Healthcare workers experience moral injury (MI), a violation of their moral code due to circumstances beyond their control. MI threatens the healthcare workforce in all settings and leads to medical errors, depression/anxiety, and personal and occupational dysfunction, significantly affecting job satisfaction and retention. This article aims to differentiate concepts and define causes surrounding MI in healthcare. A narrative literature review was performed using SCOPUS, CINAHL, and PubMed for peer-reviewed journal articles published in English between 2017 and 2023. Search terms included (...) “moral injury” and “moral distress,” identifying 249 records. While individual risk factors predispose healthcare workers to MI, root causes stem from healthcare systems. Accumulation of moral stressors and potentially morally injurious events (PMIEs) (from administrative burden, institutional betrayal, lack of autonomy, corporatization of healthcare, and inadequate resources) result in MI. Individuals with MI develop moral resilience or residue, leading to burnout, job abandonment, and post-traumatic stress. Healthcare institutions should focus on administrative and climate interventions to prevent and address MI. Management should ensure autonomy, provide tangible support, reduce administrative burden, advocate for diversity of clinical healthcare roles in positions of interdisciplinary leadership, and communicate effectively. Strategies also exist for individuals to increase moral resilience, reducing the impact of moral stressors and PMIEs. (shrink)

A paper was published in 2003 discussing the ethics of nurses participating in executions by inserting the intravenous line for lethal injections and providing care until death. This paper was circulated on an international email list of senior nurses and academics to engender discussion. From that discussion, several people agreed to contribute to a paper expressing their own thoughts and feelings about the ethics of nurses participating in executions in countries where capital punishment is legal. While a range of opinions (...) were presented, these opinions fell into two main themes. The first of these included reflections on the philosophical obligations of nurses as caregivers who support those in times of great need, including condemned prisoners at the end of life. The second theme encompassed the notion that no nurse ever should participate in the active taking of life, in line with the codes of ethics of various nursing organisations. This range of opinions suggests the complexity of this issue and the need for further public discussion. (shrink)

Michael A. PetersBeijing Normal UniversityMy deepest condolences to Pepe, Dom and Marcus and to Jim’s grandchildren. Tina and I spent a lot of time at the Marshall family home, often attending dinn...

This collection of essays, offered in honor of the distinguished career of prominent political philosophy professor Clifford Orwin, brings together internationally renowned scholars to provide a wide context and discuss various aspects of the virtue of “humanity” through the history of political philosophy.

Linda Zagzebski has recently argued that there is a conflict between a common view of the asymmetry of time and various other metaphysical hypotheses. She identifies conflicts in the case of the modal arrow of time and in the case of the causal arrow of time. In the case of the modal arrow I argue that on one view there is no conflict and that on another the principle should be abandoned that there are entailments between propositions about the (...) past and the future. In the case of the causal arrow I argue that the conflict can be avoided by the adoption of a suitable closure principle. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:EMBODIED HUMAN AGENTS INHABITING A MATERIAL WORLD? CHARLES T. HUGHES Chapman University Orange, California I. /n;troduction HE CONCEPT of a "logically possible world" has roven useful in the investigation of issues within many ranches of philosophy, including the philosophy of religion.1 Since this paper includes an analysis of one "possible worlds" objection to Christian theism, based upon the problem of evil, it will prove useful to preface my (...) discussion with a paragraph which summarizes some of the ideas important to the logic of possible worlds. Each logically possible world contains a complete set of compossible facts, which includes the past, present, and future of its objects, properties, and relations. Those complete sets of compossible facts, each of which describes the way the actual world could have been, have in common the truth of all logically necessary propositions (for example, 2 +2 = 4, "Circles cannot be squared "), and the falsity of all logically impossible propositions (for example, 2 +6 = 7, " Circles can be squared"), but differ in their truth values with respect to at least some logically contingent propositions (for example, "Elephants exist" is true in one or more possible worlds but false in all others, and "Unicorns exist " is true in one or more possible worlds but false in all others). An impossible world includes an affirmation of the falsity of at least one necessary proposition (for example,,.._,(2 +2 = 4)), and/or affirms the truth of at least one logical1 See Alvin Plantinga, The Nature of Necessity (Oxford: Clarendon Press, 1974), chapters IX and X. 389 390 CHARLES T. HUGHES ly impossible proposition (for example, " Logically necessary propositions are false in all possible worlds ").2 The actual world, which is our world, is that complete set of compossible propositions which describe the way things actually are. The actual world, therefore, differs from other possible worlds in that all of its contingent propositions correspond to the past, present, and future of all of the objects, properties, and relations which actually obtain. There is an on-going debate about the nature and ontological status of possible worlds and their objects.3 The purpose of this paper is to analyze and reject a particular "possible worlds" objection to Christian theism, based upon the problem of evil, which is not frequently discussed in philosophical literature. The problem is this : If God must actualize a possible world in order to provide human agents with the initial stage of existence they require to develop freely as rational, moral, and religious beings, who choose their own destinies, why did God not create them as incorporeal agents within an immaterial world which would, by its very nature, eliminate the physical dimension of evil and suffering which plagues the actual world? For it seems, prima facie, that God could have realized his purposes by actualizing an immaterial world, populated with human-like incorporeal agents, thereby avoiding all of the terrible evil and suffering made possible by physicality. Therefore, the existence of the actual physical world, with all its evil and suffering, is evidence against the existence of God.4 In order to show that the previously stated objection from evil could pose a genuine threat to theism, I will first identify some of my important assumptions in this paper, and then outline particular Christian ideas to determine how the " possible worlds " 2 For an argument that some impossible propositions are not self-contradictory, see Linda Zagzebski, " What If the Impossible Had Been Actual," in Michael D. Beatty, ed., Christian Theism aml the Problems of Philosophy (Notre Dame: University of Notre Dame Press, 1990), pp. 165-183. a Compare, for example, the positions of D. M. Armstrong, A Combinatorial Theory of Possibility (Cambridge: Cambridge University Press, 1989) and D. Lewis, On the Plurality of Worlds (Oxford: Blackwell, 1986). 4 Some interesting discussion of this type of problem can be found in Austin Farrer, Love Almighty and Ills Unlimited (London: Collins, 1962), pp. 69-76. EMBODIED HUMAN AGENTS 391 objection to Christian theism could arise in the first place. After that, I will discuss the nature of the " possible worlds " objection and how, in principle, it might be rebutted by theists who possess a great amount of... (shrink)

Men and women have always bargained for sex. In Hard Bargains, philosopher-lawyer Linda Hirshman and legal historian Jane Larson provide the first complete analysis of power in heterosexual relationships, combining an eye-opening legal history of sexual regulation with thought-provoking predictions of what the future might bring. Hirshman and Larson tell a riveting tale that spans the centuries--from early accounts of adulterers hanging from the gibbet, to the impact of the Kinsey Reports and Hugh Hefner's playboy philosophy, to the 1960s (...) judge who argued in favor of sex with eleven-year-olds. The book examines the factors that have shaped our notions of sex, from Catholic teaching to the theories of Sigmund Freud, and it explores the Supreme Court decisions of the last few decades that revolutionized the politics of sex. And Hard Bargains not only provides a deep understanding of historical and current disputes, it also offers striking predictions of what sexual bargaining will look like in the future--rape laws replaced by laws of sexual autonomy, adultery subjected to breach of contract action, fornicators responsible for each other's rent, prostitution considered an unfair labor practice. These are a few of the surprising--and surprisingly workable--solutions the authors foresee in the 21st century. Hard Bargains takes a forthright and level-headed look at all aspects of one of the biggest controversies in contemporary American society--heterosexual sex--and delivers a radically new perspective on the sexual lives of women and men. (shrink)

Normal propositional modal systems This first chapter has two main aims. One is to give a general account of the propositional modal systems that we shall ...

Hugh Connelly, An authentic Celtic voice : the Irish penitential and contemporary discourse on reconciliation -- Padraig Corkery, Bio-ethics and contemporary Irish moral discourse -- Amelia Fleming, The silent voice of creation and moral discourse. -- Raphael Gallagher, CSsR., A church silence in sexual moral discourse? -- Donal Harrington, Moral discourse and journalism. -- Linda Hogan, Contemporary humanitarianism: neutral or impartial? -- Vincent MacNamara, On having a religious morality. -- Enda McDonagh, A discourse on the centrality of justice in (...) moral theology. -- Suzanne Mulligan, Moral discourse in a time of AIDS. (shrink)

Hughes approaches his subjects, as he later did with pertinent issues of the twentieth-century, with both reason and compassion.This edition includes an elegant ...

Star Trek scripts have often grappled with dilemmas of medical ethics. The most explicitly medical-ethics-oriented Star Trek episode is named, aptly enough, “Ethics.” The script was written by Sara Charno and Stuart Charno, authors of two other Star Trek episodes. “Ethics” first aired on 2 March 1992. In the fall of 1992, we began to use this “Ethics” episode to motivate discussions in our first-year medical students’ course on medical ethics and the doctor-patient relationship. We asked students to write essays (...) addressing one of the many ethical dilemmas posed by the episode. Over the years, the episode has become a tradition. Both students and instructors find the formulation of dilemmas in the context of a science-fiction story to be both liberating and stimulating. In this essay, we will discuss this particular episode in some detail and then provide a brief synopsis of other episodes that might be used in ethics courses in a similar way. (shrink)

A recent focus of the debate on conscientious objection in healthcare is the question of whether practitioners should have to justify their refusal to perform certain functions. A recent article by Cowley addresses a practical aspect of this controversy, namely the question of whether doctors claiming conscientious objector status in relation to abortion should be required, like their counterparts claiming exemption from military conscription, to defend their claim before a tribunal. Cowley argues against the use of tribunals in the medical (...) case, on the grounds that there are likely to be fewer unjustified claims to conscientious objection in this context than in the military, and that in any case tribunals will not be an effective way of distinguishing genuine and false cases. I reject these arguments and propose a different conception of the role of a medical conscientious objection tribunal. (shrink)

This is an opinionated guide to the literature on epistemic dilemmas. It discusses seven kinds of situations where epistemic dilemmas appear to arise; dilemmic, dilemmish, and non-dilemmic takes on them; and objections to dilemmic views along with dilemmist’s replies to them.

Written by one of the most important founding figures of Western philosophy, Aristotle’s _Nicomachean Ethics_ represents a critical point in the study of ethics which has influenced the direction of modern philosophy. The _Routledge Guidebook to Aristotle’s Nicomachean Ethics_ introduces the major themes in Aristotle’s great book and acts as a companion for reading this key work, examining: The context of Aristotle’s work and the background to his writing Each separate part of the text in relation to its goals, meanings (...) and impact The reception the book received when first seen by the world The relevance of Aristotle’s work to modern philosophy, its legacy and influence. With further reading included throughout, this text is essential reading for all students of philosophy, and all those wishing to get to grips with this classic work. (shrink)

This study examined self-recognition processing in both the auditory and visual modalities by determining how comparable hearing a recording of one’s own voice was to seeing photograph of one’s own face. We also investigated whether the simultaneous presentation of auditory and visual self-stimuli would either facilitate or inhibit self-identification. Ninety-one participants completed reaction-time tasks of self-recognition when presented with their own faces, own voices, and combinations of the two. Reaction time and errors made when responding with both the right and (...) left hand were recorded to determine if there were lateralization effects on these tasks. Our findings showed that visual self-recognition for facial photographs appears to be superior to auditory self-recognition for voice recordings. Furthermore, a combined presentation of one’s own face and voice appeared to inhibit rather than facilitate self-recognition and there was a left-hand advantage for reaction time on the combined-presentation tasks. (shrink)

Disturbances to one's sense of self, the feeling that one has ‘lost a part of oneself’ or that one ‘no longer feels like oneself,’ are frequently recounted throughout the bereavement literature. Engaging Allan Køster's important contribution to this issue, this article reinforces his suggestion that, by rupturing the existential texture of self-familiarity, bereavement can result in experiences of estrangement that can be meaningfully understood according to the concept of self-alienation. Nevertheless, I suggest that whilst Køster's relational interpretation of alienation as (...) the withdrawal of heteronomy can be applied to the experience of world-collapse in bereavement, what sets bereavement apart from other limit situations is the fact that it involves an intersubjective relation between the living and the dead. In contrast to Køster, therefore, I suggest that the experience of self-alienation that is distinctive to bereavement results from the fact that the bereaved is exposed to, and co-opted by, the absolute alterity of death itself. (shrink)

The Neglected Argument for the Reality of God is something of a Rorschach test for scholars of Peirce.1 Some see a creative presentation of his mature philosophy of inquiry, while others find evidence that Peirce was unable to free himself of his conservative religious milieu. As the editors of The Essential Peirce collection noted: “Whether this paper is an elaboration of or an offense against pragmatism is an unsettled question.”2 The primary import of the essay, I contend, is not to (...) defend God’s reality but rather to highlight continuities between religion and science. In doing so, Peirce aims to show theologians how they might better do their jobs. My aim in this paper is to take Peirce’s advice seriously and.. (shrink)

There has been considerable work on practical reasoning in artificial intelligence and also in philosophy. Typically, such reasoning includes premises regarding means–end relations. A clear semantics for such relations is needed in order to evaluate proposed syllogisms. In this paper, we provide a formal semantics for means–end relations, in particular for necessary and sufficient means–end relations. Our semantics includes a non-monotonic conditional operator, so that related practical reasoning is naturally defeasible. This work is primarily an exercise in conceptual analysis, aimed (...) at clarifying and eventually evaluating existing theories of practical reasoning (pending a similar analysis regarding desires, intentions and other relevant concepts). (shrink)

When a loved one dies, it is common for the bereaved to feel profoundly lonely, disconnected from the world with the sense that they no longer belong. In philosophy, this experience of ‘loss and loneliness’ has been interpreted according to both a loss of possibilities and a loss of the past. But it is unclear how these interpretations apply to the distinctive way in which loss and loneliness manifest in old age. Drawing on the phenomenological analyses of old age given (...) by de Beauvoir and Améry, I consider how the diminishment of the capacity for projection and recollection complicate recent interpretations of loss and loneliness, whilst nevertheless reinforcing the conclusion that in old age subjectivity is necessarily impoverished. Developing a critical stance on de Beauvoir and Améry’s underlying conception of subjectivity, I turn to Levinas in considering whether or not there is a way to reimagine subjectivity such that the estrangement and alienation of older adults might be ameliorated rather than exacerbated. Grounded in the passive body-in-itself rather than the self-transcending capacity of the body-for-itself, I suggest it becomes possible to reconceptualise the experience of loss and loneliness in old age; both in terms of what is lost and what needs to be restored if older adults are to be helped to find themselves at home in the world in the midst of, and indeed because of, manifold loss. (shrink)

Through accessible text and dynamic photos, readers will learn about the concepts of tight and loose using such topics as knots, rings, and clothing. A “Words to Know” section at the beginning of the book helps students learn new vocabulary they will encounter in the text, while suggestions for other titles and websites encourage students to learn more.

Transhumanism and Unitarian Universalism are both the result of filtering ancient religious aspirations through the sieve of Enlightenment rationalism, humanism and individualism. The transhumanists aspire to transcendence through individual adoption of human enhancing technologies, while the UUs encourage transcendence through the critical, selective construction of personal spiritualities. Today, most religious reject the promises of human enhancement and transhumanism. But Unitarian Universalists are in the unusual position to be interlocutors between faith and science, between spirituality and techno-transcendence, between liberal religion and (...) transhumanism. One area in which both UUs and transhumanists could especially benefit from dialogue is in reimagining virtue, which both have left behind as illiberal, moralistic anachronisms. Our ability to technologically enhance moral sentiments and behavior has made defining a liberal, and yet bounded, concept of the good life urgent for both UUs and the human enhancement movement. (shrink)

This volume of recent writings, some previously unpublished, follows the sequence of a typical intermediate or upper-level logic course and allows teachers to enrich their presentations of formal methods and results with readings on corresponding questions in philosophical logic.

This paper examines the professions as examples of “moral community” and explores how professional leaders possessed of moral intelligence can make a contribution to enhance the ethical fabric of their communities. The paper offers a model of ethical leadership in the professional business sector that will improve our understanding of how ethical behavior in the professions confers legitimacy and sustainability necessary to achieving the professions’ goals, and how a leadership approach to ethics can serve as an effective tool for the (...) dissemination of moral values in the organization. (shrink)

This thesis is intended t0 help develop the theory 0f coalgebras by, Hrst, taking classic theorems in the theory 0f universal algebras amd dualizing them and, second, developing an interna] 10gic for categories 0f coalgebras. We begin with an introduction t0 the categorical approach t0 algebras and the dual 110tion 0f coalgebras. Following this, we discuss (c0)a,lg€bra.s for 2. (c0)monad and develop 2. theory 0f regular subcoalgebras which will be used in the interna] logic. We also prove that categories 0f (...) coalgebras are completc, under reasonably weak conditions, and simultaneously prove the wellknown dual result for categories 0f algebras. We dose the second chapter with 2. discussion 0f bisimulations in which we introduce a weaker 110tion 0f bisimulaticn than is current in the literature, but which is w€H—b€ha.v€d and reduces t0 the standard defmition under the assumption 0f choice. (shrink)

Finding solutions to complex health problems, such as obesity, violence, and climate change, will require radical changes in cross-disciplinary education, research, and practice. The fundamental determinants of health include many interrelated factors such as poverty, culture, education, environment, and government policies. However, traditional public health training has tended to focus more narrowly on diseases and risk factors, and has not adequately leveraged the rich contributions of sociology, anthropology, economics, geography, communication, political science, and other disciplines. Further, students are often not (...) sufficiently trained to work across sectors to translate research findings into effective, large-scale sustainable actions. During the past 2 decades, national and international organizations have called for more effective interdisciplinary, transdisciplinary, and translational approaches to graduate education. Although it has been difficult to work across traditional academic boundaries, some promising models draw on pedagogical theory and feature cross-disciplinary training focused on real-world problems, linkage between research, professional practice, community action, and cultivation of leadership skills. We describe the development the Doctor of Public Health program at the University of California, Berkeley, USA and its efforts to improve transdisciplinary and translational research education. We stress the need for international collaboration to improve educational approaches and better evaluate their impact. (shrink)