Moral Weight Research Articles

Ethical dilemmas in clinical care during COVID-19 pandemic.

In a short span of a few weeks, the COVID-19 pandemic has affected the entire world like no other event in modern history. Healthcare institutions and providers have been at the forefront of containing the ravages of this disease, and are experiencing unprecedented challenges. Medical decision making has become all the more complex because of the moral weight of difficult decisions that need to be made. This paper discusses three areas where ethical decision making is extremely important: dealing with those patients with COVID-19 who no longer have access to their doctors; following ethical criteria for assigning risky duties to healthcare professionals; and in making life and death decisions while allocating scarce resources. This paper describes a national level guidance document for the COVID-19 pandemic that is designed to facilitate ethical decision-making.

A (Thin) Boundary Not to Be Crossed, or "Lakṣmaṇ-rekhā"

This paper discusses the concept of lakṣmaṇ-rekhā that originates in the later Rāmāyaṇa tradition and for centuries has functioned as a metaphorical expression denoting a strict (moral) boundary that should not be crossed, as its transgression inevitably exposes one to danger. It has featured prominently in Indian public discourse on female chastity and is also very much present in different socio-cultural and political contexts, often vocalised in literature, works of art, etc. In the concept of lakṣmaṇ-rekhā, one of the most basic and at the same time most important functions performed in culture by symbolic boundaries is manifested—the function of delineating the known, familiar, safe and permissible from the unknown, unfamiliar, dangerous, impermissible. Significantly, these boundaries have inherent moral weight and help individuals as well as whole societies to structure and regulate the universe they live in, on the micro- and macro-scale.In this paper, first I discuss textual evidence that can be found in wellknown Hindi Rāmāyaṇas such as the Rāmcaritmānas, the Rāmcandrikā and Rādheśyām Rāmāyaṇ, as well as in the Sūrsāgar. This analysis of literary material is meant to contextualise various levels of explicit and implicit meanings of the concept of lakṣmaṇ-rekhā that emerge from traditional sources in Hindi. In the second part of this article, I offer a survey of relevant Hindi dictionary entries and then focus on modern non-literary (and not only Hindi) usages of lakṣmaṇ-rekhā. Finally, I place the previously examined literary and linguistic material in the context of the findings of contemporary social scientists on the concept of symbolic boundaries (Epstein 1992). It is hoped that this study that gives emphasis to structuring and regulating (but not only) aspect of boundaries can contribute to our understanding of how broadly understood safety and values are negotiated in contemporary Indian society by way of drawing (ethical) boundaries and what happens if they are compromised.

Pediatric Assent and Treating Children Over Objection.

* Abbreviation: AAP — : American Academy of Pediatrics More than 20 years ago, the pioneering pediatric ethicist William Bartholome1 wrote a fiery letter to the editor of this journal because he thought a recently published statement on pediatric assent, from the Committee on Bioethics of the American Academy of Pediatrics (AAP), showed insufficient respect for children.2 That AAP statement, like its 2016 update, asserts that pediatric assent should be solicited only when a child’s dissent will be honored.3,4 Bartholome1 objected that pediatricians should always solicit children’s assent and that they should acknowledge and apologize when they treat children over their objections even when they must do so to promote children’s best interests. We think Bartholome1 was right. In this brief commentary, we elaborate on his perspective about the moral value of pediatric assent, and we suggest improvements to the corresponding clinical guidance. The AAP grounds the moral value of pediatric assent by noting, “We are obliged to act out of fundamental respect for other persons by virtue of their personal autonomy.” But in drawing on the concept of autonomy, the AAP invokes too narrow a conception of respect. Indeed, the AAP acknowledges that many children “lack the agency required to be truly autonomous agents.”3 If respect is grounded … Address correspondence to Jason Adam Wasserman, PhD, William Beaumont School of Medicine, Oakland University, ODH 412, 586 Pioneer Dr, Rochester, MI 48371. E-mail: wasserman{at}oakland.edu

‘If you look at the sky you step in sh*t’: horizons of possibility and migration from Serbia

Following nearly two decades of wartime ‘entrapment’, in 2009 the conditions of possibility for mobility fundamentally changed for Serbian citizens. Of both symbolic and material consequence, Serbia’s return to respectable geopolitical standing also marked a shift toward more nuanced stance‐taking in relation to mobility – at least for members of an urban, educated generation who have taken advantage of renewed opportunities to travel. In this article, I explore the real and symbolic geographies invoked by young potential migrants in talk of leaving and staying in Serbia. I read mobility narratives as proxies for commentary on a host of other political and socio‐economic issues, drawing attention to the role of international travel in the construction of imaginary yet authoritative ‘contrapuntal’ lives lived elsewhere. I show how such imaginaries both colour how potential and return migrants narrate their everyday navigations in the ‘here and now’ and give moral weight to migratory aspirations for, and experiences of, lives lived in the ‘then and there’. In unpacking the emic terms ‘negative selection’ and , I argue that the foundational motif of these varied imaginaries is a deep investment in the ideology of meritocracy, a morally inflected register for the articulation of aspiration as well as critique.

The moralization of obesity

RationaleWeight stigma is prevalent in Western society and has numerous negative effects on people with obesity. There remains a strong and currently unmet need to understand why anti-fat attitudes are tenacious and what intervention strategies might best produce lasting attitude change. ObjectiveMany negative effects of weight stigma can be integrated by noting that people differ in the extent to which they see obesity as a moral failing. Drawing from moral psychology and weight stigma literature, we hypothesized that greater moral disapproval of obesity would be linked to greater control attributions and disgust towards obese people, stronger endorsement of discrimination, perception of greater health risks associated with obesity, resistance to attitude change, and negative perceptions of people who have bariatric surgery. MethodThree studies were conducted with U.S.-based online samples in 2017–2018, and were analyzed with correlational, analysis of variance, and linear regression models. ResultsIn Study 1, greater moralization of obesity predicted stronger belief in the controllability of obesity, greater disgust towards obese people, stronger endorsement of discrimination against obese individuals, and the perception of greater health risks associated with obesity. In Study 2, people with stronger moralized obesity attitudes rated arguments for classifying obesity as a disease as less convincing, demonstrating that moralized obesity attitudes are more resistant to persuasion than nonmoral attitudes. In Study 3, greater moralization predicted more negative responses to an individual who had bariatric surgery, even when the individual exerted strong diet and exercise-related effort to make the surgery successful. ConclusionA moral view of obesity explains why control attributions and disgust are essential components of weight stigma, and why antifat attitudes are resistant to change. We conclude with suggestions for future research and consideration of the implications of obesity moralization for other chronic health conditions.

African Futures Past

Recent anthropological research in Africa has been buzzing with the question of “futures”. In times of economic uncertainty and global volatility, in areas of the world struck by widening inequalities, poverty and risk, where people have been compelled to try their luck abroad, the future is a pressing concern. It is also a key ethnographic prism for seeing how Africans (re)imagine time, expectations and possibility in late modernity. As recently pointed out by Janet Roitman, these conversations have acquired salience in relation to a global mood of “crisis”. Crisis, Roitman argues, does not mark an objective break with a normative “before”, a new experiential condition; rather, it is a narrative that imparts new moral weight to history in the present, and thus places a distinct spin on what and how futures can be imagined. Moved by this landscape of concerns, this article wonders what archaeology might contribute to contemporary feelings about “the future” in Africa. How does a look back, and a look forward from the past, help us to tease apart the temporalities that have shaped African worlds in the long term? How might a look at the kinds of time nested in material culture recast ongoing reflections on the present and future in Africa? How might it reframe the terms – crisis, melancholia, nostalgia, hope – in which continental futures are envisioned today? I hope to address these questions by reviewing recent archaeological research in rural West Africa and drawing on my own study of the hopes and anxieties that have framed peasant social expectations in Senegal over the past 300 years. My argument, though preliminary, is that examining Africa’s future pasts – material experiences and expectations of time in recent history – offers a lively contestation of the temporal frameworks into which the continent and its futures have been written.

Limitarianism and Relative Thresholds

In her groundbreaking paper “Having too much” Ingrid Robeyns presents a limitarian theory of justice, the crux of which is that it is morally impermissible to have more resources than needed for a maximally flourishing life. This paper focuses on one component of Robeyns’ limitarian theory, namely the nature of the riches threshold, the point above which the limitarian restriction kicks in. The threshold, according to Robeyns, is located at the point in which human flourishing is satiated; above this threshold, surplus resources do not have any moral weight. In this paper I offer an alternative account of the riches threshold: a relative, resource based threshold. On this account, the riches threshold represents the maximal permissible ratio between the resources available to the richest and poorest members of society. For example, limitarianism could maintain that it is morally impermissible to have more than one hundred times the resources that the poorest member of society has. A relative threshold, I argue, offers a more attractive account of limitarianism: it is more compatible with the intuition underlying limitarianism, better attuned to the justifications of limitarianism, and it is not susceptible to objections that the flourishing satiation threshold faces.

The Nature and Operation of Structural Sin: Additional Insights from Theology and Moral Psychology

Recent work has improved the understanding of social structures in theological discourse, but ambiguity persists with respect to structures of sin. Here, a revised definition of structural sin reconnects this concept with its theological roots, adding clarity to the nature of structural sin and strengthening the moral weight of the term. Parallels with fMRI research in the field of moral psychology then refine the existing account of the operation of structural sin. Together, these insights aid in the identification of structures of sin and improve efforts to combat their influence.

‘My child, my choice’: parents, doctors and the ethical standards for resolving their disagreement

Disagreements between doctors and parents as to the appropriate treatment of a child have been exacerbated by a number of recent developments, especially the use of the internet. In normative terms there has been a popular assertion of a parent’s right to choose the treatment of his or her child and this has been defended in the bioethics literature, often in the context of a preference for a harm over a best interests principle for adjudicating these differences. This article affirms the centrality of a best interest standard and criticises arguments for giving parental views a certain moral weight based upon the view that parents know best, or on the interests of the parents, or as consistent with the use of child protection principles, or in value uncertainty.

“An Endless Sermon”: Religious Motifs in Melville’s Letters to Hawthorne

Herman Melville’s letters to Nathaniel Hawthorne during their joint residence in the Berkshires in 1850-51 have regularly drawn the close scrutiny of scholars interested in the literary, psychological, and cultural dynamics of this historic friendship, but they have seldom examined the religious language that infuses these missives. For just as Melville’s writings are permeated by the influence of the King James Bible, especially the whaling novel he was composing at this time, his letters to Hawthorne also bear the imprint of this key literary source. If Melville called his informal homilies to Hawthorne part of an “endless sermon,” his major letters of April, May, and November 1851 each bear the moral weight of a series of biblical “texts” from Job, Ecclesiastes, and the Gospel of John, respectively, with the mystical language of John being of special importance for understanding Melville’s creative and emotional identification with Hawthorne.

Iqbal’s Fractured Vision: History as a Science and the Moral Weight of the Past

This paper aims to understand how we reason from historical premises to normative conclusions, tracing this question through the work of Muhammad Iqbal. On our reading, he wavers between two views of history, one a kind of natural science, and the other akin to religious interpretation. These tell different stories about the lessons we draw from history.

O ponto de choque da moral: ação comunicativa, reconhecimento e redistribuição – Habermas, Honneth e Fraser

A moral se tornou, há muito, fruto de intensos debates na teoria social. Contemporaneamente, esses debates apresentam temas e abordagem que, cada vez mais, ganham importância. Uma parte crucial dessas questões contemporâneas vem do debate desenvolvido por Nancy Fraser e Axel Honneth sobre os conceitos de redistribuição e de reconhecimento. Partindo de posicionamentos diversos sobre o peso da moral dentro dos seus modelos teóricos, assim como o peso de reconhecimento e de redistribuição, ela e ele debatem acerca dos alicerces da teoria social pensando, em ambos os casos, em teorias abrangentes, que servem de importantes matrizes para uma sociologia crítica, na esteira da tradição de uma teoria crítica. O ponto em comum de ambos? A crítica a Habermas. Mapearei o pensamento habermasiano sobre a moral e, depois, as críticas de Honneth e Fraser ao autor para, no fim, tentar esboçar uma sociologia com base no dualismo de Frazer.

Temporally Inexpensive, Affectively Expensive: Digitally-Mediated Maternal Interpersonal Ties in the Perinatal Months

This article presents findings on the internet and maternal interpersonal connections in the critical ‘perinatal’ period before and immediately after childbirth. Drawing on qualitative interviews and online data from a range of digital sites, I advance the central argument that digitally mediated interpersonal connections are critical components of contemporary motherhoods, but that these ties have complex positive and less than positive nuances in the perinatal period. Unpacking this argument in three steps, I first discuss how the moral weight of motherhood in neoliberal societies, rendered particularly visible in the perinatal period, complicates a central boundary in the study of online interpersonal relationships between information and communication. Second, I note the relative significance, in emotional terms, of temporally-contained social ties in digitally mediated perinatal connections. Third, I consider how the material and emotional roles of traditionally held-to-be-important offline maternal support networks are re-negotiated, re-positioned and even bypassed through online ties.

Can We Identify with a Nation Low in Morality? The Heavy Weight of (Im)Morality in International Comparison

Research has shown that the perceived morality of the ingroup is a primary source of group pride and ingroup identification. The present research examined whether this is true even when a group has a poor reputation for morality in terms of dishonesty and corruption, such as in the case of Italians. To address this issue, two studies analyzed the role of the three fundamental dimensions of social judgment—morality, competence, and sociability—in predicting Italians’ identification with their nation when the salience of social comparison and the status of the comparison outgroup were varied. Findings showed that perceived morality predicted ingroup identification when participants did not engage in social comparison. Under salient social comparison, individuals based group identification on other dimensions: Perceived sociability was the main predictor of identification when respondents compared with a higher status outgroup (Germans; Study 1; N = 109), whereas perceived competence was the main predictor of identification when participants compared with a lower status outgroup (Romanians; Study 2; N = 121). Overall, findings showed compensation processes in social identification: When social comparison is salient, members of a low morality group base identification on the dimension which allows positive differentiation from the outgroup.

Gerard Manley Hopkins and Ruskin’s Idea of the Christian Artist

Abstract John Ruskin gave Gerard Manley Hopkins an aesthetic vocabulary imbued with Christian concepts of obedience, sacrifice, truth, and Divine Beauty. Even secular art is never morally neutral; Christian art has additional moral weight in the artist’s reverence for God’s self-revelation in creation. Hopkins’s Scotism confirmed his conviction that an artist’s work must be a responsible personal proclamation of truth about creation. Such moral responsibility discourages easy sentimentality but demands reverence for beauty. The depth of Hopkins’s interaction with etymology, syntax, and sound springs from Ruskinian sacrificial expenditure of workmanship and reverence for what Ruskin called “truth” to materials. “Ashboughs,” a cheerful, subtly Marian curtal sonnet, shows Hopkins’s Ruskinian principles at work late in his life, especially in the poet’s attention to diction, syntax, and divine truth revealed in concrete, worldly beauty.

Forced caesareans: applying ordinary standards to an extraordinary case

Is it morally justifiable to force non-consenting pregnant women to submit to caesarean surgery to save their fetus in distress? Even though proponents and opponents largely agree on the interests...

The surveillant consumer

We argue that modern technical and social infrastructures of surveillance have brought a novel subject position to prominence: the surveillant consumer. Surveillance has become a normalized mode of interpersonal relation that urges the person as consumer to manage others around her using surveillant products and services. We explore two configurations of this model: the consumer as observer, effectuated through products for use in the supervision of intimate relations as a component of a normalized duty of care; and the consumer as manager, effectuated through capacities for the customer to manage the labor of workers providing services to her. These models frequently intersect and hybridize as market logics overlap with intimate spheres: the surveillant consumer thus acts as an emotional manager of the experience of everyday surveillance. In turn, this managerial role reifies the equation of financial wealth with moral weight in a hierarchy of oversight, giving the wealthiest the most control and least accountability.

Nonstandard Advance Directives in Emergency Medicine: What Should We Do?

BackgroundCritically ill or injured emergency department or prehospital patients who lack decision-making capacity sometimes present with a non-standard advance directive, such as a “Do Not Resuscitate” tattoo or medallion. Emergency clinicians must immediately address the question of whether to withhold treatment based on what may or may not be a valid patient directive. DiscussionAdvance directives have been standardized for a good reason. Emergency department or prehospital healthcare providers must be able to immediately interpret and act on them without needing a legal interpretation. When faced with non-standard directives, physicians can follow them, ignore them, or simply use them as an additional piece of information about the individual’s wishes for some situations at one point in his or her life. Absent the patient’s input or that of aknowledgeable surrogate, both the patient’s initial reasons for their non-standard directive and his or her present wishes concerning resuscitation cannot be independently known. Therefore, healthcare providers must initiate treatment while they buy time, attempt to return the patient to lucidity, and search for probative information regarding their current wishes concerning medical treatment. Without such additional information, the moral weight will always favor initiating treatment, since withholding treatment is often irreversible and any treatment instituted can later be withdrawn.

In the Balance: Weighing Preferences of Decisionally Incapacitated Patients.

In this issue of the Hastings Center Report, Jason Wasserman and Mark Navin argue that patients without decisional capacity can still have relatively stable wishes or inclinations toward one treatment option over another and that these preferences are "not devoid of moral weight and might therefore guide or at least influence treatment decisions when they cannot be defeated by other considerations." This position is not controversial among most bioethicists. The hard work comes in sussing out the details of this position. How much moral weight do these preferences have? When should preferences be defeated by other considerations? How should we identify actual preferences, and how should preferences be differentiated and weighed against one another?

Prenatal parental designing of children and the problem of acceptance.

Seemingly ever improving medical technology and techniques portend the possibility of prenatally enhancing otherwise healthy, normal children-seamlessly enhancing or adding to a child's natural abilities and characteristics. Though parents normally engage in enhancing children, i.e., child rearing, these technologies present radically new possibilities. This sort of enhancement, I argue, is morally problematic for the parent: the expectations of the enhancing parent necessarily conflict with attitudes of acceptance that moral parenting requires. Attitudes of acceptance necessitate that parents are open to the essentially-individual choices of the child that will determine the kind of person he or she becomes. However, the intentional act of enhancing contradicts this openness by setting expectations on who the child becomes. Because of this, there is strong moral weight against parents' prenatally enhancing their children.