The purpose of this article is to describe the development of a model of moral distress in military nursing. The model evolved through an analysis of the moral distress and military nursing literature, and the analysis of interview data obtained from US Army Nurse Corps officers (n = 13). Stories of moral distress (n = 10) given by the interview participants identified the process of the moral distress experience among military nurses and the dimensions of the military nursing moral distress (...) phenomenon. Models of both the process of military nursing moral distress and the phenomenon itself are proposed. Recommendations are made for the use of the military nursing moral distress models in future research studies and in interventions to ameliorate the experience of moral distress in crisis military deployments. (shrink)
``What Does a Right to Physician-Assisted Suicide (PAS) Legallyentail?''''Much of the bioethics literature focuses on the morality ofPAS but ignores the legal implications of the conclusions thereby wrought. Specifically, what does a legal right toPAS entail both on the part of the physician and the patient? Iargue that we must begin by distinguishing a right to PAS qua``external'''' to a particular physician-patient relationship from a right to PAS qua ``internal'''' to a particular physician-patientrelationship. The former constitutes a negative claim right (...) inrem that prohibits outside interference with the exercise of aright to PAS while the latter can provide the patient witha positive claim right in personam to obligatory assistancefrom his physician. Importantly, I argue that the creation of sucha patient right, however, originates with the physician who may exercise an unqualified right of first refusal prior to promisingto help her patient commit suicide. In doing so, I hope to establishthat explicit physician promises of assistance in dying shouldbecome legally binding. As such, current PAS law in both theNetherlands and Oregon is in need of substantive modification. (shrink)
In many research studies, tumor biopsies are an unavoidable requirement for achieving key scientific aims. Yet some commentators view mandatory research biopsies as coercive and suggest they should be optional, or at least optional until further data are obtained regarding their scientific usefulness. Further complicating the ethical picture is the fact that some research biopsies offer a potential for clinical benefit to trial participants. We interviewed and surveyed a convenience sample of participants in phase I clinical trials at a single (...) institution. Our primary aim was to describe phase I participants’ understanding of whether a research biopsy offered them the prospect of medical benefit. We also endeavored to describe participants’ views about biopsies—specifically, the benefits of biopsies, if any, and whether biopsies were acceptable, risky, or discouraged trial participation. Finally, we collected data on demographics and attitudes to see if any strong correlations with misunderstanding, acceptability, or riskiness existed. Overall, the respondents tended to view research biopsies as acceptable, though they did not succeed in identifying the lack of benefit of a research biopsy. These findings call for renewed efforts in consent conversations and documents to carefully describe the benefits, or lack thereof, of research biopsies. (shrink)
This book deserves the attention of philosophers of religion. Tracy presents a monumental synthesis of philosophy and history within the context of a "revisionist" theological model. Part I attempts adequately to articulate a method of inquiry by outlining the sets of evaluative criteria, the uses of evidence, and the place of the various philosophical and historical methods within this model. Not only must the method be responsive to the historical tradition, but it also must heed the non-Christian scrutiny of what (...) Van A. Harvey calls the "morality of scientific knowledge," which demands a critical posture toward beliefs and tradition. Tracy’s model involves three steps: 1) phenomenology of the "religious dimension" of our "common experience and language," 2) an "historical and hermeneutical investigation" of the Christian tradition, and 3) "transcendental or metaphysical reflection" in order both to determine the "truth-status" of the previous steps and to effect a critical correlation of philosophy and hermeneutics. (shrink)
S. Adams, W. Ambrose, A. Andretta, H. Becker, R. Camerlo, C. Champetier, J.P.R. Christensen, D.E. Cohen, A. Connes. C. Dellacherie, R. Dougherty, R.H. Farrell, F. Feldman, A. Furman, D. Gaboriau, S. Gao, V. Ya. Golodets, P. Hahn, P. de la Harpe, G. Hjorth, S. Jackson, S. Kahane, A.S. Kechris, A. Louveau,, R. Lyons, P.-A. Meyer, C.C. Moore, M.G. Nadkarni, C. Nebbia, A.L.T. Patterson, U. Krengel, A.J. Kuntz, J.-P. Serre, S.D. Sinel'shchikov, T. Slaman, Solecki, R. Spatzier, J. Steel, D. Sullivan, S. (...) Thomas, A. Valette, V.S. Varadarajan, B. Velickovic, B. Weiss, J.D.M. Wright, R.J. Zimmer. (shrink)
The representation of physics problems in relation to the organization of physics knowledge is investigated in experts and novices. Four experiments examine the existence of problem categories as a basis for representation; differences in the categories used by experts and novices; differences in the knowledge associated with the categories; and features in the problems that contribute to problem categorization and representation. Results from sorting tasks and protocols reveal that experts and novices begin their problem representations with specifiably different problem categories, (...) and completion of the representations depends on the knowledge associated with the categories. For, the experts initially abstract physics principles to approach and solve a problem representation, whereas novices base their representation and approaches on the problem's literal features. (shrink)
What if human joy went on endlessly? Suppose, for example, that each human generation were followed by another, or that the Western religions are right when they teach that each human being lives eternally after death. If any such possibility is true in the actual world, then an agent might sometimes be so situated that more than one course of action would produce an infinite amount of utility. Deciding whether to have a child born this year rather than next is (...) a situation wherein an agent may face several alternatives whose effects could well ramify endlessly on such suppositions, for the child born this year would be a different person—one who preferred different things, performed different actions, and had different descendants—from a child born next year. It has recently been suggested that traditional utilitarianism stumbles on such cases of infinite utility. Specifically, utilitarianism seems to require, for its application, that all experience of pleasure and pain cease at some time in the future or asymptotically approach zero.2 If neither of these conditions holds, then the utility produced by each of two alternative actions may turn out to be infinite, and utilitarianism thus loses its ability to discriminate morally between them. (shrink)
A unifying theory of general anesthetic-induced unconsciousness must explain the common mechanism through which various anesthetic agents produce unconsciousness. Functional-brain-imaging data obtained from 11 volunteers during general anesthesia showed specific suppression of regional thalamic and midbrain reticular formation activity across two different commonly used volatile agents. These findings are discussed in relation to findings from sleep neurophysiology and the implications of this work for consciousness research. It is hypothesized that the essential common neurophysiologic mechanism underlying anesthetic-induced unconsciousness is, as with (...) sleep-induced unconsciousness, a hyperpolarization block of thalamocortical neurons. A model of anesthetic-induced unconsciousness is introduced to explain how the plethora of effects anesthetics have on cellular functioning ultimately all converge on a single neuroanatomic/neurophysiologic system, thus providing for a unitary physiologic theory of narcosis related to consciousness. (shrink)
Ontological and methodological constraints on a theory of cognition that would generalize across species are identified. Within these constraints, ecological arguments for animal-environment mutuality and reciprocity and the necessary specificity of structured energy distributions to environmental facts are developed as counterpoints to the classical doctrines of animal-environment dualism and intractable nonspecificity. Implications of and for a cognitive theory consistent with Gibson's programme of ecological psychology are identified and contrasted with contemporary cognitivism.
Is there really an ethical crisis? We propose that the situation is not as bad as many would have us believe. We have attempted to present an alternative explanation for some earlier reports of an ethical crisis. This has resulted in a number of research propositions. We are optimistic that there are, in spite of reports to the contrary, an overwhelming majority of ethical people populating our business community.
This essay explores the claim that bioethics has become a mode of biopolitics. It seeks to illuminate one of the myriad of ways that bioethics joins other institutionalized discursive practices in the task of producing, organizing, and managing the bodies—of policing and controlling populations—in order to empower larger institutional agents. The focus of this analysis is the contemporary practice of transnational biomedical research. The analysis is catalyzed by the enormous transformation in the political economy of transnational research that has occurred (...) over the past three decades and the accompanying increase in the numbers of human bodies now subjected to research. This essay uses the work of Michel Foucault, particularly his notion of docile bodies, to analyze these changes. Two loci from the bioethics literature are explored—one treating research in the United States and one treating research in developing countries. In the latter, we see a novel dynamic of the new biopolitics: the ways in which bioethics helps to create docile political bodies that will police themselves and who will, in turn, facilitate the production of docile human bodies for research. (shrink)
Within the moral/social order maintained and reproduced by biomedical ethics (i.e., the “peaceable community”), suffering is a senseless accident with no value. Insofar as suffering compromises the fundamental pillar of this order, namely, autonomy, it threatens the existence of the “peaceable community”. Consequently, biomedical ethics is only able to offer those who suffer one moral or practical response: that of elimination, embodied most vividly in the increasingly approved practice of assisted-suicide. Another moral/ social order, however, the “peaceable Kingdom” or the (...) “Body of Christ”, provides an alternative understanding of the meaning, purpose, and significance of suffering, through the Roman Catholic sacrament of anointing of the sick. Recognizing the power of sickness and suffering to “dis-inscribe” bodies of their normative self-understandings, the Church responds with a set of liturgical practices which intend to respond to the dynamics of suffering, re-inscribe these bodies, and assist persons in fulfilling the vocation of “participating in Christ's suffering for the salvation of the world”. (shrink)
According to the prevailing paradigm in social-cognitive neuroscience, the mental states of individuals become shared when they adapt to each other in the pursuit of a shared goal. We challenge this view by proposing an alternative approach to the cognitive foundations of social interactions. The central claim of this paper is that social cognition concerns the graded and dynamic process of alignment of individual minds, even in the absence of a shared goal. When individuals reciprocally exchange information about each other's (...) minds processes of alignment unfold over time and across space, creating a social interaction. Not all cases of joint action involve such reciprocal exchange of information. To understand the nature of social interactions, then, we propose that attention should be focused on the manner in which people align words and thoughts, bodily postures and movements, in order to take one another into account and to make full use of socially relevant information. (shrink)
In an influential essay entitled Why abortion is wrong, Donald Marquis argues that killing actual persons is wrong because it unjustly deprives victims of their future; that the fetus has a future similar in morally relevant respects to the future lost by competent adult homicide victims, and that, as consequence, abortion is justifiable only in the same circumstances in which killing competent adult human beings is justifiable.1 The metaphysical claim implicit in the first premise, that actual persons have a future (...) of value, is ambiguous. The Future Like Ours argument (FLO) would be valid if “future of value” were used consistently to mean either “potential future of value” or “self-represented future of value”, and FLO would be sound if one or the other interpretation supported both the moral claim and the metaphysical claim, but if, as I argue, any interpretation which makes the argument valid renders it unsound, then FLO must be rejected. Its apparent strength derives from equivocation on the concept of “a future of value”. (shrink)
In this paper we open up the topic of ethical corporate identity: what we believe to be a new, as well as highly salient, field of inquiry for scholarship in ethics and corporate social responsibility. Taking as our starting point Balmer’s (in Balmer and Greyser, 2002) AC2ID test model of corporate identity – a pragmatic tool of identity management – we explore the specificities of an ethical form of corporate identity. We draw key insights from conceptualizations of corporate social responsibility (...) and stakeholder theory. We argue ethical identity potentially takes us beyond the personification of the corporation. Instead, ethical identity is seen to be formed relationally, between parties, within a community of business and social exchange. Extending the AC2ID test model, we suggest the management of ethical identity requires a more socially, dialogically embedded kind of corporate practice and greater levels of critical reflexivity. (shrink)
This essay argues for a renewed institution of an ancient Christian practice, the Order of Widows. Drawing on the Roman Catholic tradition's recent writings on the elderly, particularly the 1998 document from the Pontifical Council for the Laity entitled “The Dignity of Older People and their Mission in the Church and in the World,” I argue that we find within the Roman Catholic tradition advocacy for a renewed understanding of the vocation of the elderly within the Church. Building on this, (...) I then trace in the broadest of outlines some elements of what a renewal of the Order of Widows might look like. In doing so, it becomes clear how this new ecclesial practice addresses health issues of older women. More importantly, such a practice moves beyond principles to demonstrate a concrete alternative. As such it would provide a powerful witness to the very culture the Church seeks to transform. (shrink)