The ‘Diversity-Compass’: Developing an Instrument for Health Care Professionals to Deal with Moral Issues Concerning Cultural, Religious and Sexual Diversity in Long-Term Care Organizations

"Culture, religion, gender identity and sexual orientation play an important role in patients’ and professionals’ care preferences and communication. Population diversity leads to differing moral perspectives regarding health, wellbeing and care practices. This can generate value conflicts between patients and professionals concerning what good care is. Accordingly, increasing societal pluralism creates novel challenges for professionals regarding how they ought to deliver equitable and diversity-responsive care to minority populations. To support professionals in dealing with moral issues related to cultural, religious and sexual diversity in long-term-care organizations, we developed an ethics support instrument called the Diversity-Compass. The Diversity-Compass is a low-threshold instrument designed to help professionals in addressing and dealing with situations in which moral conflicts pertaining to diversity occur. We employed a participatory design and conducted seven focus groups (n=55), five expert interviews (n=5) and facilitated four meetings with a working group of various care professionals (n=18) who developed and tested preliminary versions of the instrument through iterative co-creation. Resulting from this process the Diversity-Compass emerged. Next to offering a question-based, reflection-invoking conversation method, the instrument includes seven specific tips to support professionals when engaging in conversations about diversity-related moral issues with patients or other professionals. Our study is an example of how bioethicists can provide clinical ethics support by using a participatory design and co-creatively developing an instrument to aid professionals in dealing with moral issues related to cultural, religious and sexual diversity in long-term care. The Diversity-Compass can be used by organizations and professionals to promote good, diversity-responsive care. "

Vaccine refusal/hesitancy—the ethical point of view

Background In 2019, WHO classified vaccine hesitancy as one of the top 10 threats to global health. Vaccination is an area of excellence in nursing that has gained a new focus and has become a challenge in the provision of care and in the management field. Vaccine hesitation raises questions about mandatory vaccination, individual versus collective freedom that are highlighted in the current context due to the emergence of new vaccines. In this paper, we want to analyze and update knowledge about vaccines hesitancy from an ethical and bioethical perspective. Methods A combination of literature reviews on vaccine refusal/hesitancy, ethics and COVID-19 vaccine confidence, accessed on SciELO and PubMed databases and analysis of documents from General Directorate of Health and Ordem dos Enfermeiros (National Nurses Association). Results Vaccination programs aim is a collective protection. The desirable effects at individual level do not have the same ethical value at collective level, leading to cost-benefit imbalances. Moral conflicts between the individual and the collective, cost-benefit imbalances and the insufficiency of bioethics principles, lead us to the use of other moral values and principles, such as responsibility, solidarity and social justice, as a tool for ethical reflection problems related to COVID-19 vaccines. Conclusions There are no perfect solutions to ethical dilemmas and some optimal solutions could depend the context. In a pandemic situation, one of the most relevant ethical issues is the herd immunity since it leaves public health at risk. Equity and the principle of justice in vaccination campaign are shown daily in the nursing profession.

Zum Begriff des Wertes in der Ethik Immanuel Kants

The reference to “values” as normatively guiding structures is widespread in contemporary political and societal discussions. Values are expected to improve stability and provide ethical orientation in modern civilizations which are shaped by manifold cultural influences. At the same time values are often underdetermined, not well legitimized and difficult to interpret in concrete cases. The article takes up such appeals to “values” and contrasts them with Kant’s concept of moral value (in the singular). Moral value, according to Kant, remains dependent on the moral law as a formal procedure. Key issues for the understanding of moral value in Kant refer to overdetermined action and to the acquisition of maxims in life practice. An analysis of these aspects comes to the conclusion that the Kantian concept of moral value bypasses problems associated with the appeal to “values” and is promising for dealing with moral conflicts in modern societies.

Mary, did you consent?

The Christian and Islamic doctrine of the virgin birth claim God asexually impregnated the Virgin Mary with Jesus, Mary's impregnation was fully consensual (virgin consent), and God never acts immorally (divine goodness). First, I show that God's actions and Mary's background beliefs undermine her consent by virtue of coercive incentives, Mary's comparative powerlessness, and the generation of moral conflicts. Second, I show that God's non-disclosure of certain reasonably relevant facts undermines Mary's informed consent. Third, I show that a recent attempt by Jack Mulder to rescue virgin consent fails. As divine goodness and virgin consent are more central to orthodoxy, Christians and Muslims have powerful reason to reject virgin birth.

Prologue

‘Prologue’ provides a background on Henry James’s writing, the hallmarks of which are aesthetic self-consciousness and a focus on the conventions and etiquette of the social elite. James is considered to be among the greatest English-language novelists. He specialized in profound portraits of human character, the relations between genders, and moral conflicts. He wrote with extraordinary insight about women and girls, and about the power conferred by money and the vulnerability conferred by lacking it.

Dirty Hands and Moral Conflict – Lessons from the Philosophy of Evil

According to one understanding of the problem of dirty hands, every case of dirty hands is an instance of moral conflict, but not every instance of moral conflict is a case of dirty hands. So, what sets the two apart? The dirty hands literature has offered widely different answers to this question but there has been relatively little discussion about their relative merits as well as challenges. In this paper I evaluate these different accounts by making clear which understanding of concept distinctness underlies them and which of them is, ultimately, the most plausible one in the case of dirty hands and ordinary moral conflict. In order to do so, I will borrow from the terminology employed in recent debates in the philosophy of evil which have tackled a similar problem to the one at hand, i.e. defining what sets evil apart from ordinary wrongdoing. Here it has been argued that concepts could be distinct in three ways: they can have a quantitative difference, a strong qualitative or a moderate qualitative difference. I conclude that the most convincing definition of dirty hands draws a moderate qualitative distinction between ordinary moral conflict according to which dirty hands are those moral conflicts that involve a serious violation or betrayal of a core moral value.

Should Shadow Education Stay as a Shadow or Exist as Co-curricula Alongside Mainstream Education?

Intense competition and educational privatization have fostered demands for student personalization, leading to shadow education becoming entrenched in the Asian education sector. Its social influence is expanding and far-reaching, which has attracted many scholars to study this issue. Scholars have been arguing about the adverse effects of shadow education on widening the inequality of social problems, increasing students’ psychological pressures, and also the moral conflicts that teachers face. This position paper explores and discusses the rationality of shadow education from three dimensions: social, psychological, and economic. It argues that shadow education should exist as a co-curricular or supplement to formal mainstream education because it serves as a mirror that can reflect the missing parts of formal education, as shadow education can assist lower academic performing students and cater to need-oriented functions under-utilized within mainstream education. This article concludes with some recommendations for education policymakers in the Thailand Ministry of Education (MOE) in Thailand regarding the rising of the shadow education phenomenon. With stronger oversight of shadow education operators, improved communication between mainstream schools and parents, and increased financial support to the public education sector, a dynamic synergy between mainstream schools, shadow education operators, parents and students can be achieved.

Introduction: Philosophical Preliminaries

This chapter expounds some technical philosophical notions that figure prominently in the rest of the book. Among the phenomena elucidated are moral conflicts, strong permissibility versus weak permissibility, overtopping obligations versus non-overtopping obligations, weak absoluteness versus strong absoluteness, physical freedom versus deontic freedom, the Hohfeldian analysis of legal positions (claim-rights and duties, liberties and no-rights, powers and liabilities, and immunities and disabilities), and the distinction between causal relationships and constitutive relationships. Although all of these concepts and distinctions are of great significance in debates over the principle of freedom of expression, they also figure saliently in many other debates. Hence, the purpose of this introductory chapter is to provide the basic philosophical preliminaries that are needed for a rigorous engagement with the principle of freedom of expression. The chapter sets the stage for the subsequent chapters, where that principle is the focus of attention.

Жанрово-cтильова cвоєрідність Сатирич Львівської літературної групи „Дванадцятка” у контексті літературної традиції Галичини 20-40-x рр. ХX ст.

The article deals with the ideological and thematic and genre-style peculiarities of the press satire of Galychynaof the 1920’s and 1940’s, its thematic filling and specific features on the example of theworks of satirists of the Lviv literary group “The Twelve”. It is determined the specifics of the development of humorous and satirical genres, inparticularfeuilleton, mini-feuilleton, pamphlet, humoresque, mini-humoresque, fable. The features of social and moral conflicts in their work are investigated.