Background:Moral distress is recognized as a problem affecting healthcare professionals globally. Unaddressed moral distress may lead to withdrawal from the moral dimensions of patient care, burnout, or leaving the profession. Despite the importance, studies related to moral distress are scant in Thailand.Objective:This study aims to describe the experience of moral distress and related factors among Thai nurses.Design:A convergent parallel mixed-methods design was used. The quantitative and qualitative data were collected in parallel using the Measure of Moral Distress for Healthcare Professionals (...) and interview guide. The analysis was conducted separately and then integrated.Participants:Participants were Thai nurses from two large tertiary care institutions in a Southern province of Thailand.Ethical considerations:This study was approved by our organization's Institutional Review Board for Health Sciences Research, and by the Institutional Review Boards of the two local institutions in Thailand. Permission from the publisher was received to translate and utilize the Measure of Moral Distress (MMD-HP) under the license number: 4676990097151.Results:A total of 462 participants completed the survey questions. The top 7 causes of moral distress were related to system-level root causes and end-of-life care situations. Hierarchical multiple regression showed that work units, considering leaving position, and number of moral distress episodes in the past year were significant predictors of moral distress. Twenty interviews demonstrated three main themes of distressing causes: (1) powerlessness (at patients/family-, team-, and organizational-levels), (2) end-of-life issues, and (3) poor team function (poor communication and collaboration, incompetent healthcare providers, and inappropriate behavior of colleagues). The integration of data from both components indicated that the qualitative interviews enrich the quantitative findings, especially as related to the top 7 causes of moral distress.Discussion:Although the experience of moral distress among Thai nurses is similar to studies conducted elsewhere, the patient’s and family’s religious perspective that ties into the concept of moral distress needs to be explored.Conclusions:Although the root causes of moral distress are similar among different cultures, the experience of Thai nurses may vary according to culture and context. (shrink)

“Modern slavery,” a term used to describe severe forms of labor exploitation, is beginning to spark growing interest within business and society research. As a novel phenomenon, it offers potential for innovative theoretical and empirical pathways to a range of business and management research questions. And yet, development into what we might call a “field” of modern slavery research in business and management remains significantly, and disappointingly, underdeveloped. To explore this, we elaborate on the developments to date, the potential drawbacks, (...) and the possible future deviations that might evolve within six subdisciplinary areas of business and management. We also examine the value that nonmanagement disciplines can bring to research on modern slavery and business, examining the connections, critiques, and catalysts evident in research from political science, law, and history. These, we suggest, offer significant potential for building toward a more substantial subfield of research. (shrink)

In this book, the author examines the ethical implications of Artificial Intelligence systems as they integrate and replace traditional social structures in new sociocognitive-technological environments. She discusses issues related to the integrity of researchers, technologists, and manufacturers as they design, construct, use, and manage artificially intelligent systems; formalisms for reasoning about moral decisions as part of the behavior of artificial autonomous systems such as agents and robots; and design methodologies for social agents based on societal, moral, and legal values. Throughout (...) the book the author discusses related work, conscious of both classical, philosophical treatments of ethical issues and the implications in modern, algorithmic systems, and she combines regular references and footnotes with suggestions for further reading. This short overview is suitable for undergraduate students, in both technical and non-technical courses, and for interested and concerned researchers, practitioners, and citizens. (shrink)

Human interaction and communication involve space in multiple ways. This paper examines the spatial and interactional order of a covertly video-taped police interrogation. When the participants enter the interrogation room and become engaged in the interrogation process, the room itself is a constraint and a resource for interaction. While interacting within a built environment, the participants appropriate their material surroundings in ways that constitute a spatial order and make possible certain arguments. This paper examines how the physical structure of the (...) interrogation room is differentially appropriated, used, and filled in by the participants''; territorial and postural manoeuvers over the course of their interaction; and how the spatial structures thus created by the bodily appropriation of the physical locale are subsequently formulated by talk and thereby used as a metaphorical resource to frame the participants'' situated experience. Through this embedded process, the interrogators move the suspect toward confession. (shrink)

I explore some new directions—suggested by feminism—for medical ethics and for philosophical ethics generally. Moral philosophers need to confront two issues. The first is deciding which moral issues merit attention. Questions which incorporate the perspectives of women need to be posed—e. g., about the unequal treatment of women in health care, about the roles of physician and nurse, and about relationship issues other than power struggles. “Crisis issues” currently dominate medical ethics, to the neglect of what I call “housekeeping issues.” (...) The second issue is how philosophical moral debates are conducted, especially how ulterior motives influence our beliefs and arguments. Both what we select—and neglect—to study as well as the “games” we play may be sending a message as loud as the words we do speak on ethics. (shrink)

Virginia Held assesses the ethics of care as a promising alternative to the familiar moral theories that serve so inadequately to guide our lives. The ethics of care is only a few decades old, yet it is by now a distinct moral theory or normative approach to the problems we face. It is relevant to global and political matters as well as to the personal relations that can most clearly exemplify care. This book clarifies just what the ethics of (...) care is: what its characteristics are, what it holds, and what it enables us to do. It discusses the feminist roots of this moral approach and why the ethics of care can be a morality with universal appeal. Held examines what we mean by "care," and what a caring person is like. Where other moral theories demand impartiality above all, the ethics of care understands the moral import of our ties to our families and groups. It evaluates such ties, focusing on caring relations rather than simply on the virtues of individuals. The book proposes how such values as justice, equality, and individual rights can "fit together" with such values as care, trust, mutual consideration, and solidarity. In the second part of the book, Held examines the potential of the ethics of care for dealing with social issues. She shows how the ethics of care is more promising than Kantian moral theory and utilitarianism for advice on how expansive, or not, markets should be, and on when other values than market ones should prevail. She connects the ethics of care with the rising interest in civil society, and considers the limits appropriate for the language of rights. Finally, she shows the promise of the ethics of care for dealing with global problems and seeing anew the outlines of international civility. (shrink)

I explore some new directions-suggested by feminism-for medical ethics and for philosophical ethics generally. Moral philosophers need to confront two issues. The first is deciding which moral issues merit attention. Questions which incorporate the perspectives of women need to be posed-e.g., about the unequal treatment of women in health care, about the roles of physician and nurse, and about relationship issues other than power struggles. "Crisis issues" currently dominate medical ethics, to the neglect of what I call "housekeeping issues." The (...) second issue is how philosophical moral debates are conducted, especially how ulterior motives influence our beliefs and arguments. Both what we select-and neglect-to study as well as the "games" we play may be sending a message as loud as the words we do speak on ethics. (shrink)

The 2011 Historical Materialism Conference in London saw the launch of a Marxist-Feminist set of panels. This issue is inspired by the success of those panels, and the remarkably sustained interest in reviving and moving beyond older debates and discussions. The special issue’s focus, Social-Reproduction Feminism, reflects and contextualises the ongoing work and engagement with that thematic that has threaded through the conferences in the 2010s. This Introduction provides a summary overview of the Social-Reproduction Feminism framework, situating it within Marxist-Feminist (...) thinking and politics more generally, and calls on readers to consider its promise and potential as an historical-materialist approach to understanding capitalist social relations in terms of an integrated totality. (shrink)

This paper is the product of a roundtable discussion held at the international conference Horizons of Engagement: Eternalizing Bourdieu, organized by the Institute for Philosophy and Social Theory of Belgrade, Serbia, the Centre for Advanced Studies of The University of Rijeka, Croatia, the?cole Normale Sup?rieure of Paris, France, and the French Institute in Serbia. The event was planned on the occasion of the ninetieth anniversary of the birth of one of the world?s leading sociologists - Pierre Bourdieu. The greatest indicator (...) of the scope of Bourdieu?s influence is the fact that he has become the world?s most cited sociologist, ahead of?mile Durkheim, and the world?s second most cited author in social sciences and the humanities, after Michel Foucault and ahead of Jacques Derrida. As part of this discussion, we address the subject of?Bourdieu and Politics?, politics - broadly constructed. We evoke Pierre Bourdieu?s involvement in public affairs during the 1990s, while taking into account the concept of the collective intellectual that Bourdieu introduced into social sciences by giving it a specific meaning. (shrink)

Nearly two hundred years ago, Mary Wollstonecraft wrote what is considered to be the first major work of feminist political theory: A Vindication of the Rights of Women . Much has been written about this work, and about Wollstonecraft as the intellectual pioneer of feminism, but the actual substance and coherence of her political thought have been virtually ignored. Virginia Sapiro here provides the first full-length treatment of Wollstonecraft's political theory. Drawing on all of Wollstonecraft's works and treating them (...) thematically rather than sequentially, Sapiro shows that Wollstonecraft's ideas about women's rights, feminism, and gender are elements of a broad and fully developed philosophy, one with significant implications for contemporary democratic and liberal theory. The issues raised speak to many current debates in theory, including those surrounding interpretation of the history of feminism, the relationship between liberalism and republicanism in the development of political philosophy, and the debate over the canon. For political scientists, most of whom know little about Wollstonecraft's thought, Sapiro's book is an excellent, nuanced introduction which will cause a reconsideration of her work and her significance both for her time and for today's concerns. For feminist scholars, Sapiro's book offers a rounded and unconventional analysis of Wollstonecraft's thought. Written with considerable charm and verve, this book will be the starting point for understanding this important writer for years to come. (shrink)

How is feminism changing the way women and men think, feel, and act? Virginia Held explores how feminist theory is changing contemporary views of moral choice. She proposes a comprehensive philosophy of feminist ethics, arguing persuasively for reconceptualizations of the self of relations between the self and others and of images of birth and death, nurturing and violence. Held shows how social, political, and cultural institutions have traditionally been founded upon masculine ideals of morality. She then identifies a distinct (...) feminist morality that moves beyond culturally embedded notions about motherhood and female emotionality. Examining the effects of this alternative moral and ethical system on changing social values, Held discusses its far-reaching implications for altering standards of freedom, democracy, equality, and personal development. Ultimately, she concludes, the culture of feminism could provide a fresh perspective on--even solutions to--contemporary social problems. Feminist Morality makes a vital contribution to the ongoing debate in feminist theory on the importance of motherhood. For philosophers and other readers outside feminist theory, it offers a feminist moral and social critique in clear and accessible terms. (shrink)

Virginia Held assesses the ethics of care as a promising alternative to the familiar moral theories that serve so inadequately to guide our lives. The ethics of care is only a few decades old, yet it is by now a distinct moral theory or normative approach to the problems we face. It is relevant to global and political matters as well as to the personal relations that can most clearly exemplify care. This book clarifies just what the ethics of (...) care is: what its characteristics are, what it holds, and what it enables us to do. It discusses the feminist roots of this moral approach and why the ethics of care can be a morality with universal appeal. Held examines what we mean by "care," and what a caring person is like. Where other moral theories demand impartiality above all, the ethics of care understands the moral import of our ties to our families and groups. It evaluates such ties, focusing on caring relations rather than simply on the virtues of individuals. The book proposes how such values as justice, equality, and individual rights can "fit together" with such values as care, trust, mutual consideration, and solidarity. In the second part of the book, Held examines the potential of the ethics of care for dealing with social issues. She shows how the ethics of care is more promising than Kantian moral theory and utilitarianism for advice on how expansive, or not, markets should be, and on when other values than market ones should prevail. She connects the ethics of care with the rising interest in civil society, and considers the limits appropriate for the language of rights. Finally, she shows the promise of the ethics of care for dealing with global problems and seeing anew the outlines of international civility. (shrink)

L'oeuvre de Pierre Bourdieu est aujourd'hui "utilisée", citée, discutée, critiquée, dans les domaines les plus divers du savoir contemporain : de la sociologie à la philosophie en passant par l'ethnologie, la linguistique, la science politique ou l'économie institutionnaliste. Passant en revue chronologiquement l'essentiel de son oeuvre, ces Lectures de Bourdieu en facilitent une approche génétique, tout en prenant la mesure de la diversité des terrains explorés. Elles permettent aussi de percevoir un style de pensée, un "habitus sociologique" marqué par la (...) réflexivité, tout en inventoriant la "boîte à outil" conceptuels élaborés par Bourdieu (habitus, capital, champ). Ecartant la recherche de l'originalité à tout prix et la fidélité religieuse à un auteur canonique, ces Lectures de Bourdieu invitent à un rapport réaliste à l'héritage théorique de Bourdieu. Il s'agit, d'une part, de proposer un accès à l'oeuvre, de favoriser l'acquisition de schèmes d'interprétation et d'un style de recherche et d'encourager ainsi la lecture des textes originaux. Il s'agit, d'autre part, en se démarquant des travers de l'application mécaniques, tout en renonçant aux profits faciles de la distinction à tout prix et du dépassement à tout crin, d'inviter à l'appropriation active d'un mode de pensée scientifique qui n'exclut en rien les rectifications. (shrink)

Interviewers routinely orient to applicant files as they produce first pair parts that forward the business of the interview. As they do so, they make clear what they know, whether they already know it or are discovering it in the moment, whether it comes from the file in hand, and whether the applicant holds primary rights to confirm or amend that information. In these moments, participants work out issues of epistemic authority through an orchestration of multimodal behaviors, including talk, gesture, (...) gaze, and touch. Our analysis focuses specifically on two discourse slots: when interviewers confirm specific information in side sequences; and when they gloss and assess general information while calling for an account. In the former, interviewers display minimal knowledge and secondary epistemic authority; in the latter, they show strong knowledge and assert primary epistemic authority. This article demonstrates how epistemic authority, negotiated through embodied talk-in-interaction, contributes to how interviews unfold. (shrink)

L’article montre que la thématique du doux commerce a accompagné depuis les origines la construction européenne, et qu’elle a par là même contribué à masquer la dimension politique du processus d’unification et de convergence, au profit de la prédominance d’une vision pacifiée et irénique de l’économie marchande et du commerce international. Dans le contexte actuel de crise de la zone euro, la dimension conflictuelle des processus concurrentiels, leur lien avec les dynamiques de tensions internationales entre États, sont fortement réévalués.

Genre peu légitime du point de vue académique, la production d'essais économiques est pourtant un élément important dans la diffusion en France d'un sens commun politico-économique, plutôt planificateur et «keynésien» dans les années 1950-1970, néo-libéral depuis les années 1980. Après plusieurs décennies, ce genre s'est développé et transformé, mais sa position sur le marché éditorial reste, semble-t-il, relativement solide. Particulièrement mobilisé lors du changement de régime économique de 1982-1983, avec le basculement du Parti socialiste dans le «cercle de la raison» (...) libérale, ce genre est, précisément, une composante à part entière de la construction d'un ordre social libéral dans les années 1980 et 1990. Le succès, à partir de 1995, d'essais critiques est une manifestation de la crise de légitimité rencontrée aujourd'hui par les politiques libérales.Some kind of legitimate academic point of view, the production of economic tests is however an important element in the distribution in France of a political-economic common sense, rather planner and "Keynesian" in the years 1950-1970, the neo-liberal since the 1980s. After several decades, these grew and changed, but its position on the market remains editorial seems to be relatively strong. Mobilized especially when changing economic regime of 1982-1983, with the tilting of the Socialist Party in the "circle of reason" liberal, this kind is precisely one integral part of the construction of a liberal social order in 1980 and 1990. Success, from 1995, of critical essays is a manifestation of the crisis of legitimacy encountered today by liberal policies. (shrink)

It is widely agreed that social factors are related to health outcomes: much research served to establish correlations between classes of social factors on the one hand and classes of disease on the other hand. However, why and how social factors are an active part in the aetiology of disease development is something that is gaining attention only recently in the health sciences and in the medical humanities. In this paper, we advance the view that, just as bio-markers help trace (...) the causal continuum from exposure to disease development at the biological level, socio-markers ought to be introduced and studied in order to trace the social continuum from exposure to disease development. We explain how socio-markers differ from social indicators and how they can be used in combination with bio-markers in order to reconstruct the mixed mechanisms of health and disease, namely mechanisms in which both biological and social factors have an active causal role. (shrink)

There are many different forms and interpretations of rewilding: the concept and its practice vary from country to country, with distinct interpretations according to its geographical location. Despite the term rewilding having been present in the lexicon for three decades, the concept of rewilding in England has experienced a prolonged developmental stage. This paper argues that a unique form of English rewilding is now emerging, which is distinct from rewilding in other parts of the world. Compared to other locations rewilding (...) in England operates at smaller spatial scales; its ambitions to increase biodiversity, restore ecosystem functioning and increase natural autonomy are somewhat curtailed; it involves higher levels of human intervention; and, perhaps most tellingly of all, it goes by another name - 'wilding', 'wild' or 'wilder' with little mention of the much-maligned prefix 're'. This conclusion has been developed following a comparative case study of two English 'rewilding' sites (the Avalon Marshes and Wild Ennerdale) involving 49 semi-structured interviews: twelve expert interviews and nineteen and eighteen stakeholder/practitioner interviews at the Avalon Mashes and Wild Ennerdale respectively. (shrink)

Nursing professionalization is both ongoing and global, being significant not only for the nursing workforce but also for patients and healthcare systems. For this reason, it is important to have an in‐depth understanding of this process and the factors that could affect it. This literature review utilizes a welfare state approach to examine macrolevel structural determinants of nursing professionalization, addressing a previously identified gap in this literature, and synthesizes research on the relevance of studying nursing professionalization. The use of a (...) welfare state framework facilitates the understanding that the wider social, economic, and political system exercises significant power over the distribution of resources in a society, providing a glimpse into the complex politics of health and health care. The findings shed light on structural factors outside of nursing, such as country‐level education, health, labor market, and gender policies that could impact the process of professionalization and thus could be utilized to strengthen nursing through facilitating increased professionalization levels. Addressing gender inequalities and other structural determinants of nursing professionalization could contribute to achieving health equity and could benefit health systems through enhanced availability, skill‐level, and sustainability of nursing human resources, improved and efficient access to care, improved patient outcomes, and cost savings. (shrink)

We explored the comprehension of the informed consent in 77 cancer patients previously enrolled in randomised phase II or phase III clinical trials, between March and July 2011, at the San Raffaele Scientific Institute in Milano. We asked participants to complete an ad hoc questionnaire and analysed their answers. Sixty-two per cent of the patients understood the purpose and nature of the trial they were participating in; 44% understood the study procedures and 40% correctly listed at least one of the (...) major risks or complications related to their participation in the trial. We identified three factors associated with comprehension of the informed consent: age, education and type of tumour/investigator team. We suggest several possible improvements of how to obtain informed consent that will increase patient awareness, as well as the validity and effectiveness of the clinical trials. (shrink)

A modern form of narrative, comic books are used to communicate, discuss, and critique issues in business ethics and social issues in management. A description of comic books as a legitimate medium is followed by a discussion of the pedagogical uses of comic books and assessment techniques. The strengths of the pedagogy include crossing cultural barriers, understanding the complexity of individual decision-making and organizational influences, and the universality of dilemmas and values. We provide an initial source for educators on the (...) topics, comic books, plotlines, and other commentary for consideration of use in the classroom from high school to graduate business ethics and social issues in management courses. (shrink)

Traditional Informed Consent is becoming increasingly inadequate, especially in the context of research biobanks. How much information is needed by patients for their consent to be truly informed? How does the quality of the information they receive match up to the quality of the information they ought to receive? How can information be conveyed fairly about future, non-predictable lines of research? To circumvent these difficulties, some scholars have proposed that current consent guidelines should be reassessed, with trust being used as (...) a guiding principle instead of information. Here, we analyse one of these proposals, based on a Participation Pact, which is already being offered to patients at the Istituto Europeo di Oncologia, a comprehensive cancer hospital in Milan, Italy. (shrink)

For those interested in developing baccalaureate programs in health humanities, this essay draws on our experience of developing a minor in health humanities to share insights on what to expect, strategies that work well, and how to deal with obstacles. These insights range from how to explain the concept of health humanities to stakeholders to how to decide where to house a health humanities program. We share our insights in a way that promises to translate well to different institutional contexts. (...) That said, this paper is more relevant for institutional contexts where budgets are stressed and, consequently, proposals to invest in humanities programs are a difficult sell. This paper is divided into sections addressing how to earn institutional support, gain campus buy-in, identify benefits of the proposed program, decide where to house the program, calculate program cost, and secure external funding. We conclude with some final reflections on the current status of our program and why we are committed to health humanities education. (shrink)

Virginia Held's Feminist Morality defends the idea that it is possible to transform the "public" sphere by remaking it on the model of existing "private" relationships such as families. This paper challenges Held's optimism. It is argued that feminist moral inquiry can aid in transforming the public sphere only by showing just how much the allegedly "private" realms of families and personal relationships are shaped-and often misshapen-by public demands and concerns.

As in science, so in bioethics: if prohibiting conflicts of interest is not feasible, rigorous requirements for disclosure can at least manage them.

MAPEDZAHAMA V, RUDGE T, WEST S and PERRON A. Nursing Inquiry 2012; 19: 153–164 [Epub ahead of print]Black nurse in white space? Rethinking the in/visibility of race within the Australian nursing workplaceThis article presents an analysis of data from a critical qualitative study with 14 skilled black African migrant nurses, which document their experiences of nurse‐to‐nurse racism and racial prejudice in Australian nursing workplaces. Racism generally and nurse‐to‐nurse racism specifically, continues to be under‐researched in explorations of these workplaces; when racism (...) is researched, the focus is nurse‐to‐patient racism and racial prejudice. Similarly, research on the experiences of migrant nurses from a variety of ethnicities in Australia has tended to neglect their experiences of the social dynamics of the workplace, thus reinforcing their racialisation. When racialised, the migrant nurse becomes ‘the problem’ through a focus on English language competency and ensuing communication barriers. This paper applies Essed’s framework of ‘everyday racism’ to theorise narratives of racism by black African migrant nurses in Australia. In so doing, it not only brings to the fore silenced discussions of nurse‐to‐nurse racism in Australia, but also exposes the subtle, mundane nature of contemporary racism. For this reason, while the data we present must be read within their context, that is, the Australian nursing workplace, it has significance for advancing a critical analysis of racialised minority groups’ experiences of racism within seemingly ‘race‐less’ nursing workplaces internationally. (shrink)

Adaptive mutation is defined as a process that, during nonlethal selections, produces mutations that relieve the selective pressure whether or not other, nonselected mutations are also produced. Examples of adaptive mutation or related phenomena have been reported in bacteria and yeast but not yet outside of microorganisms. A decade of research on adaptive mutation has revealed mechanisms that may increase mutation rates under adverse conditions. This article focuses on mechanisms that produce adaptive mutations in one strain of Escherichia coli, FC40. (...) These mechanisms include recombination-induced DNA replication, the placement of genes on a conjugal plasmid, and a transient mutator state. The implications of these various phenomena for adaptive evolution in microorganisms are discussed. BioEssays 22:1067–1074, 2000. © 2000 John Wiley & Sons, Inc. (shrink)

Many ideas grow better when transplanted into another mind than the one where they sprang up.

In the last few decades, the ethics of care as a feminist ethic has given rise to extensive literature, and has affected moral inquiries in many areas. It offers a distinctive challenge to the dominant moral theories: Kantian moral theory, utilitarianism, and virtue ethics. This chapter outlines the distinctive features and promising possibilities of the ethics of care, and the criticisms that have been made against it. It then examines the ethics of care’s recognition of human dependency and of the (...) importance of responding to needs; its interpretation of the roles of emotion and reason in moral understanding; and its critique of liberal individualism and development of a conception of the person as relational. The ethics of care contrasts care with justice, tries to integrate them, and reconceptualizes public and private life and morality. (shrink)