken and valued. This in turn has implications for how organizations and professions might achieve alternative moral institutional orders, and for legal work to avoid the moral and social taints of dirty work. (shrink)

According to Roger Scruton, it is not possible for photographs to be representational art. Most responses to Scruton’s scepticism are versions of the claim that Scruton disregards the extent to which intentionality features in photography; but these cannot force him to give up his notion of the ideal photograph. My approach is to argue that Scruton has misconstrued the role of causation in his discussion of photography. I claim that although Scruton insists that the ideal photograph is defined by its (...) ‘merely causal’ provenance, in fact he fails to take the causal provenance of photographs seriously enough. To replace Scruton’s notion of the ideal photograph, I offer a substantive account of the causal provenance of photographs, centred on the distinctive role of ‘the photographic event’. I conclude that, with a proper understanding of the photographic process, we have good reason to re-open the question of photography as a representational art. (shrink)

Noreen Khawaja's The Religion of Existence offers an interpretation of Søren Kierkegaard's account of sin and despair as an account of alienation and our struggle to overcome it. I argue that Khawaja's interpretation of Kierkegaard is incompatible with Kierkegaard's insistence that sin must necessarily be the sinner's own fault—a result of the sinner's own free choice. I consider two possible ways of harmonizing Khawaja's account with this claim, one proposing a fictive acceptance of fault for what is not actually one's (...) fault, and one based on the claim that sin presupposes sin-consciousness, but argue that neither constitutes a satisfactory solution. I conclude that while alienation does constitute sin for Kierkegaard, it does so for a different reason than Khawaja proposes. (shrink)

Most of us would want to say that it is true that Socrates taught Plato. According to realists about past facts,1 this is made true by the fact that there is, located in the past, i.e., earlier than now, at least one real event that is the teaching of Plato by Socrates. Presentists, however, in denying that past events and facts exist2 cannot appeal to such facts to make their past-tensed statements true. So what is a presentist to do?

The Principle of Procreative Beneficence (PB) holds that when a couple plans to have a child, they have significant moral reason to select, of the possible children they could have, the child who is most likely to experience the greatest wellbeing – that is, the most advantaged child, the child with the best chance at the best life.1 PB captures the common sense intuitions of many about reproductive decisions. PB does not posit an absolute moral obligation – it does not (...) dictate what people must do. Instead it holds that there is a significant moral reason to select the best child, but one that must be weighed against other reasons.Recent research suggests that it may become possible to derive gametes (eggs and sperm) from human stem cells in vitro, a process which we will term in vitro gametogenesis (IVG). The ability to create large numbers of eggs or sperm through IVG greatly increases our capacity to select the best child possible. (shrink)

The author explores how the discursive practices of social texts relate to the subjectivities of readers. Employing Dorothy Smith's notion of femininity as textually mediated discourse, the author analyzes how teenage girls read the depictions of femininity in the glossy advertisements of fashion magazines. Through interviews with 48 girls aged 13 to 17 years, she explores both why and how young girls negotiate “what it means to be a woman.” Most young girls in her study draw on stereotypical meanings of (...) adult femininity. By giving these stereotypes truth status, these readers valorize not only patriarchal meanings of womanhood but also naturalize associations between femininity and the commodities through which this femininity is expressed as the everyday doing of gender. The author concludes by discussing implications of this study for both a feminist theory and a feminist politics of culture. (shrink)

This paper develops an inventory and conceptual map of espoused organizational values. We suggest that espoused values are fundamentally different to other value forms as they are collective value statements that need to coexist as a basis for organizational activity and performance. The inventory is built from an analysis of 3112 value items espoused by 554 organizations in the UK and USA in both profit and not-for-profit sectors. We distil these value items into 85 espoused value labels, and these are (...) assessed in terms of their similarity and difference through judgements made by 53 experienced individuals. The resulting conceptual map facilitates the evaluation of values which are espoused at the organizational level, as opposed to aggregations of personal values, an important distinction that is often ignored in the literature. This analysis identifies a number of distinct areas of emphasis occupied by espoused values. In particular, the richness of value labels that relates to broader ethical issues may be aimed at external stakeholder management, but also may have an increasing influence on organizational behaviour as they are embedded into organizational practices. By advancing our understanding of espoused values, through an analysis of those being used in practice, we provide a means by which future research into organizational values and ethical issues can progress. (shrink)

In this essay, I trace the development of Julia Kristeva's theory and practice of "the subject in process/on trial" from her semiotic works of the 1960s to her psychoanalytic writings of the 1970s and 1980s. I read Kristeva's exploration of this "subject in process/on trial" as contributing to a postmodern feminist ethics.

Photography is valued as a medium for recording and visually reproducing features of the world. I seek to challenge the view that photography is fundamentally a recording process and that every photograph is a record—a view that I claim is based on a ‘single-stage’ misconception of the process. I propose an alternative, ‘multi-stage’ account in which I argue that causal registration of light is not equivalent to recording and reproducing an image. Intervention or non-intervention by photographers is more sophisticated than (...) the traditional view allows. Using the multi-stage account, I describe four models for producing photographic images and pictures. (shrink)

Most of us would want to say that it is true that Socrates taught Plato. According to realists about past facts, this is made true by the fact that there is, located in the past, i.e., earlier than now, at least one real event that is the teaching of Plato by Socrates. Presentists, however, in denying that past events and facts exist cannot appeal to such facts to make their past-tensed Statements true. So what is a presentist to do?There are (...) at least three conditions that would ideally be met in a satisfactory solution to this problem:a) It must preserve our views about which Statements are true and which falseb) It must be transparent what the truthmakers are for those Statementsc) It must accommodate the truth-value links between various times. (shrink)

: In neocolonial contexts of globalization, the epistemological terrain of radical diversity poses significant ethical challenges to transnational feminisms. In view of historical associations between knowledge and discourses of love which were conditioned by imperialist brands of humanism and benevolence under colonialism, this paper argues for a deconstructionist approach to conceptualizing love in relation to knowledge and for an ethics that severs the association with benevolence, instead making alterity the basis for its account.

Drawing from our interdisciplinary qualitative study of LGBTI conservative Christians and their allies, we name an especially toxic form of shame—what we call sacramental shame—that affects the lives of LGBTI and other conservative Christians. Sacramental shame results from conservative Christianity's allegiance to the doctrine of gender complementarity, which elevates heteronormativity to the level of the sacred and renders those who violate it as not persons, but monsters. In dispensing shame as a sacrament, nonaffirming Christians require constant displays of shame as (...) proof that LGBTI church members love God and belong in the community. Part of what makes this shame so harmful is that parents and pastors often dispense it with sincere expressions of care and affection, compounding the sense that one's capacity to give and receive love is damaged. We foreground LGBTI Christian movements to overcome sacramental shame by cultivating nonhubristic pride, and conclude by discussing briefly their new understandings of love and justice that could have far‐reaching benefits. (shrink)