Moral distress experienced by health care professionals who provide home-based palliative care

Health care providers regularly encounter situations of moral conflict and distress in their practice. Moral distress may result in unfavorable outcomes for both health care providers and those in their care. The purpose of this study was to examine the experience of moral distress from a broad range of health care occupations that provide home-based palliative care as the initial step of addressing the issue. A critical incident approach was used in qualitative interviews to elicit the experiences on moral distress from 18 health care providers drawn from five home visiting organizations in south central Ontario, Canada. Most participants described at least two critical incidents in their interview generating a total of 47 critical incidents. Analyses of the critical incidents revealed 11 issues that triggered moral distress which clustered into three themes, (a) the role of informal caregivers, b) challenging clinical situations and (c) service delivery issues. The findings suggest that the training and practice environments for health care providers need to be designed to recognize the moral challenges related to day-to-day practice.

Distinguished algebraic semantics for t-norm based fuzzy logics:Methods and algebraic equivalencies

This paper is a contribution to Mathematical fuzzy logic, in particular to the algebraic study of t-norm based fuzzy logics. In the general framework of propositional core and ?-core fuzzy logics we consider three properties of completeness with respect to any semantics of linearly ordered algebras. Useful algebraic characterizations of these completeness properties are obtained and their relations are studied. Moreover, we concentrate on five kinds of distinguished semantics for these logics-namely the class of algebras defined over the real unit interval, the rational unit interval, the hyperreals (all ultrapowers of the real unit interval), the strict hyperreals (only ultrapowers giving a proper extension of the real unit interval) and finite chains, respectively-and we survey the known completeness methods and results for prominent logics. We also obtain new interesting relations between the real, rational and (strict) hyperreal semantics, and good characterizations for the completeness with respect to the semantics of finite chains. Finally, all completeness properties and distinguished semantics are also considered for the first-order versions of the logics where a number of new results are proved. © 2009 Elsevier B.V. All rights reserved.

A multiagent network for peer norm enforcement

In a multiagent system where norms are used to regulate the actions agents ought to execute, some agents may decide not to abide by the norms if this can benefit them. Norm enforcement mechanisms are designed to counteract these benefits and thus the motives for not abiding by the norms. In this work we propose a distributed mechanism through which agents in the multiagent system that do not abide by the norms can be ostracised by their peers. An ostracised agent cannot interact anymore and looses all benefits from future interactions. We describe a model for multiagent systems structured as networks of agents, and a behavioural model for the agents in such systems. Furthermore, we provide analytical results which show that there exists an upper bound to the number of potential norm violations when all the agents exhibit certain behaviours. We also provide experimental results showing that both stricter enforcement behaviours and larger percentage of agents exhibiting these behaviours reduce the number of norm violations, and that the network topology influences the number of norm violations. These experiments have been executed under varying scenarios with different values for the number of agents, percentage of enforcers, percentage of violators, network topology, and agent behaviours. Finally, we give examples of applications where the enforcement techniques we provide could be used.

Moral emotions and the envisioning of mitigating circumstances for wrongdoing

Anger may be more responsive than disgust to mitigating circumstances in judgments of wrongdoing. We tested this hypothesis in two studies where we had participants envision circumstances that could serve to mitigate an otherwise wrongful act. In Study 1, participants provided moral judgments, and ratings of anger and disgust, to a number of transgressions involving either harm or bodily purity. They were then asked to imagine and report whether there might be any circumstances that would make it all right to perform the act. Across transgression type, and controlling for covariance between anger and disgust, levels of anger were found to negatively predict the envisioning of mitigating circumstances for wrongdoing, while disgust was unrelated. Study 2 replicated and extended these findings to less serious transgressions, using a continuous measure of mitigating circumstances, and demonstrated the impact of
anger independent of deontological commitments. These findings highlight the differential relationship that anger and disgust have with the ability to envision mitigating factors.

Religiosity, Political Orientation, and Consequentialist Moral Thinking

Three studies demonstrated that the moral judgments of religious individuals and political conservatives are highly insensitive to consequentialist (i.e., outcome-based) considerations. In Study 1, both religiosity and political conservatism predicted a resistance toward consequentialist thinking concerning a range of transgressive acts, independent of other relevant dispositional factors (e.g., disgust sensitivity). Study 2 ruled out differences in welfare sensitivity as an explanation for these findings. In Study 3, religiosity and political conservatism predicted a commitment to judging “harmless” taboo violations morally impermissible, rather than discretionary, despite the lack of negative consequences rising from the act. Furthermore, non-consequentialist thinking style was shown to mediate the relationship religiosity/conservatism had with impermissibility judgments, while intuitive thinking style did not. These data provide further evidence for the influence of religious and political commitments in motivating divergent moral judgments, while highlighting a new dispositional factor, non-consequentialist thinking style, as a mediator of these effects.

Botanical travel, climate and David Moore’s moral geographies of Europe

During his forty-year curatorship of the Royal Dublin Society's botanical gardens in Glasnevin (1838–1879), David Moore undertook a number of excursions to continental Europe. These served to deepen the networks of plant exchange between Dublin and other botanical institutions and allowed him to examine the relationships between climate, plant survivability and societal development. This paper focuses on two trips taken in the 1860s to Scandinavia and Iberia and charts how Moore situated his experience of these places within a climatic hermeneutic. Moore's understanding of northern and southern Europe was organized around a set of judgments about their relative backwardness or advancement with respect to his experience of home and was seen through the lens of a moral climatology. Moreover, his Scots Presbyterian background and his commitment to natural theology informed his interpretation of the landscapes he encountered in his excursions across Europe.