The concept of missed care refers to an irrefragable truth that required nursing care, which is left undone, occurs in the delivery of health care. As a technical concept, missed care offers nurses the opportunity to articulate a problematic experience. But what are we to make of missed care from an ethical perspective? Can nurses be held morally responsible for missed care? Ethically speaking, it is generally accepted that if a person has a moral obligation to do something, s/he needs (...) to have the capacity to do it. If a person does not have the capacity to fulfil a moral obligation, then s/he cannot be held responsible for failing to do so. This is captured by the “ought implies can” (OIC) principle. This paper brings the OIC principle to the forefront of the discussion on missed care. It is contended that nurses – qua moral agents – may be discharged from a moral obligation to carry out a required caring act because of some inability that is not of their making and therefore may not be morally responsible for missed care. However, the OIC principle may not be applied to all situations of missed care depending on their causes. In addition, following in the thought of Sapontzis (The Southern Journal of Philosophy, 1991, XXIX, 383–393) it is contended that when an original obligation to deliver a required act of care cannot be fulfilled, other obligations may be generated as summed up in the “Principle of Making Amends” and the “Principle of Appropriate Feeling.” It is the view of this paper that these further principles could prevent the OIC principle from being used to simply excuse omissions of care from a normative standard and could support the view that nurses continue to have alternative obligations to make amends and to respond with appropriate feelings to missed care. (shrink)

Philosophers and theologians alike have debated endlessly over the relationship between divine sovereignty and human freedom. Too often, in these debates, human freedom is either denied altogether or reduced to a compatibilist notion. Many people fear that granting humans too much freedom would destroy God's sovereignty. However, the purpose of granting humans freedom is not to elevate the creature over the Creator; rather to uphold both moral responsibility and God's justice. Any theory that preserves God's sovereignty at the expense of (...) His justice, or makes His justice arbitrary, by sacrificing the kind of freedom that preserves moral responsibility, is not worthy to be held by any Christian. This thesis will contend that only libertarian freedom preserves moral responsibility, since only libertarian freedom preserves legitimate possibilities for the agent. However, a dilemma arises for Christians who advocate libertarian freedom: How can God know what future actions will occur if the actualization of the action is dependent on the libertarian free choice of an agent who does not yet exist? Many of the traditional attempts to preserve libertarian freedom fail because such attempts hold that the future is exhaustively settled. This raises a problem for libertarian freedom since an exhaustively settled future is one without possibilities, which libertarian freedom requires. In order to solve this dilemma, it will be argued that God decided not to determine all events. Instead, God actually gives humans options allowing for legitimate possibilities. In such a world, God knows all those things which He has determined to bring about, as well as all the possibilities He permits. The important distinction this thesis will make is that God knows future possibilities as possible until the agent exercises one's free choice. (shrink)