Ethics consultation has become an integral part of the fabric of U.S. health care delivery. This article summarizes the second edition of the Core Competencies for Health Care Ethics Consultation report of the American Society for Bioethics and Humanities. The core knowledge and skills competencies identified in the first edition of Core Competencies have been adopted by various ethics consultation services and education programs, providing evidence of their endorsement as health care ethics consultation (HCEC) standards. This revised report was prompted (...) by thinking in the field that has evolved since the original report. Patients, family members, and health care providers who encounter ethical questions or concerns that ethics consultants could help address deserve access to efficient, effective, and accountable HCEC services. All individuals providing such services should be held to the standards of competence and quality described in the revised report. (shrink)

What does it mean to know how to do something? This book develops a comprehensive account of know-how, a crucial epistemic goal for all who care about getting things right, not only with respect to the facts, but also with respect to practice. It proposes a novel interpretation of the seminal work of Gilbert Ryle, according to which know-how is a competence, a complex ability to do well in an activity in virtue of guidance by an understanding of what (...) it takes to do so. This idea is developed into a full-fledged account, Rylean responsibilism, which understands know-how in terms of the normative guidance and responsible control of one's acts. Within the complex current debate about know-how, this view occupies a middle ground position between the intellectualist claim that know-how just is propositional or objectual knowledge and the anti-intellectualist claim that know-how just is ability. In genuine know-how, practical ability and guiding intellect are both necessary, but essentially intertwined. (shrink)

Does the human mind resemble the machines that can behave like it? Biologically inspired machine-learning systems approach “human-level” accuracy in an astounding variety of domains, and even predict human brain activity—raising the exciting possibility that such systems represent the world like we do. However, even seemingly intelligent machines fail in strange and “unhumanlike” ways, threatening their status as models of our minds. How can we know when human–machine behavioral differences reflect deep disparities in their underlying capacities, vs. when such failures (...) are only superficial or peripheral? This article draws on a foundational insight from cognitive science—the distinction between performance and competence—to encourage “species-fair” comparisons between humans and machines. The performance/competence distinction urges us to consider whether the failure of a system to behave as ideally hypothesized, or the failure of one creature to behave like another, arises not because the system lacks the relevant knowledge or internal capacities (“competence”), but instead because of superficial constraints on demonstrating that knowledge (“performance”). I argue that this distinction has been neglected by research comparing human and machine behavior, and that it should be essential to any such comparison. Focusing on the domain of image classification, I identify three factors contributing to the species-fairness of human–machine comparisons, extracted from recent work that equates such constraints. Species-fair comparisons level the playing field between natural and artificial intelligence, so that we can separate more superficial differences from those that may be deep and enduring. (shrink)

Many virtue epistemologists conceive of epistemic competence on the model of skill —such as archery, playing baseball, or chess. In this paper, I argue that this is a mistake: epistemic competences and skills are crucially and relevantly different kinds of capacities. This, I suggest, undermines the popular attempt to understand epistemic normativity as a mere special case of the sort of normativity familiar from skilful action. In fact, as I argue further, epistemic competences resemble virtues rather than skills—a claim (...) that is based on an important, but often overlooked, difference between virtue and skill. The upshot is that virtue epistemology should indeed be based on virtue, not on skill. (shrink)

A competence model describes the abstract structure of a solution to some problem. or class of problems, facing the would-be intelligent system. Competence models can be quite derailed, specifying far more than merely the function to be computed. But for all that, they are pitched at some level of abstraction from the details of any particular algorithm or processing strategy which may be said to realize the competence. Indeed, it is the point and virtue of such models (...) to specify some equivalence class of algorithms/processing strategies so that the common properties highlighted by the chosen class may feature in psychologically interesting accounts. A question arises concerning the type of relation a theorist might expect to hold between such a competence model and a psychologically real processing strategy. Classical work in cognitive science expects the actual processing to depend on explicit or tacit knowledge of the competence theory. Connectionist work, for reasons to be explained, represents a departure from this norm. But the precise way in which a connectionist approach may disturb the satisfying classical symmetry of competence and processing has yet to be properly specified. A standard?Newtonian? connectionist account, due to Paul Smolensky, is discussed and contrasted with a somewhat different?rogue? account. A standard connectionist understanding has it that a classical competence theory describes an idealized subset of a network's behaviour. But the network's behaviour is not to be explained by its embodying explicit or tacit knowledge of the information laid out in the competence theory. A rogue model, by contrast, posits either two systems, or two aspects of a single system, such that one system does indeed embody the knowledge laid out in the competence theory. (shrink)

According to all varieties of virtue reliabilism knowledge is always gained through the exercise of epistemic competences. These competences can be conceived as competences to form true beliefs, or as competences to know. I will present a short but decisive argument against the idea that knowledge is always gained through the exercise of competences to know. The competence to know isn’t necessary for gaining knowledge.

Background: Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty. Objectives: The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi. Methodology: A cross-sectional survey was conducted in four selected hospitals in Malawi (...) with a sample of 271 clinical nurses. Data were collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0. Ethical consideration: The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi. Results: The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings. Conclusion: The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence. (shrink)

Background: Exploring the concept of ethical competence in the context of healthcare is essential as it pertains to better quality of care. The concept still lacks a comprehensive definition covering the aspects of ethical expertise, ethical knowledge and action of a health professional. Objective: This article aims to report an analysis of the concept of ethical competence. Method: A modified strategy suggested by Walker and Avant was used to analyse the concept. Results: As a result, the concept of (...) ethical competence can be defined in terms of character strength, ethical awareness, moral judgement skills and willingness to do good. Virtuous professional, experience of a professional, human communication, ethical knowledge and supporting surroundings in the organisation can be seen as prerequisites for ethical competence. Ethical competence results in the best possible solutions for the patient, reduced moral distress at work and development and democratisation of society. Conclusion: The results of the analysis establish a basis for an instrument to evaluate health professionals’ ethical competence. It will guide educators, as well as managers in healthcare, to support the development of ethical conduct in healthcare. (shrink)

I argue against traditional virtue epistemology on which knowledge is a success due to a competence to believe truly, by revealing an in-principle problem with the traditional virtue epistemologist’s explanation of Gettier cases. The argument eliminates one of the last plausible explanation of Gettier cases, and so of knowledge, in terms of non-factive mental states and non-mental conditions. I then I develop and defend a different kind of virtue epistemology, on which knowledge is an exercise of a competence (...) to know. I show how the account, while circular, is not viciously so. It explains both how knowledge is a mental state, as well as the relationship between knowledge and justification, including justified false beliefs and Gettier cases. Moreover, although direct virtue epistemology is compatible with many views on the nature of belief, it can explain how knowledge might be metaphysically more fundamental than belief as well. (shrink)

In discussions of standards of proof, a familiar perspective often emerges. According to what we call specificationism, standards of proof are legal rules that specify the quantum of evidence required to determine that a litigant’s claim has been proven. In so doing, they allocate the risk of error among litigants (and potential litigants), minimizing the risk of certain types of error. Specificationism is meant as a description of the way the rules actually function. We argue, however, that its claims are (...) either mistaken or at a minimum deeply misleading, especially when it comes to standard of proof rules (SPRs) that contain indeterminate formulas, as is typical. As against specificationism, we argue that SPRs are best understood as rules that confer competence to decide whether a given standard has been met—according to whatever vague or inchoate interpretation (if any) of the rule in question triers of fact implicitly or explicitly employ. We call this the competence-norm approach. (shrink)

Background: Nursing practice takes place in a social framework, in which environmental elements and interpersonal relations interact. Ethical climate of the work unit is an important element affecting nurses’ professional and ethical practice. Nevertheless, whatever the environmental circumstances, nurses are expected to be professionally competent providing high-quality care ethically and clinically. Aim: This study examined newly graduated nurses’ perception of the ethical climate of their work environment and its association with their self-assessed professional competence, turnover intentions and job satisfaction. (...) Method: Descriptive, cross-sectional, correlational research design was applied. Participants consisted of 318 newly graduated nurses. Data were collected electronically and analysed statistically. Ethical considerations: Ethical approval and permissions to use instruments and conduct the study were obtained according to required procedures. Data were rendered anonymous to protect participant confidentiality. Completing the questionnaire was interpreted as consent to participate. Findings: Nurses’ overall perception of the ethical climate was positive. More positive perceptions related to peers, patients and physicians, and less positive to hospitals and managers. Strong associations were found between perceived ethical climate and self-assessed competence, turnover intentions in terms of changing job, and job satisfaction in terms of quality of care. Nurses at a higher competence level with positive views of job satisfaction and low turnover intentions perceived the climate significantly more positively. Conclusion: Nursing management responsible for and having the power to implement changes should understand their contribution in ethical leadership, as well as the multidimensional nature of nurses’ work environment and the interaction between work-related factors in planning developmental measures. Future research should focus on issues in nurse managers’ ethical leadership in creating ethical work environments. There is also a need for knowledge of newly graduated nurses’ views of factors which act as enhancers or barriers to positive ethical climates to develop. Interventions, continuing education courses, and discussions designed to promote positive ethical climates should be developed for managers, nurses, and multi-professional teams. (shrink)

BackgroundThe enhancement of nursing care quality is closely related to the clinical competence of nurses, making it a crucial component within health systems.ObjectiveThe present study investigated the relationship between nurses’ clinical competence, moral identity, and moral injury during the COVID-19 outbreak.Research designThis cross-sectional study was carried out among frontline nurses, using the Moral Identity Questionnaire (MIQ), the Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP), and the Competency Inventory for Registered Nurse (CIRN) as data collection tools.Participantsand research context: The (...) research population for this study consisted of all frontline nurses (n = 251) employed in a hospital in southern Iran. Sampling was conducted between May 1, 2021 and September 30, 2021, during the COVID-19 outbreak.Ethical considerationsThe present study received approval from the research ethics committee of Rafsanjan University of Medical Sciences, with project No. 99267 and code of ethics ID No. IR. RUMS.REC.1399.262, dated 15.02.2021.ResultsAccording to the study findings, 42.2% of the nurses demonstrated high clinical competence, while 51.4% exhibited moderate clinical competence. The results indicated a positive correlation between moral identity and clinical competence but a negative correlation between moral injury and clinical competence. Furthermore, the variables of moral identity and moral injury were found to predict 10% of the variance in clinical competence.ConclusionAccording to the results, moral identity and moral injury had an impact on the clinical competence of nurses. Therefore, implementing a program aimed at enhancing moral identity and providing training strategies to address moral injury during crises like the COVID-19 pandemic can lead to improvements in nurses’ clinical competence and the overall quality of care they provide. (shrink)

Elitist scepticism of democracy has a venerable history. This paper responds to the latest round of such scepticism—the ‘competence objection’, articulated in recent work by Jason Brennan. Brennan’s charge is that democracy is unjust because it allows uninformed, irrational, and morally unreasonable voters to exercise power over high-stakes political decisions, thus imposing undue risk upon the citizenry. I show that Brennan’s objection admits of two interpretations, and argue that neither can be sustained on close examination. Along the way, I (...) consider the merits of Brennan’s preferred ‘epistocratic’ alternative to democracy, and argue that it is likely to lead to lower-quality outcomes. (shrink)

We expect decent parents will discharge their responsibilities to children properly and exercise their authority over children in a reasonable fashion. However, some would-be parents are either unable or unwilling to be decent parents. Such people fail to meet standards of parental competency, and their right either to become parents with authority over children or to continue as parents can be called into question. Although some failures of parental competency are obvious, there are significant controversies about what constitutes decent parenting. (...) This chapter explores parental competency along three dimensions. First, what are the principal elements of a satisfactory account of parental competency? Second, to what degree are there feasible strategies for tracking both prospective parental competency and actual parental competency? Third, how are judgments of parental competency (whether prospective or actual) relevant to determining who has either a right to become a parent or the right to continue as parent? (shrink)

Because corporate social responsibility can be beneficial to both companies and its stakeholders, interest in factors that support CSR performance has grown in recent years. A thorough integration of CSR in core business processes is particularly important for achieving effective long-term CSR practices. Here, we explored the individual CSR-related competencies that support CSR implementation in a corporate context. First, a systematic literature review was performed in which relevant scientific articles were identified and analyzed. Next, 28 CSR directors and managers were (...) interviewed. The literature review complemented with interview data resulted in the following eight distinct CSR-related competencies: Anticipating CSR challenges; Understanding CSR-relevant systems and subsystems; Understanding CSR-relevant standards; CSR management competencies, including Leading CSR programs, Managing CSR programs, and Identifying and realizing CSR-related business opportunities; Realizing CSR-supportive interpersonal processes; Employing CSR-supportive personal characteristics and attitudes; Personal value-driven competencies, including Ethical normative competencies, Balancing personal ethical values and business objectives, and Realizing self-regulated CSR-related behaviors and active involvement; and Reflecting on personal CSR views and experiences. Based on these results, implications for further research on this topic, as well as implications for practitioners, are discussed. (shrink)

Teachers’ social-emotional competence is considered important to master the social and emotional challenges inherent in their profession and to build positive teacher-student relationships. In turn, this is key to both teachers’ occupational well-being and positive student development. Nonetheless, an instrument assessing the profession-specific knowledge and skills that teachers need to master the social and emotional demands in the classroom is still lacking. Therefore, we developed the Test of Regulation in and Understanding of Social Situations in Teaching (TRUST), which is (...) a theory-based situational judgment test measuring teachers’ knowledge about strategies for emotion regulation and relationship management in emotionally and socially challenging situations with students. Results from three studies (N = 166 in-service teachers, N = 73 in-service teachers, N = 107 pre-service teachers) showed satisfactory internal consistency for both the emotion regulation and relationship management subtests. Furthermore, confirmatory factor analyses supported the differentiation between the two facets of social-emotional competence. Regarding convergent validity, results from Study 3 revealed a positive association between the profession-specific TRUST and pre-service teachers’ general emotional intelligence. Furthermore, small to moderate correlations with the Big Five personality traits provided evidence for the discriminant validity of TRUST. In Studies 1 and 2, we found evidence for a correlation with external criteria, that is, teachers with higher test scores reported providing more emotional support for students and having better teacher-student relationships. For teachers’ occupational well-being, we found a link with symptoms of depersonalization and job satisfaction, but none for emotional exhaustion. We will discuss the use of TRUST in research, for the evaluation of interventions, in teacher education, and professional development and will illustrate ideas for enhancing the tool. (shrink)

Several competing narratives drive the contemporary AI ethics discourse. At the two extremes are sociotechnical dogmatism, which holds that society is full of inefficiencies and imperfections that can only be solved by better technology; and sociotechnical skepticism, which highlights the unacceptable risks AI systems pose. While both narratives have their merits, they are ultimately reductive and limiting. As a constructive synthesis, we introduce and defend sociotechnical pragmatism—a narrative that emphasizes the central role of context and human agency in designing and (...) evaluating emerging technologies. In doing so, we offer two novel contributions. First, we demonstrate how ethical and epistemological considerations are intertwined in the AI ethics discourse by tracing the dialectical interplay between dogmatic and skeptical narratives across disciplines. Second, we show through examples how sociotechnical pragmatism does more to promote fair and transparent AI than dogmatic or skeptical alternatives. By spelling out the assumptions that underpin sociotechnical pragmatism, we articulate a robust stance for policymakers and scholars who seek to enable societies to reap the benefits of AI while managing the associated risks through feasible, effective, and proportionate governance. (shrink)

Background The enhancement of nursing care quality is closely related to the clinical competence of nurses, making it a crucial component within health systems. Objective The present study investigated the relationship between nurses’ clinical competence, moral identity, and moral injury during the COVID-19 outbreak. Research design This cross-sectional study was carried out among frontline nurses, using the Moral Identity Questionnaire (MIQ), the Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP), and the Competency Inventory for Registered Nurse (CIRN) as data (...) collection tools. Participants and research context: The research population for this study consisted of all frontline nurses ( n = 251) employed in a hospital in southern Iran. Sampling was conducted between May 1, 2021 and September 30, 2021, during the COVID-19 outbreak. Ethical considerations The present study received approval from the research ethics committee of Rafsanjan University of Medical Sciences, with project No. 99267 and code of ethics ID No. IR. RUMS.REC.1399.262, dated 15.02.2021. Results According to the study findings, 42.2% of the nurses demonstrated high clinical competence, while 51.4% exhibited moderate clinical competence. The results indicated a positive correlation between moral identity and clinical competence but a negative correlation between moral injury and clinical competence. Furthermore, the variables of moral identity and moral injury were found to predict 10% of the variance in clinical competence. Conclusion According to the results, moral identity and moral injury had an impact on the clinical competence of nurses. Therefore, implementing a program aimed at enhancing moral identity and providing training strategies to address moral injury during crises like the COVID-19 pandemic can lead to improvements in nurses’ clinical competence and the overall quality of care they provide. (shrink)

Generative AI agents (GenAIs) powered by Large-language models (LLMs) have emerged as prominent technological advancements. As these sophisticated systems permeate diverse sectors ranging from business to entertainment, their capability to handle moral queries becomes a focal point of exploration. This study investigates how users perceive Delphi, a GenAI trained to respond to moral queries (Jiang et al., 2025). Participants were instructed to interact with the agent, implemented either as a humanlike robot or a web client, to assess its moral (...) class='Hi'>competence and trustworthiness. Both agents received high scores for moral competence and perceived morality, yet fell short by not offering justifications for their moral decisions. Despite being deemed trustworthy, participants were hesitant about relying on such systems in the future. This study offers an initial evaluation of an algorithm with moral competence in an embodied human-like interface, paving the way for the evolution of ethical robot advisors. (shrink)

Background: Ethics, being a fundamental component of nursing practice, must be integrated in the nursing education curriculum. Even though different bodies are promoting ethics and nursing researchers have already carried out work as regards this concept, it still remains difficult to clearly identify the components of this competence. Objective: This integrative review intends to clarify this point in addition to better defining ethical competence in the context of nursing practice. Method: An integrative review was carried out, for the (...) 2009–2014 period, in the CINAHL, MEDLINE, and EMBASE databases and in the journal Nursing Ethics. The keywords nursing ethics or ethical competence were used in order to make sure to widely encompass the concept of “ethical competence” in the case of a university curriculum in nursing. In the end, 89 articles were selected. Ethical consideration: We have respected the ethical requirements required regarding the sources and authorship. There is no conflict of interest in this literature review. Results: Ethical sensitivity, Ethical knowledge, Ethical reflection, Ethical decision-making, Ethical action, and Ethical behavior are the most frequently used terms with regard to ethical competence in nursing. They were then defined so as to better ascertain the possible components of ethical competence in nursing. Conclusion: Even though ethical competence represents a sine qua non competence in nursing practice, no consensus can be found in literature with respect to its definition. The identification of its components and their relationships resulting from this integrative review adds to the clarification of its definition. It paves the way for other studies that will contribute to a better understanding of its development, especially among nursing students and practicing nurses, as well as the factors that may exert an influence. More adapted education strategies can thus be put forward to support its development. (shrink)

This article presents the derivation of moral competence in nursing practice by identifying its attributes founded on Thai culture. In this process moral competence is formed and based on the Thai nursing value system, including personal, social and professional values. It is then defined and its three dimensions (moral perception, judgment and behavior) are also identified. Additionally, eight attributes as indicators of moral competence are identified and selected from three basic values. The eight attributes are loving kindness, (...) compassion, sympathetic joy, equanimity, responsibility, discipline, honesty, and respect for human values, dignity and rights. All attributes are discussed by addressing the three moral dimensions in order to present how to deal with ethical issues in nursing practice. As a summary, a model of moral competence is presented to demonstrate moral competence in nursing practice in Thailand. (shrink)

In the study of cognitive processes, limitations on computational resources (computing time and memory space) are usually considered to be beyond the scope of a theory of competence, and to be exclusively relevant to the study of performance. Starting from considerations derived from the theory of computational complexity, in this paper I argue that there are good reasons for claiming that some aspects of resource limitations pertain to the domain of a theory of competence.

Cooperative speech is purposive. From the speaker's perspective, one crucial purpose is the transmission of knowledge. Cooperative speakers care about getting things right for their conversational partners. This attitude is a kind of respect. Cooperative speech is an ideal form of communication because participants have respect for each other. And having respect within a cooperative enterprise is sufficient for a particular kind of moral standing: we ought to respect those who have respect for us. Respect demands reciprocity. I maintain that (...) large language models aren't owed the kind of respect that partly constitutes a cooperative conversation. This implies that they aren't cooperative interlocutors, otherwise we would be obliged to reciprocate the attitude. Leveraging this conclusion, I argue that present-day LLMs are incapable of assertion and that this raises an overlooked doubt about their semantic competence. One upshot of this argument is that knowledge of meaning isn't just a subject for the cognitive psychologist. It's also a subject for the moral psychologist. (shrink)

Background Moral courage is the ability to defend and practice ethical and moral action when faced with a challenge, even if it means rejecting pressure to act otherwise. However, moral courage remains an unexplored concept among middle eastern nurses. Aim This study investigated the mediating role of moral courage in the relationship between burnout, professional competence, and compassion fatigue among Saudi Arabian nurses. Research design Correlational, cross-sectional design following the STROBE guidelines. Participants and research context Convenience sampling was used (...) to recruit nurses ( n = 684) for four government hospitals in Saudi Arabia. Four validated self-report questionnaires (Nurses’ Moral Courage Scale, Nurse Professional Competence Scale-Short Form, Maslach Burnout Inventory, and Nurses Compassion Fatigue Inventory) were used to collect data between May to September 2022. Spearman rho and structural equation modeling analyses were employed to analyze the data. Ethical considerations The ethics review committee of a government university in Ha’il region, Saudi Arabia, approval this study (Protocol no.: H-2021-012; Approved: 08/022,021). Participants were fully explained the study aims, and consent was voluntarily secured. Results The emerging model showed that burnout had a direct and positive influence on compassion fatigue, while professional competence had a direct, negative effect on compassion fatigue. Moral courage had a small and direct but negative influence on compassion fatigue. Mediation analyses also indicated that moral courage significantly mediated the indirect effects of burnout and professional competence on compassion fatigue. Conclusion Moral courage can be a crucial aspect in preserving the psychological and mental health of nurses, particularly under stressful conditions. Therefore, it is advantageous from an organizational and leadership standpoint to implement measures such as programs and interventions to foster moral courage among nurses. (shrink)

ABSTRACTAchievements are among the things that make a life good. Assessing the plausibility of this intuitive claim requires an account of the nature of achievements. One necessary condition for achievement appears to be that the achieving agent acted competently, i.e. was not just lucky. I begin by critically assessing existing accounts of anti-luck conditions for achievements in both the ethics and epistemology literature. My own proposal is that a goal is reached competently, only if the actions of the would-be-achiever make (...) success likely, and that this is the reason why she acts that way. (shrink)

Decision Making Competence (DMC) reflects individual differences in rational responding across several classic behavioral decision-making tasks. Although it has been associated with real-world risk behavior, less is known about the degree to which DMC contributes to specific components of risk attitudes. Utilizing a psychological risk-return framework, we examined the associations between risk attitudes and DMC. Italian community residents (n = 804) completed an online DMC measure, using a subset of the original Adult-DMC battery (A-DMC; Bruine de Bruin, Parker, & (...) Fischhoff, 2007). Participants also completed a self-reported risk attitude measure for three components of risk attitudes (risk-taking, risk perceptions, and expected benefits) across six risk domains. Overall, greater performance on the DMC component scales were inversely, albeit modestly, associated with risk-taking tendencies. Structural equation modeling results revealed that DMC was associated with lower perceived expected benefits for all domains. In contrast, its association with perceived risks was more domain-specific. These analyses also revealed stronger indirect effects for the DMC  expected benefits  risk-taking than the DMC  perceived risk  risk-taking path, especially for risk behaviors that may be considered more antisocial in nature. These results suggest that DMC performance differentially impacts specific components of risk attitudes, and may be more strongly related to the evaluation of expected value of the given behavior. (shrink)

Background: Ethics play an important role in activating the manpower and achieving the organizational goals. The nurse leaders’ ethical behavior can promote the care quality by affecting the nurses’ performance and bringing up several positive consequences for the organization. Objectives: The aim of this study was to identify and describe the ethical competency of nurse leaders in cultural domains and the working conditions of the Iranian healthcare setting to arrive at a more comprehensive and specific perspective. Methods: This was a (...) qualitative conventional content analysis study conducted with the participation of 14 nurse leaders at various levels. The participants were selected using the purposive sampling method, and the required data were collected using deep interview and also semi-structured interview. A deductive method of content analysis was applied in data analysis. Ethical considerations: This study was conducted in accord with the principles of research ethics and national rules and regulations relating to informed consent and confidentiality. Findings: Data analysis resulted in 17 subcategories that were subsequently grouped into three major categories including empathetic interactions, ethical behavior, and exalted manners. Discussion: Our findings are consistent with previous ones, yet presenting a more complete knowledge about aspects of ethical competency of nurse leaders. The nurse leaders can provide a proper behavioral model for the work environment through the use of new information. Conclusion: The nurse leaders introduced various aspects of ethical competency, so the leaders’ ethical competency could be promoted via planning and managing some ethical development programs. More future research is needed regarding the experiences of the subordinates and other related parties. (shrink)

This article presents a generalization of the Condorcet Jury Theorem. All results to date assume a fixed value for the competence of jurors, or alternatively, a fixed probability distribution over the possible competences of jurors. In this article, we develop the idea that we can learn the competence of the jurors by the jury vote. We assume a uniform prior probability assignment over the competence parameter, and we adapt this assignment in the light of the jury vote. (...) We then compute the posterior probability, conditional on the jury vote, of the hypothesis voted over. We thereby retain the central results of Condorcet, but we also show that the posterior probability depends on the size of the jury as well as on the absolute margin of the majority. (shrink)

According to the principle of patient autonomy, patients have the right to be self-determining in decisions about their own medical care, which includes the right to refuse treatment. However, a treatment refusal may legitimately be overridden in cases where the decision is judged to be incompetent. It has recently been proposed that in assessments of competence, attention should be paid to the evaluative judgments that guide patients' treatment decisions.In this paper I examine this claim in light of theories of (...) practical rationality, focusing on the difficult case of an anorexic person who is judged to be competent and refuses treatment, thereby putting themselves at risk of serious harm. I argue that the standard criteria for competence assess whether a treatment decision satisfies the goals of practical decision-making, and that this same criterion can be applied to a patient's decision-guiding commitments. As a consequence I propose that a particular understanding of practical rationality offers a theoretical framework for justifying involuntary treatment in the anorexia case. (shrink)

This paper identifies a class of alignment problem that does not reduce to specification gaming, Goodhart’s Law, or construct validity failure. The rules an AI system is asked to follow are often settlement proxies. These are operational forms of political and moral questions whose answers a community has had to settle. Unlike measurement proxies, which approximate empirical targets, settlement proxies do not aim at some further thing they could be brought into closer contact with. Instead, they are the target in (...) operational form. Settlement proxies are vulnerable to a form of legitimate challenge that more capable reasoning intensifies rather than resolves. The paper calls this the Competence Problem and identifies three structural features of settlements that generate it: 1) the compression of competing values into a single operational rule, 2) the presence of more than one defensible equilibrium among the rule’s possible forms, and 3) a constraint on the scope of information the rule engages. It then traces three forms that competent challenge takes in practice: 1) exceptions, 2) drift, and 3) challenge to the settlement itself. It argues that the appropriate response, even where the challenge is correct on the merits of the case, is typically not to grant it, because settlement authority depends on ratification through practice rather than case-level accuracy. The argument explains why behavioral training and corrigibility-based approaches to AI alignment leave the underlying capacity intact, and why the gap between case-level competence and ecosystem-level access is widest precisely where AI systems are now being deployed. (shrink)

ABSTRACT In this paper, I address some of the shortcomings of established clinical ethics centring on personal autonomy and consent and what I label the Doctrine of Respecting Personal Autonomy in Healthcare. I discuss two implications of this doctrine: 1) the practice for treating patients who are considered to have borderline decision‐making competence and 2) the practice of surrogate decision‐making in general. I argue that none of these practices are currently aligned with respectful treatment of vulnerable individuals. Because of (...) ‘structural arbitrariness’ in the whole process of how we assess decision‐making competence, this area is open to disrespectful treatment of people. The practice of surrogate decision‐ making on the basis of a single person's judgment is arguably not consistent with ethical and political requirements derived from the doctrine itself. In response to the inadequacies of the doctrine, I suggest a framework for reasonableness in surrogate decision‐making which might allow practice to avoid the problems above. I conclude by suggesting an extended concept of Patient Autonomy which integrates both personal autonomy and the regulative idea of morality that is required by reasonableness in deciding for non‐competent others. (shrink)

The current research considered the question of how performing an action, or merely preparing the body for action, can have an impact on social judgments related to person perception. Participants were asked to ascribe competence and warmth characteristics to a target person by reading a metaphoric text while their body was manipulated to be prepared for the processing of action-congruent information. In Experiment 1, participants whose forward body action matched the metaphoric action described in the text ascribed more (...) class='Hi'>competence characteristics to a politician than did control participants. In Experiment 2, participants whose body was merely prepared for forward movement also ascribed more competence characteristics to a politician than did control participants. In addition, the data from Experiment 2 ruled out an alternative non-embodied explanation (i.e., that effect is due to basic associative processes) grounded in the existing literatures on attitudes by demonstrating that body manipulation had no effect on competence when a non-metaphoric text was used. Finally, no evidence was found that body manipulation affects warmth judgments. These studies converge in demonstrating that forward body movements enhance the favorability of competence judgments when these match the metaphoric forward movements described by text. (shrink)

Responsible management competences are the skills of managers to deal with the triple bottom line, stakeholder value and moral dilemmas. In this paper, we analyse how managers develop responsible management competences and how the competences interact with capabilities at the organisational level. The paper contributes to the responsible management literature by integrating research on absorptive capacity and organisational learning. By creating intersections between these disparate research streams, this study enables a better understanding of the development of responsible management competences. The (...) paper is a systematic literature review on environmental competences, which are a type of responsible management competences referring to the managerial skills aimed at improving environmental sustainability. The findings demonstrate that managers who are able to recognize and acquire external knowledge develop environmental competences, and organisations capable of assimilating, transforming and exploiting knowledge develop environmental capabilities. The paper establishes that a dynamic and recursive relation exists between environmental competences and capabilities. Antecedents and contextual conditions specific to a sustainability context, such as eco-centric values and stakeholder pressures, influence the development of environmental competences. The study shows that environmental competences have a positive direct effect on environmental performance, and an indirect effect as a mediator between environmental capabilities and performance. (shrink)

This article presents the derivation of moral competence in nursing practice by identifying its attributes founded on Thai culture. In this process moral competence is formed and based on the Thai nursing value system, including personal, social and professional values. It is then defined and its three dimensions (moral perception, judgment and behavior) are also identified. Additionally, eight attributes as indicators of moral competence are identified and selected from three basic values. The eight attributes are loving kindness, (...) compassion, sympathetic joy, equanimity, responsibility, discipline, honesty, and respect for human values, dignity and rights. All attributes are discussed by addressing the three moral dimensions in order to present how to deal with ethical issues in nursing practice. As a summary, a model of moral competence is presented to demonstrate moral competence in nursing practice in Thailand. (shrink)

Abstract:Some moral responsibility theorists think that certain agents (like psychopaths) can be morally responsible—and morally criticizable—for their actions and attitudes even though they lack any competence in grasping or responding to moral norms (a blindness to moral reasons that is typically called “normative incompetence” or, more accurately, “moral incompetence”). In this essay, I provide a new argument against these theorists by exploring the intersection between two normative domains, the funny and the moral. There are, it turns out, interesting and (...) significant ways that properties from each domain bear on reasons to respond in the other, and so there are interesting and significant ways in which people’s responses to cruel jokes or insult humor may be criticizable. I then survey various personality and psychological impairments that seem to undercut criticizability in this intersecting domain. Learning about these people and their impairments yields a wealth of information about what true normative competence actually requires, as well as why competence of the specifically moral variety really is required for moral criticizability. (shrink)

In spite of the growing interest in nursing ethics, few studies have focused on ethical dilemmas experienced by nurses working with clinical studies as ‘research nurses’. The aim of the present study was to describe and explore ethical dilemmas that Swedish research nurses experience in their day-to-day work. In a qualitative study a purposeful sample of six research nurses from five wards of differing disciplines in four Swedish hospitals was interviewed. The analysis displayed several examples of ethical dilemmas, primarily tensions (...) between the nurses’ obligations to the study and to the patients involved. A guiding moral principle for the nurses was patient-centeredness, where the interest of research must not override the interest of the patient. In situations where tensions between research and patient interests occurred, and doctors and nurses disagreed upon the judgement, the nurses sometimes chose to follow the doctors’ advice, and thus acted against their own moral judgment. Such situations seemed to create feelings of moral distress among the nurses. They described their profession as being ‘invisible’ and as lacking opportunities for ethical competence building. The conclusion is that research nurses frequently experience severe and difficult ethical dilemmas in their daily work. They need to be acknowledged as a particular profession in the health care organisation and encouraged to develop their specific ethical competence. (shrink)

Durch Migrationsprozesse und zunehmenden Pluralismus ist in Deutschland das Thema „kulturelle Diversität“ in der Medizin aktueller denn je. In der medizinischen Fachliteratur und im gesellschaftlichen Diskurs wird vermehrt von interkulturellen Konflikten im Kontakt zwischen Arzt und Patient berichtet, was die Frage nach der Rolle von Interkultureller Kompetenz für die klinische Praxis aufwirft. Zunächst widmet sich der Beitrag kritisch den verschiedenen Auffassungen des Begriffs „Kultur“ im medizinischen Kontext, um anschließend eine Methode der interkulturellen Philosophie als eine Möglichkeit für eine kultursensitive Ethik (...) zu skizzieren. Anschließend wird aufgezeigt, welche Schwierigkeiten mit dem Begriff der Interkulturellen Kompetenz verbunden sind und weshalb die Autoren diesen trotzdem als unerlässlich für die Wahrnehmung potentieller Konfliktfelder als auch für den Umgang mit diesen erachten. Schließlich werden derzeitige Entwicklungen in der medizinischen Ausbildung sowie konkrete Beispiele für eine kultursensible Ethikberatung illustriert. Es zeigt sich, dass international zahlreiche Ausgestaltungen Interkultureller Kompetenz in Form von Leitfäden und konkreten Schulungsmodulen existieren, aber auch, dass es in Deutschland an konkreten Umsetzungen in der Breite mangelt und die Zusammenarbeit wissenschaftlicher Disziplinen sowie der betroffenen Institutionen derzeit noch ausbaufähig ist. (shrink)