Nurses may, and often do, experience moral distress in their careers. This is related to the complicated work environment and the complex nature of ethical situations in everyday nursing practice. The outcomes of moral distress may include psychological and physical symptoms, reduced job satisfaction and even inadequate or inappropriate nursing care. Moral distress can also impact retention of nurses. Although research has grown considerably over the past few decades, there is still a great deal about this topic that we do (...) not know including how to deal well with moral distress. A critical key step is to develop a deeper understanding of relational practice as it pertains to moral distress. In this article, exploration of the experience of moral distress among nurses is guided by the key elements of relational ethics. This ethical approach was chosen because it recognizes that ethical practice is situated in relationships and it acknowledges the importance of the broader environment on influencing ethical action. The findings from this theoretical exploration will provide a theoretical foundation upon which to advance our knowledge about moral distress. (shrink)

Background Over the past few decades, moral distress has been examined in the nursing literature. It is thought to occur when an individual has made a moral decision but is unable to act on it, often attributable to constraints, internal or external. Varying definitions can be found throughout the healthcare literature. This lack of cohesion has led to complications for study of the phenomenon, along with its effects to nursing practice, education and targeted policy development. Objectives The aim of this (...) analysis was to uncover unique definitions of moral distress as found in the nursing literature and to examine the relationship between these definitions. Research Design and Context Morse’s method of concept clarification was applied given the large body of literature which includes definitions, descriptions and measurements of the concept in research. The steps include (a) conducting a literature review; (b) analysing the literature; and (c) identifying, describing, comparing, and contrasting attributes, antecedents and consequences of each category. Findings Each of the 18 included studies described constraints in their definition of moral distress, whether implied or explicitly stated. External constraints are widely described as obstacles outside of the individual, whether institutional, systemic or situational, while internal constraints are located within the individuals themselves and are described as personal limitations, failings or weakness of will. Conclusion Upon reviewing these definitions, we determined that the term ‘internal constraints’ is problematic due to the emphasis of responsibility on the individual experiencing moral distress. We propose an alteration to ‘internal characteristics’ that will assume less responsibility of change from the individual to place a heavier onus on systemic and institutional constraints. (shrink)

This article aims to bring some work in contemporary analytic metaphysics to discussions of the Real Presence of Christ in the Eucharist. I will show that some unusual claims of the Real Presence doctrine exactly parallel what would be happening in the world if objects were to time-travel in certain ways. Such time-travel would make ordinary objects multiply located, and in the relevantly analogous respects. If it is conceptually coherent that objects behave in this way, we have a model for (...) the behaviour of the Eucharist which shows the doctrine to be coherent, at least with respect to the issues discussed. (shrink)

In this paper I propose a new solution to the problem of change: situationalism. According to this view, parts of reality fundamentally disagree about what is the case and reality as a whole is unsettled (i.e. metaphysically indeterminate). When something changes, parts of the world irreconcilably disagree about what properties it has. From this irreconcilable disagreement, indeterminacy arises. I develop this picture using situations, which are parts of possible worlds; this gives it the name situationalism. It allows a B-theory endurance (...) view on which there is genuine incompatibility when things change. There are costs to the view, which are explored, but it is a novel approach which offers a distinct explanation of what happens when things exist through change. (shrink)

Extended simples are fruitfully discussed in metaphysics. They are entities which are located in a complex region of space but do not themselves have parts. In this paper, I will discuss unextended complexes: entities which are not located at a complex region of space but do themselves have parts. In particular, I focus on one type of unextended complex: pointy complexes. Four areas are indicated where pointy complexes might prove philosophically useful. Unextended complexes are therefore philosophically fruitful, in much the (...) same way as extended simples. (shrink)

This paper outlines a novel solution to the Ship of Theseus puzzle. The solution relies on situations, a philosophical tool used in natural language semantics among other places. The core idea is that what is true is always relative to the situation under consideration. I begin by outlining the problem before briefly introducing situations. I then present the solution: in smaller situations the candidate is identical to Theseus’s ship. But in larger situations containing both candidates these identities are neither true (...) nor false. Finally, I discuss some worries for the view that arise from the nature of identity, and suggest responses. It is concluded that the solution, and the theory that underpins it, are worth further investigation. (shrink)

There is a concern about the effectiveness of petitionary prayer. If I pray for something good, wouldn’t God give it to me anyway? And if I pray for something bad, won’t God refrain from giving it to me even though I’ve asked? This problem has received significant attention. The typical solutions suggest that the prayer itself can alter whether something is good or bad. I will argue that this is insufficient to fully address the problem, but also that the problem (...) requires another assumption which can be doubted, thereby opening up a new way to solve the problem. (shrink)

Leibniz has long faced a challenge about the coherence of the distinction between necessary and contingent truths in his philosophy. In this paper, I propose and examine a new way to save genuine contingency within a Leibnizian framework. I conclude that it succeeds in formally solving the problem, but at unbearable cost. I present Leibniz’s challenge by considering God’s choice of the best possible world (Sect. 2). God necessarily exists and necessarily chooses to actualise the best possible world. The actual (...) world therefore could not be different, for if it were different it would be a distinct and inferior world and hence would not be created. In Sect. 3 I defend Leibniz from this challenge. I argue that while it is necessary for God to choose to create the best possible world, it is not necessary for any world to be the best possible. This is because the criterion for judging perfection can itself be contingent. Different criteria will judge different worlds as the best. Thus it is necessary for God to create the best, but not necessary which is the best. Distinguishing between possible worlds in Leibniz’s sense and in the modern sense allows a fuller exposition of this position. There are worries that can arise with the claim that the criterion of perfection is contingent. I consider two of the most pressing (Sect. 4). The first argues that the criterion is in God’s understanding and hence is necessary; the second alleges that a contingent criterion of perfection violates Leibniz’s cherished Principle of Sufficient Reason. These worries are well-grounded, and examining them reveals a deep incompatibility between this solution and Leibniz’s metaphysical views. I conclude that there is a real solution available, but that it is unacceptable to Leibniz or a Leibnizian. The search for a genuine solution that is genuinely Leibnizian goes on. (shrink)

In this paper, I will offer an analogy between the Trinity and extended simples that supports a Latin approach to the Trinity. The theoretical tools developed to discuss and debate extended simples in the literature of contemporary analytic metaphysics, I argue, can help us make useful conceptual distinctions in attempts to understand what it could be for God to be Triune. Furthermore, the analogy between extended simples and the Trinity might surprise some who find one of these at least plausibly (...) possible and the other incoherent. (shrink)

If something changes from being in one state to being in another state, when exactly does it change? And what’s going on at that time? These questions are often discussed under the heading of the ‘moment’ or ‘instant’ of change. In this paper, I will investigate a view on which there is an intrinsically distinguished, atomic time at which something changes, and at that time it is metaphysically indeterminate what is the case. The background metaphysical picture is situationalism, a theory (...) on which reality is composed of irreducibly conflicting parts. These conflicting parts give rise to unsettledness in reality as a whole, and also at the point of change. I propose this view as a competitor for existing accounts of the time of change, and spell out a few reasons in its favour. (shrink)

Moral distress is a common phenomenon among nurses and is related to the complicated work environments and complex nature of ethical situations in day-to-day nursing practice. Moral distress impacts nurses as well as patient care and the health care system. Few strategies have been identified for instructors to effectively engage with learners when communicating about moral distress. We discuss two key curricular and pedagogical strategies that should be utilized when learning about moral distress: difficult knowledge’ and ‘terror management theory’. Whether (...) it is with new nursing students or experienced nurses, there is necessary learning that needs to occur on moral distress. Difficult knowledge’ and ‘terror management theory’, when implemented, can provide a starting point for both the learner and the instructor to discuss the emotionally difficult and complex topic of moral distress. Knowledge about moral distress has the potential to mitigate its negative effects, therefore it is vital to consider educational strategies to teach nurses about this complex phenomenon. (shrink)

The topic of the article is the way in which a human being can grasp its own body. The confrontation between Husserl's and Sartre's philosophy about meeting Another is my way of showing the radical change in our understanding of the problem of how we know our own body. According to Husserl both our psyche and body are given to us immediately. The body of Another is given to us by means of our own body. The psyche of Another is (...) made present through his body. This conception is inverted by Sartre. Both the psyche and the body are no longer able to grasp themselves. Yet this does not mean that Another is ungraspable. Knowledge of him does not require self-knowledge. The psyche of Another is given through his body, which is given immediately. Our own body needs the body of Another - it is contained in everything that is not itself. (shrink)

The first half of the 20th century witnessed the development of the classic eugenics. Some countries in Europe and the USA of different historical past, cultures and degree of development were universally attracted by the eugenic ideology. This raises few questions concerning the basis of its universal attractiveness for masses and its success. This article answers those questions indicating strong religious-like belief in the myth which served as a base for the eugenical way of thinking being older than this thought. (...) This myth narrates a story about the existence of “real people” who lived in the past, yet unfavourable circumstances caused their degradation, but who—with the assistance of physicians technocrats of the new society and through medical procedures—may be reborn. This paper aims at the reconstruction of the myth on the basis of the writings of Plato, Campanella and Nietzsche. As examples of its “realization” of the myth, I provide the activities of the institutions like Lebensborn houses in Germany and Nobel Sperm Bank in the USA. (shrink)

Although it has been claimed that the Kharijite understanding emerged as a result of a booty division in the Prophet's time, their emergence as a sect was in the Battle of Siffin. This formation, which gained fame with the motto "The Judgment belongs only to Allah" in the arbitration issue between Hazrat Ali and Muawiya, came to the fore enough to leave Muaviye's rebellion against Hazrat Ali behind. So much so that when the battle of Siffin is mentioned, researchers focus (...) on Muawiya and Kharijites and what they did rather than what he did. Although there are many reasons for this, the most important one is the evaluation of Kharijites and Kharijites within the framework of Sunni sources. We can say that the way to be objective about Kharijites and Kharijites is to refer to the sources of the Kharijites themselves or the sects associated with the Kharijites. Kharijites are not a formation that systematizes as a creed or fiqh sect. However, The Ibâzî sect is known as a Khariji sect, as the pioneers of the sect, which would later be known as Ibâzî, were among the group that left Ali and gathered in a place called Harûra. In the year 64 Hijri, the people of Harura were divided into sects among themselves. The reason for this separation is especially because Nafi' b. Ezrak sees violence as legitimate and rejects other Muslims who do not think like them, and considers their blood, property and chastity halal. After this separation, the Kharijites were referred to as Ezârikâ, Süfriyya, Necdiyye/Necedât and Ibâzis. The Ibazis specifically stated that they were away from these sects because of their radical attitudes. This situation was especially emphasized in the correspondence between Abdullah b. İbâz and the Umayyad caliph Abdulmalik b. Marwan. However, when dealing with the subject of Kharijite, the reason for this disintegration was ignored, and the Ibazis, who had a moderate understanding, were evaluated in the same category as other Kharijite sects that were pro-violence and takfir. Ibazis strongly opposed such a generalization and argued that they should be evaluated separately from other Kharijite sects. In our study, this attitude of the Ibâzîs and their justifications have been included, and it has been tried to be explained with reference to both their own sources and Sunni sources. Another important point is that the Ibazis do not want to be called Kharijites. They considered it more appropriate to be named as Shurat, Ehlu'l-Istaqama, Haruriye and Vehbiye. The Ibâzî sect, which has managed to survive to the present day, has original views on Kharijites and Kharijites, and they also expressed an opinion on whether they see themselves as Kharijites or not. In addition, their approaches to and definitions of Kharijite differ from those mentioned in Sunni sources. Because of these connections with the Kharijites and the fact that they have reached the present day, it is a necessity to refer to the Ibâzî sources on the subject of Khârijism in terms of objectivity. However, we can say that Ibâzîs were introduced by adhering to Sunni sources. Such an approach, on the other hand, would not only cause the Ibazis to be understood correctly, but also caused them to be identified with the other Kharijite sects, especially the Ezarika. In this study, we will try to deal with the approaches of the Ibazis to the subject of Kharijite and Kharijite and whether they see themselves as a Kharijite sect, based on their own sources. (shrink)

The current study explored the extent to which children above and below the age of 7 years are able to benefit from either training in cumulative rehearsal or in the use of interactive imagery when carrying out working memory tasks. Twenty-four 5- to 6-year-olds and 24 8- to 9-year olds were each assigned to one of three training groups who either received cumulative rehearsal, interactive imagery, or passive labelling training. Participants’ ability to maintain material during a filled delay was then (...) assessed, and the nature of the distraction that was imposed during this delay was varied to shed further light on the mechanisms that individuals used to maintain the memoranda in working memory in the face of this distraction. The results suggest that the rehearsal training employed here did improve recall by virtue of encouraging rehearsal strategies, in a way that was not observed among participants receiving interactive imagery training. The fact that these effects were not mediated by age group counts against the view that younger individuals are either unable to rehearse, or show impoverished verbal serial recall because they do not spontaneously engage in rehearsal. (shrink)

Ansiklopedik tarzda kaleme alınan eserler, yazıldıkları dönemindeki ilmi seviyeyi göstermek ve muhataplarının ihtiyaç duydukları pratik bilgileri bir araya getirmek bakımından büyük öneme sahiptir. Zira bu tür eserlerin, hem müellifin çeşitli ilim dallarına vukufiyetini ortaya koyma hem de eserden istifade edecek kesimlerin ihtiyaç duyduğu bilgi birikimini tespit etme noktasında kıymetli veri kaynakları oldukları aşikârdır. İslam dünyasında erken dönemde kaleme alınan bu türdeki eserlerden biri de müellifin tek eseri olarak günümüze gelmiş ve şöhreti ile müellifini geride bırakmış olan Muhammed b. Ahmed el-Hârizmî’nin (...) Mefâtîhu’l-‘ulûm aslı eseridir. Bu çalışmada Hârizmî’nin bir bürokrat olarak kendi meslektaşlarının ihtiyaç duyduğu bilgileri bir araya getirdiği eserinde felsefeye ve felsefî ilimlere yaklaşımı incelenecektir. Çalışmanın planı, müellifin eserinde felsefeye ayırdığı bölüme başlıkları üzerinden düzenlenmiştir. (shrink)

In pediatric critical care, nurses are the primary caregivers for critically ill children and are particularly vulnerable to moral distress. There is limited evidence on what approaches are effective to minimize moral distress among these nurses. To identify intervention attributes that critical care nurses with moral distress histories deem important to develop a moral distress intervention. We used a qualitative description approach. Participants were recruited using purposive sampling between October 2020 to May 2021 from pediatric critical care units in a (...) western Canadian province. We conducted individual semi-structured interviews via Zoom. A total of 10 registered nurses participated in the study. Four main themes were identified: (1) “I’m sorry, there’s nothing else”: increasing supports for patients and families; (2) “someone will commit suicide”: improving supports for nurses: (3) “Everyone needs to be heard”: improving patient care communication; and (4) “I didn’t see it coming”: providing education to mitigate moral distress. Most participants stated they wanted an intervention to improve communication among the healthcare team and noted changes to unit practices that could decrease moral distress. This is the first study that asks nurses what is needed to minimize their moral distress. Although there are multiple strategies in place to help nurses with difficult aspects of their work, additional strategies are needed to help nurses experiencing moral distress. Moving the research focus from identifying moral distress towards developing effective interventions is needed. Identifying what nurses need is critical to develop effective moral distress interventions. (shrink)

Many philosophers have found change puzzling. How can it be that something changes in its properties and yet remains the same thing? How can one and the same thing have these different properties? Questions of this sort, about the persistence of things through change, have been an ongoing feature of philosophical discussion since the beginning of the discipline. I think that there is something puzzling here, and that investigating change can be a fruitful way of trying to understand a nest (...) of connected issues concerning identity, time, tense, objects, properties, and instantiation. But not all agree. In some fairly recent papers, for instance, it has been argued that change is not problematic: there is nothing to be worried about. The phenomenon of change, it is suggested, is not one of particular philosophical interest, and we shouldn’t expect it to illuminate our wider discussion. As I have said, I think that change is problematic. I think it is initially mysterious how things can change. I believe working through the problem can tell us things about what the world is like, and thus that it is worthwhile doing so. In this paper I’ll defend the problem from the attempted dissolutions of it. In brief, my argument will be that what we are offered is not a real dissolution of the problem but rather an existing solution to the problem, namely adverbialism. This solution is not universally or even generally accepted. Pointing to a contested solution to a problem is doesn’t successfully dissolve that problem, so the problem of change is not successfully dissolved. (shrink)

This paper constructs a model of metaphysical indeterminacy that can accommodate a kind of ‘deep’ worldly indeterminacy that arguably arises in quantum mechanics via the Kochen-Specker theorem, and that is incompatible with prominent theories of metaphysical indeterminacy such as that in Barnes and Williams (2011). We construct a variant of Barnes and Williams's theory that avoids this problem. Our version builds on situation semantics and uses incomplete, local situations rather than possible worlds to build a model. We evaluate the resulting (...) theory and contrast it with similar alternatives, concluding that our model successfully captures deep indeterminacy. (shrink)

The advent in universities of managerialism with its drive for individual accountability through performance management systems is contentious. With the implementation of a PMS at a South African university, academic heads of department have been key players in the performance reward component of the PMS. This study, following a qualitative descriptive research design based on in-depth interviews, explores a sample of HoDs’ experiences and perceptions of the institution's performance reward system. Most of the participants are sceptical of the PMS as (...) they view it as a business-oriented practice that is not compatible with the nature and objectives of higher education institutions. They consider the reward strategy not only to have a limited effect in promoting high performance behaviour, but to be a cause of discontent due to implementation inconsistencies, nebulous award criteria, lack of transparency about ratings, and the negligible monetary value of the reward. (shrink)

Este artículo examina la manera en que el diseño específico de las casas de baños de la Antigüedad tardía en la provincia romana de la Cirenaica, base de operaciones para la conquista islámica de Ifrīqiya, influyó en el desarrollo de los hammams en el norte de África y en al-Andalus. Los restos arqueológicos de los baños bizantinos/tardoantiguos y los primeros hammams son puestos en comparación para demostrar las grandes similitudes de su trazado general y dentro de este, del diseño del (...) caldarium en particular, lo que apunta a la pervivencia de los esquemas de construcción que sobreviven hasta el día de hoy en los hammams marroquíes. La característica más distintiva era la estancia rectangular para el baño de calor, calentada por un solo horno, y flanqueada por dos exedras que albergaban sendas bañeras rectangulares. Este diseño de hammam «occidental» era marcadamente distinto de los hammams contemporáneos en Oriente, que a su vez continuaron con el diseño tradicional de los baños públicos romano-bizantinos orientales. Contrariamente a lo que se presuponía, este artículo demuestra que el diseño «occidental» no se originó en los primeros momentos del Marruecos medieval y de al-Andalus, extendiéndose posteriormente hacia el Mediterráneo oriental, sino que se originó en el norte del África romano-bizantino, extendiéndose hacia el Oeste, para regresar, a través de la circularidad cultural, al lugar de origen con nuevas adaptaciones. (shrink)

If our thinking is socially conditioned, then how, at the end of 1900, did Max Planck, whose thinking was shaped by classical mechanics, manage to think that energy is quantized? After all, the idea was incommensurable with the principles of Newton’s mechanics. My thesis is that Planck did not intend to think about it. Trying to reconcile the time reversibility of the laws of mechanics with the time irreversibility of the laws of classical thermodynamics, he was constantly thinking according to (...) rules inherited from others. Trying to find a theoretical explanation of the formula describing the distribution of the energy of black-body radiation — arrived at by fitting theoretical parameters to new experimental data — he in “an act of despair” applied Boltzmann’s statistical concept of entropy. Then he noticed — on a sheet of paper — that classical and statistical formulas are identical if and only if the energy of resonators was a multiple of hν. What cannot appear in the human mind — as the mind is socially conditioned — can appear on paper. This gives a clear example of how computations in a “world on paper” can create new concepts. (shrink)

This paper interrogates the fundamental logic of data-driven decision-making as it has taken hold in education and argues for a critical analysis of data-driven education via an attitude of historical ontology. Though influenced by Foucault’s understanding of this concept, I center Colin Koopman’s recent analysis of the ‘informational person’ to point attention to the ways in which the very formatting of data may be understood as historically contingent and, thus, more contestable. After examining the background of DDDM and relevant critiques (...) of it, I suggest that investigating the socio-historical formations of data itself are important for indicating its potential dangers within education. Such a critical analysis identifies the doubled politics of data formatting, with its ability to tether subjectivity to data, while potentially baking modes of power into a variety of technological data apparatuses. To conclude, I consider Koopman’s work in terms of how it may extend critical studies of educational datafication. (shrink)

I agree with many of Adam Grobler’s theses, but several others raised my objection. (1) A.G. does not want to call scientific claims true. It is not so: very much of what scientists say about the world is true (in the classic sense), and scientists know it is. (2) A.G. leads us astray when he writes that the acceptance or rejection of hypotheses is determined, at least sometimes, by expert votes. It is not so: further research is the decisive factor (...) in accepting or rejecting hypotheses in science. (3) While A.G. is aware of some social determinants of knowledge, he ultimately states: “individuals are the subjects of scientific knowledge.” Contrary to this, I argue that one can only be a scientist as a member of a scientific thought collective. (4) A.G. believes that scientific knowledge is based on presuppositions, accepted unconsciously, that give meaning to statements made openly. After Wittgenstein, I repeat: “After all, nothing is concealed.”. (shrink)

Artykuł dotyczy problemu percepcji. Przedstawiam w nim koncpecję"widzenia jako" Wittgensteina, oraz koncepcje myślenia jako odruchu Bohma. Wskazując podobieństwa i różnice w poglądach Wittgensteina i Bohma zmierzać będę do postawienia pytania o to, co sprawia, że nasze postrzeganie jest uwarunkowane. Po dokonaniu oceny tego faktu, w dalszej kolejności postawię pytanie o możliwość percepcji nieuwarunkowanej. Tym samym spróbuję odpowiedzieć na dwa pytania: czy istnieją powody, dla których powinniśmy wyzwalać się z tego rodzaju percepcji, a także czy i jak jest to w ogóle (...) możliwe? (shrink)

This article is an attempt to determine the status of transcendence within the works of Hannah Arendt. This topic belongs to a niche when it comes to the scope of interests of the thinker whose interests focused upon the philosophy of politics. However, since Arendt concentrated on the reflection on man and his culture, her ideas reach beyond socio-political issues. Drawing a picture of the world as a place created by people, and distinguishing it from the world of nature, she (...) draws indirect attention to what goes beyond it. In Arendt’s writings, the sphere of transcendence appears as what does not appear, yet it does exist and affects our existence in an even more noticeable way than the actions of politicians. For this reason, I attempt to determine not only the ontological status of transcendence, but also the status of a thinker who appears in Arendt’s writings as a mind. These tasks will require reconstructing the sphere of what does not appear, and the way it is connected with the sphere of phenomena. This will be done on the basis of an analysis of the activities that a person performs, and individual spheres in which her life takes place. (shrink)

Ludwik Fleck says that a thought-collective develops a thought-style which shapes the ways of perceiving the world and thinking of the world by its members. So how could it happen that at the end of 1900 Max Planck, whose thinking was determined by classical mechanics, managed to think that energy is quantized - the idea that contradicted the principles of Newton's mechanics? My answer is that Planck did not intend to think it.

Is there a logic of scientific discovery? Are there logical relations between the knowledge scientists posses as they start their investigations and new hypotheses and theories they formulate? Can such relations be retrospectively reconstructed? Most philosophers of science in 20 th century claimed that processes of inventing new hypotheses or theories are not governed by any rules of logic. They claimed that new hypotheses are products of “leaps of imagination” that cannot be logically analyzed.