Moral distress has been characterised in the nursing literature as a major problem affecting nurses in all healthcare systems. It has been portrayed as threatening the integrity of nurses and ultimately the quality of patient care. However, nursing discourse on moral distress is not without controversy. The notion itself is conceptually flawed and suffers from both theoretical and practical difficulties. Nursing research investigating moral distress is also problematic on account of being methodologically weak and disparate. Moreover, the ultimate purpose and (...) significance of the research is unclear. In light of these considerations, it is contended that the notion of moral distress ought to be abandoned and that concerted attention be given to advancing inquiries that are more conducive to improving the quality and safety of moral decision-making, moral conduct and moral outcomes in nursing and healthcare domains. (shrink)

The neuroscience revolution has revived interpretations of religious experiences as wholly dependent on biological conditions. William James cautioned against allowing such neurological reductionism to overwhelm other useful perspectives. Contemporary psychologists of religion have raised similar cautions, but have failed to engage James as a full conversation partner. In this article, we present a contemporary, applied version of James's perspective. We clarify the problem by reviewing specific James-like contemporary concerns about reductionism in the neuropsychological study of religion. Then, most centrally, we (...) employ three of James's conceptual tools—pragmatism, pluralism, and radical empiricism—to moderate contemporary reductionism. Finally, we point to a constructive approach through which neuroscientists might collaborate with scholars in the humanities and psychosocial sciences, which is consistent with our conclusion that it is often no longer fruitful to separate neurobiological studies from studies that are psychosocial or sociocultural. (shrink)

In the 1830s and 1840s, the Hydrographic Office of the British Admiralty developed and oversaw one of the major state-run surveying projects of the nineteenth century. This involved a range of instruments whose circulation was increasingly regulated. Using extant museum collections and the correspondence of those involved, this article explores how such objects can be used to discuss both bureaucratic organization at a time of expanding government and the complex issues of sociability involved in hydrographic surveying. Surveying officers worked in (...) a context in which the propriety of property on public service was a pervasive question. Instruments might be given as gifts between officers, appropriated as recompense, absorbed as state property, and disputed between friends. The ownership, provision, and treatment of instruments in particular could be used to demonstrate an officer’s peculiar zeal or institutional neglect. To those outside the ship, what was understood as over-instrumentation became amusing spectacle. On board, their use was part of a deeply hierarchical order of work in regions of colonial and mercantile importance. In examining the relationships around these instruments of survey, the paper proposes a richer understanding of the material culture of hydrography in the early nineteenth century. (shrink)

Shavelson and colleagues (2023) describe how medical aid-in-dying laws in the United States prohibit assistance in administering aid-in-dying medication. This prohibition distinguishes aid in dying...

Kolbe and de Melo-Martin (2023) describe fatal problems in current definitions and measurement of moral distress and injury (MD/I) in medical professionals, which impede development of genuine atte...

To address climate change fairly, many conflicting claims over natural resources must be balanced against one another. This has long been obvious in the case of fossil fuels and greenhouse gas sinks including the atmosphere and forests; but it is ever more apparent that responses to climate change also threaten to spur new competition over land and extractive resources. This makes climate change an instance of a broader, more enduring and - for many - all too familiar problem: the problem (...) of human conflict over how the natural world should be cared for, protected, shared, used, and managed. -/- This work develops a new theory of global egalitarianism concerning natural resources, rejecting both permanent sovereignty and equal division, which is then used to examine the problem of climate change. It formulates principles of resource right designed to protect the ability of all human beings to satisfy their basic needs as members of self-determining political communities, where it is understood that the genuine exercise of collective self-determination is not possible from a position of significant disadvantage in global wealth and power relations. These principles are used to address the question of where to set the ceiling on future greenhouse gas emissions and how to share the resulting emissions budget, in the face of conflicting claims to fossil fuels, climate sinks, and land. It is also used to defend an unorthodox understanding of responsibility for climate change as a problem of global justice, based on its provenance in historical injustice concerning natural resources. (shrink)

Pickering, Newton-Howes, and Young assert that the traditional view of decisional capacity, premised on assessing patients’ abilities to communicate, understand, appreciate,...

This paper considers whether states have a duty to accept those who cross borders to escape environmental disasters associated with climate change. It then examines how such a responsibility might be distributed, focusing on the predicament of the citizens of small island states expected to be inundated by rising sea levels. In assessing states' responsibility to admit these individuals, I draw on Walzer's theory of mutual aid, demonstrating that even under this narrow conception of states' obligations, a duty to accept (...) displaced islanders can be established. However, the proximity principle is ill-suited to determining which states should shoulder responsibility in this situation. Drawing on Miller's account of remedial responsibility and his ‘connection theory,’ I suggest that the obligation to accept ‘environmental refugees’ should be shouldered principally by affluent states that share significant degrees of causal and moral responsibility for climate change, and also have particularly strong capacities to assist the displaced. (shrink)

Here are two widely held positions on the ethics of dating: First, people are generally morally justified in excluding people they don’t find attractive from their dating pool. Second, people are not justified in maintaining a dating pool that is racially exclusive, even on grounds like attraction. In this paper, we demonstrate how these positions are consistent. To do so we differentiate our attitudes in dating and our dating behavior. Then we show how existing criticisms of racialized attitudes in dating (...) are incomplete as practical criticisms of our behavior. Finally, we give our account of the moral reasons whites have to change their dating preferences when they exclude people of color. In doing so, we supplement existing discussions of race-based discrimination in dating. (shrink)

In this essay Megan J. Laverty argues that Jean-Jacques Rousseau's conception of humane communication and his proposal for teaching it have implications for our understanding of the role of listening in education. She develops this argument through a close reading of Rousseau's most substantial work on education, Emile: Or, On Education. Laverty elucidates Rousseau's philosophy of communication, beginning with his taxonomy of the three voices—articulate, melodic, and accentuated—illustrating the ways in which they both enhance and obfuscate understanding. Next, Laverty (...) provides an account of Rousseau's philosophical psychology, with specific reference to amour-propre and amour de soi. Listening plays a central role in Rousseau's philosophy of communication, Laverty maintains, because it is in the act of listening that humans fulfill, or fail to fulfill, the imperative that we seek to understand others. (shrink)

Richard Stanley Peters appreciates the centrality of concepts for everyday life, however, he fails to recognize their pedagogical dimension. He distinguishes concepts employed at the first-order (our ordinary language-use) from second-order conceptual clarification (conducted exclusively by academically trained philosophers). This distinction serves to elevate the discipline of philosophy at the expense of our ordinary language-use. I revisit this distinction and argue that our first-order use of concepts encompasses second-order concern. Individuals learn and teach concepts as they use them. Conceptual understanding (...) is an obligation that all individuals, and not just academically trained philosophers, must fulfil. I conclude that the role of philosophy in education is to provide a conversational context for the pedagogical dimension of concepts. I draw upon the philosophies of Cora Diamond, Stephen Mulhall, Iris Murdoch and Rush Rhees. (shrink)

Bringing to light new facets in the philosophy of Emmanuel Levinas and William James, Megan Craig explores intersections between French phenomenology and American pragmatism.

Introduction: toward a theory of infrahumanity -- Bioexpansionism, 1900s-1930s -- Brief histories of time: nature, culture, and the making of modern childhood -- Ocular anthropomorphisms: eugenics and primatology at the threshold of the "almost human" -- Extraterrestriality, 1940s-1970s -- On alien ground: extraterrestrial sightings, atomic warfare, and the undoing of the human body -- Inner and outer spaces: exobiology, human genetics, and the disembodiment of corporeal difference -- Interiority, 1980s-2010s -- Of sodomy and cannibalism: disgust, dehumanization, and the rhetorics of (...) same-sex and cross-species contagion -- Everything except the squeal: porcine hybridity in the obesity epidemic and xenotransplantation research -- Conclusion. the plurality is near: techniques of symbiotic re-speciation. (shrink)

In their target article, Conley et al. (2023) appropriately highlight the ongoing conceptual and practical opacity of public engagement (PE) in the translation of human gene editing (HGE) (Conley e...

Dynamic Consent is both a model and a specific web-based tool that enables clear, granular communication and recording of participant consent choices over time. The DC model enables individuals to know and to decide how personal research information is being used and provides a way in which to exercise legal rights provided in privacy and data protection law. The DC tool is flexible and responsive, enabling legal and ethical requirements in research data sharing to be met and for online health (...) information to be maintained. DC has been used in rare diseases and genomics, to enable people to control and express their preferences regarding their own data. However, DC has never been explored in relationship to historical collections of bioscientific and genetic heritage or to contexts involving Aboriginal and Torres Strait Islander people.In response to the growing interest by First Peoples throughout Australia in genetic and genomic research, and the increasing number of invitations from researchers to participate in community health and wellbeing projects, this article examines the legal and ethical attributes and challenges of DC in these contexts. It also explores opportunities for including First Peoples' cultural perspectives, governance, and leadership as a method for defining DC on cultural terms that engage best practice research and data analysis as well as respect for meaningful and longitudinal individual and family participation. (shrink)

Informed consent is the gateway to research participation. We report on the results of the formative evaluation that follows the electronic informed consent process for the All of Us Research Program. Of the nearly 250,000 participants included in this analysis, more than 95% could correctly answer questions distinguishing the program from medical care, the voluntary nature of participation, and the right to withdraw; comparatively, participants were less sure of privacy risk of the program. We also report on a small mixed-methods (...) study of the experience of persons of very low health literacy with All of Us informed consent materials. Of note, many of the words commonly employed in the consent process were unfamiliar to or differently defined by informants. In combination, these analyses may inform participant-centered development and highlight areas for refinement of informed consent materials for the All of Us Research Program and similar studies. (shrink)

Despite recent empirical interest, the links between optimism and pessimism with pro-environmental behavior remain equivocal. This research is characterized by a reliance on cross-sectional data, a focus on trait-level at the neglect of state-level optimism–pessimism, and assessments of retrospective self-reported ecological behavior that are subject to response bias. To attend to these gaps, 140 North American adults were experimentally primed with bogus optimistic or pessimistic environmental news articles, and then asked to report their levels of state optimism–pessimism, intentions to purchase (...) green products, in vivo PEB, and support for geoengineering technologies. Results confirmed that optimistic environmental messaging enhanced the expression of state optimism, which then contributed to PEB and support for geoengineering. These results have important implications for the framing of environmental messaging intended to promote ecologically conscious behavior. (shrink)

This article examines the issues that are at stake in the current resurgence of interest in the subject of habit. We focus on the role that habit has played in conceptions of the relations between body and society, and the respects in which such conceptions have been implicated in processes of governance. We argue that habit has typically constituted a point of leverage for regulatory practices that seek to effect some realignment of the relations between different components of personhood – (...) will, character, memory and instinct, for example – in order to bring about a specific end. In reviewing its functioning in this regard across a range of modern disciplines – philosophy, psychology, sociology – we explore the tensions between its use and interpretation in different lineages: in particular, the Cartesian–Kantian/ravaisson–bergson–deleuze lineages. The article then identifies how these questions are addressed across the contributions collected in this special issue. (shrink)

SUMMARYContemporary scholars seeking to advance the study of political phenomena identify their inquiry as a ‘science' that attains success through rigorous method. Thus the ‘methodological anarchism' of Paul Feyerabend's philosophy of science might seem an inauspicious place to find a fruitful disciplinary vision. Nonetheless, it echoes a longstanding conception of the ‘science' of politics articulated by Niccolò Machiavelli. Looking to Feyerabend, we propose to surmount the impasse between Machiavelli's account of politics and the demands of modern science and recover his (...) contribution to the scientific study of politics. In doing so, Machiavelli illustrates the potential of a Feyerabendian political science. (shrink)

Volume 24, Issue 8, August 2024, Page 121-123.

In lieu of an abstract, here is a brief excerpt of the content:When Is Enough, Enough?Megan HomsyThis was a case that stuck with many members of our transplant team for a long time. The patient was a 44-year-old Caucasian male evaluated for a liver transplant with a diagnosis of hepatitis C virus (HCV), originally diagnosed 11 years before the transplant evaluation. The patient met the criteria for the following substance use diagnoses: alcohol use disorder moderate in sustained remission, in (...) a controlled environment, opioid use disorder, severe, in sustained remission, on maintenance therapy, in a controlled environment, stimulant use disorder, amphetamine-type, severe, in early remission, in a controlled environment and stimulant use disorder, cocaine-type, severe in early remission, in a controlled environment.The patient had been living in a sober living housing program for approximately ten months prior to his transplant evaluation with me, his social worker. He had also been diagnosed with depression and bipolar disorder. He had been intermittently linked with mental health services and had participated in numerous detox and substance abuse programs over the last ten years, with varying degrees of success. He was in dual diagnosis treatment (i.e., treatment for co-occurring substance use and mental health disorders) through his Suboxone clinic and was completing toxicology screenings on a biweekly basis.After concluding the minimum three months of drug and alcohol treatment set forth by the state's Organ Transplantation Consortium, the patient graduated from his sober living program, moved in with his sister, and was listed for a liver transplant.The patient was transplanted five months after his clinic evaluation. At the time of the surgery, the patient's Suboxone was abruptly discontinued and replaced with IV Dilaudid. Within days of his transplant, the patient frequently expressed concerns about his pain. Several medical services attempted to manage the pain medications, resulting in his pain management plan being changed repeatedly and much confusion over his current medication regimen. During his liver transplant hospitalization, the RN found the patient with a needle in his arm, and after a search of the patient's hospital room, the hospital police found drug paraphernalia and illicit substances. The patient was eventually discharged to an inpatient substance abuse program, which he left before completing the program and against medical advice.During his first year post-transplant, I attempted to arrange other various treatment programs for him (most of which he did not follow through with) and to find housing for him (as he had been forced to leave his sister's home after his relapse). Eventually, the patient was incarcerated on drug-related charges. Numerous times, the patient missed completing his labs and his post-transplant appointments. He did not refill his immunosuppressant medications, and for lengthy periods of time, he was unreachable by the transplant care team, which resulted in my team members and I calling the patient's family, other providers, and the police for safety checks.In the aftermath of these issues, my colleagues and I had to reckon with the realization that we had failed the patient. As a team, our transplant center created a task force to review this case and what to do in the future to prevent such breakdowns in patient care. We created protocols for managing patients who, at the time of their transplant, are on Medication Assisted Treatment (MAT) such as Suboxone and methadone. Staff across the multidisciplinary team attended trainings regarding addiction, pain management, and best practices for MAT services. Additionally, our transplant center collaborated with our hospital's addiction treatment program for a streamlined referral process for transplant patients to addiction services.This patient's case and its sensational nature resulted in many conversations, both professional and unprofessional. Members of the social worker department became aware that personnel within transplant, though not involved in patient care, were inappropriately discussing this patient's case and engaging in unprofessional behavior. Said actions led to the termination of a member of the transplant team. I was placed in the unenviable [End Page E3] position of having to report this behavior to hospital management and legal teams to protect a vulnerable patient.The ethical challenge behind this case really stems from the transplant team attempting to balance two... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:684 Feminist Studies 43, no. 3. © 2017 by Feminist Studies, Inc. Megan Kaminski This Century This century is full-on burning the past past carrying back lost to re-memory the year brings millennial want: a bright new coat red shoes an end to oil pipelines and student loans encase us all in warmth not waged labor drab curtains pulled aside reveal window onto window echo us many permutations (...) bring responses wrought and metaled down empty that treasury steal back from church coffers there is something that binds more than moth-eaten sweaters more than stripped-soled shoes we wanting we to mean banks burning profits redistributed we holding the soft hands of we Megan Kaminski 685 This Century This century is not so good filled with tsunamis and snowstorms people displaced by capital and rising waters threaten to make even Kansas beach-front I’d like to stick a fork in the eye of the governor and the Koch brothers too help liberate people from bad shit minimum wage jobs and medical bills give all of us something real to be happy about like city parks clean water and a few fewer grams of rocket fuel in the arugula cats sunning themselves on warm days no old dudes wanting to mess with my uterus and a new sundress trimmed with ribbon This Century This century makes me say things about burning and baddies and whether poetry can really do much of anything unacknowledged legislator or just a lady ass atrophying perched in front of a laptop this century makes me write about changing and loving all of you and getting closer with warm-nosed nudges under your chin embraces while wearing my softest of sweaters these poems want to get out of my chair out of the house and the neighborhood out of capital and with people in favor of all of us animals and plants 686 Megan Kaminski This Century This century takes place in the streets in living rooms of friends in shared words exchanged across borders bridging the distance between you and me and we and ours and taking from board rooms and markets this century is full of things eroding making way for bodies for gardens for libraries for a commoning a burning of gates and fences and debts we spring forth in multitudes occupy more than street corners cordoned off we singing we and the streets the open fields... (shrink)

Persons with dementia often prefer to participate in decisions about their health care, but may be prevented from doing so because healthcare decision-making law facilitates use of advance directives or surrogate decision makers for persons with decisional impairments such as dementia. Federal and state disability law provide alternative decision-making models that do not prevent persons with mild to moderate dementia from making their own healthcare decisions at the time the decision needs to be made. In order to better promote autonomy (...) and wellbeing, persons with dementia should be accommodated and supported so they can make their own healthcare decisions. (shrink)

Reductionism is a central issue in the philosophy of biology. One common objection to reduction is that molecular explanation requires reference to higher-level properties, which I refer to as the context objection. I respond to this objection by arguing that a well-articulated notion of a mechanism and what I term mechanism extension enables one to accommodate the context-dependence of biological processes within a reductive explanation. The existence of emergent features in the context could be raised as an objection to the (...) possibility of reduction via this strategy. I argue that this objection can be overcome by showing that there is no tenable argument for the existence of emergent properties that are not susceptible to a reductive explanation. (shrink)

This article provides an analysis of bioprinting personalised medical device technology and its ethical challenges to regulation and research ethics. I argue the inclusion of bioprinting applications within existing regulatory frameworks does not adequately address the technologies disruption to the traditionally siloed activities of research and treatment. Using the conceptual framework of liminality, I offer a meaningful way to engage with this technology and address some identified concerns with how it will be categorised and the appropriate recognition of its evidentiary (...) thresholds. I demonstrate these concerns through the exploration of limited conventional research methodologies tasked with the production of generalisable knowledge, specifically population-based evidence that is derived from Randomised Clinical Trials. I use Australian regulatory amendments introduced in 2021 as an example of current regulatory trajectories and highlight why I believe this approach to be insufficient. The significance of this argument will be to demonstrate the disruption of bioprinting applications to current approaches in medical policy, and how various jurisdictions are enacting regulation that is not fit for purpose. (shrink)

Non-causal accounts of action explanation have long been criticized for lacking a positive thesis, relying primarily on negative arguments to undercut the standard Causal Theory of Action The Stanford Encyclopedia of Philosophy, 2016). Additionally, it is commonly thought that non-causal accounts fail to provide an answer to Donald Davidson’s challenge for theories of reasons explanations of actions. According to Davidson’s challenge, a plausible non-causal account of reasons explanations must provide a way of connecting an agent’s reasons, not only to what (...) she ought to do, but to what she actually does. That is, such explanations must be truth-apt, not mere rationalizations. My aim in this paper is to show how a non-causal account of action can provide explanations that are truth-apt and genuinely explanatory. To make this argument, I take as a given an account of the practical syllogism discussed by Michael Thompson and Eric Wiland, according to which the practical syllogism is truly practical rather than propositional in nature. Next, I present my primary positive thesis: reasons for actions have explanatory power in virtue of being parts of a structure—the practical syllogism—that contains the action being explained. I then argue that structural action explanations can meet Davidson’s challenge and that they genuinely explain actions. Finally, I conclude by addressing some objections to my argument. (shrink)

According to a well-established tradition in the philosophy of language, we can understand what makes an arbitrary sound, gesture, or marking into a meaningful linguistic expression only by appealing to mental states, such as beliefs and intentions. In this paper, I explore the contrasting possibility of understanding the meaningfulness of linguistic expressions just in terms of observable linguistic behavior. Specifically, I explore the view that a type of sound becomes a meaningful linguistic expression within a group in virtue of the (...) production of that type of item becoming that group’s widespread, copied way of getting others to involve an object or relation in their activity. After discussing a preliminary version of the view, I develop it in response to some key concerns about whether it really does, as a matter of fact, eschew mental states, and about its adequacy as an account of linguistic meaning. (shrink)

The lymphatic vasculature plays a critical role in the regulation of body fluid volume and immune function. Extensive research into the molecular mechanisms that control blood vessel growth has led to identification of molecules that also regulate development and growth of the lymphatic vessels. This is generating a great deal of interest in the molecular control of the lymphatics in the context of embryogenesis, lymphatic disorders and tumor metastasis. Studies in animal models carried out over the past three years have (...) shown that the soluble protein growth factors, vascular endothelial growth factor (VEGF)‐C and VEGF‐D, and their cognate receptor tyrosine kinase, VEGF receptor‐3 (VEGFR‐3), are critical regulators of lymphangiogenesis. Furthermore, disfunction of VEGFR‐3 has recently been shown to cause lymphedema. The capacity to induce lymphangiogenesis by manipulation of the VEGF‐C/VEGF‐D/VEGFR‐3 signaling pathway offers new opportunities to understand the function of the lymphatic system and to develop novel treatments for lymphatic disorders. BioEssays 24:1030–1040, 2002. © 2002 Wiley‐Periodicals, Inc. (shrink)