Moral distress is one of the core topics of clinical ethics. Although there is a large and growing empirical literature on the psychological aspects of moral distress, scholars, and empirical investigators of moral distress have recently called for greater conceptual clarity. To meet this recognized need, we provide a philosophical taxonomy of the categories of what we call ethically significant moral distress: the judgment that one is not able, to differing degrees, to act on one’s moral knowledge about what one (...) ought to do. We begin by unpacking the philosophical components of Andrew Jameton’s original formulation from his landmark 1984 work and identify two key respects in which that formulation remains unclear: the origins of moral knowledge and impediments to acting on that moral knowledge. We then selectively review subsequent literature that shows that there is more than one concept of moral distress and that explores the origin of the values implicated in moral distress and impediments to acting on those values. This review sets the stage for identifying the elements of a philosophical taxonomy of ethically significant moral distress. The taxonomy uses these elements to create six categories of ethically significant moral distress: challenges to, threats to, and violations of professional integrity; and challenges to, threats to, and violations of individual integrity. We close with suggestions about how the proposed philosophical taxonomy of ethically significant moral distress sheds light on the concepts of moral residue and crescendo effect of moral distress and how the proposed taxonomy might usefully guide prevention of and future qualitative and quantitative empirical research on ethically significant moral distress. (shrink)

B. A. Farrell; XIII*—Temporal Precedence, Proceedings of the Aristotelian Society, Volume 73, Issue 1, 1 June 1973, Pages 193–216, https://doi.org/10.1093/arist.

Rapid advances in high throughput genomic technologies and next generation sequencing are making medical genomic research more readily accessible and affordable, including the sequencing of patient and control whole genomes and exomes in order to elucidate genetic factors underlying disease. Over the next five years, the Human Heredity and Health in Africa (H3Africa) Initiative, funded by the Wellcome Trust (United Kingdom) and the National Institutes of Health (United States of America), will contribute greatly towards sequencing of numerous African samples for (...) biomedical research. (shrink)

This paper examines the challenge that psychoanalytic theory cannot be refuted. It does so by considering the theory in its orthodox Freudian form, and in the main branches into which it can be divided ? the theory of Instincts, of Development, of Psychic Structure, of Mental Economics or Defence, and of Symptom Formation. The essential character of the generalizations and concepts of these branches will just be indicated; and we shall ask of each branch whether it is possible to refute (...) it. A considerable amount of scientific enquiry has been done into the concepts and generalizations of psychoanalysis. Relevant examples of these enquiries will be noted; and the question asked whether these scientific studies have in fact done anything to refute or support the various branches of psychoanalytic theory. The general upshot will be that the challenge is both important and a mistake. (shrink)

Antonio Argandoña, Norbert Bilbeny, Victòria Camps, Miquel Calsina, Àngel Castiñeira, Cristian Palazzi, Ferran Requejo, Raimon Ribera, Begoña Román, Ferran Sàez, Miquel Seguró, Francesc Torralba, Josep Maria Vallès, Rosamund Thomas Ramon Llull Journal of Applied Ethics 2012 3(3):9-16.