BackgroundCommentators believe that the ethical decision-making climate is instrumental in enhancing interprofessional collaboration in intensive care units. Our aim was twofold: to determine the perception of the ethical climate, levels of moral distress, and intention to leave one's job among nurses and physicians, and between the different ICU types and determine the association between the ethical climate, moral distress, and intention to leave.MethodsWe performed a cross-sectional questionnaire study between May 2021 and August 2021 involving 206 nurses and physicians in a (...) large urban academic hospital. We used the validated Ethical Decision-Making Climate Questionnaire and the Measure of Moral Distress for Healthcare Professionals tools and asked respondents their intention to leave their jobs. We also made comparisons between the different ICU types. We used Pearson's correlation coefficient to identify statistically significant associations between the Ethical Climate, Moral Distress, and Intention to Leave.ResultsNurses perceived the ethical climate for decision-making as less favorable than physicians. They also had significantly greater levels of moral distress and higher intention to leave their job rates than physicians. Regarding the ICU types, the Neonatal/pediatric unit had a significantly higher overall ethical climate score than the Medical and Surgical units and also demonstrated lower moral distress scores and lower “intention to leave” scores compared with both the Medical and Surgical units. The ethical climate and moral distress scores were negatively correlated ; moral distress and "intention to leave" was positively correlated ; and ethical climate and “intention to leave” were negatively correlated.ConclusionsSignificant differences exist in the perception of the ethical climate, levels of moral distress, and intention to leave between nurses and physicians and between the different ICU types. Inspecting the individual factors of the ethical climate and moral distress tools can help hospital leadership target organizational factors that improve interprofessional collaboration, lessening moral distress, decreasing turnover, and improved patient care. (shrink)

A cognitive assessment strategy that is not limited to examining a set of summary test scores may be more helpful for early detection of emergent illness such as Alzheimer’s disease (AD) and may permit a better understanding of cognitive functions and dysfunctions in those with AD and other dementia disorders. A revisit of the work already undertaken by Kaplan and colleagues using the Boston Process-Approach provides a solid basis for identifying new opportunities to capture data on neurocognitive processes, test-taking strategies (...) and response styles. Thus, this critical review will combine traditional process-based assessment strategies with support provided or offered by newer technologies that have the potential to add value to data collection and interpretation. There is now considerable interest in neuropsychological test administration using computer/digital technology, both in research and in clinical settings. To add value, any computerized version of an existing cognitive test should respect the administration procedure for which normative data were obtained, should be time-saving in terms of scoring and interpretation, and should, we argue, facilitate gathering information about the processes and strategies followed in test completion. This article will offer an overview of the steps needed when implementing computerization of neuropsychological tests using a Process-Based Approach (PBA) to these technology-based adaptations and will discuss further developments in this area by linking it to future technological developments that may be possible in the area of neuropsychological assessment. Additionally, an overview of neuropsychological tests that may benefit from computerization will be presented, together with suggestions on the specific processes, strategies and features that may be captured with the aid of such computerization. Finally, hypotheses on how virtual reality could be an asset for the future of the PBA to neuropsychological assessment will also be discussed. (shrink)

In contrast to many aspects of the social responsibility of business, CSR scholarship has been largely silent on the issue of the payment of corporate tax. This is curious because such tax payments are often considered a fundamental and easily measured example of a company’s citizenship behavior. However, because the payment of corporate tax can often be legally avoided, this activity represents a boundary condition for CSR. If the law and CSR suggest that a company should pay its fair share (...) of tax, yet many successful companies actively avoid this social obligation, should they be considered socially irresponsible. This paper explores the issue of tax avoidance and the implications it has for any credible definition and measure of CSR. It also highlights an aspect of corporate practice that is deliberately hidden from public view. (shrink)

This is a coherent set of essays regarding the study of justice and it takes into consideration the needs and obligations of the individual as a member of society.

In recent years Nick Zangwill has gone a long way in championing a moderate aesthetic formalism in an attempt to accommodate those objects that many of us call beautiful despite their lack of any formal beauty. While there is some dispute in the literature about the extent to which Kant can be interpreted as an aesthetic formalist, the appeal of his famous distinction between free and dependent beauty should present a fairly natural ally for Zangwill's project. Indeed, such an alliance (...) has been expressed by Zangwill, who first reaches for this ‘invaluable but misunderstood and underappreciated distinction’ in his ‘Feasible aesthetic formalism’ . Here, Zangwill claims that this essential distinction can be cut loose from Kant's terminology and views about aesthetic judgement. More recently he expresses more strongly that ‘Kant was also a moderate formalist, who opposes extreme formalism when he distinguished free and dependent beauty in §16 of the Critique of Judgement’ . Yet, a decade on from the initial suggestion, there has been little further exploration or elucidation of this move, or indeed this potential characterization of Kant's aesthetics. It is the aim of this paper to begin to address that deficiency by identifying the extent to which a moderate formalist position is available in Kant's aesthetic. I will suggest that Kant's account does not require substantial modification in order to cast him as a moderate formalist. Taking the time to isolate the plausible grounds for characterizing Kant's aesthetic in this way, this discussion will enable us to explore some of the rival interpretations of his work such that we may also identify the kind of Kantian the moderate formalist is likely to be. (shrink)

The application of artificial intelligence and machine learning technologies in healthcare have immense potential to improve the care of patients. While there are some emerging practices surro...

Since ancient Athens, democrats have taken pride in their power and inclination to change their laws, yet they have also sought to counter this capacity by creating immutable laws. In Democracy and Legal Change, Melissa Schwartzberg argues that modifying law is a fundamental and attractive democratic activity. Against those who would defend the use of 'entrenchment clauses' to protect key constitutional provisions from revision, Schwartzberg seeks to demonstrate historically the strategic and even unjust purposes unamendable laws have typically served, (...) and to highlight the regrettable consequences that entrenchment may have for democracies today. Drawing on historical evidence, classical political theory, and contemporary constitutional and democratic theory, Democracy and Legal Change reexamines the relationship between democracy and the rule of law from a new, and often surprising, set of vantage points. (shrink)

Journal of Philosophy of Education, EarlyView.

In the Doctrine of Virtue Kant divides duties of love into three categories: beneficent activity , gratitude and Teilnehmung – commonly referred to as the duty of sympathy . In this paper I will argue that the content and scope of the third duty of love has been underestimated by both critics and defenders of Kant's ethical theory. The account which pervades the secondary literature maintains that the third duty of love includes only two components: an obligation to make use (...) of our natural receptivity to sympathetic feelings as a means to fulfilling other duties of love, and an indirect duty to cultivate these feelings. As a result, Kant's duty of sympathy has been widely regarded as a duty whose value is derived from the way in which it serves other duties, in particular, the duty of beneficent activity, which obliges agents ‘to promote according to one's means the happiness of others in need’ . Teilnehmung has thus assumed something of a second-class status among the duties to others. My aim in this paper is to demonstrate that the prevailing account of Kant's third duty of love is incomplete. (shrink)

As is clear in the 2008 report of the President's Council on Bioethics, the brain death debate is plagued by ambiguity in the use of such key terms as ‘integration’ and ‘wholeness’. Addressing this problem, I offer a plausible ontological account of organismal unity drawing on the work of Hoffman and Rosenkrantz, and then apply that account to the case of brain death, concluding that a brain dead body lacks the unity proper to a human organism, and has therefore undergone (...) a substantial change. I also show how my view can explain hard cases better than one in which biological integration is taken to imply ontological wholeness or unity. (shrink)

Abstract In the Critique of the Power of Judgment, Kant refers to the pleasure that we feel when judging that an object is beautiful as the pleasure of "mere reflection". Yet Kant never makes explicit what exactly is the relationship between the activity of "mere reflection" and the feeling of pleasure. I discuss several contemporary accounts of the pleasure of taste and argue that none of them is fully accurate, since, in each case, they leave open the possibility that one (...) can reflect without having a feeling of pleasure, and hence allow a possible skepticism of taste. I then present my own account, which can better explain why Kant thinks that when one reflects one must also have a feeling of pleasure. My view, which emphasizes the role of attention in Kant, depicts well what we do when we judge something to be beautiful. It can also suggest a way to explain the relation between judgments of taste and moral feeling, and begin to show how the faculty of feeling fills a gap in the system of our cognitive faculties. (shrink)

Competition among scientists for funding, positions and prestige, among other things, is often seen as a salutary driving force in U.S. science. Its effects on scientists, their work and their relationships are seldom considered. Focus-group discussions with 51 mid- and early-career scientists, on which this study is based, reveal a dark side of competition in science. According to these scientists, competition contributes to strategic game-playing in science, a decline in free and open sharing of information and methods, sabotage of others’ (...) ability to use one’s work, interference with peer-review processes, deformation of relationships, and careless or questionable research conduct. When competition is pervasive, such effects may jeopardize the progress, efficiency and integrity of science. (shrink)

A crucial feature of Kant's critical-period writing on the sublime is its grounding in moral psychology. Whereas in the pre-critical writings, the sublime is viewed as an inherently exhausting state of mind, in the critical-period writings it is presented as one that gains strength the more it is sustained. I account for this in terms of Kantian moral psychology, and explain that, for Kant, sound moral disposition is conceived as a sublime state of mind.

Gifts have served as a fundamental aspect of the human experience across time, even as their precise roles and functions have shifted. In the past, bioethicists and others have drawn upon anthropol...

According to terror management theory, humans rely on meaningful and permanence-promising cultural worldviews, like religion, to manage mortality concerns. Prior research indicates that, compared to religious individuals, atheists experience lower levels of meaning in life following reminders of death. The present study investigated whether reminders of death would change atheists’ meaning in life after exposure to normative support for atheism. Atheists were either reminded of death or a control topic and exposed to information portraying atheism as either common or rare, (...) and then asked to rate their perceived meaning in life. Results showed that reminders of death reduced meaning in life among atheists who were told that atheism is common. Results were consistent with the view that atheism reflects the rejection of religious faith rather than a meaningful secular terror managing worldview. Discussion considers implications for maintaining healthy existential wellbeing, identifies limitations, and highlights future research directions. (shrink)

This article discusses the concept of publicity in Kant’s moral philosophy. Insofar as the concepts of ‘public’ and ‘private’ can describe our relations with others, they can be considered to be moral concepts. I argue that we can find in Kant a moral duty not to keep our maxims of action private, or secret. Whereas Korsgaard argues that sometimes in the face of evil it is permissible to sidestep the moral law, I argue that it is rather through publicity that (...) we can deal with evil in the non-ideal world. Moreover, by being open with our maxims, moral progress is possible. View HTML Send article to KindleTo send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle. Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service.Making the Ideal Real: Publicity and Morality in KantVolume 21, Issue 2Melissa Zinkin DOI: https://doi.org/10.1017/S1369415416000042Your Kindle email address Please provide your Kindle email.@free.kindle.com@kindle.com Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Dropbox To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox. Making the Ideal Real: Publicity and Morality in KantVolume 21, Issue 2Melissa Zinkin DOI: https://doi.org/10.1017/S1369415416000042Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Google Drive To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive. Making the Ideal Real: Publicity and Morality in KantVolume 21, Issue 2Melissa Zinkin DOI: https://doi.org/10.1017/S1369415416000042Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Export citation. (shrink)

For Kant, the ideal of enlightenment is most fundamentally expressed as a self-developed soundness of judgment. But what does this mean when the judgment at issue is practical, i.e., concerns the good to be brought about through action? I argue that the moral context places special demands on the ideal of enlightenment. This is revealed through an interpretation of Kant’s prescription for moral pedagogy in the Critique of Practical Reason. The goal of the pedagogy is to cultivate the moral disposition, (...) and the method consists of training in judgment. Unfortunately, Kant seems to wind up somewhere short of this goal, leaving the young person with only an idle wish for a properly cultivated moral disposition. In this paper, I argue that when we address the special issues that arise when the enlightenment ideal is brought to bear on practical judgment — issues that stem from the intrinsic connection between practical judgment and agency — we will see that there is no lacuna in Kant’s account. (shrink)

In this paper, I argue that brain death is death because, despite the appearance of genuine integration, the brain-dead body does not in fact possess the unity that is proper to a human organism. A brain-dead body is not a single entity, but a multitude of organs and tissues functioning in a coordinated manner with the help of artificial life support. In order to support this claim, I first lay out Hoffmann and Rosenkrantz’s ontological account of the requirements for organismal (...) unity and summarize an earlier paper in which I apply this account to the brain death debate. I then further support this ontological argument by developing an analogy between the requirements for the unity of an organism and the requirements for the unity of an orchestra. To do so, I begin by examining the role that a conductor plays in unifying a traditional orchestra, and then go on to show that the human organism functions like a traditional orchestra that relies upon a conductor for its unity. Next, I consider the conditions required to achieve orchestral unity in conductorless orchestras and show that, in contrast to simpler organisms like plants, the postnatal human organism lacks those conditions. I argue, in other words, that although conductorless orchestras do exist, the human organism is not one of them. Like a traditional orchestra without a conductor, the brain-dead body is not a unified whole. (shrink)

“The object of this book,” writes William C. Dowling in his preface, “is to make the key concepts of Paul Ricoeur’s _Time and Narrative_ available to readers who might have felt bewildered by the twists and turns of its argument.” The sources of puzzlement are, he notes, many. For some, it is Ricoeur’s famously indirect style of presentation, in which the polarities of argument and exegesis seem so often and so suddenly to have reversed themselves. For others, it is (...) the extraordinary intellectual range of Ricoeur’s argument, drawing on traditions as distant from each other as Heideggerian existentialism, French structuralism, and Anglo-American analytic philosophy. Yet beneath the labyrinthian surface of Ricoeur’s _Temps et récit_, Dowling reveals a single extended argument that, though developed unsystematically, is meant to be understood in systematic terms. __Ricoeur on Time and Narrative_ _presents that argument in clear and concise terms, in a way that will be enlightening both to readers new to Ricoeur and those who may have felt themselves adrift in the complexities of _Temps et récit,_ Ricoeur’s last major philosophical work. Dowling divides his discussion into six chapters, all closely involved with specific arguments in _Temps et récit_: on mimesis, time, narrativity, semantics of action, poetics of history, and poetics of fiction. Additionally, Dowling provides a preface that lays out the French intellectual context of Ricoeur's philosophical method. An appendix presents his English translation of a personal interview in which Ricoeur, having completed _Time and Narrative, _looks back over his long career as an internationally renowned philosopher. __Ricoeur on Time and Narrative___ _communicates to readers the intellectual excitement of following Ricoeur’s dismantling of established theories and arguments—Aristotle and Augustine and Husserl on time, Frye and Greimas on narrative structure, Arthur Danto and Louis O. Mink on the nature of historical explanation—while coming to see how, under the pressure of Ricoeur’s analysis, these ideas are reconstituted and revealed in a new set of relations to one another. "The scholarship in William C. Dowling's __Ricoeur on Time and Narrative____ __is impeccable; Dowling knows Ricoeur inside out. He highlights Ricoeur's most important arguments, presents them in a limpid, concise language, and links them to the relevant nineteenth- and twentieth-century philosophical developments. Dowling's book provides us with a lucid, intelligible version of Ricoeur's major work, one that will be of considerable significance to philosophers, historians, and literary theorists." —_Thomas Pavel, Gordon J. Laing Distinguished Service Professor of French Literature, and the Committee on Social Thought, University of Chicago_ "William C. Dowling's __Ricoeur on Time and Narrative___ _is a subtle and remarkably well-sustained piece of work. It provides a detailed introduction to a major work of philosophy and narrative theory—already a considerable achievement, given the difficulty of Ricoeur's text. However, Dowling also shows us, sometimes explicitly, sometimes simply through the way he conducts his argument, why we should bother with Ricoeur—what we have to gain from knowing him better than we do, however well we may think we know him." —_Michael Wood, Charles Barnwell Straut Class of 1923 Professor of English and Comparative Literature, Princeton University _. (shrink)

There can be no doubt that Kant thought we should be reflective: we ought to care to make up our own minds about how things are and what is worth doing. Philosophical objections to the Kantian reflective ideal have centred on concerns about the excessive control that the reflective person is supposed to exert over her own mental life, and Kantians who feel the force of these objections have recently drawn attention to Kant’s conception of moral virtue as it is (...) developed in his later work, chiefly the Metaphysics of Morals. Melissa Merritt’s book is a distinctive contribution to this recent turn to virtue in Kant scholarship. Merritt argues that we need a clearer, and textually more comprehensive, account of what reflection is, in order not only to understand Kant’s account of virtue, but also to appreciate how it effectively rebuts long-standing objections to the Kantian reflective ideal. (shrink)

I propose a unified solution to two puzzles: Ross's puzzle and free choice permission. I begin with a pair of cases from the decision theory literature illustrating the phenomenon of act dependence, where what an agent ought to do depends on what she does. The notion of permissibility distilled from these cases forms the basis for my analysis of 'may' and 'ought'. This framework is then combined with a generalization of the classical semantics for disjunction — equivalent to Boolean disjunction (...) on the diagonal, but with a different two-dimensional character — that explains the puzzling facts in terms of semantic consequence. (shrink)

Building trust between academic medical centers and certain communities they depend on in the research process is hard, particularly when those communities consist of minoritized or historically marginalized populations. Some believe that engagement activities like the creation of advisory boards, town halls, or a research workforce that looks more like community members will establish or reestablish trust between academic medical centers and racialized communities. However, without systematic approaches to dismantle racism, those well‐intended actions become public performativity, and trust building will (...) fail. In this essay, we draw upon foundational ethical principles of trust, distrust, and trust building; apply the concept of bounded justice to performative trust acts; and center the works of Black and Indigenous feminist bioethicists to revisit some of the wisdom and valuable lessons they have contributed. Rebuilding trust is hard to do because people and institutions are often not honest about how hard it is and there is no simple box‐checking task that can disentangle our society's injustices, but there are steps to take in this direction. Individuals and institutions can recognize valuable relevant work that has already been written, partake in critical reflection, and then apply insights gained to take both small and sustainable steps toward transformational change and deeper trust. (shrink)