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)

In this paper, I examine Iris Marion Young's conception of power, arguing that it is incomplete in at least two ways. First, Young tends to equate the term power with the narrower notions of ‘oppression’ and ‘domination.’ Thus, Young lacks a satisfactory analysis of individual and collective empowerment. Second, as Young herself admits, it is not obvious that her analysis of power can be useful in the context of thinking about transnational justice. I conclude by considering one way in which (...) Young's analysis of power needs to be extended or perhaps modified in order to do justice to questions of transnational justice. (shrink)

On realist terms, politics is about power, security, and order, and the question of whether politics can practice compassion is irrelevant. The author argues that a politics of compassion is possible and necessary in order to address human security needs. She extend debates on care ethics to develop a politics of compassion, using the example of asylum seekers to demonstrate that politics can practice compassion with attentiveness to the needs of vulnerable people who are suffering, an active listening to the (...) voices of the vulnerable, and open, compassionate, and appropriate responses to particular needs. (shrink)

This essay focuses on the value of self-doubt in moral inquiry and in moral education. Using John Patrick Shanley’s play, Doubt: A parable, as illustration, it shows how self-doubt initiates and extends moral inquiry, highlights one’s epistemic fallibility and connects the inquirer to the virtue of humility. The essay draws on the work of Charles Sanders Peirce, Hullett, Nussbaum, Thayer-Bacon and Elbow to support the idea that the question ‘Am I wrong?’ is important for moral inquiry and for moral education.

This article surveys recent feminist contributions to moral philosophy with an emphasis on those works which engage with debates within mainstream ethics. The article begins by examining a tension said to arise from the two criteria a theory must meet if it is to count as feminist moral theory: the women's experience requirement and the feminist conclusion requirement. Subsequent sections deal with feminist relational theories of rights, feminist work on responsibility and feminist contractarian approaches to ethics. A final section looks (...) at the application of some feminist moral theories to the problem of abortion. (shrink)

This paper argues that human rights-based approaches to human security overlook the importance of caring values, relations of care, and care work in the achievement and long-term maintenance of human security. It outlines an alternative approach to the ethics of human security which combines a feminist ontological and normative position on the centrality of caring values and practices in sustaining life with a feminist account of the gendered political economy of contemporary globalisation. Moreover, it argues that a critical, feminist ethics (...) of care can provide a comprehensive ontological and normative framework for integrating economic exclusion with violence, and thus for understanding and conceptualising human security in a way that is sensitive to the role played by gender identities and other types of power relations. This, I argue, can be achieved through an interrogation of the relationship between neoliberal globalisation and hegemonic forms masculinity in the context of contemporary global governance. (shrink)

Moral distress has been written about extensively in nursing and other fields. Often, however, it has not been used with much theoretical depth. This paper focuses on theorizing moral distress using feminist ethics, particularly the work of Margaret Urban Walker and Hilde Lindemann. Incorporating empirical findings, we argue that moral distress is the response to constraints experienced by nurses to their moral identities, responsibilities, and relationships. We recommend that health professionals get assistance in accounting for and communicating their values and (...) responsibilities in situations of moral distress. We also discuss the importance of nurses creating “counterstories” of their work as knowledgeable and trustworthy professionals to repair their damaged moral identities, and, finally, we recommend that efforts toward shifting the goal of health care away from the prolongation of life at all costs to the relief of suffering to diminish the moral distress that is a common response to aggressive care at end-of-life. (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.

Abstract 1 This paper makes a preliminary case for a central and radical claim. I begin with Bernard Williams? seldom-faced argument that integrity cannot be a moral virtue because it lacks two key ingredients of moral virtues, namely a characteristic thought and motivation. Whereas, for example, generosity involves the thought that another could use assistance, and the motivation to actually give assistance, integrity lacks these two things essential to morally excellent responses. I show that several maneuvers aimed at avoiding Williams? (...) challenge fail and that others are likely to remain unpersuasive. The paper concludes by offering an argument to the best explanation: Williams? important insight is best explained by the supposition that integrity is an epistemic virtue, and an epistemic virtue of a practical sort. (shrink)

In “Conceptions of Care,” Tove Pettersen discusses and articulates select ways in which care can be comprehended. Several difficulties related to an altruistic understanding of care are examined before the author presents the case for a more favorable concept: mature care. Mature care is intended to take into account the interests of both parties to the caring relationship. This understanding of care facilitates the expression of the relational and reciprocal aspects of caring while emphasizing the equal worth of all involved. (...) Also attended to is the embeddedness of care in wider cultural and political contexts. (shrink)

In this article I wish to show how care ethics puts forward a fundamental critique on the ideal of independency in human life without thereby discounting autonomy as a moral value altogether. In care ethics, a relational account of autonomy is developed instead. Because care ethics is sometimes criticized in the literature as hopelessly vague and ambiguous, I shall begin by elaborating on how care ethics and its place in ethical theory can be understood. I shall stipulate a definition of (...) care ethics as a moral perspective or orientation from which ethical theorizing can take place. This will mean that care ethics is more a stance from which we can theorize ethically, than ready-made theory in itself. In conceiving care ethics in this way, it becomes possible to make clear that, for instance, a moral concept of autonomy is not abandoned, but instead is given a particular place and interpretation. In the final part of this article I will show how ‘relational autonomy’ can be applied fruitfully in the practice of psychiatric care. (shrink)

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)

If business requires ethical solutions that are viable in the liminal landscape between concepts and corporate office, then business ethics and corporate social responsibility should offer tools that can survive the trek, that flourish in this well-traveled, but often unarticulated, environment. Indeed, feminist ethics produces, accesses, and engages such tools. However, work in BE and CSR consistently conflates feminist ethics and feminine ethics and care ethics. I offer clarification and invoke the analytic power of three feminist ethicists 'in action' whose (...) investigations into the "grey zones" of harms; identity and representational conventions; and "asymmetrical reciprocity" harmonize with business ethics' requirements. (shrink)

This article develops an approach to ethical globalization based on a feminist, political ethic of care; this is achieved, in part, through a comparison with, and critique of, Thomas Pogge's World Poverty and Human Rights. In his book, Pogge makes the valid and important argument that the global economic order is currently organized such that developed countries have a huge advantage in terms of power and expertise, and that decisions are reached purely and exclusively through self-interest. Pogge uses an institutional (...) rights framework to argue that direct responsibility for global poverty and inequality lies with the citizens of developed countries, since suffering and death are caused by global economic arrangements designed and imposed by our governments. While this argument is certainly compelling, I have argued that it tells us little about the actual effects of globalization on the real people of the South - including women, children and the elderly. As a result, it can offer little in the way of real alternatives or policy prescriptions. As a moral orientation, a care ethic relies on a relational moral ontology, and leads us to consider different values in terms of human flourishing. Moreover, it pushes us to consider the normative implications of aspects of the global political economy which are usually not 'seen' at all, including the global distribution of care work and the corresponding patterns of gender and racial inequality, the underprovision of care and resources for caring work in both the developed and developing world, and the ways in which unpaid or low-paid caring work helps to sustain a cycle of exploitation and inequality on a global scale. (shrink)

Setting the terms of praise‐ and blameworthiness has long dominated philosophers’ discussions of responsibility. Analytic philosophy has most often looked to reason and the abstract relations between individual rational judgements and actions to advance the discourse on moral responsibility. Those whose capacity for reasoned judgement is impaired are deeply problematic. Is it proper to morally appraise ‘the mentally ill’? The philosopher T.M. Scanlon discusses moral responsibility as a precondition of moral appraisal and contends that it is not appropriate to appraise (...) a person as (morally) praise‐ or blameworthy if that person cannot be held responsible for the action(s) for which he is being praised or blamed. What are the conditions, then, under which one can properly be said to be responsible for one's actions? Can one hold ‘the mentally ill’ responsible for their actions? If not, can it in any way be reasonable to expect them to ‘take responsibility’ for their actions and/or characters? The expectation that ‘the mentally ill’ will attempt to control, i.e. take responsibility for their behaviour despite the fact of their mental illness is a pervasive feature of psychiatric approaches to the care and treatment of ‘the mentally ill’. It would seem that such treatment approaches are coherent only to the degree ‘the mentally ill’ can be considered responsible moral agents. This paper explores these issues with regard to that form of mental illness categorized as the personality disorders. It describes the morally and clinically relevant features of personality disorder, explains how they do not fit traditional analytic paradigms of ‘mental illness’ and elaborates the argument that persons with this category of mental illness are fully moral persons who are rightly subject to praise and blame. (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)

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.

Stories told about violence, trauma, and loss inform knowledge of post-conflict societies. Stories have a context which is part of the story-teller’s life narrative. Reasons for silences are varied. This article affirms the importance of telling and listening to stories and notes the significance of silences within transitional justice’s narratives. It does this in three ways. First, it outlines a critical narrative theory of transitional justice which confirms the importance of narrative agency in telling or withholding stories. Relatedly, it affirms (...) the importance of story-telling as a way to explain differentiated gender requirements within transitional justice processes. Second, it examines gendered differences in the ways that women are silenced by shame, choose silence to retain self-respect, use silence as a strategy of survival, or an agential act. Third, it argues that compassionate listening requires gender-sensitive responses that recognize the narrator’s sense of self and needs. (shrink)

Recently, moral deliberation within care institutions is gaining more attention in medical ethics. Ongoing dialogues about ethical issues are considered as a vehicle for quality improvement of health care practices. The rise of ethical conversation methods can be understood against the broader development within medical ethics in which interaction and dialogue are seen as alternatives for both theoretical or individual reflection on ethical questions. In other disciplines, intersubjectivity is also seen as a way to handle practical problems, and methodologies have (...) emerged to deal with dynamic processes of practice improvement. An example is responsive evaluation. In this article we investigate the relationship between moral deliberation and responsive evaluation, describe their common basis in dialogical ethics and pragmatic hermeneutics, and explore the relevance of both for improving the quality of care. The synergy between the approaches is illustrated by a case example in which both play a distinct and complementary role. It concerns the implementation of quality criteria for coercion in Dutch psychiatry. (shrink)

Much of feminist theory takes issue with traditional, liberal theories of consent and obligation. Though none have proposed abandoning obligation outright, there has been a general shift among feminists towards a responsibility paradigm. Responsibility models acknowledge given relationships and interdependence, and so posit responsibilities as given, regardless of whether they are voluntary. But in theories that take freedom as a principal value, a move from a socially unembedded voluntarism to socially embedded responsibility leaves something missing. Constructive accounts of and prescriptions (...) for freedom must consider the reality of social life; yet acknowledging that relations are given need not require subordinating the role of voluntarism and consent in most relationships. In this paper I offer a commitment framework that seeks to supplant obligation while also reconciling relational given-ness and voluntarism. I propose an analysis of commitment that takes relations as the starting point and then show how the concept can: 1. guide actions 2. account for responsibilities 3. enhance freedom and 4. avoid a large share of coercive forces that are believed as necessary for reinforcing obligation and responsibility fulfillment. (shrink)

Grounding Knowledge is written partly out of a sense of celebration and partly out of a sense of consternation. The celebration is generated by the feeling that epistemology has started to explore...

This paper comes out of a panel honoring the work of Anne Donchin (1940-2014), which took place at the 2016 Congress of the International Network on Feminist Approaches to Bioethics (FAB) in Edinburgh. My general aim is to highlight the contributions Anne made to feminist bioethics, and to feminist reproductive ethics in particular. My more specific aim, however, is to have a kind of conversation with Anne, through her work, about whether reproductive justice could demand insurance coverage for in vitro (...) fertilization. I quote liberally from Anne’s work for this purpose, but also to shower the reader with her words, reminding those of us who knew her well what a wonderful colleague she was. (shrink)

The priority that Tessman’s argument gives to phenomenological and neuropsychological explanations of moral requirements entails a fundamental shift in our understanding of these. Two central problems of normative theory come together in Tessman’s account. The first arises when an agent’s sense of requirement clashes with what a systematic theory prescribes. The second arises when neuropsychological accounts fail to fit the prescription. Tessman argues that no account successfully resolves moral dilemmas such that ought always implies can, and she argues that neuropsychology (...) explains our sense of impossible requirements. This explanation eliminates the role of a prescriptive theory in explaining an agent’s sense of requirement. (shrink)

Drawing from work in feminist moral philosophy, Tobin argues that the most common methodology used in practical ethics is a questionable methodology for addressing practical problems across diverse cultural contexts because the kind of impartiality it requires is neither feasible nor desirable. She then defends an alternative methodology for practical ethics in a global context and uses her proposed methodology to evaluate a problem that confronts many Sunni Muslim women around the world.

Contemporary approaches to the study of suicide tend to examine suicide as a medical or public health problem rather than a moral problem, avoiding the kinds of judgements that have historically characterised discussions of the phenomenon. But morality entails more than judgement about action or behaviour, and our understanding of suicide can be enhanced by attending to its cultural, social, and linguistic connotations. In this work, I offer a theoretical reconstruction of suicide as a form of moral experience that delineates (...) five distinct, yet interrelated domains of understanding: the temporal, the relational, the existential, the ontological, and the linguistic. Attention to each of these domains, I argue, not only enriches our understanding of the moral realm but also provides a heuristic for examining the moral traditions and practices that constitute contemporary understandings of suicide. (shrink)

In this methodological reflection, I describe the multidisciplinary hermeneutic process of philosophizing about teacher dissatisfaction. I discuss how philosophy serves as a starting point for interpretive work based on interviews with former teachers and readings of qualitative and quantitative research on teacher attrition and dissatisfaction. The result has been a project that enabled me to offer new descriptions of phenomena and to develop concepts that can be used to interpret the moral dimensions of teacher dissatisfaction. The fact that I return (...) to language and concepts as my research outcomes is why, despite my multidisciplinary approach, I continue to describe my work as philosophical. I suggest that philosophical enquiry pursued through empirical research has the potential to inform larger empirical studies, serve as a “sensitizing instrument” for empirical analysis, and to open discursive spaces where common understandings limit interpretive possibilities. (shrink)

The physical nearness, or proximity, inherent in the nurse–patient relationship has been central in the discipline as definitive of the nature of nursing and its moral ideals. Clearly, this nearness is in service to those in need of care. This proximity, however, is not unproblematic because it contributes to two of the most prolonged difficulties, both for individual nurses and the discipline of nursing — moral distress and moral ambiguity. In this paper we explore proximity using both a moral and (...) geographical lens and offer some insights regarding this practice reality. We examine the effect of proximity to patients on nurses’ moral responsiveness, particularly as it affects nurses’ moral distress. Proximity is paradoxical in this regard because, while it propels nurses to act, it can also propel nurses to ignore or abandon. Likewise, we argue that nursing's tendency to define itself in relation to the closeness of the nurse–patient relationship leads to problems of moral ambiguity. Our recommendations include moving others closer to the bedside and thus to the work of nursing in the literal and theoretical sense. (shrink)

Despite the fact that most of us value integrity, and despite the fact that we readily understand one another when we talk and argue about it, integrity remains elusive to understand. Considerable scholarly attention has left troubling disagreement on fundamental issues: Is integrity in fact a virtue? If it is, what is it a virtue of? Why exactly should we value integrity? What is the appropriate way to have concern for one’s own integrity? Is having integrity compatible with having significant (...) moral flaws? After an overview of common ‘data points’ or platitudes concerning integrity, this article outlines six distinct views of integrity that have been defended and draws attention to problems each has accommodating these data points. (shrink)

Emotions play an important part in moral life. Within clinical ethics support (CES), one should take into account the crucial role of emotions in moral cases in clinical practice. In this paper, we present an Aristotelian approach to emotions. We argue that CES can help participants deal with emotions by fostering a joint process of investigation of the role of emotions in a case. This investigation goes beyond empathy with and moral judgment of the emotions of the case presenter. In (...) a moral case deliberation, the participants are invited to place themselves in the position of the case presenter and to investigate their own emotions in the situation. It is about critically assessing the facts in the case that cause the emotion and the related (moral) thoughts that accompany the emotion. It is also about finding the right emotion in a given situation and finding the right balance in dealing with that emotion. These steps in the moral inquiry give rise to group learning. It is a process of becoming open towards the perspectives of others, leading to new insights into what is an appropriate emotion in the specific situation. We show how this approach works in moral case deliberation. A physician presents a situation in which he is faced with a pregnant woman who is about to deliver multiple extremely premature infants at the threshold of viability. The moral deliberation of the case and the emotions therein leads to the participants’ conclusion that “compassion” is a more adequate emotion than “sadness”. The emotion “sadness” is pointed towards the tragedy that is happening to the woman. The emotion “compassion” is pointed towards the woman; it combines consideration and professional responsibility. Through the shift towards compassion, participants experienced more creativity and freedom to deal with the sad situation and to support the woman. The paper ends with an analysis and reflection on the deliberation process. In the conclusion we argue for more attention to emotions in clinical ethics support and offer some directions for doing this in the right way. (shrink)

Both in the Netherlands and in Britain, practices of ‘life story work’ have emerged in nursing for persons with intellectual disabilities. The narrative approach to care and support may at the same time be considered as an attempt to compensate for the ‘disabled authorship’ of many persons with intellectual disabilities and as a sign of controversy with standard practices of diagnosis and treatment that tend to neglect the personal identities of both clients and care givers, their particular historical and relational (...) contexts and their spiritual needs. This paper argues that narrative ethics not only offers an appropriate moral framework for practices of life story work, but that these practices are a narrative ethics in action. Starting with an account of the concept of ‘life story work’ as it has been introduced in nursing practices in the field of intellectual disability, the paper explains its relationship with key characteristics of narrative ethics. The teleological dimension in narrative ethics and in practices of life story work sparks off a dialectic process of understanding of the client and self‐understanding of the care giver. It also invites a respect for life in its openness toward the future and presupposes an openness toward other possible versions of the life narrative. The phenomenological and hermeneutic‐interpretative methodologies in narrative ethics aim at a ‘sudden moment of intimacy’ in relationships of nurses and clients. The ‘epiphany’ of this essential moment of recognition, insight and engagement cannot, however, be brought about by methodology. (shrink)

This paper makes the case for a pluralist, contextualist view of nursing ethics. In defending this view, I briefly outline two current perspectives of nursing ethics – the Traditional View and the Theory View. I argue that the Traditional View, which casts nursing ethics as a subcategory of healthcare ethics, is problematic because it (1) fails to sufficiently acknowledge the unique nature of nursing practice; and (2) applies standard ethical frameworks such as principlism to moral problems which tend to alienate (...) or undermine nursing ethical concerns. Alternatively, the Theory View, which aims to build an independent and comprehensive theory of nursing ethics, is also found wanting because it (1) fails to sufficiently acknowledge the heterogeneous nature of nursing practices; (2) overemphasizes the differences and undervalues the similarities between nurses and other health professionals; and (3) assumes that one ethical framework can be meaningfully applied across diverse moral problems and contexts.My alternative, is to argue that nursing ethics inquiry should take a pluralist and critical stance towards available ethical frameworks and the negotiation of the ethical realm. On this view, the search for moral consensus or a unique ethical framework for nursing is replaced by the task of working strategically with multiple frameworks in order to expand the moral agency of nurses and empower them to positively engage with moral uncertainty as an inevitable feature of living a moral life. I conclude by indicating some of the implications that this has for the teaching of nursing ethics. (shrink)

Naturalized moral epistemology eschews practices of assuming to know a priori the nature of situations and experiences that require moral deliberation. Thus it promises to close a gap between formal ethical theories and circumstances where people need guidelines for action. Yet according experience so central a place in inquiry risks "naturalizing" it, treating it as incontestable, separating its moral and political dimensions. This essay discusses these issues with reference to Margaret Walker's Moral understandings.

This article briefly outlines some of the key problems with the way in which the moral realm has traditionally been understood and analysed. I propose two alternative views of what is morally interesting and applicable to nursing practice and I indicate that instability has its upsides. I begin with a moral tale – a 'Good Samaritan' story – which raises fairly usual questions about the nature of morality but also the more philosophically fundamental question about the relationship between subjectivity and (...) moral agency. I then consider this relationship from the perspectives of two twentieth century philosophers: Emmanuel Levinas and Michel Foucault. Levinas' basic point is that the experience of ethical subjectivity is made possible through others: the demand to respond to the existence of others is the basic social structure that precedes individual freedom. If Levinas posits intersubjectivity as a fundamental or primitive feature of the moral realm, Foucault poses an even more basic question: how have moral subjects and relations of obligation been constituted? The aim of ethical inquiry, for Foucault, is to describe the network of discourses, institutions, relations, and practices through which certain kinds of subjects are constituted and constitute themselves, e.g. as a kind of person who can act morally. Finally, I consider some recent research in philosophy of nursing which illustrates how Levinasian and/or Foucauldian perspectives can deepen understanding of nurses' moral practices, specifically, the work of Norwegian public health nurses, Canadian pediatric nurses, and Irish midwives. I suggest that in spite of the instability of morality in general and the particular ethical challenges that face nurses, there are grounds for hope and possible strategies for living in unstable times. (shrink)

In November 2004, the Swiss population voted to accept a law on research using human embryonic stem cells. In this paper, we use Switzerland as a case study of the shaping of the ostensibly ethical debate on the use of embryos in embryonic stem cell research by legal, political and social constraints. We describe how the national and international context affected the content and wording of the law. We discuss the consequences of the revised law's separation of stem cell research (...) from other forms of embryo research, its definitions of embryo and of spare embryos, and the introduction of donorship into the Swiss ethical debate on IVF. We focus on the exclusion of the potential embryo donors' voices and perspectives from the debate, and consider the effects of this exclusion on ethical discourse and the political process. (shrink)

ABSTRACT This article concentrates on the care for people who suffer from progressive dementia. Dementia has a great impact on a person’s well‐being as well as on his or her social environment. Dealing with dementia raises moral issues and challenges for participants, especially for family members. One of the moral issues in the care for people with dementia is centred on responsibilities; how do people conceive and determine their responsibilities towards one another? To investigate this issue we use the theoretical (...) perspective of Margaret Walker. She states that ideas about identity play a crucial role in patterns of normative expectations with regard to the distribution of responsibilities in daily practices of care. The results of this study show how the identity of a family‐member is put under pressure and changes during her loved one’s illness that leads to difficulties and misunderstandings concerning the issue of responsibility. These results offer an insight into the complexities of actual practices of responsibility and highlight the importance for those caring for people with dementia of attending carefully to how they see themselves and how they see other people involved (Who am I? Who do I want to be for the other?). Answers to such questions show what people expect from themselves and from one another, and how they, at any rate, are distributing responsibilities in a given situation. Professional caregivers should take into account that family members might have different ideas about who they are and consequently about what their responsibilities are. (shrink)

Different embodiments of technology permeate all layers of public and private domains in society. In the public domain of aged care, attention is increasingly focused on the use of socially assistive robots (SARs) supporting caregivers and older adults to guarantee that older adults receive care. The introduction of SARs in aged-care contexts is joint by intensive empirical and philosophical research. Although these efforts merit praise, current empirical and philosophical research are still too far separated. Strengthening the connection between these two (...) fields is crucial to have a full understanding of the ethical impact of these technological artefacts. To bridge this gap, we propose a philosophical-ethical framework for SAR use, one that is grounded in the dialogue between empirical-ethical knowledge about and philosophical-ethical reflection on SAR use. We highlight the importance of considering the intuitions of older adults and their caregivers in this framework. Grounding philosophical-ethical reflection in these intuitions opens the ethics of SAR use in aged care to its own socio-historical contextualisation. Referring to the work of Margaret Urban Walker, Joan Tronto and Andrew Feenberg, it is argued that this socio-historical contextualisation of the ethics of SAR use already has strong philosophical underpinnings. Moreover, this contextualisation enables us to formulate a rudimentary decision-making process about SAR use in aged care which rests on three pillars: (1) stakeholders’ intuitions about SAR use as sources of knowledge; (2) interpretative dialogues as democratic spaces to discuss the ethics of SAR use; (3) the concretisation of ethics in SAR use. (shrink)

Social scientists often lament the fact that philosophically trained ethicists pay limited attention to the insights they generate. This paper presents an overview of tendencies in sociological and anthropological studies of morality, ethics and bioethics, and suggests that a lack in philosophical interest might be related to a tendency among social scientists to employ either a deficit model (social science perspectives accommodate the sense of context that philosophical ethics lacks), a replacement model (social scientists have finally found the “right way” (...) of doing ethics), or a dismissal model (ethics should be abandoned all together as a misconstrued veil of power). Increased awareness of differences in styles of reasoning and objects of research interest might help to overcome the hostility, and an anthropological project is presented as an invitation to a dialogue informed by awareness of such differences. (shrink)

In the social sciences, the iconic definition of privilege is that of unearned advantage. Consequently, professionals in the social services may devote less attention to the examination of their own professional privilege since it has been earned. This article addresses ethical concerns about the earned privilege that accrues to professionals in the caring fields and the potential effects on service users. This paper will focus particularly on some of the pedagogical dimensions. The inherent paradox in socializing students into professional roles, (...) which enhance privilege, while attempting to reduce the power differentials with service users, requires attention by teachers. How one might lessen the hierarchy that is created between the helper and service user as a result of that privilege will be explored. The paper will detail professional privilege and both constructive and problematic impacts on the helping relationship. The ‘uneven’ advantage of being able to set the standards of health and morality are also discussed. In the process, ethical trespass may result. We will explore this concept and its implications. Because, privilege contributes to social stratification between helpers and recipients, the final segment offers one educational strategy that can be used to potentially lessen the ‘we–they’ duality. (shrink)

For nursing, the idea of bearing witness is of utmost importance. Nurses are present with persons who experience changes in their health and quality of life and who live intense and profound moments of struggling, questioning, and finding meaning. Nurses are also with persons from moment to moment as their lives unfold, and when joy, serenity, contentment, vulnerability, sadness, fear, and suffering are experienced. In this paper, it is proposed that bearing witness is a moral way of engaging in the (...) nurse–person relationship. Based on Levinas’s ethics of the face, it is claimed that bearing witness is enacting one’s moral responsibility, which arises from the encounter with the other. Drawing on Parse’s human becoming theory, ways of witnessing and bearing witness are defined and discussed. It is suggested that bearing witness is a human‐to‐human way of being‐relating, a mode of human coexistence. Bearing witness is being present and attentive to the truth of another’s experiences. Moreover, in this paper, the ways nurses enact their moral agency and bear witness to others placed in their care, or turn away, are explored. Nurses’ moral agency is located in the constrained moral space of contemporary health care. Hence, the creation of a moral space, which allows nurses to enact their moral responsibility of bearing witness to other persons’ experiences of health and quality of life, is called for. In doing so, it is suggested that the act of bearing witness needs a specific nursing knowledge base and a recognition that being present and being with another is a valuable nursing practice that is utterly meaningful for persons who are living through difficult times. (shrink)

How ethics in human services is a political activity, shaping social relationships, is explored through the examination of two opposing discourses, a principle-based and a situated/relational narrative. Factors such as neo-liberalism, managerialism, and the risk-aversive society give a context for the reasons that the principle-based discourse has been the predominant influence, and what interests are served by this trope taking center stage. A delineation and critique of both perspectives are provided, including an explanation of the epistemological underpinnings of these discourses. (...) The piece ends with what needs to be done to strengthen ethics. (shrink)

The theory and practise of care is defined and enacted differently in different national as well as cultural contexts, illuminating how differently constructed the personal and societal structures in Europe are. A common trait is however that care work paid or non-paid, private or public is identified with women. To navigate in the landscape of care and ethics requires taking into account the constitutive relation between one’s identity, embodiment and position. The author suggests conceiving care as an existential condition of (...) life demanded from all human beings. This will free care from the identification with women and pave a way towards a more gender equal and just society with less gender segregation in the labour market and at the arena of education. (shrink)

This dissertation addresses the following questions: How should epistemologists conceptualize testimony? What do people use testimony to do? And why does ‘what people do’ with testimony matter epistemically? In response to these questions I both define and characterize testimony. While doing so I argue for the following answers, given here very briefly: What do people do when they testify? They tell each other things and avow that those things are true, offering their statements to others as reasons to believe. More (...) importantly, they interact with each other in order to negotiate about significance. Why do these activities matter epistemically? Because by engaging in them people generate understanding, as well as knowledge, that no one involved may have had prior to negotiation. Not only that, but they generate collective hermeneutic resources—conceptual tools with which to interpret and understand. In so doing, they not only learn, they create significance and (re)construct social worlds, living together as epistemic, moral, and political agents. So, how should epistemologists conceptualize testimony? They should treat it as a particular speech act that most often occurs as part of a testimonial exchange—an interactive, interpretive, dialogical activity that people use in order to negotiate about significance and generate understanding. This characterization of testimony is an important contribution because it: reveals some of the distinctively social aspects of testimonial knowledge and understanding; suggests better answers to epistemic questions about testimony than those based on typical characterizations in the literature; leads discussion on the topic in a number of new directions; and it lays a foundation for an ethics of testimony that cannot be separated from epistemic concerns. Neither can those concerns be separated from social, moral, and political considerations. The position thus pushes epistemologists to investigate the intertwining of epistemic, moral, and political agency. (shrink)

Margaret Walker's Moral Understandings offers an “expressive-collaborative,” culturally situated, practice—based picture of morality, critical of a “theoretical-juridical” picture in most prefeminist moral philosophy since Henry Sidgwick. This essay compares her approach to ethics with that of John Rawls, another exemplar of the “theoretical-juridical” model, and asks how Walker's approach would apply to several ethical issues, including interaction with animals, social reform and revolution, and basic human rights.

In this paper we propose a theoretical framework for analysing the history and function of ethics as a form of regulation. Ethics in the form of codes, rules and declarations, constitutes regulatory policies, and we wish to suggest analysing such policies from an organizational perspective. In many instances ethics policies are reactions to particular events involving harm of patients or research participants. As such they seem to come forward as solutions to specific problems. However, not all such events that instigate (...) the making of new policies, and policies often have other effects and are used for other purposes than what we might expect from the events preceding them: when ethics takes on the form of policy making, the relationship between problems and solutions is more complex. We suggest that an organizational perspective on ethics codes, rules and declarations can deliver a relevant framework for future studies of the implications of wanting to address ethical problems through policy making. (shrink)