IntroductionThe objectives of this study are to assess and compare differences in the intensity, frequency, and overall severity of moral distress among a diverse group of healthcare professionals.MethodsParticipants from within Baylor Health Care System completed an online seven-point Likert scale (range, 0 to 6) moral distress survey containing nine core clinical scenarios and additional scenarios specific to each participant’s discipline. Higher scores reflected greater intensity and/or frequency of moral distress.ResultsMore than 2,700 healthcare professionals responded to the survey (response rate 18.14 (...) percent); survey respondents represented multiple healthcare disciplines across a variety of settings in a single healthcare system. Intensity of moral distress was high in all disciplines, although the causes of highest intensity varied by discipline. Mean moral distress intensity for the nine core scenarios was higher among physicians than nurses, but the mean moral distress frequency was higher among nurses. Taking into account both intensity and frequency, the difference in mean moral distress score was statistically significant among the various disciplines. Using post hoc analysis, differences were greatest between nurses and therapists.ConclusionsMoral distress has previously been described as a phenomenon predominantly among nursing professionals. This first-of-its-kind multidisciplinary study of moral distress suggests the phenomenon is significant across multiple professional healthcare disciplines. Healthcare professionals should be sensitive to situations that create moral distress for colleagues from other disciplines. Policy makers and administrators should explore options to lessen moral distress and professional burnout that frequently accompanies it. (shrink)

Moral Case Deliberations are reflective dialogues with a group of participants on their own moral dilemmas. Although MCD is successful as clinical ethics support, it also has limitations. 1. Lessons learned from individual MCDs are not shared in order to be used in other contexts 2. Moral learning stays limited to the participants of the MCD; 3. MCD requires quite some organisational effort, 4. MCD deals with one individual concrete case. It does not address other, similar cases. These limitations warrant (...) research into complementary ways of providing CES to healthcare professionals. Our research objective was therefore to develop a low threshold CES tool based on a series of MCDs on autonomy in long-term care. We used a qualitative research design in which we analyzed the process and content of a series of MCDs, combined with reflections on the theoretical background of MCD. In total 28 MCDs were analyzed by means of a thematic content analysis. In various rounds of development, the results of the analysis were combined with theoretical reflections on CES. Consequently, the tool was evaluated in three focus groups and adjusted. The CES tool, called ‘moral compass’, guides the users through a series of six subsequent questions in order to methodically reflect on their concrete moral dilemma, in the form of a booklet of 23 pages. It combines a methodical element that encourages and structures a reflection process with a substantive element, including norms, values, options, strategies, and insights regarding dealing with client autonomy. By using data from a series of MCDs, combined with theoretical reflections on MCD, ethics support and moral learning, we developed a thematic, low-threshold CES tool that supports healthcare professionals in daily practice in dealing with moral questions regarding client autonomy. It integrates examples and insights from earlier MCDs on the same topic. The moral compass is not a replacement of, but can be used complementary to MCD. The feasibility and impact of the moral compass need to be investigated in an evaluative follow-up study. The methodology presented in this paper may be used to develop moral compasses on different topics in various healthcare organizations. (shrink)

_The Routledge Handbook of Neuroethics_ offers the reader an informed view of how the brain sciences are being used to approach, understand, and reinvigorate traditional philosophical questions, as well as how those questions, with the grounding influence of neuroscience, are being revisited beyond clinical and research domains. It also examines how contemporary neuroscience research might ultimately impact our understanding of relationships, flourishing, and human nature. The _Handbook_ features easy-to-follow chapters that appear here for the first time in print and—written by (...) 61 key scholars and fresh voices—represent the wide range of viewpoints in neuroethics. The volume spotlights new technologies and historical articulations of key problems, issues, and concepts, and includes cross-referencing between chapters to highlight the complex interactions of concepts and ideas within neuroethics. These features enhance the _Handbook_’s utility by providing readers with a contextual map for different approaches to issues, and a guide to further avenues of interest. (shrink)

My purpose in what follows is not so much to defend the basic principle of utilitarianism as to indicate the form of it which seems most promising as a basic moral and political position. I shall take the principle of utility as offering a criterion for two different sorts of evaluation: first, the merits of acts of government, social policies, and social institutions, and secondly, the ultimate moral evaluation of the actions of individuals. I do not take it as implying (...) that the individual should live his life on the basis of constant evaluations of this sort. For there are different levels of decision making each with its appropriate criteria. For example, we each inevitably make many of our decisions from the point of view of our own personal self-fulfilment and this cannot regularly take a directly utilitarian form, nor should the utilitarian want it to do so. His claim is at most that we should sometimes review our life from the point of view of a kind of impersonal moral truth of a universalistic utilitarian character. (shrink)

The period of the mid-1920s to the mid-1980s was a portentous period for Soviet psychology. As this period recedes into the past, the figure of L. S. Vygotskii rises more and more before us. Vygotskii died of tuberculosis when not quite 37 years old. He was a psychologist for only 10 years, and it was only in the last 6 of these that he did the work we now associate with his name. During those brief years Vygotskii wrote over 120 (...) works, including more than 10 large books. His was a short life — filled with inspired, indefatigable, and heroic work. A significant part of his written work has remained unpublished and indeed much of it remained unfinished. A seven-volume collection of Vygotskii's work is currently underway, and even this will not contain everything he wrote. The final volume of this collection will include his articles "The Sense of the Psychological Crisis" and "Spinoza's Theory of the Passions.". (shrink)

_The Routledge Handbook of Neuroethics_ offers the reader an informed view of how the brain sciences are being used to approach, understand, and reinvigorate traditional philosophical questions, as well as how those questions, with the grounding influence of neuroscience, are being revisited beyond clinical and research domains. It also examines how contemporary neuroscience research might ultimately impact our understanding of relationships, flourishing, and human nature. The _Handbook_ features easy-to-follow chapters that appear here for the first time in print and—written by (...) 61 key scholars and fresh voices—represent the wide range of viewpoints in neuroethics. The volume spotlights new technologies and historical articulations of key problems, issues, and concepts, and includes cross-referencing between chapters to highlight the complex interactions of concepts and ideas within neuroethics. These features enhance the _Handbook_’s utility by providing readers with a contextual map for different approaches to issues, and a guide to further avenues of interest. (shrink)

Agents and Lives offers a new and important rethinking of the traditional "humanist" view of literature. That tradition's valuation of literature for its "moral import" is extended in a wider, more complex, open and exploratory understanding of those terms. Goldberg's argument ranges across literature since the Renaissance, focusing on examples from George Eliot's novels and Pope's poetry. An appendix assesses the relationship of his argument to recent accounts of literature offered by moral philosophers such as Iris Murdoch, Bernard Williams, Martha (...) Nussbaum and Richard Rorty. (shrink)

BackgroundPublic awareness and engagement are among the main prerequisites for protecting the rights of research participants and for successful and sustainable functioning of research biobanks. The aim of our study was to analyse public awareness and attitudes towards research biobanks in Latvia, and to compare these data with the results of the 2010 Eurobarometer study. We also analysed the influence of awareness and attitudes towards biobanks on willingness to participate in biobank studies and on preferred type of informed consent.MethodsWe developed (...) a 12-question survey repeating seven questions about biobanks from the 2010 Eurobarometer questionnaire and adding five others. After describing the study variables, we performed a two-stage analysis of the results. In the first stage we analysed differences between the answers from 2010 and 2019 and conducted univariate analyses of relationships among particular variables, and between those variables and the socio-demographic characteristics of participants. In the second stage we investigated multivariable associations of willingness to participate and type of consent with awareness, trust and the socio-economic characteristics of participants.ResultsAccording to our study, the general public in Latvia is still not well informed about research biobanks. Fewer respondents have heard about research biobanks than in 2010. At the same time, the number of respondents who are willing to donate biological samples and personal data to a biobank has increased, e.g. the number of respondents who would definitely or probably be willing to provide information about themselves has increased from 25.8.% to 40.7 since 2010. Overall, concerns about the donation of different types of biological samples and data to a biobank have slightly decreased.ConclusionsPublic awareness about biobanks is important for their sustainability. It needs to be increased not only by traditional methods of informing the public, but also by more innovative and participatory approaches, e.g. by citizen science projects. There is a need to strengthen the public visibility and trustworthiness of ethics committees in Latvia in the field of biobanking. (shrink)

The literature on public perceptions of, and attitudes towards, nanotechnology used in the agrifood sector is reviewed. Research into consumer perceptions and attitudes has focused on general applications of nanotechnology, rather than within the agrifood sector. Perceptions of risk and benefit associated with different applications of nanotechnology, including agrifood applications, shape consumer attitudes, and acceptance, together with ethical concerns related to environmental impact or animal welfare. Attitudes are currently moderately positive across all areas of application. The occurrence of a negative (...) or positive incident in the agri-food sector may crystallise consumer views regarding acceptance or rejection of nanotechnology products. •Acceptance of agrifood nanotechnology based on perceptions of risk, benefit and ethics.•Attitudes towards nanotechnology in general are currently moderately positive.•Occurrence of a major nanotechnology-related "event" may crystallise consumer attitude. (shrink)

While it is acknowledged that there is a need for more qualitative research on suicide, it is also clear that the ethics of undertaking such research need to be addressed. This article uses the case study of the authors’ experience of gaining ethics approval for a research project that asks people what it is like to feel suicidal to (a) analyse the limits of confidentiality and anonymity and (b) consider the ways in which the process of ethics review can shape (...) and constrain suicide research. This leads to a discussion of the ways in which ethics committees assess and monitor qualitative research more generally and some preliminary suggestions for how this might be improved. (shrink)

The emergence of macroscopic variables can be effected through coarse graining. Despite practical and fundamental benefits conveyed by this partitioning of state space, the apparently subjective nature of the selection of coarse grains has been considered problematic. We provide objective selection methods, deriving from the existence of relatively slow dynamical time scales. Using a framework for nonequilibrium statistical mechanics developed by us, we show the emergence of both spatial variables and order parameters. Although significant objective criteria are introduced in the (...) coarse graining, we do not provide a unique prescription. Most significantly, the grains, and by implication entropy, are only defined modulo a characteristic time scale of observation. (shrink)

Perspective and reflection have each been considered in some way basic to phenomenal consciousness. Each has possible evolutionary value, though neither seems sufficient for consciousness. Consider an account of consciousness in terms of the combination of perspective and reflection, its relationship to the problem of other minds, and its capacity to inherit evolutionary explanation from its components.

Walter Freeman's theory of nonlinear neurodynamics has had a major impact on brain dynamics in modern cognitive neuroscience. Steven Bressler's theory of neurocognitive networks follows from Freeman's work, and his empirical evidence for the coordination of cortical areas by phase-coupled beta rhythms in large-scale cognitive brain networks supports Freeman's ideas on nonlinear brain dynamics. Bressler's work, taking Freeman's concepts into the realm of cognitive neurodynamics, also supports Scott Kelso's theory of metastability in coordination dynamics. The aims of the present paper (...) are threefold: 1) to explore relevant concepts in Freeman's theoretical framework, 2) unify it and provide empirical support for it, and 3) explore its import for the study of consciousness. We take as our point of departure Bressler and Kelso's 2016 publication on cortical coordination dynamics and the Freeman-Kelso dialogue noted in the literature on this topic. In our view, Freeman's conceptual framework has great explanatory power. Its grounding in a dynamical systems approach to the study of brain function, and its incorporation of embodiment, make it relevant to the study of consciousness. Thus, with Freeman, we argue that the scientific understanding of consciousness must move beyond notions of computationalism and mental representations, to employ concepts of nonlinear brain dynamics and embodiment. (shrink)

The man in the street to-day is aware that recent developments in the physical sciences have necessitated a fundamental revision of the concepts of physics; he finds that Einstein is no less upsetting to his ideas than was Copernicus to those of his own time or than Darwin was to Bishop Wilberforce. The plain man who has “ philosophical leanings ” is aware that questions previously regarded as metaphysical—and about which philosophers have written much that is unintelligible—are now recognized as (...) falling within the scope of physics. Every reader of this Journal is aware that the criticism to which the main concepts of physics—space, time, matter—have been subjected is so fundamental that it is no longer possible to say that there are material bodies in space, which have events happening to them at a given time. We must substitute the conception of a fourfold continuum within which space, time and matter are inextricably involved. Finally, we are told that this new way of regarding the classical trinity suggests the consequence that we know nothing about the “ inner nature ” of the terms with which we deal, we can make no assertions as to the ultimate nature of that to which they may refer. In this respect the prevailing temper of the present-day scientist is to be contrasted with the cocksureness of most nineteenth-century physicists l who, even if they did not go so far as to say “ we know what matter is,” at least suggested that only the metaphysician had, or could have, any doubts as to its nature and reality^. (shrink)

It is widely accepted now that a patient's right to refuse treatment extends to circumstances in which the exercise of that right may lead to the patient's death. However, it is also often effectively assumed, without argument, that this implies a patient's right to request another agent to intervene so as to bring about his or her death, in a way which would render that agent guilty of murder in the absence of such a request. But the right to refuse (...) treatment can, logically, have no such implication, and the mistaken supposition that it does conflates a right to die with a right to be killed. Confusion over this issue is brought out by an examination of conflicting opinion concerning the permissible termination of ventilation for mentally competent patients. A wider lesson may be drawn regarding the need for the ethical assessment of new forms of life-sustaining medical technology. (shrink)

Misogyny is a significant but unspoken presence in organization studies, in terms of people’s experiences of work and as a theorised concept. In this essay we argue that our community should dare to name misogyny for its unique insight into the enduring patriarchal power relations that condition so many organizations and so much of our organization theory. We develop this argument in two ways: first, we suggest that misogyny provides a unique descriptive linguistic label for experiences of gendered hatred, violence, (...) and social policing; and second, a philosophical understanding of misogyny enables analysis, understanding, and challenges to the physical or symbolic violence that women experience in and around organizations as sites for the reproduction of patriarchy. Drawing on recent developments in feminist analytic philosophy, we follow the movement away from understanding misogyny-as-individual-emotions to misogyny-as-affective-practice. This allows us to frame two related concepts, organized and organizational misogyny, demonstrating the potential that misogyny brings to understanding individual experiences, collective affect, and influential social forces. Despite the discomfort produced by hate-based concepts such as misogyny, we conclude that their exclusion from organization studies has two effects: the continuing reproduction of violent hostility, and acceptance of a partial account of multiple forms of oppression and inequality. Our research agenda, founded on this need for naming such experiences, the significance of affect, and aggregated oppressions, demonstrates the potential contribution of misogyny to addressing these issues and finding some hope for change. (shrink)

This book assesses how Vatican II opened up the Catholic Church to encounter, dialogue, and engagement with other world religions. Opening with a contribution from the President of the Pontifical Council for Interreligious Dialogue, Cardinal Jean-Louis Tauran, it next explores the impact, relevance, and promise of the Declaration Nostra Aetate before turning to consider how Vatican II in general has influenced interfaith dialogue and the intellectual and comparative study of world religions in the postconciliar decades, as well as the contribution (...) of particular past and present thinkers to the formation of current interreligious and comparative theological methods. Additionally, chapters consider interreligious dialogue vis-à-vis theological anthropology in conciliar documents; openness to the spiritual practices of other faith traditions as a way of encouraging positive interreligious encounter; the role of lay and new ecclesial movements in interreligious dialogue; and the development of Monastic Interreligious Dialogue. Finally, it includes a range of perspectives on the fruits and future of Vatican’s II’s opening to particular faiths such as Judaism, Islam, Hinduism, and Buddhism. (shrink)

The present study is the result of two questions which arose in dealing with the Critique of Pure Reason. What is the relationship of the “Doctrine of Method” to the “Doctrine of Elements?” Does the “Doctrine of Method” tell us anything important about Kant and his philosophy? It will be the contention of this paper that the second half of the Critique relies heavily on the “Doctrine of Elements,” and is a natural expansion of the first half of the Critique. (...) In effect, this is a tentative denial of Norman Kemp Smith’s patchwork thesis. With respect to the second question mentioned above, we shall see that Kant does have a very special place for methodology in his philosophy. This methodology of philosophy has implications for a theory of the division of the sciences and the method proper to each of them. (shrink)

The Vygotsky Anthology brings together, for the first time, a selection of extracts from the best translations available of Vygotsky's writings, spanning the entire arc of his career. Vygotsky was arguably one of the greatest educational psychologists of the 20th century. Grounded in his experience as a teacher, an expert in special education, a research psychologist and an outstanding theorist, the editors of this unique anthology chart his enormous influence on professionals working in education and child development around the world. (...) The extracts are introduced by the editors' commentaries, helpfully setting them in the context of Vygotsky's life and work, providing a collection of work that adequately represents his writing, and conveying some of the great pleasures of reading him. In the passages selected here, his voice is clearly heard, the intellectual brilliance of his insights is reflected, his line of argument is clear, and his humour and humanity are evident. With its inclusion of recent translations of essential texts, this anthology will help students to understand the full diversity of Vygotsky's influence on today's classrooms. Seen as a companion volume to Myra Barr's previous work Vygotsky the Teacher (Routledge, 2022), the value of this text to teachers, educational psychologists, and other practitioners working in the field of education and child development, will be significant and lasting. It is a key reference book for new generations of Vygotsky students. (shrink)

Part I: Consciousness and the metaphysics of experience. Orientations. What I believe. The privacy of experience. Final causes. The importance of subjectivity : an inaugural lecture. Is consciousness mysterious? Consciousness. The distinctiveness of American philosophy. The world of description and the world of acquaintance -- Part II: The metaphysics of time and the absolute. The unreality of time. Ideal immortality. Russell and Bradley on relations. The self and its world in Bradley and Husserl. Absolute idealism. Pantheism -- Part III: Ethics, (...) animal rights, and the environment. The greatest happiness principle. Is the esse of intrinsic value percipi? Pleasure, pain and value. Metaphysics, physicalism, and animal rights. Vivisection, morals, medicine : commentary from an antivivisectionist philosopher. Non-human rights : an idealist perspective. Are there intrinsic values in nature? An idealist's prayer for the world. (shrink)