Moral distress is a phenomenon of increasing concern in nursing practice, education and research. Previous research has suggested that moral distress is associated with perceptions of ethical climate, which has implications for nursing practice and patient outcomes. In this study, a randomly selected sample of registered nurses was surveyed using Corley’s Moral Distress Scale and Olson’s Hospital Ethical Climate Survey (HECS). The registered nurses reported moderate levels of moral distress intensity. Moral distress intensity and frequency were found to be inversely (...) correlated with perceptions of ethical climate. Each of the HECS factors (peers, patients, managers, hospitals and physicians) was found to be significantly correlated with moral distress. Based on these findings, we highlight insights for practice and future research that are needed to enhance the development of strategies aimed at improving the ethical climate of nurses’ workplaces for the benefit of both nurses and patients. (shrink)

Moral distress in health care has been identified as a growing concern and a focus of research in nursing and health care for almost three decades. Researchers and theorists have argued that moral distress has both short and long-term consequences. Moral distress has implications for satisfaction, recruitment and retention of health care providers and implications for the delivery of safe and competent quality patient care. In over a decade of research on ethical practice, registered nurses and other health care practitioners (...) have repeatedly identified moral distress as a concern and called for action. However, research and action on moral distress has been constrained by lack of conceptual clarity and theoretical confusion as to the meaning and underpinnings of moral distress. To further examine these issues and foster action on moral distress, three members of the University of Victoria/University of British Columbia (UVIC/UVIC) nursing ethics research team initiated the development and delivery of a multi-faceted and interdisciplinary symposium on Moral Distress with international experts, researchers, and practitioners. The goal of the symposium was to develop an agenda for action on moral distress in health care. We sought to develop a plan of action that would encompass recommendations for education, practice, research and policy. The papers in this special issue of HEC Forum arose from that symposium. In this first paper, we provide an introduction to moral distress; make explicit some of the challenges associated with theoretical and conceptual constructions of moral distress; and discuss the barriers to the development of research, education, and policy that could, if addressed, foster action on moral distress in health care practice. The following three papers were written by key international experts on moral distress, who explore in-depth the issues in three arenas: education, practice, research. In the fifth and last paper in the series, we highlight key insights from the symposium and the papers in the series, propose to redefine moral distress, and outline directions for an agenda for action on moral distress in health care. (shrink)

In this book it is argued that this picture of Feyerabend is false.

It is extraordinary, when one thinks about it, how little attention has been paid by theorists of the nature and justification of punishment to the idea that punishment is essentially a matter of self-defense. H. L. A. Hart, for example, in his famous “Prolegomenon to the Principles of Punishment,” is clearly committed to the view that, at bottom, there are just three directions in which a plausible theory of punishment can go: we can try to justify punishment on purely consequentialist (...) grounds, which for Hart, I think, would be to try to construct a purely utilitarian justification of punishment; we can try to justify punishment on purely retributive grounds; or we can try to justify punishment on grounds that are some sort of shrewd combination of consequentialist and retributive considerations. Entirely absent from Hart's discussion is any consideration of the possibility that punishment might be neither a matter of maximizing the good, nor of exacting retribution for a wrongful act, nor of some imaginative combination of these things, but, rather, of something altogether different from either of them: namely, the exercise of a fundamental right of self-protection. Similarly, but much more recently, R. A. Duff, despite the fact that he himself introduces and defends an extremely interesting fourth possibility, begins his discussion by writing as though, apart from his contribution, there are available to us essentially just the options previously sketched by Hart. Again, there is no mention here, any more than in Hart's or any number of other recent discussions, of the possibility that we might be able to justify the institution of punishment on grounds that are indeed forward-looking, to use Hart's famous term, but that are not at all consequentialist in any ordinary sense of the word. (shrink)

Stakeholder theory provides a framework for investigating the relationship between corporate social performance (CSP) and corporate financial performance. This relationship is investigated by examining how change in CSP is related to change in financial accounting measures. The findings provide some support for a tenet in stakeholder theory which asserts that the dominant stakeholder group, shareholders, financially benefit when management meets the demands of multiple stakeholders. Specifically, change in CSP was positively associated with growth in sales for the current and subsequent (...) year. This indicates that there are short-term benefits from improving CSP. Return on sales was significantly positively related to change in CSP for the third financial period, indicating that long-term financial benefits may exist when CSP is improved. (shrink)

‘What it is like’ talk (‘WIL-talk’) — the use of phrases such as ‘what it is like’ — is ubiquitous in discussions of phenomenal consciousness. It is used to define, make claims about, and to offer arguments concerning consciousness. But what this talk means is unclear, as is how it means what it does: how, by putting these words in this order, we communicate something about consciousness. Without a good account of WIL-talk, we cannot be sure this talk sheds light, (...) rather than casts shadows, on our investigations of consciousness. The popular technical account of WIL-talk (see e.g. Lewis, 1995, and Kim, 1998) holds that WIL-talk involves technical terms — terms which look like everyday words but have a distinct meaning — introduced by philosophers. I argue that this account is incorrect by showing that the alleged technical terms were not introduced by philosophers, and that these terms do not have a technical meaning. (shrink)

"Clare O'Farrell is to be congratulated on producing a truly magnificent book on the work of Michel Foucault. There are details, insights and observations that will engage the specialist and there is an extensive documentation of Foucault's output. If there is a more comprehensive book on Foucault's work I have yet to see it. I anticipate those teaching and taking courses on Foucault's work will find Clare O'Farrell's book to be an invaluable resource'" - Barry Smart, University of (...) Portsmouth "Dr. Clare O'Farrell has written a marvelous introduction to this Foucault for that ever growing number of readers who are working in what has come to be designated as cultural studies. This volume captures the penetrating interdisciplinary concerns that have made Foucault a guide to so many beyond the frontiers of philosophy and history, beyond the borders of the academic community itself. O'Farrell is an excellent guide to Foucault's exploration of culture, highlighting, as she does, the characteristic insights of his learning: the instability of cultural forms of order, the subversive potential of historical analyses, the variety of true discourses within history, and his commitment to social justice. O'Farrell reveals Foucault as he is: the engaged moralist who survived the twentieth century's systems of total explanation. This is an excellent introduction for the general reader to a passionate mind that continues to spread its influence'" - James Bernauer, Boston College Michel Foucault's work is one of the most influential sources of ideas in the humanities and social sciences today. Clare O'Farrell offers a comprehensive and accessible introduction to Foucault's enormous, diverse and challenging output. Her book provides a range of practical tools and a reference work for readers who wish to understand and apply his ideas at both introductory and advanced levels. This volume includes: - a discussion of Foucault's situation in the contemporary context exploring his role as an iconic thinker, with clear explanations as to why his work is so difficult to come to grips with, and also importantly, why it is of interest to so many people. - the location of Foucault's work within its own historical, social and political setting. - brief summaries in chronological order of all of Foucault's major works, including the more recently published volumes of lectures. - the organization of Foucault's work around five distinct but interrelated series of assumptions which underpin his world view: namely order, history, truth, power and ethics. Ideas for which he is well-known, such as archaeology, genealogy, discourse, discipline, governmentality, the subject and others are defined and discussed within the framework of these five assumptions. - a chronology of Foucault's life, work and times. - a very extensive list of key concepts in Foucault's work with detailed references pointing to where the relevant material can be found in his writings. - a wide-ranging list of resources and a bibliography of Foucault's work for easy consultation. (shrink)

Summary With regard to the dynamics of human experience and behavior, Gestalt theoretical psychotherapy relies mainly on Kurt Lewin’s dynamic field theory of personality. GTP is carried out by including a re-interpretation of Lewin’s theory in some aspects of psychotherapeutic practice in relation to critical realism. Human experience and behavior are understood to be functions of the person and the environment in a psychic field, which encompasses both of these mutually dependent factors. The anthropological model of this approach is, therefore, (...) not mono-personal but, a priori, structural and relational in nature. It does not one-sidedly focus on the “inner components” of a person, but on the interrelation of the individual and a given environment, which affects experience and behavior. After a brief introduction of these basic concepts, this lecture will focus especially on Lewin’s concept of tension-systems, which may be considered as the Gestalt theoretical counterpart of Freud’s drive theory. Further, we define the basic assumptions which underlie GTP and explain how the person moves through her/his life experience in terms of Gestalt psychology. (shrink)

Approaches to business ethics can be roughly divided into two streams: ‹codes of behavior’ and ‹forms of subjectification’, with code-oriented approaches clearly dominating the field. Through an elaboration of poststructuralist approaches to moral philosophy, this paper questions the emphasis on codes of behaviour and, thus, the conceptions of the moral and responsible subject that are inherent in rule-based approaches. As a consequence of this critique, the concept of a practice-based ‹ethics of responsiveness’ in which ethics is never final but rather (...) always ‹to come’, is investigated. In such an approach the ethical self is understood as being continuously constituted within power/knowledge relations. Following this line, we ask how one can become a responsible subject while also acknowledging certain limits of full responsibility. We thereby explore responsibility as a considered but unconditional openness in response to the other. (shrink)

Mr. B. A. Farrell has argued that psychoanalysis is refutable, without clarifying different senses of 'refutable'. Once this clarification is done and the relevant literature examined, however, it is seen that psychoanalysis is not refutable in several important senses of 'refutable', although it is refutable in a sense that is quite uninteresting.

I shall attempt something rash in this paper. I shall draw your attention to some past and current work on perception by psychologists and others. I shall concentrate on work in vision and hearing. This outline will occupy the first part of my lecture. I shall then go on, in the second part, to suggest that this scientific work has certain philosophical implications. This whole attempt is a bit rash for obvious reasons. It is not easy to outline fairly and (...) accurately past and current work in any branch of science. I am very liable, therefore, to do an injustice to the efforts of psychologists and others in this field. What makes matters more difficult for me is that I also have to show that this work is of philosophical interest. What has led me to embark on this perilous enterprise is a hunch I have developed in recent years. I have the hunch that philosophers who are interested in perception would do well to pay rather more attention than they have been wont to do in the past to the work and discourse coming out of the scientific laboratory and similar places. (shrink)

Behind the third ventricle of the human brain a miniscule pedunculate bud, close to the optic thalamus, that is, to the two beds of optic nerves, a gland soft in substance yet containing gritty particles. Function: unknown. Because of its pine-cone shape it is called the conarium or pineal body , even though the recent photographs of it by Nilsson and Lindberg show it to be morphologically reminiscent of nothing so much as the plucked tail of a gamebird, which Simon (...) Dedalus refers to as ‘the pope's nose’. Today it is presumed to be an endocrine gland of some sort, even though there is no doubt that morphogenetically in all vertebrates it is a vestigial unpaired eye. As fossil evidence indicates—and we still find it almost fully developed in some extant amphibians—ancestral vertebrates possessed in addition to the paired bilateral eyes a solitary dorsal eye opening at the top of the skull to the sky. This singular evagination of the brain—something betwixt a visual organ and a gland—seems to hold a special fascination for philosophers. Here we shall consider two of them: René Descartes , the father, as we say, of modern philosophy; and Georges Bataille , the father, as many say, of post-modern philosophy. Three hundred years separate them. Devotion to the pineal body conjoins them. (shrink)

Family members do not have an official position in the practice of euthanasia and physician assisted suicide in the Netherlands according to statutory regulations and related guidelines. However, recent empirical findings on the influence of family members on EAS decision-making raise practical and ethical questions. Therefore, the aim of this review is to explore how family members are involved in the Dutch practice of EAS according to empirical research, and to map out themes that could serve as a starting point (...) for further empirical and ethical inquiry. A systematic mixed studies review was performed. The databases Pubmed, Embase, PsycInfo, and Emcare were searched to identify empirical studies describing any aspect of the involvement of family members before, during and after EAS in the Netherlands from 1980 till 2018. Thematic analysis was chosen as method to synthesize the quantitative and qualitative studies. Sixty-six studies were identified. Only 14 studies had family members themselves as study participants. Four themes emerged from the thematic analysis. 1) Family-related reasons to request EAS. 2) Roles and responsibilities of family members during EAS decision-making and performance. 3) Families’ experiences and grief after EAS. 4) Family and ‘the good euthanasia death’ according to Dutch physicians. Family members seem to be active participants in EAS decision-making, which goes hand in hand with ambivalent feelings and experiences. Considerations about family members and the social context appear to be very important for patients and physicians when they request or grant a request for EAS. Although further empirical research is needed to assess the depth and generalizability of the results, this review provides a new perspective on EAS decision-making and challenges the Dutch ethical-legal framework of EAS. Euthanasia decision-making is typically framed in the patient-physician dyad, while a patient-physician-family triad seems more appropriate to describe what happens in clinical practice. This perspective raises questions about the interpretation of autonomy, the origins of suffering underlying requests for EAS, and the responsibilities of physicians during EAS decision-making. (shrink)

Does feminism give a much-needed voice to women in a patriarchal world? Or is the world not really patriarchal? Has feminism begun to level the playing field in a world in which women are more often paid less at work and abused at home? Or are women paid equally for the same work and not abused more at home? Does feminism support equality in education and in the military, or does it discriminate against men by ignoring such issues as male-only (...) draft registration and boys lagging behind in school? The only book of its kind, this volume offers a sharp, lively, and provocative debate on the impact of feminism on men. Warren Farrell--an international best-selling author and leader in both the early women's and current men's movements--praises feminism for opening options for women but criticizes it for demonizing men, distorting data, and undervaluing the family. In response, James P. Sterba--an acclaimed philosopher and ardent advocate of feminism--maintains that the feminist movement gives a long-neglected voice to women in a male-dominated world and that men are not an oppressed gender in today's America. Their wide-ranging debate covers personal issues, from love, sex, dating, and rape to domestic violence, divorce, and child custody. Farrell and Sterba also look through their contrasting lenses at systemic issues, from the school system to the criminal justice system; from the media to the military; and from health care to the workplace. A perfect book to get students thinking and debating, Does Feminism Discriminate Against Men? A Debate is ideal for courses in gender studies, sociology, psychology, economics, feminist philosophy, and contemporary moral issues. It is also compelling reading for anyone interested in the future of men and women. (shrink)

" Façonner le monde atome par atome " : tel est l'objectif incroyablement ambitieux affiché par les promoteurs américains de la " National Nanoinitiative ", lancée en 1999. Un projet global de " convergence des sciences ", visant à " initier une nouvelle Renaissance, incorporant une conception holiste de la technologie fondée sur [..] une analyse causale du monde physique, unifiée depuis l'échelle nano jusqu'à l'échelle planétaire. " Ce projet démiurgique est aujourd'hui au coeur de ce qu'on appelle la " (...) technoscience ", étendard pour certains, repoussoir pour d'autres. En précisant dans ce livre la signification de ce concept, pour sortir enfin du sempiternel conflit entre technophiles et technophobes, son auteur propose d'abord une sorte d'archéologie du terme " technoscience ". Loin d'être un simple renversement de hiérarchie entre science et technique, il s'agit d'un changement de régime de la connaissance scientifique, ayant désormais intégré la logique entrepreneuriale du monde des affaires et mobilisant des moyens considérables. Surtout, Bernadette Bensaude-Vincent montre que le brouillage de la frontière entre science et technique n'est que la manifestation d'un tremblement plus général, marqué par l'effacement progressif des distinctions traditionnelles : nature/artifice, inerte/vivant, matière/esprit, homme/machine, etc. Alors que nos sociétés sont silencieusement reconfigurées par les nanotechnologies, Internet, le génie génétique ou les OGM, ce livre montre l'importance de faire enfin pleinement entrer les questions de choix technologiques et scientifiques dans la sphère du politique et dans l'arène publique. Car la technoscience est un processus historique qui engage la nature en la refaçonnant et qui implique la société dans son ensemble. (shrink)

In many countries grappling with the politics of equal recognition, the experiences, beliefs and reasons for action of people who identify as non-binary are starting to be seen as valid and intelligible.1 And, despite some gender clinics still responding cautiously to requests for non-standard medical interventions, their treatment needs are now recognised in major clinical guidelines. This is the current social context in which Notini and colleagues outline the case of ‘Phoenix’, an 18-year-old birth-assigned woman, who has requested the indefinite (...) continuation of puberty suppression, a treatment that was initiated when the client was 11 years old to mitigate their intense distress at the onset of puberty. Drawing on a conception of health as overall well-being, the authors conclude that OPS is ‘consistent with the proper goals of medicine’, and that there are ‘equity-based reasons’ for offering OPS to adults as a group. They concede that the physical risks are greater for OPS than for hormonal interventions generally provided to people with a binary gender identity. They also acknowledge the need for ‘a fine-grained ethical evaluation of Phoenix’s particular situation’ to assess whether the potential benefits of OPS outweigh the potential harms for this individual. Here I respectfully raise three points to amplify the authors’ discussion. First, there seem to be significant ethical issues of a general, not a particular, kind arising from the type of individual evaluation they call for. Following initial screening for significant mental distress and other major vulnerabilities, the key undertaking …. (shrink)

Sobre el libro: Isaiah Berlin ha sido, además de un original e intuitivo historiador de las ideas y autor de numerosos conceptos teórico-políticos, un reconocido teorizador de la libertad y defensor acérrimo del pluralismo. Rasgos que lo han convertido en un innegable referente intelectual en nuestra época. Sobre el editor: El Editor de la presente obra, Pablo Badillo O'Farrell, con motivo del centenario del nacimiento de Berlin, ha reunido un número de contribuciones de estudiosos italianos y españoles que ofrecen, (...) desde muy diferentes perspectivas, un amplio abanico de miradas diversas sobre la obra y el pensamiento del autor, que van desde el análisis y confrontación del pluralismo valorativo y la ética de la libertad, al de la interculturalidad o la identidad personal y el nacionalismo, pasando por la confrontación de historicismo, historia de las ideas y contra-corriente. (shrink)

This book should be read by everyone who wants to understand special education today. New Perspectives in Special Educationopens the door to the fascinating and vitally important world of theory that informs contemporary special education. It examines theoretical and philosophical orientations such as ‘positivism’, ‘poststructuralism’ and ‘hermeneutics’, relating these to contemporary global views of special education. Offering a refreshingly balanced view across a broad range of debates, this topical text guides the reader through the main theoretical and philosophical positions that (...) may be held with regard to special education, and critically examines positions that often go unrecognised and unquestioned by practitioners and academics alike. It helps the reader to engage with and question the positions taken by themselves and others, by providing thinking points and suggestions for further reading at the end of each chapter. Perspectives covered include: Positivism and empiricism Phenomenology and hermeneutics Historical materialism and critical theory Holism and constructivism Structuralism and post structuralism Pragmatism and symbolic interactionism Psychoanalysis Postmodernism and historical epistemology Anyone wishing to gain a fuller understanding of special education should not be without this stimulating and much needed text. (shrink)

"Daimon Life is life-enchancing. To read it is to become richer in word." –John Llewelyn Disclosure of Martin Heidegger’s complicity with the National Socialist regime in 1933-34 has provoked virulent debate about the relationship between his politics and his philosophy. Did Heidegger’s philosophy exhibit a kind of organicism readily transformed into ideological "blood and soil"? Or, rather, did his support of the Nazis betray a fundamental lack of loyalty to living things? David Farrell Krell traces Heidegger’s political authoritarianism to (...) his failure to develop a constructive "life-philosophy"—his phobic reactions to other forms of being. Krell details Heidegger’s opposition to Lebensphilosophie as expressed in Being and Time, in an important but little-known lecture course on theoretical biology given in 1929–30 called "The Basic Concepts of Metaphysics," and in a recently published key text, Contributions to Philosophy, written in 1936–38. Although Heidegger’s attempt to think through the problems of life, sexual reproduction, behavior, environment, and the ecosystem ultimately failed, Krell contends that his methods of thinking nonetheless pose important tasks for our own thought. Drawing on and away from Heidegger, Krell expands on the topics of life, death, sexuality, and spirit as these are treated by Freud, Nietzsche, Derrida, and Irigaray. Daimon Life addresses issues central to contemporary philosophies of politics, gender, ecology, and theoretical biology. (shrink)

Synthetic biologists are extremely concerned with responsible research and innovation. This paper critically assesses their culture of responsibility. Their notion of responsibility has been so far focused on the identification of risks, and in their prudential attitude synthetic biologists consider that the major risks can be prevented with technological solutions. Therefore they are globally opposed to public interference or political regulations and tend to self-regulate by bringing a few social scientists or ethicists on board. This article emphasizes that ethics lies (...) beyond prudence and requires a cultural evaluation of the modes of existence of the various microorganisms designed by synthetic biologists, independently of their potential applications. (shrink)

The current empirical research and normative arguments on physician-assisted dying in the Netherlands seem insufficient to provide ethical guidance to general practitioners in the practice of PAD, due to a gap between the evidence and arguments on the one hand and the uncertainties and complexities as found in everyday practice on the other. This paper addresses the problems of current ethical arguments and empirical research and how both seem to be profoundly influenced by the Dutch legislative framework on PAD and (...) a certain view on ethics. Furthermore, the paper elaborates on how other approaches to empirical research in bioethics, such as found in the broad field of narrative research, could supplement the empirical and ethical evaluation of PAD in the Netherlands. This paper also addresses the challenging question of how empirical data—in this case narratives—relate to normativity. The paper is written in the form of a personal narrative of the author, a young Dutch general practitioner and researcher in bioethics. This style is intentionally chosen, to illustrate how work context and professional background influence the observations one makes and the questions one may ask about the topic of PAD. In addition, by using this style, this paper not only gives a different perspective on a much-contested bioethical issue, but also on the challenges faced when a physician–bioethicist has to navigate different disciplinary fields and epistemological paradigms, especially since the ‘empirical turn’ in bioethics. (shrink)