The nurse's moral competences in the management of situations which present ethical implications are less investigated in literature than other ethical problems related to clinical nursing. Phenomenology affirms that emotional warmth is the first fundamental attitude as well as the premise of any ethical reasoning. Nevertheless, it is not clear how and when this could be confirmed in situations where the effect of emotions on the nurse's decisional process is undiscovered. To explore the processes through which situations of moral distress (...) are determined for the nurses involved in nursing situations, a phenomenological–hermeneutic analysis of a nurse's report of an experience lived by her as a moral distress situation has been conducted. Nursing emerges as a relational doctrine that requires the nurse to have different degrees of personal involvement, the integration between logical–formal thinking and narrative thinking, the perception of the salience of the given situation also through the interpretation and management of one's own emotions, and the capacity to undergo a process of co‐construction of shared meanings that the others might consider adequate for the resolution of her problem. Moral action requires the nurse to think constantly about the important things that are happening in a nursing situation. Commitment towards practical situations is directed to training in order to promote the nurse's reflective ability towards finding salience in nursing situations, but it is also directed to the management of nursing assistance and human resources for the initial impact that this reflexive ability has on patients' and their families' lives and on their need to be heard and assisted. The only case analysed does not allow generalizations. Further research is needed to investigate how feelings generated by emotional acceptance influence ethical decision making and moral distress in nursing situations. (shrink)

Pandemic infection by COVID‐19 could be changing the public image of the nursing profession in Italy. Recently, as in any western country, we were being registered with an increase in the number of violence against healthcare professionals. Nevertheless, due to pandemic in the social media, the nursing profession is remembered for competence, determination, courage, and humanity, and it is continually remercied by people, politicians, and journalists. In this paper, we will conduct a phenomenological argument that proposes both phenomena can be (...) explained by Paul Ricoeur's courses of recognition. In cases of violence, patients and their family members reacting because they feel betrayed for a real or alleged injustice—primarily not to be listened to by health professionals. Nurses and other professionals are often unable to take the right grade of involvement for understanding patient's needs. On the other hand, during COVID‐19 pandemic, patients and family members perceive the extraordinary daily work of caring, and they react thanking. The principle of the gift is implicated in both cases: the crisis of gift received or donated can be explaining violence; gratitude and thanks can be explaining by gratuitousness of care. (shrink)

Are there, in addition to the various actual objects that make up the world, various possible objects? Are there merely possible people, for example, or merely possible electrons, or even merely possible kinds? We certainly talk as if there were such things. Given a particular sperm and egg, I may wonder whether that particular child which would result from their union would have blue eyes. But if the sperm and egg are never in fact brought together, then there is no (...) actual object that my thought is about.1 Or again, in the semantics for modal logic we presuppose an ontology of possibilia twice over.2 For first, we countenance various possible worlds, in addition to the actual world; and second, each of these worlds is taken to be endowed with its own domain of objects. These will be the actual objects of the world in question, but they need not be actual simpliciter, i.e., actual objects of our world. What are we to make of such discourse? There are four options: (i) the discourse is taken to be unintelligible; (ii) it is taken to be intelligible but nonfactual, i.e. as not in the business of stating facts; (iii) it is taken to be factual but reducible to discourse involving no reference to possibilia; (iv) it is taken to be both factual and irreducible.3 These options range from a fullblooded form of actualism at one extreme to a full-blooded form of possibilism at the other. The two intermediate positions are possibilist in that they accept the intelligibility of possibilist discourse but actualist in that they attempt to dispense with its prima facie commitment to possibilia. All four positions have found advocates in the literature. Quine, in his less irenic moments, favors option (i); Forbes ([85], p. 94) advocates option (ii), at least for certain parts of possibilist discourse; many philosophers, including Adams [74] and myself, opt for (iii); while Lewis [86] and Stalnaker [75] have endorsed versions of (iv), that differ in how full-blooded they take the possible objects to be. My focus in the present article is on the third option.. (shrink)

In this article we focus on female genital mutilation. We analyse this problem as one of the most important issues of multiculturalism, which is also coming to the attention of the public in Italy as a consequence of the growing number of immigrants from African countries. The fundamental problem is about the acceptability of this practice: can female genital mutilation be permitted and, if so, on what basis? We will try to cope with this as a genuine conflict between culture-relative (...) values and universal values, such as human rights. Some attention will be drawn to Italian law. Finally, the impact on nurses of requests for genital mutilation will be described. (shrink)

We reflect upon the meaning of freedom and autonomy in nursing behaviour, attempting to outline the contemporary situation of nursing in Italy, where the profession is achieving important results after a long period of submission and subordination. The way to real emancipation is not easy, but a statement of law on the one hand - abolishing constraints such as the Mansionario - and professional self-regulation on the other - the recent new Deontological Code - represent a real conquest in that (...) direction. However, no statement of law or deontology can be sufficient without deeper reflection by the profession on itself and its tasks, potentiality, social importance and self-esteem. (shrink)

In this paper, we discuss the largely neglected topic of semantics in medicine and the associated ethical issues. We analyse several key medical terms from the informed perspective of the healthcare professional, the lay perspective of the patient and the patient’s family, and the descriptive perspective of what the term actually signifies objectively. The choice of a particular medical term may deliver different meanings when viewed from these differing perspectives. Consequently, several ethical issues may arise. Technical terms that are not (...) commonly understood by lay people may be used by physicians, consciously or not, and may obscure the understanding of the situation by lay people. The choice of particular medical terms may be accidental use of jargon, an attempt to ease the communication of psychologically difficult information, or an attempt to justify a preferred course of action and/or to manipulate the decision-making process. (shrink)

Ethical challenges are traditionally described in a negative light, even though moral conflict can express the individual ability to perceive when something is not working and promote change. The true question, therefore, is not to how to silence moral conflict but how to educate it. Although the need for ethical support of health- and social-care professionals in elderly care is clearly perceived, there is no universal method for providing effective interventions. The authors hypothesize that adequate training sessions can help care (...) professionals enhance this skill, once clear goals and specific educational techniques are set. This research tests the hypothesis on twenty care professionals working in acute and residential care settings for the elderly, building on the ethics round method. Mixed methods drawn from literature and the experience of educators were adapted to meet different educational goals. Moral issues can hardly be removed from a context characterized by increasing demand and decreasing resources, but they can be recognized and addressed with common efforts, a critical attitude, and a growth mindset. Enhancing these skills in qualified workers can help them accept the reality of work, release pressure, and identify common team goals. Introducing these skills before graduation can help future workers avoid unreal expectations and reduce frustration and early job quit rates. (shrink)

Few conditions have sparked as much controversy as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Professional consensus has long suggested that the condition should be classified as psychiatric, while patients and advocacy groups have insisted it is a serious biological disease that requires medical care and research to develop it. This longstanding debate shifted in 2015, when U.S. governmental health authorities fully embraced medical classification and management. Given that some globally respected health authorities now insist that ME/CFS is a serious biological disease, (...) this paper asks whether it can be ethical for the U.K. practice guideline now in development to characterize the condition as a mental health disorder. Following a brief history of ME/CFS controversy, I offer three arguments to show that it would be unethical for the U.K. to now characterize ME/CFS as a mental health condition, considering the relevance of that conclusion for ME/CFS guidelines elsewhere and for other contested conditions. (shrink)

Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) is a highly contested illness. This paper analyzes the discursive production of knowledge about, and recognition of ME/CFS. By mobilizing insights from social epistemology and epistemic injustice studies, this paper reveals how actors, through their social-discursive practices, attribute to establishing, sustaining, and disregarding their own and others’ epistemological position. In focusing on the case of the Dutch newspaper reporting about ME/CFS, this paper shows that the debate about this condition predominantly revolves around the ways (...) in which people who make truth claims are represented. In being portrayed as gendered, affectatious, formerly very able, fanatical, or benevolent, people with ME/CFS are constructed as non-/credible. In the debate about what causes ME/CFS, by contrast, the production of non-/credible knowledge focuses more on the content of epistemic positions. Actors in this debate argue that they know the (clear) causes for the illness, something which functions as a discursive strategy to establish and enhance their credibility. This paper contends, however, that since this discursive demarcation of causes is consistently infused with uncertainty – with multi-interpretability, with diffuse explanations, and absence of current knowledge – the credibility of these actors’ epistemic position is undercut rather than established. (shrink)

En este artículo se realiza una aproximación a Miguel Mañara, ejemplar figura del hombre barroco del siglo XVII. Aunque su personalidad se ha visto manipulada a partir de la época romántica con su vinculación a don Juan Tenorio, todo es ajeno a la verdad. De familia noble, caballero de Calatrava, tras enviudar joven, sufre un proceso de conversión que le hace seguir el ejemplo de Jesucristo en la Hermandad de la Santa Caridad cuya regla principal de conducta era el enterrar (...) a los muertos sin familia y en la que realizó una abnegada labor con la fundación de un hospital para socorrer a los enfermos sin sustento. Escritor brillante ante la idea de la muerte con su Discurso de la Verdad, dirigió́ los postulados artísticos de la iglesia del hospital donde destaca la escena de su retablo mayor en la que se efigia, con suma belleza, la escena del Entierro de Cristo debida a la gubia de Pedro Roldán. (shrink)