Registered nurses (RNs) employed in an urban medical center in the USA identified moral distress as a practice concern. This study describes RNs' moral distress and the frequency of morally distressing events. Data were collected using the Moral Distress Scale and an open-ended questionnaire. The instruments were distributed to direct-care-providing RNs; 100 responses were returned. Morally distressing events included: working with staffing levels perceived as `unsafe', following families' wishes for patient care even though the nurse disagreed with the plan, and (...) continuing life support for patients owing to family wishes despite patients' poor prognoses. One high frequency distressing event was carrying out orders for unnecessary tests and treatments. Qualitative data analysis revealed that the nurses sought support and information from nurse managers, chaplaincy services and colleagues. The RNs requested further information on biomedical ethics, suggested ethics rounds, and requested a non-punitive environment surrounding the initiation of ethics committee consultations. (shrink)

The debate on abortion has tended to avoid the psychological significance of an unwanted pregnancy, dominated istead by the strong emotions the subject excites. Eva Pattis Zoja examines the thoughts that surround a woman's decision to end a pregnancy, and presents the challenging thesis that voluntary abortion can often be a violent and unconscious act of self-realisation. Treating a theme which is central to our existence, the author makes no attempt to argue for or against, or to deny the painful (...) nature of the subject which she tackles, but instead looks at the way in which a decision to abort can affect a woman's inner life. (shrink)

In order to receive controlled pain medications for chronic non-oncologic pain, patients often must sign a “narcotic contract” or “opioid treatment agreement” in which they promise not to give pills to others, use illegal drugs, or seek controlled medications from health care providers. In addition, they must agree to use the medication as prescribed and to come to the clinic for drug testing and pill counts. Patients acknowledge that if they violate the opioid treatment agreement, they may no longer receive (...) controlled medications. OTAs have been widely implemented since they were recommended by multiple national bodies to decrease misuse and diversion of narcotic medications. But critics argue that OTAs are ethically suspect, if not unethical, and should be used with extreme care if at all. We agree that OTAs pose real dangers and must be implemented carefully. But we also believe that the most serious criticisms stem from a mistaken understanding of OTAs’ purpose and ethical basis. (shrink)

Are democratic states permitted to denationalize citizens, in particular those whom they believe pose dangers to the physical safety of others? In this article, I argue that they are not. The power to denationalize citizens—that is, to revoke citizenship—is one that many states have historically claimed for themselves, but which has largely been in disuse in the last several decades. Recent terrorist events have, however, prompted scholars and political actors to reconsider the role that denationalization can and perhaps should play (...) in democratic states, in particular with respect to its role in protecting national security and in supporting the global fight against terror more generally. In this article, my objective is to show that denationalization laws have no place in democratic states. To understand why, I propose examining the foundations of the right of citizenship, which lie, I shall argue, in the very strong interests that individuals have in security of residence. I use this formulation of the right to respond to two broad clusters of arguments: (1) those that claim that it is justifiable to denationalize citizens who threaten to undermine the safety of citizens in a democratic state or the ability of a democratic state to function as a democratic state, and (2) those that claim that it is justifiable to denationalize dual citizens because they possess citizenship status in a second country that is also able to protect their rights. (shrink)

Today there are over 1,500 public-use airports in the United States. Each of these airports provides a service to the surrounding community, whether in the form of a general aviation or commercial air service facility. An airport is dependent on many facets of the local government infrastructure for support services. Also, the airports have ties to neighboring or resident military installations. A military installation has similar missions and objectives to an airport, a situation that enables a working relationship that is (...) complementary to each party. For example, airports and military installations alike must provide such services as emergency response, fire protection, airspace control, environmental protection, and a safe infrastructure for aircraft operations. While many aspects of the relationships are intangible and subjective, others are easily measured. (shrink)

This article experiments with multimedia storytelling to re-vision difference outside biomedical and humanistic frames by generating new understandings of living dis/artfully with illness. We present and analyze seven short videos created by women and trans people living with illness as part of an arts-based research project that aimed to speak back to hegemonic concepts of disability that create barriers to healthcare.1 We call for a welcoming in of disability studies’ disruptive and re-imaginative orientations to bodily difference to unsettle medicine’s humanistic (...) accounts. In turn, we advance medical post-humanistic approaches that call on disability studies to re-embody its theories and approaches. (shrink)

In 1935, a group of mathematical statisticians in the United States announced the founding of a new professional organization, the Institute of Mathematical Statistics. In the coming years, this institution became a significant source of support for the growing community of mathematical statisticians. Thus it would seem that the formation of the Institute marked the beginning of the process of the creation of that community. This paper, however, argues that those who initially participated in the Institute constituted a small, loosely (...) organized, but wellconnected group within the broader scientific world even before they joined together formally to promote their discipline. We will examine some aspects of their education, employment, and interests in order to determine how American mathematical statisticians set themselves apart from other scientists and helped to define their discipline before the community acquired its official status. (shrink)

Multiculturalism has become a political touchstone in many countries around the world. While many of those on the right oppose it, and many of those on the left embrace it, things are not this simple. For those who defend them, multicultural policies are generally seen as key to the fair and successful integration of minorities, many of whom are immigrants, into diverse democratic societies. For those who oppose multiculturalism, who have become part of the so-called "backlash" against multiculturalism, they are (...) charged with generating segregation rather than inclusion, undermining national cultures, reinforcing difference, and privileging minority groups. Around the world, we see failing attempts at migrant integration, persistent religious intolerance and racial and ethnic discrimination, resurgent national minorities, emboldened majorities, permanent minorities, continuing social isolation, and increasing extremism, including in the form of white nationalism. But is multiculturalism the solution to these problems or does it just make them worse? In this for-and-against book, two prominent scholars of multiculturalism put forward different answers to this important question. While Patti Tamara Lenard argues for minority rights as both the consequence of a right to culture and a way to redress the effects of nation-building, Peter Balint rejects minority rights altogether, instead arguing for a re-imagined liberal neutrality. This theoretical disagreement plays out in real-world policy disagreement. Lenard, for example, argues strongly in favor of exemptions from general rules for minority cultures including the right of Sikhs to be exempt from helmet laws, and for Jews and Muslims to be exempt from bans on male circumcision. She also defends the right of minority cultures to have government-supported separate spaces. Balint, on the other hand, argues directly against these types of exemptions and government support. He is opposed to any form of differentiation based on culture, religion, or ethnicity. The book uses a wide range of real-world examples to demonstrate their significant theoretical disagreement, and to recommend very different policy proposals. (shrink)

In this article Troels Norager discusses the subject of sacrifice in the context of Kierkegaard's Works of Love and Fear and Trembling. The first section argues that contrary to contemporary attempts to turn Kierkegaard into a phenomenologist of love, Kierkegaard should be regarded as a radical Christian thinker who (partly for biographical reasons) deliberately emphasized the necessity of being willing to sacrifice one's most precious love object. The second part deals with Abraham's dilemma in Genesis 22 and argues, critically surveying (...) the intriguing interpretation proposed by Ingolf Dalferth, that no credible solution to this deeply troubling story is to be found. In the final section the author ponders the contemporary significance of Abraham's sacrifice and briefly points to insights from eminent political philosophers like Rawls and Habermas. This leads to the conclusion that theology should finally be taking leave of Abraham by rejecting Abraham as the 'Father of faith' and as a paradigm to be emulated. Instead, theologians and philosophers of religion are called upon to embrace our post-secular modernity without surrendering to the demands of authoritarian religion. (shrink)

In this article, we extend the well-known ‘agreeing-to-disagree’ and ‘no-trade’ results from economics and game theory to international relations. We show that two rational countries should never agree to go to war when war is inefficient and when rationality is common knowledge. We argue that this result might provide one possible explanation for the empirical finding, often referred to as the ‘democratic peace’, that modern democracies rarely go to war with one another. We propose that the informational properties of pluralistic (...) institutions (as opposed to oligarchies or dictatorships) lead to better decision-making by democracies and that democracies are therefore more likely to be the rational actors necessary for the ‘no-war’ result. We discuss empirical evidence in support of this proposition. (shrink)

Democratic theory offers robust resources in order to defend the claim that noncitizens are, in many cases, entitled to the right to vote in their place of residence, regardless of their citizenship. On this, Avner de Shalit and I are in broad agreement. But the route we take to justify this right rests on substantially different argumentation: whereas I believe that residence is necessary and sufficient to justify the right to vote at the municipal and, more controversially, at the national (...) level, de Shalit believes that noncitizens must also intend to reside in a city over the longer term in order to merit the right to vote on city matters. I will argue that this focus on intention is dangerous for the most vulnerable of city dwellers, who are most in need of the right to vote, even if only at the city level. In particular, I argue that the only way that the right to vote can play its protective role is if it is available to migrants on the basis of residence, regardless of their stated intention. (shrink)

Examines the facts about the issue being covered, with information about arguments and opinions from around the globe. Special research projects, as well as a great variety of additional resources, invite the reader to engage with the issues that are currently shaping the world.

Trust is a central element of any well-functioning democracy, and the fact that it is widely reported to be on the wane is a worrisome phenomenon of contemporary politics. It is therefore critical that political and social philosophers focus on efforts by which to rebuild trust relations. I argue that a shared public culture is up to the task of trust-building, for three reasons. First, a shared public culture gives citizens an insight into the motivations that inspire fellow citizens to (...) action. Second, a shared public culture serves to generate both positive and negative sanctions, an understanding of which helps citizens to predict how their fellow citizens will behave. Third, a shared public culture generates a sense that we belong together. There are, of course, many communities that can reasonably be interpreted as having a shared public culture, even though they are characterized by low levels of trust. This observation leads me to suggest two features that a shared public culture must have in order to facilitate the emergence of trust relations: citizens must be willing to cooperate and they must be willing to submit to common institutions that will be responsible for coordinating this large-scale cooperation. If these conditions are fulfilled, a shared public culture will serve as a reliable source of trust relations. (shrink)

European Journal of Political Theory, Volume 21, Issue 3, Page 594-600, July 2022. In The Shifting Border, Ayelet Shachar offers us two concrete proposals for combatting the danger posed by the shifting border, especially to those crossing borders in search of safety. One proposal suggests that human rights travel with migrants, so that agents who control the border must take responsibility for protecting their human rights at the border. A second proposal, which forms the basis of my commentary below, asks (...) that states consider alternative ways for migrants to seek protection safely. In responding to this second proposal, I make two proposals of my own that stem from Shachar's analysis: her analysis offers us the resources we need in order to expand, not only the channels available to migrants for seeking protection, but also our sense of who should be involved in controlling admission, and expanding the “who” that is involved in admission gives meaning to the concept of “moral proximity” which can help to overcome the territorial imperative that dominates the rules governing international migration, i.e., the imperative that protection travels with physical access to territory, only. (shrink)

Algorithmic fairness is a new interdisciplinary field of study focused on how to measure whether a process, or algorithm, may unintentionally produce unfair outcomes, as well as whether or how the potential unfairness of such processes can be mitigated. Statistical discrimination describes a set of informational issues that can induce rational (i.e., Bayesian) decision-making to lead to unfair outcomes even in the absence of discriminatory intent. In this article, we provide overviews of these two related literatures and draw connections between (...) them. The comparison illustrates both the conflict between rationality and fairness and the importance of endogeneity (e.g., “rational expectations” and “self-fulfilling prophecies”) in defining and pursuing fairness. Taken in concert, we argue that the two traditions suggest a value for considering new fairness notions that explicitly account for how the individual characteristics an algorithm intends to measure may change in response to the algorithm. (shrink)

In this article, I argue that there are good reasons to permit states to engage in their own forms of prioritization of refugees for admission, if doing so enables more refugees overall to find safety. I identify three distinct clusters of programs that states operate, those that emphasize contribution-based reciprocity, those that emphasize anticipated benefit, and those that elevate cultural considerations. I assess the legitimacy of these programs separately, and then consider them together, to defend the view that – overall, (...) considering the profound need for resettlement spots – they warrant our normative support. At least at first glance, the reason that these programs are legitimate is that they are all underpinned by principles in moral philosophy that in general command widespread support. In the final section, I examine the discomfort they generate, and suggest that the discomfort has three related sources: (i) that there is something wrong with considering the benefits refugees may bring when at issue is simply whether states are carrying out their moral duties towards them; (ii) that the result of permitting such prioritization is that those who are most vulnerable are left behind; and (iii) that cultural considerations can easily slide into racist considerations. While I agree that we must be attentive to how these programs operate in practice, and whether they generate harm (in particular, more harm than good), I believe that in the current context, these objections can be adequately countered so that we should in general offer these programs our cautious, and conditional, support. (shrink)

The global space is in need of creative solutions to the challenges posed by those seeking, and deserving of, asylum. In some democratic states, experiments in permitting citizens to have a greater role in selecting refugees for admission are underway; in this article, I consider the conditions that must apply to any citizen‐selection scheme, in order for such a scheme to be morally acceptable. I begin with an account of the way in which citizen‐selection schemes – usually called ‘sponsorship programs’ (...) – operate presently. I then offer a justification for engaging citizens in refugee resettlement in general, as well as in selecting specific refugees for admission in particular, and then identify several conditions that must attend any permissible citizen‐selection scheme. I defend this account from two objections: (1) that states should be the primary, and indeed only, agent that selects refugees for admission and (2) that citizens will inevitably use problematic criteria in selecting refugees for admission, so they should be denied the right to do so. I conclude with some proposals for how a citizen‐selection scheme can be crafted to respond to this latter worry, including an outline of an exception clause that permits citizens to make the case that some refugees ought to be resettled, even if not specially selected by the UNHCR for resettlement priority, including especially family members and friends. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Knowing the EastPatti M. MarxsenKnowing the East. By Paul Claudel. Translated by James Lawler. Princeton, NJ: Princeton University Press, 2004. 136 pp.Fifty years after his death, Paul Claudel (1868–1955) is remembered for many things. Not only was he a major twentieth-century poet and playwright, he was an astute observer of Dutch, Spanish, and Japanese art. Not only was he the brother of sculptor Camille Claudel, he was a (...) diplomat who lived for nearly twenty years in Asia, including a stint as the French ambassador to Japan (1921–1927). When he was elected as a member of the Académie Française in 1946 at nearly 80 years of age he quipped, "For an academic, that is puberty." He died at 87, having lived large in two centuries and on three continents.Following an adolescence marked with indifference toward religion, Claudel experienced a profound conversion to Catholicism during a Christmas night service at Notre Dame Cathedral in Paris at the age of 18. With Christianity at the center of his universe and under the influence of Symbolist poets Rimbaud and Mallarmé, he developed a response to the world that was at once poetic and spiritual. Through his poetry, plays, and essays, he insisted on a fundamental unity between matter and spirit, a harmonious and vast universe into which the human mind could enter. And, at least for him, the point of entry was the portal of the Church. He struggled at times, but never lost sight of his faith. For all this, he is often credited with the revival of French Catholicism in the wake of WWI. After all, if Paul Claudel could take religion seriously and find meaning in it, pourquoi pas the rest of us?The facts of his extraordinary biography form a peculiar background to the recent translation by James Lawler of Claudel's collection of prose poems titled Knowing [End Page 229] the East. First published in 1946 as Connaissance de l'est, these sixty-one texts were written between 1895 and 1905 during Claudel's first visits to China and Japan as a young vice-consul stationed in Shanghai. He was twenty-six and still finding his poetic voice. And though his stance in the world is decidedly Christian, the content of this intriguing work reveals an inner dialogue with Buddhist ideas of interconnection, harmony, the ongoing quest for a higher life condition, and the overwhelming impact of nature in the lives of mere humans.In "Pagoda," Claudel describes a seven-story Chinese pagoda as it "amplifies and multiplies the roof, exaggerates the horned corners that rise with an elegant surge, and turns their curves upward to the sky." This form that "does away with walls" and concentrates on the uplifting roof creates a space where "Buddha, Prince of Peace, dwells inside with all the gods." In this architecture he reads a structuring of physical and spiritual space, a kind of never ending upward movement divided into "the seven mystical heavens." The culminating effect is the heavenly achievement of the unknowable. And so, after going as far as he can go into the world of the spirit, he ends this prose poem with an abrupt return to temporal reality. "I have no more to say of the Pagoda. I do not know its name."Elsewhere, in "The Wanderer," he turns his sense of awe toward nature. "Every tree has its personality, every small beast its role, every voice its part in the symphony," he writes. "As one understands music, so I understand nature, like a detailed narrative of proper names; as my walk and the day advance, so does the elaboration of the doctrine." The "doctrine," it seems, is the idea of dependent origination, the interrelation of all life that springs from a single source. In the last line, he states, "I understand the world's harmony. When will I grasp its melody?"In "The Temple of Consciousness" Claudel climbs "the black rock's vertical wall, and only at this late afternoon hour do I know myself to be on the right track." Below, he observes golden rice fields. Ahead there is an "old stairway overlaid with hoary moss... (shrink)