C. Brown

Since Andrew Jameton introduced the term “moral distress” (MD) in 1984, the idea has gained enormous attention in the healthcare literature. We offer a critical, narrative review of the understandings of MD that have been proposed, with an eye towards their scope and corresponding ability to speak to the moral vulnerability inherent in human life. Jameton’s understanding of MD is narrow in the sense that it requires the presence of institutional constraints (e.g., hierarchies or hospital policies) that prevent a healthcare professional from doing what they take to be morally right. Other theorists have suggested that internal constraints (e.g., lack of moral courage) can engender MD as well, and still others have suggested that neither kind of constraint is necessary, as MD can arise from moral conflicts and moral uncertainty in addition to constraints. We criticize understandings of MD that emphasize institutional and/or internal constraints, as they exclude cases in which MD does not arise from any flaw or shortcoming and so for which there is no fix. However, we also criticize understandings of MD that look beyond constraints in general, as they lose sight of MD’s distinguishing feature as a moral experience, namely the anguished or panicked sense that one is constrained from doing what one takes to be morally required. We suggest that the corrective involves acknowledging a third kind of constraint: human constraints, or constraints that arise from the human condition rather than any kind of flaw or shortcoming.

The valence of a life – that is, whether it is good, bad or neutral – is an important consideration in population ethics. This paper examines various definitions of valence. The main focus is ‘temporal’ definitions, which define valence in terms of the ‘shape’ of a life’s value over time. The paper argues that temporal definitions are viable only with a restricted domain, and therefore are incompatible with certain substantive theories of well-being. It also briefly considers some popular non-temporal definitions, and raises some problems for these.

Whether value is “additive,” that is, whether the value of a whole must equal the sum of the values of its parts, is widely thought to have significant implications in ethics. For example, additivity rules out “organic unities,” and is presupposed by “contrast arguments.” This paper reconsiders the significance of value additivity. The main thesis defended is that it is significant only for a certain class of “mereologies”, roughly, those in which both wholes and parts are “complete”, in the sense that they can exist independently. For example, value additivity is significant in the case of a mereology of material objects, but not in the case of a mereology of propositions.

How wrong is it to deceive a person into having sex with you? The common view seems to be that this depends on the nature of the deception. If it involves something very important, such as your identity, then the wrong done is very serious. But if it involves some- thing more trivial, such as your natural hair colour, then the wrong seems less great. Tom Dougherty rejects this view. He argues that sexual deception is always seriously wrong. In this paper, I present a response to Doughterty’s argument. I propose an analysis of the wrong- ness in deception according to which acts of deception, in sexual relations and elsewhere, may differ in their degree of wrongness, and some may not be seriously wrong.

Should we allow grave harm to befall one individual so as to prevent minor harms befalling sufficiently many other individuals? This is a question of aggregation. Can many small harms 'add up', so that, collectively, they morally outweigh a greater harm? The 'Close Enough View' supports a moderate position: aggregation is permissible when, and only when, the conflicting harms are sufficiently similar, or 'close enough', to each other. This paper surveys a range of formally precise interpretations of this view, and reveals some of the problems they face. It also proposes a novel interpretation which avoids these problems.

Suppose we believe that a property F is coextensive with moral permissibility. F may be, for example, the property of having the best consequences, if we are Consequentialists, or that of conforming to a universalisable maxim, if we are Kantians, and so on. This may raise the following problem. It is plausible that permissibility is “closed under implication”: any act that is implied by a permissible act must itself be permissible. Yet, in some cases, F might not be closed under implication. If that is so, then F cannot be coextensive with permissibility. Maximalism has been proposed as a solution to this problem. A “maximal” act is one not implied by any other act. Maximalism restricts the claim that F is coextensive with permissibility to maximal acts only. A non‐maximal act may be permissible without being F if it is implied by a maximal act that is F. The general aim of this paper is to investigate these issues by considering the formal structure of acts, or the “act‐implication” relation. Discussions of Maximalism have tended to assume implicitly that acts have structure of some sort, but there has been little careful attention given to this structure. I aim to show that, by thinking about structure, we can provide a stronger defence of Maximalism.

Ethical descriptivism is the view that all ethical properties are descriptive properties. An argument for this view proposed by Frank Jackson begins with the premise that the ethical supervenes on the descriptive; any worlds that differ ethically must differ also descriptively. This chapter observes that Jackson’s argument follows a curious route, taking a linguistic detour between metaphysical starting and ending points, and raises some worries stemming from this. It then proposes an improved version of the argument, which avoids these worries, and responds to some potential objections to this version of the argument.

The valence of a life – that is, whether it is good, bad or neutral – is an important consideration in population ethics. This paper examines various definitions of valence. The main focus is ‘temporal’ definitions, which define valence in terms of the ‘shape’ of a life’s value over time. The paper argues that temporal definitions are viable only with a restricted domain, and therefore are incompatible with certain substantive theories of well-being. It also briefly considers some popular non-temporal definitions, and raises some problems for these.

This manuscript explores the argument for lower student-to-school counselor ratios in U.S. public education. Drawing upon a comprehensive historical review and existing research, we establish the integral role of school counselors and the notable benefits of reduced student-to-counselor ratios. Our analysis of national data exposes marked disparities across states and districts, with the most underfunded often serving higher percentages of low-income students and students of color. This situation raises significant ethical concerns, prompting a call for conscientious policy reform and targeted investment. Informed by emerging best practices, we propose recommendations for enhancing counselor staffing and ultimately student outcomes. This ethical argument underscores the need for proactive actions and provides a basis for future research to further delineate the impact of school counselor ratios on educational equity and student success.

Scholars and providers are coming to realize that one’s ability to notice and respond to internal body sensations contributes to an overall sense of wellbeing. Research has demonstrated a relationship between interoceptive awareness and anxiety, for example. Currently, however, tools for evaluating one’s interoception lack the conceptual foundation and clarity necessary to identify everyday behaviors that specifically reflect interoceptive awareness. Unlike existing interoceptive measures, the Sensory Profile Interoception scale is participation-based and grounded in Dunn’s Sensory Processing framework. In this study we investigated concurrent validity by correlating the SPI with the Adolescent/Adult Sensory Profile ; we investigated construct validity by correlating the SPI with the Perth Alexithymia Scale, the Body Awareness Scale, and the State-Trait Anxiety Inventory. Using the REDCAP online platform, 74 college-aged participants completed the measures. Using Spearman rank order correlations there were statistically significant relationships between the corresponding sensory pattern subscales on SPI and A/ASP. The PAS was only weakly related to the registration subscale of the SPI. The BAS had significant relationships with seeking and avoiding on the SPI. The STAI had significant relationships with sensitivity and registrations of the SPI. Taken together, these findings provide evidence of construct validity of the SPI to identify participation patterns associated with both high and low interoception. With the more precise information the SPI provides, professionals can design tailored interventions to support everyday life goals and researchers can study interoception within authentic activities.