Aims:The aim of this narrative synthesis was to explore the necessary and sufficient conditions required to define moral distress.Background:Moral distress is said to occur when one has made a moral judgement but is unable to act upon it. However, problems with this narrow conception have led to multiple redefinitions in the empirical and conceptual literature. As a consequence, much of the research exploring moral distress has lacked conceptual clarity, complicating attempts to study the phenomenon.Design:Systematic literature review and narrative synthesis (November (...) 2015–March 2016).Data sources:Ovid MEDLINE®In-Process & Other Non-Indexed Citations 1946–Present, PsycINFO®1967–Present, CINAHL®Plus 1937–Present, EMBASE 1974–24 February 2016, British Nursing Index 1994–Present, Social Care Online, Social Policy and Practice Database (1890–Present), ERIC (EBSCO) 1966–Present and Education Abstracts.Review methods:Literature relating to moral distress was systematically retrieved and subjected to relevance assessment. Narrative synthesis was the overarching framework that guided quality assessment, data analysis and synthesis.Results:In all, 152 papers underwent initial data extraction and 34 were chosen for inclusion in the narrative synthesis based on both quality and relevance. Analysis revealed different proposed conditions for the occurrence of moral distress: moral judgement, psychological and physical effects, moral dilemmas, moral uncertainty, external and internal constraints and threats to moral integrity.Conclusion:We suggest the combination of (1) the experience of a moral event, (2) the experience of ‘psychological distress’ and (3) a direct causal relation between (1) and (2) together are necessary and sufficient conditions for moral distress. (shrink)

La première note est consacrée à un bloc interprété par F. Courby comme un élément du dallage ayant porté le tombeau de Dionysos. Mais ce bloc constituait à l’origine un socle isolé ; ce n’est que dans une seconde phase qu’il a été associé à d’autres blocs pour former un plateau sur lequel on a implanté un pressoir. La seconde note se fonde sur de nouveaux relevés des canalisations aménagées dans les substructions Sud du temple des Alcméonides, destinées à réunir (...) deux sources. Celle de l’Ouest existait depuis longtemps ; son débouché était situé au pied du mur de terrasse qui avait porté le temple préalcméonide et qui constitue le premier aménagement monumental du sanctuaire. L’hypothèse d’un détournement de la fontaine Cassotis à l’intérieur du temple est rejetée. La troisième note est consacrée aux fragments d’une sima en marbre provenant d’une toiture inachevée ; l’existence de deux modules amène à postuler à l’existence d’un bâtiment à deux ailes, probablement contemporain du temple du ive s. et peut-être à confondre avec le «monument en calcaire gris ». (shrink)

Here I consider the two most venerated arguments about the existence of God: the Ontological Argument and the Argument from Evil. The Ontological Argument purports to show that God’s nature guarantees that God exists. The Argument from Evil purports to show that God’s nature, combined with some plausible facts about the way the world is, guarantees (or is very compelling grounds for thinking) that God does not exist. Obviously, both arguments cannot be sound. But I argue here that they are (...) both unsound for the very same reason. (shrink)

There are many alleged problems with trusting another person’s moral testimony, perhaps the most prominent of which is that it fails to deliver moral understanding. Without moral understanding, one cannot do the right thing for the right reason, and so acting on trusted moral testimony lacks moral worth. This chapter, however, argues that moral advice differs from moral testimony, differs from it in a way that enables a defender of moral advice to parry this worry about moral worth. The basic (...) idea is that an advisor and an advisee can together constitute a joint agent, and that this joint agent’s action can indeed have moral worth. So while the advisee himself might not do the right thing for the right reason (this because all alone he lacks the right reason), and while the advisor herself might not do the right thing for the right reason (this because all alone she does not do the right thing), they together do the right for the right reason. (shrink)

This paper argues that the classification of propositional attitudes into the de re, de dicto, and de se is incomplete. De se attitudes are widely agreed to be closely connected to de re attitudes. But there is a species of belief that is linked to agent-centered action in the way that de se beliefs are, but is also associated with entities, places, and especially times, under a description. These mark out a fourth kind. One way to think about what makes (...) them distinctive is that, despite being ‘essentially indexical’ they can be retained across different contexts of evaluation without having diagonal content. The paper also discusses the connection between such beliefs and the kinds of utterances (like ‘Don't put off for tomorrow what you can do today’) that are contested as examples of what David Kaplan called ‘monsters.’. (shrink)

This Element introduces the philosophical literature on models, with an emphasis on normative considerations relevant to models for decision-making. Chapter 1 gives an overview of core questions in the philosophy of modeling. Chapter 2 examines the concept of model adequacy for purpose, using three examples of models from the atmospheric sciences to describe how this sort of adequacy is determined in practice. Chapter 3 explores the significance of using models that are not adequate for purpose, including the purpose of informing (...) public decisions. Chapter 4 provides a basic framework for values in modelling, using a case study to highlight the ethical challenges in building models for decision making. It concludes by establishing the need for strategies to manage value judgments in modelling, including the potential for public participation in the process. (shrink)

This paper argues that under some conditions, when one person acts on the direction of another person, the two of them thereby act together, and that this explains why both the director and the directee can be responsible for what is done. In other words, a director and a directee can be a joint agent, one whose members are responsible for what they together do. This is most clearly so when the directive is a command. But it is also sometimes (...) so when the directive is a bit of advice. (shrink)

Autant d'études classiques qui accompagnent les grands ouvrages d'Eric Weil, Logique de la philosophie, Philosophie morale, Philosophie politique.

We review and present a new meta‐analysis of research suggesting that ethicists in the United States appear to behave no morally better overall than do non‐ethicist professors. Measures include: returning library books, peer evaluation of overall moral behavior, voting participation, courteous and discourteous behavior at conferences, replying to student emails, paying conference registration fees and disciplinary society dues, staying in touch with one's mother, charitable giving, organ and blood donation, vegetarianism, and honesty in responding to survey questions. One multi‐measure study (...) found ethicists tending to embrace more stringent moral views, especially about meat eating and charitable donation. The same multi‐measure study found ethicists and other professors to show similarly small‐to‐medium correlations between their expressed normative attitudes and their self‐reported or directly measured behavior. (shrink)

According to the analysis of concessive conditionals suggested by Crupi and Iacona, a concessive conditional $$p{{\,\mathrm{\hookrightarrow }\,}}q$$ p ↪ q is adequately formalized as a conjunction of conditionals. This paper presents a sound and complete axiomatic system for concessive conditionals so understood. The soundness and completeness proofs that will be provided rely on a method that has been employed by Raidl, Iacona, and Crupi to prove the soundness and completeness of an analogous system for evidential conditionals.

This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics research entails drawing boundaries around what research counts as empirical bioethics research, and we discuss whether the standards agreed in the consensus process draw these boundaries correctly. Second, we expand on the discussion in the original paper of the role and significance of the concept of (...) ‘integrating’ empirical methods and ethical argument as a standard for research practice within empirical bioethics. (shrink)

O autor, na multiplicidade de seus aspectos, detém-se em considerações sobre o Estado, mas não se limita à perspectiva dos escritos tradicionais de Teoria Geral. Recolhe momentos de sua configuração histórica, de partes relevantes de sua fisionomia jurídica e, de modo particular, emite reflexões filosóficas sobre a morfologia estrutural e o sentido ético dessa entidade. O enfoque, porém, dista de ser mero tangenciar o assunto, porquanto insere, a cada passo, proposições que exprimem sua opinião pessoal e a ideologia de quem (...) anuncia mas, sobretudo, realiza com coerência e determinação, uma pauta de condutas orientada por valores definidos e estáveis. (shrink)

In 1970 a coalition of student activists opposing the Vietnam War circulated documents revealing the involvement of several prominent social scientists in U.S. counterinsurgency activities in Thailand--activities that could cause harm to the people who were the subject of the scholars' research. The disclosure of these materials, which detailed meetings with the Agency for International Development and the Defense Department, prompted two members of the Ethics Committee of the American Anthropological Association to issue an unauthorized rebuke of the accused. Over (...) the next two years, the AAA agonized over the allegations and the appropriate response to them. Within an academic community already polarized by the war, political and professional acrimony reached unprecedented levels. Although the association ultimately passed a code of ethics, the key issues raised in the process were never fully resolved. Now back in print, Eric Wakin's Anthropology Goes to War is the first comprehensive study of what became known as the Thailand Controversy--and a timely reminder of a debate whose echoes may be heard in our own time. (shrink)

In this article we distinguish between philosophical bioethics (PB), descriptive policy orientated bioethics (DPOB) and normative policy oriented bioethics (NPOB). We argue that finding an appropriate methodology for combining empirical data and moral theory depends on what the aims of the research endeavour are, and that, for the most part, this combination is only required for NPOB. After briefly discussing the debate around the is/ought problem, and suggesting that both sides of this debate are misunderstanding one another (i.e. one side (...) treats it as a conceptual problem, whilst the other treats it as an empirical claim), we outline and defend a methodological approach to NPOB based on work we have carried out on a project exploring the normative foundations of paternal rights and responsibilities. We suggest that given the prominent role already played by moral intuition in moral theory, one appropriate way to integrate empirical data and philosophical bioethics is to utilize empirically gathered lay intuition as the foundation for ethical reasoning in NPOB. The method we propose involves a modification of a long-established tradition on non-intervention in qualitative data gathering, combined with a form of reflective equilibrium where the demands of theory and data are given equal weight and a pragmatic compromise reached. (shrink)

In recent years there has been a wealth of literature arguing the need for empirical and interdisciplinary approaches to bioethics, based on the premise that an empirically informed ethical analysis is more grounded, contextually sensitive and therefore more relevant to clinical practice than an ‘abstract’ philosophical analysis. Bioethics has (arguably) always been an interdisciplinary field, and the rise of ‘empirical’ (bio)ethics need not be seen as an attempt to give a new name to the longstanding practice of interdisciplinary collaboration, but (...) can perhaps best be understood as a substantive attempt to engage with the nature of that interdisciplinarity and to articulate the relationship between the many different disciplines (some of them empirical) that contribute to the field. It can also be described as an endeavour to explain how different disciplinary approaches can be integrated to effectively answer normative questions in bioethics, and fundamental to that endeavour is the need to think about how a robust methodology can be articulated that successfully marries apparently divergent epistemological and metaethical perspectives with method. This paper proposes ‘Reflexive Bioethics’ (RB) as a methodology for interdisciplinary and empirical bioethics, which utilizes a method of ‘Reflexive Balancing’ (RBL). RBL has been developed in response to criticisms of various forms of reflective equilibrium, and is built upon a pragmatic characterization of Bioethics and a ‘quasi-moral foundationalism’, which allows RBL to avoid some of the difficulties associated with RE and yet retain the flexible egalitarianism that makes it intuitively appealing to many. (shrink)

Ernesto Laclau and Chantal Mouffe have attempted to save the concept of ?hegemony? from its economistic and essentialist Marxist roots by incorporating the linguistic influences of post?structuralist theory. Their major Marxist detractors criticise their trajectory as a ?descent into discourse? ? a decay from well?grounded, material reality into the idealistic and problematic realm of language and discourse. Both sides of the debate seem to agree on one thing: the line from Marxism to post?Marxism is the line from the economy to (...) language, from ?reality? to discourse. This article focuses on Gramsci?s writings on language to argue against both sides of this debate. It illustrates how language is central to Gramsci?s historical materialism and that he does not oppose it to materiality. It argues that Gramsci adopted the very term hegemony substantially from his university studies in linguistics ? the debates from which Ferdinand de Saussure also developed structuralism. For Gramsci, such linguistic issues were directly related to the ?questione della lingua? and Italian unification. Moreover, language lies at the centre of Gramsci?s understanding of the relationship between coercion and consent. This not only troubles Laclau & Mouffe?s reading of Gramsci, but it illuminates a more productive conception of hegemony that can address recent debates around post?structuralism and the use of ?hegemony? to analyse globalisation and an increasingly technological and electronic world. (shrink)

Austerity, by its very nature, imposes constraints by limiting the options for action available to us because certain courses of action are too costly or insufficiently cost effective. In the context of healthcare, the constraints imposed by austerity come in various forms; ranging from the availability of certain treatments being reduced or withdrawn completely, to reductions in staffing that mean healthcare professionals must ration the time they make available to each patient. As austerity has taken hold, across the United Kingdom (...) and Europe, it is important to consider the wider effects of the constraints that it imposes in healthcare. Within this paper, we focus specifically on one theorised effect—moral distress. We differentiate between avoidable and unavoidable ethical challenges within healthcare and argue that austerity creates additional avoidable ethical problems that exacerbate clinicians’ moral distress. We suggest that moral resilience is a suitable response to clinician moral distress caused by unavoidable ethical challenges but additional responses are required to address those that are created due to austerity. We encourage clinicians to engage in critical resilience and activism to address problems created by austerity and we highlight the responsibility of institutions to support healthcare professionals in such challenging times. (shrink)

Are philosophical arguments as effective as narratives in influencing charitable giving and attitudes toward it? In four experiments, we exposed online research participants to either philosophical arguments in favor of charitable giving, a narrative about a child whose life was improved by charitable donations, both the narrative and the argument, or a control text (a passage from a middle school physics text or a description of charitable organizations). Participants then expressed their attitudes toward charitable giving and were either asked how (...) much they would hypothetically donate if given $10 (Experiment 1) or told they had a 10% chance of winning $10 and given the opportunity to donate from their potential winnings (Experiments 2–4). Across the four experiments, participants in all of the narrative conditions and in some of the argument conditions tended to express more positive attitudes toward charitable giving and donated about $1 more on average than did participants in the control conditions. These effects appear to have been mediated by the “narrative transportation” scale, which suggests that appeals to donate can be effective if they engage participants’ emotions, imagery, and interest. (shrink)

First Published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

ABSTRACT In this paper we set forth what we believe to be a relatively controversial argument, claiming that ‘bioethics’ needs to undergo a fundamental change in the way it is practised. This change, we argue, requires philosophical bioethicists to adopt reflexive practices when applying their analyses in public forums, acknowledging openly that bioethics is an embedded socio‐cultural practice, shaped by the ever‐changing intuitions of individual philosophers, which cannot be viewed as a detached intellectual endeavour. This said, we argue that in (...) order to manage the personal, social and cultural embeddedness of bioethics, philosophical bioethicists should openly acknowledge how their practices are constructed and should, in their writing, explicitly deal with issues of bias and conflict of interest, just as empirical scientists are required to do. (shrink)

This is a book about Kant's views on causality as understood in their proper historical context. Specifically, Eric Watkins argues that a grasp of Leibnizian and anti-Leibnizian thought in eighteenth-century Germany helps one to see how the critical Kant argued for causal principles that have both metaphysical and epistemological elements. On this reading Kant's model of causality does not consist of events, but rather of substances endowed with causal powers that are exercised according to their natures and circumstances. This (...) innovative conception of Kant's view of causality casts a light on Kant's philosophical beliefs in general, such as his account of temporality, his explanation of the reconciliation of freedom and determinism, and his response to the skeptical arguments of Hume. (shrink)

" Ce général expérimenté nous parle avec une grande sagesse des qualités humaines et de la conscience nécessaires pour combattre l'ennemi et diriger les hommes. Ses pages m'ont surpris par leur limpidité et leur profondeur. Nous sommes bien loin de l'armée archaïque que j'ai connue dans ma jeunesse ", père Guy Gilbert. Ce livre s'adresse au jeune étudiant qui réfléchit à devenir officier. Aucun ouvrage, récent en tout cas, n 'avait encore pris ces jeunes et leurs parents pour cible, afin (...) de tenter de leur parler, avec des mots du début du 21e siècle, de la guerre et du terrorisme, mais aussi de morale et d'amitié, de courage et de volonté. Et d 'amour et de vertus, et de principes. Et de discipline et de sacrifice et de générosité, qu'il a en quantité à condition qu'on lui explique comment il va en faire le meilleur usage. Ses propos intéresseront aussi tous ceux qui, même en dehors des corps armés, s 'interrogent sur l'énigme de l'homme face à la violence. (shrink)

Justice, Sustainability, and Security not only enhances our knowledge of these issues, but it teases out our moral dimensions and offer prescriptions for how governments and global actors might craft their policies to better consider their effects on the global human condition.

Fyodor Dostoyevsky expressed a strange and surprising sentiment through one of the characters of The Brothers Karamazov. A dying young man named Markel declares: Every one of us has sinned against all men, and I more than others." He later says: "...every one of us is answerable for everyone else and for everything." Markel's absurd claims have engendered many reflections on the nature of suffering and what it means to be responsible for someone else's suffering. The world has no shortage (...) of pain and evil; what exactly is the relationship between suffering and responsibility? Markel's declarations press forward a question that drives this essay collection: how responsible should we consider ourselves for the suffering of the world? This volume is a collection of essays that struggle in various ways to understand and respond to several philosophical, theological and practical problems. In each case the authors grapple with issues surrounding suffering, immorality, evil, exploitation and oppression. The contributors share a clear concern for the ways that philosophers and theologians should respond to the problems of suffering and evil. They also share a conviction that these remain intense and central problems for philosophy and theology. Evil is an obstacle for belief, for morality, for hospitality, and for hope. This book struggles to address the particular and strong sense of responsibility that falls on Christians when it comes to understanding and, more importantly, responding to the problems of suffering and evil in the world. (shrink)

A full understanding of emotion necessitates the bridging of disciplinary perspectives and methodological approaches. This special section uses emotional development as a foil to illustrate how suc...

Even though Kant’s theory of cognition (Erkenntnis) is central to his Critique of Pure Reason, it has rarely been asked what exactly Kant means by the term “cognition”. Against the widespread assumption that cognition (in the most relevant sense of that term) can be identified with knowledge or if not, that knowledge is at least a species of cognition, we argue that the concepts of cognition and knowledge in Kant are not only distinct, but even disjunct. To show this, we (...) first (I) investigate Kant’s explicit characterizations of the nature of cognition. As it turns out, he introduces several different notions that must be carefully distinguished before identifying the one that is central to his project in the first Critique. We then (II) consider the basic features of Kant’s conception of knowledge, indicating both how it involves assent and objective justification and how it relates to our contemporary conception. Next (III), we compare and contrast Kant’s understanding of cognition and his conception of knowledge in a way that allows us to present their fundamental differences and connections. We argue that while cognition, in the most relevant sense, is a species of representation that differs from other representations in that it involves the conceptual determination of a sensibly given object, knowledge (for Kant) is a kind of assent to a judgment that requires consciousness of a sufficient epistemic ground. Finally (IV), by appreciating the differences between cognition and knowledge, we explain several of the implications this conception of cognition has for some of Kant’s main claims in the Critique of Pure Reason as a whole. Among other things, we show how Kant can deny cognition of specific things in themselves while allowing philosophical knowledge about things in themselves in general (e.g. that they exist, are not in space and time, etc.). (shrink)

Over the last decade, patient and public involvement (PPI) has become a requisite in applied health research. Some funding bodies demand explicit evidence of PPI, while others have made a commitment to developing PPI in the projects they fund. Despite being commonplace, there remains a dearth of engagement with the ethical and theoretical underpinnings of PPI processes and practices. More specifically, while there is a small (but growing) body of literature examining the effectiveness and impact of PPI, there has been (...) relatively little reflection on whether the concept/practice of PPI is internally coherent. Here, the authors unpick a ‘paradox’ within PPI, which highlights a tension between its moral and pragmatic motivations and its implementation. The authors argue that this ‘professionalisation paradox’ means we need to rethink the practice, and purpose, of PPI in research. (shrink)

Artificially intelligent systems (AISs) are being created by software developing companies (SDCs) to influence clinical decision‐making. Historically, clinicians have led healthcare decision‐making, and the introduction of AISs makes SDCs novel actors in the clinical decision‐making space. Although these AISs are intended to influence a clinician's decision‐making, SDCs have been clear that clinicians are in fact the final decision‐makers in clinical care, and that AISs can only inform their decisions. As such, the default position is that clinicians should hold responsibility for (...) the outcomes of the use of AISs. This is not the case when an AIS has influenced a clinician's judgement and their subsequent decision. In this paper, we argue that this is an imbalanced and unjust position, and that careful thought needs to go into how personal moral responsibility for the use of AISs in clinical decision‐making should be attributed. This paper employs and examines the difference between prospective and retrospective responsibility and considers foreseeability as key in determining how personal moral responsibility can be justly attributed. This leads us to the view that moral responsibility for the outcomes of using AISs in healthcare ought to be shared by the clinical users and SDCs. (shrink)

This is the first complete, one-volume English translation of the ancient Chinese text Xunzi, one of the most extensive, sophisticated, and elegant works in the tradition of Confucian thought. Through essays, poetry, dialogues, and anecdotes, the Xunzi articulates a Confucian perspective on ethics, politics, warfare, language, psychology, human nature, ritual, and music, among other topics. Aimed at general readers and students of Chinese thought, Eric Hutton's translation makes the full text of this important work more accessible in English than (...) ever before. Named for its purported author, the Xunzi has long been neglected compared to works such as the Analects of Confucius and the Mencius. Yet interest in the Xunzi has grown in recent decades, and the text presents a much more systematic vision of the Confucian ideal than the fragmented sayings of Confucius and Mencius. In one famous, explicit contrast to them, the Xunzi argues that human nature is bad. However, it also allows that people can become good through rituals and institutions established by earlier sages. Indeed, the main purpose of the Xunzi is to urge people to become as good as possible, both for their own sakes and for the sake of peace and order in the world. In this edition, key terms are consistently translated to aid understanding and line numbers are provided for easy reference. Other features include a concise introduction, a timeline of early Chinese history, a list of important names and terms, cross-references, brief explanatory notes, a bibliography, and an index. (shrink)

In this paper we set forth what we believe to be a relatively controversial argument, claiming that 'bioethics' needs to undergo a fundamental change in the way it is practised. This change, we argue, requires philosophical bioethicists to adopt reflexive practices when applying their analyses in public forums, acknowledging openly that bioethics is an embedded socio-cultural practice, shaped by the ever-changing intuitions of individual philosophers, which cannot be viewed as a detached intellectual endeavour. This said, we argue that in order (...) to manage the personal, social and cultural embeddedness of bioethics, philosophical bioethicists should openly acknowledge how their practices are constructed and should, in their writing, explicitly deal with issues of bias and conflict of interest, just as empirical scientists are required to do. (shrink)

In our seventh and final piece on the theme “Good without God”, Jonathan Ives argues that reliance on God as an external source of moral authority leads to a kind of moral cowardice.

Volume 20, Issue 4, May 2020, Page 80-82.