Philosophy Compass, Volume 17, Issue 4, April 2022. -/- In a moment where needs for care are acute and their provision precarious, feminist care ethics has gained new relevance as a framework for understanding and responding to necessary interdependence. This article reviews and evaluates two long-standing critiques of care ethics in light of this recent research. First, I assess what I call the pluralist feminist critique, or the dispute over the ability of care ethics to address the needs and histories (...) of a range of marginalized subjects. I identify two forms of this critique: the first disputes the biased starting points shaping the development of the theory, and the second concerns the weaponization of care in support of domination. Although these critiques are well-established, I draw attention to recent responses that move care theory in generative directions. I argue that the pluralist feminist critique demands both self-critical transformation in dialog with other feminist schools of thought and a robust account of care ethics' normative authority. I then take up critiques those levied by mainstream ethicists concerned with care theory's adequacy as an ethical approach. I show that recent work on normative authority, conceptual uniqueness, and the grounding of responsibility must be engaged before care theory can be dismissed as “under-theorized.” In articulating these two sets of critiques and evaluating recent rebuttals to them, I argue for a pluralist feminist theory of care within which strands informed by varying philosophical schools and methods can coexist. (shrink)

Background:While there have been studies exploring moral habitability and its impact on the work environments of nurses in Western countries, little is known about the moral habitability of the work environments of nurses and midwives in resource-constrained settings.Research objective:The purpose of this research was to examine the moral habitability of the work environment of nurses and midwives in Ghana and its influence on their moral agency using the philosophical works of Margaret Urban Walker.Research design and participants:A critical moral ethnography was (...) conducted through the analysis of interviews with 30 nurses and midwives, along with observation, and documentary materials.Ethical considerations:After receiving ethics approval, signed informed consent was obtained from participants before data collection.Results:Five themes were identified: (1) holding onto the values, identities, and responsibilities of being a midwife/nurse; (2) scarcity of resources as limiting capacity to meet caring responsibilities; (3) gender and socio-economic inequities shaping the moral-social context of practice; (4) working with incoherent moral understandings and damaged identities in the context of inter- and intra-professional relationships; and (5) surviving through adversity with renewed commitment and courage.Discussion:The nurses and midwives were found to work in an environment that was morally uninhabitable and dominated by the scarcity of resources, overwhelming and incoherent moral responsibilities, oppressive conditions, and workplace violence. These situations constrained their moral agency and provoked suffering and distress. The nurses and midwives negotiated their practice and navigated through morally uninhabitable work environment by holding onto their moral values and commitments to childbearing women.Conclusion:Creating morally habitable workplaces through the provision of adequate resources and instituting interprofessional practice guidelines and workplace violence prevention policies may promote safe and ethical nursing and midwifery practice. (shrink)

In this article, I investigate how we may include investigations of actual context in the investigation of moral problems in philosophy. The article has three main parts. The focus of the first is a survey of the dominant view of how to incorporate context into moral philosophy and to exemplify this view, I investigate examples from influential introductions to moral philosophy, identifying what I call the assumption of abstraction. In the second part I present three traditions which attribute a more (...) prominent place to context in philosophical work and which therefore offer resources for thinking about context: moral contextualism, particularism and contextualism in political philosophy. Unconvinced that these resources are sufficient for an understanding of how actual context may be of importance in philosophy, I in the third part turn to a systematic investigation of three suggestions for how to incorporate actual context onto philosophy: the application approach, the bottom-up approach and the contextual approach. Furthermore, I argue that the third and most radical approach develops a superior understanding of how to include context in moral philosophy, reflecting the impossibility of making normatively neutral investigations of context in moral philosophy. (shrink)

Nurses and other medical practitioners often experience moral distress: they feel an anguished sense of responsibility for what they take to be their own moral failures, even when those failures were unavoidable. However, in such cases other people do not tend to think it is right to hold them responsible. This is an interesting mismatch of reactions. It might seem that the mismatch should be remedied by assuring the practitioner that they are not responsible, but I argue that this denies (...) something important that the phenomenon of moral distress tells us. In fact, both the practitioners’ tendencies to hold themselves responsible and other people’s reluctance to hold the practitioners responsible get something right. The practitioners may be right that they are responsible in the sense of having failed to meet a binding moral requirement, even when the requirement was impossible to meet. This makes moral distress a fitting response because it correctly represents their own action as a wrongdoing. However, others may meanwhile be right that the practitioners are not responsible in the sense of being culpable and blameworthy. To blame others, or oneself, for certain failures, including those that are unavoidable, would be unfair. My claim depends on distinguishing between the fittingness and the fairness of holding someone (including oneself) responsible for moral failure. Having drawn the distinction, I suggest that moral distress should be addressed in a way that both recognizes it as a fitting response and avoids the unfairness of blame. (shrink)

I briefly introduce Moral Failure as a book that brings together philosophical and empirical work in moral psychology to examine moral requirements that are non-negotiable and that contravene the principle that “ought implies can.” I respond to Rivera by arguing that the process of construction that imbues normative requirements with authority need not systematize or eliminate conflicts between normative requirements. My response to Schwartzman clarifies what is problematic about nonideal theorizing that limits itself to offering action-guidance. In response to Kittay, (...) I defend my rejection of “ought implies can,” and consider the implications of the concept of unfair moral requirements. (shrink)

This paper draws on Claudia Card’s discussions of moral luck to consider the complicated moral life of people—described as pessimists—who accept the heavy knowledge of the predictability of the bad moral luck of oppression. The potential threat to ethics posed by this knowledge can be overcome by the pessimist whose resistance to oppression, even in the absence of hope, expresses a sense of still having a ‘‘claim’’ on flourishing despite its unattainability under oppression.

Implicit in feminist and other critiques of ideal theorizing is a particular view of what normative theory should be like. Although I agree with the rejection of ideal theorizing that oppression theorists (and other theorists of justice) have advocated, the proposed alternative of nonideal theorizing is also problematic. Nonideal theorizing permits one to address oppression by first describing (nonideal) oppressive conditions, and then prescribing the best action that is possible or feasible given the conditions. Borrowing an insight from the "moral (...) dilemmas debate"— namely that moral wrongdoing or failure can be unavoidable—I suggest that offering (only) action-guidance under non-ideal conditions obscures the presence and significance of unavoidable moral failure. An adequate normative theory should be able to issue a further, non-action-guiding evaluative chim, namely that the best that is possible under oppressive conditions is not good enough, and may constitute a moral failure. I find exclusively action-guiding nonideal theory to be both insufficiently nonidealizing (because it idealizes the moral agent by falsely characterizing the agent as always able to avoid moral wrongdoing) and meanwhile too strongly adapted to the nonideal (because normative expectations are lowered and detrimentally adapted to options that, while the best possible, are still unacceptable). (shrink)

The notion of virtue in general, and courage in particular, has had a hard time integrating itself into the everyday lexicon of bioethics. Following the lead of enlightenment moral philosophy, which concentrates on the theory of right action as opposed to the ancient Greeks' emphasis on the development of good character, bioethics, with some notable exceptions, has tended to relegate consideration of the virtues to the sidelines of moral argument. Recently, however, there have been calls for the necessity of “moral (...) courage” in the context of clinical ethics. As nurses, physicians, and other health care professionals confront a variety of moral contexts in which the virtue of courage is invoked to "do the right thing," stand up for patients' rights, and uphold the ethical standards of their professions, they are increasingly reminded of their moral duty to exhibit courage in the face of institutional obstacles to the proper care of their patients. For example, a nurse's hesitation to approach a physician to request increased sedation for an agitated patient out of fear of retaliation is represented in one article as a lack of courage.In this paper we offer a critical assessment of such invocations of courage. While we find courage to be an indispensable virtue in some challenging contexts, in other settings we find invocations of courage to be both an unfortunate endorsement of an oppressive status quo that can divert attention from the real problems and an undesirable and potentially destructive strategy within health care institutions whose goal is medically excellent and morally good clinical practice. As we shall argue, a call to virtuousness is not always virtuous. (shrink)

-/- Background: Nurses who provide aggressive care often experience the ethical challenge of needing to preserve the hope of seriously ill patients and their families without providing false hope. -/- Research objectives: The purpose of this inquiry was to explore nurses’ moral competence related to fostering hope in patients and their families within the context of aggressive technological care. A secondary purpose was to understand how this competence is shaped by the social–moral space of nurses’ work in order to capture (...) how competencies may reflect an adaptation to a less than ideal work environment. -/- Research design: A critical qualitative approach was used. -/- Participants: Fifteen graduate nursing students from various practice areas participated. -/- Ethical considerations: After receiving ethics approval from the university, signed informed consent was obtained from participants before they were interviewed. -/- Findings: One overarching theme ‘Mediating the tension between providing false hope and destroying hope within biomedicine’ along with three subthemes, including ‘Reimagining hopeful possibilities’, ‘Exercising caution within the social–moral space of nursing’ and ‘Maintaining nurses’ own hope’, was identified, which represents specific aspects of this moral competency. -/- Discussion: This competency represents a complex, nuanced and multi-layered set of skills in which nurses must be well attuned to the needs and emotions of their patients and families, have the foresight to imagine possible future hopes, be able to acknowledge death, have advanced interpersonal skills, maintain their own hope and ideally have the capacity to challenge those around them when the provision of aggressive care is a form of providing false hope. -/- Conclusion: The articulation of moral competencies may support the development of nursing ethics curricula to prepare future nurses in a way that is sensitive to the characteristics of actual practice settings. (shrink)

The ethical ‘eye’ of nursing, that is, the particular moral vision and values inherent in nursing work, is constrained by the preoccupations and practices of the superordinate biomedical structure in which nursing as a practice discipline is embedded. The intimate, situated knowledge of particular persons who construct and attach meaning to their health experience in the presence of and with the active participation of the nurse, is the knowledge that provides the evidence for nurses’ ethical decision making. It is largely (...) invisible to all but other nurses. Two nurse researchers, Joan Liaschenko of the University of Minnesota and Patricia Rodney of the University of Victoria, have investigated the ethical concerns of practising nurses and noted in their separate enquiries the invisible nature of critical aspects of nursing work. Noting the similarities in their respective observations, and with the feminist ethics of Margaret Urban Walker as a theoretical framework, this article examines the concept of ‘invisibility’ as it relates to nursing work and nursing ethics. (shrink)

Since Carol Gilligan's analysis of the “Heinz dilemma,” many philosophers working on care have articulated critiques of abstraction and principles in ethics. Their objections to abstraction and principles have not always been systematically set out. In this paper, I try to clarify the debate. I begin by distinguishing several aspects of the care critique. I then consider the strengths of each from a Kantian perspective. I conclude that, although some of these objections point out potential misuses of abstraction and principle, (...) and in doing so, suggest strategies and cautions for their correct and careful use in ethics, they do not present a successful challenge to abstraction or principles as such. (shrink)

This dissertation attempts to preserve the central tenets of a global moral theory called “the capabilities approach” as defended by Martha Nussbaum, but to do so in a way that better realizes its own goals of identifying gender injustices and gaining cross-cultural support by providing an alternative defense of it. Capabilities assess an individual’s well-being based on what she is able to do (actions) and who she is able to be (states of existence). Nussbaum grounds her theory in the intuitive (...) idea that each and every person is worthy of equal respect and dignity. The problem with grounding a theory in a version of intuitionism is that it runs the risk of authoritarian moral reasoning. I argue Nussbaum, in fact, is the final arbiter who decides which intuitions are mistaken, which are not, and how to interpret what people say to fit into her own framework. This method of justifying capabilities is most problematic in cases of social inequality whereby dominant group members do not feel they need to check their intuitions against non-dominant group members, and even if they did, they are not forced to take the non-dominant group’s intuitions seriously. I find capabilities as a global moral theory to be very promising, and I agree with Nussbaum that a list of capabilities is beneficial for identifying people who are not able to live a truly dignified human life. However, I am also sympathetic to the criticism of defending capabilities using a version of intuitionism. So, I offer an alternative method of justifying the capabilities rooted in the discourse ethics tradition. This method seeks all persons that are affected by the outcome to freely and equally share their opinion. This avoids the charge of authoritarian moral reasoning, because (1) it seeks perspectives other than simply one’s own, but unlike traditional ethics, it (2) pays special attention to the ways in which power relations shape dialogue. Ultimately, I hope to have preserved the central tenets of the capabilities approach while better realizing Nussbaum’s commitment to defending a theory that is gender sensitive and has gained cross-cultural support. (shrink)

Following the revival of virtue theory, some moral theorists have argued that virtue ethics can provide the basis for a radical politics. Such a politics essentially departs from the liberal model of the moral agent as an autonomous reason-giver. It instead privileges an understanding of the agent as conditioned by her community, and in the case of social oppression and marginalization, communal virtues may become a vehicle for social change. This essay compares political appropriations of virtue theory by Christian theologian (...) Stanley Hauerwas and secular feminist thinkers Lisa Tessman and Margaret Urban Walker. Hauerwas and feminist theorists both embrace a kind of embodied vulnerability as a political virtue, arguing that it enables more genuine social recognition. The virtue feminist critique is more robust than Hauerwas's, however, insofar as it understands mutual recognition to involve acknowledgment of social difference and the concomitant pursuit of justice. (shrink)

Tessman responds to her three critics’ comments on Burdened Virtues, focusing on their concerns with her stipulation of an “inclusivity requirement,” according to which one cannot be said to flourish without contributing to the flourishing of an inclusive collectivity. Tessman identifies a naturalized approach to ethics—which she distinguishes from the naturalism she implicitly endorsed in Burdened Virtues—that illuminates how a conception of flourishing that meets the inclusivity requirement could carry moral authority.

People have various desires, but it is a contested moral issue when a desire becomes of such importance that it legitimizes a moral claim on others. This paper explores how the normative significance of desire satisfaction can be assessed and argues that a normatively significant desire can constitute a pro tanto obligation to help satisfy it. The paper presents a framework that relates the normative significance of a given desire to the general goal of living a reasonably valuable life and (...) inquires how the latter can be given determinate content without excluding a heterogeneity of the personal good. The paper contends that the set of possibly normatively significant desires is thus restricted by considerations about intelligibility, adequacy, and replaceability, which are mediated by societal background theories. (shrink)

Socially Assistive Robots are increasingly conceived as applicable tools to be used in aged care. However, the use carries many negative and positive connotations. Negative connotations come forth out of romanticized views of care practices, disregarding their already established technological nature. Positive connotations are formulated out of techno-deterministic views on SAR use, presenting it as an inevitable and necessary next step in technological development to guarantee aged care. Ethical guidance of SAR use inspired by negative connotations tends to be over-restrictive (...) whereas positive connotations tend to provide over-permissive guidance. To avoid these extremes, we report on the development and content of 21 ethical orientations regarding SAR use in aged care. These orientations resulted from a multi-phased project, which consisted of empirical-ethical research focusing on older adults’ intuitions regarding SAR use and philosophical-ethical research focusing on philosophical-ethical argumentations regarding SAR use. This project led to the Socio-historical contextualization of the ethics of SAR use, in which the ethical impact of SAR use is localized on three interrelated analysis levels: societal, organizational, and individual-relational. The 21 novel orientations regarding SAR use are structured according to these levels and further categorized into foundational and applied orientations. The first category leads to critical reflection on SAR use while the latter category inspires decision-making processes regarding this use. While going beyond the care-romantic and techno-deterministic gaze of SAR use in aged care, the described orientations balance themselves between their over-restrictiveness and over-permissiveness. (shrink)

A prominent trend in moral philosophy today is the interest in the rich textures of actual human practices and lives. This has prompted engagements with other disciplines, such as anthropology, history, literature, law and empirical science, which have produced various forms of contextual ethics. These engagements motivate reflections on why and how context is important ethically, and such metaethical reflection is what this article undertakes. Inspired by the work of the later Wittgenstein and the Danish theologian K.E. Løgstrup, I first (...) describe one of the ways in which context plays a central role with regard to ethical meaning and normativity. I then examine how ‘context’ is to be defined, and finally I discuss some of the questions which arise when giving context prominence in ethics – namely, how to delimit the scope of relevant context, the relevant traits of a particular context and what ‘the ethical’ is. (shrink)

ABSTRACTWhen is sacrifice – and particularly self-sacrifice – called for? This question turns out to be difficult to answer, for it tends to arise when values conflict, and hence the answer to it depends on how conflicts of values are to be resolved. If values are constructed, and if there is no single right way to construct them or prioritize them when they conflict, though there are identifiable ways in which the construction of values can go wrong, we may be (...) left in a position of ambivalence about what should be sacrificed. In cases of conflict in which self-sacrifice is one of the options, ambivalence may be particularly appropriate. In part this is because there may be in such cases special sources of plurality and incommensurability of values, because the conflict is likely to be between something that is valued by a social group, and something that is valued particularly by an individual who has to consider self-sacrificing. And in part it is because individuals may have trouble balancing self-regarding and other-regarding concerns in the process of value construction. This paper elaborates these complications, and presents cases in which we might suspect that someone has self-sacrificed too much or too little. (shrink)

A prominent trend in moral philosophy today is the interest in the rich textures of actual human practices and lives. This has prompted engagements with other disciplines, such as anthropology, history, literature, law and empirical science, which have produced various forms ofcontextual ethics. These engagements motivate reflections on why and how context is important ethically, and such metaethical reflection is what this article undertakes. Inspired by the work of the later Wittgenstein and the Danish theologian K.E. Løgstrup, I first describe (...) one of the ways in which context plays a central role with regard to ethical meaning and normativity. I then examine how ‘context’ is to be defined, and finally I discuss some of the questions which arise when giving context prominence in ethics – namely, how to delimit the scope of relevant context, the relevant traits of a particular context and what ‘the ethical’ is. (shrink)

Recent work in behavioral economics and psychology provides valuable resources for religious ethicists. This book discussion examines contributions by Cass Sunstein, Daniel Kahneman, George Akerlof and Rachel Kranton, Uri Gneezy and John A. List, and Douglas Hough. This literature raises important questions about ethical decision-making, moral agency and responsibility, and the ethics of life in global capitalism. It also opens up promising areas for interdisciplinary dialogue between economics and religious studies. This book discussion concludes that religious ethicists have much to (...) contribute to the conversations about moral anthropology that are now being held in behavioral economic research, and to the broader political economic debates in which this research participates. (shrink)

Starting from the intuition, shared by many women, that the legal right to an abortion must be defended but that they themselves could never undergo one, I offer an account of why pregnancy is morally valuable and why, nevertheless, it is often permissible to end one. Developing the idea that human pregnancy centrally involves the activity of calling a fetus into personhood, I argue that the permissibility of stopping this activity hinges on the goodness or badness of one's moral luck.

Feminist critiques of intention challenge some aspects of traditional just war reasoning, including the criteria of right intention and discrimination. I take note of these challenges and propose some directions just war reasoners might take in response. First, right intention can be evaluated more accurately by judging what actors in war actually do than by attempting to uncover inward dispositions. Assessing whether agents in war have taken due care to minimize foreseeable collateral damage, avoided intentional targeting of noncombatants, corrected previous (...) mistakes in their later actions, and taken responsibility to repair unintended damage they cause are examples of ways in which just war reasoners can evaluate intention by looking at actions. (shrink)

The dissertation attempts to answer the question of how to theorize resistance from within the philosophy of social science. To answer this question we must consider more than just the philosophy of social science; we also must look to political and moral philosophy. Resistance to the social norms of one’s community is possible to theorize from within the philosophy of social science once we develop a sufficiently nuanced account of social and moral communities, according to which membership in a community (...) is not defined by sharing judgments, conceptual frameworks, or comprehensive worldviews, but by sharing terms of discourse so that discussion about judgments, conceptual frameworks, and comprehensive worldviews is possible. Understanding the structure of one’s moral community is not the same as to endorsing that structure. This suggests that contestation is already present within communities about what ‘we’ do, up to and including who ‘we’—as a ‘community’—are. Challenging communitarian understandings of what makes a community a community, I argue that communities are best understood as forming around common concerns or perceptions of problems. This contestation plays a major role in determining the identities of communities, and these identities are constantly shifting. (shrink)

Starting from the intuition, shared by many women, that the legal right to an abortion must be defended but that they themselves could never undergo one, I offer an account of why pregnancy is morally valuable and why, nevertheless, it is often permissible to end one. Developing the idea that human pregnancy centrally involves the activity of calling a fetus into personhood, I argue that the permissibility of stopping this activity hinges on the goodness or badness of one's moral luck.

This essay argues for a new, “meta,” level of integrity that is created by the context of structural injustice. The essay will draw from Margaret Walker to bring out a defining social value of integrity, namely, its ability to facilitate reliable response to harms caused by “moral luck.” The essay will then argue that, when bad luck is caused by complex social-structural function, traditional advice for maintaining one's integrity fails to provide adequate guidance; following such advice facilitates unjust social-structural function, (...) and so unreliability in response to harm. The essay will address this problem by arguing that in the context of structural injustice, a “meta-level” meaning of integrity emerges. This new meta-level of integrity, unlike the more traditional first-level integrity, does not instruct an individual to disassociate herself from structural harms; instead, it instructs an individual to manage the way in which she participates in unjust social structures. Meta-level integrity, unlike first-level integrity, does not facilitate an end to structural harm, but it does promote a reliable presence of social-justice movements within unjust structures. (shrink)

Tessman responds to her three critics’ comments on Burdened Virtues, focusing on their concerns with her stipulation of an “inclusivity requirement,” according to which one cannot be said to flourish without contributing to the flourishing of an inclusive collectivity. Tessman identifies a naturalized approach to ethics—which she distinguishes from the naturalism she implicitly endorsed in Burdened Virtues—that illuminates how a conception of flourishing that meets the inclusivity requirement could carry moral authority.

Lisa Tessman’s Moral Failure: On the Impossible Demands of Morality raises important questions about ideal theory, oppression, and the role of action guidance in normative philosophy. After a brief overview of feminist and anti-racist philosophers’ critiques of ideal theory, I examine Tessman’s claim that nonideal oppression theorists focus too narrowly on action guidance and thereby obscure other important normative issues, such as the problem of moral failure. Although I agree with Tessman’s advocacy of a wider focus—and with her suggestion that (...) situations of inevitable moral failure are particularly important to examine in contexts of oppression—I question whether nonideal oppression theorists actually emphasize action guidance to the exclusion of other concerns. I conclude with a brief examination of the way that ideal and nonideal theory have been defined and understood in debates about normative methodology, and I suggest that a move away from Rawls’s account of the ideal/nonideal distinction would benefit feminists and other oppression theorists. (shrink)

This article gives an overview of the nursing ethics arguments on euthanasia in general, and on nurses' involvement in euthanasia in particular, through an argument-based literature review. An in-depth study of these arguments in this literature will enable nurses to engage in the euthanasia debate. We critically appraised 41 publications published between January 1987 and June 2007. Nursing ethics arguments on (nurses' involvement in) euthanasia are guided primarily by the principles of respect for autonomy, nonmaleficence, beneficence and justice. Ethical arguments (...) related to the nursing profession are described. From a care perspective, we discuss arguments that evaluate to what degree euthanasia can be considered positively or negatively as a form of good nursing care. Most arguments in the principle-, profession- and care-orientated approaches to nursing ethics are used both pro and contra euthanasia in general, and nurses' involvement in euthanasia in particular. (shrink)

Consistency is usually seen as one of the hallmarks and a cardinal virtue of moral theory, as well as of any defensible real-life moral perspective. In everyday life a consistent set of moral beliefs is conductive to moral clarity, communicability, responsibility and responsiveness. But this is just one side of the story. In this paper I argue that inconsistency, properly understood, is a productive and constructive aspect of both moral philosophy and our moral lives. After an introductory glance at Ralf (...) Waldo Emerson and Hannah Arendt, the argument proceeds in three main steps. First, I discuss the philosophical importance of paying heed to inconsistencies in our moral lives, which often are prematurely pruned from moral philosophy. Second, I discuss the positive moral roles of inconsistency in terms of responsiveness to different situations, values, needs and concerns that call upon our attention in everyday life. Third, I argue that moral inconsistencies contribute to the necessary adaptability of our moral understandings to changing conditions. Fourth, in the place of a conclusion, I revisit the issue of consistency, clarity and accountability. (shrink)