Moral Distress,Workplace Health,and Intrinsic Harm

Moral distress is now being recognized as a frequent experience for many health care providers, and there's good evidence that it has a negative impact on the health care work environment. However, contemporary discussions of moral distress have several problems. First, they tend to rely on inadequate characterizations of moral distress. As a result, subsequent investigations regarding the frequency and consequences of moral distress often proceed without a clear understanding of the phenomenon being discussed, and thereby risk substantially misrepresenting the nature, frequency, and possible consequences of moral distress. These discussions also minimize the intrinsically harmful aspects of moral distress. This is a serious omission. Moral distress doesn't just have a negative impact on the health care work environment; it also directly harms the one who experiences it. In this paper, I claim that these problems can be addressed by first clarifying our understanding of moral distress, and then identifying what makes moral distress intrinsically harmful. I begin by identifying three common mistakes that characterizations of moral distress tend to make, and explaining why these mistakes are problematic. Next, I offer an account of moral distress that avoids these mistakes. Then, I defend the claim that moral distress is intrinsically harmful to the subject who experiences it. I conclude by explaining how acknowledging this aspect of moral distress should reshape our discussions about how best to deal with this phenomenon.     

Ethics,evolution and culture

Recent work in the fields of evolutionary ethics and moral psychology appears to be converging on a single empirically- and evolutionary-based science of morality or ethics. To date, however, these fields have failed to provide an adequate conceptualisation of how culture affects the content and distribution of moral norms. This is particularly important for a large class of moral norms relating to rapidly changing technological or social environments, such as norms regarding the acceptability of genetically modified organisms. Here we suggest that a science of morality/ethics can benefit from adopting a cultural evolution or gene-culture coevolution approach, which treats culture as a second, separate evolutionary system that acts in parallel to biological/genetic evolution. This cultural evolution approach brings with it a set of established theoretical concepts (e.g. different cultural transmission mechanisms) and empirical methods (e.g. evolutionary game theory) that can significantly improve our understanding of human morality.

VIRTUE ETHICS AND THE SELECTION OF CHILDREN WITH IMPAIRMENTS: A REPLY TO ROSALIND MCDOUGALL

In ‘Parental Virtues: A New Way of Thinking about the Morality of Reproductive Actions’ Rosalind McDougall proposes a virtue‐based framework to assess the morality of child selection. Applying the virtue‐based account to the selection of children with impairments does not lead, according to McDougall, to an unequivocal answer to the morality of selecting impaired children. In ‘Impairment, Flourishing, and the Moral Nature of Parenthood,’ she also applies the virtue‐based account to the discussion of child selection, and claims that couples with an impairment are morally justified in selecting a child with the same impairment. This claim, she maintains, reveals that the flourishing of a child should be understood as requiring environment‐specific characteristics. I argue that McDougall's argument begs the question. More importantly, it does not do justice to virtue ethics. I also question to what extent a virtue ethics framework can be successfully applied to discussions about the moral permissibility of reproductive actions.     

Emergency Contraceptives and the Beginning of Human Animals

Emergency contraceptives may sometimes prevent implantation, thereby causing the death of the embryo. According to some positions contrary to abortion, because the embryo is a human animal, there are usually decisive moral reasons not to use them. In this article, I will show that objecting to the use of emergency contraceptives on those grounds is unjustified. If organisms are real existents, then according to the most plausible conception of what is required for a group of cells to compose one, the embryo cannot qualify as a single organism. On the other hand, if organisms are virtual objects, then whether or not the embryo qualifies as one is morally irrelevant. I conclude that even if those positions are right about the morality of abortion, they are not entitled to oppose the use of emergency contraceptives.     

Moral Horizons of Land and Place

ABSTRACT

A recent ‘moral turn’ in anthropology has cast new light on morality as a subject of ethnographic inquiry, and on the making of moral meaning and judgment. This article, and the special issue it prefaces, contribute to this emergent literature through foregrounding and examining the moral dimensions of land and place. Taking up Didier Fassin’s injunction for a critical moral anthropology – rather than an anthropology of morality – we look to land and place as groundings for moral challenges and practices that are nevertheless not place-bound. A critical moral anthropology of land and place should be directed, we argue, to the interplay of mobility and emplacement, to the dynamics of landscape and ‘dwelling’, and to the multiplicities of expectation and meaning that surround the making and exploitation of resources. In contexts of global and local change, land and place offer productive grounds from which to consider the moral horizons – both spatial and temporal – of our world and our discipline.     

Animal morality: What is the debate about?

Empirical studies of the social lives of non-human primates, cetaceans, and other social animals have prompted scientists and philosophers to debate the question of whether morality and moral cognition exists in non-human animals. Some researchers have argued that morality does exist in several animal species, others that these species may possess various evolutionary building blocks or precursors to morality, but not quite the genuine article, while some have argued that nothing remotely resembling morality can be found in any non-human species. However, these different positions on animal morality generally appear to be motivated more by different conceptions of how the term “morality” is to be defined than by empirical disagreements about animal social behaviour and psychology. After delving deeper into the goals and methodologies of various of the protagonists, I argue that, despite appearances, there are actually two importantly distinct debates over animal morality going on, corresponding to two quite different ways of thinking about what it is to define “morality”, “moral cognition”, and associated notions. Several apparent skirmishes in the literature are thus cases of researchers simply talking past each other. I then focus on what I take to be the core debate over animal morality, which is concerned with understanding the nature and phylogenetic distribution of morality conceived as a psychological natural kind. I argue that this debate is in fact largely terminological and non-substantive. Finally, I reflect on how this core debate might best be re-framed.     

Re-Moralizing the Suicide Debate

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

The Unbounded Space and Moral Transgression: Capitalist Expansion in West New Britain

ABSTRACT

Capitalist transformations in West New Britain Province, Papua New Guinea, have focused on setting boundaries on land and social relations as an efficient way to generate productive relations. But for the Maututu around Bialla town where the palm oil industry has been established the perception of productivity rests not on establishing boundaries but on exploring horizons. Recent dramatic changes to the economy and demography of this area have introduced moral conflict into Maututu endeavours to generate well-being. Maututu have responded to these conflicts in ways that continue to bring their indigenous morality to bear on the moral strategies pursued by state and capitalist forces.     

Why We Need to Teach the Evolution of Morality

Here, in textbook style, is a concise biological account of the evolution of morality. It addresses morality on three levels: moral outcomes (behavioral genetics), moral motivation or intent (psychology and neurology), and moral systems (sociality). The rationale for teaching this material is addressed in Allchin (2009). Classroom resources (including accompanying images and video links) and a discussion of teaching strategies are provided online at: .     

Sexual selection for moral virtues

Moral evolution theories have emphasized kinship, reciprocity, group selection, and equilibrium selection. Yet, moral virtues are also sexually attractive. Darwin suggested that sexual attractiveness may explain many aspects of human morality. This paper updates his argument by integrating recent research on mate choice, person perception, individual differences, costly signaling, and virtue ethics. Many human virtues may have evolved in both sexes through mutual mate choice to advertise good genetic quality, parenting abilities, and/or partner traits. Such virtues may include kindness, fidelity, magnanimity, and heroism, as well as quasi-moral traits like conscientiousness, agreeableness, mental health, and intelligence. This theory leads to many testable predictions about the phenotypic features, genetic bases, and social-cognitive responses to human moral virtues.     

Wild justice and fair play: cooperation,forgiveness, and morality in animals

In this paper I argue that we can learn much about ‘wild justice’ and the evolutionary origins of social morality – behaving fairly – by studying social play behavior in group-living animals, and that interdisciplinary cooperation will help immensely. In our efforts to learn more about the evolution of morality we need to broaden our comparative research to include animals other than non-human primates. If one is a good Darwinian, it is premature to claim that only humans can be empathic and moral beings. By asking the question ‘What is it like to be another animal?’ we can discover rules of engagement that guide animals in their social encounters. When I study dogs, for example, I try to be a ‘dogocentrist’ and practice ‘dogomorphism.’ My major arguments center on the following ‘big’ questions: Can animals be moral beings or do they merely act as if they are? What are the evolutionary roots of cooperation, fairness, trust, forgiveness, and morality? What do animals do when they engage in social play? How do animals negotiate agreements to cooperate, to forgive, to behave fairly, to develop trust? Can animals forgive? Why cooperate and play fairly? Why did play evolve as it has? Does ‘being fair’ mean being more fit – do individual variations in play influence an individual's reproductive fitness, are more virtuous individuals more fit than less virtuous individuals? What is the taxonomic distribution of cognitive skills and emotional capacities necessary for individuals to be able to behave fairly, to empathize, to behave morally? Can we use information about moral behavior in animals to help us understand ourselves? I conclude that there is strong selection for cooperative fair play in which individuals establish and maintain a social contract to play because there are mutual benefits when individuals adopt this strategy and group stability may be also be fostered. Numerous mechanisms have evolved to facilitate the initiation and maintenance of social play to keep others engaged, so that agreeing to play fairly and the resulting benefits of doing so can be readily achieved. I also claim that the ability to make accurate predictions about what an individual is likely to do in a given social situation is a useful litmus test for explaining what might be happening in an individual's brain during social encounters, and that intentional or representational explanations are often important for making these predictions.     

Parental virtue: a new way of thinking about the morality of reproductive actions

In this paper I explore the potential of virtue ethical ideas to generate a new way of thinking about the ethical questions surrounding the creation of children. Applying ideas from neo‐Aristotelian virtue ethics to the parental sphere specifically, I develop a framework for the moral assessment of reproductive actions that centres on the concept of parental virtue. I suggest that the character traits of the good parent can be used as a basis for determining the moral permissibility of a particular reproductive action. I posit three parental virtues and argue that we can see the moral status of a reproductive action as determined by the relationship between such an action and (at least) these virtues. Using a case involving selection for deafness, I argue that thinking in terms of the question ‘would a virtuous parent do this?’ when morally assessing reproductive action is a viable and useful way of thinking about issues in reproductive ethics.     

Ape imagination? A sentimentalist critique of Frans de Waal’s gradualist theory of human morality

This essay draws on Adam Smith’s moral sentimentalism to critique primatologist Frans de Waal’s gradualist theory of human morality. De Waal has spent his career arguing for continuity between primate behavior and human morality, proposing that empathy is a primary moral building block evident in primate behavior. Smith’s moral sentimentalism—with its emphasis on the role of sympathy in moral virtue—provides the philosophical framework for de Waal’s understanding of morality. Smith’s notion of sympathy and the imagination involved in sympathy is qualitatively different from animal sympathy. I argue that Smithian sympathy includes the ability to represent propositional attitudes and take into account multiple perspectives which are then synthesized into a singular impartial perspective. Furthermore, Smithian moral judgment requires the capacity for emotion regulation and moral self-cultivation, or the ability to shape and control one’s reactive attitudes. Taken together, these capacities far outstrip the capacities of animals, disrupting de Waal’s gradualism.     

REASONS TO REDEFINE MORAL DISTRESS: A FEMINIST EMPIRICAL BIOETHICS ANALYSIS

There has been increasing debate in recent years about the conceptualization of moral distress. Broadly speaking, two groups of scholars have emerged: those who agree with Jameton’s ‘narrow definition’ that focuses on constraint and those who argue that Jameton’s definition is insufficient and needs to be broadened. Using feminist empirical bioethics, we interviewed critical care nurses in the United Kingdom about their experiences and conceptualizations of moral distress. We provide our broader definition of moral distress and examples of data that both challenge and support our conceptualization. We pre‐empt and overcome three key challenges that could be levelled at our account and argue that there are good reasons to adopt our broader definition of moral distress when exploring prevalence of, and management strategies for, moral distress.     

Objectivity and Illusion in Evolutionary Ethics: Comments on Waller

In this paper I argue that any adequate evolutionary ethical theory needs to account for moral belief as well as for dispositions to behave altruistically. It also needs to be clear whether it is offering us an account of the motivating reasons behind human behaviour or whether it is giving justifying reasons for a particular set of behaviours or, if both, to distinguish them clearly. I also argue that, unless there are some objective moral truths, the evolutionary ethicist cannot offer justifying reasons for a set of behaviours. I use these points to refute Waller's claims that the illusion of objectivity plays a dispensable role in Ruse's theory, that my critique of Ruse's Darwinian metaethics is built on a false dilemma, that there is nothing to be distressed about if morality is not objective, and that ethical beliefs are subject to a kind of causal explanation that undermines their objectivity in a way that scientific beliefs are not.     

The Evolution of Morality

Here, in textbook style, is a concise biological account of the evolution of morality. It addresses morality on three levels: moral outcomes (behavioral genetics), moral motivation or intent (psychology and neurology), and moral systems (sociality). The rationale for teaching this material is addressed in Allchin (2009). Classroom resources (including accompanying images and video links) and a discussion of teaching strategies are provided online at: http://EvolutionOfMorality.net.     

A reexamination of Gilligan’s analysis of the female moral system

Gilligan’s (1982) refinement of Kohlberg’s theory on moral development operates on two theses: (1) females, more so than males, reach moral decisions based on the personalities of the relevant individuals; and (2) female behaviors stemming from moral decisions are based upon “care” and “responsibility for others.” This article accepts the first thesis but argues that the second is incorrect. That is, self-interest—i.e., aiding “blood” kin and/or carefully monitoring reciprocity—rather than “altruism” is argued to be the operant dynamic in forging distaff morality and resultant behavior. Six empirical examples are presented as contraindicative of Gilligan’s second thesis. Finally, it is suggested that selection for the psychological traits of independence and the mastery of subtle social chess yielded ancestral females who had more descendants—us—than did females with alternative profiles. Nancy S. Coney is a professor at Western Illinois University and is interested in both clinical and nonclinical aspects of women’s psychology. Wade C. Mackey is interested in biocultural anthropology and has authored two books on fathering:Fathering Behaviors (Plenum, 1995) andThe American Father (Plenum, 1996).     

Moral Darwinism: Ethical evidence for the descent of man

Could an ethical theory ever play a substantial evidential role in a scientific argument for an empirical hypothesis? InThe Descent of Man, Darwin includes an extended discussion of the nature of human morality, and the ethical theory which he sketches is not simply developed as an interesting ramification of his theory of evolution, but is used as a key part of his evidence for human descent from animal ancestors. Darwin must rebut the argument that, because of our moral nature, humans are essentially different in kind from other animals and so had to have had a different origin. I trace his causal story of how the moral sense could develop out of social instincts by evolutionary mechanisms of group selection, and show that the form of Utilitarianism he proposes involves a radical reduction of the standard of value to the concept of biological fitness. I argue that this causal analysis, although a weakness from a normative standpoint, is a strength when judged for its intended purpose as part of an evidential argument to confirm the hypothesis of human descent.