Background: Moral distress is recognized as a problem affecting healthcare professionals globally. Unaddressed moral distress may lead to withdrawal from the moral dimensions of patient care, burnout, or leaving the profession. Despite the importance, studies related to moral distress are scant in Thailand. Objective: This study aims to describe the experience of moral distress and related factors among Thai nurses. Design: A convergent parallel mixed-methods design was used. The quantitative and qualitative data were collected in parallel using the Measure of (...) Moral Distress for Healthcare Professionals and interview guide. The analysis was conducted separately and then integrated. Participants: Participants were Thai nurses from two large tertiary care institutions in a Southern province of Thailand. Ethical considerations: This study was approved by our organization's Institutional Review Board for Health Sciences Research, and by the Institutional Review Boards of the two local institutions in Thailand. Permission from the publisher was received to translate and utilize the Measure of Moral Distress (MMD-HP) under the license number: 4676990097151. Results: A total of 462 participants completed the survey questions. The top 7 causes of moral distress were related to system-level root causes and end-of-life care situations. Hierarchical multiple regression showed that work units, considering leaving position, and number of moral distress episodes in the past year were significant predictors of moral distress. Twenty interviews demonstrated three main themes of distressing causes: (1) powerlessness (at patients/family-, team-, and organizational-levels), (2) end-of-life issues, and (3) poor team function (poor communication and collaboration, incompetent healthcare providers, and inappropriate behavior of colleagues). The integration of data from both components indicated that the qualitative interviews enrich the quantitative findings, especially as related to the top 7 causes of moral distress. Discussion: Although the experience of moral distress among Thai nurses is similar to studies conducted elsewhere, the patient’s and family’s religious perspective that ties into the concept of moral distress needs to be explored. Conclusions: Although the root causes of moral distress are similar among different cultures, the experience of Thai nurses may vary according to culture and context. (shrink)

Recent estimates indicate that over 40,000 children die annually in the United States and a majority have life-limiting conditions. Children at end of life require extensive healthcare resources, including multiple hospital readmissions and emergency room visits. Yet, many children still suffer from symptoms at end of life—including fatigue, pain, dyspnea, and anxiety—with less than 10% of these children utilizing hospice care services. A critical barrier to pediatric hospice use was the original federal regulations associated with the hospice care that required (...) a diagnosis of 6 months to live and the discontinuation of all curative treatments. The Concurrent Care Provision of the United States’ Affordable Care Act eliminated the need to forgo curative therapies in order to enroll in hospice for children in Medicaid or Children’s Health Insurance Program. Concurrent care for children can help mitigate the tension families experience in choosing between essential forms of care, as well as contribute to improved end-of-life outcomes for the child and possibly bereavement outcomes for the family. Understanding concurrent care for children from a social justice perspective has important advocacy and research implications for hospice and palliative care clinicians providing care for children and their families. We apply Powers and Faden’s theory of social justice “as the moral foundation of public health and health policy” to the provision of concurrent care to children near end of life and families in the United States. The goals of applying this theory are to explore additional insights and perspectives into concurrent care policy may provide and to assess the usefulness of this theory when applied to end-of-life health policy. We argue that concurrent care policy is socially just since it has potential to promote well-being in vulnerable children and families and can limit the inequity children at end-of-life experience in access to high-quality hospice care. (shrink)

Intuitively, one who counts a morally bad person as a friend has gone wrong somewhere. But it is far from obvious where exactly they have gone astray. Perhaps in cultivating a friendship with a bad person, one extends to them certain goods that they do not deserve. Or perhaps the failure lies elsewhere; one may be an abettor to moral transgressions. Yet another option is to identify the mistake as a species of imprudence—one may take on great personal risk in (...) counting a bad person as a friend. In this paper, I argue that none of these intuitive explanations are entirely convincing; for many such proposals run contrary to widely accepted features of friendship. However, they do point us in the direction of a more satisfying explanation—one which concerns a person’s moral priorities. An individual who counts a morally bad person as a friend is, I propose, one who betrays a distinct kind of defect in her values. (shrink)

Despite his awareness that organisms are well suited to the habitats they are typically found in, Aristotle nowhere tries to explain this. It is unlikely that he thinks this “fit” (as I call it) between organisms and their habitats is simply a lucky coincidence, given how vehemently he rejects that as an explanation of the fit between organisms’ various body parts. But it is quite puzzling that Aristotle never explicitly addresses this, since it is a question that seemed so pressing (...) to later philosophers and biologists such as Darwin. In this paper I offer a solution to that puzzle. As I argue, the type of habitat an organism lives in is partly constitutive of its essence or nature. The reason Aristotle does not ask, for instance, why marsh-dweller birds live in marshes, is that it is simply constitutive of their nature that they do so. Given that habitat is built into a kind’s essence, the answer to such a question is obvious and the question would have seemed to him trivial. By attending to the details of his biological treatises, I show that Aristotle’s conception of a living being’s essence is much more nuanced than one can glean from his discussions in the Physics and Metaphysics alone. (shrink)

According to a number of contemporary theorists, aesthetic reasons can invite or entice us but never compel us. In this paper, I develop a Kantian account of the normative force of aesthetic reasons. While Kant would likely agree that aesthetic reasons do not give rise to obligations, his account nevertheless gives us the resources for explaining how aesthetic reasons can still have more force than merely enticing reasons. This account appeals to the distinct normativity of aesthetic judgments on Kant's theory (...) and the way in which this kind of normativity structures aesthetic exchanges with other judging subjects. I argue that, in addition to the moral reasons we have for appreciating and preserving beauty, Kant’s account can accommodate distinctly aesthetic reasons for doing so that stem from our membership in aesthetic communities. (shrink)

The target article raises important questions about the applicability of experimental social psychology research on topics with policy implications. This commentary focuses on the importance of attending to a variety of factors to improve ecological validity as well as considering the ultimate factors shaping behavior and the role of natural categories in the stability of stereotypes and their influence.

Disability through the Lens of Justice offers a contextual framework for considering the limitations that disability places on individuals. Specifically, those that prevent individuals from having control in certain domains of their life, by restricting the availability of acceptable options or the ability to choose between them. Begon argues that our theory of justice should be concerned with the lives individuals can lead, and not with whether their bodies and minds function typically. The problem that disability raises is not the (...) mere fact of difference, but the ways in which that difference is accommodated (or not) and the limitations it may cause. In Disability Through the Lens of Justice, Begon offers a new framework to the disability and justice model. She argues that achieving justice does not require 'normalisation', or the elimination of difference, but through implementating a model which enables all individuals to control their lives as they choose. (shrink)

Recent arguments for the basic status of economic liberty can be deployed to show that all liberty is basic. The argument for the basic status of all liberty is as follows. First, John Tomasi’s defense of basic economic liberties is successful. Economic freedom can be further defended against powerful high liberal objections, which libertarians including Tomasi have so far overlooked. Yet arguments for basic economic freedom raise a puzzle about the distinction between basic and non-basic liberties. The same reasons that (...) economic liberties and the traditionally defined list of basic liberties are basic can also be given for all other liberties. Therefore, high liberals and Rawlsian libertarians ought to accept almost all other liberties as basic, even liberties that may strike us as trivial, silly, or unimportant. This claim has revisionary implications for high liberalism. Namely, liberals should endorse strong institutional protections for almost all liberties, even at the expense of other social values. (shrink)

While Kant was arguably as deeply engaged with the emerging special sciences of his time as he was with Newtonian physics, there is a deep tension in his treatment of these disciplines. On the one hand, Kant endorses a reductionist approach in natural science. On the other hand, Kant is committed to a variety of anti-reductionist positions in empirical psychology, chemistry, and the emerging biological sciences. This chapter examines the precise form that Kant’s anti-reductionism takes in each of these domains (...) and the corresponding set of questions about the extent to which each of these constitutes a genuine science for Kant. (shrink)

The aim of this chapter is to explore various ways of thinking about the concept of manipulation in order to capture both current and potentially future instances of machine manipulation, manipulation on the part of everything from the Facebook advertising algorithm to super-intelligent AGI. Three views are considered: a conservative one, which slightly tweaks extant influence-based theories of manipulation; a dismissive view according to which it doesn't matter much if machines are literally manipulative, provided we can classify them as so (...) doing to make sense of our interactions with them; and an ameliorative analysis, according to which we should change our concept of manipulation better to make sense of machine manipulation. We tentatively favor the latter. (shrink)

Mental representations—like many other things—seem to have parts. However, it isn’t clear how to properly understand the idea of a part of a representation. In this paper I shed new light on how representations can have a mereology. In particular, it has been recognized that there is a mereological element to Kant’s distinction between two kinds of representations: intuitions and concepts. A concept depends upon its parts, whereas an intuition is prior to its parts. The paper thus focuses on an (...) exploration of how to make sense of the parts and wholes of intuitions and concepts. (shrink)

The recent development of a field known as experimental philosophy— in particular, its subfield devoted to moral decision making—invites us to reflect on what it means to experiment in ethics and how it is that philosophers determine the good. Furthermore, as this new discipline uses the methods of experimental psychology to examine our intuitions about such things as praise, blame, and moral responsibility, we ought to consider the relationship between ethics and our psychological makeup. To this end, it will be (...) beneficial to consider the American pragmatists’ interpretations of these issues. Ethics, for these thinkers, was both a psychological and an experimental enterprise, one in which all of our psychological capabilities are brought to bear in solving specific moral problems through the testing of hypothetical and tentative solutions. I plan to argue here that the future of experimental ethics will find itself indebted to the American past, not only in its attempts to address the empirical data it already collects but in rethinking the scope of ethics and experimentation. (shrink)

Research on authentic learning has been predominantly focussed on skills-based training: there is a paucity of research on models of authentic learning available for adaptation in the humanities undergraduate classroom. In this article, I will seek to address this gap by proposing that legal trials are ideal models for designing authentic learning scenarios in undergraduate teaching and learning contexts, with a specific focus on the humanities. First, I discuss why and how the structure of legal trials can produce authentic learning (...) environments. Second, I present an undergraduate classroom project that combined two disciplinary fields – Shakespearean drama and criminal law – in an effort to enhance student learning and engagement. I outline how the authentic learning scenario was implemented and evaluated and, finally, reflect on the barriers, challenges and potentially transformative effect of authentic learning environments on students and educators. This new intervention combines legal studies... (shrink)

Este artigo é sobre a folksonomia como uma ferramenta que contribui para as atividades colaborativas de grupos de usuários na rede social acadêmica Passei Direto, com o objetivo de analisar a folksonomia como ferramenta de apoio em grupos colaborativos nessa rede social, por meio de estudo de caso holístico e exploratório, sendo realizada observação direta intensiva. A justificativa baseou-se na necessidade de compreender a potencialidade das atividades cooperativas e a solução das necessidades informacionais. Concluiu-se que a folksonomia é uma ferramenta (...) de apoio em grupos colaborativos no Passei Direto, onde os usuários, no uso de tags em práticas de indexação, visam a enriquecer e ampliar as possibilidades de acesso às informações. No entanto, apesar de representar uma ferramenta de forte cunho colaborativo, a folksonomia também deixa lacunas no tocante à recuperação da informação, dada a falta de padronização e controle dessa ferramenta, embora essas características façam parte da sua essência. (shrink)

Leading animal models are powerful tools for translational research, but they also present obstacles. Poorly conducted preclinical research in animals is a common cause of translational failure, but even when such research is well-designed and carefully executed, challenges remain. In particular, dominant models may bias research directions, elide essential aspects of human disease, omit important context, or subtly shift research targets. Recognizing these stumbling blocks can help us find ways to avoid them: employing a wider range of models, incorporating more (...) realistic environmental conditions, better aligning studies between animals and patients, and focusing on human biology and therapeutic goals. Such changes are costly; but insisting it would be impractical or unrealistic to change strategies offers no way out of the current impasse. Rather, we must acknowledge the obstacles as well as the advantages presented by core models, and direct some of our investments in translational research toward getting around them. The dominance of biomedical research by a handful of animal models introduces subtle but significant obstacles to translation. Recognizing these obstacles is a critical first step toward finding ways around them; this paper describes how dominant models can create roadblocks, and suggests strategies to improve the efficiency of translation from animal models to humans. (shrink)

Presents profiles of such well-known authors and celebrities as Susan Sontag, Beverly Sills, Bernard Malamud, Isaac Bashevis Singer, and Joseph Brodsky.

In the management of common property resources, privatization is often advocated as the surest path to sustainability because of its reliance on human self-interest in natural resources decision making. This article demonstrates that the motive of self-interest, though powerful, does not necessarily lead to environmental outcomes that promote the common good. The key to avoiding the Tragedy of the Commons is not private ownership but controlling access.

In assessing ethical issues concerning the sex-industry, feminist liberalism ought to combine the concern for the worker that is central to its treatment of prostitution, with sensitivity to the social and cultural embeddedness of self that is central to its treatment of pornography. That would enable us to then look at live-actor pornography as a form of prostitution that raises additional questions about third party consumption — and analysis both more theoretically coherent and practically useful.

How do elite universities in the United States and United Kingdom work to meaningfully address decades of deeply embedded institutional racism and classism? They don’t.Continuing their work of expo...

The second premise of the Kalām cosmological argument, as defended by William Lane Craig, has two supporting arguments; the Hilbert’s Hotel argument and the suc.

The thin red line ( TRL ) is a theory about the semantics of future-contingents. The central idea is that there is such a thing as the ‘actual future’, even in the presence of indeterminism. It is inspired by a famous solution to the problem of divine foreknowledge associated with William of Ockham, in which the freedom of agents is argued to be compatible with God’s omniscience. In the modern branching time setting, the theory of the TRL is widely regarded (...) to suffer from several fundamental problems. In this paper we propose several new TRL semantics, each with differing degrees of success. This leads up to our final semantics, which is a cross between the TRL and supervaluationism. We discuss the notions of truth, validity and semantic consequence which result from our final semantics, and demonstrate some of its pleasing results. This account, we believe, answers the main objection in the literature, and thus places the TRL on the same level as any other competing semantics for future contingents. (shrink)

It is often said that time must have a beginning because otherwise the series of past events would have the paradoxical features of an actual infinite. In the present paper, we show that, even given a dynamic theory of time, the cardinality of an endless series of events, each of which will occur, is the same as that of a beginningless series of events, each of which has occurred. Both are denumerably infinite. So if an endless series of events is (...) possible, then the possibility of a beginningless series of past events should not be rejected merely on the ground that it would be an actual infinite. What would be required to rebut our argument is a symmetry breaker – something that motivates treating the past relevantly differently to the future. We consider several attempts to provide a symmetry breaker and show that none of them is successful. (shrink)

In this paper we will put forward a novel semantics for future contingents. The idea behind the semantics is to be a compromise position between the ‘Ockhamist’ semantics, first put forward by Prior [1966], Thomason [1970] etc., and a version of the Thin Red Line semantics recently proposed by Malpass and Wawer [2012]. The new position is able to represent alternative possibilities in two different ways, as actual or counterfactual, which corresponds to a similar distinction in two-dimensional semantics between (...) the primary and secondary intension. We prove a theorem about the notion of validity that results from the new definition, which in the context of the literature about TRL-theories and Ockhamism has some significance. (shrink)

Este artículo se centra en un argumento presentado por Fara (2010) en contra del supervaluacionismo en el contexto de la vaguedad. Muestro cómo dicho argumento es igualmente aplicable al supervaluacionismo de tiempo ramificado (presentado por primera vez por Thomason 1970), pero no a la semántica 'STRL' de Malpass y Wawer (2012), que está estrechamente relacionada.

The History of Philosophical and Formal Logic introduces ideas and thinkers central to the development of philosophical and formal logic. From its Aristotelian origins to the present-day arguments, logic is broken down into four main time periods: Antiquity and the Middle Ages The early modern period High modern period Early 20th century Each new time frame begins with an introductory overview highlighting themes and points of importance. Chapters discuss the significance and reception of influential works and look at historical arguments (...) in the context of contemporary debates. To support independent study, comprehensive lists of primary and secondary reading are included at the end of chapters, along with exercises and discussion questions. By clearly presenting and explaining the changes to logic across the history of philosophy, The History of Philosophical and Formal Logic constructs an easy-to-follow narrative. This is an ideal starting point for students looking to understand the historical development of logic. (shrink)

James Anderson and Greg Welty have resurrected an argument for God’s existence, which we will call the argument from logic. We present three lines of response against the argument, involving the notion of necessity involved, the notion of intentionality involved, and then we pose a dilemma for divine conceptualism. We conclude that the argument faces substantial problems.

We examine two competing solutions to Benardete paradoxes: causal finitism, according to which nothing can have infinitely many causes, and the unsatisfiable pair diagnosis (UPD), according to which such paradoxes are logically impossible and no metaphysical thesis need be adopted to avoid them. We argue that the UPD enjoys notable theoretical advantages over causal finitism. Causal finitists, however, have levelled two main objections to the UPD. First, they urge that the UPD requires positing a ‘mysterious force’ that prevents paradoxes from (...) arising. Since such a force is implausible, the UPD is in trouble. Second, they employ recombination or patchwork principles to argue that paradoxical situations would be possible if causal finitism were false. Since such situations are not possible, causal finitism is true, and so a substantive metaphysical thesis is needed to avoid the paradoxes. We argue that the UPD proponent can successfully respond to these objections. (shrink)

What is free will? Why is it important? Can the same act be both free and determined? Is free will necessary for moral responsibility? Does anyone have free will, and if not, how is creativity possible and how can anyone be praised or blamed for anything? These are just some of the questions considered by Joseph Keim Campbell in this lively and accessible introduction to the concept of free will. Using a range of engaging examples the book introduces the (...) problems, arguments, and theories surrounding free will. Beginning with a discussion of fatalism and causal determinism, the book goes on to focus on the metaphysics of moral responsibility, free will skepticism, and skepticism about moral responsibility. Campbell shows that no matter how we look at it, free will is problematic. Thankfully there are a plethora of solutions on offer and the best of these are considered in full in the final chapter on contemporary theories of free will. This includes a rigorous account of libertarianism, compatabilism, and naturalism. _Free Will_ is the ideal introduction to the topic and will be a valuable resource for scholars and students seeking to understand the importance and relevance of the concept for contemporary philosophy. (shrink)

_If you were free in doing something and morally responsible for it, you could have done otherwise. That_ _has seemed a pretty firm proposition among the old, new, clear, unclear and other propositions in the_ _philosophical discussion of freedom and determinism. If you were free in what you did, there was an_ _alternative. It is also at least natural to think that if determinism is true, you can never do otherwise than_ _you do. G. E. Moore, that Cambridge reasoner in (...) whose shadow Wittgenstein ought to be standing,_ _considered the matter. He pointed out that even if determinism is true, there remains a sense in which you_ _can still do otherwise than you do: you will do otherwise if you so choose. That, on reflection, is consistent_ _with determinism. The doctrine of the compatibility of freedom and determinism is saved. Joseph Keim_ _Campbell, strong philosopher at Washington State University, provides the latest thinking on this seemingly_ _unavoidable dispute. You do not have to agree that either compatibilism or incompatibilism must be true in_ _order to appreciate the carefulness of his reasoning in this piece of ongoing American philosophy. It_ _requires and repays attention._. (shrink)

This article situates the analysis of fair-trade consumption in the context of debates about civic activism and political participation. It argues that fair-trade consumption should be understood as a political phenomenon, which, through the mediating action of organizations and campaigns, makes claims on states, corporations, and institutions. This argument is made by way of a case study of Traidcraft, a key player in the fair-trade movement in the United Kingdom. The study focuses on how Traidcraft approaches and enrolls its supporters.

In lieu of an abstract, here is a brief excerpt of the content:The Medusa Complex:Matricide and the Fantasy of CastrationJessica Elbert MayockThe theoretical structures of psychoanalysis have excluded the female subject by placing her outside of the Symbolic, and feminist theorists' responses to this problem have been divided. Some theorists (such as Kristeva) accept the notion of an unalterable Lacanian Symbolic, while others (such as Irigaray) maintain that the current Symbolic is a manifestation of male fantasy, and suggest that feminist (...) thinkers explore the possibility of reorganizing the Symbolic. Amber Jacobs, in her recent work On Matricide (2007), takes up this challenge by analyzing matricide in myth in order to reveal matricide as latent content untheorized within psychoanalysis. Jacobs claims that the structure of the Lacanian Symbolic illegitimately asserts the "law of the father" as the only possible law, excluding any possibility of a "law of the mother" by erasing the maternal role in theory and symbolization. Her project, following Irigaray, is to make visible those unconscious contents excluded by the patriarchal imaginary in order to "be able to intervene into psychoanalysis for the purpose of working toward theorization of unconscious structures that are not reducible to the structure of Oedipus alone" (Jacobs 2007, x). If Jacobs's suggestion is correct, then analysis of Freud's evidence for the Oedipus Complex (and its accompanying concepts) will reveal repressed contents and traces of these untheorized unconscious structures—particularly those associated with the maternal body.With these considerations in mind, I take up the Freudian case of Little Hans, where Freud finds his most seminal evidence for castration anxiety [End Page 158] and the Oedipus Complex. I will demonstrate Freud's systematic occlusion of the maternal body through his overvaluation of the male body/the phallus in order to expose the elements of male fantasy that construct the Oedipus Complex. I organize these psychical elements in a configuration called "The Medusa Complex," since Freud uses the image of Medusa to explain his theory of castration. In rereading the details of this case, a powerful male fantasy begins to emerge: the desire to appropriate the female generative power. This is achieved through the theory of castration, which the decapitation of Medusa symbolizes, and the unconscious wish for male parthenogenesis—one product of this wish is the Lacanian Symbolic structure, where only the male principle of the phallus is generative. The Medusa Complex is comprised of the two intertwined male fantasies of female castration and male parthenogenesis, as well as the associated resistances that result from initiation into this paradigm. The theory of castration and the Oedipus Complex are attempts to conceal the powerful maternal body and assert male superiority and dominance.In the case of Little Hans, "Analysis of a Phobia in a Five Year Old Boy" (1909), Little Hans develops a fear of horses (especially biting horses) and is afraid to go out into the street. Hans's treatment is undertaken by his father, a medical doctor, who keeps careful notes and acts under Freud's supervision (mostly via letters). The boy's phobia begins around the time his little sister Hanna is born, as Freud and the father eventually admit, though her role in their narrative is nonexistent.1 They interpret Hans's phobia as a classic Oedipal triangle in which he desires his mother and fears the hostility of his father; his fear is translated into fear of the castrating father. Throughout the case, Freud and the father emphasize the boy's alleged awe of the adult male genital organ. In this paper, I will revisit the case (preserved in careful detail by the boy's father) and systematically return the maternal body to its rightful place within the narrative, shifting both the structure and the meaning of the phobia.I am here reading the case as an example of manifest content—like the surface content of a dream—in order to expose the male desires that create it. The current Symbolic is essentially a dream of the male imaginary, and my method is to reveal the latent content of the dream, especially the fantasies that inform it. Desire is the generating force behind this dream, and until we encounter and understand this desire, it will continue to compulsively... (shrink)

In this article, we examine the link between board composition and an enterprise strategy outcome, stakeholder relations. Because a firm’s enterprise strategy is set at the highest level of the organization, we expect the presence of stakeholder directors (suppliers, customers, employees, and community representatives) to be positively associated with stakeholder performance.Results from an analysis of 3,268 board members representing 250 firms are discussed in the context of both corporate governance and stakeholder management literatures.

Recently, a range of educational theorists have explored and extended upon popular currents in political theory through articulating “open” and “unknowing” pedagogies. Such contributions represent a radical turn away from the presumed “universals” found in proclamations of justice and emancipation and, ultimately, the centering of class analysis. At the same time, inspired by and building upon Bourdieuian theory, another cluster of educational research has developed a nuanced understanding of the social, cultural, and educational mechanisms involved in class reproduction. In this (...) essay, Jessica Gerrard offers a critical — though sympathetic — response to these dual trends. Bringing together theories of reproduction in conversation with theories of pedagogical possibility, Gerrard argues for a renewed understanding of working-class relations to education that incorporates an understanding of working-class action and struggle. (shrink)

Virtuosity and the early Royal Society of London Content Type Journal Article Pages 1-3 DOI 10.1007/s11016-010-9506-0 Authors Jessica Ratcliff, Graduate School of Library and Information Science, University of Illinois at Urbana-Champaign, 501 E. Daniel St, Champaign, II 61820, USA Journal Metascience Online ISSN 1467-9981 Print ISSN 0815-0796.