Research on moral distress has paid limited attention to nurses’ responses and actions. In a survey of nurses’ perceptions of moral distress and ethical climate, 292 nurses answered three open-ended questions about situations that they considered morally distressing. Participants identified a range of situations as morally distressing, including witnessing unnecessary suffering, being forced to provide care that compromised values, and negative judgments about patients. They linked these situations to contextual constraints such as workload and described responses, including feeling incompetent and (...) distancing themselves from patients. Participants described considerable effort to effect change, calling into question the utility of defining moral distress as an “inability to act due to institutional constraints” or a “failure to pursue a right course of action.” Various understandings of moral distress operated, and action was integral to their responses. The findings suggest further conceptual work on moral distress and effort to support system-level change. (shrink)
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)
Although ethical leadership by formal nurse leaders is critical to enhancing ethical health-care practice, research has shown that many nurses feel unsupported by their leaders. In this article, we consider the limited attention directed toward ethical leadership of formal nurse leaders and how our own research on ethical nurse leadership compares to other research in this field. In searching Nursing Ethics since its inception 20 years ago, we found only a dozen articles that directly addressed this topic. We then reviewed (...) nurses’ professional codes of ethics in Canada and found significant retractions of ethical guidelines for formal nurse leaders’ ethical responsibilities over the past decade. We began to seek explanations of why this is so and offer some recommendations for the study and enhancement of ethics for formal nurse leadership. (shrink)
Robert Solomon has usefully set forth the outlines of an ontology of ethics for the employee. I seize upon three of the insights in his paper-specifically, relating to employee role, social nature, and virtue-and develop them along Aristotelean lines, showing along the way how classic "dilemmas" of the business ethics literature can be recast as problems of employee character and virtue.
The eight pieces constituting this Meeting Report are summaries of presentations made during a panel session at the 2011 Association for Practical and Professional Ethics (APPE) annual meeting held between March 3rd and 6th in Cincinnati. Lisa Newton organized the session and served as chair. The panel of eight consisted both of pioneers in the field and more recent arrivals. It covered a range of topics from how the field has developed to where it should be going, from identification of (...) issues needing further study to problems of training the next generation of engineers and engineering-ethics scholars. (shrink)
There is increasing emphasis on the need for collaboration between practice and academic leaders in health care research. However, many problems can arise owing to differences between academic and clinical goals and timelines. In order for research to move forward it is important to name and address these issues early in a project. In this article we use an example of a participatory action research study of ethical practice in nursing to highlight some of the issues that are not frequently (...) discussed and we identify the impact of things not-named. Further, we offer our insights to others who wish to be partners in research between academic and practice settings. These findings have wide implications for ameliorating misunderstandings that may develop between nurse leaders in light of collaborative research, as well as for participatory action research. (shrink)
Accountability is viewed as a civilizing element in society, with professional accountability formalized in most cases as duties dating to the Greeks and Socrates; journalists must find their own way, without formal professional or government regulation or licensing. Three scholars look at the process in a line from the formal professional discipline to suggesting problems the journalism fraternity faces without regulation to suggesting serious internal ethics conferences as 1 solution to the problem.
Except for a small clutch of academic shark-defenders, everyone seems to know that hostile takeovers are wrong, destructive of people and industries, and damaging to the long-term competitiveness of corporate America. But analysis of the takeover process, absent insider trading, fails to identify any injury that is not replicated elsewhere in the business system. Current suggestions for remedying the situation seem inadequate, ill-fitted to the problem, or hostile to the entire capitalist system. Could it be that it is that system (...) as a whole, or the assumptions underlying it, that is at fault? (shrink)
In all the criticisms that have shadowed the financial industry in recent years, the burden seems to be, that the reckless (as opposed to malicious) bankers too often took money of which they were the appointed stewards, and used it for speculation, especially in junk bonds. AsShaheen Borna and James Lowry argue in their "Gambling and Speculation" (the only article on gambling that I was able to raise on my computer) business speculation is probably wrong, since it is very like (...) gambling, which everyone knows is wrong. But why is gambling wrong? Ifwe, as the ethicists of business, are to adopt an uncharacteristically judgmental posture toward the most venerable American institutions, occupying the tallest and closest of American buildings, by calling their residents "gambIers," then surely we ought to be able to provide an account of the blameworthiness of gambling itself. That, at any rate, is the challenge I set myself for this paper. (shrink)
In all the criticisms that have shadowed the financial industry in recent years, the burden seems to be, that the reckless bankers too often took money of which they were the appointed stewards, and used it for speculation, especially in junk bonds. AsShaheen Borna and James Lowry argue in their "Gambling and Speculation" business speculation is probably wrong, since it is very like gambling, which everyone knows is wrong. But why is gambling wrong? Ifwe, as the ethicists of business, are (...) to adopt an uncharacteristically judgmental posture toward the most venerable American institutions, occupying the tallest and closest of American buildings, by calling their residents "gambIers," then surely we ought to be able to provide an account of the blameworthiness of gambling itself. That, at any rate, is the challenge I set myself for this paper. (shrink)
Is good morality the natural outcome of profitable business practices? The thesis explored here is one version of the recent literature on corporate culture, typified by the bestselling In Search of Excellence — that the corporation that creates a strong culture, one that best serves the customer, the product, and the employee, must also be profitable. The thesis turns out to have an historical parallel in Plato's Republic (subtitled, I suppose, In Search of Justice). Parallel virtues can be worked out (...) for state and corporation. In the end, profitability turns out not to be a necessary consequence of excellence, just as Plato's Ideal state turned out to be mortal. (shrink)
Primary school teachers generally have to teach several subjects. Their training, however, is often fairly short and it is tempting to force‐feed them with everything they need to know to teach these subjects. It is more realistic to accept that a short course cannot do everything. Instead, it would be better to equip these students with skills that help them cope when their initial knowledge is weak. This study describes a problem‐based learning approach to skill development in science lesson planning (...) where subject knowledge was initially weak. It examines student–teacher confidence in and satisfaction with this planning, motivation and feelings about collaborative work. Advice is offered on adopting a PBL approach for developing lesson planning skills. (shrink)
Abstract: It is not too early to suggest that the attempts to place medical care in private hands (through group insurance arrangements) has not fulfilled its promise—or better, the promises that were made for it. Yet history has not been kind to plans to make government the single payer, and the laudable progress in medical technology has placed high-technology medical care beyond the reach of most private budgets. In this paper I suggest that the major problem of the U.S. health (...) care system as presently conceived is a failure of legitimacy, and I put forward a proposal that purports to solve that problem. The proposal is to localize health care, on the model of a public school system, on the argument that such localization will answer most of the questions of legitimacy at the core of the private insurance imbroglio, provide a brake for medical costs, while preserving our ability to take advantage of the most advanced medical interventions. I present some initial arguments for the proposal, but await its proof in the dialogue emerging as the present insurance system collapses. (shrink)
The decade in which the Business Ethics Quarterly has flourished has been a good one for business and business ethics, in which new guiding theories (like stakeholder theory), new interpretations of older ethical concepts (trust, virtue, and the social contract, for instance), and whole new paradigms of doing business (the Triple Bottom Line) have entered the literature. But practice has not kept up with theory, and the theoretical gains seem to be offset by terrible losses in the temperance of greed, (...) the fostering oftrustworthiness, and sensitivity to the natural environment. (shrink)
In this paper, I examine Scotus’s claim that the categories are the subject of a propter quid science. In order to see the significance of this claim, I first trace the development of the idea that the categories are the subject of a science from Martin of Denmark, Peter of Auvergne, and Simon of Faversham. I then turn toDuns Scotus’s account of the categories as the subject of a propter quid science. Throughout the discussion, I concentrate on the fundamental problems (...) confronting anyone who claims that there is a science of the categories: namely, how they, being ten, can have an appropriate unity. Scotus, as we will see, will answer this problem by claiming that the intellect causes a greater unity in second intentions than the corresponding unity that exists in the world. As a consequence, Scotus contends that the categories are the subject of a propter quid science, one that is radically different from the science of metaphysics. (shrink)
We argue that the goal of natural excellence, discoverable by scientific observation of the species, is appropriately called good, and the proper object of human development and education. That affirmation stands, but we are forced to acknowledge several conceptual difficulties (in the deliberate creation of “natural” excellences, for example, and in cases of plurality of excellences) and a final inability to reconcile human freedom—surely part of the natural excellence of human life—with the need to prevent humans from using that freedom (...) to sacrifice it (through, for instance, drugs, self-indulgence, and emotional enthusiasms). (shrink)
Everyone knows that somehow we must protect the natural environment as part of the ethical imperatives of doing business, especially in the era of globalization of business. But where, actually, do we find the structure of ethical imperatives that will support that “must”? The drawbacks of several candidates, some of them discussed in papers elsewhere in this volume, are considered, then supplemented with the Japanese concept of kyosei as supplying a missing link between ethics and the land. In the end, (...) some questions are raised about the possibility of success of the entire environmental enterprise in face of the provisions of global trade agreements. (shrink)
Does “business ethics,” as we have developed it in the United States, apply without change when business goes abroad? We argue that we cannot assume, in foreign nations (especially in the developing world), that the assumptions of U.S. business practice and business ethics hold without modification. An attempt to find a universally applicable ethic for global business results in the tentative formulation of “ten commandments” to guide the practice of business in the nations of the world.
Philosophers and physicians alike tend to discuss the physician-patient relationship in terms of physician privilege and patient autonomy, stressing the duty of the physician to respect the autonomy and the variously elaborated rights of the patient. The authors of this article argue that such emphasis on rights was initially productive, in a first generation of debate on medical ethical issues, but that it is now time for a second generation effort that will stress the importance of the unique experiential aspects (...) of the physician-patient relationship — mutual trust, suffering and healing. We attempt here to initiate this second-generation discussion, presenting the first generation's philosophical background, criticizing it from the perspective of clinical experience, and seeking a synthesis in the relational qualities of patient and physician interacting in a medical context. (shrink)