Stress reactions following acute situations involving moral challenges among health care professionals

Many health care professionals have to make morally difficult decisions during acute, stressful situations. The aim was to explore the applicability of an existing qualitatively developed model of individual reactions among professional first responders following such situations using a quantitative approach. According to the model, the interaction of antecedent individual and contextual characteristics affect the immediate emotional reactions to acute, stressful events involving a moral dilemma. Continuous coping efforts and the quality of social support will also affect the long‐term positive and negative reactions to the event. The participants (n = 204, about 50% response rate) represented three Swedish health care professions stationed at a university hospital and a regional hospital: Physicians (n = 50), nurses (n = 94) and “others” (n =60, mainly social welfare officers and assistant nurses). Except for the personality dimension emotional stability which was measured using an established instrument, all measurement scales were operationalizations of codes and categories from the qualitative study (ten scales altogether). Four multiple regression analyses were performed with long‐term positive and negative reactions in everyday acute and morally extremely taxing situations respectively as dependent variables. The outcome showed that long‐term positive reactions covaried with much use of the coping strategies Emotional distancing and Constructive emotional confrontation and a perception of a well‐functioning Formal social support. Regarding long‐term negative reactions, higher age and little use of Emotional distancing accounted for much of the variance. Immediate emotional reactions also contributed significantly. Conclusion: the results largely supported the model concepts and their assumed relationships.     

A semantic challenge to non-realist cognitivism

Abstract

Recently, some philosophers have attempted to escape familiar challenges to orthodox nonnaturalist normative realism by abandoning the robust metaphysical commitments of the orthodox view. One such view is the ‘Non-Metaphysical Non-Naturalism’ or ‘Non-Realist Cognitivism’ proposed by Derek Parfit and a few others. The trouble is that, as it stands, Non-Realist Cognitivism seems unable to provide a substantive non-trivial account of the meaning and truth conditions of moral claims. The paper considers various strategies one might use to address the challenge. There is a rich field of views that are cognitivist and non-realist. But the paper is skeptical of the prospects of Non-Realist Cognitivism.     

Ethical intuitionism and the linguistic analogy

It is a central tenet of ethical intuitionism as defended by W. D. Ross and others that moral theory should re?ect the convictions of mature moral agents. Hence, intuitionism is plausible to the extent that it corresponds to our well-considered moral judgments. After arguing for this claim, I discuss whether intuitionists o?er an empirically adequate account of our moral obligations. I do this by applying recent empirical research by John Mikhail that is based on the idea of a universal moral grammar to a number of claims implicit in W. D. Ross’s normative theory. I argue that the results at least partly vindicate intuitionism.     

Intention as action under development: why intention is not a mental state

This paper constructs a theory according to which an intention is not a mental state but an action at a certain developmental stage. I model intention on organic life, and thus intention stands to action as (e.g.) tadpole stands to frog. I then argue for this theory by showing how it overcomes three problems: intending while (1) merely preparing, (2) not taking any steps, and (3) the action is impossible. The problems vanish when we see that not all actions are mature. Just as some frogs (such as tadpoles) are immature frogs, some actions (such as intentions) are immature actions.     

Righteous or self‐righteous anger? Justice sensitivity moderates defensive outrage at a third‐party harm‐doer

While bystanders' outrage over moral transgressions may represent a genuine desire to restore justice, such expressions can also be self‐serving—alleviating guilt and bolstering one's moral status. Four studies examined whether individual differences in observer justice sensitivity (JS_O) moderate the degree to which outrage at third‐party harm‐doing reflects concerns about one's own moral identity rather than justice per se. Among participants low (vs. high) in JS_O, feelings of guilt predicted greater outrage and desire to punish a corporation's sweatshop labor practices (Studies 1 & 2). Furthermore, affirming one's personal moral identity reduced outrage and support for punishing a corporate harm‐doer among those low, but not high in JS_O (Studies 3 & 4). Similar moderation was absent for other forms of justice sensitivity and just world beliefs. Effects were not explained by negative affect, empathy, personal harm, or political orientation. Results suggest that JS_O uniquely differentiates defensive and justice‐driven moral outrage (150/150).     

Victims' Stories: A Call to Care

In her book Victims' Stories and the Advancement of Human Rights, Diana Meyers offers a careful analysis of victims' stories as a narrative genre, and she argues that stories in this genre function as a call to care: they both depict a moral void and issue a moral demand, thereby fostering the development of a culture of human rights. This article, while finding Meyers's articulation of this idea compelling, questions Meyers's account of how victims' stories do their moral work. Whereas Meyers argues that victims' stories are complete narratives, characterized by a distinctive form of closure, it suggests that the moral power of victims' stories may lie in part in their open‐endedness or lack of closure. In telling their stories, victims engage their audiences in a new moral relationship and implicitly give them a role to play in bringing about the moral (and narrative) closure they seek.     

德行领导与员工不道德行为、利他行为:道德推脱的中介作用

以道德推脱理论为基础,运用问卷调查法,通过对776名员工的调查,探讨了德行领导对员工不道德行为和利他行为的影响及道德推脱在这一影响中的中介作用。研究发现:(1)德行领导会抑制员工不道德行为的产生、促进员工利他行为的出现;(2)道德推脱会促进员工不道德行为的产生、抑制员工利他行为的出现;(3)德行领导通过道德推脱的完全中介作用负向影响员工的不道德行为,通过道德推脱的部分中介作用正向影响员工的利他行为。     

Collectivizing Rescue Obligations in Bioethics

Bioethicists invoke a duty to rescue in a wide range of cases. Indeed, arguably, there exists an entire medical paradigm whereby vast numbers of medical encounters are treated as rescue cases. The intuitive power of the rescue paradigm is considerable, but much of this power stems from the problematic way that rescue cases are conceptualized—namely, as random, unanticipated, unavoidable, interpersonal events for which context is irrelevant and beneficence is the paramount value. In this article, I critique the basic assumptions of the rescue paradigm, reframe the ethical landscape in which rescue obligations are understood, and defend the necessity and value of a wider social and institutional view. Along the way, I move back and forth between ethical theory and a concrete case where the duty to rescue has been problematically applied: the purported duty to regularly return incidental findings and individual research results in genomic and genetic research.     

The Association Between Psychological Well-Being and Problematic Use of Internet Communicative Services Among Young People

Previous studies on problematic Internet use have focused almost exclusively on the fact that presence of negative functioning, such as social anxiety, depressive symptoms, or loneliness, represents a risk factor for unhealthy use of the web. For this reason the aim of the present study was to investigate the association between psychological well-being dimensions and problematic use of Internet communicative services. In the current study 495 undergraduate students were recruited. The Italian adaptations of the Psychological Well-being Scales and the Generalized Problematic Internet Use Scale 2 (GPIUS2) were used to assess psychological well-being dimensions and generalized problematic Internet use, respectively. Psychological well-being dimensions explained a significant portion of variance for the GPIUS2 total score levels, after controlling for sex, age, and occupational status. The levels of Autonomy, Environmental Mastery, and Positive Relations with Others acted as significant negative predictors of the tendency to use the web for regulating negative feelings, compulsive use of the web, and the negative outcomes that can arise as a result. The overall findings of the present study provide preliminary evidence that low psychological well-being is associated with problematic use of Internet communicative services.