Kolbe and de Melo-Martin (2023) describe fatal problems in current definitions and measurement of moral distress and injury (MD/I) in medical professionals, which impede development of genuine atte...

Pro Doernberg and Truog (2023), we recognize and acknowledge five spheres of morality in medicine. We posit that these spheres represent domains of practical engagement, which, as the authors note,...

Injuries from failed suicide attempts account for a large number of patients cared for in the emergency and trauma setting. While a fundamental underpinning of clinical ethics is that patients have a right to refuse treatment, individuals presenting with life-threating injuries resulting from suicide attempts are almost universally treated in this acute care setting. Here we discuss the limitations on physician ability to determine capacity in this setting and the challenges these pose in carrying out patient wishes.

Fiester and Yuan (2023) highlight ethical concerns important for considering behavioral contracts to manage charged/challenging interactions with patients and/or families. We support the viability...

Moral distress names a widely discussed and concerning clinician experience. Yet the precise nature of the distress and the appropriate practical response to it remain unclear. Clinicians speak of their moral distress in terms of guilt, regret, anger, or other distressing emotions, and they often invoke them interchangeably. But these emotions are distinct, and they are not all equally fitting in the same circumstances. This indicates a problematic ambiguity in the moral distress concept that obscures its distinctiveness, its relevant circumstances, (...) and how individual clinicians and the medical community should practically respond to it. We argue that, in a range of situations that are said to be morally distressing, the characteristic emotion can be well‐understood in terms of what Bernard Williams calls “agent‐regret.” We show what can thereby be gained in terms of a less ambiguous concept and a more adequate ethical response to this distinctive and complex clinician experience. (shrink)

Volume 20, Issue 7, July 2020, Page 77-80.

Asks whether science can give any hope that some of our being will survive after death, challenging accepted views of mortality.

Recent scholarship in intellectual humility (IH) has attempted to provide deeper understanding of the virtue as personality trait and its impact on an individual's thoughts, beliefs, and actions. A limitations-owning perspective of IH focuses on a proper recognition of the impact of intellectual limitations and a motivation to overcome them, placing it as the mean between intellectual arrogance and intellectual servility. We developed the Limitations-Owning Intellectual Humility Scale to assess this conception of IH with related personality constructs. In Studies 1 (...) (n= 386) and 2 (n = 296), principal factor and confirmatory factor analyses revealed a three-factor model – owning one's intellectual limitations, appropriate discomfort with intellectual limitations, and love of learning. Study 3 (n = 322) demonstrated strong test-retest reliability of the measure over 5 months, while Study 4 (n = 612) revealed limitations-owning IH correlated negatively with dogmatism, closed-mindedness, and hubristic pride and positively with openness, assertiveness, authentic pride. It also predicted openness and closed-mindedness over and above education, social desirability, and other measures of IH. The limitations-owning understanding of IH and scale allow for a more nuanced, spectrum interpretation and measurement of the virtue, which directs future study inside and outside of psychology. (shrink)

This paper provides an analysis of U.S. farmland owners, operators, and workers by race, ethnicity, and gender. We first review the intersection between racialized and gendered capitalism and farmland ownership and farming in the United States. Then we analyze data from the 2014 Tenure and Ownership Agricultural Land survey, the 2012 Census of Agriculture, and the 2013–2014 National Agricultural Worker Survey to demonstrate that significant nation-wide disparities in farming by race, ethnicity and gender persist in the U.S. In 2012–2014, White (...) people owned 98% and operated 94% of all farmland. They generated 98% of all farm-related income from land ownership and 97% of income from farm owner-operatorship. Meanwhile, People of Color farmers were more likely to be tenants rather than owners, owned less land, and generated less farm-related wealth per person than their White counterparts. Hispanic farmers were also disproportionately farm laborers. In addition to racial and ethnic disparities, there were disparities by gender. About 63% of non-operating landowners, 86% of farm operators, and 87% of tenant farmers were male, and female farmers tended to generate less income per farmer than men. This data provides evidence of ongoing racial, ethnic and gender disparities in agriculture in the United States. We conclude with a call to address the structural drivers of the disparities and with recommendations for better data collection. (shrink)

Business Ethics: A European Review, EarlyView.

Bringing to light new facets in the philosophy of Emmanuel Levinas and William James, Megan Craig explores intersections between French phenomenology and American pragmatism.

ABSTRACT This article considers three kinds of relations: being-there-alongside, waiting, and staying, that come into focus at or after the end of life. The first relation is explored in light of Heidegger’s and Levinas’s contrasting accounts of responsibility, the second in terms of Bergson’s notion of hesitation, and the third in relation to Winnicott’s description of a “holding environment.” The work serves as a plea for spaces and practices that support more generous, open-ended, and nuanced relations among those who are (...) dying and those who attend to and survive them. (shrink)

To address climate change fairly, many conflicting claims over natural resources must be balanced against one another. This has long been obvious in the case of fossil fuels and greenhouse gas sinks including the atmosphere and forests; but it is ever more apparent that responses to climate change also threaten to spur new competition over land and extractive resources. This makes climate change an instance of a broader, more enduring and - for many - all too familiar problem: the problem (...) of human conflict over how the natural world should be cared for, protected, shared, used, and managed. -/- This work develops a new theory of global egalitarianism concerning natural resources, rejecting both permanent sovereignty and equal division, which is then used to examine the problem of climate change. It formulates principles of resource right designed to protect the ability of all human beings to satisfy their basic needs as members of self-determining political communities, where it is understood that the genuine exercise of collective self-determination is not possible from a position of significant disadvantage in global wealth and power relations. These principles are used to address the question of where to set the ceiling on future greenhouse gas emissions and how to share the resulting emissions budget, in the face of conflicting claims to fossil fuels, climate sinks, and land. It is also used to defend an unorthodox understanding of responsibility for climate change as a problem of global justice, based on its provenance in historical injustice concerning natural resources. (shrink)

For much of their history, the relationship between anthropology and psychology has been well captured by Robert Frost's poem, “Mending Wall,” which ends with the ironic line, “good fences make good neighbors.” The congenial fence was that anthropology studied what people think and psychology studied how people think. Recent research, however, shows that content and process cannot be neatly segregated, because cultural differences in what people think affect how people think. To achieve a deeper understanding of the relation between process (...) and content, research must integrate the methodological insights from both anthropology and psychology. We review previous research and describe new studies in the domain of folk biology which examine the cognitive consequences of different conceptualizations of nature and the place of humans within it. The focus is on cultural differences in framework theories among Native Americans and European American children and adults living in close proximity in rural Wisconsin. Our results show that epistemological orientations affect memory organization, ecological reasoning, and the perceived role of humans in nature. This research also demonstrates that cultural differences in framework theories have implications for understanding intergroup conflict over natural resources and are relevant to efforts to improve science learning, especially among Native American children. (shrink)

This book explores Rousseau's contribution to the Republican tradition in political thought. Through comparisons with various Republican lineages, it addresses problems that have defined and redefined Republicanism: attaining virtue, preserving liberty, sustaining the social order, orienting persons toward the common good, and having the law rule over men.

This Paper argues that to protect at-risk communities — and all Americans — from the deadly effects of environmental racism, Congress must pass the Environmental Justice for All Act. The Act is intended to “restore, reaffirm, and reconcile environmental justice and civil rights.” It does so by restoring an individual’s right to sue in federal court for discrimination based on race, ethnicity, or national origin regardless of intent under the Civil Rights Act of 1964, strengthening the National Environmental Policy Act, (...) and providing economic incentives focused on environmental justice. (shrink)

Drawing on Simone de Beauvoir’s account of “the serious world” and her considerations of childhood in The Ethics of Ambiguity and The Second Sex, this paper considers how the formal and social legislation of cis gender by adults forecloses the moral freedom of children. More specifically, Beauvoir’s account of becoming is read as a claim about how the serious world works. It is argued that her description of becoming in Volume II of The Second Sex shows us how gender is (...) fastened to and enforced in lived experience by adults in order to produce and maintain an unethical social order, namely the serious world of cis. Through this reading of Beauvoir, this article accounts for the moral injury of contemporary anti-trans legislation that targets children and advances preliminary remarks on gender freedom as necessary to moral freedom. (shrink)

BackgroundCommunity engagement within biomedical research is broadly defined as a collaborative relationship between a research team and a group of individuals targeted for research. A Community Advisory Board is one mechanism of engaging the community. Within genomics research CABs may be particularly relevant due to the potential implications of research findings drawn from individual participants on the larger communities they represent. Within such research, CABs seek to meet instrumental goals such as protecting research participants and their community from research-related risks, (...) as well as intrinsic goals such as promoting the respect of participants and their community. However, successful community engagement depends on the degree to which CABs legitimately represent and engage with communities targeted for research. Currently, there is little literature describing the use of CABs in genomics research taking place in developing countries, and even less in the field of genomics research relating to mental illness. The aim of this article is to describe and consider the contributions made by a researcher-driven, population-specific CAB in a genomics of schizophrenia research project taking place in South Africa, from the perspective of the research team.DiscussionFour broad discussion topics emerged during the CAB meetings namely: 1) informed consent procedures, 2) recruitment strategies, 3) patient illness beliefs and stigma experiences, and 4) specific ethical concerns relating to the project. The authors consider these discussions in terms of their contributions to instrumental and intrinsic goals of community engagement.SummaryThe CAB gave valuable input on the consent processes and materials, recruitment strategies and suggested ways of minimizing the potential for stigma and discrimination. All of these contributions were of an instrumental nature, and helped improve the way in which the research took place. In addition, and perhaps more importantly, the CAB made a unique and important contribution relating to intrinsic functions such as promoting the respect and dignity of research participants and their community. This was particularly evident in ensuring sensitivity and respect of the community’s traditional beliefs about schizophrenia and its treatment, and in this way promoting a respectful relationship between the research team and the participants. (shrink)

Reductionism is a central issue in the philosophy of biology. One common objection to reduction is that molecular explanation requires reference to higher-level properties, which I refer to as the context objection. I respond to this objection by arguing that a well-articulated notion of a mechanism and what I term mechanism extension enables one to accommodate the context-dependence of biological processes within a reductive explanation. The existence of emergent features in the context could be raised as an objection to the (...) possibility of reduction via this strategy. I argue that this objection can be overcome by showing that there is no tenable argument for the existence of emergent properties that are not susceptible to a reductive explanation. (shrink)

Moral distress has been characterised in the nursing literature as a major problem affecting nurses in all healthcare systems. It has been portrayed as threatening the integrity of nurses and ultimately the quality of patient care. However, nursing discourse on moral distress is not without controversy. The notion itself is conceptually flawed and suffers from both theoretical and practical difficulties. Nursing research investigating moral distress is also problematic on account of being methodologically weak and disparate. Moreover, the ultimate purpose and (...) significance of the research is unclear. In light of these considerations, it is contended that the notion of moral distress ought to be abandoned and that concerted attention be given to advancing inquiries that are more conducive to improving the quality and safety of moral decision-making, moral conduct and moral outcomes in nursing and healthcare domains. (shrink)

Public health nurses (PHN) have had a long history of working with new mothers in the community. Their practice includes collaboration, building therapeutic relationships, mutual goal setting, establishing trust, supporting clients’ strengths, empowerment and social justice. The wealth of information that new mothers receive both solicited and unsolicited may come from many different sources such as medicine, midwifery and those created personally by families. Although much of the information on mothering is presented with the intent of helping, it can also (...) be hegemonic and oppressive depending on different discourses, stereotypes and myths of mothering and therefore may cause confusion, guilt and uncertainty. Public health nurses often address conflicting social, cultural and personal discourses about mothering practices in order to support an empowering mothering experience. The term ‘social mediator’ was purposefully created in an attempt to describe the unique work of PHNs that this author has witnessed through her own research and practice as a PHN. This paper will present a discussion of the author's own work and research findings that will suggest how feminist poststructuralist theory may be used to guide and understand information exchange between PHNs and mothers as they mediate different social, cultural and personal discourses on mothering. (shrink)

In this target article by Morain and Largent (2023), the authors focus on an investigator’s duty to patient-subjects specifically regarding incidental or collateral findings within the context of e...

Here are two widely held positions on the ethics of dating: First, people are generally morally justified in excluding people they don’t find attractive from their dating pool. Second, people are not justified in maintaining a dating pool that is racially exclusive, even on grounds like attraction. In this paper, we demonstrate how these positions are consistent. To do so we differentiate our attitudes in dating and our dating behavior. Then we show how existing criticisms of racialized attitudes in dating (...) are incomplete as practical criticisms of our behavior. Finally, we give our account of the moral reasons whites have to change their dating preferences when they exclude people of color. In doing so, we supplement existing discussions of race-based discrimination in dating. (shrink)

In this essay Megan J. Laverty argues that Jean-Jacques Rousseau's conception of humane communication and his proposal for teaching it have implications for our understanding of the role of listening in education. She develops this argument through a close reading of Rousseau's most substantial work on education, Emile: Or, On Education. Laverty elucidates Rousseau's philosophy of communication, beginning with his taxonomy of the three voices—articulate, melodic, and accentuated—illustrating the ways in which they both enhance and obfuscate understanding. Next, Laverty (...) provides an account of Rousseau's philosophical psychology, with specific reference to amour-propre and amour de soi. Listening plays a central role in Rousseau's philosophy of communication, Laverty maintains, because it is in the act of listening that humans fulfill, or fail to fulfill, the imperative that we seek to understand others. (shrink)

Equity in health and health care is animportant issue. It has been proposed that thepursuit of equity in health care is beinghampered by the dominance of individualism inhealth care practices. This paper explores theway in which communitarian ideals and practicesmight lend themselves to the pursuit of equity.Communitarians acknowledge, respect and fosterthe bonds that unite and identify communities.The paper argues that, to achieve equity inhealth care, these bonds need to be recognisedand harnessed rather than ignored. The notionof individual autonomy in the (...) context of thecommunity is examined. Alternative concepts ofautonomy – social autonomy and communityautonomy – are seen to be more respectful andnurturing of both the individual and thecommunity. Moreover, these concepts appeardesirable for the pursuit of health care equitygoals. The paper concludes with some thoughtsabout how equity in Australia's health caresystem can reasonably progress within acommunitarian vision. Disadvantaged communitiesare discussed throughout, in particular,Australian Aboriginal communities. (shrink)

This paper considers whether states have a duty to accept those who cross borders to escape environmental disasters associated with climate change. It then examines how such a responsibility might be distributed, focusing on the predicament of the citizens of small island states expected to be inundated by rising sea levels. In assessing states' responsibility to admit these individuals, I draw on Walzer's theory of mutual aid, demonstrating that even under this narrow conception of states' obligations, a duty to accept (...) displaced islanders can be established. However, the proximity principle is ill-suited to determining which states should shoulder responsibility in this situation. Drawing on Miller's account of remedial responsibility and his ‘connection theory,’ I suggest that the obligation to accept ‘environmental refugees’ should be shouldered principally by affluent states that share significant degrees of causal and moral responsibility for climate change, and also have particularly strong capacities to assist the displaced. (shrink)

In this study we use dual process theory of self-regulation to develop a framework that outlines the mediating and moderating mechanisms explaining the relationship between leader emotional exhaustion and leadership style (transformational leadership and abusive supervision). Using Glomb et al.’s (2011) framework, we identify empathy and negative emotion as mediators that are of particular importance for leaders. In addition, we propose that leader mindfulness moderates these processes to improve leadership style. Using a time-lagged survey of leaders (N = 505) we (...) found that leader empathy and negative emotion mediated the relationships between emotional exhaustion and leadership style. Furthermore, we found that leader mindfulness significantly moderated the indirect effect of leader emotional exhaustion on leadership style through negative emotion. However, leader mindfulness did not moderate the relationship between emotional exhaustion and empathy. Theoretical and practical implications are discussed. (shrink)

I argue that propaganda does not characteristically interfere with individual rationality, but instead with group agency. Whereas it is often claimed that propaganda involves some sort of incitement to irrationality, I show that this is neither necessary nor sufficient for a case’s being one or propaganda. For instance, some propaganda constitutes evidence of the speaker’s power, or else of the risk and futility of opposing them, and there is nothing irrational about taking such evidence seriously. I outline an alternative account (...) of propaganda inspired by Hannah Arendt, on which propaganda characteristically creates or destroys group agency. One aspiring to control the public should have an interest in both creating and suppressing group agency, I argue, both because groups have capacities that individuals don’t, and because participation in group action can have a transformative effect upon the individual. Finally, I suggest that my characterization of propaganda suggests a vision of resistance to propaganda quite unlike the one that emerges from irrational-belief accounts, on which propaganda cannot be resisted by oneself. (shrink)

The topic of fake news has received increased attention from philosophers since the term became a favorite of politicians (Habgood-Coote 2016; Dentith 2016). Notably missing from the conversation, however, is a discussion of fake news and conspiracy theory media as a market. This paper will take as its starting point the account of noxious markets put forward by Debra Satz (2010), and will argue that there is a pro tanto moral reason to restrict the market for fake news. Specifically, we (...) begin with Satz’s argument that restricting a market may be required when i) that market inhibits citizens from being able to stand in an equal relationship with one another, and ii) this problem cannot be solved without such direct restrictions. Our own argument then proceeds in three parts: first, we argue that the market for fake news fits Satz’s description of a noxious market; second, we argue against explanations of the proliferation of fake news that are couched in terms of “epistemic vice”, and likewise argue against prescribing critical thinking education as a solution to the problem; finally, we conclude that, in the absence of other solutions to mitigate the noxious effects of the fake news market, we have a pro tanto moral reason to impose restrictions on this market. At the end of the paper, we consider one proposal to regulate the fake news market, which involves making social media outlets potentially liable in civil court for damages caused by the fake news hosted on their websites. (shrink)

Les études sur l’Obéissance à l’Autorité (OtA) de Milgram ont depuis longtemps été comprises comme démontrant que les gens ont une tendance à suivre aveuglément les ordres de l’autorité. Plus récemment, nous avons proposé un modèle d’obéissance basé sur le suivisme engagé (engaged followership), qui suggère que la décision d’une personne d’accepter les requêtes d’une figure d’autorité est basée sur son identification avec cette personne et/ou la cause qu’elle représente. Dans cet article, nous présentons nos raisons de soutenir cette perspective (...) et faisons le point sur les éléments empiriques dont nous disposons actuellement pour la soutenir. Nous indiquons également quelles questions restent posées, et posons ainsi les bases d’un programme pour des recherches futures. (shrink)

This article argues that Maurice Merleau-Ponty advances a queer notion of love. In particular, I argue that his notion of love as an institution, as a hollow fueled by the imaginary dimension of existence, shows that love unhinges petrified ideals of gender. I suggest that the crucial insight to be found in Merleau-Ponty's account of love is that love is a lived openness that invites us to seek out new ways of being.

According to many accounts, propaganda is a variety of politically significant signal with a distinctive connection to irrationality. This irrationality may be theoretical, or practical; it may be supposed that propaganda characteristically elicits this irrationality anew, or else that it exploits its prior existence. The view that encompasses such accounts we will call irrationalism. This essay presents two classes of propaganda that do not bear the sort of connection to irrationality posited by the irrationalist: hard propaganda and propaganda by the (...) deed. Faced with these counterexamples, some irrationalists will offer their account of propaganda as a refinement of the folk concept rather than as an attempt to capture all of its applications. The author argues that any refinement of the concept of propaganda must allow the concept to remain essentially political, and that the irrationalist refinement fails to meet this condition. (shrink)

As members of the fetal surgery advisory board at a large tertiary care center, we read with great interest Hendriks’ et al. target article proposing a new ethical framework for fetal therap...

This paper takes up the question of how videographic public announcements (VPAs)---i.e. videos that a wide swath of the public sees and knows that everyone else can see too--- have functioned to mobilize people politically, and how the presence of deepfakes in our information environment stands to change the dynamics of this mobilization. Existing work by Regina Rini, Don Fallis and others has focused on the ways that deepfakes might interrupt our acquisition of first-order knowledge through videos. But I point (...) out that even where every audience member takes a video to be veridical, where first-order knowledge acquisition is secure, an audience aware of deepfakes in their environment will not acquire higher order knowledge in the way that has erstwhile been characteristic for audiences of VPAs. Engaging with ideas from the literatures on public announcement logic, common knowledge, and convention, I enumerate a variety of ways in which we should expect this absence of higher order knowledge to throw up barriers to political mobilization. I go on to apply my analysis of VPAs to the mechanisms by which an uptick in publicly available videos of police brutality over the last decade, mediated by camera phones and social media, was responsible for the largest mass protests in US history in summer 2020. This makes vivid the stakes of the transformation in our mobilizing environment that I've claimed deepfakes effect: where we lose the common-knowledge-generating effects of VPAs, there are fresh obstacles to this sort of mass mobilization. (shrink)

Video‐recording healthcare interactions provides important opportunities for research and service improvement. However, this method brings about tensions, especially when recording sensitive topics. Subsequent reflection may compel the researcher to engage in ethical and moral deliberations. This paper presents experiences from a South African genetic counselling study which made use of video‐recordings to understand communicative processes in routine practice. Video‐recording as a research method, as well as contextual and process considerations are discussed, such as researching one's own field, issues of trust (...) and anonymity, the challenge of providing true informed consent and capturing details which may cause psychological harm. Several recommendations for research practice in diverse healthcare settings are made. This includes the value of reflective pieces, the importance of retrospective consent, disclosure of the limitations to anonymity, as well as the collective responsibility of those involved to produce ethical research. These recommendations have value for genetic counselling and other healthcare fields. (shrink)

Object-oriented ontology (OOO) is a philosophy that asks us to step outside the human-centric view of the world to recognize that objects have realities of their own. Although we cannot directly access a thing-in-itself, we can still come to know something about it through an indirect access that Graham Harman suggests is provided by aesthetics, specifically the metaphor. In the metaphor, we step into the place of the object-in-itself (that withdraws) and experience a taste of its reality. This main purpose (...) of this article is to show that the visual arts—specifically Haim Steinbach’s art works—offer a different way to know objects. Steinbach “arranges” found objects on shelves; this emphasis on “arrangement” raises questions about the nature of the space between objects. I argue that it is this space between objects (rather than the indirect contact with objects) that grants us some access to the thing-in-itself. By relating the spaces between objects to silence, I show that it is in these spaces that objects speak. In other words, the theatricality of the metaphor Harman privileges for understanding the object only exists in a silence that emerges from the spaces between objects. (shrink)

Children's overextensions of spatial language are often taken to reveal spatial biases. However, it is unclear whether extension patterns should be attributed to children's overly general spatial concepts or to a narrower notion of conceptual similarity allowing metaphor‐like extensions. We describe a previously unnoticed extension of spatial expressions and use a novel method to determine its origins. English‐ and Greek‐speaking 4‐ and 5‐year‐olds used containment expressions (e.g., Englishinto, Greekmesa) for events where an object moved into another object but extended such (...) expressions to events where the object moved behind or under another object. The pattern emerged in adult speakers of both languages and also in speakers of 10 additional languages. We conclude that learners do not have an overly general concept of Containment. Nevertheless, children (and adults) perceive similarities across Containment and other types of spatial scenes, even when these similarities are obscured by the conventional forms of the language. (shrink)