Background and aim Healthcare professionals are regularly exposed to moral challenges in patient care potentially compromising quality of care and safety of patients. Preventive clinical ethics support aims to identify and address moral problems in patient care at an early stage of their development. This study investigates the occurrence, risk factors, early indicators, decision parameters, consequences and preventive measures of moral problems. Method Semi-structured expert interviews were conducted with 20 interprofessional healthcare professionals from 2 university hospitals in (...) Basel, Switzerland. A Likert scale questionnaire was completed by the interviewees and analysed using descriptive and inferential statistics. Results Healthcare professionals are frequently exposed to a variety of moral problems, such as end-of-life decisions, resource allocation and assessing the patient's will or decisional capacity. Thirty-four different risk factors for moral problems are identified, e.g. patient vulnerability, divergent values or world views, inadequate resources or poor ethical climate. Twenty-one early indicators are recognised such as disagreement between healthcare professionals, patients and relatives, emotional disturbances, gut feeling or conflict of conscience. A variety of preventive measures are suggested and presented in a preventive clinical ethics support process model. The most helpful measures are early ethical conversations with colleagues, early team-internal ethical case discussions and an ethics-trained contact person on the ward. Ethics training, kerbside consultations, proactive ethics consultations, ethics screening and rounds are also considered helpful. Conclusions Clinical ethics support services should not only offer reactive and complex, but also proactive and low-threshold support for healthcare professionals, patients and relatives. (shrink)

This fascinating study, Steven Lukes, one of the foremost political theorists writing in English today, examines value pluralism and moral conflict and their implications for political thinking and practice. In Parts I and II he discusses them directly and their consequences for how we are to think about equality, liberty, power, and authority. In Part III he focuses on the non-obvious role of morality in Marxist theory and practice, and in Part IV he examines the contributions of contemporary (...) political thinkers, including Vaclav Havel. In the final section he puts theory to the test, looking at important political issues and showing how political moralities influence the world we live in. This book will be of particular interest to teachers and students of political theory, political philosophy, and moral philosophy. (shrink)

Two groups of agents, G1 and G2, face a *moral conflict* if G1 has a moral obligation and G2 has a moral obligation, such that these obligations cannot both be fulfilled. We study moral conflicts using a multi-agent deontic logic devised to represent reasoning about sentences like "In the interest of group F of agents, group G of agents ought to see to it that phi". We provide a formal language and a consequentialist semantics. An (...) illustration of our semantics with an analysis of the Prisoner’s Dilemma follows. Next, necessary and sufficient conditions are given for (1) the possibility that a single group of agents faces a moral conflict, for (2) the possibility that two groups of agents face a moral conflict within a single moral code, and for (3) the possibility that two groups of agents face a moral conflict. (shrink)

This work takes up the problem of moral conflict, wherein a person must choose between two or more evils. The problem lies behind such issues as the defensive war, therapeutic abortion, and contraception. It becomes a religious question because, as the author argues, religion elicits the same kind of openness to values as is needed for addressing moral dilemmas. After culling insights out of the history of Christian ethics, Blasi presents phenomenologies of both moral decision making (...) and religion, and uses the results to address the variety of moral dilemmas. (shrink)

In this revised edition of Moral Conflicts of Organ Retrieval: A Case for Constructive Pluralism, Charles Hinkley develops and applies the moral philosophy of constructive pluralism to issues and conflicts related to organ transplantation.

After distinguishing three criteria of adequacy for any acceptable moral theory's treatment of moral conflict, or conflicts of duties, I explain how Kant's ethics can satisfy all three. Although Kant denies the possibility of conflicting duties, he does allow conflicting "grounds of obligation." I develop a new interpretation of such conflicts, rejecting one proposed earlier by Onora O'Neill.

The paper proposes a revised logic of rights in order to accommodate moral conflict. There are often said to be two rival philosophical accounts of rights with respect to moral conflict. Specificationists about rights insist that rights cannot conflict, since they reflect overall deontic conclusions. Generalists instead argue that rights reflect pro tanto constraints on behaviour. After offering an overview of the debate between generalists and specificationists with respect to rights, I outline the challenge of (...) developing a logic of rights-reasoning that is compatible with generalism. I then proceed to offer a new logical framework, which utilizes a simple non-monotonic logic of practical reasoning. Both generalist and specificationist interpretations of the logic are explored. The revised logic shows that traditional characterizations of the debate between specificationists and generalists obscure other relevant philosophical positions. (shrink)

Moral conflicts over medical treatment that are the result of differences in fundamental moral commitments of the stakeholders, including religiously grounded commitments, can present difficult challenges for clinical ethics consultants. This article begins with a case example that poses such a conflict, then examines how consultants might use different approaches to clinical ethics consultation in an effort to facilitate the resolution of conflicts of this kind. Among the approaches considered are the authoritarian approach, the pure consensus approach, (...) and the ethics facilitation approach described in the Core Competencies for Healthcare Ethics Consultation report of the American Society for Bioethics and Humanities, as well as a patient advocate approach, a clinician advocate approach, and an institutional advocate approach. The article identifies clear limitations to each of these approaches. An analysis of the introductory case illustrates those limitations, and the article concludes that deep-seated conflicts of this kind may reveal inescapable limits of current approaches to clinical ethics consultation. (shrink)

This book addresses ethical conflicts arising from saving the lives of patients who need a transplant while treating living and dead donors, organ sellers, animals, and embryos with proper moral regard. Our challenge is to develop a better world in the light of debatable values and uncertain consequences.

Why democracy? Most often this question is met with an appeal to some decidedly moral value, such as equality, liberty, dignity or even peace. But in contemporary democratic societies, there is deep disagreement and conflict about the precise nature and relative worth of these values. And when democracy votes, some of those who lose will see the prevailing outcome as not merely disappointing, but morally intolerable. How should citizens react when confronted with a democratic result that they regard (...) as intolerable? Should they revolt, or instead pursue democratic means of social change? In this book, Robert Talisse argues that each of us has reasons to uphold democracy - even when it makes serious moral errors - and that these reasons are rooted in our most fundamental epistemic commitments. His original and compelling study will be of interest to a wide range of readers in political philosophy and political theory. (shrink)

There are genuine moral conflicts. sometimes by doing what we ought to do we do what we ought not to do. "pace" bernard williams the existence of such conflicts is compatible with the truth of moral realism. we realize this when we understand that ascriptions of rightness, wrongness, and obligatoriness are "de re" rather than "de dicto".

The article focuses on the study on moral conflicts and ethical relativism. There are few theories in the history ethics that stated that a moral dilemma can not be adhered by to moral requirements. According to philosophy professor David Wong, occurrence of irresolvable moral disagreement is one of the normative problems. On the other hand, the author asserted that single-agent moral conflicts do not necessarily fall under the relativism theory.

Michael Moehler’s Minimal Morality is a wonderful and important book, from which I have learned a great deal. It reinvigorates rational choice moral theory in the process of confronting what I see as the most important issue in social and moral philosophy today: can those in a deeply morally divided society endorse a common moral framework to structure social cooperation? Is a rational moral order possible under conditions of deep and wide moral diversity? Minimal Morality’s (...) answers are thoughtful and innovative. I am not, however, entirely persuaded that Minimal Morality can fulfil its promise of grounding a cooperative order when ‘traditional’ modes moral justification cannot. (shrink)

By making use of Aurel Kolnai's ethical writings I want to offer a more adequate understanding of moral conflicts and moral dilemmas. Insisting on Kolnai's phenomenological method, in particular, focussing on the agent's moral awareness (or conscience) and his deliberation, results in an understanding of moral conflicts as moments of moral choice rather than anomalies of moral theory. In this way, I argue that one can account for Bernard Williams's phenomenological description of moral (...) conflicts without having to accept his anti-realist conclusions. Moreover, this approach indicates the adequacy of ordinary moral reasoning for decisionmaking and action guidance. Lastly and importantly, the essay illustrates the relevance of Kolnai's writings to contemporary moral philosophy. (shrink)

Reza Akbari Solving moral conflicts entails a decision-making process. So any suggested approach to moral conflicts is included in the domain of practical rationality. The practical rationality is based on theoretical rationality. Both the theoretical and practical rationality have a realistic kind of approach and an idealistic kind of approach. In the theoretical rationality, the idealistic approaches demand certainty in a strict sense, following epistemic guidelines; and in the practical rationality, they demand the best possible choice. Nevertheless, there (...) are some difficulties with the idealistic approaches. Concerning the realistic approaches, we can gain access to two truths: First, each situation is an individual circumstance and each person has certain epistemic features, and so it is not possible to present general, universalizable solutions to conflicts even in a particular scope. Second, the acceptance of some propositions is a voluntary act, and so cognitive space and previous beliefs of any individual have a role in the acceptance of a belief and the following universalizations. By attention to extensive emphasis of the religion on moral doctrines, it can be said that religious education through practical patterns has a positive role in solving moral conflicts. (shrink)

Much research is currently being conducted on health care practitioners' experiences of moral distress, especially the experience of nurses. What moral distress is, however, is not always clearly delineated and there is some debate as to how it should be defined. This article aims to help to clarify moral distress. My methodology consists primarily of a conceptual analysis, with especial focus on Andrew Jameton's influential description of moral distress. I will identify and aim to resolve two (...) sources of confusion about moral distress: the compound nature of a narrow definition of distress which stipulates a particular cause, i.e. moral constraint, and the distinction drawn between moral dilemma and moral distress, which implies that the two are mutually exclusive. In light of these concerns, I argue that the definition of moral distress should be revised so that moral constraint should not be a necessary condition of moral distress, and that moral conflict should be included as a potential cause of distress. Ultimately, I claim that moral distress should be understood as a specific psychological response to morally challenging situations such as those of moral constraint or moral conflict, or both. (shrink)

Recent years have seen a growth of interest in the great English idealist thinker T. H. Green as philosophers have begun to overturn received opinions of his thought and to rediscover his original and important contributions to ethics, metaphysics, and political philosophy. This collection of essays by leading experts, all but one published here for the first time, introduces and critically examines his ideas both in their context and in their relevance to contemporary debates.

In this paper I would like to make a contribution to the debate on rights-talk and duties-talk relationship and priority by addressing the problem from a peculiar angle: that of moral conflicts and dilemma. My working hypothesis is that it should be possible to identify some basic and relevant normative features of rights-talk and duties-talk by observing how they modify the description of moral conflicts. I will try to show that both rights and duties posses original and irreducible (...) normative features, and that these latter can be employed in a general assessment of their pro and con. I will first show the conceptual relationship between rights and duties, analyzing in the process a deflationary argument for rights. Second, I will define the general features of moral conflict and dilemma. I will then analyze the different readings that can be given, taking rights or duties as standpoints, of two kinds of moral conflicts: «asymmetric» and «symmetric» conflicts. (shrink)

According to one understanding of the problem of dirty hands, every case of dirty hands is an instance of moral conflict, but not every instance of moral conflict is a case of dirty hands. So, what sets the two apart? The dirty hands literature has offered widely different answers to this question but there has been relatively little discussion about their relative merits as well as challenges. In this paper I evaluate these different accounts by making (...) clear which understanding of concept distinctness underlies them and which of them is, ultimately, the most plausible one in the case of dirty hands and ordinary moral conflict. In order to do so, I will borrow from the terminology employed in recent debates in the philosophy of evil which have tackled a similar problem to the one at hand, i.e. defining what sets evil apart from ordinary wrongdoing. Here it has been argued that concepts could be distinct in three ways: they can have a quantitative difference, a strong qualitative or a moderate qualitative difference. I conclude that the most convincing definition of dirty hands draws a moderate qualitative distinction between ordinary moral conflict according to which dirty hands are those moral conflicts that involve a serious violation or betrayal of a core moral value. (shrink)

If we ask ourselves whether ultimate moral conflicts exist, and if we take seriously the goal of capturing ordinary emotional experience in our views about morality, we find the evidence mixed. We might have some reason for concluding that some situations are ultimate moral conflicts, but we also have good reasons of the same kind for concluding that these situations are not ultimate moral conflicts. So this kind of argument does not provide secure enough footing for any (...) sort of powerful criticism of moral theories which deny the existence of ultimate moral conflicts. Those who want to argue for the reality of ultimate moral conflicts can still argue from something other than ordinary emotional experience. Any such alternative strategy, though, will involve a retreat from the idea that ordinary emotional experience provides unambiguous support for the existence of ultimate moral conflicts and a secure point from which to criticize moral theories.I conclude, then, that accepting the reality of ultimate moral conflicts does not allow a truer picture of ordinary emotional experience. I am not sure, though, that this should be good news for those who believe in a moral realm without ultimate moral conflicts. What is most striking about ordinary emotional experience is not its tendency to support one or another picture of the moral realm, with or without ultimate moral conflicts, but its failure to endorse any very determinate picture of a moral realm. This suggests a rather shocking gap in our understanding of the concepts of moral obligation, prohibition, and permission, concepts which, after all, are alleged to play a familiar and vital role in our lives. Perhaps this gap can be filled by arguments beginning somewhere other than ordinary emotional experience. (Although skeptics will point to the failure of deontic logicians to find any decisive reason to choose between accounts that do and do not permit ultimate moral conflicts.) Alternatively, though, the ambiguity of ordinary emotional experience on the question of ultimate moral conflict might provide one kind of support for the suspicion, famously entertained by Elizabeth Anscombe, that the word “ought,” used to refer to a specifically moral realm, is a word “containing no intelligible thought: a word retaining the suggestion of force, and apt to have a strong psychological effect, but which no longer signifies a real concept at all - No content could be found in the notion ‘morally ought’; if it were not that - philosophers try to find an alternative (very fishy) content and to retain the psychological force of the term.” G.E.M. Anscombe, “Modem Moral Philosophy,” Philosophy 33 (1958): 8. (shrink)

The most cited sustainability definition, by the World Commission on the Environment and Development, contains a moral imperative, as pointed out by several scholars. While ethical implications have been examined by philosophers and social scientists, concepts such as agricultural sustainability have been challenged less. The present work should contribute to the debate on the implicit moral values of agricultural sustainability and help uncover conflicting moral perspectives regarding agricultural sustainability. Choosing the social dimension of agricultural sustainability as starting (...) point, the idea of conflict interrupting the functionality or longevity of any social system, such as a farm is introduced. Based on the idea of agricultural value chains, different stakeholders’ interests for seven moral conflict scenarios in agriculture and the moral arguments behind them are identified. These are sorted according to ethical theories and argumentation patterns are detected. The three central moral premises, as well as their importance to the sustainability context, are discussed. Finally, working hypotheses are proposed which can help create more comprehensive ideas about the social dimension of agricultural sustainability, furthering the consideration of normative aspects in the context of agricultural sustainability. (shrink)

This paper explores the possibility of moral conflict in Kant’s ethics. An analysis of the only explicit discussion of the topic in his published writings confirms that there is no room for genuine moral dilemmas. Conflict is limited to nonconclusive ‘grounds’ of obligation. They arise only in the sphere of ethical duty and, though defeasible, ought to be construed as the result of valid arguments an agent correctly judges to apply in the situation at hand. While (...) it is difficult to determine in theory what makes some of them stronger than others, these ‘grounds’ can account for practical residue in conflict cases and for a plausible form of agent regret. The principle that ‘ought implies can’ survives intact. (shrink)

While not an explicit claim of Hegel’s, this paper aims to use his analysis of ‘Conscience’ in the Phenomenology of Spirit to demonstrate that the conflict betweendifferent moral judgments is morally necessary. That is, rather than being the unfortunate result of ‘hard’ cases, I argue that moral conflict is a necessary condition for the possibility of duty. Grasping the moral ground of moral conflict, I contend, allows us to understand why such conflicts arise, (...) how and why they become entrenched into ‘moral issues’ and what our duties are in such cases. Thus, I aim to articulate both the moral necessity and dutiful resolution of seemingly intractable moral conflicts. (shrink)

Doctor's Dilemmas, a fascinating study of the moral dilemmas confronting health professionals and patients alike, examines areas of health care where ethical conflicts often arise. Gorovitz illuminates these conflicts by clearly explaining and applying a broad range of philosophical concepts. He lays the groundwork for informed ethical decision-making and provides the general reader with a lucid overview of the complexities of medical practice. Written in accessible, conversational style and making extensive use of anecdotes, examples, and references to literature, Doctor's (...) Dilemmas offers profound insights into medical ethics for all those involved with the health professions--be they doctors, nurses, administrators, or patients. (shrink)

The central question of this paper is how modern liberal political theory can understand and make sense of value pluralism and the conflicts upon which it is premissed. It is a commonplace that liberalism was born out of conflict, and has been partly characterised ever since as a series of attempts to accommodate it within the framework of the nation state . However, it is also true that liberals have proposed many different routes to the resolution, or containment, of (...) conflict, and these different routes are manifestations of different understandings of conflict itself both within an individual life and between lives. Thus, some assert the irreducible heterogeneity of value: John Stuart Mill famously inveighs against the attempt to model all human life on a single pattern and tells us that ‘human beings are not sheep, and even sheep are not indistinguishably alike. A man cannot get a coat or a pair of boots to fit him unless they are either made to his measure or he has a whole warehouseful to choose from; and is it easier to fit him with a life than with a coat?’ . On Mill's account, plurality is the natural condition of humanity. We should neither hope for nor expect the elimination of conflict, and a world in which there is diversity is richer and better for it. (shrink)

COVID-19 has truly affected most of the world over the past many months, perhaps more than any other event in recent history. In the wake of this pandemic are patients, family members, and various types of care providers, all of whom share different levels of moral distress. Moral conflict occurs in disputes when individuals or groups have differences over, or are unable to translate to each other, deeply held beliefs, knowledge, and values. Such conflicts can seriously affect (...) healthcare providers and cause distress during disastrous situations such as pandemics when medical and human resources are stretched to the point of exhaustion. In the current pandemic, most hospitals and healthcare institutions in the United States have not allowed visitors to come to the hospitals to see their family or loved ones, even when the patient is dying. The moral conflict and moral distress among care providers when they see their patients dying alone can be unbearable and lead to ongoing grief and sadness. This paper will explore the concepts of moral distress and conflict among hospital staff and how a system-wide provider wellness programme can make a difference in healing and health. (shrink)

Multiculturalism is higher on the daily political agenda than it has ever been. Leading politicians and public commentators speak with an unparalleled bluntness about the perceived limitations of multiculturalism while representatives of cultural, minorities express concern about marginalisation. This debate is taking place against a background of fear about terrorism, the integrity of national identities and a loosely construed ‘clash of civilizations’. Secularism is pitted against religious fundamentalism, respect for difference against the right of freedom of speech, integration against self-determination, (...) and duties of citizenship against minority rights. This book confronts the reality of moral conflict in the debate on multiculturalism while resisting the simplification which too frequently accompanies daily commentary on both sides of an increasingly polarised debate. The volume as a whole marks an important step in the attempt to examine the underlying concepts, of the nature and legitimate extent of disagreement, of secularism, the nature of power, the state and citizenship, which inevitably constitute key assumptions in the debate. Bringing together leading scholars on multiculturalism: Gerald Gaus, Peter Jones, John Horton, Tariq Modood, Chandran Kukathas, Bhikhu Parekh, Matthew Festenstein and Cecile Laborde, this book discusses the latest developments in the field. It will be of strong interest students and scholars of multiculturalism, political science, political theory, international relations, sociology, philosophy and anthropology. (shrink)

Multiculturalism is higher on the daily political agenda than it has ever been. Leading politicians and public commentators speak with an unparalleled bluntness about the perceived limitations of multiculturalism while representatives of cultural, minorities express concern about marginalisation. This debate is taking place against a background of fear about terrorism, the integrity of national identities and a loosely construed ‘clash of civilizations’. Secularism is pitted against religious fundamentalism, respect for difference against the right of freedom of speech, integration against self-determination, (...) and duties of citizenship against minority rights. This book confronts the reality of moral conflict in the debate on multiculturalism while resisting the simplification which too frequently accompanies daily commentary on both sides of an increasingly polarised debate. The volume as a whole marks an important step in the attempt to examine the underlying concepts, of the nature and legitimate extent of disagreement, of secularism, the nature of power, the state and citizenship, which inevitably constitute key assumptions in the debate. Bringing together leading scholars on multiculturalism: Gerald Gaus, Peter Jones, John Horton, Tariq Modood, Chandran Kukathas, Bhikhu Parekh, Matthew Festenstein and Cecile Laborde, this book discusses the latest developments in the field. It will be of strong interest students and scholars of multiculturalism, political science, political theory, international relations, sociology, philosophy and anthropology. (shrink)

From some perspectives, it seems obvious that emotions and feelings must be both reasonable and morally significant: from others, it may seem as obvious that they cannot be. This paper seeks to advance discussion of ethical implications of the currently contested issue of the relationship of reason to feeling and emotion via reflection upon various examples of affectively charged moral dilemma. This discussion also proceeds by way of critical consideration of recent empirical enquiry into these issues in the literature (...) of so-called emotional intelligence. In this regard, despite ambiguities in their accounts of the relationship of reason to emotion, advocates of emotional intelligence generally incline to therapeutic conceptions of emotional health which are not inconsistent with currently fashionable cognitivist accounts of feeling and emotion. All the same, it is arguable that therapeutic or other strategies which overplay the possibility of cognitive or other resolution of emotional conflict are prey to certain difficulties. First, they underemphasise those passive but identity-constitutive aspects of affect which are not obviously rationally accountable. Secondly, they insufficiently recognise the extent to which emotional conflicts can be significantly implicated in moral diversity. In view of either or both of these points, they may fail to appreciate the moral inappropriateness of attempts to resolve certain forms of emotional conflict or tension. (shrink)