This contribution seeks to understand the pervasive phenomenon of work compulsion among knowledge workers in our present network society. Knowledge workers not only have to work all the time from anywhere, but they also appear to want to. This study argues that this curious phenomenon may be attributed to the thumotic satisfaction that knowledge work generates. What is more, the neoliberal theory of human capital has found a way to harness thumotic satisfaction to the profit incentive, and has created arguably (...) the most productive working subject to date. The argument is divided into four parts: First, the paper analyses the government(- ality) of control operative in the network society by defining “neoliberalism”. It then focuses on Foucault’s examinations of German and American neoliberalism in the 20th century, treating them as instances of governmentality. The aim is to assess whether employing a governmentality lens is a valid approach for critically analysing present-day neoliberalism. If it proves justifiable, which I argue it does, the study explores the potential valuable insights gained from examining contemporary neoliberalism through this particular analytical framework. Second, the study turns to the “spiritedness” of knowledge workers under the conditions of stealth control that typify the neoliberal network society. Curiously, these highly engaged workers have reportedly experienced increased overall well-being. However, their overinvestment in work appears to be disproportionate to absolute necessity, increased earnings or improved overall quality of life. This paper contends that work compulsion generates and is in turn fuelled by thumotic satisfaction. Third, the study tries to ascertain the connection between neoliberal governmentality and thumos. Neoliberal governmentality appears to have found a way to appropriate thumotic satisfaction to produce and sustain the competitive entrepreneurial spirit. The fourth part of the study considers how the knowledge worker might resist the compulsion to work incessantly. (shrink)

McKillop explores the thought of a number of English-Canadian thinkers from the 1860s to the 1920s, decades that saw Canada’s entry into the modern age.

The Groningen protocol allows for the euthanasia of severely ill newborns with a hopeless prognosis and unbearable suffering. We understand the impetus for such a protocol but have moral and ethical concerns with it. Advocates for euthanasia in adults have relied on the concept of human autonomy, which is lacking in the case of infants. In addition, biases can potentially influence the decision making of both parents and physicians. It is also very difficult to weigh the element of quality of (...) life on the will to live. We feel an important line has been crossed if the international medical community consents to the active euthanasia of severely ill infants and are concerned about the extension of the policy to other at risk groups. (shrink)

The physician charter on medical professionalism creates standards of ethical behaviour for physicians and has been endorsed by professional organisations worldwide. It is based on the cardinal principles of the primacy of patient welfare, patient autonomy, and social welfare. There has been little discussion in the bioethics community of the doctrine of the charter and none from a Jewish ethical perspective. In this essay the authors discuss the obligations of the charter from a Jewish ethical viewpoint and call on other (...) cultures to develop their own unique perspectives on this important document. (shrink)

The validity of the double effect doctrine is examined in euthanasia and abortion. In these two situations killing is a method of treatment. It is argued that the doctrine cannot apply to the care of the dying. Firstly, doctors are obliged to harm patients in order to do good to them. Secondly, patients should make their own value judgments about being mutilated or killed. Thirdly, there is little intuitive moral difference between direct and indirect killing. Nor can the doctrine apply (...) to abortion. Doctors kill fetuses as a means of treating the mother. They also kill them as an inevitable side effect of other treatment. Drawing a moral distinction between the direct and the indirect killing gives counterintuitive results. It is suggested that pragmatic rules, not ethics, govern practices around euthanasia and cause it to be more restricted than abortion. (shrink)

In our ‘The Professional Virtue of Civility and the Responsibilities of Medical Educators and Academic Leaders’,1 we provided an historically based conceptual account of the professional virtue of civility and the role of leaders of academic health centres in creating and sustaining an organisational culture of professionalism that promotes civility among healthcare professionals and between medical educators and learners. We emphasised that any adequate understanding of the virtues, including professional virtues, has cognitive, affective, behavioural and social components. Some of the (...) commentators expand on these components in important ways. Xuhao et al emphasises the importance of role models, especially in the hierarchical context of medical education.2 The hierarchy of faculty in the senior position and junior doctors and other learners below them has characterised medical education for centuries. Xuhao et al rightly call for academic leaders to shape this hierarchy in a morally responsible way, by becoming ‘exemplary role models’.2 Berry, a clinician manager, in critiquing our account, calls for an increased appreciation for the psychological and environmental factors that might explain why uncivil behaviour occurs.3 …. (shrink)

Health care should be preferentially allocated to younger patients. This is just and is seen as just. Age is an objective factor in rationing decisions. The arguments against 'ageism' are answered. The effects of age on current methods of rationing are illustrated, and the practical applications of an age-related criterion are discussed. Ageist policies are in current use and open discussion of them is advocated.

The target articles in this issue advance our understanding of bioethical considerations in pragmatic trials (Garland, Morain, and Sugarman 2023; Morain and Largent 2023). Both articles appreciate...

An argument is a conceptual instrument through which a certain logical f order between propositions can be seen to exist. But does an argument show that a proposition is true? It does, if by ‘that’ you mean that the proposition can be seen to follow through the instrument of a valid argument which employs true premises. But when we wonder whether to believe that a proposition is true we do not always wonder whether or not the proposition follows logically from (...) other propositions. We want to know f whether the proposition is in itself true, whether or not it follows from another proposition or series of propositions. That a proposition is true f may be a fact, whether or not the machinery of reason has succeeded in focusing our attention on its truth by extracting its truth from other true premises. (shrink)

Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months for evidence of the discussion of patient wishes concerning (...) ventilator support, artificial nutrition and hydration , resuscitation and hospice care. A Kaplan–Meier analysis was also performed and 2-year survival calculated.Results: 60 cancer and 32 ALS patients were enrolled. ALS patients were more likely than cancer patients to have evidence of discussion about their wishes for ventilator support , ANH , DNR and hospice care . At 6 months, 91% of ALS patients were alive compared with 62% of cancer patients; at 2 years, 63% of ALS patients were alive compared with 23% of cancer patients .Conclusions: Cancer patients were less likely than ALS patients to have had documented advanced care planning discussions despite worse survival. This may reflect perceptions that ALS has a more predictable course, that advanced cancer has a greater number of treatment options, or differing views about hope. Nevertheless, cancer patients may be less adequately prepared for end-of-life decision-making. (shrink)

An attempt is made to show that Wittgenstein's later philosophy of logic is not the kind of conventionalism which is often ascribed to him. On the contrary, Wittgenstein gives expression to a “mixed” theory which is not only interesting but tends to resolve the perplexities usually associated with the question of the a priori character of logical truth. I try to show that Wittgenstein is better understood not as denying that there are such things as “logical rules” nor as denying (...) that the results of applying such rules are “logically necessary,” but as trying to understand what it is to appeal to a logical rule and what it means to say that the results of applying such a rule are “necessary.” He is not so much overthrowing standard accounts of logical necessity as discovering the limits of the concept. (shrink)

There are many people in the world who want to be Somebody. Let us describe someone as Somebody who comes to believe that, in one or more respects, he or she is a special or significant person and who succeeds, through whatever means, in acquiring some sort of reputation and some sort of fame. People want to become Somebody because they believe that unless they succeed in that respect they will turn out to be a mere mediocrity, or worse still, (...) to be thought of as a mere mediocrity. People want to leave some sort of mark in this world before they die. They do not want their passage through this world to be utterly ineffectual. This, I think, is the seed from which the ideal of being Somebody emerges. (shrink)

Some approaches to the assessment of moral intuitions are discussed. The controlled ethical trial isolates a moral issue from confounding factors and thereby clarifies what a person's intuition actually is. Casuistic reasoning from situations, where intuitions are clear, suggests or modifies principles, which can then help to make decisions in situations where intuitions are unclear. When intuitions are defended by a supporting principle, that principle can be tested by finding extreme cases, in which it is counterintuitive to follow the principle. (...) An approach to the resolution of conflict between valid moral principles, specifically the utilitarian and justice principles, is considered. It is argued that even those who justify intuitions by a priori principles are often obliged to modify or support their principles by resort to the consideration of consequences. (shrink)

Beginning in the 20th century, scientific research came to be dominated by a growing class of credentialed, professional scientists who overwhelmingly displaced the learned amateurs of an earlier time. By the end of the century, however, the exclusive realm of professional scientists conducting research was joined, to a degree, by “citizen scientists.” The term originally encompassed non-professionals assisting professional scientists by contributing observations and measurements to ongoing research enterprises. These collaborations were especially common in the environmental sciences, where citizen scientists (...) participated in counting wildlife and measuring environmental conditions. Later, patient groups began to play a more active role in supporting clinical trials and collecting health records from affected individuals. (shrink)

Prior research has demonstrated that trust in robots and performance of robots are two important factors that influence human–autonomy teaming. However, other factors may influence users’ perceptions and use of autonomous systems, such as perceived intent of robots and decision authority of the robots. The current study experimentally examined participants’ trust in an autonomous security robot (ASR), perceived trustworthiness of the ASR, and desire to use an ASR that varied in levels of decision authority and benevolence. Participants (N = 340) (...) were recruited from Amazon Mechanical Turk. Results revealed the participants had increased trust in the ASR when the robot was described as having benevolent intent compared to self-protective intent. There were several interactions between decision authority and intent when predicting the trust process, showing that intent may matter the most when the robot has discretion on executing that intent. Participants stated a desire to use the ASR in a military context compared to a public context. Implications for this research demonstrate that as robots become more prevalent in jobs paired with humans, factors such as transparency provided for the robot's intent and its decision authority will influence users’ trust and trustworthiness. (shrink)

Background Duty to care is integral to nursing practice. Personal obligations that normally conflict with professional obligations are likely amplified during a public health emergency such as COVID-19. Organizations can facilitate a nurse’s ability to fulfill the duty to care without compromising on personal obligations. Research Aim The study aimed to explore the relationships among duty to care, perception of supportive environment, perceived stress, and COVID-19-specific anxieties in nurses working directly with COVID-19 patients. Research Design The study design was a (...) cross-sectional descriptive study using an online survey. It was conducted at an ANCC Magnet® designated 385-bed acute care teaching hospital located in a suburban area. Participants and Research Context Included in this study were 339 medical surgical nurses working directly with COVID-19 patients during the early phase of the pandemic. Ethical Considerations The study was reviewed by the institution’s clinical research committee and determined to be exempt. A survey invitation letter with a voluntary implied consent agreement was sent to participants with a description of the research study attached to the anonymous survey. Results Nurses with specific COVID-19-related anxieties were more likely to agree that it was ethical to abandon the workplace during a pandemic. Conclusions Organizations can and ought to mitigate the negative effects of COVID-19 on duty to care in future pandemics and healthcare emergencies by incorporating several recommendations derived from this study. (shrink)

In this commentary on Carse and Rushton’s call for reorientation of moral distress, we state agreement with the authors that the discourse of moral distress should refocus on the moral components of integrity. We then explain how our philosophical taxonomy of moral distress, mentioned by the authors, appeals to moral integrity. In this process, we clarify our taxonomy’s appeal to Aristotle’s concept of akrasia. We conclude by offering support of Carse and Rushton’s challenge to organizations to strengthen moral integrity by (...) fostering resilience. (shrink)

Since Austin’s introduction of the locutionary-illocutionary-perlocutionary distinction, it has been a matter of debate within speech act theory whether illocutionary acts like promising, warning, refusing and telling require audience ‘uptake’ in order to be performed. Philosophers on different sides of this debate have tried to support their positions by appealing to hypothetical scenarios, designed to elicit intuitive judgements about the role of uptake. However, philosophers’ intuitions appeared to remain deadlocked, while laypeople’s intuitions have not yet been probed. To begin rectifying (...) that, we ran two experiments probing lay intuitions about the implications of uptake failure. Overall, we found that participants’ responses were skewed towards agreement that speech acts were performed, despite the lack of uptake. There were, however, significant differences across the four different speech act types we investigated (with the highest levels of agreement found for refusing, followed by warning, then telling, and finally promising). We also obtained evidence of complex effects relating to the (high or low) stakes involved in the scenarios. While this study only represents an initial exploration of intuitions about uptake, our results form a basis for further research into their nature and significance, across a range of speech acts, scenarios, and experimental designs. (shrink)

Calling is a very important concept in Christianity. In the medieval era, calling was restricted to ecclesiastical work alone, a devotion to the life of contemplation. Ordinary work or physical labour was not considered qualified to be a calling. Martin Luther was the one who taught that the ordinary work of the ordinary people was also God’s calling and equally spiritual as the ecclesiastical work. However, Miroslav Volf, a Croatian theologian, criticised Luther that his view of calling was too static (...) and irrelevant to the modern context where people often choose to quit a job because of its negative effects and some people have to do multiple jobs in order to make ends meet. While recognising the validity of Volf’s critique, this article seeks to demonstrate that even in the modern context, calling is still a very important theological concept to reflect upon work. Luther’s vocational view of work could be retrieved in discussing the theology of work by putting it in dialogue with Calvin, Kuyper, and other theologians.Contribution: This article seeks to show that the concept of calling is indispensable in constructing a sound theology of work for the modern context. By understanding work as calling, Christian workers are enabled to see how they are participating in God’s redemptive work through their jobs. (shrink)

The sudden emergence of the COVID-19 pandemic brought global disruption to every aspect of society including healthcare, supply chain, the economy, and social interaction. Among the many emergent considerations were the safety and public health of the public, patients, essential workers, and healthcare professionals. In certain locations, clinical research was halted—or terminated—in deference to the immediate needs of patient care, and clinical trials focusing on the treatment and prevention of coronavirus infection were prioritized over studies focusing on other diseases. Difficult (...) decisions were made rapidly; flexibility and reconsideration were necessary not only because the intensity and severity of infection varied over time and by locale but also because knowledge of the disease and understanding of its treatment grew. Here we discuss the ethical challenges in decision-making and competing ethical tensions during the pandemic in an effort to advance future preparedness. (shrink)