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

The aim of this study was to explore the existence of moral distress among nurses in Lilongwe District of Malawi. Qualitative research was conducted in selected health institutions of Lilongwe District in Malawi to assess knowledge and causes of moral distress among nurses and coping mechanisms and sources of support that are used by morally distressed nurses. Data were collected from a purposive sample of 20 nurses through in-depth interviews using a semi-structured interview guide. Thematic analysis (...) of qualitative data was used. The results show that nurses, irrespective of age, work experience and tribe, experienced moral distress related to patient/nursing care. The major distressing factors were inadequate resources and lack of respect from patients, guardians, peers and bosses. Nurses desire teamwork and ethics committees in their health institutions as a means of controlling and preventing moral distress. There is a need for creation of awareness for nurses to recognize and manage moral distress, thus optimizing their ability to provide quality and uncompromised nursing care. (shrink)

Moral distress is the sense that one must do, or cooperate in, what is wrong. It is paradigmatically faced by nurses, but it is almost a universal occupational hazard.

Ong, Caroline As health systems become more complex, moral distress is increasingly being recognised as a significant phenomenon amongst health professionals. It can be described as the state of being distressed when one is unable to act according to what one believes to be morally right. It may compromise patient care, the health professional involved and the organisation. Cumulative experiences of incompletely resolved moral distress - a phenomenon which is called moral residue - may leave (...) us susceptible to more frequent and more severe moral distress. Clear open communication, respect, inclusivity, openness to differences, compassion, support, education and the capacity to grow in self-awareness are key aspects in minimising moral distress. Early recognition of its symptoms and addressing both personal and external constraints of actions can also minimise moral residue and build resilience to further distress. (shrink)

Question: Do clinicians providing abortion practicing in states that restrict abortion experience more moral distress than those practicing in states that protect abortion? -/- Findings: In this national, purposive survey study of 310 clinicians providing abortion, moral distress was elevated among all clinicians, with those practicing in restrictive states reporting higher levels of moral distress compared with those practicing in protective states. -/- Meaning: The findings suggest that structural changes addressing bans on necessary health (...) care, such as federal protection for abortion, are needed at institutional, state, and federal policy levels to address clinician moral distress. (shrink)

Moral distress is a well-documented phenomenon in the nursing profession, and increasingly thought to be implicated in a nation-wide nursing shortage in the US. First identified by the philosopher Andrew Jameton in 1984, moral distress has also proven resistant to various attempts to prevent its occurrence or at least mitigate its effects. While this would seem to be bad news for nurses and their patients, it is potentially good news for philosophical counselors, for whom there is (...) both socially important and philosophically interesting work to be done. In an effort to encourage such work, this paper explicates the philosophical (as opposed to more purely psychological or institutional) contours of the problem. A subsequent paper, titled 'A Philosophical Counseling Approach to Moral Distress,' will highlight ways in which such a response would differ from the strategies so far deployed within the nursing profession. (shrink)

Health care providers (HCPs) are routinely placed into morally challenging situations that have the potential to cause moral distress. This is especially true for HCPs working in the military, whether they are on deployment outside their typical contexts of practice such as in disaster relief (e.g., Haiti and the Ebola missions in West Africa), or in more typically military settings such as peace keeping or armed conflicts (e.g., Afghanistan, Syria). Moral distress refers to “painful feelings and/or (...) psychological disequilibrium” (Nilsson, Sjöberg, Kallenberg, & Larsson, 2011, p. 50) that occur when an individual is aware of a morally appropriate action in a moral dilemma but obstruction prevents them from carrying it out, or when in a situation where they must choose between upholding equally treasured but conflicting moral values. Similarly, moral distress can occur when faced with a ‘tragic choice’ where all available courses of action require something of moral significance to be given up, such as surgical triage in a mass casualty event (Hunt, Sinding, & Schwartz, 2012). In the literature, moral distress has been connected to negative psychological effects and even stress related mental health issues including compassion fatigue, burnout, and post-traumatic stress disorder (Owen & Wanzer, 2014; Gustafsson, Eriksson, Strandberg, & Norberg, 2010; Litz, et al., 2009). (shrink)

Concerns of moral distress in health care have never been more relevant. In her book, Health Care Ethics Through the Lens of Moral Distress, Kristen Jones-Bonofiglio provides a comprehensive review of the effects of moral distress on providers and health care delivery, while highlighting the complexities of making ethical decisions in practice. Jones-Bonofiglio’s thoroughness and use of interdisciplinary, historical, and cultural scholarship makes this book an excellent introductory resource on moral distress for (...) health care providers and researchers alike. (shrink)

ABSTRACT Objectives There is little research on moral uncertainties and distress of palliative and hospice care providers (PHCPs) working in jurisdictions anticipating legalising voluntary assisted dying (VAD). This study examines the perception and anticipated concerns of PHCPs in providing VAD in the State of Queensland, Australia prior to legalisation of the practice in 2021. The findings help inform strategies to facilitate training and support the health and well-being of healthcare workers involved in VAD. Design The study used a (...) qualitative approach to examine and analyse the perception and anticipated concerns of PHCPs regarding challenges of providing assisted dying in Queensland. Fourteen PHCPs were recruited using a purposive sampling strategy to obtain a broad representation of perspectives including work roles, geographical locations and workplace characteristics. Data were collected via one in-depth interview per participant. The transcripts were coded for patterns and themes using an inductive analysis approach following the tradition of Grounded Theory. Setting The study was conducted in hospital, hospice, community and residential aged care settings in Queensland, Australia. These included public and private facilities, secular and faith-based facilities, and regional/rural and urban facilities. Participants Interviews were conducted with fourteen PHCPs: 10 nurses and 4 physicians; 11 female and 3 male. The median number of years of palliative care practice was 17, ranging from 2 to 36 years. For inclusion, participants had to be practising palliative and hospice care providers. Results PHCPs are divided on whether VAD should be considered part of palliative care. Expectations of moral distress and uncertainty about practising VAD were identified in five areas: handling requests, assessing patient capacity, arranging patient transfers and logistical issues, managing unsuccessful attempts, and dealing with team conflicts and stigma. Conclusions The possibility of having to practise VAD causes moral distress and uncertainty for some PHCPs. Procedural clarity can address some uncertainties; moral and psychological distress, however, remains a source of tension that needs support to ensure ongoing care of both patients and PHCPs. The introduction of VAD post-legalisation may present an occasion for further moral education and development of PHCPs. (shrink)

When our nearest and dearest experience medical crises, we may need to step into caregiving roles. But in doing so, we may find that our new caregiving relationship is actually in tension with the loving relationship that motivated us towards care. What we owe and are entitled to as friends, spouses, and family members, can be different from what we owe and are entitled to as caregivers. For this reason, caregiving carries with it the risk of a type of (...) class='Hi'>moral distress that I call “role conflict distress.” Rather than view role conflict distress as a sign that we are falling short, I suggest that it actually speaks to the commitment that we have to the loving relationship that grounds our duty of care. (shrink)

Michael H. Mitias argues that friendship is a central moral value constituting an integral part of the good life and therefore deserving a prominent place in ethical theory. He consequently calls upon ethicists to make immediate and decisive adjustments toward accommodating what he regards as a neglected organic relationship between friendship and morality. This is not a fanciful amendment to our standard conception of morality but a radical proposal grounded in a unifying vision to recapture the right way of (...) doing ethics. While the assessment is compelling, and the plea well-placed, neither has been fully understood in the scholarly reception of Mitias. This paper clarifies both. What sets it apart from other reactions to Mitias is a holistic approach drawing on literary considerations as well as philosophical ones. The combined aim is to demonstrate that Mitias is not seeking simply to restore friendship to its rightful place in normative ethical theory, which is indeed the full extent of his formal mission, but that he is seeking to do so specifically within virtue ethics. This interpretation rests on a broad engagement with Mitias’s publications beyond the recent treatise often taken understandably yet erroneously to be his only work on the subject. (shrink)

Margaret Urban Walker argues that hospital ethics committees should think of their task as "keeping moral space open." I develop her suggestion with analogies: Enlarge the windows (i.e., expand what counts as an ethical issue); add rooms and doors (i.e., choose particular issues to engage). Examples include confidentiality defined as information flow, and moral distress in the healthcare workplace.

"What is the significance of our gut feelings? Can they disclose our deep selves or point to a shared human nature? The phenomenon of perpetrator disgust provides a uniquely insightful perspective by which to consider such questions. Across time and cultures, some individuals exhibit signs of distress while committing atrocities. They experience nausea, convulse, and vomit. Do such bodily responses reflect a moral judgment, a deep-seated injunction against atrocity? What conclusions can we draw about the relationship of our (...) gut feelings to human nature and moral frameworks? Drawing on a broad range of historical examples as well as the latest scholarship from the philosophical and scientific study of emotions, this book explores the relationship of cognition and emotion through the lens of perpetrator disgust. Considering a range of interpretations of this phenomenon, it becomes evident that gut feelings do not carry a straightforward and transparent intentionality in themselves, nor do they motivate any core, specific response; they are templates that can embody a broad range of values and morals. Using this core insight, the book proposes a contextual understanding of emotions, by which an agent's environment shapes their available hermeneutic equipment-concepts, categories, names-that individuals rely on to make sense of their emotions and navigate the world"--. (shrink)

Here are four examples of “seeing.” You see that something green is wriggling. You see that an iguana is in distress. You see that someone is wrongfully harming an iguana. You see that torturing animals is wrong. The first is an example of low-level perception. You visually represent color and motion. The second is an example of high-level perception. You visually represent kind properties and mental properties. The third is an example of moral perception. You have an impression (...) of moral properties. The fourth is an example of intuition. You intellectually grasp a general moral truth. Should moral perceptions be thought of as high-level perceptions or as intuitions? Most proponents of moral perception have thought of them as high-level perceptions. I give epistemological and methodological reasons for thinking that at least some are examples of what I call low-level intuitions—experiences in which we both apprehend abstract generalities and apply them to concrete particulars. (shrink)

Moral dilemmas are situations in which the agents are provided by two conflicting moral judgments but it's not possible for them to act upon both judgments at the same time. Proponents of moral dilemmas say that agents in conflicting situations, have to act in a way that it is morally wrong. Agents will experience negative feelings such as guilt, regret and remorse, no matter which alternative is chosen by them. Opponents, on the other hand, argue in contrary (...) and say that these situations don't avoid incoherence in a moral theory. They claim that although a good moral theory should be action guiding in any situation, it shouldn’t provide the agent with two conflicting moral judgments. Moral dilemmas violate the principle of being action guiding in a moral theory. Proponents often argue in virtue ethics framework and believe that virtue ethic theory is coherent and action guiding and it provides an appropriate explanation for moral dilemmas. Keywords . (shrink)

Nichols’s view of empathy (in Sentimental Rules) in light of experimental moral psychology suffers from several deficiencies: (1) It operates with an impoverished view of the altruistic emotions (empathy, sympathy, concern, compassion, etc.) as mere short-term, affective states of mind, lacking any essential connection to intentionality, perception, cognition, and expressiveness. (2) It fails to keep in focus the moral distinction between two very different kinds of emotional response to the distress and suffering of others—other-directed, altruistic, emotions that (...) have moral value, and self-directed emotional responses, such as personal distress, that do not. (3) Nichols is correct to see morality as requiring affectivity, and the capability of emotional response to others; but his incorrect view of altruistic emotions (and of emotions in general) leads him to misstate the connection between morality and emotion. (4) Nichols’s specific attempt to ground moral judgment in emotion fails, but the argument he provides for it is part of the explanation of point (2), his failure to sustain the distinction between egoistic and altruistic emotions. (5) Without in any way denying that moral philosophy is strengthened by knowledge of empirical psychology, I suggest that the foregoing failures of Nichols’s argument are partly due to his misuse of particular empirical results and findings, and possibly in part to a weakened commitment to the distinctive contribution the humanistic methods of philosophy make to our understanding of the moral dimension of life. (shrink)

Many accounts of the morality of abortion assume that early fetuses must all have or lack moral status in virtue of developmental features that they share. Our actual attitudes toward early fetuses don’t reflect this all-or-nothing assumption: early fetuses can elicit feelings of joy, love, indifference, or distress. If we start with the assumption that our attitudes toward fetuses reflect a real difference in their moral status, then we need an account of fetal moral status that (...) can explain that difference. I argue that we can have or lack relational obligations to early fetuses in light of our own activities or choices, independent of the fetus’s own features or properties. Those relational obligations make the early fetus morally considerable to the persons who stand in a moral relation to it. Pregnant persons (and other participants in the procreative process) can come to have relational obligations to an early fetus just in virtue of their own decision to create a person, either by intentionally getting pregnant or by deciding to continue a pregnancy. That decision not only makes it appropriate for them to care about the fetus, but it also generates obligations to the fetus that they didn’t have before that decision. (shrink)

David Hume endorses three claims that are difficult to reconcile: (1) sympathy with those in distress is sufficient to produce compassion towards their plight, (2) adopting the general point of view often requires us to sympathize with the pain and suffering of distant strangers, but (3) our care and concern is limited to those in our close circle. Hume manages to resolve this tension, however, by distinguishing two types of sympathy. We feel compassion towards those around us because associative (...) sympathy causes us to mirror their pain and suffering, but our ability to enter into the afflictions of those remote from us involves cognitive sympathy and merely requires us to reflect upon how we would feel in their shoes. This hybrid theory of sympathy receives support from recent work on affective mirroring and cognitive pretense. Hume’s account should appeal to contemporary researchers, therefore, who are interested in the nature of moral imagination. (shrink)

The thought that empathy plays an important role in moral motivation is almost a platitude of contemporary folk psychology. Parallel themes were mooted in German moral philosophy and aesthetics in the 1700s, and versions of the empathy construct remained prominent in continental accounts of moral motivation through the nineteenth century and early twentieth centuries. This chapter elucidates the Empathic Motivation Hypothesis (EMH) and sets out some of the conceptual and empirical challenges it faces. It distinguishes empathic concern (...) from other dimensions of empathy (e.g., resonance, attunement, distress, and non-empathic concern) and examines the merits of EMH as a developmental thesis, focusing on evidence from psychopathology and attachment theory. (shrink)

This article was championed in view of the notion of (perceived) economic rationalisation which seem to be the foremost of patients' care in the NHS as opposed to addressing distress to their existing well-being, while in a state of being tormented with agonising news of prolonged ill health. Serious consideration is given to addressing the need to rationalise resources in ensuring the long standing history of the NHS' free health care is critically addressed, but not in a way that (...) destroys confidence on the ability of professionals to manifest ethical prudence in their acts of judgments about whether patients' care is to be imminent or prolonged on a waiting list. There is certainly serious impacts to be comprehended with in situations of economic rationality through services provided by the NHS, but it is believed that tangible outcomes about definitive care for patients should be addressed collaboratively. (shrink)

Business Ethics and medical ethics are in principle compatible: In particular, the tools of business ethics can be useful to those doing healthcare ethics. Health care could be conducted as a business and maintain its moral core.

To what extent are experiences of powerlessness explained as involving a loss of control, and to what extent are attempts to increase patients’ control suitable as means of addressing these experiences? In this paper, I present some findings from a recent project in the phenomenology of powerlessness to argue that in response to experiences of powerlessness, the ideal of control has limited use in either a diagnostic or therapeutic function.

Most psychological and philosophical theories assume that we know what we feel. This general view is often accompanied by a range of more specific claims, such as the idea that we experience one emotion at a time, and that it is possible to distinguish between emotions based on their cognition, judgment, behaviour, or physiology. One common approach is to discriminate emotions based on their motivations or ultimate goals. Some argue that empathic distress, for instance, has the potential to motivate (...) empathic concerns; personal distress, on the other hand, is self-oriented and motivates egoistic concerns. In this paper, I argue against this and similarly teleological views of emotions and affect. Through a close study of the emotional breakdown of an American drone operator, I make the case that understanding our emotions entails much more ambiguity than dominant theories assume. In our emotional lives, disorientation and confusion are often the norm. (shrink)

On an account of virtue as skill, virtues are acquired in the ways that skills are acquired. In this paper I focus on one implication of that account that is deserving of greater attention, which is that becoming more skillful requires learning from one’s failures, but that turns out to be especially challenging when dealing with moral failures. In skill acquisition, skills are improved by deliberate practice, where you strive to correct past mistakes and learn how to overcome your (...) current limitations. A similar story applies to virtue acquisition, as moral failures will be a part of anyone’s life, and we will all have to learn from these experiences. However, despite the importance of being able to learn from our mistakes, this is very difficult in practice, given that failure of any kind can be distressing, and especially so for moral failure. The distress created by a recognition of moral failure often prompts responses of anger, avoidance, or defensiveness; rather than attempts to make amends and when necessary to work on self-improvement. The most potentially distressing response to moral failure is shame, as it is often associated with defensiveness. It is here where emotion regulation will be important to manage that distress, and I focus on the skill of emotion differentiation. I argue that emotion differentiation is a promising strategy for distinguishing the emotions we may experience in the wake of failure, including shame, and to encourage those emotions that motivate self-improvement. Thus, emotion regulation is important for virtue acquisition. (shrink)

In the first wave of the COVID-19 pandemic, healthcare workers in some countries were forced to make distressing triaging decisions about which individual patients should receive potentially life-saving treatment. Much of the ethical discussion prompted by the pandemic has concerned which moral principles should ground our response to these individual triage questions. In this paper we aim to broaden the scope of this discussion by considering the ethics of broader structural allocation decisions raised by the COVID-19 pandemic. More specifically, (...) we consider how nations ought to distribute a scarce life-saving resource across healthcare regions in a public health emergency, particularly in view of regional differences in projected need and existing capacity. We call this the regional triage question. Using the case study of ventilators in the COVID-19 pandemic, we show how the moral frameworks that we might adopt in response to individual triage decisions do not translate straightforwardly to this regional-level triage question. Having outlined what we take to be a plausible egalitarian approach to the regional triage question, we go on to propose a novel way of operationalising the ‘save the most lives’ principle in this context. We claim that the latter principle ought to take some precedence in the regional triage question, but also note important limitations to the extent of the influence that it should have in regional allocation decisions. (shrink)

Multi-user online environments involve millions of participants world-wide. In these online communities participants can use their online personas – avatars – to chat, fight, make friends, have sex, kill monsters and even get married. Unfortunately participants can also use their avatars to stalk, kill, sexually assault, steal from and torture each other. Despite attempts to minimise the likelihood of interpersonal virtual harm, programmers cannot remove all possibility of online deviant behaviour. Participants are often greatly distressed when their avatars are harmed (...) by other participants’ malicious actions, yet there is a tendency in the literature on this topic to dismiss such distress as evidence of too great an involvement in and identification with the online character. In this paper I argue that this dismissal of virtual harm is based on a set of false assumptions about the nature of avatar attachment and its relation to genuine moral harm. I argue that we cannot dismiss avatar attachment as morally insignificant without being forced to also dismiss other, more acceptable, forms of attachment such as attachment to possessions, people and cultural objects and communities. Arguments against according moral significance to virtual harm fail because they do not reflect participants’ and programmers’ experiences and expectations of virtual communities and they have the unintended consequence of failing to grant significance to attachments that we take for granted, morally speaking. Avatar attachment is expressive of identity and self-conception and should therefore be accorded the moral significance we give to real-life attachments that play a similar role. (shrink)

Recent advances in stem cell-derived human brain organoids and microelectrode array (MEA) tech- nology raise profound questions about the potential for these systems to give rise to sentience. Brain organoids are 3D tissue constructs that recapitulate key aspects of brain development and function, while MEAs enable bidirectional communication with neuronal cultures. As brain organoids become more sophisticated and integrated with MEAs, the question arises: Could such a system support not only intelligent computation, but subjective experience? This paper explores the philosophical (...) implications of this thought experiment, considering scenarios in which brain organoids exhibit signs of sensory awareness, distress, preference, and other hallmarks of sentience. It examines the ethical quandaries that would arise if compelling evidence of sentience were found in brain organoids, such as the moral status of these entities and the permissibility of different types of research. The paper also explores how the phenomenon of organoid sentience might shed light on the nature of consciousness and the plausibility of artificial sentience. While acknowledging the speculative nature of these reflections, the paper argues that the possibility of sentient brain organoids deserves serious consideration given the rapid pace of advances in this field. Grappling with these questions proactively could help set important ethical boundaries for future research and highlight critical avenues of scientific and philosophical inquiry. The thought experiment of sentient brain organoids thus serves as a valuable lens for examining deep issues at the intersection of neuroscience, ethics, and the philosophy of mind. (shrink)

Most people agree that inflicting unnecessary suffering upon animals is wrong. Many fewer people, including among ethicists, agree that painlessly killing animals is necessarily wrong. The most commonly cited reason is that death (without pain, fear, distress) is not bad for them in a way that matters morally, or not as significantly as it does for persons, who are self-conscious, make long-term plans and have preferences about their own future. Animals, at least those that are not persons, lack a (...) morally significant interest in continuing to live. At the same time, some argue that existence itself can be good, insofar as one’s life is worth living. For animals, a good life can offset a quick, if early, death. So, it seems to follow that breeding happy animals that will be (prematurely) killed can be a good thing overall. Insofar as slaughter and sale makes it economically sustainable to raise new ones, who would otherwise not exist, raising and killing animals for food who will have lives worth living is good overall. It benefits them as well as consumers, and makes the world better by adding to the sum of happiness. The process of raising and killing animals with positive welfare produces a sequence of replacement that maintains or increases overall welfare, all else being equal (assuming in particular no overall negative impact on the welfare of other parties). Call this the Replaceability Argument (RA) and the ensuing controversy the Replaceability Problem (RP). This is a problem at the crossroads of the ethics of killing, agricultural ethics, procreation ethics, and population ethics. (shrink)

An examination of two recent documents of Catholic Social Doctrine, Caritas in Veritate and Vocation of the Business Leader, is undertaken to uncover their assessment of our current cultural and moral crisis, of which our present economic distress is but one aspect, and their proposal for cultural renewal including a return to sound economic decision making. The intellectual commitments of molders of the modern mind such as Bacon, Descartes, and Hobbes severed morality at its metaphysical roots. Destroying the (...) anthropological underpinnings of ethics catapults the contemporary world into a state of nihilism. In such a condition economic disorder is inevitable. The human person is crushed in a regime that searches for more relentlessly. The demand for metaphysical and moral reconstruction is met by Pope Benedict XVI with his insistence on receptivity to what is. Contemplation of an ultimate reality given to us takes us to the Person of Jesus Christ. The Christian faith is the context of authentic integral human development. Being made in the image of God gives every human person an inviolable dignity and makes every person subject to transcendent moral norms. A truth-filled love informs the conduct of enterprise. Goods that are truly goods and services that truly serve are produced or supplied. Promotional efforts are conducive to the pursuit of wisdom. People are given meaningful work that utilizes and develops their higher faculties and are let in on the financial success of the venture. The environment is respected as a home place ought to be. The Christian business leader can have a transformative effect on the business world through the power of grace. (shrink)

Marie Oldfield, Pro Bono Economics & Refugee Council. Over half the total applications for asylum the UK receives each year are initially rejected, yet nearly a third of these initial rejections are subsequently overturned on appeal. This process that fails to get decisions right first time imposes significant costs, not just on the applicants themselves, but also more widely on UK taxpayers. Asylum seekers are not entitled to welfare benefits nor employment except in some limited cases, and are often placed (...) in unsuitable conditions with lack of appropriate support to prepare their case for asylum. These unfortunate circumstances mean that they are unable to gather and present all the required evidence first time, even when the case for asylum is legitimate. As a result, the application is rejected and thus begins a cycle of appeals that might eventually lead to a successful outcome for the asylum seeker but will, in the process, burden the taxpayer with unnecessary administrative cost and cause the asylum seeker needless distress and prevent them from accessing suitable economic opportunities. • Our study estimates that there are approximately 4,000 initial rejections that are successfully appealed each year and, with each appeal incurring direct administrative costs of around £1,000, the price tag of incorrect initial decisions adds up to a hefty £4 million per year in unnecessary administrative costs alone. • There are other costs, too, that negatively impact asylum seekers and taxpayers, albeit in a more indirect manner. The longer the appeals process is dragged out, the more delay there is to successful asylum seekers entering the labour market which means lost economic activity and forgone tax revenue for the Exchequer. Long periods of unemployment also result in skills attrition and lower the probability of the asylum seeker successfully entering the labour market in the future. • A lengthy appeals process heightens stress and worsens mental health in asylum seekers, a group arguably already more vulnerable on this front. Unnecessary human suffering aside, there is also a monetary cost borne by the taxpayer should NHS mental health services become involved. Thus, there is a pressing and viable case for providing asylum seekers a stable environment in which to complete their applications for asylum. This would increase the likelihood of reaching correct decisions in the first instance, avoid unnecessary administrative costs of an arduous appeals process, enable successful asylum seekers to access the labour market and contribute to the Exchequer, and avoid placing extra demands on already strained NHS mental health services. (shrink)

All societies have to balance privacy claims with other moral concerns. However, while some concern for privacy appears to be a common feature of social life, the definition, extent and moral justifications for privacy differ widely. Are there better and worse ways of conceptualising, justifying, and managing privacy? These are the questions that lie in the background of this thesis. -/- My particular concern is with the ethical issues around privacy that are tied to the rise of new (...) information and communication technologies (henceforth “ICT”). The focus here is on technologies involved in processing personal data in its broadest sense, including “any operation or set of operations which is performed on personal data or on sets of personal data, whether or not by automated means, such as collection, recording, organisation, structuring, storage, adaptation or alteration, retrieval, consultation, use, disclosure by transmission, dissemination or otherwise making available, alignment or combination, restriction, erasure or destruction.” The issue of moral concern is commonly designated as that of 'data privacy'. -/- The first step is to consider why privacy matters, or ought to matter, in the first place. And here we run into our first difficulty, since both the conceptualisation of privacy and the justification for the right to privacy are matters for contention. On the one hand, we are animated by a moral concern for privacy in some sense; on the other, we lack the conceptual and moral resources for making sense of this concern or for promoting particular social policies and criticising others. This often-cited dichotomy and its ensuing confusion have been the central motivation for most of the philosophical literature on privacy – including this thesis. -/- In what follows, I will suggest a way out of the confusion that pervades the current debate on data privacy. I will essentially argue two claims: one, that the concept of (data) privacy is uniquely characterised by a particular context within which we exchange information; two, that because (data) privacy constitutes an intrinsic value, its moral concerns and justifications ought to be deliberated as such. -/- The first chapter sketches the current data privacy landscape by introducing a number of concepts and arguing the unique nature of the landscape. I argue that the traditional distinction between four kinds of privacy (physical, mental, decisional and informational) is no longer accurate, given the technological context that reduces, unifies and processes all aspects of people’s lives by means of digital data. In fact, to hold on to the distinction leads to a fundamental misconception of data privacy. I further argue that today’s distinction between data protection and data privacy runs the risk of ignoring the fact that the former is an inherent aspect of the latter. These arguments allow me to settle on a (provisional) definition of data privacy: controlling how data about identifiable people is processed by ICT. -/- Next, I draw a line between descriptive and normative accounts of data privacy, and explain why this book belongs to the latter category. After a brief discussion of the coherence and distinctiveness theses, and of the difference between instrumental and intrinsic theories of privacy, I introduce the problem of data privacy as a distinct, coherent, and intrinsic moral concern. Three arguments support this position: one, data privacy is a coherent moral concern because it is motivated by a singular moral concept; two, data privacy is a distinct moral concern because the privacy challenges we face today are of a fundamentally new nature – distinct from any moral concerns we’ve faced in the past; and three, data privacy is an intrinsic moral concern that is predominantly justified, not by what it instrumentally protects us from, but by what it intrinsically constitutes. -/- Chapter Two makes the case against a harm-based, consequentialist approach to data privacy. After a brief introduction to the basic tenets of consequentialism I discuss harm-based arguments in favour as well as against privacy. I explain how privacy may protect us against psychological distress, but at the same time constitute the source of that distress; how privacy may be necessary for the proper functioning of democratic societies, but at the same time provide a cloak for anti-social and immoral behaviour; and how privacy protects us against the improper use of our personal data by others, but at the same enables us to conceal information or spread false information about ourselves in ways that are harmful to others. Next, I argue that consequentialism essentially relies on two flawed presumptions – that we know what harm is, and that we know how to predict it – and discuss the controversies surrounding definitions and predictions of harm. This argument becomes especially pertinent in today’s rapidly changing technological context: we may guess, and make assumptions, perhaps even find correlations, but don’t really know or understand (yet) with any degree of certainty the harmful consequences today’s data privacy violations are causing or will eventually cause – if any. -/- I illustrate this with examples of recent data privacy violations, and with a brief overview of consequentialist arguments for and against data privacy. Those who invoke consequentialist arguments against data privacy claim that personal data is nothing more than a raw material that can be turned into something useful and valuable without harming anyone. Choosing to move fast and break things – a popular mantra that promotes the benefits of technological “permissionless innovation” over and above its risks and costs – they draw our attention to the many benefits free data flows generate. Those who rely on consequentialist arguments in favour of data privacy, on the other hand, insist on actual and potential misuse of personal data. Rather careful than sorry, they draw our attention to the urgent need to take back control and protect ourselves against data privacy violations – precisely because we don’t know which harm they may cause in the future. Others go one step further and argue that these violations are part of a broader ideology of power. -/- What Chapter Two demonstrates is that vague definitions, unreliable predictions and inconclusive allegations of harm from both sides of the debate perpetuate a stalemate that fails to produce morally defensible answers to our growing data privacy concerns. Deliberating about data privacy from a consequentialist perspective is a dead end. -/- Chapter Three proposes an alternative to the harm-based approach, namely that privacy is an intrinsic value that deserves moral protection for its own sake. After a brief account of what I take values to be, and why we have a need to protect them, I introduce the foundational value of respect for persons, and lay out my main argument in two steps. The conceptual component of my argument returns to the definition of data privacy I had temporarily settled on in Chapter One, but now with the added consideration of the particular context, and particular circumstances and attitudes, within which information is exchanged. This addition is crucial, as it reveals the fundamental value that is at stake in our data privacy concerns, namely the inherent value of each and every person, which we protect by upholding an ethical principle commonly known as the principle of respect for persons. It is for this reason that the violation of privacy cannot (only) be expressed in terms of harm. I further argue that the principle of respect for persons is consistent with, and in fact unthinkable without, some degree of privacy. -/- I reply to potential challenges to a value-based approach to data privacy by showing that (i) values and value trade-offs are fundamentally different from consequential benefits and cost-benefit analyses; (ii) the suspension of one value in favour of another is not inherently contradictory; what matters is morally defensible deliberation about values and valid individual consent; (iii) data privacy concerns cannot be reduced to other moral concerns and therefore deserve a specific, distinct protection. -/- Finally, because this is a thesis in applied ethics, I attempt an answer to the question as to how we ought to apply a value-based approach to practical data privacy concerns. I argue that a revised, three-pronged version of John Rawls’ reflective equilibrium, founded on the non-negotiable principle of respect for persons, is the best possible procedure to deliberate data privacy concerns in relation to other moral values. (shrink)

When a circular coin is rotated in depth, is there any sense in which it comes to resemble an ellipse? While this question is at the center of a rich and divided philosophical tradition (with some scholars answering affirmatively and some negatively), Morales et al. (2020, 2021) took an empirical approach, reporting 10 experiments whose results favor such perspectival similarity. Recently, Burge and Burge (2022) offered a vigorous critique of this work, objecting to its approach and conclusions on both philosophical (...) and empirical grounds. Here, we answer these objections on both fronts. We show that Burge and Burge’s critique rests on misunderstandings of Morales et al.’s claims; of the relation between the data and conclusions; and of the philosophical context in which the work appears. Specifically, Burge and Burge attribute to us a much stronger (and stranger) view than we hold, involving the introduction of “a new entity” located “in some intermediate position(s) between the distal shape and the retinal image.” We do not hold this view. Indeed, once properly understood, most of Burge and Burge’s objections favor Morales et al.’s claims rather than oppose them. Finally, we discuss several questions that remain unanswered, and reflect on a productive path forward on these issues of foundational scientific and philosophical interest. (shrink)

En el presente estudio participaron 270 estudiantes en dos muestras; la primera con alumnos de bachillerato, la segunda con alumnos universitarios, ambos del estado de Puebla, México. La investigación fue básicamente cuantitativa, sin embargo, el instrumento utilizado permitió obtener valiosa información cualitativa. El objetivo fue contrastar los resultados históricos de test con dilemas morales clásicos. Los participantes se enfrentaron al Dilema del tranvía, al Dilema de la pasarela y al Dilema de Sofía. Los resultados demostraron que es válida la categorización (...) en cuatro posturas morales básicas: utilitarismo, emotivismo, deontología y ética de la virtud. Y si bien se obtuvieron, en una primera instancia, resultados cuantitativos catalogados como mayormente utilitarios, lo cierto es que las creencias morales exhibidas en el estudio superan el dualismo utilitarismo-emotivismo de estudios previos consultados. In the present study, 270 students participated in two samples, the first with high school students, the second with university students, both from the state of Puebla. The research was quantitative, however, the instrument used allowed obtaining valuable qualitative information. The objective was to contrast the historical test results with classic moral dilemmas. Participants faced the Trolley Dilemma, Footbridge Dilemma and Sophia’s Dilemma. The results showed that the categorization in four basic moral positions is valid: utilitarianism, emotivism, deontology and virtue ethics. And although quantitative results cataloged as mostly utilitarian were obtained in the first instance, the truth is that the moral beliefs exhibited in the study surpass the utilitarianism-emotivism dualism of previous studies consulted. (shrink)

Arguably the most foundational principle in perception research is that our experience of the world goes beyond the retinal image; we perceive the distal environment itself, not the proximal stimulation it causes. Shape may be the paradigm case of such “unconscious inference”: When a coin is rotated in depth, we infer the circular object it truly is, discarding the perspectival ellipse projected on our eyes. But is this really the fate of such perspectival shapes? Or does a tilted coin retain (...) an elliptical appearance even when we know it’s circular? This question has generated heated debate from Locke and Hume to the present; but whereas extant arguments rely primarily on introspection, this problem is also open to empirical test. If tilted coins bear a representational similarity to elliptical objects, then a circular coin should, when rotated, impair search for a distal ellipse. Here, nine experiments demonstrate that this is so, suggesting that perspectival shapes persist in the mind far longer than traditionally assumed. Subjects saw search arrays of three-dimensional “coins,” and simply had to locate a distally elliptical coin. Surprisingly, rotated circular coins slowed search for elliptical targets, even when subjects clearly knew the rotated coins were circular. This pattern arose with static and dynamic cues, couldn’t be explained by strategic responding or unfamiliarity, generalized across shape classes, and occurred even with sustained viewing. Finally, these effects extended beyond artificial displays to real-world objects viewed in naturalistic, full-cue conditions. We conclude that objects have a remarkably persistent dual character: their objective shape “out there,” and their perspectival shape “from here.”. (shrink)

Introspection is a fundamental part of our mental lives. Nevertheless, its reliability and its underlying cognitive architecture have been widely disputed. Here, I propose a principled way to model introspection. By using time-tested principles from signal detection theory (SDT) and extrapolating them from perception to introspection, I offer a new framework for an introspective signal detection theory (iSDT). In SDT, the reliability of perceptual judgments is a function of the strength of an internal perceptual response (signal- to-noise ratio) which is, (...) to a large extent, driven by the intensity of the stimulus. In parallel to perception, iSDT models the reliability of introspective judgments as a function of the strength of an internal introspective response (signal-to-noise ratio) which is, to a large extent, driven by the intensity of conscious experiences. Thus, by modelling introspection after perception, iSDT can calibrate introspection’s reliability across a whole range of contexts. iSDT offers a novel, illuminating way of thinking about introspection and the cognitive processes that support it. (shrink)

Our pains can be more or less intense, our mental imagery can be more or less vivid, our perceptual experiences can be more or less striking. These degrees of intensity of conscious experiences are all manifestations of a phenomenal property I call mental strength. In this article, I argue that mental strength is a domain-general phenomenal magnitude; in other words, it is a phenomenal quantity shared by all conscious experiences that explains their degree of felt intensity. Mental strength has been (...) largely overlooked in favor of mental states’ type, representational contents, domain-specific phenomenology, or processes such as attention. Considering mental strength in our reflections about the mind illuminates debates about the relation of representational contents and phenomenal character, and it also helps address questions about the structure and functions of consciousness. Mental strength provides a unifying construct to model what is shared in the phenomenology of different types of conscious experiences. (shrink)

In this chapter, we discuss a selection of current views of the neural correlates of consciousness (NCC). We focus on the different predictions they make, in particular with respect to the role of prefrontal cortex (PFC) during visual experiences, which is an area of critical interest and some source of contention. Our discussion of these views focuses on the level of functional anatomy, rather than at the neuronal circuitry level. We take this approach because we currently understand more about experimental (...) evidence at this coarse level and because these results are appropriate for arbitrating between current theoretical frameworks. We discuss the Two-Visual-Systems Hypothesis (Milner & Goodale 1995; 2006), Local Recurrency (Lamme 2010; Lamme 2006), Higher Order (Lau 2008; Lau & Rosenthal 2011) and Global Workspace theories (Baars 1997; Baars 2005; Dehaene & Naccache 2001; Dehaene 2014). Despite the apparent stark differences between conscious and unconscious perceptual processing, available evidence suggests that their neural substrates must be largely shared. This indicates that the difference in neural activity between conscious and unconscious perceptual processing is likely to be subtle and highly specialized. We argue that current experimental evidence about the involvement of specific activity in prefrontal cortex supports the higher order neural theory of consciousness. In consequence, imaging techniques that focus only on marked differences between conscious and unconscious level of activity are likely to be insensitive to the relevant neural activity patterns that underlie conscious experiences. Finally, it follows from the evidence we discuss that the functional advantages of conscious over unconscious perceptual processing may be more limited than commonly thought. (shrink)

Metacognition is the capacity to evaluate the success of one's own cognitive processes in various domains; for example, memory and perception. It remains controversial whether metacognition relies on a domain-general resource that is applied to different tasks or if self-evaluative processes are domain specific. Here, we investigated this issue directly by examining the neural substrates engaged when metacognitive judgments were made by human participants of both sexes during perceptual and memory tasks matched for stimulus and performance characteristics. By comparing patterns (...) of fMRI activity while subjects evaluated their performance, we revealed both domain-specific and domain-general metacognitive representations. Multivoxel activity patterns in anterior prefrontal cortex predicted levels of confidence in a domain-specific fashion, whereas domain-general signals predicting confidence and accuracy were found in a widespread network in the frontal and posterior midline. The demonstration of domain-specific metacognitive representations suggests the presence of a content-rich mechanism available to introspection and cognitive control. (shrink)

Comenzamos este texto con una pregunta, por algo que podríamos llamar un signo propio de la época, a saber, la proliferación de aproximaciones espaciales a los más diversos problemas y desde las más diversas disciplinas. No podemos dejar de notar que eso, cuyos signos se dejan recoger a pesar de su dispersión, en algo que llamamos época, sobreviene después de un agotamiento de la radicalización del historicismo y de un pensamiento del tiempo.

In this paper I argue that many scholars involved in the contemporary free will debates have underappreciated the philosophical appeal of agent causation because the resources of contemporary emergentism have not been adequately introduced into the discussion. Whereas I agree that agent causation’s main problem has to do with its intelligibility, particularly with respect to the issue of how substances can be causally relevant, I argue that the notion of substance causation can be clearly articulated from an emergentist framework. According (...) to my proposal, a free agent is _a causally powerful substance that emerges in an anomic way from her constitutive mental events_, downwardly constraining, selecting and, in this way, having control on them. As we shall see, this particular concept of agent causation not only makes sense of the deep insight behind agent libertarianism, but it also provides us with the resources to solve some of the main objections that have been raised against it. It is true that here I cannot develop a complete defense of the evidential credentials of emergentism. Still, even if the considerations that follow do not serve to convince detractors of agent causal libertarian accounts of free will, they do suggest that libertarian agent causation is more promising than is typically acknowledged. (shrink)

Darwin’s theory is often illustrated with depictions of different finch beaks or with lined-up skeletons displaying subtle bone-structure changes throughout evolutionary history. In The Deep Histor...

I present here a case against the evidentialist approach that claims that in so far as our interests are epistemic what should guide our belief formation and revision is always a strict adherence to the available evidence. I go on to make the stronger claim that some beliefs based on admittedly “insufficient” evidence may exhibit epistemic virtue. I propose that we consider a form of courage to be an intellectual or epistemic virtue. It is through this notion of courage that (...) we can see a weakness in the evidentialist position. Adopting a doxastically courageous approach allows us to acknowledge the role that evidence has in epistemic justification and its connection with promoting epistemic value, but it avoids the narrowness of an evidentialist position. The epistemically courageous agent is not one who disregards the evidence entirely, but she also realizes that taking risks will not necessarily keep her from her epistemic goals. Believing something in the face of insufficient evidence is not always an epistemic vice to be avoided, and the agent that recognizes this is better off for it. (shrink)

Consciousness and confidence seem intimately related. Accordingly, some researchers use confidence ratings as a measure of, or proxy for, consciousness. Rosenthal discusses the potential connections between the two, and rejects confidence as a valid measure of consciousness. He argues that there are better alternatives to get at conscious experiences such as direct subjective reports of awareness (i.e. subjects’ reports of perceiving something or of the degree of visibility of a stimulus). In this chapter, we offer a different perspective. Confidence ratings (...) in general, and metacognitive measures in particular, may offer important advantages over subjective ratings. The arguments we offer here are supported by empirical, practical and socio-strategic considerations. However, we do not suggest consciousness and confidence are interchangeable. We recognize the limitations of confidence ratings in some experimental designs and for some research questions. Nevertheless, we also address a potential conceptual link between consciousness and confidence that stems from Rosenthal’s very own work on mental quality space theory. (shrink)

Studying the neural correlates of conscious awareness depends on a reliable comparison between activations associated with awareness and unawareness. One particularly difficult confound to remove is task performance capacity, i.e. the difference in performance between the conditions of interest. While ideally task performance capacity should be matched across different conditions, this is difficult to achieve experimentally. However, differences in performance could theoretically be corrected for mathematically. One such proposal is found in a recent paper by Lamy, Salti and Bar-Haim [Lamy (...) D, Salti M, Bar-Haim Y. Neural correlates of subjective awareness and unconscious processing: an ERP study. J Cognitive Neurosci 2009,21:1435-46], who put forward a corrective method for an electroencephalography experiment. We argue that their analysis is essentially grounded in a version of High Threshold Theory, which has been shown to be inferior in general to Signal Detection Theory. We show through a series of computer simulations that their correction method only partially removes the influence of perfor- mance capacity, which can yield misleading results. We present a mathematical correction method based on Signal Detection Theory that is theoretically capable of removing performance capacity confounds. We discuss the limitations of mathemati- cally correcting for performance capacity confounds in imaging studies and its impact for theories about consciousness. (shrink)

This work proposes that pain meets the requirements of being characterized as a secondary quality, as it covers, like a color, a determined extension. The argument seeks to establish a literal pain-color analogy through an inquiry into the intensity and location of the pain. From the classic intensity/location relationship reported by patients with acute appendicitis, three degrees of pain are distinguished: mild, moderate, and severe. The objective is only achieved by examining the Body’s extensional determinations (primary quality) insofar as each (...) of these degrees of pain covers three particular measures. Once these three measures have been explored according to the perforation process (tissue damage), the work ends by identifying pain as a transcendent moment. (shrink)

Definiciones de epistemología hay muchas, al igual que clases y estilos. Sin embargo, más allá de esta diversidad, es necesario contar con una definición básica que guíe nuestra comprensión del tema. Dos serán las preguntas que nos ayuden a ello en este artículo: a) ¿qué es la epistemología? y b) ¿para qué le sirve al científico?

To find the neural substrates of consciousness, researchers compare subjects’ neural activity when they are aware of stimuli against neural activity when they are not aware. Ideally, to guarantee that the neural substrates of consciousness—and nothing but the neural substrates of consciousness—are isolated, the only difference between these two contrast conditions should be conscious awareness. Nevertheless, in practice, it is quite challenging to eliminate confounds and irrelevant differences between conscious and unconscious conditions. In particular, there is an often-neglected confound that (...) is crucial to eliminate from neuroimaging studies: task performance. Unless subjects’ task performance is matched (and hence perceptual signal processing is matched), researchers risk finding the neural correlates of perception, rather than conscious perception. Here, we discuss the theoretical motivations for the performance matching framework and review empirical demonstrations of, and theoretical inferences derived from, obtaining differences in consciousness while controlling for task performance. We summarize signal detection theoretic modeling frameworks that explain how it is that we can derive performance-matched differences in consciousness without the effect being trivially driven by differences in criterion setting, and also provide principles for designing experimental paradigms that yield performance-matched differences in awareness. Finally, we address potential technical and theoretical issues that stem from matching performance across conditions of awareness, and we introduce the notion of “triangulation” for designing comprehensive experimental sets that can better reveal the neural substrates of consciousness. (shrink)

The book intends to interpret how different religions articulate their territories and manage the relationship with other religions, understanding systems and multiple everyday spaces, in a dynamic that is not only a component of contemporary reality, but is central to living it. The underlying thesis is that religion is the great geopolitical issue of our time, but an interpretation is only possible in terms of religious plurality and how ideas, symbolism, subjectivities and practices are incorporated in the daily life of (...) those who share the religious times and spaces, producing territorial identities and imaginary concrete cartographies as world projects. The volume has articles that focus on the religious space being gestated, expanded, contracted, celebrated or represented as a foundation for common life, as well as inter-religious conflicts arising in a world of diverse and differential coexistence. It is not a debate about classical geopolitics, but how geopolitical relations cross cultural-religious experience. (shrink)

When visual attention is directed away from a stimulus, neural processing is weak and strength and precision of sensory data decreases. From a computational perspective, in such situations observers should give more weight to prior expectations in order to behave optimally during a discrimination task. Here we test a signal detection theoretic model that counter-intuitively predicts subjects will do just the opposite in a discrimination task with two stimuli, one attended and one unattended: when subjects are probed to discriminate the (...) unattended stimulus, they rely less on prior information about the probed stimulus’ identity. The model is in part inspired by recent findings that attention reduces trial-by-trial variability of the neuronal population response and that they use a common criterion for attended and unattended trials. In five different visual discrimination experiments, when attention was directed away from the target stimulus, subjects did not adjust their response bias in reaction to a change in stimulus presentation frequency despite being fully informed and despite the presence of performance feedback and monetary and social incentives. This indicates that subjects did not rely more on the priors under conditions of inattention as would be predicted by a Bayes-optimal observer model. These results inform and constrain future models of Bayesian inference in the human brain. (shrink)