Moral Uncertainty Research Articles

Creating the Culture of Reform in Antebellum America , and: Our Sisters' Keepers: Nineteenth-Century Benevolence Literature by American Women (review)

Creating the Culture of Reform in Antebellum America. By T. Gregory Garvey. (Athens: University of Georgia Press, 2006. Pp. xii, 263. Cloth, $39.95.)Our Sisters' Keepers: Nineteenth-Century Benevolence Literature by American Women. Edited by Jill Bergman and Debra Bernardi. Studies in American Literary Realism and Naturalism. (Tuscaloosa: University of Alabama Press, 2005. Pp. x, 299. Cloth, $60.00; Paper, $27.95.)Reviewed by R. Bryan BademanThe two books reviewed here have come from English departments and bear several of the trademarks of that discipline. T. Gregory Garvey's Creating the Culture of Reform is a partly theoretical project that foregrounds its contributions to political and cultural theory. While Garvey relies on the work of historians in piecing together the history on which his work is based, his primary interlocutors are readers of Jurgen Habermas, John Rawls, and their critics. The essays in Our Sisters' Keepers are not so rigorously theoretical in their aims or approach, but they too, by an understandable disciplinary bias, are less engaged with (or up to date on) historical narratives and more interested in the literary contributions of a cohort of nineteenth-century female benevolence writers.1 As a result, some of the arguments made in both books will seem to historians already well established, while others stand in need of some interdisciplinary translation. Nevertheless, intellectual and cultural historians will find much in these pages from which to benefit. Garvey highlights an important genealogy for American democracy, and the volume on benevolence literature unpacks a distinctive articulation of American selfhood. Besides their disciplinary origins, the two books seem to have little in common - one being an exercise in historically grounded political theory, and the other taking a close and careful look at a literary genre that despite its contemporary pervasiveness no longer attracts much attention. That being said, the books do advance arguments that allow for fruitful comparison.The title of Garvey's book is precise if somewhat opaque to nonspecialists. Garvey is principally interested in the early nineteenth-century emergence of a of reform, which, while incapable of arresting the accelerating political polarization in the young nation, nonetheless created instruments of public dialogue that addressed the nation's most threatening and divisive questions (1). Garvey's culture of is thus fundamentally a mode of debate, rather than a group of reformers or their institutions. And he argues that this culture's significance lies in its bringing about a right of access to critical public discourse, which played a decisive role in emerging definitions of American equality and citizenship (199).According to Garvey, the of reform originated in the religious disestablishment struggles of the Revolutionary years. As Americans wrestled with social fragmentation and moral uncertainty, they turned first to democratic religion - evangelical revivals, in particular - to reassure themselves of cosmic order. In so doing, evangelicals pioneered certain modes of publicity that would later flourish specifically religious spheres (1). For Garvey, although religious contexts were important seedbeds for reform, religious institutions could not ultimately address the full range of social divisions in America, so the of reform quickly spilled over into civic arenas. Indeed, even specifically religious debates like the Unitarian controversy soon migrated to the pluralistic public sphere as both sides sought public legitimacy. Thus while the of reform emerged in a religious context, religious leaders and institutions simply could not contain it. Still, according to Garvey, reform's remained indebted to evangelical Christianity's momentum and spiritual and salvine goals, even as it carried these things outside the boundaries of religion. …

Slouching Towards Equality

Drawing on his work in two previous articles, Christopher Peters contends that uncertainty about substantive moral norms cannot justify a presumption of equal treatment. Arguments for equal treatment in the face of uncertainty are types of consequentialist claims; they are not claims of what Peters calls prescriptive equality, that is, for treating likes alike merely because they are alike. Peters contends that the consequentialist case for equal treatment as a response to uncertainty fails in two respects. First, it fails to demonstrate that equal treatment is likely to be a more satisfactory response to moral uncertainty than unequal treatment. Second, it is logically incoherent because it simultaneously relies upon and denies the possibility of confidence in moral judgment. Peters concludes that no valid case can be made for defaulting to equal treatment in the face of moral uncertainty.

Environmental Damage as Negative Externality: Uncertainty, Moral Complexity and the Limits of the Market

The economic concept of negative externalities is the dominant frame in environmental policies. Revisiting environmental damage with a sociological approach, I show how the process of externalities definition and internalisation is a political process in which a public is constituted and common problems are collectively defined and addressed. In particular, I highlight the presence in this process of two kinds of uncertainty which have to be dealt with: epistemic uncertainty and moral uncertainty. Keeping these two forms of uncertainty analytically separated is useful in order to understand the limits of the market as a way to internalize environmental externalities and to analyse in their specificities the different types of translation, mediation and composition which are needed in order to create the conditions for a truly inclusive and democratic public deliberation on environmental damage and its reparation.

Coping with Moral Uncertainty

More than we usually let on, I suspect, we moral philosophers appreciate that rival moral theories stand a decent chance of being right. I might be a consequentialist, but I cannot deny the existence of compelling arguments and intuitions on the deontological side. Moreover, although it seems to me extremely implausible that there really is nothing bad about torment or wrong with cruelty, I cannot entirely shut out worries that the moral nihilists might be right. It is high time we moral philosophers owned up to our doubts and squarely faced the question of how to incorporate such uncertainty into moral thought and practice. A few philosophers have pioneered this sort of inquiry. Among them, no one has thought as long, hard, and well about moral epistemology as Walter Sinnott-Armstrong. Unlike most of us in ethics, Sinnott-Armstrong does not come to questions of moral epistemology as an amateur he has made original contributions to epistemology proper, especially on the subject of skepticism. So I come to his excellent book, Moral Skepticisms, x less as a critic than as someone eager to learn more and understand his view better. My comment therefore will consist primarily in a request for clarification.

A Welcoming Wilderness

Wild berries have long been integral to Newfoundlanders’ and Labradorians’ food stores. Berry picking remains an important late summer and early fall activity, combining traditional, geographical knowledge with material culture, foodways and custom. Berries may also be Newfoundland and Labrador’s most successful culinary tourism product to date, combining attributes of health, wilderness and resourcefulness. Whereas ethical and moral uncertainty or conviction precludes many tourists from trying seal products, and health concerns prevent the enjoyment of regional favorites such as fish and chips, berries offer visitors a window into local culture beyond reproach. Reifying the text and images of national and provincial tourist literature emphasizing the area’s “outdoor nature product,” the berries serve as an iconic image of a resourceful people intimately connected to a bountiful, welcoming wilderness.

The Coproduction of Moral Discourse in U.S. Community Psychiatry

Anthropologists often criticize the discipline of bioethics because its remote, abstract theories fail to capture how front-line clinicians experience and resolve moral uncertainty. The critique overlooks, however, the ways that everyday, emergent moral discourse is influenced--over time and through several mediations--by formal ethical notions. High-order ethical pronouncements become sedimented into the conditions of work, illustrated in this article by a two-year ethnographic study of Assertive Community Treatment (ACT), a popular mode of outpatient psychiatric services. ACT clinicians' moral unease when they break the confidentiality of patients is connected to high-order debates, dating back 35 years, about ensuring patients' autonomy without abandoning them. These debates originally spurred the invention of ACT, and they get braided into today's moral discourse through several mediations: regulatory paperwork, the mandates and micropolitics of staff-patient interactions, and the idealized self-image of front-line staff. This article shows how everyday moral talk is coproduced by both the immediate contexts of clinical work and the categories of formal bioethics.

Moral Knowledge and Moral Uncertainty1

AbstractApplying a broadly Wittgensteinian view of knowledge and its relation to the conditions in which the word “know” is ordinarily used, the paper defends the claim that there can be knowledge (and thus also truth) in moral matters and rejects the idea that a cross‐culturally homogeneous moral language is a necessary condition for this. However, the fact that moral knowledge is available sometimes does not imply that it is available always. Taking issue in particular with Ronald Dworkin, the paper also argues that where moral questions are a matter of judgement, there may well be no right answer to them and, further, that this is a feature by no means unique to moral discourse.

Deontology, Individualism, and Uncertainty

How should deontological theories that prohibit actions of type K — such as intentionally killing an innocent person — deal with cases of uncertainty as to whether a particular action is of type K? Frank Jackson and Michael Smith, who raise this problem in their paper “Absolutist Moral Theories and Uncertainty” (2006), focus on a case where a skier is about to cause the death of ten innocent people — we don’t know for sure whether on purpose or not — by causing an avalanche; and we can only save the people by shooting the skier. One possible deontological attitude towards such uncertainty is what Jackson and Smith call the threshold view, according to which whether or not the deontological constraint applies depends on our degree of (justified) certainty meets a given threshold. Jackson and Smith argue against the threshold view that it leads to implausible paradoxical moral dilemmas in a special kind of case. In this response, we show that the threshold view can avoid these implausible moral dilemmas, as long as the relevant deontological constraint is grounded in individualistic patient-based considerations, such as what an individual person is entitled to object to.

Making and Unmaking Possessive Individuals: ‘Xavier Borrowing’ at a Catholic Mission Pacific Islands Secondary School1

Xavier High School, a Micronesian boarding school founded by American Jesuit priests, is the setting for this examination of how students critique the concept of the possessive individual. The paper shows how exchange and the words used to describe exchange have been continually contested throughout the school's 50‐year history. Notions of exchange and its meanings are asserted and denied in school practice by the term ‘Xavier borrowing’, a phrase reflecting the inability of words to describe definitively the work of exchange. Viewing the school's history through contested property relations reveals the moral uncertainties inherent in making and unmaking possessive individuals.

The faceless encounter: ethical dilemmas in telephone nursing

This paper aims to present the findings of a study designed to describe ethical dilemmas, in the form of conflicting values, norms and interests, which telenurses experience in their work. Telephone nursing is an expanding part of health care. Telephone nurses in Sweden assess care needs, provide advice, support and information, and recommend and coordinate healthcare resources. Lately, ethical demands on healthcare professionals in general have increased. The reasons include new biomedical competence, an ageing population and constrained resources which have made priority setting a primary concern for doctors and nurses. When ethical problems arise, colleagues need open dialogue. Despite this, nurses lack such a dialogue. A purposeful sample of 12 female telenurses in Sweden was interviewed twice during 2004 and 2005. The transcribed interviews were analysed thematically. Five themes were found: talking through a third party; discussing personal and sensitive problems over the phone; insufficient resources and the organization of health care; balancing callers' information needs with professional responsibility; and differences in judging the caller's credibility. The present study has identified five different themes in which Swedish telenurses experience ethical dilemmas in their work. This shows how ethical dilemmas in various forms are present in telenursing. Questions of autonomy, integrity and prioritizing are particularly highlighted by the participating nurses. Telenurses in Sweden also experience new ethical demands due to a multicultural society. Although several of the identified dilemmas also occur in other areas of nursing we argue that these situations are particularly challenging in telenursing. The work organization should provide opportunities for ethical competence-building, where ethical dilemmas in telenursing are highlighted and discussed. Such a strategy might lead to decreased moral uncertainty and distress among telenurses, with positive consequences for callers.

The Ethical Issues in Uranium Mining Research in the Navajo Nation*

We explore the experience of Navajo communities living under the shadow of nuclear age fallout who were subjects of five decades of research. In this historical analysis of public health (epidemiological) research conducted in the Navajo lands since the inception of uranium mining from the 1950s untill the end of the 20th century, we analyze the successes and failures in the research initiatives conducted on Navajo lands, the ethical breaches, and the harms and benefits that this research has brought about to the community. We discuss how scientific and moral uncertainty, lack of full stakeholder participation and community wide outreach and education can impact ethical decisions made in research.

A Tundra of Sickness: The Uneasy Relationship between Toxic Waste, TEK, and Cultural Survival

In 1992 an abandoned federal radioactive waste dump was discovered in Arctic Alaska. The discovery of this site, a byproduct of the Atomic Energy Commission program known as Project Chariot, sent shockwaves throughout Iñupiaq communities and ignited a heated controversy over the health effects of subsisting on a "tundra of sickness." Drawing on thirty months of ethnographic research in Arctic Alaska, this paper explores a host of environmental, social, and moral uncertainties sparked by toxic waste. Anthropological claims regarding the extent to which "traditional ecological knowledge" will empower local communities and foster self-determination are challenged. Ultimately the paper argues that TEK has been conceived in such restrictive terms that it misrepresents the dynamic, emerging, and at times contradictory responses to toxic waste in the Arctic today. Moreover, there is dire need for a more materialist, as opposed to discourse-based, approach that acknowledges the very real threat of toxic waste to physical, and therefore, cultural reproduction.

Ethical Dilemmas and Moral Distress in Oncology Nursing Practice

Although ethical values and principles guide oncology nursing practice, nurses often are challenged to fulfill every professional core duty and responsibility in their everyday practice. Nurses commonly encounter clinical situations that have ethical conflicts, and they often have difficulty recognizing and articulating them. Unresolved conflicts can cause feelings of frustration and powerlessness, which can lead to compromises in patient care, job dissatisfaction, disagreements among those in the healthcare team, and burnout. This article reviews the ethical principles and values individual nurses bring to their practice as well as those basic to the profession of nursing. This article also discusses ethical conflicts in oncology practice and describes how nurses, especially students and novice nurses, may react to such situations with moral uncertainty or distress. In addition, a process for analyzing and resolving ethical problems in clinical situations is outlined. Increasing awareness and dialogue about ethical issues is an important first step in the process. Additional resources in the clinical setting may encourage nurses to actively participate in ethical decision making and take deliberate action as moral agents.

A pluralist view of nursing ethics

This paper makes the case for a pluralist, contextualist view of nursing ethics. In defending this view, I briefly outline two current perspectives of nursing ethics - the Traditional View and the Theory View. I argue that the Traditional View, which casts nursing ethics as a subcategory of healthcare ethics, is problematic because it (1) fails to sufficiently acknowledge the unique nature of nursing practice; and (2) applies standard ethical frameworks such as principlism to moral problems which tend to alienate or undermine nursing ethical concerns. Alternatively, the Theory View, which aims to build an independent and comprehensive theory of nursing ethics, is also found wanting because it (1) fails to sufficiently acknowledge the heterogeneous nature of nursing practices; (2) overemphasizes the differences and undervalues the similarities between nurses and other health professionals; and (3) assumes that one ethical framework can be meaningfully applied across diverse moral problems and contexts. My alternative, is to argue that nursing ethics inquiry should take a pluralist and critical stance towards available ethical frameworks and the negotiation of the ethical realm. On this view, the search for moral consensus or a unique ethical framework for nursing is replaced by the task of working strategically with multiple frameworks in order to expand the moral agency of nurses and empower them to positively engage with moral uncertainty as an inevitable feature of living a moral life. I conclude by indicating some of the implications that this has for the teaching of nursing ethics.

Moral Uncertainty and the Afterlife: Explaining the Popularity of Marie Corelli's Early Novels

Marie Corelli's early popular success as a novelist took place within a culture anxious about the meaning and experience of death. Generally, Corelli is considered to be a writer of romantic fiction, but this essay considers the heterogeneous appeal that she was able to generate through her engagement with the contemporary cultural and emotional fascination with mortality and the destruction of the corporeal form. Through a consideration of theories about the role of popular fiction in cultural debate, it is possible to reconsider rather than dismiss Corelli's success as aberrant, the common twentieth century practice. She devises specific narrative constructs that allow readers to engage in social debates about the body and contemplate alternative religious beliefs. This essay analyses death scenes in five of Corelli's early best-sellers—Ardath (1895), Thelma (1897), The Soul of Lilith (1892), The Sorrows of Satan (1895), and The Murder of Delicia (1896). These death scenes are distinct rather than formulaic and, by considering their cultural context, it is possible to understand the way Corelli's fiction negotiates different subject positions and responds to varied rather than specific cultural perspectives. Best-selling fiction requires a writer to effect ambiguity rather than clear cultural alignment in order to achieve resonance with differentiated audiences. This essay proposes that the example of the varied and nuanced appeal Corelli offered her contemporary audiences necessitates a revaluation of the place of popular fiction in literary and cultural histories.

Responsabilidad profesional: máximos, mínimos, excelencia y veracidad

Professional responsibility provides the groundwork for medicine since the existence of the Hippocratic Oath. Physicians must be prepared to justify their decisions and actions, based on scientific issues but also considering the underlying professional responsibilities. Ethical theories form a major part of such justification. A number of competing ethical theories may be identified. The maximal, minimal and excellence ethical theories agree with our experience with moral uncertainties. But veracity ethics is a new form of answering moral questions. Clinical situations are unavoidably conflictive. Lucid understanding of the necessary character of these conflicts leads to self-recognition and the itinerary of veracity ethics runs from misunderstanding to recognition. The self-awareness that veracity offers to physicians is difficult and painful due to the narcissistic humiliation that it inflicts on them.

Baudelaire's 'Le Spleen de Paris': Shifting Perspectives by Maria C. Scott

MLR, I0I.4, 2oo6 1129 The second section offers us a parallel reading by Sarga Houssa of the Voyage en Orient as done by Lamartine and by Nerval, followed by Hisashi Mizuno's work manlike analysis of Nerval's commentaries onWagner's aesthetics: there is nothing particularly new in either paper. The third article, by Corinne Bayle, presents a fas cinating confrontation of Nerval's sonnet sequence Le Christ aux Oliviers with two paintings by Chasseriau of the same subject. There are some original insights into both Nerval and Chasseriau, as well as into the relationships between poetry and painting. It is in the third section, 'Figurations', that we find the most interesting contri butions of the volume. In a concise and brilliant article, Bertrand Marchal unpacks the symbolic and thematic ramifications of the chimere for both the sonnet sequence bearing the name and forNerval's work as awhole. Daniel Sangsue analyses anumber of aspects of the theme of revenance and the figure of the mort vivant inNerval, and as the final paper in this section Michel Brix offers a study of the impossible erotics of Nerval, in both its ironic and pathetic dimensions. The final section, 'Voisinages', is themost heterogeneous and least satisfying group of papers. However, one article, Jerome Thelot's virtuoso study of the slim output of Maurice de Guerin, makes some suggestive rapprochements with Nerval around the themes of memoire and poesie. All in all, this collection is a timely contribution toNerval studies in the run-up to the bicentenary of his birth, with a sufficient number of interesting papers tomake this volume aworthwhile acquisition for a specialist library. UNIVERSITY OF NEW SOUTH WALES MAURICE BLACKMAN Baudelaire's 'Le Spleen de Paris': Shifting Perspectives. By MARIA C. SCOTT. (Stu dies in European Cultural Transition, 29) Aldershot: Ashgate. 2005. 238 pp. ?47.50. ISBN o-7546-5IiI-8. The principal aim of this study of Baudelaire's prose poems is an examination of the shifting perspectives on the viewpoint of the narrator, who, we are frequently reminded, must not be confused with the poet himself. It comprises five chapters on perspectives current in recent criticism: caricature, prostitution, morality, allegory, and aesthetics. The author makes no claim to being exhaustive. Indeed, her approach is consciously limited and partial, focusing on about two-thirds of the collection. The emphasis throughout is on the poet's taste formystification and the consequent nar rative, aesthetic, and moral uncertainties that have stimulated the ingenuity of recent commentators. By her own confession she rarely ventures a totalizing explanation, being forced by the nature of the subject to perpetuate the sense of uncertainty. The author appears in total command of the critical corpus that has grown round Le Spleen de Paris and her erudition is nothing if not impressive, but the reader cannot on oc casion avoid a sense of frustration at the emerging critical stasis. The commentaries abound with qualifying expressions such as 'itmay be that', 'itmight be', 'possibly', 'it is possible that', 'itwould seem', somuch so that one is led towonder what exactly has been gained by so many tentative interpretations. For example, the chapter on prostitution contains a fascinating discussion of the social and legal conditions in nineteenth-century Paris. This together with an account of Regnier's satire, which Baudelaire mentions, leads to a possible 'alternative perspective' (p. 72) thatMade moiselle Bistouri's obsession with doctors and surgery could have had something to do with abortion. Scott stresses that such a diagnosis is purely hypothetical, but jus tified because it underlines our 'incomplete knowledge of "Mademoiselle Bistouri" and of its author's intentions' (p. 72). But there is confusion here between the poem, which is relatively transparent, and the character, who remains amystery. Any one II30 Reviews explanation would greatly diminish the impact and the scope of the poem, and go counter to the poet's intention, which is to convey the scandal and mystery ofmadness and of the 'monstre innocent'. Echos from other works are sometimes made to influence the possible reading of a poem without due regard to context. The title of 'Le Chien et le flacon' recalls the prologue toGargantua, which compares the diligent reader to a...

Absolutist Moral Theories and Uncertainty

Absolutist Moral Theories and Uncertainty

A NECESSIDADE DE AGÊNCIAS REGULADORAS SOB A PERSPECTIVA DA NOVA ECONOMIA INSTITUCIONAL

This paper aims to analyze how the operation of a public utility commission can be grounded on the concepts derived from new institutional economics. Drawing on the literature of franchise bidding system - also known as Demsetz bidding (1968) - and the critical work of Williamson (1976), this paper look forward to identifying how variables such as (i) limited rationalism, (ii) moral hazard and (iii) transaction costs can affect public decision making to define which governance structure is more suitable to regulate each specific utility. This theoretical analysis points out that the absence of a public utility commissions as proposed by Demsetz, increases the possibilities of moral hazard and uncertainty in environments where market failures and assets specificities are present.

A Framework for Integrated Pediatric Palliative Care: Being with Dying

Recent studies highlight the need for an integrated model for palliative and end-of-life pediatric care. About 55,000 children die each year in the United States and, on any given day, about 8,600 children could benefit from care that acknowledges their limited life expectancy and severity of illness. Two case studies of children illustrate different approaches-one that aggressively applies all possible technologies to maximize chances of survival and another that focuses on the patient's overall quality of life and on healing rather than curing. The cases highlight characteristics of an integrated model of palliative care to address clinical, moral, and ethical uncertainties. This model integrates being with doing, provides for developing attunement and presence as capacities for being with children and their parents, and addresses challenges in the healthcare environment. Strategies for integrating palliative care into pediatric practice include listening, fostering respect for the child and parents across the organization, nurturing collaborative connections, managing uncertainty, tolerating ambiguity, making peace with conflict, and committing to self-care. Every pediatric nurse can play a role in making the vision of palliative care a reality integrated into the fabric of pediatric practice.