M Smith

This article features an exemplary case of a terminally ill man with a do-not-resuscitate (DNR) order who is subject to a resuscitation attempt after suffering an out-of-hospital cardiac arrest (OHCA). The case is explored for its philosophical implications in the broader perspective of medical ethics. It is argued that the metaphysics of modern medical practice seems to have shifted away from the overall purpose and meaning of medical intervention to a primary concern with immediate effects of treatment, led on by medical advances and strict adherence to standard procedures. Whether it being the attempted resuscitation of a terminally ill patient in cardiac arrest, or the overtreatment of terminally ill or dying patients in general. In this article it is concluded that the best overall pre-hospital care is not achieved by adherence to standard procedures alone but also rests on the recognition and support of emergency medical technicians (EMTs) as moral agents, capable of exercising moral judgment based on the individual patients’ situation. Our intention is not to critique the actions of individuals, nor do we make claims about frequency of occurrence. Rather, we draw attention to a general shift in focus and mode of thinking in the Danish healthcare system to discuss solutions. The study was approved by University of Southern Denmark’s Ethics Committee. Written informed consent to participate and publish was obtained from the participant. This study was supported by the Danish Air Ambulance.

BackgroundAlthough commonly used to evaluate health interventions, cluster randomized trials raise difficult ethical issues. Recognizing this, the Ottawa Statement on the Ethical Design and Conduct of Cluster Randomized Trials, published in 2012, provides 15 recommendations to address ethical issues across seven domains. But due to several developments in the design and implementation of cluster randomized trials, there are new issues requiring guidance. To inform the forthcoming update of the Ottawa Statement, we aimed to identify any gaps in the Ottawa Statement discussed within the literature.MethodsWe searched Google Scholar, Scopus, and Web of Science using the ‘cited by’ function on 11 November 2022.We included all types of publications, including articles, book chapters, commentaries, editorials, ethics guidelines, theses and trial-related publications (i.e., primary reports, protocols, and secondary analyses), that cited and engaged with the Ottawa Statement, the Ottawa Statement précis, or one or more of its four background papers. Data were extracted by four reviewers working in rotating pairs. Reviewers captured relevant text verbatim and recorded whether it reflected a gap relating to one or more of the Ottawa Statement domains. Using a thematic analysis approach, semantic coding was used to summarize the content of the data into distinct gaps within the Ottawa Statement domains, which was subsequently expanded in an inductive manner through discussion.ResultsThe qualitative analysis of the text from 53 articles resulted in the identification of 24 distinct gaps in the Ottawa Statement: 4 gaps about justifying the cluster randomized design; 2 gaps about research ethics committee review; 3 gaps about identifying research participants; 4 gaps about obtaining informed consent; 3 gaps about gatekepeers; 6 gaps about assessing benefits and harms; 1 gap about protecting vulnerable participants; and 1 gap about equity-related issues in cluster randomized trials.ConclusionIdentifying 24 gaps reveals a need to update the Ottawa Statement. Alongside additional gaps identified in ongoing empirical work and through engagement with our patient and public partners, the gaps identified through this citation analysis should be considered in the forthcoming Ottawa Statement update.

This chapter contains the observations of Dr. Deepak P., Prof. Aurelia Ayisi, and Prof. Marquita Smith. Dr. Deepak P. is a Senior Lecturer in Computer Science at the School of EEECS, specializing in AI ethics, Social choice, and NLP. Prof. Aurelia Ayisi is a lecturer and researcher in the Department of Communication Studies at the University of Ghana, focusing on digital communication, media, and information literacy, with an emphasis on access, competencies, and global disparities. The interview was conducted in August 2024 to discuss the challenges of elections in Africa (especially Ghana) and the UK. The interviewers included the editors of the PROMISE book (Biplav Srivastava, Anita Nikolich, Andrea Hickerson, Tarmo Koppel) joined by Prof. Marquita Smith, Associate Dean of Graduate Programs and Research / Associate Professor Communication, University of Mississippi and assisted by Kausik Lakkaraju.

Many debate the benefits of using artificial intelligence (AI) to improve civic engagement and encourage more inclusive and participatory governance. This chapter explores how AI-driven platforms can be used to boost voter participation. In addition to enhancing voter engagement, AI can help counter misinformation by facilitating better communication between citizens and governments. This helps to support and sustain democratic societies. A review of existing literature highlighted the potential for AI to empower marginalized communities, bridge information gaps, and lower barriers to civic participation. However, ethical considerations such as data privacy and information bias are also addressed to ensure that AI’s role in civic engagement promotes accurate information for citizens.

Background Unit-based critical care nurse leaders (UBCCNL) play a role in exemplifying ethical leadership, addressing moral distress, and mitigating contributing factors to moral distress on their units. Despite several studies examining the experience of moral distress by bedside nurses, knowledge is limited regarding the UBCCNL’s experience. Research aim The aim of this study was to gain a deeper understanding of the lived experiences of Alabama UBCCNLs regarding how they experience, cope with, and address moral distress. Research design A qualitative descriptive design and inductive thematic analysis guided the investigation. A screening and demographics questionnaire and a semi-structured interview protocol were the tools of data collection. Participant and research context Data were collected from 10 UBCCNLs from seven hospitals across the state of Alabama from February to July 2023. Ethical considerations This study was approved by the Institutional Review Board at the University of Alabama in Huntsville. Informed consent was obtained from participants prior to data collection. Findings UBCCNLs experience moral distress frequently due to a variety of systemic and organizational barriers. Feelings of powerlessness tended to precipitate moral distress among UBCCNLs. Despite moral distress resulting in increased advocacy and empathy, UBCCNLs may experience a variety of negative responses resulting from moral distress. UBCCNLs may utilize internal and external mechanisms to cope with and address moral distress. Conclusions The UBCCNL’s experience of moral distress is not dissimilar from bedside staff; albeit, moral distress does occur as a result of the responsibilities of leadership and the associated systemic barriers that UBCCNLs are privier to. When organizations allocate resources for addressing moral distress, they should be convenient to leaders and staff. The UBCCNL perspective should be considered in the development of future moral distress measurement tools and interventions. Future research exploring the relationship between empathy and moral distress among nurse leaders is needed.

In this paper I argue that Christopher Kutz misapplies his theory of joint action when he attributes shareowners responsibilities on the basis of their intentional participation in the corporations in which they invest. Instead I propose that his theory of joint action should be used to attribute shareowners responsibilities on the basis of their intentional participation in the stock market. If shareholders’ accountability is grounded in their intentional participation in the stock market, then shareholders cannot take responsibility for corporation’s individual actions. Instead they are solely responsible for the benefits they gain from holding shares if these are a result of moral wrongdoing and for this they should be held accountable.

The purpose of this study is twofold: 1) to determine if an ethics presentation at an Italian university can change student perceptions of ethics; and 2) to compare results of this study with previously published results from US students. The ethics presentation, previously developed by Smith et al. (2005) for accounting and business classes, made available on the Internet, was adapted and used in classes in Italy. Like the US, Italy has faced significant financial scandals and corporate failures in recent years. Both Italian and US penal laws have been changed to prevent future financial frauds, but there are limits to what laws can accomplish. The ethics presentation described in this paper was an effort to encourage students to consider the importance of ethics. The impact of the presentation on Italian student perspectives is described. In addition, a comparison is made of the impact of the presentation in Italy and in the US, which shows that students in both countries regard ethics as a very important topic.

Moral distress (MD) is well-documented within the nursing literature and occurs when constraints prevent a correct course of action from being implemented. The measured frequency of MD has increased among nurses over recent years, especially since the COVID-19 Pandemic. MD is less understood among nurse leaders than other populations of nurses. A qualitative systematic review was conducted with the aim to synthesize the experiences of MD among nurse leaders. This review involved a search of three databases (Medline, CINAHL, and APA PsychINFO) which resulted in the retrieval of 303 articles. PRISMA review criteria guided authors during the article review and selection process. Following the review, six articles were identified meeting review criteria and quality was assessed using the Critical Appraisal Skills Programme (CASP) Checklist for qualitative studies. No ethical review was required for this systematic review. The six studies included in this review originated from the United States, Brazil, Turkey, and Iran. Leadership roles ranged from unit-based leadership to executive leadership. Assigned quality scores based upon CASP criteria ranged from 6 to 9 (moderate to high quality). Three analytical themes emerged from the synthesis: (1) moral distress is consuming; (2) constrained by the system; and (3) adapt to overcome. The unique contributors of MD among nurse leaders include the leadership role itself and challenges navigating moral situations as they arise. The nurse leader perspective should be considered in the development of future MD interventions.

This article argues that an analysis of the operations of raciality requires a description of violence whose interpretive ground is not sustained by the individual subject. By drawing on the work of Denise Ferreira da Silva, Stefano Harney, Fred Moten and others, I suggest such a description might prove a disruptive mechanism in the capacity for raciality to function as both authorizing force and the conditions of existence. In doing so, I expand on existing scholarly work that identifies manifold failings in post-enlightenment thinking and its tethering of racial subjugation to selfhood, sovereignty and agency. Moreover, I demonstrate why ethico-juridical interpretations of violence against nonwhite subjects consistently fail to identify its authorizing force, raciality.

The fact that racism and other forms of discrimination and injustice have persisted in our own nursing communities despite our rhetoric of caring and compassion can no longer be denied. This fact gave rise to a webinar in which the scholars represented in this issue of Nursing Philosophy appear. The webinar centered on the philosophy, phenomenology and scholarship of Indigenous nurses and nurses of color. The authors of the articles in this issue are giving us the precious gift of their ideas. All of us, white scholars and scholars of color, must come together to receive this gift, learn from their words and their insight, debate the ideas, honor the perspectives, and consider ways that we can move this discourse forward to create new possibilities for nursing, new possibilities to shape the future development of our discipline.

In this essay, I consider Sally Haslanger’s social constructivist account of race and propose a modification to the nature of hierarchy specified. According to Haslanger, race will cease to exist post-hierarchy, given that she builds in a requirement of synchronic hierarchy for the existence of race. While Haslanger maintains that racial identity would linger beyond hierarchical treatment in the form of ethnicity, I will suggest this fails to provide adequate conceptual justice for the cultures and aesthetics which emerged out of past oppression. In response, I propose a modification which would allow us to recognize the possibility of post-hierarchical races.

The control of various introduced species brings to the fore questions around how species are categorised as ‘native’ or ‘invasive’, belonging or not belonging. In far north Queensland, Australia, the Cape York region is a complex mixture of land tenures, including pastoral leases, National Parks and Aboriginal land, and overlapping management agreements. Weed control comprises much of the work that land managers in Cape York do. However, different land managers target different introduced species for control, and the ways in which certain species are understood as more or less problematic indicate how land managers understand and seek to order landscapes. Through investigating the various positions that introduced species occupy, I will explore how Cape York emerges as a ‘hybrid landscape’ that is produced in contested, overlapping and ambiguous ways, and is rife with ‘feral dynamics’.

Sina Queyras, in the essay “Lyric Conceptualism: A Manifesto in Progress,” describes the Lyric Conceptualist as a poet capable of recognizing the effects of disparate movements and employing a variety of lyric, conceptual, and language poetry techniques to continue to innovate in poetry without dismissing the work of other schools of poetic thought. Queyras sees the lyric conceptualist as an artistic curator who collects, modifies, selects, synthesizes, and adapts, to create verse that is both conceptual and accessible, using relevant materials and techniques from the past and present. This dissertation responds to Queyras’s idea with a collection of original poems in the lyric conceptualist mode, supported by a critical exegesis of that work. “Smutty Alchemy,” the poetry collection, navigates lyric and conceptual traditions and forms to discuss scientific subject matter, taking as a focal point the work of Margaret Cavendish, a writer at the start of the seventeenth-century scientific revolution. The exegesis aims to situate the collection, “Smutty Alchemy,” within the intellectual context both of contemporary Canadian poetry and of creative-scientific writing. Stylistically, “Smutty Alchemy” speaks to the concerns of lyric conceptualism by blurring the lines among lyric, conceptual and language poetry traditions, playing with such recognized forms as sonnets, triolets, epic poems, and free verse, as well as refigured poetic shapes, such as the element poems, the cursed sonnets, and invented poetic shapes, such as the tardigrade-shaped poems, which specifically reference concrete poetry. Feminist writers and critics can both refuse to limit subject matter or style based on the autobiographical and confessional modes of the lyric poets and still discuss the mark of the personal upon even the most process-intensive poetics and “objective” voices. Additionally, they refuse to adhere strictly to any stringent rule-making of the conceptualists, or to choose exclusively a focus on language moments as do the language poets. My project explores this impetus towards the understanding of poetic forms, coupled with the impulse to delimit and expand the range of those forms by creating a poetry collection that pairs scientific subject matter with experiential knowing and the synthetic and invented poetic shapes of lyric conceptualism.