BACKGROUND & AIMS: :A new argument has been made against moral enhancement by authors who are otherwise in favour of human enhancement. Additionally, they share the same evolutionary toolkit for analysing human traits as well as the belief that our current morality is unfit to deal with modern problems, such as climate change and nuclear proliferation. The argument is put forward by Buchanan and Powell and states that other paths to moral progress are enough to deal with these problems. Given the likely costs and risks involved with developing moral enhancement, this argument implies moral enhancement is an unpromising enterprise. After mentioning proposed solutions to such modern problems, I will argue that moral enhancement would help implement any of them. I will then detail Buchanan and Powell's new argument disfavouring moral enhancement and argue that it makes too bold assumptions about the efficacy of traditional moral progress. For instance, it overlooks how that progress was to achieve even in relatively successful cases such as the abolition of slavery. Traditional moral progress is likely to require assistance from non-traditional means in order to face new challenges.

背景与目标： : 有人提出了反对道德提升的新论点，否则他们赞成人类的提升。此外，他们共享相同的进化工具包，用于分析人类特征，并认为我们目前的道德不适合处理现代问题，例如气候变化和核扩散。布坎南和鲍威尔提出了这一论点，并指出道德进步的其他途径足以解决这些问题。考虑到发展道德增强可能带来的成本和风险，该论点暗示道德增强是一个毫无希望的企业。在提到针对此类现代问题的拟议解决方案之后，我将认为道德提升将有助于实施其中的任何一个。然后，我将详细介绍布坎南和鲍威尔的新论点，该论点不利于道德提升，并认为它对传统道德进步的功效做出了过于大胆的假设。例如，即使在废除奴隶制等相对成功的情况下，它也忽略了如何取得这一进展。传统的道德进步很可能需要非传统手段的帮助，以便面对新的挑战。

BACKGROUND & AIMS: :Nature-based tourism (NBT) is vulnerable to a rapid increase in visitors because natural resources are often open access. Market failure caused by over-exploitation of natural resources is an example of social dilemmas in common-pool resource systems. Game theory, which describes people's decision making under conflicts, has been applied to the analysis of social dilemmas in NBT. However, previous studies use non-cooperative games assuming individualistic players and discuss the emergence of social dilemmas only in a limited situation. Here, we demonstrate, by developing a two-player non-cooperative game of wildlife viewing, that the traditional game-theoretic approach fails to find social dilemmas. By analysing the competition between tour operators (players) with different social value orientations (SVOs), we found that concentration of tours becomes a Pareto-inefficient Nash equilibrium (PINE) when both players are competitive. Whether the wildlife-viewing market is a Prisoner's dilemma depends on players' SVOs. Furthermore, we found that fair punishment on competitive players promotes rather than suppresses the emergence of PINE. Our results suggest that the diversity of SVOs is an essential factor in understanding social dilemmas in NBT.

背景与目标： : 自然旅游 (NBT) 容易受到游客迅速增加的影响，因为自然资源通常是开放的。过度开发自然资源引起的市场失灵是公共资源系统中社会困境的一个例子。描述人们在冲突下的决策的博弈论已被应用于NBT的社会困境分析。但是，以前的研究使用假设个人主义玩家的非合作游戏，并仅在有限的情况下讨论社会困境的出现。在这里，我们通过开发两人的野生动物观赏非合作游戏来证明，传统的博弈论方法无法找到社会困境。通过分析具有不同社会价值取向 (SVOs) 的旅游经营者 (玩家) 之间的竞争，我们发现，当两个玩家都具有竞争力时，旅游集中度就变成了帕累托效率低下的纳什均衡 (PINE)。野生动物观赏市场是否是囚徒困境，取决于玩家的SVOs。此外，我们发现对竞争对手的公平惩罚会促进而不是抑制松树的出现。我们的结果表明，svo的多样性是理解NBT社会困境的重要因素。

BACKGROUND & AIMS: :As concern for the oral health of vulnerable populations grows, dentistry continues to seek effective ways to respond. In August 2005, Dr. Donald Patthoff and Dr. Frank Catalanotto convened a national workshop at the American Dental Association headquarters on the ethics of access to oral health care. A series of papers were produced for the workshop and subsequently revised for publication. This one responds to the paper by Dr. David Chambers on moral communities and the discursive imperative for building community and consensus around issues affecting equitable access to oral health care. I explore three interrelated issues that ought to be considered when endeavoring to build moral communities: 1) the problem of power relations-a fundamental constituent within discourse that can impede constructive efforts; 2) the discursive disconnect between theoretical ethics and social constructs affecting dentistry; and 3) the bioethical principle of nonmaleficence as a priority in the desire for building moral communities. In essence, this article responds also to the call from ethicists who see a significant need for substantive interdisciplinary contributions to inform how people at different social levels react in ethically problematic situations in its broad social context.

背景与目标： : 随着对弱势人群口腔健康的关注日益增加，牙科继续寻求有效的应对方法。在2005年8月，Donald Patthoff博士和Frank Catalanotto博士在美国牙科协会总部召开了一次关于获得口腔保健道德的全国研讨会。为讲习班编写了一系列论文，随后修订以供出版。这篇文章回应了大卫·钱伯斯博士关于道德社区的论文，以及围绕影响公平获得口腔保健的问题建立社区和共识的话语必要性。我探讨了在努力建立道德社区时应该考虑的三个相互关联的问题: 1) 权力关系问题-话语中的一个基本组成部分，可以阻碍建设性的努力; 2) 影响牙科的理论伦理和社会建构之间的话语脱节; 3) 在建立道德社区的愿望中，将非恶意的生物伦理原则作为优先事项。从本质上讲，本文还回应了伦理学家的呼吁，他们认为非常需要跨学科的实质性贡献，以告知处于不同社会水平的人们在广泛的社会背景下在道德上有问题的情况下如何做出反应。

BACKGROUND & AIMS: :An integrated and collaborative team provides the best clinical care of patients and families during end-of-life moments. Behavioral Health Clinicians (BHCs) bring a skill set for facilitating team interactions, attending to group process, as well as making space for the patient or family voice in the care, often with more time available for these roles. Through a case scenario, this article explores the relevant existing codes of ethics and professional conduct for professionals practicing in integrated care settings as they pertain to end-of-life transitions and care. Most notably, potential ethical issues pertaining to patient autonomy, scope of practice, confidentiality, multiple relationships, and record keeping all come to play during end-of-life care when practicing in an integrated primary care setting. Gaps in the existing codes are discussed and recommendations for providing ethically informed patient- and family-centered end-of-life care are suggested.

背景与目标： : 一个集成和协作的团队在临终时刻为患者和家人提供最佳的临床护理。行为健康临床医生 (BHCs) 带来了一套技能来促进团队互动，参与小组过程，以及为患者或家人在护理中的声音腾出空间，通常有更多的时间来担任这些角色。通过案例，本文探讨了在综合护理环境中执业的专业人员的相关现有道德和专业行为守则，因为它们与临终过渡和护理有关。最值得注意的是，与患者自主权，执业范围，保密性，多重关系和记录保存有关的潜在道德问题在综合初级保健环境中执业时都会发挥作用。讨论了现有法规中的空白，并提出了提供以道德为基础的以患者和家庭为中心的临终关怀的建议。

BACKGROUND & AIMS: :Tomasello provides compelling evidence that children understand that people are morally obligated toward members of their social group. We call for expanding the scope of inquiry to encompass the full developmental trajectory of humans' understanding of the relation between moral obligation, sociality, and stancetaking in interaction. We suggest that humans display a lifelong preoccupation with the sociality of moral obligation.

背景与目标： : Tomasello提供了令人信服的证据，表明儿童了解人们在道德上对其社会群体的成员负有义务。我们呼吁扩大调查范围，以涵盖人类对道德义务，社会性和相互作用之间关系的理解的完整发展轨迹。我们建议人类终生关注道德义务的社会性。

BACKGROUND & AIMS: :Tomasello argues that humans' sense of moral obligation emerges early in development, relies on a shared "we," and serves as the foundation of cooperation. This perspective complements our theoretical view of the human self as information agent. The shared "we" promotes not only proximal cooperative goals but also distal ones via the construction of shared understanding - it promotes culture.

背景与目标： : Tomasello认为，人类的道德责任感在发展的早期就出现了，依赖于共同的 “我们”，并成为合作的基础。这种观点补充了我们关于人类自我作为信息代理的理论观点。共享的 “我们” 不仅通过构建共享的理解来促进近端合作目标，而且促进远端合作目标-它促进文化。

BACKGROUND & AIMS: :This article discusses the most common diagnostic dilemmas when trying to distinguish between tumor and sports injury or other trauma. Bone tumors frequently occur in the same young active patients who experience sports injuries. If the pain persists longer than expected, imaging studies should be obtained to prevent a delay in diagnosis or an inappropriate arthroscopy. A history of spontaneous fracture or a fracture after minor trauma should raise suspicion for underlying lesion as the cause. Occasionally necrosis and/or hemorrhage within a soft tissue sarcoma is so extensive that only a small cuff of viable tumor tissue is present.

背景与目标： : 本文讨论了试图区分肿瘤和运动损伤或其他创伤时最常见的诊断难题。骨肿瘤经常发生在经历运动损伤的年轻活跃患者中。如果疼痛持续时间超过预期，应进行影像学检查以防止诊断延迟或关节镜检查不当。自发性骨折或轻微创伤后的骨折史应引起怀疑潜在病变是原因。有时，软组织肉瘤内的坏死和/或出血非常广泛，以至于只有一小部分存活的肿瘤组织存在。

BACKGROUND & AIMS: INTRODUCTION:Migraine is characterised as episodes of headache plus a variety of accompanying symptoms. Its pharmacological control remains unsatisfactory for some patients. The use of placebo in drug clinical trials on migraine commonly leads to numerous ethical uncertainties. METHODS:The purpose of this paper is to illustrate how the deliberation method helps in analysing the issues and finding solutions to selected ethical problems. Ethical decisions that try to solve conflicts arising from placebo use in clinical trials may be adopted using the moral deliberation method. Thus, the conflict is systematically assessed by identifying the following: Relevant facts; Values in conflict; Duties, or in other words, possible courses of action. Moral duty is following the optimal course of action. To identify this, it is recommended to state extreme courses of action, then intermediate courses of action, and then to proceed to the optimal course(s) of action. RESULTS AND CONCLUSIONS:In this paper, the application of this method is shown in several conflicting situations arising in two placebo-controlled clinical trials with drugs under development for the prophylaxis and acute treatment of migraine.

背景与目标：

BACKGROUND & AIMS: :This paper discusses a case vignette that captures an ethically challenging situation in qualitative research. The study was about families who had experienced a life-saving bone marrow transplantation between siblings, who were children at the time of transplantation. A difficult situation emerged during a joint family interview that took place a few years after the transplantation. Parents, donor and the recipient were present, both still children. The difficulties included a confrontation of the 10-year old donor child with accusations and pejorative statements from the other family members and his sidelining from the conversation. The interviewers have been acutely aware that their presence in this situation in this moment was an intrusion into family dynamics. The paper argues, on the basis of the vignette, that professional norms of qualitative research need to be reconsidered. Specifically, it is argued that interviewers are obligated to take an engaged moral stance, by taking a position in an exchange of moral arguments.

背景与目标： : 本文讨论了一个案例插图，该插图捕捉了定性研究中道德上具有挑战性的情况。该研究是关于在兄弟姐妹之间经历过挽救生命的骨髓移植的家庭，这些兄弟姐妹在移植时是孩子。移植后几年，在一次家庭联合采访中出现了困难的情况。父母、捐赠者和接受者都在场，都是孩子。困难包括与其他家庭成员的指控和贬义陈述对10岁的捐助者儿童的对抗，以及他在谈话中的旁白。面试官敏锐地意识到，他们在这种情况下的出现是对家庭动态的入侵。本文认为，在插图的基础上，需要重新考虑定性研究的专业规范。具体来说，有人认为，采访者有义务通过交换道德论点来采取积极的道德立场。

BACKGROUND & AIMS: :Incapacitated adult patients are commonly divided into two groups for purposes of decision making; those with a surrogate and those without. Respectively, these groups are often referred to as represented and unrepresented, and the relative ethics of decision making between them raises two particular issues. The first issue involves the differential application of the best interests standard between groups. Second is the prevailing notion that representedness and unrepresentedness are categorical phenomena, though it is more aptly understood as a multidimensional and continuous variable based on relational moral authority. This paper examines the nature of representedness as it relates to ethical norms of surrogate decision making.

背景与目标： : 出于决策目的，无行为能力的成年患者通常分为两组; 有代理人的人和没有代理人的人。这些群体通常被称为有代表性的群体和无代表性的群体，它们之间决策的相对伦理提出了两个特殊的问题。第一个问题涉及群体之间最佳利益标准的不同应用。其次是普遍的观念，即代表性和不代表性是分类现象，尽管它被更恰当地理解为基于关系道德权威的多维和连续变量。本文研究了代表性的性质，因为它与替代决策的道德规范有关。

BACKGROUND & AIMS: :It is argued, in this paper, that moral theories should not be discussed extensively when teaching applied ethics. First, it is argued that, students are either presented with a large amount of information regarding the various subtle distinctions and the nuances of the theory and, as a result, the students simply fail to take it in or, alternatively, the students are presented with a simplified caricature of the theory, in which case the students may understand the information they are given, but what they have understood is of little or no value because it is merely a caricature of a theory. Second, there is a methodological problem with appealing to moral theories to solve particular issues in applied ethics. An analogy with science is appealed to. In physics there is a hope that we could discover a unified theory of everything. But this is, of course, a hugely ambitious project, and much harder than, for example, finding a theory of motion. If the physicist wants to understand motion, he should try to do so directly. We would think he was particularly misguided if he thought that, to answer this question, he first needed to construct a unified theory of everything.

背景与目标： : 本文认为，在教授应用伦理学时，不应广泛讨论道德理论。首先，有人认为，要么向学生提供有关该理论的各种细微差别和细微差别的大量信息，结果，学生根本无法接受，要么向学生介绍了该理论的简化漫画，在这种情况下，学生可能会理解他们所提供的信息，但是他们所理解的信息几乎没有价值，因为它只是理论的讽刺画。其次，有一个方法论问题，即诉诸道德理论来解决应用伦理学中的特定问题。与科学的类比很吸引人。在物理学中，我们希望能够发现一个统一的万物理论。但这当然是一个雄心勃勃的项目，而且比例如找到运动理论要困难得多。如果物理学家想了解运动，他应该尝试直接这样做。如果他认为，为了回答这个问题，他首先需要构建一个统一的万物理论，我们会认为他特别被误导了。

BACKGROUND & AIMS: :Based on the analysis of a French pre-exposure prophylaxis trial (Ipergay), and focusing on the communication strategies used to recruit volunteers, this article explores the figure who serves to justify the trial and who shapes the way in which populations concerned by this prevention tool are targeted. We show that this figure is that of the fallible man, a classic in moral philosophy: while aware of what is good or right for him, he is unable to put this knowledge into practice. The targeting of fallible men makes sense in the context of a resurgence of high-risk behaviors objectified in the late 1990s: qualifying gays who take risks as fallible individuals create a distance with respect to the "barebacker" who risks his life deliberately and has no intention of changing his behavior. Recognizing that certain gays are vulnerable to risk also provides justification for a preventive strategy that acknowledges the inadequacy of behavioral prevention, without giving up on prevention altogether. All in all, this analysis shows that the technological and epidemiological realism often highlighted in pre-exposure prophylaxis interventions is not without a moral dimension, attentive to individuals' contradictions and singularities, doubts and uncertainties, and to the risk of stigmatization inherent to the acknowledgement of risk-taking.

背景与目标： : 基于对法国暴露前预防试验 (Ipergay) 的分析，并着重于用于招募志愿者的沟通策略，本文探讨了为该试验辩护的人物以及谁塑造了与该预防工具有关的人群的方式。我们证明这个数字是容易犯错的人的数字，这是道德哲学的经典: 尽管意识到什么对他有利或正确，但他无法将这些知识付诸实践。在20世纪90年代末中物化的高风险行为死灰复燃的背景下，针对容易犯错的人是有意义的: 作为容易犯错的人冒险的合格同性恋者与故意冒险的 “barebacker” 保持距离。无意改变他的行为。认识到某些同性恋者容易受到风险的影响，也为预防策略提供了理由，该策略承认行为预防的不足，而又不完全放弃预防。总而言之，这项分析表明，暴露前预防干预措施中经常强调的技术和流行病学现实主义并非没有道德层面，关注个人的矛盾和奇异性，怀疑和不确定性，以及承认风险所固有的污名化风险。

BACKGROUND & AIMS: The aims of the current investigation were (1) to examine the ethical and professional conflicts experienced by Tasmanian registered nurses in attempting to provide optimal pain management, and (2) to examine nurse satisfaction with their professional relationship with physicians and with their level of involvement in pain management. A total of 1,015 registered nurses completed a 21-item survey examining ethical and professional conflicts encountered during patient pain management. Data also were gathered investigating nurse satisfaction with their involvement in and professional relationship with physicians during pain management. The respondents who felt adequately consulted by physicians were significantly more likely to instigate the consultation process than the respondents who felt that they were not adequately consulted by physicians about their patient's pain status. This was marked in relation to the need for increased pain relief medications. Nurses who did not feel adequately consulted by physicians were significantly more likely to experience ethical conflicts such as concerns about undermedication and patient reluctance to report pain. Nurses' concerns related to ethical conflicts concerning effective pain management are affected by their relationship with physicians. Education, for both nurses and physicians, concerning the role of the nurse in the workplace will help to ensure that these conflicts do not arise. Guidelines concerning the level of patient care at which consultation is necessary will ensure fewer conflicts and greater nurse satisfaction in the workplace.

背景与目标： 当前调查的目的是 (1) 检查塔斯马尼亚注册护士在尝试提供最佳疼痛管理时遇到的道德和专业冲突，以及 (2) 检查护士对他们与医生的专业关系以及他们的水平的满意度。参与疼痛管理。共有1,015名注册护士完成了一项21项调查，检查了患者疼痛管理过程中遇到的道德和专业冲突。还收集了调查护士在疼痛管理期间对其参与的满意度以及与医生的专业关系的数据。认为医生充分咨询的受访者比认为医生没有充分咨询患者疼痛状况的受访者更有可能发起咨询过程。这与增加止痛药的需求有关。没有得到医生充分咨询的护士更容易遇到道德冲突，例如对药物不足和患者不愿报告疼痛的担忧。护士与有效疼痛管理有关的道德冲突的担忧受到与医生关系的影响。对于护士和医生而言，有关护士在工作场所中的作用的教育将有助于确保不会发生这些冲突。有关需要咨询的患者护理水平的指南将确保减少工作场所的冲突并提高护士的满意度。

BACKGROUND & AIMS: :This research aimed to (a) determine whether mastery and intrateam performance achievement goals predicted prosocial and antisocial teammate behavior, (b) explore whether effects of intrateam performance goals were mediated by moral disengagement, and (c) examine whether any effects (Study 2 only) were moderated by cohesion. In Study 1, team athletes (N = 282) from Australia completed questionnaires assessing the aforementioned variables. Structural equation modeling indicated that prosocial teammate behavior was positively predicted by mastery approach goals, and negatively predicted by mastery- and intrateam performance avoidance goals, whereas antisocial teammate behavior was positively predicted by intrateam performance-approach and -avoidance goals; these latter effects were mediated by moral disengagement. In Study 2, team athletes (N = 452) from the United Kingdom completed a measure of cohesion in addition to the Study 1 instruments; the analyses largely confirmed the Study 1 findings. However, the undesirable effect of mastery-avoidance goals on prosocial behavior seen in Study 1 was only apparent in Study 2 when individuals held strong perceptions of team cohesion. In sum, this investigation makes a novel contribution to the literature on team functioning in sport, being the first to explore how athletes' normative goals relative to their teammates might shape effective interaction processes.

背景与目标： : 这项研究旨在 (a) 确定掌握和内部绩效目标是否能预测亲社会和反社会的队友行为，(b) 探索内部绩效目标的影响是否由道德脱离介导，以及 (c) 检查是否有任何影响 (仅研究2) 由凝聚力调节。在研究1中，来自澳大利亚的团队运动员 (N = 282) 完成了评估上述变量的问卷调查。结构方程模型表明，亲社会队友的行为是由掌握方法目标积极预测的，而由掌握和内部人员绩效回避目标消极预测的，而反社会队友的行为是由内部人员绩效方法和回避目标积极预测的; 后一种影响是由道德脱离介导的。在研究2中，来自英国的团队运动员 (N = 452) 除了研究1工具外，还完成了凝聚力的测量; 分析在很大程度上证实了研究1的发现。然而，只有在研究2中，当个人对团队凝聚力有强烈的感知时，在研究1中观察到的掌握回避目标对亲社会行为的不良影响才明显。总而言之，这项调查为有关运动团队功能的文献做出了新的贡献，是第一个探索运动员相对于队友的规范性目标如何塑造有效互动过程的文献。

BACKGROUND & AIMS: :For nursing, the idea of bearing witness is of utmost importance. Nurses are present with persons who experience changes in their health and quality of life and who live intense and profound moments of struggling, questioning, and finding meaning. Nurses are also with persons from moment to moment as their lives unfold, and when joy, serenity, contentment, vulnerability, sadness, fear, and suffering are experienced. In this paper, it is proposed that bearing witness is a moral way of engaging in the nurse-person relationship. Based on Levinas's ethics of the face, it is claimed that bearing witness is enacting one's moral responsibility, which arises from the encounter with the other. Drawing on Parse's human becoming theory, ways of witnessing and bearing witness are defined and discussed. It is suggested that bearing witness is a human-to-human way of being-relating, a mode of human coexistence. Bearing witness is being present and attentive to the truth of another's experiences. Moreover, in this paper, the ways nurses enact their moral agency and bear witness to others placed in their care, or turn away, are explored. Nurses' moral agency is located in the constrained moral space of contemporary health care. Hence, the creation of a moral space, which allows nurses to enact their moral responsibility of bearing witness to other persons' experiences of health and quality of life, is called for. In doing so, it is suggested that the act of bearing witness needs a specific nursing knowledge base and a recognition that being present and being with another is a valuable nursing practice that is utterly meaningful for persons who are living through difficult times.

背景与目标： : 对于护理而言，见证的想法至关重要。护士与经历健康和生活质量变化的人在一起，他们经历了激烈而深刻的挣扎，质疑和寻找意义的时刻。当人们的生活展开时，护士也会不时地与他们在一起，当他们经历快乐、宁静、满足、脆弱、悲伤、恐惧和痛苦时。本文提出，见证是一种从事护人关系的道德方式。根据列维纳斯 (Levinas) 的面孔伦理，据称见证是在履行一个人的道德责任，这是由于与另一个人的相遇而产生的。借鉴Parse的人类成为理论，定义并讨论了见证和见证的方式。建议见证是人与人之间的联系方式，是人类共存的一种方式。见证见证正在出现，并关注他人经历的真相。此外，在本文中，探讨了护士如何制定自己的道德观念，并为被照顾或转身的他人作证。护士的道德代理机构位于当代医疗保健的道德空间中。因此，需要创造一个道德空间，使护士能够履行其道德责任，见证他人的健康和生活质量。在这样做时，建议见证行为需要一个特定的护理知识库，并认识到与他人在一起是一种有价值的护理实践，对于生活在困难时期的人来说是完全有意义的。