Moral distress has received much attention in the international nursing literature in recent years. In this article, we describe the evolution of the concept of moral distress among nursing theorists from its initial delineation by the philosopher Jameton to its subsequent deployment as an umbrella concept describing the impact of moral constraints on health professionals and the patients for whom they care. The article raises worries about the way in which the concept of moral distress has been portrayed in some (...) nursing research and expresses concern about the fact that research, so far, has been largely confined to determining the prevalence of experiences of moral distress among nurses. We conclude by proposing a reconsideration, possible reconstruction and multidisciplinary approach to understanding the experiences of all health professionals who have to make difficult moral judgements and decisions in complex situations. (shrink)

In spite of feminist recognition that hierarchical organizations are an important location of male dominance, most feminists writing about organizations assume that organizational structure is gender neutral. This article argues that organizational structure is not gender neutral; on the contrary, assumptions about gender underlie the documents and contracts used to construct organizations and to provide the commonsense ground for theorizing about them. Their gendered nature is partly masked through obscuring the embodied nature of work.jobs and hierarchies, common concepts in organizational (...) thinking, assume a disembodies and universal worker. This worker is actually a man; men's bodies, sexuality, and relationships to procreation and paid work are subsumed in the image of the worker. Images of men's bodies and masculinity pervade organizational processes, marginalizing women and contributing to the maintenance of gender segregation in organizations. The positing of gender-neutral and disembodied organizational structures and work relations is part of the larger strategy of control in industrial capitalist societies, which, at least partly, are built upon a deeply embedded substructure of gender difference. (shrink)

Gender, ‘race’, poverty, health and discourses of health reform in the context of globalization: a postcolonial feminist perspective in policy researchIn this paper, I draw on extant literature and my empirical work to discuss the impact of globalization and healthcare reform on the lives of women — those from countries of the South as well as of the North. First, I review briefly the economic hardships identified in different sectors of the population that have been attributed to how globalization is (...) now working. Second, I examine what these global processes mean for health, with particular focus on poverty, gender, racialization and health. Third, I reflect on how nurse scientists might develop research agendas in the 21st century that would foster social transformation and social justice for all people. The position taken here is not an indictment of globalization. Rather, I argue that globalization is a fact in all of our lives. There are positive aspects of globalization. There are also negative aspects which we must collectively address, given that the issues identified can have deleterious consequences for the world’s poor, women in particular. I suggest that, to construct knowledge for practice and praxis, research agendas of the future should be inclusive of subaltern voices. I argue that drawing on a postcolonial feminist epistemology might help us to define such agendas, and express the multilayered sociopolitical contexts of health and illness in advocacy with policy‐makers. (shrink)

In the last three decades, considerable theoretical and empirical research has been undertaken on the topic of moral distress among health professionals. Understood as a psychological and emotional response to the experience of moral wrongdoing, there is evidence to suggest that—if unaddressed—it contributes to staff demoralization, desensitization and burnout and, ultimately, to lower standards of patient safety and quality of care. However, more recently, the concept of moral distress has been subjected to important criticisms. Specifically, some authors argue that the (...) standard account of moral distress elucidated by Jameton :542–551, 1984) does not refer to a discrete phenomenon and/or that it is not sufficiently broad and that this makes measuring its prevalence among health professionals, and other groups of workers, difficult if not impossible. In this paper, we defend the standard account of moral distress. We understand it as a concept that draws attention to the social, political and contextual determinants of moral agency and brings the emotional landscape of the moral realm to the fore. Given the increasing pressure on health professionals worldwide to meet efficiency, financial and corporate targets and reported adverse effects of these for the quality and safety of patient care, we believe that further empirical research that deploys the standard account moral distress is timely and important. (shrink)

This research uses a survey to analyze types of benefits sought by partners in cross-sector collaborations in Spain and to test and build upon theories that indicate prior collaboration experience and partner alignment will positively affect value creation through the collaboration. Using exploratory factor analysis to operationalize a broad range of potential benefits into more specific concepts, the results of this study identify distinct factors that characterize the types of benefits sought by non-profit organizations and businesses engaged in cross-sector collaborations. (...) Findings show that prior experience and alignment positively affect each factor for value creation. Prior experience is also found to influence the type of benefits sought from cross-sector collaborations and to positively affect alignment in terms of mission and strategy. Unexpectedly, the study also finds that prior experience moderates the effect of alignment on value creation. (shrink)

In this article, the author addresses two feminist issues: first, how to conceptualize intersectionality, the mutual reproduction of class, gender, and racial relations of inequality, and second, how to identify barriers to creating equality in work organizations. She develops one answer to both issues, suggesting the idea of “inequality regimes” as an analytic approach to understanding the creation of inequalities in work organizations. Inequality regimes are the interlocked practices and processes that result in continuing inequalities in all work organizations. Work (...) organizations are critical locations for the investigation of the continuous creation of complex inequalities because much societal inequality originates in such organizations. Work organizations are also the target for many attempts to alter patterns of inequality: The study of change efforts and the oppositions they engender are often opportunities to observe frequently invisible aspects of the reproduction of inequalities. The concept of inequality regimes may be useful in analyzing organizational change projects to better understand why these projects so often fail and why they succeed when this occurs. (shrink)

Holobionts, consisting of a host and diverse microbial symbionts, function as distinct biological entities anatomically, metabolically, immunologically, and developmentally. Symbionts can be transmitted from parent to offspring by a variety of vertical and horizontal methods. Holobionts can be considered levels of selection in evolution because they are well-defined interactors, replicators/reproducers, and manifestors of adaptation. An initial mathematical model is presented to help understand how holobionts evolve. The model offered combines the processes of horizontal symbiont transfer, within-host symbiont proliferation, vertical symbiont (...) transmission, and holobiont selection. The model offers equations for the population dynamics and evolution of holobionts whose hologenomes differ in gene copy number, not in allelic or loci identity. The model may readily be extended to include variation among holobionts in the gene identities of both symbionts and host. (shrink)

We show that Bounded Forcing Axioms (for instance, Martin's Axiom, the Bounded Proper Forcing Axiom, or the Bounded Martin's Maximum) are equivalent to principles of generic absoluteness, that is, they assert that if a $\Sigma_1$ sentence of the language of set theory with parameters of small transitive size is forceable, then it is true. We also show that Bounded Forcing Axioms imply a strong form of generic absoluteness for projective sentences, namely, if a $\Sigma^1_3$ sentence with parameters is forceable, then (...) it is true. Further, if for every real x, $x^{\sharp}$ exists, and the second uniform indiscernible is less than $\omega_2$ , then the same holds for $\Sigma^1_4$ sentences. (shrink)

The best framework for moral and political thought is the one that creates the best climate for good political judgments. I argue that universalistic theories of justice fall short in this regard because they cannot distinguish idealization from abstraction. After describing how an ethic of care guides judgments, I suggest the practical effects that make this approach preferable. The ethic of care includes more aspects of human life in making political judgments.

ACKNOWLEDGEMENTS I would like to thank the following: Professor DW Harding for suggesting inquiry into Binet's work and for allowing use of his own ideas in ...

Why do sociological theorists remain uninterested in and resistant to feminist theory? Notwithstanding indications of increasing openness to feminist theory, journals and texts on sociological theory reflect a continuing pattern of neglect. I identify reasons for this pattern, including tensions resulting from the introduction of gender as a central analytical category: Not only does gender challenge the dichotomous categories that define sociology's boundaries and identity, it also displaces the discipline's central problematic of modernity. The significance of this displacement is apparent (...) when the discipline's responses to feminist and postmodernist theory are compared. I discuss the relevance of feminist theoretical work to contemporary issues in sociological theory, with specific attention to the synthetic nature of feminist theorizing, to work on rethinking power, resistance, and oppression, and to efforts to effect a conceptual shift from "either/or" to "both/and" thinking and to establish new grounds for assessing knowledge claims. (shrink)

Following an extensive review of the moral intensity literature, this article reports the findings of two studies (one between-subjects, the other within-subject) that examined the effect of manipulated and perceived moral intensity on ethical judgment. In the between-subjects study participants judged actions taken in manipulated high moral intensity scenarios to be more unethical than the same actions taken in manipulated low moral intensity scenarios. Findings were mixed for the effect of perceived moral intensity. Both probable magnitude of consequences (a factor (...) consisting of magnitude of consequences, probability of effect, and temporal immediacy) and social consensus had a significant effect; proximity did not. In the within-subject study manipulated moral intensity had a significant effect on ethical judgment, but perceived moral intensity did not. Regression of ethical judgment on age, gender, major, and the three perceived moral intensity factors was significant between-subjects, but not within-subject. Ethical judgment was found to be a more robust predictor of intention than perceived moral intensity using a within-subject design. (shrink)

The factor structure of the Multidimensional Ethics Scale (MES; Reidenbach and Robin: 1988, Journal of Business Ethics 7, 871–879; 1990, Journal of Business Ethics 9, 639–653) was examined for the 8-item short form (N = 328) and the original 30-item pool (N = 260). The objectives of the study were: to verify the dimensionality of the MES; to increase the amount of true cross-scenario variance through the use of 18 scenarios varying in moral intensity (Jones: 1991, Academy of Management Review (...) 16, 366–395); and, to examine the items for measurement precision using item-response theory (IRT) methods. Results of confirmatory and exploratory factor analysis failed to conclusively support the hypothesized 3- (short form) or 5-factor (long form) structure; both instruments were instead dominated by a general factor. Item response theory analyses using Samejima’s (1969, Psychometrika Monograph Supplement 34, (4, Pt. 2)) graded response model revealed that many items in the 30-item pool performed very well, and suggested that a different collection of items be used to form a short-form version of the MES. Our proposed 10-item instrument includes more discriminating items than the 8-item version, and has the added advantage of including two items from each of the five ethical philosophies represented in the original 30-item pool. (shrink)

How do we know which institutions provide good care? Some scholars argue that the best way to think about care institutions is to model them upon the family or the market. This paper argues, on the contrary, that when we make explicit some background conditions of good family care, we can apply what we know to better institutionalized caring. After considering elements of bad and good care, from an institutional perspective, the paper argues that good care in an institutional context (...) has three central foci: the purpose of care, a recognition of power relations, and the need for pluralistic, particular tailoring of care to meet individuals? needs. These elements further require political space within institutions to address such concerns. (shrink)

A psychoanalytic and philosophical exploration of sublimation as a key term in Jacques Lacan's theories of ethics and feminine sexuality.

La transición a una sola moneda, sin problemas aparentes, de 12 países encierra un sinfín de nuevas cuestiones que tanto para los expertos, como para los no especialistas del tema, obliga a un nuevo enfoque que no es fácil de precisar.

El propósito del presente trabajo investigativo es identificar las premisas de la doctrina utilitarista moderna respecto a la dualidad de los conceptos de ser humano y persona, dado que esta corriente del pensamiento es la principal responsable de las concepciones sobre lo que implica ser un humano y, consecuentemente, sobre lo que es una persona, definiciones claves para comprender y debatir diferentes temas trascendentales como el aborto, la eutanasia, los embriones congelados, entre otras discusiones de gran relevancia en la actualidad. (...) A partir de un análisis del estado del arte, la crítica textual y el análisis bioético de la filosofía utilitarista, se pretende exponer cómo esta doctrina ha impregnado la cultura de la sociedad posmoderna al punto de desembocar en un movimiento que puede redefinir la naturaleza y condición humanas, así como construir un arquetipo de lo que es una persona en el sentido estricto del utilitarismo, es decir, desde su autonomía, funcionalidad y facultades plenamente racionales, lo cual plantea un problema bioético para establecer una defensa objetiva de la dignidad humana. (shrink)

This paper aims to trace the evolution of Bachelard's thought as he gropes toward a concrete formulation of a philosophy of the imagination. Reverie, the creative daydream, occupies the central position in Bachelard's emerging metaphysic, which becomes increasingly “phenomenological” in a manner reminiscent of Husserl. This means that although Bachelard does not use Husserlian terms, he appropriates the following features of (Husserlian) phenomenology: 1. a desire to “embracket” the initial (rationalistic) impulse; and 2. an aspiration to apprehend in its entirety, (...) the creative epiphany of an image. Ultimately, this paper aims to show that there is a sense in which Bachelard's metaphysical concerns in his poetics are an outgrowth of (rather than radical break from) his earlier scientific and epistemological concerns. What results in reverie is an aesthetic intentionality providing a metaphysic of the imagination: the aesthetic object, such as fire or water, is an object only insofar as it enables/calls forth a subject to enter into a receptive, self-aware and cosmic state of being; subject-ness and object-ness are intimately and archetypally intertwined. Bachelard's “new poetics” results from his transplantation/cross-fertilization of the general epistemology of the “new scientific spirit” on to/across his aesthetics. (shrink)

The HOD Dichotomy Theorem states that if there is an extendible cardinal, δ, then either HOD is “close” to V or HOD is “far” from V. The question is whether the future will lead to the first or the second side of the dichotomy. Is HOD “close” to V, or “far” from V? There is a program aimed at establishing the first alternative—the “close” side of the HOD Dichotomy. This is the program of inner model theory. In recent years the (...) third author has provided evidence that there is an ultimate inner model—Ultimate-L—and he has isolated a natural conjecture associated with the model—the Ultimate-L Conjecture. This conjecture implies that that the first alternative holds—HOD is “close” to V. This is the future in which pattern prevails. In this paper we introduce a very different program, one aimed at establishing the second alternative—the “far” side of the HOD Dichotomy. This is the program of large cardinals beyond choice. Kunen famously showed that if AC holds then there cannot be a Reinhardt cardinal. It has remained open whether Reinhardt cardinals are consistent in ZF alone. It turns out that there is an entire hierarchy of choiceless large cardinals of which Reinhardt cardinals are only the beginning, and, surprisingly, this hierarchy appears to be highly ordered and amenable to systematic investigation, as we shall show in this paper. The point is that if these choiceless large cardinals are consistent then the Ultimate-L Conjecture must fail. This is the future where chaos prevails. (shrink)

Geroscience and philosophy of aging have tended to focus their analyses on the biological and chronological dimensions of aging. Namely, one ages with the passage of time and by experiencing the cellular-molecular deterioration that accompanies this process. However, our concept of aging depends decisively on the social valuations held about it. In this article, we will argue that, if we study social aging in the contemporary world, a novel phenomenon can be identified: the paradox of aging in the digital era. (...) If the social understanding of aging today is linked to unproductivity and obsolescence; then there is a possibility that, given the pace of change of digital technologies, we become obsolete at an early chronological and biological age, and therefore, feel old at a younger age. First, we will present the social dimension of aging based on Rowe and Kahn's model of successful aging. We will also show that their notion of social aging hardly considers structural aspects and weakens their approach. Second, departing from social aging in its structural sense, we will develop the paradox of aging in the digital era. On the one hand, we will explain how the institutionalization of aging has occurred in modern societies and how it is anchored in the concepts of obsolescence and productivity. On the other hand, we will state the kind of obsolescence that digitalization produces and argue that it can make cohorts of biologically and chronologically young individuals obsolete, and thus they would be personally and socially perceived as old. (shrink)

Realizabilities are powerful tools for establishing consistency and independence results for theories based on intuitionistic logic. Troelstra discovered principles ECT 0 and GC 1 which precisely characterize formal number and function realizability for intuitionistic arithmetic and analysis, respectively. Building on Troelstra's results and using his methods, we introduce the notions of Church domain and domain of continuity in order to demonstrate the optimality of “almost negativity” in ECT 0 and GC 1 ; strengthen “double negation shift” DNS 0 to DNS (...) 1 and use it with GC 1 and Markov's Principle MP to characterize the classically provably realizable formulas of analysis; and show that intuitionistic analysis with GC 1 , MP and DNS 1 is consistent and satisfies Troelstra's and Church's Rules. We end with a discussion of semi-intuitionistic theories and a conjecture. (shrink)

Superstrong cardinals are never Laver indestructible. Similarly, almost huge cardinals, huge cardinals, superhuge cardinals, rank-into-rank cardinals, extendible cardinals, 1-extendible cardinals, 0-extendible cardinals, weakly superstrong cardinals, uplifting cardinals, pseudo-uplifting cardinals, superstrongly unfoldable cardinals, Σn-reflecting cardinals, Σn-correct cardinals and Σn-extendible cardinals are never Laver indestructible. In fact, all these large cardinal properties are superdestructible: if κ exhibits any of them, with corresponding target θ, then in any forcing extension arising from nontrivial strategically <κ-closed forcing Q∈Vθ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} (...) \setlength{\oddsidemargin}{-69pt} \begin{document}$${\mathbb{Q} \in V_\theta}$$\end{document}, the cardinal κ will exhibit none of the large cardinal properties with target θ or larger. (shrink)

This volume explores facets of Nietzsche relatively untouched by the majority of the vast literature on him.

We introduce the large-cardinal notions of ξ-greatly-Mahlo and ξ-reflection cardinals and prove (1) in the constructible universe, L, the first ξ-reflection cardinal, for ξ a successor ordinal, is strictly between the first ξ-greatly-Mahlo and the first Π1ξ-indescribable cardinals, (2) assuming the existence of a ξ-reflection cardinal κ in L, ξ a successor ordinal, there exists a forcing notion in L that preserves cardinals and forces that κ is (ξ+1)-stationary, which implies that the consistency strength of the existence of a (ξ+1)-stationary (...) cardinal is strictly below a Π1ξ-indescribable cardinal. These results generalize to all successor ordinals ξ the original same result of Mekler–Shelah [A. Mekler and S. Shelah, The consistency strength of every stationary set reflects, Israel J. Math.67(3) (1989) 353–365] about a 2-stationary cardinal, i.e. a cardinal that reflects all its stationary sets. (shrink)

Frege's life and character -- The project -- Frege's new logic -- Defining the numbers -- The reconception of the logic, I-"Function and concept" -- The reconception of the logic, II- "On sense and meaning" and "on concept and object" -- Basic laws, the great contradiction, and its aftermath -- On the foundations of geometry -- Logical investigations -- Frege's influence on recent philosophy.

Universalistic claims about the nature of justice are presumed to require larger commitments from a global perspective than partialist claims. This essay departs from standard partialist accounts by anchoring partialist claims in a different account of the nature of responsibility. In contrast to substantive responsibility, which is akin to an obligation and derived from principles, relational responsibilities grow out of relationships and their complex intertwining. While such accounts of responsibility are less clear cut, they will prove in the long run (...) to be more valuable in thinking about global ethics. I illustrate this point by considering the moral issue surrounding abandoned relationships. The approach offered here—partiality that rests upon relational responsibilities—makes the responsibilities owed by those in higher income countries towards lower income countries much richer and more complex than is usually presumed. (shrink)

Martin's axiom is equivalent to the statement that the universe is absolute under ccc forcing extensions for Σ 1 sentences with a subset of $\kappa, \kappa , as a parameter.

Ethicists and others who study and teach the social implications of science and technology are faced with a formidable challenge when they seek to address “emerging technologies.” The topic is incredibly important, but difficult to grasp because not only are the precise issues often unclear, what the technology will ultimately look like can be difficult to discern. This paper argues that one particularly useful way to overcome these difficulties is to engage with their natural science and engineering colleagues in laboratories. (...) Through discussions and interactions with these colleagues ethicists can simultaneously achieve three important objectives. First they can get a great deal of assistance in their research into the social implications of future technologies by talking with people that are actively creating those futures. Second their presence in the lab and the discussions that result can be a very powerful method for educating not only students, but faculty about the ramifications of their work. And third, because the education is directly linked to the students’ everyday work it is likely that it will not just be a theoretical exercise, but have direct impact on their practice. (shrink)

Stambaugh (philosophy, City U. of New York) elucidates one of the central themes in the work of German philosopher Martin Heidegger (1889-1976), based on her talks with him, and on her extensive study of his works, several of which she has ...