In this dissertation I examine the topics of ethics, religion, and their relationship in the work of Charles Taylor. I take Taylor's attempt to confront modern disenchantment by seeking a kind of re-enchantment as my guiding thread. Seeking re-enchantment means, first of all, defending an `engaged realist' account of strong evaluation, i.e., qualitative distinctions of value that are seen as normative for our desires. Secondly, it means overcoming self-enclosure and achieving self-transcendence, which I argue should be understood in terms of (...) transcending a `lower' mode of selfhood for a `higher' one in concern for `strong goods'. One of the main issues that Taylor raises is whether re-enchantment requires theism for its full adequacy. He advances - often as `hunches' - controversial claims regarding the significance of theism (1) for defending strong evaluative realism and (2) for motivating an ethic of universal human concern. I seek to fill out his hunches in terms of a theistic teleological perspective that is centered on the `telos of communion'. I argue that such a view is important for overcoming the problem of what Bernard Williams calls the `radical contingency' of ethical beliefs, which seems to undermine their normative authority. However, I argue that if a non-theistic view of cosmic purpose (e.g., Thomas Nagel's view) can be regarded as a viable option, then it could also help to address this problem and support a kind of re-enchantment. Taylor also advances the controversial view that (3) there is an ineradicable draw to `transcendence' in human life in connection to the quest for the meaning of life. Here he opposes certain mainstream theories of secularization that see it as a process involving the ineluctable fading away of the relevance of religion. I seek to fill out and defend Taylor's view in this matter. Besides providing a reading of Taylor's work as a whole and advancing further some of the issues he raises, I also examine his general evaluative framework based on his account of strong evaluation. In doing so I show how he provides a distinct and important perspective among contemporary moral philosophers. (shrink)

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)

I argue for the merits of studying historical moral revolutions to inform moral and political philosophy. Such a research program is not merely of empirical, historical interest but has normative implications. To explain why, I situate the proposal in the tradition of naturalized epistemology. As Alison M. Jaggar and other scholars have argued, a naturalistic approach is characteristic of much feminist philosophy. Accordingly, I argue that the study of moral revolutions would be especially fruitful for feminist moral and political philosophers.

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)

This paper provides a new argument for the relevance of empirical research to moral and political philosophy and a novel defense of the positive program in experimental philosophy. The argument centers on the idea that normative concepts used in moral and political philosophy can be evaluated in terms of their fruitfulness in solving practical problems. Empirical research conducted with an eye to the practical problems that are relevant to particular concepts can provide evidence of their fruitfulness along a number of (...) dimensions. An upshot of the argument is that philosophers should not only engage with but must also be involved in conducting experimental studies that examine the practical roles that normative concepts can play. Rather than just clearing the way for philosophical work to be done, the argument has the further implication that empirical research will be required to advance at least some important debates in moral and political philosophy. (shrink)

It may be the case that the most challenging moral problem of the twenty‐first century will be the relationship between the individual moral agent and the practices and institutions in which the moral agent is embedded. In this paper, we continue the efforts that one of us, Joan Liaschenko, first called for in 1993, that of using feminist ethics as a lens for viewing the relationship between individual nurses as moral agents and the highly complex institutions in which they do (...) the work of nursing. Feminist ethics, with its emphasis on the inextricable relationship between ethics and politics, provides a useful lens to understand the work of nurses in context. Using Margaret Urban Walker's and Hilde Lindemann's concepts of identity, relationships, values, and moral agency, we argue that health care institutions can be moral communities and profoundly affect the work and identity and, therefore, the moral agency of all who work within those structures, including nurses. Nurses are not only shaped by these organizations but also have the power to shape them. Because moral agency is intimately connected to one's identity, moral identity work is essential for nurses to exercise their moral agency and to foster moral community in health care organizations. We first provide a brief history of nursing's morally problematic relationship with institutions and examine the impact institutional master narratives and corporatism exert today on nurses’ moral identities and agency. We close by emphasizing the significance of ongoing dialogue in creating and sustaining moral communities, repairing moral identities, and strengthening moral agency. (shrink)

This positional paper explores the role of personal networks (family and friends) in caring for people with mental health problems. Since the eighties, major changes have been made in the organization and focus of professional mental healthcare. Correspondingly, new expectations and changes in the division of care responsibilities between people with mental health problems, their personal networks and their professional care providers were created. In this paper, I investigate how the transition in mental healthcare changed the allocation of care responsibilities (...) between personal networks, people with mental health problems and professional caregivers. I will consider why care responsibilities of personal networks have been taken for granted in these processes, and discuss whether personal networks should have a more prominent voice in the assignment of care responsibilities, and how this can be done. A theoretical framework of feminist care ethics inspired by scholars such as Margaret Urban Walker, Joan Tronto and Hilde Lindemann is used to reflect on the need for social inclusion. (shrink)

Despite the amount of attention that activists, educators, psychologists, and the media place on bullying and bullying prevention, there has been no sustained philosophical reflection on bullying, nor has there been a feminist analysis of the growing literature on bullying. This essay seeks to satisfy those two needs. The first section is a broad introduction to the literature on bullying. I define bullying and distinguish it from teasing, sassing, roughhousing, and other more benign interactions. I also outline two common solutions (...) to bullying: zero-tolerance policies and “ecological” interventions. The second section uses feminist ethics of care to analyze the effectiveness of each approach. I argue that ecological approaches to bullying are preferable to zero-tolerance policies because they operate on a relational model of the self and identity-formation. I elaborate a notion of affirmation as the mechanism that stabilizes and solidifies our sense of self across time. I then use affirmation to analyze three things: why people bully one another, the specific harm inflicted by bullying, and why ecological approaches are more effective in reducing bullying. The third section uses my account of affirmation to critique the scientism and troublingly gendered assumptions that underlie much of the work on bullying. (shrink)

It is time for the noon conference. Your job is to impart a career-changing experience in ethics to a group of students and interns gathered from four different schools with varying curriculums in ethics. They have just finished 1½ h of didactic sessions and lunch. One third of them were on call last night. Your first job is to keep them awake. The authors argue that this “tragic case” approach to ethics education is of limited value because it limits understanding (...) of moral problems to dilemmas; negates the moral agency of the student; encourages solutions that are merely intellectual; and suggests that ethical encounters are a matter for experts. The authors propose an alternative that focuses on three issues: the provider-patient relationship, the relationships between providers in the everyday world of health work and, the social position of healthcare providers in society. In this approach, teachers are not experts but more like guides on a journey who help students to learn that much of ethical practice comprises living through difficult situations of caring for vulnerable others and who help students to navigate some of these difficulties. (shrink)

Background: Over the last decade, new healthcare policies are transforming healthcare practices towards independent living and self-care of older people and people with a chronic disease or disability within the community. For professional caregivers in home care, such as nurses, this requires a shift from a caring attitude towards the promotion of patient autonomy. Aim: To explore how nurses in home care deal with the transformation towards fostering patient autonomy and self-care. Research design and context: A case study was conducted (...) in a professional development course for home care nurses, including participant observations and focus groups. The theoretical notion of ‘relational agency’ and the moral concept of ‘practices of responsibility’ were used to conduct a narrative analysis on the nurses’ stories about autonomy. Participants: Eight nurses, two coaches and two university lecturers who participated in the learning circle. Ethical considerations: Informed consent was sought at the start of the course and again, at specific moments during the course of the learning circle. Findings: Three main themes were found that expressed the moral demands experienced and negotiated by the nurses: adapting to the person, activating patients’ strengths and collaboration with patients and informal caregivers. Discussion: On a policy and organisational level, the moral discourse on patient autonomy gets intertwined with the instrumental discourse on healthcare budget savings. This is manifested in the ambiguities the nurses face in fostering patient autonomy in their daily home care practice. To support nurses, critical thinking, moral sensitivity and trans-professional working should be part of their professional development. Conclusion: The turn towards autonomy in healthcare raises moral questions about responsibilities for care. Promoting patient autonomy should be a collaborative endeavour and deliberation of patients, professional and informal caregivers together. (shrink)

We cannot rethink the ethical and political dimensions of memory—especially its role in constituting persons and identities—without rethinking the nature of memory itself. I first describe a traditional epistemological view of memory, according to which memory is a faculty for preserving knowledge of the past, and then juxtapose a relational theory of memory developed by Sue Campbell. The relational theory is represented in terms of a distinction between actions and achievements; this distinction enables us to both clarify and defend the (...) shift from an epistemological to a political conception of memory. On the resulting view, accuracy, not truth, is the appropriate norm for evaluating memory, and remembering is no longer conceived as an interior process. In the penultimate section I confront an objection to a relational theory of memory—and to relational theories of cognition generally—and suggest a strategy of response. (shrink)

In this paper, for the benefit of reflection processes in clinical and in local, regional, and national priority-setting, we aim to develop an ethical theoretical framework that includes both ethical principles and medium-range narratives. We present our suggestion in the particular case of having to choose between treatment interventions for attention deficit hyperactivity disorder (ADHD) and treatment interventions for other conditions or diseases, under circumstances of scarcity. In order to arrive at our model, we compare two distinct ethical approaches: a (...) generalist (principles) approach and a particularist (narratives) approach. Our focus is on Sweden, because in Sweden prioritization in healthcare is uniquely governmentally regulated by the “ethics platform.” We will present a (fictional) scenario to analyse the strengths and weaknesses of the generalist principled perspective of the ethics platform and the particularist perspective of narrative ethics. We will suggest an alternative (moderately particularist) approach to prioritization, which we dub a “principles plus medium-range narratives” approach. Notwithstanding the undeniably central role of principles in distributive justice, we claim that medium-range narratives concerning individuals or groups who stand to benefit or lose from ADHD prioritization practices should also be read or listened to and taken into account at all levels of priority-setting. These narratives are expected to ethically optimize clinical priority-setting, as well as that undertaken at local, regional, and national levels. (shrink)

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)

Participation of older people in designing and improving the care and services provided in residential care settings is limited. Traditional forms of democratic representation, such as client councils, and consumer models are management-driven. An alternative way of involving older people in the decisions over their lives, grounded in notions of care ethics and deliberative democracy, was explored by action research. In line with this tradition older people engage in collective action to enhance the control over their lives and those of (...) others. In this article the theoretical background of altruistic action is presented and illustrated by a case example of a group of older women who changed the food policies within their residential home. Altruistic action is the joint and coordinated action by a group of clients based on their agenda. Such action is given in by a shared dissatisfaction and search for connections. Altruistic action may enhance the sense of self, belonging and ownership, and create a transformative movement enhancing the wellbeing and community life in residential settings. (shrink)

Background:The decision whether to initiate cardiopulmonary resuscitation may sometimes be ethically complex. While studies have addressed some of these issues, along with the role of nurses in cardiopulmonary resuscitation, most have not considered the importance of nurses acting as advocates for their patients with respect to cardiopulmonary resuscitation.Research objective:To explore what the nurse’s advocacy role is in cardiopulmonary resuscitation from the perspective of patients, relatives, and health professionals in the Basque Country (Spain).Research design:An exploratory critical qualitative study was conducted from (...) October 2015 to March 2016. Thematic analysis was used to analyse the data.Participants:Four discussion groups were held: one with patients and relatives (n = 8), two with nurses (n = 7 and n = 6, respectively), and one with physicians (n = 5).Ethical considerations:Approval was obtained from the Basque Country Clinical Research Ethics Committee.Findings:Three significant themes were identified: (a) accompanying patients during end of life in a context of medical dominance, (b) maintaining the pact of silence, and (c) yielding to legal uncertainty and concerns.Discussion:The values and beliefs of the actors involved, as well as pre-established social and institutional rules reduced nurses’ advocacy to that of intermediaries between the physician and the family within the hospital environment. On the contrary, in primary health care, nurses participated more actively within the interdisciplinary team.Conclusion:This study provides key information for the improvement and empowerment for ethical nursing practice in a cardiac arrest, and provides the perspective of patients and relatives, nurses and physicians. (shrink)

ABSTRACTGiven the existing inequities in climate change, any proposed climate engineering strategy to solve the climate problem must meet a high threshold for justice. In contrast to an overly thin paradigm for justice that demands only a science-based assessment of potential temperature-related benefits and harms, we argue for the importance of attention to recognitional justice. Recognitional justice, we go on to claim, calls for a different type of assessment tool. Such an assessment would pay attention to neglected considerations such as (...) relationships, context, power, vulnerability, narrative, and affect. Here we develop a care-ethics related tool for assessing the justice of climate engineering with stratospheric aerosols, and suggest that qualitative social science methods may be required for its effective application. We illustrate the use of this tool with a case study involving interviews about stratospheric aerosol injection conducted in Kenya, the Solomon Islands... (shrink)

In this paper, we argue that ‘good care’ in residential nursing homes is enacted through different care practices that are either inspired by a ‘professional logic of care’ that aims for justice and non-maleficence in the professional treatment of residents, or by a ‘relational logic of care’, which attends to the relational quality and the meaning of interpersonal connectedness in people’s lives. Rather than favoring one care logic over the other, this paper indicates how important aspects of care are constantly (...) negotiated between different care practices. Based on the intricate everyday negotiations observed during an ethnographic field study at an elderly nursing home in Germany, the paper puts forth the argument that care is always a matter of tinkering with different, sometimes competing ‘goods’. This tinkering process, which unfolds through ‘intuitive deliberation’, ‘situated assessment’ and ‘affective juggling’ is then theorized along the conceptualization of a ‘practical ethics of care’: an ethics which makes no a priori judgments of what may be considered as good or bad care, but instead calls for momentary judgments that are pliable across changing situations. (shrink)

In an age of professionalization and specialization, the practice of clinical ethics is facing an identity crisis. Are clinical ethicists moral experts, ethics experts, or merely quasi-lawyers giving legal advice? Are they extensions of the hospital, always working to advance the hospital’s interests? Or is there another option? Since 1998, when the American Society for Bioethics and Humanities first issued its Core Competencies for Healthcare Ethics Consultation, there has been debate about the role of standardization and proceduralism in clinical ethics (...) consultation. Now, as ASBH continues to move forward with its credentialing program, proceduralism in clinical ethics must be critically examined. In this paper, I argue that the proceduralist approach to clinical ethics consultation, as espoused by the ASBH’s call for credentialing, creates a demeaning experience for all parties involved and precludes goods internal to the practice of clinical ethics consultation from being actualized. As a practice embedded in medicine and in institutions such as the hospital, clinical ethics consultation must define and examine its own goods in order to bring about more than a sterile, law-like solution to difficult moral quandaries, as these sterile solutions leave patients, families, and providers unsatisfied, abandoned, and disappointed. Thus, in an effort to push back against this proceduralism in clinical ethics consultation, I will offer a preliminary exploration of what these goods might be. (shrink)

This paper focuses on the reasons for, and consequences of, expanding our notions of human embodiment to virtual worlds. Increasingly, it is within virtual environments that we seek to extend, and enhance, who we are. Yet, philosophical worries persist about what sorts of selves count as moral agents, and the extent to which self-enhancements affect personal identity and agency. This paper critiques and expands the discourse on embodiment and personal identity by locating it within the virtual environments of Second Life, (...) challenging the prevailing limitations of what counts as identity-constituting embodiment. I argue that more inclusive notions of embodiment make possible a deeper understanding of its moral and epistemic force that constitutes and locates our identities in a universe of shared moral understandings. Thus, by including enhanced virtual embodiments alongside the non-virtual, not only do we expand our ideas of what it might mean to be embodied, but we also deepen our moral vocabularies of the self. (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 two observations regarding nursing ethics research in the past two decades, namely, the dominant influence of both the empirical methods and the principles approach, we present the cornerstones of a foundational argument-based nursing ethics framework. First, we briefly outline the general philosophical–ethical background from which we develop our framework. This is based on three aspects: lived experience, interpretative dialogue, and normative standard. Against this background, we identify and explore three key concepts—vulnerability, care, and dignity—that must be observed in (...) an ethical approach to nursing. Based on these concepts, we argue that the ethical essence of nursing is the provision of care in response to the vulnerability of a human being in order to maintain, protect, and promote his or her dignity as much as possible. (shrink)

A decision was made at the UNFCCC, COP-18 meeting in Doha in 2012 to create a work programme on loss and damage. Part of this programme was to include the production of a technical paper to enhance the general understanding of non-economic losses from climate change. The following article looks carefully at that paper in order to discover whether it provides an adequate conceptual understanding of non-economic losses. Several shortcomings of the paper’s conceptualization of these losses are identified. An alternative (...) ethical framework with methods better suited for capturing a fuller range of non-economic losses is considered. This framework is likely to be most useful if used prospectively for the purpose of devising better adaptation policies to head off potential future losses rather than if used retrospectively for quantifying losses that have already occurred for the purposes of providing compensation. (shrink)

Frailty has recently become a medical category with physical symptoms that define its diagnosis. This paper uses the resources of an ethics of care to analyze the relationship between frailty and fragility or vulnerability, the positives of frailty becoming a diagnostic category, and some problematic aspects of the same process.

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)

Allies are extremely important to LGBT rights. Though we don’t often enumerate what tasks we expect allies to do, a fairly common conception is that allies “support the LGBT community.” In the first section I introduce three difficulties for this position that collectively suggest it is conceptually insufficient. I then develop a positive account by starting with whom allies are allied to instead of what allies are supposed to do. We might obviously say here that allies are allied to the (...) LGBT community, but I will argue that this community is better thought of as a loose coalition because there are often intersectional issues and conflicting interests that challenge any unified sense of community. I argue that people typically become allies because a friend or family member is experiencing some kind of specific harm; if that harm or discrimination is what causally explains why people become allies, then allies are required to do more than we commonly think. Although allies have a prima facie obligation to honor what members of a subcommunity identify as a harm, this obligation is defeasible if an ally believes fulfilling the obligation would be harmful. I conclude by looking at how we can understand what an ally is in terms of a larger discussion about moral obligations. If people already have these obligations, whatever they are, because morality requires it, then the status “ally” is redundant. I conclude by showing that certain social statuses can not only transform or reprioritize prior moral commitments, but can also introduce new kinds of responsibility that an agent did not have before. (shrink)

Moral constructions of suicide are deliberately avoided in contemporary suicidology, yet morality persists, little or imperfectly acknowledged, in its practices and in the policies, discourses, and instruments that it underpins. This study used narrative methodologies to examine the normative force of suicidology and its implications for persons who had engaged in an act of nonfatal suicidal behavior. I interviewed a convenience sample of twelve persons from two inner–urban community mental health centers who were receiving crisis and case management services after (...) a recent act of nonfatal suicidal behavior. Interviews focused on events leading up to and after participants’ suicidal behavior; the responses their suicidal behavior generated in others, including family, friends, and the health professionals caring for them; and cultural views of suicide more broadly. Analysis of these interviews revealed that, although participants’ narratives were broadly consistent with a number of recognizable, canonical story formats common to our cultural repertoire of stories of suicide, they also revealed important tensions, divisions, conflicts, and challenges to contemporary suicidological discourse and practice. Despite evidence to suggest that biomedical understandings of suicide provided some therapeutic benefit to participants, they did not address important social and moral dimensions of human life or explore their connection to suicidal behavior—aspects of the suicidal event that were critical to its causation and to its retelling and “resolution.” The results of this study provide important insights into the moral features of suicidal behavior, the moral and ethical implications of suicide research, and the limitations of moral and ethical discourse in suicidology. (shrink)

Internationally, there is an on-going dialogue about how to professionalize ethics consultation services . Despite these efforts, one aspect of ECS-competence that has received scant attention is the liability of failing to adequately capture all of the relevant moral considerations in an ethics conflict. This failure carries a high price for the least powerful stakeholders in the dispute. When an ECS does not possess a sophisticated dexterity at translating what stakeholders say in a conflict into ethical concepts or principles, it (...) runs the risk of naming one side's claims as morally legitimate and decrying the other's as merely self-serving. The result of this failure is that one side in a dispute is granted significantly more moral weight and authority than the other. The remedy to this problem is that ECSs learn how to expand the diagnostic moral lens they employ in clinical ethics conflicts. (shrink)

This paper describes the approach of empirical ethics, a form of ethics that integrates non-positivist ethnographic empirical research and philosophy. Empirical ethics as it is discussed here builds on the ‘empirical turn’ in epistemology. It radicalizes the relational approach that care ethics introduced to think about care between people by drawing in relations between people and technologies as things people relate to. Empirical ethics studies care practices by analysing their intra-normativity, or the ways of living together the actors within these (...) practices strive for or bring about as good practices. Different from care ethics, what care is and if it is good is not defined beforehand. A care practice may be contested by comparing it to alternative practices with different notions of good care. By contrasting practices as different ways of living together that are normatively oriented, suggestions for the best possible care may be argued for. Whether these suggestions will actually be put to practice is, however, again a relational question; new actors need to re-localize suggestions, to make them work in new practices and fit them in with local intra-normativities with their particular routines, material infrastructures, know-how and strivings. (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)

Notwithstanding the fact that care ethics has received increased attention, it has also faced much criticism. One of the focal points of critics is the normativity of care. Only when the objective normative basis of care is sufficiently clarified can care practices be evaluated and optimized from an ethical point of view. We emphasize that two levels of normativity can be identified: the context level and the foundational anthropology level. The personalist approach to care ethics is normatively stronger, at least (...) on one level, namely the foundational anthropology level. This personalist approach to care ethics indicates in which direction action must be taken so that human action may be considered ethically sound. (shrink)

Medical futility is often defined as providing inappropriate treatments that will not improve disease prognosis, alleviate physiological symptoms, or prolong survival. This understanding of medical futility is problematic because it rests on the final outcomes of procedures that are narrow and medically defined. In this article, Walker's `expressivecollaborative' model of morality is used to examine how certain critical care interventions that are considered futile actually have broader social functions surrounding death and dying. By examining cardiopulmonary resuscitation and life-sustaining intensive care (...) measures as moral practices, we show how so-called futile interventions offer ritualistic benefit to patients, families, and health care providers, helping to facilitate the process of dying. This work offers a new perspective on the ethical debate concerning medical futility and provides a means to explore how the social value of treatments may be as important in determining futility as medical scientific criteria. (shrink)

Ten nurses at a university hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of nurses and physicians about being in ethically difficult situations in surgical units. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation. The main theme in the narratives was being close to and moved by the suffering of patients and relatives. The nurses' responsibility for patients and relatives was expressed as a commitment to act, and they needed to ask themselves (...) whether their responsibility had been fulfilled, that nothing had been left undone, overlooked or neglected, before they could leave the unit. When there was confirmation by the patients, relatives, colleagues and themselves that the needs of patients and relatives had been attended to in a morally and professionally satisfying manner, this increased the nurses' confidence and satisfaction in their work, and their strength to live with the burden of being in ethically difficult situations. (shrink)

In this paper I engage interdisciplinary conversation on inaction as the dominant response to climate change, and develop an analysis of the specific phenomenon of complacency through a critical-feminist lens. I suggest that Chris Cuomo's discussion of the “insufficiency” problem and Susan Sherwin's call for a “public ethics” jointly point toward particularly promising harm-reduction strategies. I draw upon and extend their work by arguing that extant philosophical accounts of complacency are inadequate to the task of sorting out what it means (...) to be complacent on climate change. I offer a sketch for an alternative account, which I take to be a start in the direction of mapping out a diverse array of “motivational vices” that need to be named, grappled with, and remedied. (shrink)

Health care professionals’ and trainees’ conceptions of their responsibilities to patients can change over time for a number of reasons: evolving career goals, desires to serve different patient populations, and changing family obligations, for example. Some changes in conceptions of responsibility are healthy, but others express moral damage. Clinicians’ changes in their conceptions of what they are responsible for express moral damage when their responses to others express a meager, rather than robust, sense of what they owe others. At least (...) two important expressions of moral damage in the context of health care are these: callousness and divestiture. Callousness describes the poor condition of a clinician's capacity for moral perception; when her capacity to accurately appreciate features of moral relevance that configure others’ needs, vulnerabilities, and desert of care diminishes, such that she fails to respond with care to those for whom she has duties to care, she is callous. Callousness has been explored in detail elsewhere,1 and so the focus of this paper is divestiture. A clinician divests when the value of responding with care to others becomes less centrally and importantly constitutive of his personal and professional identity. Divestiture has important consequences for patients and health professions education, which I will explore here. (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)

: Are social movements responsible for their unfinished agendas? Feminist successes in opening the professions to women paved the way for the emergence of the upper middle-class two-career household. These households sometimes hire domestic servants to accomplish their child care work. If, as I shall argue, this practice is unjust and furthers social inequality, then it poses a moral problem for any feminist commitment to social justice.

Morally unequal treatment of different nonhuman species, like pigs and dogs, can seem troublingly inconsistent. A position Todd May calls moral individualism and relationalism appears to justify the moral discomfit attending such species-differentiated treatment. Yet some of its basic assumptions are challenged by a philosophical style Roger Scruton called narrative philosophy. Expanding upon Christopher Cordner’s discussion of narrative philosophy, this paper develops a narrative-style philosophical critique of Todd May’s moral individualism and relationalism, especially its reductionist understanding of moral reasons, consistency, (...) and relevance. Such criticism opens up the possibility that the unequal treatment of nonhuman species like pigs and dogs is perfectly consistent and even justified. However, the paper then presents a narrative-style argument that such species-differentiated treatment may be morally inconsistent and unjustified after all. (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.

In this paper I discuss a framework for the analysis of media discourse – the ‘analytics of mediation’ – that takes into account the embeddedness of media texts both in technological artefacts and in social relationships and, hence, seeks to integrate the multi-modal with the critical analysis of discourse. On the methodological level, the analytics of mediation applies a multi-modal discourse analysis onto media texts in order to study their visual and linguistic properties: camera/visual; graphic/pictorial or aural/linguistic. On the social (...) theory level, the analytics of mediation addresses critical concerns on the ethical and political role of television and other media in our ‘global village’. Can television foster a cosmopolitan consciousness or does its ‘fake proximity’ alienate the spectator from the rest of the world? Can we talk about the media as agents of global citizenship or do the media lead to compassion fatigue – a Western denial of humanitarian problems? I illustrate such questions by drawing on one concrete example of television news. (shrink)

This paper attempts to make more explicit the relationship between narrativity and feminist care ethics. The central concern is the way in which narrativity carries the semantic load that some accounts of feminist care ethics imply but leave hanging. In so doing, some feminist theorists of care-based ethics then undervalue the major contribution that narrativity provides to care ethics: it carries the semantic load that is essential to the best care. In this article, I defend the narrative as the central (...) medium though which we make sense of and communicate our lives and their attendant hopes and cares. More than just working with the narrative of the cared-for, caring is about investing in the narrative of the cared-for in order to meet the needs of this cared-for and how this narrative might turn out. I will further demonstrate how the attitude of caring or investing in a narrative would amount to what Gabriel Marcel has described as the attitude of disponibilité. (shrink)

The current state of global poverty presents citizens in the Global North with a moral crisis: Do we care? In this essay, I examine two competing moral accounts of why those in the North should or should not give care (in the form of charity) to impoverished peoples in the Global South. Nineteen years ago feminist philosopher Nel Noddings wrote in Caring that “we are not obliged to care for starving children in Africa” (1986, p. 86). Noddings’s work belongs to (...) the arena of care ethics - the feminist philosophical view that morality is about responding to, caring for, and preventing harm to those particular people to whom one has emotional attachments. By contrast, Peter Singer’s recent work, One World, advances an impartialist view of morality, which demands that we dispassionately dispense aid to the most needy (2002, p.154). Thus this question needs answering: am I obliged to give care to desperately poor strangers, and if so, which moral framework (Singer's impartialism, or feminism’s care ethics) gives the best account of that obligation? I argue that as an American feminist I should care for Africans with whom I will never have a personal relationship. However, this obligation can be generated without relying on the impartialist understanding of morality. (shrink)