ABSTRACT In the present study, we examined how the perceived attainability and relatability of moral exemplars predicted moral elevation and pleasantness among both adult and college student participants. Data collected from two experiments were analyzed with Bayesian multilevel modeling to explore which factors significantly predicted outcome variables at the story level. The analysis results demonstrated that the main effect of perceived relatability and the interaction effect between attainability and relatability shall be included in the best prediction model, and thus, were (...) deemed to predict the outcome variables significantly. The main effect of relatability as well as its interaction with attainability positively predicted elevation and pleasantness. We discussed educational implications of the findings in terms of how relatability may be the first point of emphasis for moral educators to focus on and attainability can then bolster the effectiveness. These relatable and attainable moral exemplars can be sources for moral elevation and pleasantness, which promote motivation to emulate moral behavior presented by the exemplars. (shrink)

Emotion is closely associated with language, but we know very little about how children express emotion in their own writing. We used a large‐scale, cross‐sectional, and data‐driven approach to investigate emotional expression via writing in children of different ages, and whether it varies for boys and girls. We first used a lexicon‐based bag‐of‐words approach to identify emotional content in a large corpus of stories (N>100,000) written by 7‐ to 13‐year‐old children. Generalized Additive Models were then used to model changes in (...) sentiment across age and gender. Two other machine learning approaches (BERT and TextBlob) validated and extended these analyses, converging on the finding that positive sentiments in children's writing decrease with age. These findings echo reports from previous studies showing a decrease in mood and an increased use of negative emotion words with age. We also found that stories by girls contained more positive sentiments than stories by boys. Our study shows the utility of large‐scale data‐driven approaches to reveal the content and nature of children's writing. Future experimental work should build on these observations to understand the likely complex relationships between written language and emotion, and how these change over development. (shrink)

"A collection of essays on the early modern English writer, proto-feminist, and rhetorician Mary Astell. Includes discussions on human nature, equality, rationality, power, freedom, friendship, marriage, and education"--Provided by publisher.

In “Ethical Responsibilities for Companies that Process Personal Data” McCoy et al. (2023) proposed three substantive principles that should underlie corporations’ treatment of data: minimizing har...

Machine generated contents note: Preface; Introduction Angus Dawson; Part I. Concepts: 1. Resetting the parameters: public health as the foundation for public health ethics Angus Dawson; 2. Health, disease and the goal of public health Bengt Brülde; 3. Selective reproduction, eugenics and public health Stephen Wilkinson; 4. Risk and precaution Stephen John; Part II. Issues: 5. Smoking, health and ethics Richard Ashcroft; 6. Infectious disease control Marcel Verweij; 7. Population screening Ainsley Newson; 8. Vaccination ethics Angus Dawson; (...) 9. Environment, ethics and public health: the climate change dilemma Anthony Kessel and Carolyn Stephens; 10. Public health research ethics: is non-exploitation the new principle for population-based research ethics? John McMillan; 11. Equity and population health: toward a broader bioethics agenda Norman Daniels; 12. Health inequities James Wilson; Index. (shrink)

The main aim of this final essay is to draw on the insights gathered in the Debate “Do Referendums Enhance or Threaten Democracy” to inform future normative and empirical discussions about the design of popular vote processes. We first offer some clarifications regarding three of the concerns raised by respondents about our introductory essay. We then propose a systematic classification of the lines of variation along which the design of popular vote processes usually varies. More precisely, we highlight nine lines (...) of variation: trigger, origin of the text, legal basis, scope, trigger requirements, time, ballot, information, and decision rule. We conclude by emphasizing the relevance and necessity of debating the formal institutional design of popular vote processes. (shrink)

ABSTRACT In recent years there has been intense debate regarding the level of medical care provided to ‘standard care’ control groups in clinical trials in developing countries, particularly when the research sponsors come from wealthier countries. The debate revolves around the issue of how to define a standard of medical care in a country in which many people are not receiving the best methods of medical care available in other settings. In this paper, we argue that additional dimensions of the (...) standard of care have been hitherto neglected, namely, the structure and efficiency of the national health system. The health system affects locally available medical care in two important ways: first, the system may be structured to provide different levels of care at different sites with referral mechanisms to direct patients to the appropriate level of care. Second, inefficiencies in this system may influence what care is available in a particular locale. As a result of these two factors locally available care cannot be equated with a national ‘standard’. A reasonable approach is to define the national standard of care as the level of care that ought to be delivered under conditions of appropriate and efficient referral in a national system. This standard is the minimum level of care that ought to be provided to a control group. There may be additional moral arguments for higher levels of care in some circumstances. This health system analysis may be helpful to researchers and ethics committees in designing and reviewing research involving standard care control groups in developing country research. (shrink)

Biosemiotics to date has focused on the exchange of signals between organisms, in line with bioacoustics; consideration of the wider acoustic environment as a semiotic medium is under-developed. The nascent discipline of ecoacoustics, that investigates the role of environmental sound in ecological processes and dynamics, fills this gap. In this paper we introduce key ecoacoustic terminology and concepts in order to highlight the value of ecoacoustics as a discipline in which to conceptualise and study intra- and interspecies semiosis. We stress (...) the inherently subjective nature of all sensory scapes and propose that they should always bear an organismic attribution. Key terms to describe the sources and scales of soundscapes are described. We introduce epithets for soundscapes to point to the degree to which the global environment is implicated in semiosis ; terms for describing key ecological structures and processes and examples of ecoacoustic events are described. The acoustic eco-field is recognized as the semiotic model that enables soniferous species to intercept core resources like food, safety and roosting places. We note that whilst ecoacoustics to date has focused on the critical task of the development of metrics for application in conservation and biodiversity assessment, these can be enriched by advancing conceptual and theoretical foundations. Finally, the mutual value of integrating ecoacoustic and biosemiotics perspectives is considered. (shrink)

In a powerful and original contribution to the history of ideas, Hannah Dawson explores the intense preoccupation with language in early-modern philosophy, and presents a groundbreaking analysis of John Locke's critique of words. By examining a broad sweep of pedagogical and philosophical material from antiquity to the late seventeenth century, Dr Dawson explains why language caused anxiety in writers such as Montaigne, Bacon, Descartes, Hobbes, Gassendi, Nicole, Pufendorf, Boyle, Malebranche and Locke. Locke, Language and Early-Modern Philosophy demonstrates that (...) new developments in philosophy, in conjunction with weaknesses in linguistic theory, resulted in serious concerns about the capacity of words to refer to the world, the stability of meaning, and the duplicitous power of words themselves. Dr Dawson shows that language so fixated all manner of early-modern authors because it was seen as an obstacle to both knowledge and society. She thereby uncovers a novel story about the problem of language in philosophy, and in the process reshapes our understanding of early-modern epistemology, morality and politics. (shrink)

ABSTRACT In recent years there has been intense debate regarding the level of medical care provided to ‘standard care’ control groups in clinical trials in developing countries, particularly when the research sponsors come from wealthier countries. The debate revolves around the issue of how to define a standard of medical care in a country in which many people are not receiving the best methods of medical care available in other settings. In this paper, we argue that additional dimensions of the (...) standard of care have been hitherto neglected, namely, the structure and efficiency of the national health system. The health system affects locally available medical care in two important ways: first, the system may be structured to provide different levels of care at different sites with referral mechanisms to direct patients to the appropriate level of care. Second, inefficiencies in this system may influence what care is available in a particular locale. As a result of these two factors locally available care cannot be equated with a national ‘standard’. A reasonable approach is to define the national standard of care as the level of care that ought to be delivered under conditions of appropriate and efficient referral in a national system. This standard is the minimum level of care that ought to be provided to a control group. There may be additional moral arguments for higher levels of care in some circumstances. This health system analysis may be helpful to researchers and ethics committees in designing and reviewing research involving standard care control groups in developing country research. (shrink)

Narrative is increasingly being recognised as an important tool both to manage and understand organisations. In particular, narrative is recognised to have an important influence on the perception of environmental issues in business, a particularly contested area of modern management. Management literature is, however, only beginning to develop a framework for evaluating the quality and legitimacy of narratives. Due to the highly fluid nature of narratives, the traditional notion of truth as reflecting ' objective reality' is not useful here. In (...) this article, an alternative approach that evaluates a narrative in two stages is developed. First, a horizontal reading investigates the surface of the narrative, its textual features, instrumental devices and its integrity as a text, to assess the quality of a narrative. Second, a more philosophical or vertical reading makes explicit the underlying value assumptions that author and reader bring to the writing and reading of the narrative to assess the narrative's claim to legitimacy. The framework is then tested against a narrative on the relationship between business and environment as espoused by a supply chain manager of a UK-based manufacturing company. (shrink)

Background:Stigma is considered a major barrier to accessing healthcare services by female sex workers. Current knowledge of nurses’ attitudes appears to imply a stigma toward female sex workers. But in-depth understanding of their perceptions is scarce. Furthermore, factors that inform a conceptual understanding of how this occurs are lacking.Objectives:The study aimed to explore nurses’ attitudes toward female sex workers and factors affecting caring for female sex workers.Research design:This was a qualitative study. A content analysis approach was adopted in analyzing the (...) data.Participants and research context:Thirty-three practicing nurses participated in seven semi-structured focus group interviews and three key informants participated in three individual interviews in Hong Kong.Ethical considerations:This study was approved by the Ethics Committee of one university in Hong Kong.Findings:The findings revealed three themes: (1) accept, stigmatize, or against sex work; (2) reluctance, hesitation, or willingness to care for female sex workers; and (3) factors affecting the care of female sex workers.Discussion and conclusion:This study found that nurses held different attitudes toward female sex workers, and they experienced feelings of reluctance, hesitation, or willingness to care for female sex workers. Multi-level factors could affect their level of comfort of caring for female sex workers. Intervention should be developed to encourage health professionals to examine their personal views toward female sex workers introspectively, how their attitude may have affected the provision of quality services, and to enhance the provision of sensitive non-discriminative services to female sex workers. (shrink)

The Bubonic Plague outbreak that wormed its way through San Francisco’s Chinatown in 1900 tells a story of prejudice guiding health policy, resulting in enormous suffering for much of its Chinese population. This article seeks to discuss the potential for hidden “prejudice” should Artificial Intelligence (AI) gain a dominant foothold in healthcare systems. Using a toy model, this piece explores potential future outcomes, should AI continue to develop without bound. Where potential dangers may lurk will be discussed, so that the (...) full benefits AI has to offer can be reaped whilst avoiding the pitfalls. The model is produced using the computer programming language MATLAB and offers visual representations of potential outcomes. Interwoven with these potential outcomes are numerous historical models for problems caused by prejudice and recent issues in AI systems, from police prediction and facial recognition software to recruitment tools. Therefore, this research’s novel angle, of using historical precedents to model and discuss potential futures, offers a unique contribution. (shrink)

This second edition represents a wide-ranging critical introduction to the psychology of Carl Jung, one of the founders of psychoanalysis. Including two new essays and thorough revisions of most of the original chapters, it constitutes a radical assessment of his legacy. Andrew Samuels' introduction succinctly articulates the challenges facing the Jungian community. The fifteen essays set Jung in the context of his own time, outline the current practice and theory of Jungian psychology and show how Jungians continue to question and (...) evolve his thinking and apply it to aspects of modern culture and psychoanalysis. The volume includes a full chronology of Jung's life and work, extensively revised and up to date bibliographies, a case study and a glossary. It is an indispensable reference tool for both students and specialists, written by an international team of Jungian analysts and scholars from various disciplines. (shrink)

Das 20. Jahrhundert war durch eine radikale Rückbesinnung auf die Möglichkeiten und Grenzen von Sprache gekennzeichnet. Der neuzeitliche Traum einer restlosen Benennung des Weltganzen wird fraglich, wenn ihr Medium – die propositionale Aussagelogik – unter Verdacht gerät. -/- Der Band wirft die brisante Frage auf, ob der für das Jahrhundert prägende linguistic turn nicht so sehr in einer Hinwendung, als vielmehr in einer »Abwendung« vom Sagen besteht, die sich in der Entsagungsgeste von Melvilles Bartleby emblematisch verkörpert. Einzelanalysen zu literarischen Strategien (...) bei Mallarmé, Wittgenstein, Celan, Foucault, Adorno, Derrida, Lévinas u.a.m. führen vor, wie Unterlassen nicht nur ein kritisches, sondern auch stets ein schöpferisches Moment in sich birgt. (shrink)

Do democratic systems that include binding referendum and initiative processes violate a core principle of democracy, namely that legislators should be accountable? Some have argued that they do: these popular vote processes would grant the right to legislate to ordinary voters even though they cannot be held accountable—i.e., face possible consequences imposed by others for their actions and decisions. As a result, we should favor conventional representative systems over systems with popular vote processes. In this article, I analyze this ‘accountability (...) objection’ to referendums and initiatives and the conception of voters as ‘legislators’ on which it relies and argue that it does not withstand scrutiny. I first demonstrate that there is no sound basis to characterize only voters in popular votes, and not voters in elections, as ‘legislators’. Therefore, the scope of the objection is broader than anticipated by its proponents: it cannot be consistently used to dismiss popular votes without also being fatal to elections. I then argue that voters’ lack of accountability is not fatal to either mass voting process. The institutional role of ordinary voters provides them with co-lawmaking powers; but these are not the kind of special powers that justify holding certain actors accountable in democratic systems. This does not exclude that voters have responsibilities. I close by highlighting that, compared to conventional representative systems, democratic systems including well-designed popular vote processes could offer voters more supportive conditions to meet such possible responsibilities. (shrink)

PDP networks that use nonmonotonic activation functions often produce hidden unit regularities that permit the internal structure of these networks to be interpreted (Berkeley et al., 1995; McCaughan, 1997; Dawson, 1998). In particular, when the responses of hidden units to a set of patterns are graphed using jittered density plots, these plots organize themselves into a set of discrete stripes or bands. In some cases, each band is associated with a local interpretation. On the basis of these observations, Berkeley (...) (2000) has suggested that these bands are both subsymbolic and symbolic in nature, and has used the analysis of one network to support the claim that there are fewer differences between symbols and subsymbols than one might expect. We suggest below that this conclusion is premature. First, in many cases the local interpretation of each band is difficult to relate to the interpretation of a network's response; a more appropriate relationship only emerges when a band associated with one hidden unit is considered in the context of other bands associated with other hidden units (i.e., interpretations of distributed representations are more useful than interpretations of local representations). Second, the content that a band designates to an external observer (i.e., the interpretation assigned to a band by the researcher) can be quite different from the content that a band designates to the output units of the network itself.. We use two different network simulations – including the one described by Berkeley (2000) – to illustrate these points. We conclude that current evidence involving interpretations of nonmonotonic PDP networks actually illustrates the differences between symbolic and subsymbolic processing. (shrink)

Selon Derrida, 'Tout vrai questionnement est sommé par un certain type d'eschatologie' : la philosophie serait tirée de son sommeil dogmatique par une injonction eschatologique. Ainsi, alors que la notion d'eschatologie est originellement théologique et désigne la doctrine de la fin des temps, elle est convoquée par la philosophie contemporaine chez Heidegger, puis chez Levinas et Derrida, justement pour réfuter toute philosophie téléologique de l'histoire. Comment comprendre ce réinvestissement inattendu? Cet ouvrage propose d'abord une généalogie du motif eschatologique dans la (...) philosophie contemporaine, afin de comprendre comment l'eschatologie peut s'émanciper du domaine théologique et acquérir une spécificité philosophique. Ensuite, il s'attelle à décrire le motif eschatologique propre à Levinas et Derrida, qu'ils pensent en dialogue avec le messianisme et la phénoménologie. Enfin, il s'intéresse à l'opérativité spéculative de ce motif, qu'on appelle 'eschatologie du présent' : un schème qui exige d'interrompre le présent et la présence, pour construire une éthique de l'événement. L'eschatologie doit ainsi être pensée comme l'insomnie de la philosophie, 'l'appel à une infinie responsabilité de l'homme, à un inlassable éveil', selon la formule de Levinas. Elle devient l'injonction éthique, le nom de l'énigme de l'altérité - une altérité que je ne pourrai jamais comprendre au sein d'un horizon, mais qui m'assigne comme responsabilité et vigilance."--Page 4 of cover. (shrink)

ERRATUMWe regret that, due to a technical error, the uncorrected version of Angus Dawson's article was printed in 19:1. We apologise to the author and reprint in full the corrected version of the paper on the following pages. A. Dawson et al.. Bioethics 2005; 19: 72–89. ABSTRACTThere are many different ethical arguments that might be advanced for and against childhood vaccinations. In this paper I will explore one particular argument that focuses on the idea that childhood vaccinations are (...) justifiable because they are held to be in the best interests of a particular child. Two issues arise from this idea. The first issue is how best interests are to be determined in the case of childhood vaccinations. The second issue is what follows from this to justify potential interventions within the family in relation to such vaccinations. I argue that best interests must be characterised objectively in such situations and that this means that, in at least some cases, parental decision‐making about vaccinating their children may be overridden. (shrink)

Le concept de " care ", qui désigne tout à la fois une attitude morale - l'attention à l'autre, la sollicitude à son égard - et un ensemble de pratiques destinées à prendre soin des autres, a fait une entrée remarquée dans le débat public au printemps 2010. Tandis que certains y ont vu le pivot d'un projet de société alternatif, d'autres ont immédiatement répliqué que le care ne présentait aucun intérêt politique, voire constituait un concept écran masquant sous une (...) rhétorique en vogue un ensemble de problèmes politiques sérieux, tels que l'accroissement des inégalités ou la permanence des rapports de domination. Face à la polarisation du débat, comme aux malentendus concernant le care auxquels il a donné lieu, cet ouvrage collectif voudrait poser une double question : les théories du care sont-elles dotées d'une portée politique? Et si tel est le cas, en quoi consiste cette dernière? En réunissant les contributions de sociologues et de philosophes qui pensent les pratiques sociales par le biais du concept de care et des théories du care, cet ouvrage souhaite ainsi interroger ce que le care fait au politique et à nos manières de le concevoir, ou autrement dit, comment la prise en compte des activités de care et de l'éthique sociale qui leur est immanente peut faire surgir de nouvelles questions comme de nouvelles perspectives dans notre manière de définir ce que serait une société juste ou décente. (shrink)

Drawing on two long-term ethnographic fieldworks with social entrepreneurs, this article starts to uncover the multilayered nature of the motivations underlying the creation of social enterprises. We investigate the following research question: what types of self-oriented motivations might drive social entrepreneurs? Departing from previous research and popular opinion, which foregrounds the primacy of prosocial intentions, we show the critical role played by self-oriented motives. To explain this finding, we advance three analytical categories of self-oriented motives—entrepreneurial lifestyle, repurposing expertise, and solving (...) a social or environmental puzzle. We then illuminate these categories through the illustrative examples of six social entrepreneurs. Based on our findings, we contend that creating a social enterprise can also be the unintended consequence of adopting entrepreneurial behavior, leading to the creation of a venture guided by these three types of self-oriented motivations. Finally, we consider the implications of this study for the field of social entrepreneurship. (shrink)

ERRATUMWe regret that, due to a technical error, the uncorrected version of Angus Dawson's article was printed in 19:1. We apologise to the author and reprint in full the corrected version of the paper on the following pages. A. Dawson et al.. Bioethics 2005; 19: 72–89. ABSTRACTThere are many different ethical arguments that might be advanced for and against childhood vaccinations. In this paper I will explore one particular argument that focuses on the idea that childhood vaccinations are (...) justifiable because they are held to be in the best interests of a particular child. Two issues arise from this idea. The first issue is how best interests are to be determined in the case of childhood vaccinations. The second issue is what follows from this to justify potential interventions within the family in relation to such vaccinations. I argue that best interests must be characterised objectively in such situations and that this means that, in at least some cases, parental decision‐making about vaccinating their children may be overridden. (shrink)

This paper explores the alleged role of a conception of human nature for Kant’s justification of the duty to leave the state of nature and the related right to coerce others to enter the civil condition in the Doctrine of Right (1797). I criticise the interpretation put forward by Byrd and Hruschka, according to which Kant’s postulate of public right is a preventive measure based on a “presumption of badness” of human beings. Although this reading seems to be supported by (...) § 42 of the Doctrine of Right, I shall argue that the paragraph neither offers a justification of why we have a duty to leave the state of nature, nor explains why individuals are allowed to coerce others to do so. I offer an alternative interpretation of § 42 by focusing on the difference between formal and material violations of right and argue that the rationale behind the postulate of public right is the idea that remaining in the state of nature is a formal violation of the concept of right. It is therefore not prudential reason that authorizes us to coerce others to enter the lawful condition. (shrink)

The papers in this issue of Public Health Ethics arise from a workshop on the role of political philosophy in public health ethics, held at Manchester Metropolitan University in September 2008.1 Part of the reason for exploring the role of political philosophy in relation to public health (and public health ethics) is the thought that the political is ineliminably social: it is about how we live together. Exactly what public health is and what it ought to be is contested, but (...) it surely involves the two senses of public in the sense of the object of attention (i.e., societal or population health) and also the mode of delivery (i.e., collective or participatory action) (Verweij and Dawson, 2007). Political philosophy is concerned with actions in the public sphere related to both these elements. (shrink)

The World Health Organisation's programme for the eradication of poliomyelitis as currently practised in India raises many ethical issues. In this paper we concentrate on just two. The first is the balance to be struck between the risks and benefits generated by the eradication programme itself. The issue of risks and benefits arises in relation to the choice between two different vaccine types available for polio programmes: oral polio vaccine (OPV) and inactivated polio vaccine (IPV). OPV is the vaccine currently (...) used in the eradication campaign in India. We argue that given the current risks/benefits profile of this vaccine, there is an urgent need to review the programme and take remedial action to address existing problems (at least in India). The second issue we discuss is the fact that there is little effort to gain the informed consent of the parents of vaccinated children, as they are not currently told about the potential limitations of OPV or the possibility of vaccine-induced harm. We suggest that such a policy might be justifiable, given the importance of polio eradication, but only if there is a system of compensation for vaccine-induced harm as part of the eradication programme itself. There is a real danger that if these issues are not addressed then public trust in the eradication programme and vaccination programmes as a whole will be lost. (shrink)

"Has any individual ever shaped his own civilization more thoroughly than Confucius? Certainly no other world figure has ever been presented as more of an exemplar to his countrymen. Yet what we know about the man himself is vague and shadowy, and the sayings attributed to him may seem obscure to the Westerner. Raymond Dawson addresses these paradoxes. Taking as a model the Chinese tradition of commentary on classical texts--in this case the Analects, the oldest and most reliable Confucian (...) text--he finds a body of thought whose expression does seem to reflect the views and aspirations of a recognizable person. He shows how the separate components of the Master's thought cohere into a distinct social, ethical, and intellectual system. Dawson elucidates the contemporary applicability of the sayings as well as the strength of their influence throughout the two and a half millennia of their currency, even in a China that has formally rejected them."-- provided by publisher. (shrink)

The concept of continuing professional development (CPD) for teachers combines issues of training, recognition, and professional effectiveness. In this article, we examine the conditions and effects of the implementation of CPD policies at the international and national levels, before looking comparatively at concrete CPD training provision in two “academies” in France. We seek to identify certain conditions for the renewal of in-service teacher training engineering devices and, more broadly, to document major contemporary issues for the teaching profession: attractiveness, recognition, renewal, (...) mobility, and professional development. (shrink)

Anti-Academy examines the ideas, processes, workshops and legacies of three radical educational models in 1960s Japan, the USA and Denmark. Comprised of three sections, each relating to one of these school's programmes, Anti-Academy explores life at Bigakko, Tokyo, The Intermedia Programme at the University of Iowa, and Ex-School, Copenhagen. Anti-Academy is a comprehensive interpretation of how these three academies situated themselves on the peripheries of the art world, existing in opposition to the mainstream, and responding to the political and social (...) climate, location and cultural context of the day.Published alongside an exhibition of the same name, 21 November 2013 - 18 February 2014. (shrink)

Background Despite news reports of morally distressing situations resulting from complex and demanding community-care delivery in Canada, there has been little research on the topic of ethical conflicts experienced by community-based health care professionals. Research aim To identify ethical conflicts experienced by community nurses. Research design Data were collected using semi-structured interviews and then relevant text was extracted and condensed using qualitative content analysis. This research was part of a larger grounded theory project examining how community nurses manage ethical conflict. (...) Research context and participants Community nurses, including 13 public health nurses and 11 home care nurses from two Canadian provinces, were interviewed. Ethical considerations Study approval was granted by the Health Research Ethics Authority of Newfoundland and Labrador and by provincial health authorities. Findings Seven ethical conflicts were identified and assigned to one of two groups. In the grouping categorized as challenges with obligations or risks, the ethical conflicts were: (1) screening for child developmental issues knowing there is a lack of timely early intervention services; (2) encountering inequities in the health care system; (3) not fulfilling principles, goals, and initiatives of primary and secondary prevention; and (4) feeling powerless to advocate for clients. The remaining ethical conflicts were categorized as challenges with process, risks, and consequences, and were: (5) jeopardizing therapeutic relationships while reporting signs of a child at risk; (6) managing confidentiality when neighbors are clients; and (7) supporting client autonomy and decision-making but uncertain of the consequences. Conclusions Research investigation will continue to be important to raise awareness and mobilize ethics supports as health care services are steadily shifted from institutional to community settings. Moreover, with heightened potential for communicable disease outbreaks across international borders from global warming, community nurses around the world will continue to be required to address ethically-difficult care situations with competence and compassion. (shrink)