Moral Reservations Research Articles

Moral reconciling at career launch: politics, race, and occupational choice

Abstract Recent research suggests that college-educated young adults, especially those who are politically liberal and/or racially marginalized, exhibit moral reservations about their intended occupations. How do they justify entering occupations that conflict with their morals, and with what consequences? This article examines the case of 74 mostly liberal prospective law school students from a range of racial backgrounds followed over 2 years. In interviews at career launch, respondents criticized the legal profession for its perceived perpetuation of inequality and violence. Despite their moral reservations, they articulated three occupational justification narratives for attending law school: lifting up (exceptional lawyering); leveraging out (legal education for nonlawyer aspirations); and leaning in (conscientious class mobility/maintenance). These narratives differentiate between morally ‘good’ and ‘bad’ occupational domains—a cultural-cognitive process we term moral reconciling. We theorize how moral reconciling at career launch charts young adults down different early career trajectories, with implications for occupational sorting and change.

Physicians' Experiences and Perceptions of Environmental Factors Affecting Their Practices of Continuous Deep Sedation until Death: A Secondary Qualitative Analysis of an Interview Study.

As previous research has paid little attention to environmental factors affecting the practice of continuous deep sedation until death (CDS), we aimed to explore these using physicians’ experiences and perceptions. We performed an interpretative thematic analysis of primary data from a qualitative interview study conducted from February to May 2019 in Belgium with 47 physicians. Structural factors were identified: the lack of professional and/or technical support in monitoring sedated patients; the use of guidelines in team contexts; the time constraints for treating individual patients and work pressure; the structural knowledge gap in medical education; the legal context for assisted dying; and the lack of a clear legal context for CDS. Cultural factors were identified: the moral reservations of care teams and/or institutions towards CDS; the presence of a palliative care culture within care teams and institutions; the culture of fear of making clinical errors regarding CDS among a group of physicians; the professional stigma of performing assisted dying among some of the physician population; the different understandings of CDS in medical and policy fields; and the societal taboo around suffering at the end of life and natural death. To conclude, improving CDS practice requires a whole-system approach considering environmental factors.

Health Care Providers as Agents of Change: Integrating PrEP With Other Sexual and Reproductive Health Services for Adolescent Girls and Young Women.

Background: Successful integration of pre-exposure prophylaxis (PrEP) with existing reproductive health services will require iterative learning and adaptation. The interaction between the problem-solving required to implement new interventions and health worker motivation has been well-described in the public health literature. This study describes structural and motivational challenges faced by health care providers delivering PrEP to adolescent girls and young women (AGYW) alongside other SRH services, and the strategies used to overcome them.Methods: We conducted in-depth interviews (IDIs) and focus group discussions (FGDs) with HCWs from two demonstration projects delivering PrEP to AGYW alongside other SRH services. The Prevention Options for the Women Evaluation Research (POWER) is an open label PrEP study with a focus on learning about PrEP delivery in Kenyan and South African family planning, youth mobile services, and public clinics at six facilities. PrIYA focused on PrEP delivery to AGYW via maternal and child health (MCH) and family planning (FP) clinics in Kenya across 37 facilities. IDIs and FGDs were transcribed verbatim and analyzed using a combination of inductive and deductive methods.Results: We conducted IDIs with 36 participants and 8 FGDs with 50 participants. HCW described a dynamic process of operationalizing PrEP delivery to better respond to patient needs, including modifying patient flow, pill packaging, and counseling. HCWs believed the biggest challenge to sustained integration and scaling of PrEP for AGYW would be lack of health care worker motivation, primarily due to a misalignment of personal and professional values and expectations. HCWs frequently described concerns of PrEP provision being seen as condoning or promoting unprotected sex among young unmarried, sexually active women. Persuasive techniques used to overcome these reservations included emphasizing the social realities of HIV risk, health care worker professional identities, and vocational commitments to keeping young women healthy.Conclusion: Sustained scale-up of PrEP will require HCWs to value and prioritize its incorporation into daily practice. As with the provision of other SRH services, HCWs may have moral reservations about providing PrEP to AGYW. Strategies that strengthen alignment of HCW personal values with professional goals will be important for strengthening motivation to overcome delivery challenges.

Experiences, Personal Attitudes, and Professional Stances of Swiss Health Care Professionals Toward Voluntary Stopping of Eating and Drinking to Hasten Death: A Cross-Sectional Study

ContextVoluntary stopping of eating and drinking (VSED) is the self-determined decision of an individual with the decision-making capacity to cause premature death. During the course of VSED, the person is dependent on the support of relatives and health professionals. To date, little is known of the attitudes of Swiss health professionals on this topic. ObjectivesThe objective of this study was to assess the experiences, personal attitudes, and professional stances of Swiss health care professionals toward VSED. MethodsWe conducted a nationwide cross-sectional survey by questioning family physicians and the heads of outpatient care and long-term care (e.g., nursing directors, institute directors, or head nurses) about VSED (n = 1681; response rate 40.1%). Descriptive data analysis and hypothesis testing (occupational group, age, sex, professional years, VSED experience, and regions) were subsequently conducted. ResultsIndividuals who are willing to die are granted the right to professional accompaniment during VSED (agreement 97.8%), and their death is usually classified as a natural form of dying (63.5%) and only rarely (5.4%) as suicide. Family physicians have significantly more moral concerns during accompaniment compared with the heads of outpatient and long-term care (P < 0.001). ConclusionSwiss health care professionals support the autonomy and self-determination of patients, which is also reflected in their positive attitude toward VSED, even if they have moral reservations when accompanying patients.

Edición genómica heredable: un estudio exploratorio desde la perspectiva del principio bioético de la beneficencia

Propósito/Contexto. Este artículo busca comprender el significado que tendría, para un grupo de personas residentes en Bogotá, la posibilidad de realizar variaciones genéticas, previas al nacimiento, en seres humanos. El estudio se centró en la aplicación de la técnica de alteración genómica CRISPR-Cas9, desde la perspectiva del principio bioético de la beneficencia, que está dirigido a realizar el mayor bien posible.Metodología/Enfoque. Primero, se efectuó una revisión teórica de la técnica CRISPR-Cas9 y del principio bioético de la beneficencia. Luego, se estudiaron documentos regulatorios internacionales acerca de la edición genómica. Con base en esto, se aplicó una encuesta, apoyada por un video, para conocer la decisión hipotética que tomaría un grupo de profesionales legos en temas bioéticos, frente a otro grupo de universitarios que recibieron formación bioética. Resultados/Hallazgos. Los resultados mostraron que la modificación genómica destinada a la prevención o a la terapia fue aprobada por ambos grupos, aunque con diferencias. La mejora genómica fue rechazada, en general, por considerarse inmoral; en ambos grupos se abrió la posibilidad de admitirla, no obstante, pero solo como preparación genómica para las futuras generaciones, debido a los efectos del cambio climático.Discusión/Conclusiones/Contribuciones. El principio bioético de la beneficencia resulta esclarecedor porque sugiere el bien, no solo individual sino común. Igualmente, se corrobora que existe una reserva moral frente a la edición genómica heredable.

Autonomous morals: Inferences of mind predict acceptance of AI behavior in sacrificial moral dilemmas

Three studies compared people's judgments of autonomous vehicles (AVs) and humans faced with a moral dilemma. Study 1 showed that, for identical decisions, AVs were judged as more blameworthy, less moral, and less trustworthy compared to humans. However, perceiving AVs as having a human-like mind reduced this difference. Study 2 extended this finding by manipulating AV mindedness. Describing AVs' decision-making capacity in mentalistic terms (relative to mechanistic terms) reduced blame and anger and fostered greater trust and perceptions of morality. Study 3, replicated these findings, and demonstrated that perceived mindedness predicted judgments of trust, morality, and willingness to purchase or ride in an AV. These findings suggest that people's moral reservations about AVs may derive from doubting that AVs have the mental capacities necessary for moral judgment, and that one route for improving trust in AVs is to design them with a veneer of human-like mental qualities.

E. S. Piccolomini Historia de duobus amantibusa: Nyelvi és kulturális gátak tizenhat korai fordítás tükrében

The paper discusses general factors influencing the translators of Eneas Silvius Piccolomini's Historia de duobus amantibus, who translated the love story from Latin into eight vernacular languages during the 15-16th centuries. These factors fell into two broader categories: linguistic limitations and cultural-moral restrictions. The paper argues that the limited knowledge of Latin language and the deficiencies of knowledge concerning classical culture or the moral reservations towards the original Latin text from the part of the translators all influenced the love story's translations. The paper offers a series of case studies to illustrate how translators operational in different vernaculars had faced similar problems and how diverse their responds were to them in altogether sixteen early translations of Historia. Originally written as a conference presentation in 2017, the present paper gives a short summary of the conclusions connected to translatology of the author's recently published monograph: MÁTÉ (2018).

Nurse leaders' role in medical assistance in dying: A relational ethics approach.

Recent changes to the Criminal Code of Canada have resulted in the right of competent adult Canadians to request medical assistance in dying (MAID). Healthcare professionals now can participate if the individual meets specific outlined criteria. There remains confusion and lack of knowledge about the specific role of nurses in MAID. MAID is a controversial topic and nurses may be faced with the challenge of balancing the duty to provide routine care, with moral reservations about MAID. The role of a nursing leader is to support nurses by ensuring they have the knowledge they require to care for patients requesting the service, whether or not the nurse is directly involved in the MAID process. The moral dilemmas raised by MAID provide an opportunity to look at a relational ethics approach to nursing leadership both for MAID and other difficult situations that arise in nursing practice. Relational ethics is a framework that proposes that the ethical moments in healthcare are based on relationships and fostering growth, healing, and health through the foundational concepts of mutual respect, engagement, embodiment, and environment. This article will use a relational ethics framework to examine how nursing leadership can support nurses who care for patients requesting MAID.

Moral Concerns About Responsibility Denial and the Quarantine of Violent Criminals

Some contemporary philosophers maintain we lack the kind of free will that makes us morally responsible for our actions. Some of these philosophers, such as Derk Pereboom, Gregg Caruso, and Bruce Waller, also argue that such a view supports the case for significant reform of the penal system. Pereboom and Caruso explicitly endorse a quarantine model for dealing with dangerous criminals, arguing that while not responsible for their crimes such criminals should be detained in non-harsh conditions and offered the opportunity for rehabilitation. Waller does not explicitly endorse the quarantine model, but his view is similar in significant respects. I argue that such views can too easily lead to the endorsement of legal policies which would result in more frequent punishment of innocent persons for crimes they have not committed. Thus, we should have deep moral reservations about such views.

Incentives to Breach

Empirical evidence and common sense tell us that most people are responsive to economic incentives as well as social and moral norms, and that these sets of incentives are often in tension. The tradeoffs between moral and financial preferences are particularly salient in much legal decision-making, especially in the private law context. This paper presents the methods and results of two new behavioral studies designed to elicit evidence for how people factor both monetary and non-monetary incentives in breach of contract. Participants in Study 1 played a Trust game modified to capture key features of a breach decision. Subjects were offered increasing payouts to break the deal they had made with an anonymous partner. 18.6% participants indicated willingness to break a deal for any amount of profit, and over a quarter (27.9%) were unwilling to breach even when offered $24, almost triple the initial payout, with the remaining subjects identifying a break-point somewhere in between. Study 2 used hypothetical scenarios asking subjects to take the perspectives of buyers or sellers and to indicate how much profit or savings an alternate deal would have to offer in order for the subject to breach the original contract, and found a similar curve. The paper concludes with a discussion of how these methods and preliminary findings may be deployed for more fine-grained inquiries into when individuals do and do not choose a financially attractive breach about which they have moral reservations.

Don’t bring it on: the case against cheerleading as a collegiate sport

The 2010 Quinnipiac cheerleading case raises interesting questions about the nature of both cheerleading and sport, as well as about the moral character of each. In this paper we explore some of those questions, and argue that no form of college cheerleading currently in existence deserves, from a moral point of view, to be recognized as a sport for Title IX purposes. To reach that conclusion, we evaluate cheerleading using a quasi-legal argument based on the NCAA’s definition of sport and conclude that cheerleading fails to qualify as a legitimate sport. A philosophical argument leads to the same conclusion, primarily because of the essential entertainment-aspect of cheerleading. We then examine a consequentialist moral case for making cheerleading an intercollegiate sport and argue that the balance of moral reasons is against doing so. Finally, we look at cheerleading’s newest offspring – Acrobatics and Tumbling, and STUNT – and express our moral reservations about their current claims to be worthy of Title IX recognition. While we would not claim that any single one of our arguments is decisive, we are convinced that the cumulative weight of the arguments against granting intercollegiate sport status to any of the forms of cheerleading or its derivatives is, at present, irresistible.

The Poetics of Indeterminacy: Corneille's Le Cid

This article theorizes that it was an aesthetic motivation that prompted Corneille to leave Le Cid open-ended, despite his assertion in the 1660 examen that it was respect for the bienséances that obliged him to close the tragedy on such an uncertain note. While moral reservations may have played a role, surely an artist as committed to his craft as Corneille was motivated by some overriding aesthetic goal as well. In consequence, Chimène's defiance at the play's end must be viewed as an integral component of the tragedy and not just a reflection of the author's reluctance to violate dramaturgical precepts. I argue that by leaving the dénouement in doubt, Corneille draws deliberate attention to his aesthetic manipulation of the well-known historical/literary precedent. Additionally, and perhaps more importantly, his aesthetic manipulation of history shields Chimène's heroism from the quotidian reality of degradation and devolution that are the defining traits of non-aesthetic realities.

Who Is Willing to Sacrifice Ethical Values for Money and Social Status?

Women select into business school at a lower rate than men and are underrepresented in high-ranking positions in business organizations. We examined gender differences in reactions to ethical compromises as one possible explanation for these disparities. In Study 1, when reading decisions that compromised ethical values for social status and monetary gains, women reported feeling more moral outrage and perceived less business sense in the decisions than men. In Study 2, we established a causal relationship between aversion to ethical compromises and disinterest in business careers by manipulating the presence of ethical compromises in job descriptions. As hypothesized, an interaction between gender and presence of ethical compromises emerged. Only when jobs involved making ethical compromises did women report less interest in the jobs than men. Women’s moral reservations mediated these effects. In Study 3, we found that women implicitly associated business with immorality more than men did.

Evaluation of exclusion prenatal and exclusion preimplantation genetic diagnosis for Huntington's disease in the Netherlands

Individuals at 50% risk of Huntington's disease (HD) who prefer not to know their carrier status, might opt for exclusion prenatal diagnosis (ePND) or exclusion preimplantation genetic diagnosis (ePGD). This study aims to provide a better understanding of couples' motives for choosing ePND or ePND, and surveys couples' experiences in order to make recommendations for the improvement of counselling for exclusion testing. This qualitative retrospective interview study focussed on couples who underwent ePND or ePGD for HD in the period 1996-2010. Seventeen couples were included of which 13 had experienced ePND and 6 ePGD. Mean time-interval since exclusion-testing was 3.9 years. Couples' moral reservations regarding termination of pregnancy (TOP) or discarding healthy embryos were counterbalanced by the wish to protect their future child against HD. Seven couples had terminated a total of 11 pregnancies with a 50% HD risk, none showed regret. ePGD was used by couples who wanted to avoid (another) TOP. ePND and ePGD are acceptable reproductive options for a specific group of counsellees. To guarantee sound standards of care, it is imperative that candidate couples be given in-depth non-directive counselling about all possible scenarios, and adequate professional and psychological support prior to, during and after ePND/ePGD.

Tax Exemption, Moral Reservation, and Regulatory Incentivisation

This paper focuses on those parts of the regulatory environment that are designed to encourage scientific and technological innovation. Patent law is the obvious example; but tax law can also signal encouragement for particular activities. The key question is whether regulators will, or should, withhold tax incentives where there are some, but not universal, moral reservations about an innovation. In order to earth this question, three recent cases at the ECJ, two involving the controversial practice of cord-blood banking, are examined. Insofar as these cases offer any evidence of the prevailing regulatory approach, it seems to be similar to that found in patent law – that is, moral reservations do not count against the applicability of a tax exemption so long as they are not universally recognised.

Attitudes Toward Embryo Research, Worldviews, and the Moral Status of the Embryo Frame

Embryo research for obtaining stem cells is an attitudinal object embedded in a complex space of high expectations for reaching desirable goals, and also of strong moral reservations about the utilization and production of human embryos for research ends. An explanatory model of public attitudes to embryo research is offered here, composed of general variables and worldviews (expectations about scientific-technological advances, reservations to science, trust in scientists, religiosity, gender) and highly specific ones (one evaluative, views on “the moral status of the embryo,” and the other of a cognitive nature, “biological literacy”). A key factor in accepting or rejecting this line of research is the current, de facto, competition between biological science and moral and religious creeds in shaping a frame or image of the moral status of the embryo, either as a pure biological entity or, alternatively, as an actual or potential human being entitled to special protection.

Trench Knives and Mustard Gas: With the 42nd Rainbow Division in France (review)

Reviewed by: Trench Knives and Mustard Gas: With the 42nd Rainbow Division in France John F. Votaw Trench Knives and Mustard Gas: With the 42nd Rainbow Division in France. By Hugh S. Thompson. Edited, with an Introduction by Robert H. Ferrell. College Station: Texas A&M University Press, 2004. ISBN 1-58544-290-9. Maps. Photographs. Notes. Further reading. Index. Pp. xii, 205. $29.95. In 2008 ninety years will have passed since the guns fell silent in France at the conclusion of the First World War. The United States sent more than two million men and about 16,000 women to serve alongside the soldiers of the Allied nations in that war to end war. Second Lieutenant Hugh S. Thompson was one of those soldiers. He was born in 1893 in Chattanooga, Tennessee, educated for two years at the Citadel in South Carolina and assigned to Company L, 168th (formerly the 3rd Iowa) Infantry Regiment, 42nd "Rainbow" Division. The 42nd was a composite division formed from troops from twenty-six states and the District of Columbia. The division headquarters was established in France on 1 November 1917. The 42nd served in every major campaign of the AEF until the Armistice on Monday, 11 November 1918. The Rainbow Division's veterans made American Secretary of War Newton D. Baker an honorary member of the division after the war. The division history bears the banner "Americans All." It was with this famous and courageous unit that Lieutenant Hugh Thompson served with distinction. The editor is a skillful, experienced historian accustomed to working with military materials. He has allowed the voice of Lieutenant Thompson to clearly carry the story of one officer's service in the most trying days of his life in battle. However, this is not a history in the usual sense. It deals with the impressions of battle and recollections of Thompson's fellow officers and soldiers going about their duties in France, not the details of military operations. It is the war of squads and platoons, not brigades and divisions. After returning from the trenches near Badonviller in the Lorraine region in the early spring of 1918, Thompson observed: "The smell of animals, even the [End Page 588] luscious manure piles, was welcome after the stinking trenches" (p. 64). Seriously wounded in the St. Mihiel operation, he received medical care in several base hospitals in France and then returned to the United States for a long, painful recovery. He died in Darlington, South Carolina in 1961. Thompson relied upon a "sketchy diary," letters sent home to his family, and loaned items from friends to write his narrative, which was serialized in the Chattanooga Times in 1934. Memoirs written many years after events can be subject to clouded recollections and interventions of moral reservations. Thompson used fictitious names for some of his contemporaries "[f]or reasons of propriety." As a result, we learn of Captain Clifton, Lt. Colonel Townes and many soldiers by only their last names. The editor's end notes fill in some of the details of the organization of the Rainbow Division and the colloquialisms of the doughboys. An appendix with the division order of battle and the names of key commanders would have been helpful. A bit more detail on the maps would have allowed orientation as Thompson spun out his adventures. A number of excellent general and popular histories have appeared recently. Perhaps the best of the personal memoirs are George C. Marshall's Memoirs of My Services in the World War 1917-1918, published in 1976, and Joseph Dorst Patch's A Soldier's War, published in 1966. Lieutenant Thompson's memoir should be included in that group of high quality first person accounts. Texas A&M Press and Robert Ferrell have made a significant contribution to the literature of World War I, one that gives us authentic details of the human dimension of modern warfare. This book is informative for the casual reader of history who is interested in World War I, but it will be most useful for specialists eager to understand how combat in the Great War affected the doughboys of Uncle Sam's expeditionary army. John F. Votaw First...

Skulls, brains, and memorial culture: on cerebral biographies of scientists in the nineteenth century.

In this paper, I will argue that the scientific investigation of skulls and brains of geniuses went hand in hand with hagiographical celebrations of scientists. My analysis starts with late-eighteenth century anatomists and anthropologists who highlighted quantitative parameters such as the size and weight of the brain in order to explain intellectual differences between women and men and Europeans and non-Europeans, geniuses and ordinary persons. After 1800 these parameters were modified by phrenological inspections of the skull and brain. As the phrenological examination of the skulls of Immanuel Kant, Wilhelm Heinse, Arthur Schopenhauer and others shows, the anthropometrical data was interpreted in light of biographical circumstances. The same pattern of interpretation can be found in non-phrenological contexts: Reports about extraordinary brains were part of biographical sketches, mainly delivered in celebratory obituaries. It was only in this context that moral reservations about dissecting the brains of geniuses could be overcome, which led to a more systematic investigation of brains of geniuses after 1860.

Physician-Assisted Suicide: A Conservative Critique of Intervention

In course of years, my views with respect to morality of physician-assisted suicide have not wavered one bit. I'm opposed to it. Strongly opposed to it. I agree with Karl Barth that is for God and God alone to make an end of human and that God gives life to us an inalienable loan. (1) I believe that meaning and hope are possible in all of life's situations, even in midst of suffering. I am very uncomfortable with idea of physicians, who are trained to preserve life, dispensing lethal drugs to be used to end life. In recent years, however, as Oregon has legalized physician-assisted suicide and other states have considered doing so, I have found myself wrestling with a very difficult question. Do those of us with deep moral reservations about morality of physician-assisted suicide have any business using coercive power of government to try to prevent those who disagree with us from doing what they believe is right? Are there any compelling arguments to justify placing legal roadblocks in way of terminally ill individuals who wish to end their suffering by ending their lives, provided such decisions are made only after thoughtful, careful deliberation in an environment devoid of social pressure? When what some might do poses a significant risk to health and well-being of others, a strong case can be made for intervention. But does a rationale based on protection of those who might be harmed work in case of physician-assisted suicide? Protecting vulnerable individuals from threats posed by others is one matter. But what it consequences of act are born primarily by perpetrator of act? One of most frequent arguments made by those opposed to legalization--an argument with strong overtones of paternalism--holds that we always ought to intervene to prevent self-destructive behavior. But do we have either right or wisdom to decide what is best for other people in situations in which they are perfectly capable of making their own decisions? In On Liberty, John Stuart Mill cautions, person should be free to do as he likes in his own concerns, but he ought not be free to do as he likes in acting for another, under pretext that affairs of other are his own affairs. (2) A distinction is often made between hard (or strong) paternalism, which would permit intervening because of a belief that those doing intervening know what is best for others, and soft (or weak) paternalism, which would permit intervening to secure an outcome consistent with values held by those who are being coerced. Because of deficiencies in our decisionmaking processes or failures of will, we sometimes act in ways at odds with our own deeply held values and desires, or fail to do things mandated by these values. In such cases, coercive intervention can have salutary effect of forcing us to do what in fact we really want to do. In a thoughtful little book published three decades ago, Joel Feinberg, commenting on John Stuart Mill's strong defense of individual liberty, observes, Nevertheless, there are some actions that create a powerful presumption that an actor in his right mind would not choose them. stronger presumption, the more elaborate and fastidious should be legal paraphernalia required, and stricter standards of evidence, if that presumption is to be overridden. And what of suicide? Feinberg comments, The desire to commit suicide must always be presumed to be both nonvoluntary and harmful to others until shown otherwise. (Of course, in some cases it can be shown otherwise.) (3) There is a good deal of wisdom in Feinberg's approach. Suicide and attempted suicide often are acts of desperation by individuals who, as a result of mental illness or other distorting factors, are not in full command of their senses. In such cases, an ethic that values life and affirms dignity of each person mandates intervention to prevent self-destruction. …

Sex selection and preimplantation genetic diagnosis

Sex selection and preimplantation genetic diagnosis