Moral distress has been covered extensively in the nursing literature and increasingly in the literature of other health professions. Cases that cause nurses’ moral distress that are mentioned most frequently are those concerned with prolonging the dying process. Given the standard of aggressive treatment that is typical in intensive care units (ICUs), much of the existing moral distress research focuses on the experiences of critical care nurses. However, moral distress does not automatically occur in all end-of-life circumstances, nor does every (...) critical care nurse suffer its damaging effects. What are the practices of these nurses? What specifically do they do to navigate around or through the distressing situations? The nursing literature is lacking an answer to these questions. This article reports a study that used narrative analysis to explore the reported practices of experienced critical care nurses who are skilled at and comfortable working with families and physicians regarding the withdrawal of aggressive treatment. A major finding was that these nurses did not report experiencing the dam-Moral Agency, Moral Imagination, and Moral Community: Antidotes to Moral Distress Terri Traudt, Joan Liaschenko, and Cynthia Peden-McAlpine Terri Traudt, MBC, MA, is a Communications Consultant specializing in bioethics at the Center for Bioethics at the University of Minnesota, in Minneapolis. [email protected] Joan Liaschenko, PhD, RN, FAAN, is a Professor at the Center for Bioethics and Nursing at the University of Minnesota. Cynthia Peden-McAlpine, PhD, ACNS, BC, is an Associate Professor in the School of Nursing at the University of Minnesota. © 2016 by The Journal of Clinical Ethics. All rights reserved. aging effects of moral distress as described in the nursing literature. The verbal communication and stated practices relevant to this finding are organized under three major themes: (1) moral agency, (2) moral imagination, and (3) moral community. Further, a total of eight subthemes are identified. The practices that constitute these themes and subthemes are further detailed and discussed in this article. Understanding these practices can help mitigate critical care nurses’ moral distress. (shrink)

Terri Traudt, Joan Liaschenko, and Cynthia Peden-McAlpine’s study contributes to a much-needed reorientation in thinking about and working with the challenges of moral distress. In providing a vital example of nurses able to navigate morally distressing situations in positive and constructive ways, and offering an analysis of the component elements of these nurses’ success, the study helps identify promising directions we might take in addressing the epidemic of moral distress. It also invites important questions, concerning the challenges faced (...) by clinicians who do not who work in healthy “moral communities,” who lack the ethical competencies, and who don’t have the presumptive authority and recognition enjoyed by the seasoned clinicians studied here. We explore some of these questions, and suggest ways we might build on the insights of Traudt and colleagues’ study. (shrink)

Ethics and the Community of Inquiry gets to the heart of democratic education and how best to achieve it. The book radically reshapes our understanding of education by offering a framework from which to integrate curriculum, teaching and learning and to place deliberative democracy at the centre of education reform. It makes a significant contribution to current debates on educational theory and practice, in particular to pedagogical and professional practice, and ethics education.

Traditionally, the term ‘diaspora’ (from the Greek translation of the Hebrew Bible) referred to the dispersion of the Jewish people from ancient Israel. It had a pejorative connotation, associated...

While a number of studies have examined the impact of gender/sex on ethical decision-making, the findings of this body of research do not provide consistent answers. Furthermore, very few of these studies have incorporated cross-cultural samples. Consequently, this study of 222 American and Spanish business executives explored sex differences in ethical judgments and intentions to act ethically. While no significant differences between males and females were found with respect to ethical judgments, females exhibited higher intentions to act more ethically than (...) males. This difference was true of both U.S. and Spanish executives. Further research is warranted to develop a clearer understanding of the linkage between ethical judgment and intention to act in an ethical manner. These findings have implications for global firms, particularly regarding codes of conduct and ethics training. (shrink)

More ethics research needs to explore the global differences in ethical evaluations. This study explored the relationships among nationality, teleological evaluations, ethical judgments, and ethical intentions using a sample of 222 American and Spanish business professionals. The path analysis indicated that teleological evaluations were related to ethical judgments and that both ethical judgments and teleological evaluations were related to ethical intentions. Executive nationality was related to teleological evaluations and ethical intentions with American individuals having higher teleological assessments and intentions to (...) act ethically than the Spanish individuals. These findings have implications for global companies, which are presented along with the study's limitations and future research suggestions. (shrink)

From climate change, debt, and refugee crises, to energy security, environmental disasters, and terrorism, the events that lead nightly newscasts and drive public policy demand a global perspective. In the twentieth century the world sought solutions through formal institutions of international governance such as like the United Nations, the International Criminal Court, and the World Bank, but present-day our responses to global realities are often more provisional, improvisational, and contingent. Tracing this uneven history in order to identify principal actors, contesting (...) ideologies, and competing rhetoric, Negative Cosmopolitanism challenges the Kantian ideal of cosmopolitanism as the precondition for a perpetual global peace. Uniting researchers working on contemporary problems with those studying related issues of the past--including slavery, industrial capitalism, and corporate imperialism--essays in this volume scrutinize the entanglement of cosmopolitanism within expanding networks of trade and global capital from the eighteenth-century to the present. By doing so, the contributors pinpoint the ways in which whole populations have been unwillingly caught up in a capitalist reality that has little in common with the earlier ideals of cosmopolitanism. A model for provoking new and necessary questions about neoliberalism, biopolitics, colonialism, citizenship, and xenophobia, Negative Cosmopolitanism establishes a fresh take on the representation of globalization and modern life in history and literature. (shrink)

O’BRIEN T and ACKROYD S. Nursing Inquiry 2012; 19: 39–50 Understanding the recruitment and retention of overseas nurses: realist case study research in National Health Service Hospitals in the UKThis paper illustrates one of the possible applications of critical realist ideas to the analysis of health services, in the use of comparative case study research design, to elucidate the causal social processes underlying events. In the research reported here, a comparative research design was used as a basis for improving our (...) understanding of the processes involved in the assimilation of overseas nurses (OSN) into the salient long‐term workforce of the National Health Service (NHS) hospitals in the UK. The work brought to light the salient experiences of overseas nurses during their initial work in the NHS hospitals, and these were used as a basis for developing an account of the general mechanisms typically underlying the recruitment and assimilation at work. The authors conclude that successful assimilation is often hindered by the presence of occupational closure mechanisms, by which home nurses effectively excluded recruits from participation and promotion; these mechanisms, which articulate with everyday racism, threaten successful assimilation for obvious reasons. If the treatment recruits receive does not lead to withdrawal, it is because they typically have very strong economic motives to continue despite unfavourable and sometimes inhumane treatment. Thus, the research offered substantial reasons why recruitment policies should be reviewed by policy‐makers. (shrink)

The COVID-19 pandemic has strained healthcare resources the world over, requiring healthcare providers to make resource allocation decisions under extraordinary pressures. A year later, our understanding of COVID-19 has advanced, but our process for making ethical decisions surrounding resource allocation has not. During the first wave of the pandemic, our institution uniformly ramped-down clinical activity to accommodate the anticipated demands of COVID-19, resulting in resource waste and inefficiency. In preparation for the second wave, we sought to make such ramp down (...) decisions more prudently and ethically. We report the development of a tool that can be used to make fair and ethical decisions in times of resource scarcity. We formed an interprofessional team to develop and use this tool to ensure that a diverse range of stakeholder perspectives were represented in this development process. This team, called the clinical activity recovery team, established institutional objectives that were combined with well-established procedural values, substantive ethical principles and decision-making criteria by using a variation on the well-known accountability for reasonableness ethical framework. The result of this is a stepwise, semiquantitative, ethical decision tool that can be applied to resource allocation challenges in order to reach fair and ethically defensible decisions. This ethical decision tool can be applied in various contexts and may prove useful at both the institutional and the departmental level; indeed this is how it is applied at our centre. As the second wave of COVID-19 strains healthcare resources, this tool can help clinical leaders to make fair decisions. There are no data in this work. (shrink)

With the passage by virtually every state legislature of healthcare proxy laws, the medical profession increasingly can expect to rely on the participation of surrogates in making decisions on behalf of incompetent patients. Several concerns about the legitimacy of proxy decision making have been discussed in the ethical and general medical literature: the lack of concordance between the views of patients and their surrogates have been documented on multiple occasions, and cases of abuse by proxies or potential conflict of interest (...) have been reported. Another dilemma that deserves discussion arises when proxies demand withdrawal of treatment that physicians and nurses regard as essential to the wellbeing of the patient. The following case highlights this dilemma. (shrink)

This paper reports the framework, method and main findings of an analysis of cultural milieus in 4 European countries. The analysis is based on a questionnaire applied to a sample built through a two-step procedure of post-hoc random selection from a broader dataset based on an online survey. Responses to the questionnaire were subjected to multidimensional analysis-a combination of Multiple Correspondence Analysis and Cluster Analysis. We identified 5 symbolic universes, that correspond to basic, embodied, affect-laden, generalized worldviews. People in this (...) study see the world as either a) an ordered universe;b) a matter of interpersonal bond;c) a caring society;d) consisting of a niche of belongingness;e) a hostile place. These symbolic universes were also interpreted as semiotic capital: they reflect the capacity of a place to foster social and civic development. Moreover, the distribution of the symbolic universes, and therefore social and civic engagement, is demonstrated to be variable across the 4 countries in the analysis. Finally, we develop a retrospective reconstruction of the distribution of symbolic universes as well as the interplay between their current state and past, present and future socio-institutional scenarios. (shrink)

Global ethics has recently emerged as a popular concept among researchers in the field of international management and is of immediate concern among managers of multinational enterprizes (MNEs). This paper presents an integrative framework covering a range of factors and issues relevant to multinationals with respect to ethical decision making. The paper provides an overview of the existing literature on the topic, and framework is aimed at providing the managers of multinationals with a basis for relating and synthesizing the perspectives (...) and prescriptions that are available for incorporating ethics into the strategic decision-making process. (shrink)

Sarbanes–Oxley Section 406 requires a code of ethics for top financial and accounting officers in public companies. The objective of this research is to discover the impact of a financial code of ethics on firm behavior. We performed a longitudinal tracking of firm adoption of a financial code of ethics starting in 2005. We checked these companies’ codes again in 2011 to confirm their continued implementation. Financial restatements were used as a dependent variable to measure improved financial reporting after the (...) adoption of the financial codes. The results confirm that the adoption of a financial code of ethics improves the integrity of financial reporting. (shrink)

The overturn of Roe v. Wade has resulted in fewer rights and resources for people seeking abortion care, particularly in the South. The Hyde Amendment has historically restricted abortion access for those enrolled in Medicaid. We argue here that its guarantees of minimum abortion coverage should be leveraged to offset harms where possible.

Other formats of this book available via https://openeducationalberta.ca/educationaltechnologyethics/.

The rubber hand paradigm is used to create the illusion of self-touch, by having the participant administer stimulation to a prosthetic hand while the Examiner, with an identical stimulus , administers stimulation to the participant’s hand. With synchronous stimulation, participants experience the compelling illusion that they are touching their own hand. In the current study, the robustness of this illusion was assessed using incongruent stimuli. The participant used the index finger of the right hand to administer stimulation to a prosthetic (...) hand while the Examiner used a paintbrush to administer stimulation to the participant’s left hand. The results indicate that this violation of tactile expectations does not diminish the illusion of self-touch. Participants experienced the illusion despite the use of incongruent stimuli, both when vision was precluded and when visual feedback provided clear evidence of the tactile mismatch. (shrink)

ABSTRACT Most of the ethical decision making literature that guides mental health practice comes from the Western hemisphere. The well-meaning application of Western values in supervision can result in the intrusion of ethical standards that may not match the context and lacks sensitivity. In this qualitative study, researchers explored the supervisory experiences of 25 mental health professionals of 14 different nationalities, navigating complex ethical challenges in supervision practice in 17 countries. Using thematic analysis, several well-supported themes emerged. Recommendations for practice (...) include the importance of supervisors taking primary responsibility for initiating cultural discussions and fostering a collaborative approach to navigating complex cultural dilemmas. (shrink)

This symposium provides five case studies of the ways that John Dewey's philosophy and practice were influenced by women or "weirdoes" (our choices include F. M. Alexander, Albert Barnes, Helen Bradford Thompson, Elsie Ripley Clapp, and Jane Addams) and presents some conclusions about the value of dialoging across difference for philosophers and other scholars.

Individuals are downloading copyrighted materials at escalating rates (Hill 2007; Siwek 2007). Since most materials shared within these networks are copyrighted works, providing, exchanging, or downloading files is considered to be piracy and a violation of intellectual property rights (Shang et al. 2008). Previous research indicates that personal moral philosophies rooted in moral absolutism together with social context may impact decision making in ethical dilemmas; however, it is yet unclear which motivations and norms contextually impact moral awareness in a peer-to-peer (...) (P2P) file sharing context (Shang et al. 2008). In sum, factors affecting the decision to share copyrighted material require further clarification and investigation (Shang et al. 2008). The purpose of this study was to use a consumer-based scenario and multiple ethics measures to explore how idealism, formalism, and perceived social consensus impact users’ propensity to recognize that the sharing of copyrighted media through P2P networks was an ethical issue and their subsequent ethical intentions. Results showed that high levels of idealism and formalism were associated with an increased recognition that file sharing was an ethical issue, but neither construct had a direct effect on ethical intention. Strong social consensus among respondents that other people consider file sharing to be unethical was also positively related to the recognition that file sharing was an ethical issue, and ethical recognition was a moderate predictor of intention not to engage in file sharing. Finally, a post hoc mediation analysis indicated that idealism, formalism, and social consensus operated through recognition of an ethical issue to impact ethical intention (indirect-only mediation). (shrink)

The rubber hand paradigm is used to create the illusion of self-touch, by having the participant administer stimulation to a prosthetic hand while the Examiner, with an identical stimulus, administers stimulation to the participant’s hand. With synchronous stimulation, participants experience the compelling illusion that they are touching their own hand. In the current study, the robustness of this illusion was assessed using incongruent stimuli. The participant used the index finger of the right hand to administer stimulation to a prosthetic hand (...) while the Examiner used a paintbrush to administer stimulation to the participant’s left hand. The results indicate that this violation of tactile expectations does not diminish the illusion of self-touch. Participants experienced the illusion despite the use of incongruent stimuli, both when vision was precluded and when visual feedback provided clear evidence of the tactile mismatch. (shrink)

Presents a plethora of approaches to developing human potential in areas not conventionally addressed. Organized in two parts, this international collection of essays provides viable educational alternatives to those currently holding sway in an era of high-stakes accountability.

My topic is a long-standing tension in the interpretation of religion. On the one hand, it seems undeniable — seems almost to go without saying — that liturgical and sacrificial practices, sacred dance, divination, procession and pilgrimage are intentional actions undertaken by persons. Yet there is a distinguished tradition in the study of religion according to which religious activity is typically caused by forces over which the agent has little or no control. Visible, latter-day members of this tradition include Hume, (...) Nietzsche, Marx, Durkheim, Freud, and, in some moods, Wittgenstein, but its roster is by no means limited to the religiously unmusical. (shrink)

It is a mixed pleasure to see F. Matthias Alexander acknowledged in the fall 2007 issue of Education and Culture ("Dewey, women, and weirdoes: Or, the potential rewards for scholars who dialog across difference," 23[2], 27-62). As a professional descendant of Alexander who has been teaching the Alexander Technique (AT) for 30 years, I am glad to see Cunningham et al. including him in the list of positive influences in John Dewey's life. However, I believe Cunningham's contribution to this article, (...) "Shared explorations of body-mind: The reciprocal influences of Dewey and F. M. Alexander," falls short in its acknowledgement of Alexander and in one important aspect is incorrect. In this response, I hope to set the .. (shrink)

In the second half of the eighteenth century, German philosophy came for a while to dominate European philosophy. It changed the way in which not only Europeans, but people all over the world, conceived of themselves and thought about nature, religion, human history, politics, and the structure of the human mind. In this rich and wide-ranging book, Terry Pinkard interweaves the story of 'Germany' - changing during this period from a loose collection of principalities into a newly-emerged nation with a (...) distinctive culture - with an examination of the currents and complexities of its developing philosophical thought. He examines the dominant influence of Kant, with his revolutionary emphasis on 'self-determination', and traces this influence through the development of romanticism and idealism to the critiques of post-Kantian thinkers such as Schopenhauer and Kierkegaard. His book will interest a range of readers in the history of philosophy, cultural history and the history of ideas. (shrink)

Although Hegel's philosophy of history is recognized as a great intellectual achievement, it is also widely regarded as a complete failure. Taking his cue from the third century Greek historian Polybius, who argued that the rapid domination of the Mediterranean world by Rome had instituted a new phase of world history, Hegel wondered what the rise of European modernity meant for the rest of the world. In his account of the contingent paths of world history, he argued that at work (...) behind it is an eternal human struggle over justice, and that it had led to a new conception of justice in which nobody by nature had authority to rule over anybody else. Moving away from the ancient conception of justice as ordered through a cosmic system, the modern conception is based instead on freedom. This is, so Hegel argues, not an accident of history but part of the necessary development of the institutions and practices through which humans establish and maintain their changing shapes of agency. Behind it is an infinite end, justice, which as infinite is neither something which can ever be finally achieved nor a goal to which we are getting closer but which requires an infinite effort at sustaining.--. (shrink)

The Phenomenology of Spirit is both one of Hegel's most widely read books and one of his most obscure. The book is the most detailed commentary on Hegel's work available. It develops an independent philosophical account of the general theory of knowledge, culture, and history presented in the Phenomenology. In a clear and straightforward style, Terry Pinkard reconstructs Hegel's theoretical philosophy and shows its connection to ethical and political theory. He sets the work in a historical context and shows the (...) contemporary relevance of Hegel's thought for European and Anglo-American philosophers. The principal audience for the book is teachers and students of philosophy, but the great interest in Hegel's work and the clarity of Pinkard's exposition ensure that historians of ideas, political scientists, and literary theorists will also read it. (shrink)

Children improve at word learning during the 2nd year of life—sometimes dramatically. This fact has suggested a change in mechanism, from associative learning to a more referential form of learning. This article presents an associative exemplar‐based model that accounts for the improvement without a change in mechanism. It provides a unified account of children's growing abilities to (a) learn a new word given only 1 or a few training trials (“fast mapping”); (b) acquire words that differ only slightly in phonological (...) form; (c) generalize word meanings preferentially along particular dimensions, such as object shape (the “shape bias”); and (d) learn 2nd labels for already‐named objects, despite a persisting resistance to doing so (“mutual exclusivity”). The model explains these improvements in terms of increased attention to relevant aspects of form and meaning, which reduces memory interference. The interaction of associations and reference in word learning is discussed. (shrink)

Terry Pinkard draws on Hegel's central works as well as his lectures on aesthetics, the history of philosophy, and the philosophy of history in this deeply informed and original exploration of Hegel's naturalism.

In this book Macdonald elaborates a democratic framework based on the new theoretical concepts of 'public power', 'stakeholder communities' and 'non-electoral representation', and illustrates the practical implications of these proposals for projects of global institutional reform.