While various definitions of moral distress have been proposed, some agreement exists that it results from illegitimate constraints in clinical practice affecting healthcare professionals’ moral agency. If we are to reduce moral distress, instruments measuring it should provide relevant information about such illegitimate constraints. Unfortunately, existing instruments fail to do so. We discuss here several shortcomings of major instruments in use: their inability to determine whether reports of moral distress involve an accurate assessment of the requisite clinical and logistical facts (...) in play, whether the distress in question is aptly characterized as moral, and whether the moral distress reported is an appropriate target of elimination. Such failures seriously limit the ability of empirical work on moral distress to foster appropriate change. (shrink)

The aims of this paper are fourfold. The first aim is to characterize two distinct forms of circumstantial moral luck and illustrate how they are implicitly recognized in pre-theoretical moral thought. The second aim is to identify a significant difference between the ways in which these two kinds of circumstantial luck are morally relevant. The third aim is to show how the acceptance of circumstantial moral luck relates to the acceptance of resultant moral luck. The fourth aim is to defuse (...) a legitimate concern about accepting the existence of circumstantial moral luck, namely the fact that its existence implies substantial moral risks. (shrink)

Moral luck occurs when factors beyond an agent’s control positively affect how much praise or blame she deserves. Kinds of moral luck are differentiated by the source of lack of control such as the results of her actions, the circumstances in which she finds herself, and the way in which she is constituted. Many philosophers accept the existence of some of these kinds of moral luck but not others, because, in their view, the existence of only some of them would (...) make morality unfair. I, however, argue that this intermediary approach is unstable, because either morality is fair in ways that rule out resultant, circumstantial, and constitutive moral luck (and this leads to moral responsibility skepticism), or morality is unfair in ways that permit the existence of those kinds of moral luck. Thus, such intermediary approaches lack the motivation that their proponents have long taken them to have. In the appendix, I point to ways in which morality is unfair concerning the scope of moral responsibility, moral obligation, moral taint, being a good or bad person, and flourishing. (shrink)

In this paper I suggest that there is a way to make sense of blameworthiness for morally problematic actions even when there is no bad will behind such actions. I am particularly interested in cases where an agent acts in a biased way, and the explanation is socialization and false belief rather than bad will on the part of the agent. In such cases, I submit, we are pulled in two directions: on the one hand non-culpable ignorance is usually an (...) excuse, but in the case of acting in a biased way we feel some pull to find the agent blameworthy. I argue that agents are sometimes blameworthy, (where I really mean that they are blameworthy, and not just that it is permissible to reproach them), even if they do not have any bad will. I argue that although the paradigmatic account of blameworthiness is based on quality of will, we can and should be willing to allow that there are non-paradigmatic cases. I argue that the zone of responsibility can be extended to include acts that we are not fully in control of, and acts whose moral status we are non-culpably ignorant about at the time of acting. This extension of responsibility happens through a voluntary taking of responsibility. I argue that there are certain conditions under which we should take responsibility, and that when we do so, we genuinely are responsible. (shrink)

On the traditional view, moral distress arises only in cases where an individual believes she knows the morally right thing to do but fails to perform that action due to various constraints. We seek to motivate a broader understanding of moral distress. We begin by presenting six types of distress that fall outside the bounds of the traditional definition and explaining why they should be recognized as forms of moral distress. We then propose and defend a new and more expansive (...) definition of moral distress and examine how it can enable the development of a taxonomy of moral distress. (shrink)

Since 1945 responsibility for atrocity has been individualized, and international tribunals and courts have been given effective jurisdiction over it. This article argues that the move to individual responsibility leaves significant "excesses" of responsibility for war crimes unaccounted for.

: This paper explores vicarious responsibility and circumstantial luck from a first-person perspective, drawing on ethnographic research on parenting in Reform Era China. The paper focuses on how informants drew boundaries between what they could and could not control in raising a child who might thrive in a hypercompetitive society. In doing so, the paper engages the question, “What kind of moral agent do we want?” by proposing that we also ask, “What kind of moral agent do we find?” In (...) contrast to the hypothetical figure of a walled-off agent who must be convinced of the duty to take on responsibilities in a circumstance of moral luck, empirical research finds instead a vulnerable agent who has taken on ‘too much’. (shrink)