This paper explores the impact of the Human Rights Act 1998 on decision making in adult social care in England and Wales. It focuses on a review of the Act by the government in June 2006 and subsequent new guidance on implementation addressed to policy makers, managers and practitioners. The meaning of ?rights? in contemporary legal and social theory is considered and the potential of human rights law to improve the experiences of service users is evaluated in the light of (...) recent research findings and proposed policy changes. (shrink)

In 2012, chief nursing officers (CNO) in England published a policy on compassion in response to serious criticisms of patients’ care. Because their objective is fundamentally to shape nursing, this study argues, following Popper, that the policy should be analysed. An appraisal tool, developed from Popper, Gadamer, Jauss and Thiselton, is the framework for this analysis. The CNO policy document identified six values and behaviours, termed ‘6Cs’, required by all nurses, midwives and care staff. The document contains no data, references (...) or acknowledgements, but is similar to the 6Cs defined by the Canadian nursing nun, Sister M. Simone Roach, in her theory of caring published 30 years earlier. Roach considered caring and the components of it, including compassion, to be moral virtues, an inner motivation to care. This study suggests that without explicit reference to Roach's ideas, and her underlying theoretical base, the CNO requirement has the effect of turning virtues into commodities and a form of external control, described by Ritzer as a McDonaldized dehumanization. This study, which has international relevance beyond England and the UK, suggests that the CNO revise their policy by acknowledging Roach's 6Cs and openly discuss the implications of her work for their policy. (shrink)

Background: Moral distress is a growing problem for healthcare professionals that may lead to dissatisfaction, resignation, or occupational burnout if left unattended, and nurses experience different levels of this phenomenon. Objectives: This study aims to investigate the factor structure of the Persian version of the Moral Distress Scale–Revised in intensive care and general nurses. Research design: This methodological research was conducted with 771 nurses from eight hospitals in the Mazandaran Province of Iran in 2017. Participants completed the Moral Distress Scale–Revised, (...) data collected, and factor structure assessed using the construct, convergent, and divergent validity methods. The reliability of the scale was assessed using internal consistency (Cronbach’s alpha, Theta, and McDonald’s omega coefficients) and construct reliability. Ethical considerations: This study was approved by the Ethics Committee of Mazandaran University of Medical Sciences. Findings: The exploratory factor analysis ( N = 380) showed that the Moral Distress Scale–Revised has five factors: lack of professional competence at work, ignoring ethical issues and patient conditions, futile care, carrying out the physician’s orders without question and unsafe care, and providing care under personal and organizational pressures, which explained 56.62% of the overall variance. The confirmatory factor analysis ( N = 391) supported the five-factor solution and the second-order latent factor model. The first-order model did not show a favorable convergent and divergent validity. Ultimately, the Moral Distress Scale–Revised was found to have a favorable internal consistency and construct reliability. Discussion and conclusion: The Moral Distress Scale–Revised was found to be a multidimensional construct. The data obtained confirmed the hypothesis of the factor structure model with a latent second-order variable. Since the convergent and divergent validity of the scale were not confirmed in this study, further assessment is necessary in future studies. (shrink)

ABSTRACTOrganization and management researchers praise the value of care in the workplace. However, they overlook the conflict between caring for work and for coworkers, which resonates with the dilemma of care allocation highlighted by ethicists of care. Through an in-depth qualitative study of two organizations, we examine how this dilemma is confronted in everyday organizational life. We draw on the concept of boundary work to explain how employees negotiate the boundary of their caring responsibilities in ways that grants or denies (...) care to coworkers. We argue that the possibility of an ethics of care for coworkers requires boundary work that suspends the separation of personal and professional selves and constitutes the worker as a whole person. We contribute to research on care in organizations by showing how care for coworkers may be enabled or undermined by maintaining or suppressing the care allocation dilemma. (shrink)

The current pandemic period has triggered a series of changes in society, at both individual and collective behavioral levels. These changes were perceived as either positive or negative by the impacted bodies, leading to both social change and positive interactions in a tense context. In this paper, the authors will deal with Pandemica Panotpica, subjugation infiltrating all levels of society, and the approach adopted by several countries in trying to find countermeasures to combat the virus' proliferation. Our research scope began (...) at the onset of the pandemic and ended on early January 2021. (shrink)

Because of the transfer of responsibility from hospitals to community-based settings, providers in home-based care have more responsibilities and a wider range of tasks and responsibilities than before, often with limited resources. The increased responsibilities and the complexity of tasks and patient groups may lead to several ethical challenges. A systematic search in the databases MEDLINE, CINAHL, and SveMed+ was carried out in February 2019 and August 2020. The research question was translated into a modified PICO (Population, Intervention, Comparison, and (...) Outcome) worksheet. A total of 40 articles were included. The review is conducted according to the Vancouver Protocol. The main findings from the systematic literature review show that ethical challenges experienced by healthcare and social care providers in home-based care are related to autonomy and balancing ethical principles, decisions regarding intensity of care, challenges related to priority settings, truth-telling, and balancing the professional role. Findings regarding ethical challenges within home-based care are in line with findings from institutional healthcare and social care settings. However, some significant differences from the institutional context are also highlighted. (shrink)

Background: In accordance with ethical guidelines for nurses, leaders for nurse services in general are responsible for facilitating professional development and ethical reflection and to use ethical guidelines as a management tool. Research describes a gap between employees’ and nurse leaders’ perceptions of priorities. Objective: The purpose of this article is to gain deeper insight into how nurses as leaders in somatic hospitals describe ethical challenges. Design and method: We conducted individual, quality interview with 10 nurse leaders, nine females and (...) one male nurse aged 34–64 years. We used a hermeneutical approach to analyse the data. Ethical considerations: The participants received oral and written information about the study. Participation in the study was voluntary, and the participants were given the opportunity to withdraw. All of them gave written consent. The Norwegian Centre for Research Data approved the research project. In addition, the head of the hospitals gave permission to conduct our study. Findings: Four main areas were identified: deficient ethical language, conflicting demands on nurse leaders regarding staff management, concerns regarding young nurses’ ethical consciousness and restricting factors on the creation of a climate of ethics. The nurse leaders experienced considerable pressure. An unexpected finding was the lack of – and even disregard for – an ethical language. Discussion and conclusion: It is crucial to recognise ethics in all types of nursing approaches and to make it explicit. Ethical language must be implemented in nursing education. It must be recognised and used in clinical practice. Recommendations: We recommend further research be conducted into how nurses understand the concept of ethics and how to incorporate ethical principles into clinical nursing and nurse leadership. (shrink)

Sea-level rise (SLR) is a threat to coastal areas and there is growing interest in how social values, risk perception and fairness can inform adaptation. This study applies these three concepts to an urban community at risk of SLR in Botany Bay, Australia. The study engaged diverse groups of residents via an online survey. Cluster analysis identified four interpretive communities: two groups value work-life balance, are concerned about SLR and would likely engage in collective adaptation. The third group value everything (...) about Botany Bay and are active in organisations that could prove to be an important outreach. The fourth group were older men, disengaged from both SLR and policy but could respond to individual consultation and targeted communication. Thus, multifarious approaches can engage diverse communities in fair decision-making and transform community-facilitated adaptation. (shrink)

Many philosophers have defended the view that we are subject to the following evidential ought: “One ought to believe in accordance with one's evidence.” Although they agree on this, a more fundamental question keeps dividing them: from where does the evidential ought derive its normative force? The instrinsicalist answer to this question is sometimes described as the claim that "there is a brute epistemic value in believing in accordance with one's evidence" (Cowie, 2014, 4005). But what does this really mean? (...) Intrinsicalists' negative claim is that the normative source of the evidential ought has nothing to do with the fulfilment of our epistemic purposes. But what is their positive claim exactly? This paper aims at improving our understanding of intrinsicalism. Its conclusion is that there is only one possible way of being an intrinsicalist. Intrinsicalists need to be constitutivists. (shrink)

In "Implementing Expanded Prenatal Genetic Testing: Should Parents Have Access to Any and All Fetal Genetic Information?," Bayefsky and Berkman argue in favor of establishing three categorie...

Management and organization researchers are being called to conduct research that is more caring, yet the concept of care and how to practice it within the profession is undertheorized. Adopting a feminist epistemology and methodology, we develop the concept of care by weaving the personal, ethical, and political into the research process. First, we reflect critically on how aspects of care—attentiveness, responsibility, competence, and responsiveness (Tronto, Moral boundaries: a political argument for an ethic of care, Routledge, 1993; Tronto, Caring democracy: (...) markets, equality, and justice, New York University Press, 2013)—unfolded in our personal research experiences, and secondly, we conduct a review of articles published in management and organization studies and analyse expressed or concealed conceptions of care in scholars’ accounts of research purpose and ethics. We find three ethical sensibilities at the heart of enacting care: encountering the ‘other’, interpreting roles and responsibilities, and deliberating needs and resources. We contribute to a feminist research ethics by highlighting issues related to care that are concealed in dominant ethos guiding management and organization research. Further, we develop methodological insights for implementing an ethic of care as an alternative ethical standpoint in business research ethics. Finally, we provide suggestions for how to embed more care within research ethics practices in academic institutions. (shrink)

Background: Empathy and moral courage are important virtues in nursing and nursing ethics. Hence, it is of great importance that nursing students and nurses develop their ability to empathize and their willingness to demonstrate moral courage. Research aim: The aim of this article is to explore third-year undergraduate nursing students’ perceptions and experiences in developing empathy and moral courage. Research design: This study employed a longitudinal qualitative design based on individual interviews. Participants and research context: Seven undergraduate nursing students were (...) interviewed during or immediately following their final clinical placement. Ethical considerations: The Norwegian Social Science Data Services (NSD) approved the study. Participants were informed that their participation was voluntary and were assured confidentiality. They were informed that they could withdraw from the study at any time, without providing reasons. Findings: Affective empathy seemed to be strong among third-year undergraduate nursing students. However, they tried to handle the situations in a ‘professional’ way, and to balance their emotions. At the same time, they expressed how difficult it can be to show moral courage when confronted with poor patient care. In addition, they spoke about a lack of role models during clinical practice and supervision. Conclusions: Undergraduate nursing students are in a vulnerable position throughout their journey to become professional and to develop empathy and moral courage. The professional socialisation and forming of professional empathy and moral courage among nursing students, may be seen as a complex interaction of formal and hidden curriculum, where role models play an important role. We argue that the main theme ‘Vulnerable students – a journey towards professional empathy and moral courage’ may cover the longitudinal project as a whole. This vulnerability is something both teachers and supervisors should be aware of when following up with students in their clinical placements. (shrink)

BIEN’s definitive statement of a Basic Income (BI) and the commentaries on its five characteristics are examined in turn, to identify potential clarifications, revisions and omissions. The following amendments are proposed as a basis for further discussion: to shift the position of ‘unconditionally’ in the definitive statement so that it refers to the cash payment rather than to its delivery; some clarifications to characteristics 3 ‘individual’ and 4 ‘universal’; to introduce ‘uniform’, without which BIs could be used to endorse flagrant (...) discrimination against, or even zero amounts for, less favoured groups; to restore the comprehensive nature of ‘unconditionality’ (which is now characteristic 6), by substituting ‘behavioural requirement’ in place of ‘work requirement’; to give the characteristic ‘without means test’ its own commentary (no. 7). The introduction of ‘uniform’ and ‘behavioural’ into the definitive statement should help to prevent BIEN’s definition from being regarded as male orientated. (shrink)

Eric Olson distinguishes his animalistic account of transtemporal personal identity from the apparently similar Bodily Criterion, among other things, by accusing the latter of being contaminated with Cartesian implications owing to its usage of the term ‚body‘. In contrast, Olson argues, Animalism is able to avoid these implications by substituting the concept of body for the concept of organism, which makes Animalism not only a distinct position, but also the better alternative to the Bodily Criterion. The paper critically reconstructs Olson’s (...) charge of Cartesianism against the Bodily Criterion, thereby differentiating between several variants of it. This eventually adds up to an evaluation of how suitable these criticisms are for defending Animalism at the expense of the Bodily Criterion. (shrink)

In this paper, I reflect on an important article by Bob Veatch in the inaugural issue of the Hastings Center Report, entitled “Experimental Pregnancy.” It is a report and elegant analysis of the Goldzieher Study, in which nearly 400 women were randomized to receive hormonal contraception or placebo absent consent or disclosure about placebo use, resulting in several pregnancies. Noting the study’s limited notoriety, I first consider the narratives that have instead dominated bioethics’ approach to pregnancy and research: thalidomide and (...) diethylstibesterol. These narratives have facilitated a narrow focus on avoiding fetal risk, to the exclusion of other ethically relevant considerations. I then revisit “Experimental Pregnancy” and offer two ways in which Bob’s analysis serves as an important corrective, first, by foregrounding research subjects, and second, by normalizing pregnancy and thus foregrounding foundational ethical considerations that are sometimes lost amidst pregnancy’s presumed exceptionalism. (shrink)

Debates in metaethics about metanormative realism, quasi-realism, anti-realism, and nihilism mostly focus on epistemic reasons for beliefs about values. Very little has been said about our practical reasons for metaethical beliefs, and even less is said about practical reasons for other attitudes we might take toward metaethical views. This paper shows why a recent argument bucking that trend fails to show that we have practical reasons to believe realism over nihilism, but that for many of us, we do have practical (...) reason to hope that what I call Optimistic Realism is true. (shrink)

In Ludwig Wittgenstein's writings, ethics takes a central place in his thinking. This element investigates his engagement with ethics in both early and later thinking. Starting from the remarks on ethics in the Tractatus Logico-Philosophicus and the framing of these remarks, it presents two influential approaches to Tractarian ethics, before it develops a coherent reading of ethics in the early thinking, focusing on ethical silence and the relationship notions of world and the philosophical 'I'. The reading of 'A Lecture on (...) Ethics' focuses on the critique of ethical theory and the personal dimension of ethics, two themes also running through Wittgenstein's later thinking. It considers Wittgenstein's later ethical investigations, of ethical examples, ethically relevant language uses of language and the connections between reflections on ethics and living. It also considers the role of the other in Wittgenstein's later thinking. (shrink)

Hannah James makes a persuasive case for the use of donated bodies and body parts in surgical training, enabling high fidelity training, improved competency of surgeons and reduced risk of harm to patients from trainees ‘learning on the job’.1 She also identifies some pertinent ethical questions that arise from this practice that should be considered by training organisations, regulatory authorities and the trainees themselves. Many countries throughout the world have regulated programmes, governed by strict ethical principles, for donating bodies, usually (...) to academic institutions for the purposes of medical education.2 In the UK the Human Tissue Authority sets out guiding principles for institutions licensed to handle human tissue including donation of bodies for anatomical examination, education and research; consent, dignity, quality, and honesty and openness.3 The Nuffield Council on Bioethics, in its 2011 report, Human Bodies: donation for medicine and research, identified a number of relevant ethical values including autonomy, altruism, justice, dignity, reciprocity, maximising welfare, and honesty and respect.4 While this report did not focus specifically on donation of human tissue for education and training the principles identified are equally relevant in this context. In terms of maximising welfare whole body donation for education and training provides benefit to many patients over a relatively short time frame …. (shrink)

In this special issue of _difference_s, leading feminist theorists acknowledge Derrida’s contribution to feminist theory, discuss the crucial place of difference in both Derridian deconstruction and feminist theory, and reflect on the ethical, professional, and epistemological implications of Derrida’s thought for the discipline of women’s studies. In bringing together major feminist critics whose work has been touched by the writings of Derrida, this issue both pays tribute to and reflects upon Derrida’s ideas. Among the essayists included, Jane Gallop considers Derrida’s (...) writings on Levinas; Judith Butler reads Derrida’s final interview in _Le Monde_ in 2004; Elizabeth Grosz signals Derrida as a rare philosopher for whom sexual difference was crucial; Gayatri Chakravorty Spivak explores the figure of the mother’s child in Derrida, focusing on the critique of reproductive heteronormativity and the question of agency in feminism; and Joan Wallach Scott argues for the importance of critique in the academy. The issue also includes an edited transcription of a vibrant discussion between feminist theorists and Derrida called “Women in the Beehive: A Seminar with Jacques Derrida,” which took place at Brown University’s Pembroke Center for Teaching and Research on Women in 1984. _Contributors_. Fran Bartkowski, Anne-Emmanuelle Berger, Susan Bernstein, Judith Butler, Pheng Cheah, Drucilla Cornell, Jane Gallop, Elizabeth Grosz, Peggy Kamuf, Christie McDonald, Joan Wallach Scott, Gayatri Chakravorty Spivak. (shrink)

This article discusses ‘Notes on Language Games’, written by Harold Garfinkel in 1960 and never before published, one of three distinct versions of his famous ‘Trust’ argument, i.e., that constitutive criteria define shared events, objects, and meanings. The argument stands in contrast to an approach to cultural anthropology that was becoming popular in 1960 called ‘ethnoscience’. In this previously unknown manuscript, Garfinkel proposes that cultural events and language events are the same, in that both are created through constitutive commitments to (...) interactional systems. The best-known version of the Trust argument (Garfinkel, 1963) emphasizes Schutz, while other versions build on Parsons (Garfinkel 2019). In this third version, the Trust conditions are elaborated in terms of Wittgenstein’s language games. Various strands of Garfinkel’s thinking about culture, language and interaction are interwoven. That Garfinkel was working with Parsons in 1960 to document a contractual basis for social events and their assembly practices in ‘systems of interaction’, a constitutive practice argument with roots in Durkheim’s work, is yet another strand. The article highlights how the Trust argument is the key to everything, not only ethnomethodology, but also Garfinkel’s attempt to develop a general sociology of culture, language and interaction. (shrink)

The principled approach to theory building that has been a conspicuous mark of bioethical theory for the past generation has in recent years fallen under considerable critical scrutiny. Although some critics have confined themselves to reordering the dominant principles, others have rejected a principled approach entirely and turned to alternative paradigms. Prominent among critics are antiprin-ciplists, who want to jettison the principle-based approach altogether and adopt a casuistic model, and communitarians, who favor an eclectic model combining features of both the (...) casuistic model and a modified principled approach. Particularly conspicuous in virtually all such critiques is their challenge to the preeminence of the principle of autonomy. Critical barbs have been aimed not only at theories favoring a hierarchical ordering of moral principles that give first place to autonomy, but also at those that include autonomy among a set of ostensibly coequal principles. Though these critics have performed a valued function by displacing bioethical principles from their Olympian perch beyond actual decision-making contexts, some version of the principle of autonomy may, nonetheless, be well worth defending but for very different reasons than those put forward by its supporters. (shrink)

In this article, I compare the ways in which Baudrillard and Heidegger seek to bring attention to the importance of death for our personal existential situation which has now become repressed in conceptions of existence and society. Heidegger critiques public conceptions of death that serve to cover up its importance. Less well known is that, somewhat in parallel fashion, Baudrillard charts a ‘genealogy’ of the ‘extradition’ of the dead from the centre of the social and he claims that we live (...) currently in a death denying society. This reduces the meaning of our own impending deaths. However, unlike Heidegger, Baudrillard’s ‘genealogical’ critique of the exclusion of death in modern society is not a one-way dismissal because he proposes an alternative social role for death in the form of ‘primitive symbolic exchange’. (shrink)

Can mental causation be naturalised without being eliminated? Thomas Buchheim argues that it can, proposing a neo-Aristotelian account dubbed "Horizontal Dualism". In this paper I assess this proposal. This article is part of a series of articles commenting on Thomas Buchheim's target article "Neuronenfeuer und seelische Tat. Ein neoaristotelischer Vorschlag zum Verständnis mentaler Kausalität", published in Philosophisches Jahrbuch 119,2 (2012), 332-346. The article was reprinted in: Mentale Verursachung [Mental Causation], ed. by Wilhelm Vossenkuhl, (Jahrbuch-Kontroversen 1), Freiburg: Alber, 2014.

Much attention in philosophy of religion has been devoted to the question of whether faith is epistemically rational. But is it morally and practically permissible? This paper explores a response to a family of arguments that Christian faith is morally impermissible or practically irrational, even if epistemically justified. After articulating the arguments, I consider how they would fare if they took seriously the traditional notion that genuine faith is always accompanied by Christian hope. I show how the norms of hope (...) regulate Christian faith in such a way that it does not involve, and certainly does not entail, the morally and practically problematic attitudes and behaviors with which it is associated. (shrink)