Evaluating the feasibility and first perceived outcomes of a newly developed clinical ethics support instrument called CURA. This instrument is tailored to the needs of nurses that provide palliative care and is intended to foster both moral competences and moral resilience. This study is a descriptive cross-sectional evaluation study. Respondents consisted of nurses and nurse assistants (n = 97) following a continuing education program (course participants) and colleagues of these course participants (n = 124). Two questionnaires with five-point Likert scales (...) were used. The feasibility questionnaire was given to all respondents, the perceived outcomes questionnaire only to the course participants. Data collection took place over a period of six months. Respondents were predominantly positive on most items of the feasibility questionnaire. The steps of CURA are clearly described (84% of course participants agreed or strongly agreed, 94% of colleagues) and easy to apply (78–87%). The perceived outcomes showed that CURA helped respondents to reflect on moral challenges (71% (strongly) agreed), in perspective taking (67%), with being aware of moral challenges (63%) and in dealing with moral distress (54%). Respondents did experience organizational barriers: only half of the respondents (strongly) agreed that they could easily find time for using CURA. CURA is a feasible instrument for nurses and nurse assistants providing palliative care. However, reported difficulties in organizing and making time for reflections with CURA indicate organizational preconditions ought to be met in order to implement CURA in daily practice. Furthermore, these results indicate that CURA helps to build moral competences and fosters moral resilience. (shrink)

This book updates and adds to the classic Social Movements of the Sixties and Seventies, showing how social movement theory has grown and changed.

The purpose of the study was to develop an understanding of how nursing students gained perspective on nursing care of diverse populations through watching documentaries in a cultural diversity course. The basis of this paper is our analyses of students’ written responses and reactions to documentaries viewed in class. The guiding theoretical frameworks for the course content and the study included postcolonial feminism, Foucauldian thought, and cultural safety. Krathwohl's Taxonomy of the Affective Domain was used to identify themes and determine (...) how undergraduate nursing students were progressing in achieving learning outcomes. Our findings suggest that while the use of documentaries serves as a tool for deepening students’ understanding of the realities of various populations, this activity, in the absence of critical reflection, may inadvertently promote stereotypes and further marginalize different people groups. Even though nursing students reflected on the importance of cultural safety in nursing, our findings indicate that their actions may not reflect this, especially since these students are in the early stages of the nursing program. Students need to be provided with a space where they can explore implicit biases evoked by exposure to new information about different people groups as a way of enhancing culturally safe care. (shrink)

In this essay, Feigenbaum examines heterosexism as it functions politically and interpersonally in her own experience. She loosely traces her analysis along the current political climate of the bans on same-sex marriages, using this discussion to introduce and illustrate how heterosexual dominance functions. The author aims throughout to clarify what heterosexism looks like “in action,” and she moves toward providing steps to recognize, name, interrupt, and counter heterosexist privilege.

Individuals are faced with the many opportunities to pirate. The decision to pirate or not may be related to an individual''s attitudes toward other ethical issues. A person''s ethical and moral predispositions and the judgments that they use to make decisions may be consistent across various ethical dilemmas and may indicate their likelihood to pirate software. This paper investigates the relationship between religion and a theoretical ethical decision making process that an individual uses when evaluating ethical or unethical situations. An (...) ethical decision making model was studied for general unethical scenarios and for the unethical behavior of software piracy. The research model was tested via path analysis using structural equation modeling and was found to be appropriate for the sample data. The results suggest that there is a relationship between religion and the stages of an ethical decision making process regarding general ethical situations and software piracy. (shrink)

Scientists and decision makers rely on climate models for predictions concerning future climate change. Traditionally, physical processes that are key to predicting extreme events are either directly represented or indirectly represented. Scientists are now replacing physically based parameterizations with neural networks that do not represent physical processes directly or indirectly. I analyze the epistemic implications of this method and argue that it undermines the reliability of model predictions. I attribute the widespread failure in neural network generalizability to the lack of (...) process representation. The representation of climate processes adds significant and irreducible value to the reliability of climate model predictions. (shrink)

Moral distress forms a major threat to the well-being of healthcare professionals, and is argued to negatively impact patient care. It is associated with emotions such as anger, frustration, guilt, and anxiety. In order to effectively deal with moral distress, the concept of moral resilience is introduced as the positive capacity of an individual to sustain or restore their integrity in response to moral adversity. Interventions are needed that foster moral resilience among healthcare professionals. Ethics consultation has been proposed as (...) such an intervention. In this paper, we add to this proposition by discussing Moral Case Deliberation (MCD) as a specific form of clinical ethics support that promotes moral resilience. We argue that MCD in general may contribute to the moral resilience of healthcare professionals as it promotes moral agency. In addition, we focus on three specific MCD reflection methods: the Dilemma Method, the Aristotelian moral inquiry into emotions, and CURA, a method consisting of four main steps: Concentrate, Unrush, Reflect, and Act. In practice, all three methods are used by nurse ethicists or by nurses who received training to facilitate reflection sessions with these methods. We maintain that these methods also have specific elements that promote moral resilience. However, the Dilemma Method fosters dealing well with tragedy, the latter two promote moral resilience by including attention to emotions as part of the reflection process. We will end with discussing the importance of future empirical research on the impact of MCD on moral resilience, and of comparing MCD with other interventions that seek to mitigate moral distress and promote moral resilience. (shrink)

The current process towards formalization within evaluation research, in particular the use of pre-set standards and the focus on predefined outcomes, implies a shift of ownership from the people who are actually involved in real clinical ethics support services in a specific context to external stakeholders who increasingly gain a say in what ‘good CESS’ should look like. The question is whether this does justice to the insights and needs of those who are directly involved in actual CESS practices, be (...) it as receivers or providers. We maintain that those actually involved in concrete CESS practices should also be involved in its evaluation, not only as respondents, but also in setting the agenda of the evaluation process and in articulating the criteria by which CESS is evaluated. Therefore, we propose a participatory approach to CESS evaluation. It focuses on the concrete contexts in which CESS takes place, reflective and dialogical learning processes, and how to be democratic and inclusive. In particular, this approach to CESS evaluation is akin to realist evaluation, dialogical evaluation, and responsive evaluation. An example of a participatory approach to evaluating CESS is presented and some critical issues concerning this approach are discussed. (shrink)

In this essay Suzanne Rice examines Aristotle's ideas about virtue, character, and education as elements in an Aristotelian conception of good listening. Rice begins by surveying of several different contexts in which listening typically occurs, using this information to introduce the argument that what should count as “good listening” must be determined in relation to the situation in which listening actually occurs. On this view, Rice concludes, there are no “essential” listening virtues, but rather ways of listening that may (...) be regarded as virtuous in the context of particular concrete circumstances. (shrink)

This article discusses an approach to translational bioethics (TB) that is concerned with the adaptation—or ‘translation’—of concepts, theories and methods from bioethics to practical contexts, in order to support ‘non-bioethicists’, such as researchers and healthcare practitioners, in dealing with their ethical issues themselves. Specifically, it goes into the participatory development of clinical ethics support (CES) instruments that respond to the needs and wishes of healthcare practitioners and that are tailored to the specific care contexts in which they are to be (...) used. The theoretical underpinnings of this participatory approach to TB are found in hermeneutic ethics and pragmatism. As an example, the development of CURA, a low-threshold CES instrument for healthcare professionals in palliative care, is discussed. From this example, it becomes clear that TB is a two-way street. Practice may be improved by means of CES that is effectively tailored to specific end users and care contexts. The other way around, ethical theory may be enriched by means of the insights gained from engaging with practice in developing CES in a process of co-creation. TB is also a two-way street in the sense that it requires collaboration and commitment of both bioethicists and practitioners, who engage in a process of mutual learning. However, substantial challenges remain. For instance, is there a limit to the extent to which a method of moral reasoning can be adapted in order to meet the constraints of a given healthcare setting? Who is to decide, the bioethicist or the practitioners? (shrink)

On March 27, 1784, Goethe writes to Johann Gottfried Herder: -/- I have found–neither gold nor silver, but what makes me unspeakably happy–the os intermaxillare in the human! With Loder I compared human and animal skulls, came upon its trace, and look, there it is. Only, I beg of you not to mention it, since it must be handled confidentially. (WA 4.6:258). -/- The bone whose discovery so elated Goethe, then called the "intermaxillary bone" but now the "premaxilla," is a (...) pair of cranial bones that are located at the front of the upper jaw and bear the incisors in animals that have these teeth. Goethe expresses happiness in finding this bone specifically in humans, a discovery that opposed the prevailing anatomical opinion at the time. Goethe in the Roman Campagna (1787) – Johann Heinrich Wilhelm Tischbein -/- In his essay that was finished by the end of October 1784 and later given the title, "An Intermaxillary Bone of the Maxilla Is to Be Ascribed to the Human as well as to Animals." Goethe claims, citing the work of J. F. Blumenbach and Petrus Camper, that the bone has recently garnered attention as a "distinguishing mark" between humans and apes (LA 1.9:154). -/- Yet, upon reexamination of these anatomists' works, I argue that Goethe misrepresents their positions and overstates the significance of his discovery, at least in a certain sense: while Camper and Blumenbach do deny the intermaxillary bone to humans, they do not construe its absence as an important distinguishing mark between humans and animals. Not only did Goethe's discovery not have the significance he attributed to it, but also historians of science claim that he did not discover it all: the intermaxillary bone had already been described in the human by several anatomists before him. It would thus seem that Goethe misinterpreted the significance of what he had not found, and that his unspeakable happiness was unwarranted. -/- However, Goethe's discovery holds another, heretofore-unrecognized significance. I argue that it signals a change in his vision of nature to one that criticizes and departs from the anthropocentric ontology that grounded the natural sciences of his time. If this anthropocentricism is not overturned and the foundation of natural science not reconceived, Goethe maintains, then the study of nature will be indefinitely frustrated, always floundering, and never able to progress. In light of this threat, Goethe reconceives the foundation of natural science by developing anonathropocentric concept of nature that attempts to escape the pitfalls of the human-centered perspective. His concept of nature's harmony, which I argue reflects a nonathropocentric visions of nature, requires the revaluation of the terms in which historians have disputed his discovery of the intermaxillary bone; the originality of his discovery cannot be limited to establishing the bone's presence in humans but must be extended to the concept of nature's harmony complementary to it. -/- Goethe's discovery, I conclude, remains valuable and worthy of the excitement it initially incites in him. I show how it responds to a paradox of contemporary natural science in which the objective methods intended to eliminate anthropocentrism from the investigation of nature surreptitiously reintroduced it to that investigation. Furthermore, I argue that Goethe's nonanthropocentric vision of nature and his criticism of anthopocentricism are applicable to current questions in environmental ethics. By undermining the foundation of anthropocentric ethics, Goethe also challenges the present anthropocentric modus operandi that continues to condone the environmentally destructive anthropogenic activities responsible for species extinction, chemical pollution, and the loss of natural habitats and biodiversity, in addition to other signs of the Anthropocene. (shrink)

Although the most common understanding of suicide is intentional self-killing, this conception either rules out someone who lacks mental capacity being classed as a suicide or, if acting intentionally is meant to include this sort of case, then what it means to act intentionally is so weak that intention is not a necessary condition of suicide. This has implications in health care, and has a further bearing on issues such as assisted suicide and health insurance. In this paper, I argue (...) that intention is not a necessary condition of suicide at all. Rather, I develop a novel approach that deploys the structure of a homicide taxonomy to classify and characterise suicides to arrive at a conceptually robust understanding of suicide. According to my analysis of suicide, an agent is the proximate cause of his death. Suicide is ‘self-killing,’ rather than ‘intentional self-killing.’ Adopting this understanding of suicide performs several functions: We acquire an external standard to assess diverging analyses on specific cases by appealing to homologous homicides. Following such a taxonomy differentiates types of suicides. This approach has application in addressing negative connotations about suicide. As a robust view, adding intention is an unnecessary complication. It is more consistent with psychological and sociological assessments of suicide than ‘intentional self-killing.’ It has useful applications in informing public policy. This paper’s focus is on classifying types of suicides, rather than on the moral permissibility or on underlying causes of suicidal ideation and behaviour. (shrink)

Increasingly complex and autonomous systems require machine ethics to maximize the benefits and minimize the risks to society arising from the new technology. It is challenging to decide which type of ethical theory to employ and how to implement it effectively. This survey provides a threefold contribution. First, it introduces a trimorphic taxonomy to analyze machine ethics implementations with respect to their object (ethical theories), as well as their nontechnical and technical aspects. Second, an exhaustive selection and description of relevant (...) works is presented. Third, applying the new taxonomy to the selected works, dominant research patterns, and lessons for the field are identified, and future directions for research are suggested. (shrink)

Suzanne de Castell, Helen Freeman; Education as a Socio-Practical Field: the theory/practice question reformulated, Journal of Philosophy of Education, Volume 1.

Has exclusion of Darwin's views on evolution distorted 20c philosophy? Cunningham suggests a reappraisal.

Translator's Preface LA LOGIQUE DE HUSSERL, etude sur "Logique for- melle et logique transcendentale" the original of the present translation, was published ...

"In recent years, we have grown accustomed to philosophical language that is intensely self-conscious and rhetorically thick, often tragic in tone. It is enlivening to read Bergson, who exerts so little rhetorical pressure while exacting such a substantial effort of thought.... Bergson's texts teach the reader to let go of entrenched intellectual habits and to begin to think differently—to think in time.... Too much and too little have been said about Bergson. Too much, because of the various appropriations of his (...) thought. Too little, because the work itself has not been carefully studied in recent decades."—from Thinking in Time Henri Bergson, whose philosophical works emphasized motion, time, and change, won the Nobel Prize for Literature in 1927. His work remains influential, particularly in the realms of philosophy, cultural studies, and new media studies. In Thinking in Time, Suzanne Guerlac provides readers with the conceptual and contextual tools necessary for informed appreciation of Bergson's work. Guerlac's straightforward philosophical expositions of two Bergson texts, Time and Free Will and Matter and Memory, focus on the notions of duration and memory—concepts that are central to the philosopher's work. Thinking in Time makes plain that it is well worth learning how to read Bergson effectively: his era and our own share important concerns. Bergson's insistence on the opposition between the automatic and the voluntary and his engagement with the notions of "the living," affect, and embodiment are especially germane to discussions of electronic culture. (shrink)

In the VIBeS study, Pierson et al. (2024) observe that the views of U.S. bioethicists do not align with views of clinicians or with broader U.S. public opinion. They also note that the bioethics co...

This article presents an ethics support instrument for healthcare professionals called CURA. It is designed with a focus on and together with nurses and nurse assistants in palliative care. First, we shortly go into the background and the development study of the instrument. Next, we describe the four steps CURA prescribes for ethical reflection: (1) Concentrate, (2) Unrush, (3) Reflect, and (4) Act. In order to demonstrate how CURA can structure a moral reflection among caregivers, we discuss how a case (...) was discussed with CURA at a psychogeriatric ward of an elderly care home. Furthermore, we go into some considerations regarding the use of the instrument in clinical practice. Finally, we focus on the need for further research on the effectiveness and implementation of CURA. (shrink)

By the 1990s the dynamic array of creative direct action tactics used against militarised technologies that emerged from women’s anti-nuclear protest camps in the 1980s became largely eclipsed by cyberfeminism’s focus on digital and online technologies. Yet recently, as robots and algorithms are put forward as the vanguards of new drone execution regimes, some are wondering if now is the time for another Greenham Common. In this article I return to cyborg feminism and anti-nuclear activisms of the 1980s to explore (...) what drone feminism might look like today. I examine how anti-nuclear protesters infused affect and techné, creating innovative images of, and tactics for, material resistance. I argue that Greenham women’s cyborg feminisms arose from their material entanglements with the military base. In their efforts to reveal and undermine the national and imperial myths upon which warfare is based, protesters re-imagined technological possibilities based upon a global accountability for ‘earthly survival’. (shrink)

Just War theory specifies that recourse to war must be a last resort. This specification accords with a more general aim to limit the occurrence of war by articulating demanding conditions under which war can be morally legitimate. Although it has critics among contemporary Western philosophers, the condition of last resort is widely accepted as a basic element of Just War theory. It is not itself an issue of dispute between historical as opposed to contemporary Just War theorists, or between (...) traditional as opposed to revisionist Just War theorists. The defensibility of “last resort” as a necessary condition of legitimate recourse to war will depend on how the condition is best interpreted and on its moral rationale. (shrink)

Some jurisdictions that have decriminalized assisted dying exclude psychiatric patients on the grounds that their condition cannot be determined to be irremediable, that they are vulnerable and in need of protection, or that they cannot be determined to be competent. We review each of these claims and find that none have been sufficiently well-supported to justify the differential treatment psychiatric patients experience with respect to assisted dying. We find bans on psychiatric patients’ access to this service amount to arbitrary discrimination. (...) Proponents of banning the practice ignore or overlook alternatives to their proposal, like an assisted dying regime with additional safeguards. Some authors have further criticized assisted dying for psychiatric patients by highlighting allegedly problematic practices in those countries which allow it. We address recent evidence from the Netherlands, showing that these problems are either misrepresented or have straightforward solutions. Even if one finds such evidence troubling despite our analysis, other jurisdictions need not adopt every feature of the Dutch system. (shrink)

This paper disputes Uwe Steinhoff’s view that a _jus ad bellum_ requirement of necessity can be merged with a condition of proportionality. It argues that the proposed merger detracts from a conceptual and moral understanding of the structure and rationale of both the necessity and the proportionality considerations applicable in a range of moral contexts, including those of war and so-called lesser evils cases, where these conditions are intended as action-guiding.

Kant formulated a secular argument against suicide’s permissibility based on what he regarded as the intrinsic value of humanity. In this paper, I first show that Kant’s moral framework entails that some types of suicide are morally permissible. Just as some homicides are morally permissible, according to Kant, so are suicides that are performed according to equivalent maxims. Intention, foreseeability, voluntariness, diminished responsibility, and mental capacity determine the moral characterization of the killing. I argue that a suicide taxonomy that differentiates (...) types of suicide according to morally relevant criteria is compatible with Kantian ethics; it establishes that even where we hold a robust deontological sanctity of life position, we are not obligated to preserve the lives of people whose future life only offers profound suffering, and helping them to die may be justifiable if doing so honors their dignity and autonomy. Nevertheless, homicide and suicide are only weakly morally symmetrical in that even if a given suicide is morally impermissible, we do not normally have the right to prevent it forcibly, though this may be altered by juridical laws under some circumstances. (shrink)

In this book, Suzanne Kirschner traces the origins of contemporary psychoanalysis back to the foundations of Judaeo-Christian culture, and challenges the prevailing view that modern theories of the self mark a radical break with religious and cultural tradition. Instead, she argues, they offer an account of human development which has its beginnings in biblical theology and neoplatonic mysticism. Drawing on a wide range of religious, literary, philosophical and anthropological sources, Dr Kirschner demonstrates that current Anglo-American psychoanalytic theories are but (...) the latest version of a narrative that has been progressively secularized over the course of nearly two millennia. She displays a deep understanding of psychoanalytic theories, while at the same time raising provocative questions about their status as knowledge and as science. (shrink)