Medical Ethics, Moral Courage, and the Embrace of Fallibility.

Experts have an obligation to make difficult decisions rather than offloading these decisions onto others who may be less well equipped to make them. This commentary considers this obligation through the lens of drafting critical care rationing protocols to address COVID-19-induced scarcity. The author recalls her own experience as a member of multiple groups charged with the generation of protocols for how hospitals and states should ration critical care resources like ventilators and intensive care unit beds, in the event that there would not be enough to go around as the COVID-19 pandemic intensified. She identifies several obvious lessons learned through this process, including the need to combat the pervasive effects of racism, ableism, and other forms of discrimination; to enhance the diversity, equity, and inclusion built into the process of drafting rationing protocols; and to embrace transparency, including acknowledging failings and fallibility. She also comes to a more complicated conclusion: Individuals in a position of authority, such as medical ethicists, have a moral obligation to embrace assertion, even when such assertions may well turn out to be wrong. She notes that when the decision-making process is grounded in legitimacy, medical ethics must have the moral courage to embrace fallibility.

El valor y la dignidad de la vida terminal. Prolegómenos filosóficos para una crítica de la eutanasia / The value and dignity of terminal life. Philosophical prolegomena for a critique of eutanasia

La actitud que se adopte sobre la licitud de la eutanasia depende de la posición que se mantenga acerca del valor y la dignidad de la vida humana terminal. Los debates morales en nuestro tiempo adolecen de una anomalía derivada de la falta de posiciones básicas compartidas por los que intervienen en ellos. Sin embargo, no es imposible, aunque sí difícil, mantenerlos. Sobre la dignidad de la vida humana disputan, al menos, dos actitudes. Para una, la dignidad de la vida depende del mantenimiento de alguna cualidad decisiva, como la autonomía, la autodeterminación o la ausencia de sufrimientos intensos. Para otra, la dignidad, inherente a la persona desde su nacimiento hasta su muerte, no depende de ninguna cualidad o propiedad. Para ella, el sufrimiento no constituye una negación de la dignidad de la vida. Esta última resulta filosóficamente más correcta. En cualquier caso, no debe dejarse de lado la distinción entre la moral y el derecho

The attitude we adopt towards the lawfulness of euthanasia depends on our position on the value and dignity of the life of the terminal ill patient. Contemporary moral debates lacks of a shared basic position, but it is not impossible to discuss. On human dignity there are two attitudes. For one of them, dignity depends on maintaining of one decisive quality, as autonomy, autodetermination or lack of intense suffering. For the other conception of dignity, it does not depend on any attribute of human life. Sufferance is not a refutation of dignity. This second idea of dignity is more correct in philosophical terms. Anyway, the difference between law and moral must be taken into account

The American Association for Thoracic Surgery 2016 ethics forum: Working virtues in surgical practice.

Moral virtues are the complement to ethical principles. They constitute the elements of character that drive habits and daily routines. Certain virtues are especially important in surgery, shaping surgical practice even when no big decisions are at hand. Eight virtues are described and the work they do is explored: trustworthiness, equanimity, empathy, advocacy, compassion, courage, humility, and hope.

Moral enhancement requires multiple virtues.

Some of the debates around the concept of moral enhancement have focused on whether the improvement of a single trait, such as empathy or intelligence, would be a good in general, or in all circumstances. All virtue theories, however, both secular and religious, have articulated multiple virtues that temper and inform one another in the development of a mature moral character. The project of moral enhancement requires a reengagement with virtue ethics and contemporary moral psychology to develop an empirically grounded model of the virtues and a fuller model of character development. Each of these virtues may be manipulable with electronic, psychopharmaceutical, and genetic interventions. A set of interdependent virtues is proposed, along with some of the research pointing to ways such virtues could be enhanced.

Failing a student nurse: a new horizon of moral courage.

The factors preventing registered nurses from failing students in practice are multifaceted and have attracted much debate over recent years. However, writers rarely focus on what is needed to fail an incompetent pre-registration nursing student in their final placement. This hermeneutic study explored the mentor experience of failing a pre-registration nursing student in their final placement. A total of 19 mentors were recruited from 7 different healthcare organisations in both inner city and rural locations in the southeast of England. Participants took part in individual reflective interviews about their experience of failing a pre-registration nursing student in their final placement. These experiences were interpreted through a hermeneutic discovery of meaning. The new horizon of understanding which developed as a result of this research is framed within the context of moral stress, moral integrity and moral residue with the overall synthesis being that these mentors' stories presented a new horizon of moral courage.