BackgroundEthical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that (...) promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.MethodsIn this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.ResultsThe review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.ConclusionsThe review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations. (shrink)

An important aspect of moral expertise is moral sensitivity, which is the ability to be sensitive to the presence of morally salient features in a context. This requires being able to see and acquire the morally relevant information, as well as organise and interpret it, so that you can undertake the related work of moral judgement, focus (or motivation) and action. As a distinct but interrelated component of ethical expertise, moral sensitivity can and must be trained and educated. However, despite (...) its importance to moral education, there has been comparatively little discussion about the role of ethical sensitivity and the ways that it can be trained within the context of Kant’s, and Kantian, ethics. This paper seeks to address this gap. While Kant does not explicitly focus in detail on moral sensitivity, by breaking sensitivity down into seven distinct aspects through drawing on the Four Component Model, we are able to identify a wealth of resources in Kant’s work from which we can con- struct an account of moral sensitivity education that draws on his underlying moral theory. (shrink)

In nursing practice, awareness of ethical inner values and a common understanding of nursing and caring are needed. It is therefore important to highlight ideas of caring in nursing practice. The aim of this paper was to illuminate nursing, caring and ethical inner values in caring and caring in nursing practice. By being attentive, open, respectful and treating the patient as a person, nurses can enhance both their own and the patient's sense of personal meaning in the caring relationship. Nurses (...) can use self‐reflection to create an awareness of nursing, caring and ethical inner values in caring. (shrink)

This essay argues for a transversal posthumanities-based pedagogy, rooted in an attentive ethico-onto-epistemology, by reading the schizoanalytical praxes of Deleuzoguattarian theory alongside the work of various feminist new materialist scholars.

BackgroundThis article aims to contribute to a better conceptualization of pain and suffering by providing non-essential and non-naturalistic definitions of both phenomena. Contributions of classical evidence-based medicine, the humanistic turn in medicine, as well as the phenomenology and narrative theories of suffering and pain, together with certain conceptions of the person beyond them are critically discussed with such purpose.MethodsA philosophical methodology is used, based on the review of existent literature on the topic and the argumentation in favor of what are (...) found as better definitions of suffering and pain.ResultsPain can be described in neurological terms but cognitive awareness, interpretation, behavioral dispositions, as well as cultural and educational factors have a decisive influence on pain perception. Suffering is proposed to be defined as an unpleasant or even anguishing experience, severely affecting a person at a psychophysical and existential level. Pain and suffering are considered unpleasant. However, the provided definitions neither include the idea that pain and suffering can attack and even destroy the self nor the idea that they can constructively expand the self; both perspectives can b e equally useful for managing pain and suffering, but they are not defining features of the same. Including the existential dimension in the definition of suffering highlights the relevance of suffering in life and its effect on one’s own attachment to the world. An understanding of pain and suffering life experiences is proposed, meaning that they are considered aspects of a person’s life, and the self is the ever-changing sum of these experiences.ConclusionsThe provided definitions will be useful to the identification of pain and suffering, to the discussion of how to relieve them, and to a better understanding of how they are expressed and experienced. They lay the groundwork for further research in all these areas, with the twofold aim of a) avoiding epistemological mistakes and moral injustices, and b) highlighting the limitations of medicine in the treatment of suffering and pain. (shrink)

Kant wants to show that freedom is possible in the face of natural necessity. Transcendental idealism is his solution, which locates freedom outside of nature. I accept that this makes freedom possible, but object that it precludes the recognition of other rational agents. In making this case, I trace some of the history of Kant’s thoughts on freedom. In several of his earlier works, he argues that we are aware of our own activity. He later abandons this approach, as he (...) worries that any awareness of our activity involves access to the noumenal, and thereby conflicts with the epistemic limits of transcendental idealism. In its place, from the second Critique onwards, Kant argues that we are conscious of the moral law, which tells me that I ought to do something, thus revealing that I can. This is the only proof of freedom consistent with transcendental idealism, but I argue that such an exclusively first-personal approach precludes the recognition of other rational agents. I conclu.. (shrink)

Both Kant and Levinas state that traditional ontology is a type of philosophy that illegitimately forces the structure of human reason onto other beings, thus making the subject the center and origin of all meaning. Kant’s critique of the ontology of his scholastic predecessors is well known. For Levinas, however, it does not suffice. He rejects what we could call an ‘existential ontology’: a self-centered way of living as a whole, of which all philosophical ontology is but a branch. Alternatively, (...) he presents an ethical way of living centered on ‘the Other’. Kant also, however, eventually turns to ethics to uncover a more fundamental domain of meaning. Hence, both thinkers ultimately agree about the primacy of ethics over theory. Despite this concurrence, Levinas nevertheless criticizes all aspects of Kant’s turn towards ethics: his reason for making this turn, the kind of critique that he applies to this domain, and the outcome thereof. These three points reflect Levinas’ more general critique t.. (shrink)

Research on moral judgment has been dominated by rationalist models, in which moral judgment is thought to be caused by moral reasoning. The author gives 4 reasons for considering the hypothesis that moral reasoning does not cause moral judgment; rather, moral reasoning is usually a post hoc construction, generated after a judgment has been reached. The social intuitionist model is presented as an alternative to rationalist models. The model is a social model in that it deemphasizes the private reasoning done (...) by individuals and emphasizes instead the importance of social and cultural influences. The model is an intuitionist model in that it states that moral judgment is generally the result of quick, automatic evaluations (intuitions). The model is more consistent than rationalist models with recent findings in social, cultural, evolutionary, and biological psychology, as well as in anthropology and primatology. (shrink)

Background:It is stated that high ethical sensitivity positively affects the quality of nursing care. However, the relationship between nursing care quality and ethical sensitivity has not been clearly demonstrated in researches.Aim:This study was carried out to determine the relationship between surgical nurses’ care behaviors and their ethical sensitivity.Method:The sample of this cross-sectional, descriptive-correlational study consists of 308 nurses who worked at the surgical departments in four Turkish hospitals. The data were collected using the “Nurse Description Form” developed by the researcher, (...) “Caring Behaviours Inventory-24” and “Ethical Sensitivity Questionnaire.” Data were evaluated by the Mann Whitney U test, Kruskal Wallis one-way analysis of variance and Spearman correlation analysis.Ethical considerations:The study was approved by the ethics committee. Verbal and written consent was received from the nurses.Results:It was found in the study that nurses’ Caring Behaviours Inventory-24 total score median was 5.25 (4.83–5.58), nurses’ perception level of caring quality was high, median of Ethical Sensitivity Questionnaire total score was 89.00 (75.00–101.00) and nurses’ ethical sensitivity was moderate. A negative significant relation was found between nurses’ Caring Behaviours Inventory-24 total score and Ethical Sensitivity Questionnaire total score (r = -0.162; p = 0.009). A negative relation was also detected between nurses’ working period at the current clinic and providing benefit (r = -0.147; p = 0.012), holistic approach (r = -0.139; p = 0.018) and orientation (r = -0.175; p = 0.003) scores of Ethical Sensitivity Questionnaire sub-scales.Conclusion:Nurses’ perception levels of caring quality were high and their ethical sensitivity levels were moderate. It was found out that nurses’ ethical sensitivity increased together with their perception of caring quality, and as their working period at the current clinic increased, the ethical sensitivity also increased in terms of the sub-scales of providing benefit, holistic approach, and orientation. The factors that adversely affect the quality of nursing care and ethical sensitivity should be examined and attempts should be made to improve the working environment. (shrink)

Trigger warnings have been the flashpoints of many discussions in recent years. A prominent claim among those arguing against trigger warnings is what I will call the “coddling argument”, according to which trigger warnings coddle by allowing people to avoid ideas that they disagree with or find difficult. In this paper, I try to both make sense of and refute the coddling argument from a vice epistemological perspective. As I argue, CA is best understood as an expression of concern about (...) the encouragement of epistemic vices, specifically in higher education, which lead to people avoiding and closing themselves off from difficult or challenging topics. I argue that this is misguided: trigger warnings exist for people who need to be warned about certain contents because they already know about these issues. Demands for such warnings are usually made by those who have themselves experienced the difficult things defenders of CA purport they are trying to hide from. We do, however, need to take into account that trigger warnings might be misused by those who really do need to learn about topics that might be a trigger for others, and I will discuss how this issue could be addressed. (shrink)

This paper argues for Kantian “universalism,” according to which the subject of empirical cognition is not merely individual, but universal. In the first section, I consider the limitations of Hume’s individualist view of the subject of judgment, which is able to explain how another person exerts power over my judgments, but cannot explain how what she says can challenge or support my judgments. In the second section, I argue that Kant’s universalism accounts for the possibility of rational support both among (...) different judgments in me, and among judgments of different subjects. The third section looks at the consequences of universalism for Kant’s account of testimony. I argue that on Kant’s view, it does not matter whether I learn something from my own experience or from your experience. Testimony thus does not emerge in Kant’s philosophy as a significant topic. In the fourth section, I argue that the enlightenment project of overcoming prejudice and acquiring wisdom makes it imperative that knowledge be not only universally shareable, but also actually shared among members of an epistemic community. (shrink)

It is argued that dignity can be considered both subjectively, taking into account individual differences and idiosyncrasies, and objectively, as the foundation of human rights. Dignity can and should also be explored as both an other-regarding and a self-regarding value: respect for the dignity of others and respect for one’s own personal and professional dignity. These two values appear to be inextricably linked. Aristotle’s doctrine of the mean enables nurses to reflect on the appropriate degree of respect for the dignity (...) of others and of respect for themselves. To develop an understanding of the rationale for and the significance and implications of dignity in health care practice, a view of human nature is proposed that implies vulnerability and fallibility, and that urges that an ethic of aspiration is embraced. Anonymized vignettes are included to illustrate points about the everyday nature of dignity. (shrink)

Moral judgment has typically been characterized as a conflict between emotion and reason. In recent years, a central concern has been determining which process is the chief contributor to moral behavior. While classic moral theorists claimed that moral evaluations stem from consciously controlled cognitive processes, recent research indicates that affective processes may be driving moral behavior. Here, we propose a new way of thinking about emotion within the context of moral judgment, one in which affect is generated and transformed by (...) both automatic and controlled processes, and moral evaluations are shifted accordingly. We begin with a review of how existing theories in psychology and neuroscience address the interaction between emotion and cognition, and how these theories may inform the study of moral judgment. We then describe how brain regions involved in both affective processing and moral judgment overlap and may make distinct contributions to the moral evaluation process. Finally, we discuss how this way of thinking about emotion can be reconciled with current theories in moral psychology before mapping out future directions in the study of moral behavior. (shrink)

The aim of the present study was to investigate the association between work-related moral stress, moral climate and moral sensitivity in mental health nursing. By means of the three scales Hospital Ethical Climate Survey, Moral Sensitivity Questionnaire and Work-Related Moral Stress, 49 participants’ experiences were assessed. The results of linear regression analysis indicated that moral stress was determined to a degree by the work place’s moral climate as well as by two aspects of the mental health staff’s moral sensitivity. The (...) nurses’ experience of ‘moral burden’ or ‘moral support’ increased or decreased their experience of moral stress. Their work-related moral stress was determined by the job-associated moral climate and two aspects of moral sensitivity. Our findings showed an association between three concepts: moral sensitivity, moral climate and moral stress. Despite being a small study, the findings seem relevant for future research leading to theory development and conceptual clarity. We suggest that more attention be given to methodological issues and developing designs that allow for comparative research in other disciplines, as well as in-depth knowledge of moral agency. Copyright © 2011 by SAGE Publications. (shrink)

Background:In research on co-creation in nursing, a caring manner can be used to create opportunities whereby the patient’s quality of life can be increased in palliative home care. This can be described as an ethical cornerstone and the goal of palliative care. To promote quality of life, nurses must be sensitive to patients’ and their relatives’ needs in care encounters. Co-creation can be defined as the joint creation of vital goals for patients through the process of shared knowledge between nurses, (...) patients and their relatives.Aim:The aim of this study was to explore nurses’ experiences of caring encounters and co-creation in palliative home care from an ethical perspective.Research design, participants, and research context:A hermeneutical approach was used. The material consisted of texts from interviews with 12 nurses in a home care context. The method was inspired by thematic analysis.Ethical considerations:Informed consent was sought from the participants regarding study participation and the storage and handling of data for research purposes.Findings:An overall theme, a main theme and four sub-themes emerged. Through ethical sensitivity and perceptivity, nurses can balance their actions in the moment and change their nursing care actions according to the patient’s wishes through co-creation in encounters. Here the time is crucial, as the time needed is unique to each patient.Discussion:The themes together can be considered prerequisites for good palliative home care. If nurses fail to be sensitive and perceptive in encounters with dying patients, good palliative home care cannot be achieved. Ethical sensitivity and perceptiveness can also be considered a part of nurses’ ethical competence.Conclusion:Patients’ dignity can be preserved through ethical sensitivity and perceptiveness, which is fundamental for good palliative care. Co-creation from patients’ perspectives should be the focus of future research. (shrink)

In this article I argue that Levinas can be read as a critic, not just of Heideggerian being, but also of being-with. After pointing out that the publication of the Black Notebooks only makes this criticism more interesting to revisit, I first of all discuss passages from both earlier and later writings in which Levinas explicitly takes issue with Heidegger’s claim that there is no self outside of a specific socio-historical community. I then explain how these criticisms are reflected in (...) Levinas’s own account, arguing that Levinasian subjectivity and alterity are precisely defined by their not belonging to a larger unity; to the extent that they partake in a multi-personal collectivity, this does not take the form of a traditional community. In the final section, I look into a different and seemingly opposing argument Levinas makes against Heidegger: on the basis of the latter’s reflections on death, he argues that Dasein is anti-social rather than overly immersed in the socio-historical. Arguing that this rests on a misreading of Being and Time, I use this opportunity to raise questions about Levinas’s interpretation of Heidegger and his “otherwise than being-with” more generally, for Levinas’s account runs into several problems as well. Yet as I will conclude, this in fact offers a valuable insight, not just for the present-day reception of Heidegger, but also for thinking community today. It indicates that a radical break with human situatedness does not automatically fare better than a firmly enrooted account of existence. (shrink)

Ethical sensitivity was introduced to caring science to describe the first component of decision making in professional practice; that is, recognizing and interpreting the ethical dimension of a care situation. It has since been conceptualized in various ways by scholars of professional disciplines. While all have agreed that ethical sensitivity is vital to practice, there has been no consensus regarding its definition, its characteristics, the conditions needed for it to occur, or the outcomes to professionals and society. The purpose of (...) this article is to explore the meaning of the concept of ethical sensitivity based on a review of the professional literature of selected disciplines. Qualitative content analysis of the many descriptors found within the literature was conducted to enhance understanding of the concept and identify its essential characteristics. Ethical sensitivity is considered to be an emerging concept with potential utility in research and practice. (shrink)

This paper assesses the prospects of combining the distinctive strengths of the two major educational research programs of critical thinking and critical pedagogy—or, described more accurately, overcoming their shared limitations—in a new and superior educational objective called criticality. Several recent proposals explore the possibilities of engaging in bridge-building between these camps. The plan is that the distinctive strengths of these paradigms—the logical and epistemological precision of critical thinking together with the socio-political consciousness of critical pedagogy—could complement each other, while the (...) associated adjustments to the overall picture could also help us to address their shared shortcomings. This gives us a new and more grounded educational goal of criticality, as suggested and developed independently by a growing number of thinkers. This article joins the ongoing conversation but provides a more counterreactionary tone by striving to vindicate the traditional mainstream conception of critical thinking. I maintain that despite their admirable ambitions, the various expressions of criticality do not succeed in combining the best parts of critical thinking and critical pedagogy, since on a deep metatheoretical level these two paradigms have irreconcilable core principles. First, I argue that the depiction of the failures of critical thinking used to motivate criticality is to a large degree a straw man: in actuality, the existing conceptualization of critical thinking can already do the desired extra socio-political educational work, so there really is no pressing need for the suggested augmentations. Second, the traditional worries of indoctrination, which have followed critical pedagogy since the inception of this educational movement, still remain unresolved within criticality. The only way to address this concern successfully is to lean on critical thinking as the core of our educational theory, bringing us right back to where we started. (shrink)

Clinical practices are considered one of the cornerstones in nurses' education. This study provides a framework to determine how factors in the academic environment, influence nursing student's satisfaction with their practices. A cross-sectional analytical study was conducted in a convenience sample of 574 nursing students at a private university in Valencia, during the 2016/2017 academic year, 79% were women. Two statistical methodologies were used for data analysis: hierarchical regression models and fuzzy sets qualitative comparative analysis. The HRM indicate that the (...) students' mean score influences all dimensions of satisfaction. Furthermore, in the fsQCA, the type of service and center, as well as the type of management, the preference in the choice of the practice center and the number of students per period per clinical educator influence satisfaction with clinical practices. These results could be used to understand how academic factors influence nursing students' satisfaction with their clinical practices and to create intervention programmes that improve it. This will help prepare students to be the future nursing workforce. (shrink)